About the project:

KHPT has been selected by The Global Fund to Fight AIDS, Tuberculosis and Malaria (the “Global Fund”) key project elements include community engagement, capacity building and technical assistance.

 Geography and duration:

The Impact India project will be implemented between 2024-2027 in 14 states and one UT (Assam, Karnataka, Bihar, Telangana, Punjab, Haryana, Uttar Pradesh, Uttarakhand, Himachal Pradesh, Delhi, Rajasthan, Madhya Pradesh, Gujarat, West Bengal and Chandigarh). KHPT will partner with suitable organisations as Sub Recipients (SRs) in implementing the project.

Key activities:

The major interventions of the project encompass

• TB Champion Engagement
• Strengthening counselling and patient support systems.
• TB Mukt Grama Panchayat activities
• Nationwide Technical Assistance for Direct Beneficiary Transfer (DBT) and Pradhan Mantri TB Mukt Bharat Abhiyan (PMTBMBA)

 Expected outcomes:

• Over 4800 local self-governance bodies like Panchayat Raj empowered to saturate communities with TB screening, referrals and linkages.
• Over 4800 Gram Panchayats strengthened to own and drive the health and TB agenda at the lowest levels.
• Over 300 TB Champions involved per intervention district for greater penetration of TB knowledge and the creation of a stigma-free environment at family and community levels.
• Efficient systems established to deliver DBT and PMTBMBA activities through technical assistance across the intervention geographies.
• Over 13000 NTEP staff capacitated with counselling and soft skills.

About the project: The project aims to empower vulnerable communities, in terms of TB awareness, demand generation, mitigation of TB stigma faced, and community lead monitoring of TB services, eventually for all health-related services.

Funder: Stop TB Partnership

Geography: Kamrup Metro district of Assam and Bengaluru Urban in Karnataka

Duration:  May 2023 to April 2024

Target population: Communities of People Living with HIV (PLHIV), urban vulnerable, LGBTQIA+ communities, garment factory workers, and female sex workers (FSWs)

Key Activities:

• Strengthen the TB response with rights-based, people-centred approaches, through community led monitoring forums by training of community leaders, leaders from Garment workers, PLHIVs, FSWs, LGBTQIA+ in Community Rights and Gender training.
• Stigma Assessment among PLHIV, LGBTQIA+, FSWs, urban vulnerable, garment workers using the STOP TB Stigma Assessment tool
• To adapt and pilot the OneImpact app in project geographies, which helps in empowering people affected by TB to access health and support services, claim their rights, and identify and reduce stigma. This app piloting will be in collaboration with Blossom Trust.
• To participate and engage in various TB advocacy and accountability initiatives at national, regional and global levels.

Expected outcome: Reduction in TB stigma and increasing access to early diagnosis, treatment and health as a right for persons with TB.

About the project:

India’s National Strategic Plan (NSP) for Tuberculosis Elimination (2017-2025) emphasizes the need for person-centred care and the community’s active participation in ending TB. The National Tuberculosis Elimination Programme (NTEP), which envisions the elimination of TB in India by 2025, recognizes that in order to detect and treat the ‘missing million’ persons with TB, there need to be diverse approaches addressing the varying needs of different vulnerable populations.

‘Breaking the Barriers’ (BTB) is a four year project, supported by the United States Agency for International Development (USAID), which aims to develop innovative and effective behaviour change operational models that improve coverage of specific vulnerable populations including urban vulnerable groups, tribal communities, migrants, mining and industrial workers and tea garden workers, through increased case notification and improved successful treatment outcomes of both drug-sensitive (DS-TB) and drug-resistant TB (DR-TB).

Geography and duration:

The Breaking the Barriers project will be implemented between 2020-2024 in 15 districts across the states of Karnataka, Telangana, Bihar and Assam by KHPT.

Key activities:

• Mapping of vulnerable populations – Estimating the size of each vulnerable group in the specific intervention districts to guide micro planning and evaluation
• Community engagement – Promoting community participation to build ownership and promote participation of community structures to strengthen TB efforts on the ground
• Individual and family engagement – Developing behaviour change solution frameworks, creating support platforms for persons with TB  and caregivers, and building and strengthening empowered TB Champions
• Technical support to NTEP in ACSM activities – Coordinating efforts of State NTEPs to create TB awareness among the general population in the project invention districts
• Advocacy and Communications –  Developing a stakeholder landscape analysis and outreach strategy, as well as a media and communications strategy

Expected outcomes:

Intermediate outcomes

• Improved comprehensive knowledge about TB among vulnerable populations and persons with TB among vulnerable population groups.
• Improved health-seeking behaviour for diagnosis of TB among vulnerable population groups.
• Improved adherence to treatment among persons with TB from vulnerable populations
• Reduced stigma (self, family and community)
• Improved self-esteem and life aspirations among persons with TB

Long-term outcomes

• Increased TB case notification among vulnerable populations
• Improved successful treatment outcomes for DS-TB and DR-TB
• Adoption of the solutions and models by the state NTEPs and Central TB Division

About the project:

Building on the success of the TB Mukt Bharat initiative, implemented by the Government of India, and the Kshaya Muktha Karnataka by the Government of Karnataka, KHPT has been a key player in urban areas, providing technical support to the state government. Notably, KHPT’s Breaking the Barriers (BTB) project has been instrumental in overcoming the challenges associated with TB elimination in India. In continuation of this, KHPT is now working to demonstrate the development of comprehensive models for TB-free wards in Mysuru city, in collaboration with the National TB program.

The project focuses on urban settings to identify solutions, collaborate with local urban administrative entities, and implement the TB Resilient Ward concept within selected urban geographies. The initiative will strive to enhance healthcare access for vulnerable populations and support the creation of a comprehensive TB Resilient Ward model. Lastly, KHPT will also focus on strengthening urban local bodies (ULBs) and stakeholders and encouraging community engagement and ownership in TB Resilient Wards. ULBs and community groups like the Mahila Arogya Samithi (MAS) will be empowered to engage in the decision-making processes pertinent to urban TB control.

Geography: Three Urban Primary Health Centres (UPHCs) covering nine wards of Mysuru district

Duration: April 2024 – March 2025

Donor: United States Agency for International Development (USAID)

Key Activities:

• The project will start with the identification of vulnerable areas through community mapping. It will then engage community structures for TB initiatives, training volunteers for TB control, and strengthening outreach services. Innovative community engagements will be a key focus, along with linking ABHA cards to reduce expenses. The project will also promote health literacy and awareness of TB through monthly campaigns, ensuring a comprehensive approach to TB prevention and care.
• Setting up Arogya-One kiosk-based health centres for basic point-of-care screening, education, advice, and referral services.
• Building the capacity of healthcare staff to address social health determinants for TB.
• Establishing a monitoring system and gathering feedback periodically through stakeholder consultation.
• Developing and sharing training materials for health and other stakeholders and creating a strategy document for urban TB control.

Expected outcomes

• Identifying and defining criteria for TB Resilient wards
• 30 Key MAS members will be capacitated on TB awareness, screening, testing, and providing support
• Early detection of TB through increased demand generation and testing services by 20% of the existing presumptive testing in UPHCs and a 10% increase in the number of patients identified
• Building capacities of the UPHC staff on community perspectives and vulnerabilities for TB
• Stakeholders sensitised and capacitated in the TB Resilient Wards concept and capacitated to take ownership of TB prevention and care initiatives

About the project:

 India bears a quarter of the global burden  of  TB and it is estimated that 40 percent of the country’s population harbours the ‘silent infection’ of Latent TB. Latent TB Infection (LTBI) occurs when the TB bacteria in the body are inactive. Persons with LTBI do not have symptoms and are not contagious. However, there is a risk of such persons developing active TB, especially if they have certain medical conditions which weaken the immune system,  are underweight or malnourished, or use alcohol and tobacco products.  The progression of LTBI into Active TB Infection can be prevented by the Provision of TB Preventive Treatment (TPT) to high-risk groups among whom TB infection has been ruled out. The Programmatic Management of TPT (PMTPT) is being given greater importance by the National Tuberculosis Elimination Programme (NTEP) to accelerate the decline in new TB cases with the goal of TB elimination by 2025.

 The Joint Effort for Elimination of Tuberculosis (JEET) 2.0 JEET Project aims to address LTBI through the demonstration and scale-up of models for improving access to TPT to all child and adult contacts of index TB cases (the first person to be identified with TB in a particular setting). The project will address the LTBI burden by household contact tracing of all  persons with pulmonary TB receiving care in the public and private sector, ensuring access to quality care by intensive household contact tracing, offering contacts screening and testing for disease and infection, and creating linkages to treatment and adherence support. KHPT is an implementing partner of FIND, which is funded by the Global Fund to Fight Against AIDS, Tuberculosis and Malaria (GFATM).

Geography and duration:

JEET 2.0 is being implemented between April 2021 and March 2024 in the six Karnataka districts of Bijapur, Bagalkot, Belgaum, Bengaluru City, Bengaluru Urban and Bengaluru Rural.

Key Activities:

• Contact tracing
• Counselling and symptom screening of all contacts of Index TB Patients
• TPT initiation and follow up
• Facilitation of free X-rays for symptomatic contacts to rule out active TB

 Expected Outcomes:

The development and scale-up of models and approaches which:

• Increase in the number of household contacts screened
• Increase in the number of individuals in contact with persons with TB initiated on preventive therapy
• Increase in the number of contacts initiated on TPT completing treatment