Divine
Exploring Project DIVINE
The ‘Delhi Integrated Community Volunteers Initiative’ (DIVINE) project was a three year initiative from 2008 to 2010. It was later extended. The initiative focuses on involving the communities as active stakeholders in generating awareness on TB and motivating patients for testing and treatment.
- Objectives
- Approach
- Activities
- Expected outcome
- Ensure early detection of TB cases and increase in the case detection rate and treatment surveillance.
- Strengthen identification of Multi Drug Resistant (MDR) cases and ensure completion of treatment of the same.
DIVINE Project usesa community centric approach (COACH) to strengthen the ‘Revised National Tuberculosis Control Programme (RNCTP)’ by sensitizing community volunteers, Private Health Providers (PHPs), paediatriciansand Directly Observed Therapy, Short-course(DOTS) providers.
- AT THE INDIVIDUAL LEVEL
Patient-centred outreach for motivating them to adopt behavior change actions.
Building linkages of TB patients with quality services. - AT THE INTERPERSONAL LEVEL
Joint sessions for TB patients and members of the caregiver community with an aim to empower the TB patients and encourage them to adopt behavior change actions.
Building linkages of the TB patients with social protection services. - AT THE COMMUNITY LEVEL
Building/strengthening the existing formal, informal and traditional community structures such as Nyaya Panchayat, Health and Nutrition Committee, etc.
Converging these community structures for creating an enabling environment for the TB patients and their families.
- Developing linkages with other local service providers such as ASHA workers and existing community-based organizations such as Support Groups and NGOs
- Developing a cadre of Volunteers and Community DOTS Providers for following up the cases that are under treatment and tracing the defaulters and bringing them back to restart the treatment.
- Generating awareness on TB
- Enhancing ‘Referral of TB suspects’ to the Designated Microscopy Centers (DMCs) run by the project
- Providing services as DOTS providers for TB patients
Despite suffering for long, Reshmi (26) was not given any attention by her family members as they were struggling to survive after the lockdown during COVID. By the time she visited the TB DOTS centre, she had severe symptoms such as weight reduction, blood in the sputum and fever. Her treatment did not begin for 10 days despite being declared positive as she was not traceable. Continuous follow-up by DIVINE Project DOTs Centre team revealed that she was hospitalized for termination of pregnancy. It took lot of efforts to convince her to start the CAT-1 treatment. But her condition was still deteriorating. A subsequent CBNAAT test showed her to be multi-drug-resistance (MDR). Reshmi was hospitalized as her condition further deteriorated. XDR treatment with associated drug regimen was started immediately as she also had a family history of XDR. She stabilized after weeks of medication and was discharged. Throughout the treatment, she experienced Cycloserine side effects such as confusion, suicidal tendencies and sadness. Her husband refused to support her but she could recover thanks to the emotional and nutritional support provided by the project team.
