Locations: Tata Institute of Social Sciences, Mumbai

Sponsor: Global Fund

Saksham Pravaah*

Saksham Pravaah is a TISS project that implements counselling services for Drug Resistant (DR) TB patients in collaboration with the Mumbai District Tuberculosis (TB) Control Society (MDTCS). The programme supported by the Global Fund for AIDS, TB and Malaria was initiated in August 2014 as an extension of the HIV counselling capacity building initiative. Saksham means "Capable" or “Self- reliant” in Sanskrit.

The goal of this project is:

To strengthen the TB control programme of the MDTCS by providing counselling services for DR TB patients, and TB-HIV co-infected patients and their home caregivers, in select wards of Mumbai district; and building capacities of TB personnel for improving uptake of HIV services among TB patients.

The Specific objectives are:

  • To provide counselling services to DR TB and TB-HIV co-infected patients,
  • To improve TB treatment adherence among DR TB patients
  • To link TB and TB-HIV patients with required social protection services
  • To achieve a higher percentage of TB patients testing for HIV and improve enrolment for ART among TB-HIV positive patients.

The programme has 27 counsellors who are placed in the 24 wards of Mumbai and in Sewri TB Hospital.

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

  • Provide counselling services to 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
  • Undertake HIV risk assessment counselling for the registered DR TB patients and link them for HIV services.

As a comprehensive approach, Saksham also builds capacities of MDTCS staff on communication skills and psycho-social aspects of TB .The competency based training programmes build essential competencies for improved interpersonal communication and people skills for reaching out to marginalized populations at risk of, or affected by TB.

Saksham Plus*

Saksham in collaboration with SHARE INDIA, Hyderabad and Centre for Disease Control, Atlanta, USA will provide additional counsellors to the Mumbai District TB Control Society. The project is called “Saksham Plus” and 17 additional counsellors will be placed in the 7 wards of Mumbai viz Bandra East, Bandra West, Goregaon, Andheri East, Andheri West, Malad and Kurla in order to increase take up, saturate coverage and provide quality counselling. The Saksham Plus counsellors will work in tandem with the existing Mumbai DR TB counsellors and will work towards achieving the goals and objectives of Saksham Pravaah.

The MoU was formalised on July 04, 2016 at TISS in the presence of Prof. Parasuraman, Director, TISS.

Prof. Shalini Bharat, Deputy Director (Academic), TISS & Project Director, Saksham and Mr. C. P. Mohan Kumar, Registrar, TISS and Dr. Ganesh Oruganti, Project Director, SHARE INDIA signed the MoU on behalf of Saksham, TISS and SHARE INDIA respectively.

Saksham has demonstrated the need for moving beyond a bio-medical approach as far as Tuberculosis (TB) treatment is concerned and till March 2016 has registered over 4800 DR TB patients in Mumbai for counselling services.

Based on the experience of Mumbai, Saksham in partnership with the Central TB Division (CTD), Ministry of Health and Family Welfare has scaled up this project to Maharashtra, Gujarat, Rajasthan and Karnataka. In this expanded phase of the project, the goal is to the strengthen National TB control program (with special focus on MDR and XDR TB) in states of Maharashtra, Gujarat, Karnataka and Rajasthan through structural and psycho-social support interventions.

The specific objectives of this phase 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
  • To evaluate the role of pycho-social and structural interventions in TB treatment adherence among DR TB patients, in order to inform the state RNTCP programme.

The project will continue until December 31, 2017 and Saksham will place one DR TB counsellor for each district in the 4 states.

Saksham ‘Jan Urja’*

Saksham, TISS and Tata Power Community Development Trust have come together to implement Saksham ‘Jan Urja' - a project for TB prevention and TB treatment adherence through community engagement in M Ward. As both partners are located in M ward, this initiative is symbolic of their commitment to improve health in the Ward. The 3 year project aims to enhance TB awareness, TB treatment literacy, and create an enabling environment leading to early TB diagnosis and higher TB treatment adherence in M Ward. It is based on WHO’s ‘Engage Community Strategy’.

The MoU between TISS and Tata Power was formalised on March 14, 2015 at TISS in the presence of Prof. Parasuraman, Director, TISS and Dr. Daksha Shah, City TB Officer, Mumbai District TB Control Society & Deputy Executive Health Officer, Municipal Corporation of Greater Mumbai.

Prof. Shalini Bharat, Deputy Director (Academic), TISS& Project Director, Saksham and Mr. Debabrata Guha, Chief Executive Officer, Tata Power Community Development Trust, signed the MoU on behalf of Saksham, TISS and   Tata Power Community Development Trust, respectively.

The Goal of this intervention is:

To strengthen the TB control and treatment programme in M Ward through community engagement and psycho-social counselling and support.

The specific Objectives are:

  • To strengthen TB control and treatment programme in M Ward through community engagement and providing psycho-social counselling services to TB patients.
  • To support the existing health system in M Ward to become TB patient friendly.
  • To evaluate the role of community engagement and psycho-social interventions in TB awareness and treatment, in order to inform the state RNTCP programme.

* Saksham Pravaah, the TB Counselling project and Saksham ‘Jan Urja’ in M ward, are 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. Saksham 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.