RNTCP Annual Report 2012 - TBC India

Human Resource Development
The ultimate goal of HRD for comprehensive TB control
is to have the right number of people, with the right
skills, in the right place, at the right time, who are motivated
and supported to provide the right services to the
right people.
Vision: A world where every person, everywhere has
access to a motivated and supported health worker, who
is skilled in TB control.
Goal: Health workers at different levels of the health
system have the skills, knowledge, and attitudes (professional
competence) necessary to successfully implement
and sustain comprehensive TB control services based on
the Stop TB Strategy.
A sufficient number of health workers of all categories
involved in comprehensive TB control is available at all
levels of the health system with the needed support systems
to motivate staff to use their competencies to provide
quality preventive and curative TB services for the
entire population according to their needs.
Committed, qualified and trained health care providers
equitably distributed at all levels are the foundation of an
effective health system specifically in the context of TB
since DOTS is human resource intensive and requires a
strong patient-provider bond and extensive supervision
and monitoring.
The main thrust of the RNTCP was the provision of
diagnostic and treatment facilities at the peripheries of
the district and the creation of a sub-district level supervisory
unit, which would also provide diagnostic and
treatment services. Accordingly, and based on the TB
epidemiology of the country, Designated Microscopy
Centres (DMC) were set-up for every 100,000 population
(for every 50,000 population in tribal and hilly areas)
and TB units were set up at every 500,000 population (at
every 250,000 population for hilly and tribal areas).
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Unprecedented programme expansion in the last five years
has outpaced capacity at central, state and district level to
ensure quality of services. A workload analysis done by
CTD, PATH & Initiatives Inc, highlighted the human resource
gaps in many cadres. Members of the staff at
state and district levels have to perform multiple functions
leading to increased workload and being overburdened.
Rapid turnover of officials and staff also necessitates
frequent trainings, which is neglected at times.
In addition, enhanced case finding, treatment, MDR, TB-
HIV, PPM, and ASCM activities required to achieve
Universal Access over the next 5 years necessarily need a
better approach to human resource development. Hence,
there is an urgent need for national HRD planning that
strategically and comprehensively addresses the overall
staffing issues related to recruitment, capacity development,
performance and retention.
Key strategies for HR for TB control:
� HR needs assessment
� HR policy revisions
� Organize on going in-service training
� Initial training in all aspects of basic DOTS, TB-
HIV, MDR-TB, accounts, procurement, ACSM,
etc. for existing staff and new hires including
private providers in TB control
� Retraining for major performance problems
� On the job training for small performance problems
� Continued education
� Advanced training on management aspects such
as health financing, leadership/governance, business
planning, organizational development.