Addressing poverty in TB programmes of Bihar

[Guest guest]

Berlin 2010: Addressing poverty in TB programmes of Bihar

Bobby Ramakant - CNS

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44.3 per cent people in Indian state of Bihar are living below the poverty line,

which is the second highest number of poor people in any state of India (Orissa

has the most poor people in India). Not surprisingly diseases that are

associated with poverty like tuberculosis (TB) are at alarming levels.

 

However there is a annual reduction in poverty, and TB programme performance is

improving as well, said Dr AK Jha, State TB Officer, Bihar. Dr Jha was speaking

at the consultative workshop of the TB and poverty sub-working group of the Stop

TB Partnership held in India (29-30 October 2010), the secretariat of which has

now moved to the South-East Asian office of the International Union Against

Tuberculosis and Lung Disease (The Union).

 

There are sessions at the ongoing 41st Union World Conference on Lung Health,

Berlin, Germany (11-15 November 2010) addressing TB and poverty as well.

The annual reduction in poverty ratio in Bihar state is the same as that for the

country.

 

There are a range of factors outlined by Dr Jha that would have contributed to

decline in poverty in Bihar that include the recent development in Bihar, growth

of agriculture economy, extensive outwards internal migration of workers to

other states of India, self-employment programmes launched by the government,

˜swarnajayanti grameen swarojgar yojna (golden jubilee rural self-employment

scheme),  Mahatma Gandhi National Rural Employment Guarantee Scheme (MNREGS),

public distribution system and nutrition programmes, social security programmes,

national old age pension scheme, sarva siksha abhiyan (education for all

campaign), and National Rural Health Mission (NRHM) among others.

Another major issue in Bihar is migration, particularly male migration for work.

Inter-state inter-census male migrants as percentage of total population was

1.18 in 1981 and increased to 1.32 in 1991: additional 1,700,000†said Dr Jha.

The revised national TB control programmes (RNTCP) in Bihar has taken a range of

steps to address poverty in TB control programmes and reach out to the unreached

TB patients and provide optimal diagnosis, treatment and care.

The state TB programme in Bihar took several steps to address poverty in TB

control programmes like identifying TB vulnerable groups in the state,

identifying district health societies, mapping marginalized and discriminated

groups and areas where they reside (like 'dalits' and 'maha-dalit tola'), urban

poor, or areas where flood affected and displaced people take shelter.

The state TB programme has participated in the regular health 'melas' (fair)

which provides a platform for communication with the marginalized community

about TB and the services available through RNTCP.

 

These are also effective opportunities to provide information about the nearest

designated sputum microscopy centre and referral for sputum microscopy is also

done at such community gatherings.

" NGOs like ADRA India are regularly organizing folk media shows for difficult to

reach areas and for various ethnic minority groups like the ‘Mushahars’ in

Bihar " said Dr Jha.

The communication is always intriguing – and so in Bihar, the state TB

programme has combined education with entertainment – so as to convey useful

information in a powerful manner in local dialects on issues like how TB

spreads, importance of DOTS, rights and responsibilities of TB patients, among

others.

 

It is important to underline that Bihar’s communication initiative on rights

and responsibilities of TB patients, is in line with the WHO Stop TB Strategy of

which the Patients' Charter for TB Care is an integral part of.

" The sputum collection and transport scheme has helped in extending diagnostic

services to remote regions in the Purnea division of Bihar " said Dr Jha.

" NGOs like the Damien Foundation (DFIT) and LEPRA India are providing assistance

to the patients by providing them food if the patient is the sole earning member

of the household " added Dr Jha. " These NGOs also help in providing drugs to the

DOTS providers along with the government and programme staff " said Dr Jha.

Despite of commendable efforts of the Bihar state TB programme, challenges

continue to confront the fight against TB. Large scale migration of people for

work to other states in India is one such challenge. Dr Anil Garg from

Chandigarh State TB programme said that the box of anti-TB drugs of the migrant

patient should be transferred to the DOTS clinic that migrant is going to access

care from. There were concerns raised about cost of courier which is not

budgeted currently. Dr Garg said that the cost of wasting two boxes worth (one

each in the two DOTS centres where the migrant person will receive treatment) on

one person is not justified. It is clear that the issue of migrants needs more

attention.

" Participation of TB programme managers in meetings of social welfare department

and integrating RNTCP in poverty alleviation programmes will be very useful "

said Dr Jha.

Another important challenge Dr Jha highlighted was the need to advocate for a

legal framework to protect TB patients from loss of employment during their

treatment.

Bobby Ramakant

Citizen News Service CNS

Email: bobby@...

Website: www.citizen-news.org

Online at:

http://www.citizen-news.org/2010/11/addressing-poverty-in-tb-programmes-of.html