Karnataka's Tuberculosis control programme hit due to health workers' strike

The strike by National Health Mission workers attached to the Revised National Tuberculosis Control Programme (RNTCP) had badly hit the TB control project in the state.

A tuberculosis unit comprises a senior treatment supervisor, senior lab supervisor, a Health Visitor who goes to the field, and a lab technician.

With 1,278 National Health Mission workers on strike, there is no one to dispense TB medicines and upload patients’ details on NIKSHAY database. NIKSHAY is a database of all TB patients including Multi-Drug Resistant cases across the country and this database is used for monitoring. The TB patients get Rs 500 for their nutrition only after their data is uploaded.

Dr Manjunath, a senior treatment supervisor in Udupi district hospital told DH, “For how many days can a junior health assistant, pharmacist or a permanent lab technician manage in our absence? They do not update NIKSHAY and so patients won’t get their incentive for nutrition or drug supply,” he said.

National TB treatment guidelines recommend directly observed therapy (DOT) when treating TB patients, especially drug-resistant TB, and HIV patients. A TB Health Visitor provides the prescribed TB drugs and watches the patient swallow every dose. This helps prevent TB from spreading to others. It also decreases the chances of treatment failure and relapse.

Venkatesh O, a Tuberculosis Health Visitor in CV Raman General Hospital, Bengaluru, has been working for the past 13 years in RNTCP. “Patients visit the nearest health centre for tablets. The treatment lasts for six months. Up to two months, we make sure patients ingest the medicines in our presence, till they test negative. As we’re on strike, this isn’t happening.”

He further added that if the medicines are sent home chances are that the patients may miss their dose. Every two months the patient has to get tested, which includes a sputum test. “We visit their households everyday and update NIKSHAY everyday so that they don’t relapse,” Venkatesh said.

Ramesh Reddy, Joint Director, Tuberculosis, Department of Health and Family Welfare, told DH, “The NHM strike has definitely affected RNTCP as 1,278 employees in the programme are NHM workers. For now, our junior health assistants, permanent lab technicians, and pharmacists are dispensing medicines.

The state has a tuberculosis unit for every 2.5 lakh population. In all, there are 271 TB units in primary health centres, community health centres, taluk hospitals, and district hospitals.