THALI

Tuberculosis Health Action Learning Initiative (THALI) is a four year-project (2016-2020) which was undertaken in partnership with Karnataka Health Promotion Trust (KHPT). The project was a patient-centred and family-focused initiative on that was operational in the urban settings. It ensured better treatment outcomes by supporting the vulnerable people in gaining access to quality TB prevention and care services from healthcare providers of the patient’s choice.
OPERATIONAL AREA
It was implemented in the Hyderabad, Warangal and Karimnagar districts of Telangana State and Krishna, Vishakhapatnam and Guntur districts of Andhra Pradesh.

Objectives

  • Demonstrate community-centric and community driven interventions to improve health seeking behaviour & service delivery by increasing the identification and treatment of the TB/DR-TB patients
  • Offer customised care and support to the patients based on their needs.
  • Translate lessons learnt from the project into demonstrative and innovative models

Approach

The project adopted an approach of working through existing community structures such as youth associations, self-help groups, labour unions and faith-based organizations etc. and initiating Health Education Centres. These platforms were used to ensure that relevant information is readily available and to conduct support group meetings for patients, care givers and health care providers to clarify doubts and reduce stigma and discrimination.

Activities

  • Organizing support group meetings to offer peer support to the patients
  • Addressing self-stigma and clearing the doubts of TB patients about treatment and its side effects
  • Conducting risk and need assessment of patients by identifying the causes of treatment failure of each patient
  • Customising the Continuum of care for each patient
Nagamani
Nagamani a widow who was also living with HIV was on ART treatment for one and half years. She used to stay with her son’s family. When she was diagnosed with TB, she did not have the courage to disclose it to her son fearing that he will not allow her to stay with them.
She took the medicines and went home in a confused state. Thankfully, THALI team members visited her and supported her in disclosing her status to her son and daughter-in-law. They explained them everything about the TB treatment and management of side effects of the treatment.
The team counseled them about the precautions to be taken to help in checking the spread of TB and counseled her daughter-in-law and also told about the PLHA support group meetings. They not only helped her daughter-in-law understand the issues but also convinced her to support Nagamani throughout the recovery process taking care of her treatment and nutrition needs.
Nagmani is now happy that she could complete her treatment without being depressed thanks to the THALI team and the support group meetings.

Expected outcome

  • Groups that had higher risk of non-adherence to treatment leading to treatment failure were identified
  • People who had symptoms similar to TB were identified and referred for TB testing through community stakeholders.
  • Many persons who were referred for testing and were diagnosed of TB completed their treatment regime successfully and were declared cured.
  • Risk & Needs Assessment (RANA) tool was administered to all newly diagnosed TB patients to identify risk and devise special care packages
  • The special package called Differentiated Care Model (DCM) supported complete family education and improved overall treatment outcomes in the high risk group members
  • Meetings of Patient Support Group were successful in addressing self-stigma and clearing their doubts about treatment and its side effects.
  • TB patients who came forward to create awareness among others were identified as TB Champions.
  • The Health Information Centers (HIC)were successful in making TB information readily available.