MEMORANDUM OF UNDERSTANDING signed between Government of India, Ministry of Health & Family Welfare and the Tibetan Voluntary Health Association (TVHA) for TB prevention and control project in Tibetan refugee community in India with a grant for two and a half years.
The Global Fund to fight AIDS, Tuberculosis and Malaria (here in after referred to as Global Fund) has agreed to fund the Central TB Division, MOH&FW for “Providing Universal Access to TB/DR TB Control Services and Strengthening Civil Society in TB Care and Control “under grant agreement (Grant number– IDA-T-CTD) from 1st Oct 2015 to 31st December 2017. This Memorandum of Understanding (here in after referred to as “MoU”), is entered into between the Central TB Division (CTD), Ministry of Health & Family Welfare, Government of India with Office at Nirman Bhawan, Maulana Azad Road, New Delhi – 110801 (herein after referred to as “CTD”, or the first Party to the MoU”), and Tibetan Voluntary Health Association, (herein after referred to as “TVHA” or “the second party to the MoU”).
The Department of Health (DOH), one of the seven departments of Central Tibetan Administration (CTA) is registered in the name of Tibetan Voluntary Health Association (TVHA) under the Indian Society Registration Act XXI 1860. It is working as a registered charitable organization catering to the basic health care needs of Tibetan people living in India and Nepal. The total Tibetan refugee population in India is 94,203. Established in December 1981, its goal is to provide a comprehensive (preventive, promotive and curative) health care to the Tibetan refugee population in exile (India and Nepal) through a network of 50 health centers; 7 hospitals, 5 primary health centers and 38 clinics spread across India and Nepal. The Department plays a key and leadership role in overall policy in health, health care financing, planning and implementation of all health programs and projects in Tibetan communities in exile.
As per the MOU of this project, Both Government of India, Ministry of Health & Family Welfare and the Tibetan Voluntary Health Association (TVHA) agree as follows:
The Tibetan TB Control Program of Tibetan Voluntary Health Association through its network of its health centers at Tibetan settlements in India will be responsible for implementing the following strategies in coordination with Central TB Division’s RNTCP:
- TB awareness and community outreach campaign
- Intensified case detection and contract tracing in remote refugee settlements and congregate institutional settings
- Treatment of diagnosed TB patients using DOTS strategy
- Capacity building of TB Control Program’s workforce and infrastructure
- Main Activities:
- The proposed project will design and implement a robust community wide TB awareness campaign to highlight important messages about signs and symptoms of TB, TB diagnosis, clarification of TB related misconception and social stigma, importance of TB screening and treatment adherence etc, among the Tibetan population living in India particularly the mobile sections of the population living in urban dwellings.
- Active case detection will be performed in about 15 major Tibetan settlements in India, having high burden of TB and consisting of underserved populations, by a team comprising of TB field coordinators, outreach workers, doctors and nurses. It will be carried out in households, schools and monasteries located in each settlement
- Diagnostic testing will be provided to the suspected TB cases as per program guidelines by sputum testing with routine microscopy followed by supportive diagnosis using X-ray (digital X ray) and GeneXpert MTB/RiF assay as per program guidelines. The cartridges for the CBNAAT machine would be provided through the program.
- All people diagnosed with TB will be referred to the nearest TVHA TB treatment center or RNTCP center for enrolment in treatment. Project staff will ensure and confirm from local treatment centers that all people diagnosed with TB have been enrolled for treatment
- Contact Tracing: The contacts of the diagnosed TB cases including family members and friends will be provided a separate screening to verify their status
- Trainings will be provided to the doctors and nurses and other relevant healthcare staffs by experienced resource persons in areas of RNTCP, DOT, clinical management of TB, MDR TB, TB surveillance and program management. In addition, the laboratory technicians working in Tibetan TB treatment centers will be provided training in areas of diagnostic tools for the efficient detection of TB and MDR TB cases.
- Recruitment of staff of the project strictly as per positions and provisions of budget attached (Annexure1) to facilitate greater efficiency in all areas of TB program management at the local level which include awareness, access to diagnosis and treatment, reporting, monitoring and TB data compilation.
- Additionally, the infrastructural upgradation of the laboratories based in various TB treatment centers will be carried out within approved budget so that the laboratory technicians are reinforced to carry out effective testing at the TB treatment centers.
- Free TB medicines along with hospitalization support will be provided to the patients and those who are unable to afford them through implementation of Direct Observed Therapy (DOT) by the field TB nurses. The project will coordinate with RNCTP to facilitate greater access of medicines for the Tibetan TB patients.
- Regular review meetings at district level would be conducted as per the work plan to identify the challenges and issues in implementation of the project and find solutions in coordination with RNTCP program managers.
Tibetan Voluntary Health Association (Department of Health, CTA) thanks Government of India, Ministry of Health & Family Welfare for support for TB prevention and control project in Tibetan refugee community in India