The Mumbai experience in building field level partnerships for DOTS implementation

Area of Science:

• Public Health
• Infectious Disease Control
• Health Systems Strengthening

Background:

• The Revised National Tuberculosis (TB) Control Programme (RNTCP) faced challenges in Mumbai, a megacity with high TB incidence.
• Inadequate public health infrastructure led to poor support for field staff and role confusion.

Purpose of the Study:

• To describe a partnership between the TB program and a Non-Governmental Organization (NGO) in Mumbai.
• To analyze problems and identify key organizations for optimizing resource utilization in TB control.

Main Methods:

• Methodological analysis of program challenges and networking to involve key stakeholders.
• Forming partnerships for external quality assurance in sputum microscopy.
• Collaborating on staff training, Information, Education, and Communication (IEC) material development.
• Engaging local NGOs and private doctors for increased case finding and Directly Observed Treatment (DOT).

Main Results:

• Partnerships facilitated an external quality assurance scheme for sputum microscopy.
• Collaborative training and team-building exercises strengthened program and public health staff capacity.
• NGO partnerships aided IEC material development and increased case finding.
• Involvement of local NGOs and private doctors improved access to DOT.

Conclusions:

• Partnerships are crucial for addressing urban TB control challenges, including infrastructure limitations.
• Collaborative efforts enhance quality assurance, training, case finding, and treatment adherence.
• Lessons learned highlight key issues for policymakers in urban TB management.