Saksham, Tata Institute of Social Sciences

Locations: Tata Institute of Social Sciences, Mumbai

Sponsor: Global Fund for AIDS TB and Malaria

*Saksham Pravaah

Saksham Pravaah (Saksham means "Capable" or “Self- reliant” in Sanskrit) is a TISS project that provides counselling services to Drug Resistant (DR) TB patients in partnership with the Central TB Division (CTD), Ministry of Health and Family Welfare. 

The goal is to strengthen the National TB control program (with special focus on DR TB) in states of Maharashtra, Gujarat, Karnataka and Rajasthan through structural and psycho-social support interventions.

The objectives of  Saksham Pravaah are:

  • To strengthen Maharashtra, Gujarat, Karnataka and Rajasthan state’s TB prevention, treatment and care programme through psycho-social counselling services including HIV counselling, testing and treatment initiation for Drug Resistant TB patients
  • To improve treatment adherence among DR TB patients through counselling and by linking them with required social protection services

The project was initiated in October 2015 and has currently placed 214 professionally trained counsellors in the 4 implimentation states. 

The Saksham Pravaah intervention is based on the social structural approach to disease prevention and control. The counsellors undertake the following activities:

  • Provide counselling services to Drug Resistant (DR) TB patients and their home care givers for treatment adherence.
  • Identify patients who are at a risk of dropping out of the treatment due to social stigma or economic burdens and connect them to governmental and nongovernmental social protection services for nutrition, educational and livelihood support.

In 2017 – 18, Saksham Pravaah counsellors have registered 93% of DR-TB patients (more than 11,000 DR TB patients) who were initiated on treatment by RNTCP for counselling services. Understanding the importance of involving caregivers as partners in treatment completion, 82% patient caregivers were also provided counselling. One of the major aims of DR-TB counselling is adherence to treatment and completion of treatment. Given the duration of the treatment, this cannot be considered as a one-time activity and Saksham Pravaah Counsellors provide regular follow up counselling to all the patients registered under Saksham Pravaah for counselling services. 71% of the patients were given first follow up home visit counselling.

Saksham Pravaah counsellors are alert about any instances of treatment interruptions and out of the total treatment interruption instances, 81% patients were counselled and were retrieved back on regular treatment.

The Saksham Pravaah intervention adopts a psycho-social approach and premium is put on addressing the social factors through linking patients in need to various GoI social protection schemes or other NGOs working to support patient. Saksham Pravaah counsellors have also provided social protection linkages like helping DR-TB patients acquire Aadhar card, ration card, bank account etc. Hearing aids were also provided to patients who suffered hearing loss due to adverse reaction of DR-TB drugs. Furthermore, counsellors have also provided nutrition linkages like milk, curd, eggs, protein powder, rice, dal, wheat powder etc., to patients in order to help them adhere to the treatment.

Altogether Saksham Pravaah Counsellors have provided Nutritional Support to 1476 patients, linked 266 patients to various Social Protection Schemes and facilitated the opening of 127 bank accounts for patients.

Saksham Pravaah has been awarded an extension by the Ministry of Health and Family Welfare in January 2018 and the Global Fund for ADS TB and Malaria funded project will now continue until March 2021.

 

Saksham Jan Urja

Saksham Jan Urja started as a community based programme in April 2016 with Community Engagement and Psycho Social Support as the core strategy by engaging Community stakeholders in the M ward, Mumbai which has a high burden of TB. The programme has deployed 11 “Saksham Sathis” or Community Social Workers in eleven designated health posts of M-ward. The community awareness activities aim to increase awareness among the community. The symptomatic persons from the community via community or self-referrals are therein guided to the nearby health system for testing with the help of Saksham Sathis. Those turning positive for TB are initiated to avail treatment services from the health system. Saksham Jan Urja has effectively conducted more than 1300 stakeholder meetings and 1400 community awareness activities in M-Ward over the span of eighteen months. To enhance the role of the community and to instill community ownership into the programme for long term sustainability of the programme, the concept of community TB referral centers titled “Jan Bhagidari Kendras” were opened in 2017.The first Jan Bhagidari Kendra opened in May 2017. Eleven Jan Bhagidari Kendras were opened as part of this process.

Some Highlights :

Saksham had developed an android based application – “Saksham Against TB (SAT) Application (App) to record secure and confidential real time counselling date. The app was launched in March 2017.  

Saksham Pravaah was invited for the End TB Summit organised in Delhi on March 13, 2018 as a partner in achieving the commitment to “End TB in India by 2025” given by the honourable Prime Minister of India.

Saksham Pravaah consellors have been garnering media attention in local and national news. Saksham Pravaah Mumbai Counsellor, Ms.Suchita Surve was interviewed by The Hindu  after receiving an award for the “Best Counsellor” given by Municipal Corporation of Greater Mumbai ( MCGM) in a function organised on March 28, 2018 as part of the World TB Day Celebration. She highlighted the issue of Stigma of TB patients in the interview. ( http://www.thehindu.com/news/cities/mumbai/stigma-around-tb-still-persists-ounsellor/article23409285.ece).In the same function, MCGM also felicitated TISS for their important contribution for TB control in Mumbai.  

Saksham completed a decade of meaningful contribution in the field of HIV and TB and Saksham will now once again partner with the National AIDS Control Programme and will undertake Capacity Building for HIV Counsellors and Auxiliary Nurse and Midwives (ANM) across India. This project is also funded by the Global Fund for ADS TB and Malaria and is called “Saksham Prerak”. The project will continue until March 2020.



*Saksham Pravaah and Saksham Jan Urja is the result of the learning accrued from the GFATM (Global Fund to fight AIDS, Tuberculosis and Malaria) -Round 7, Counselling Component which was awarded to TISS as Principle Recipient of the grant from September 2008 – June 2015. TISS along with 38 partnering institutions of higher learning, implemented a national level programme on capacity building of HIV counsellors and institutions for the National AIDS Control Programme.