In Andhra Pradesh state of India, a doctor gulped down sleeping pills when pulled up by authorities for not doing field visits to follow up tuberculosis (TB) patients, according to The Times of India. “There was no other medical officer” in the clinic so she couldn’t go to field visits and rather attended to her duties within the clinic – argued the doctor.
India’s national TB programme which is the Revised National TB Control Programme (RNTCP) has incorporated the Patients’ Charter for TB Care (The Charter) which is also an integral component of the WHO Stop TB Strategy (2006-2015) at the global level.
The Patients’ Charter for TB Care puts forth a rights-and-responsibilities based framework to engage affected communities effectively in TB programmes at all levels, with dignity.
The question is: who has the expertise required to do effective advocacy, communication and social mobilization (ACSM) at the community level? Who can better work on solutions for challenges that confront TB programme outcomes?
The issue of no-doctor-in-clinic is also a sad and disappointing reality. Engaging communities effectively to play this key role might help.
The question of financial resources shouldn’t arise because doctors have been given resources to do these field visits, which includes a vehicle!
“The doctors do not go to the field. Hyderabad is the worst performing district in the state. We have given vehicles to these officers, but still they do not go for field work,” said Gulzar Natarajan, district collector who had pulled up doctors who were not performing their duties .
Dr. KS Sachdeva, Chief Medical Officer (CMO), RNTCP, Central TB Division, Government of India, said in a press conference held in Hyderabad on 24 January 2011: “As we all know, TB is an infectious disease and it is very important for us to detect the TB at the early stages and provide complete treatment.”
Dr. Sachdeva had further informed the media on 24 January 2011 that having achieved the global objectives of 70% case detection and 85% treatment success rate for last three consecutive years, the programme has set for itself an ambitious target of Universal Access to Quality TB Care for all TB patients from whichever healthcare provider they choose to seek care. This calls for reaching out the unreached and fostering an active involvement of private healthcare providers, non-governmental organisations and empowering community to demand for quality TB care services.
Translating ’empowering community to demand for quality TB care services’ into reality is a clear mountainous challenge in no uncertain terms. (CNS)