national health prog.

1. GROUP ACTIVITY
Comparative Study Of National Health
Programs
Presented By:
Shiavng Sharma(PG/14/55)
Ashwanee Patel(PG/14/14)

2. National Tuberculosis
Control Program

3. RNTCP Organization structure: National level
Health Minister
Health Secretary
MD NRHM Director Health
Services
Additional / Deputy / Joint
Director
(State TB Officer)
State TB Cell
Deputy STO, MO, Accountant,
IEC Officer, SA,
DEO, TB HIV Coordinator etc.,
State Training and Demonstration
Center (TB)
Director, IRL Microbiologist, MO,
Epidemiologist/statistician, IRL LTs etc.,
NTF Presentations for RNTCP
Sensitization First edition 10th Nov 06

4. RNTCP Organization structure: State level

5. Structure of RNTCP at district levels
Medical officer-TB Control,
Senior Treatment supervisor(STS),
Senior TB Laboratory Supervisor(STLS)
Medical Officer, paramedical staff
And Laboratory Technician (20-50%)
NTF Presentations for RNTCP
Sensitization First edition 10th Nov 06
One/ 500,000
(250,000 in hilly/
difficult/ tribal area)
One/ 100,000
(50,000 in hilly/ difficult/
tribal area)
TB Health Visitors (TBHV),
DOT Provider
(MPW, NGO, PP, ASHA,
Community Volunteers)
District Health Services
District TB Centre
Tuberculosis Unit
Microscopy Centre
DOT Centre
Nodal point for TB
control
Chief Medical Officer and
other supporting staff
District Administration
District Magistrate/
District Collector
DTO, MO-DTC (15%), LT, DEO,
Driver, Urban TB Coordinators,
TBHVs, Communication Facilitators

6. Supervision,
Monitoring, and
Evaluation activities under
RNTCP

7. Levels Category of
Supervisor
Field visits (No. of
days/month)
Objective Facilities to be
visited
National Officials from
Ministry of Health
and Family
Welfare, GoI.
RNTCP inclusive as a
supervisory agenda in
their routine field visits
for supervision.
Supervision of
Programme.
State TB Cell, DTC,
TUs, DMCs, PHIs,
DOT Centre, Drug
Store, DOTS Plus
Site, ICTC Centre,
CCC, ART Centre
National DDG (TB) and
other officials
from Central TB
Division.
10 days/month (1-2
days per visit)
Supervision of
Programme.
State TB Cell, DTC,
TUs, DMCs, PHIs,
DOT Centre, Drug
Store, DOTS Plus
Site, ICTC Centre,
CCC, ART Centre
National Central Internal
Evaluation
One per month Evaluation of
Programme
Performance
including all aspects
such as data
validation etc…
State TB Cell, DTC,
TUs, DMCs, PHIs,
DOT Centre, Drug
Store, DOTS Plus
Site, ICTC Centre,
CCC, ART Centre
National National
Reference
Laboratory
All states assigned to
be visited at least once
in a year.
Supervision and
Evaluation of
External Quality
Assurance activities
State TB Cell, DTC,
TUs, DMCs, PHIs,
DOT Centre, Drug
Store, DOTS Plus
Site, ICTC Centre,
CCC, ART Centre
National NACO and CTD One state per
quarter
Supervision of
TB-HIV
collaborative
activities
State TB Cell, DTC,
TUs, DMCs, PHIs,
DOT Centre, Drug
Store, DOTS Plus
Site, ICTC Centre,
CCC, ART Centre

8. Levels Category of
Supervisor
Field visits (No.
of
days/month)
Objective Facilities to be
visited
State Officials from
Ministry of
Health and
Family Welfare,
State and State
Health Society.
RNTCP inclusive as
a
supervisory agenda
in
their routine field
visits
for supervision.
Supervision of
Programme.
DTC, TUs, DMCs,
PHIs, DOT Centre,
Drug Store, DOTS
Plus Site, ICTC
Centre, CCC, ART
Centre
State STO
(Including visits
by STC/STDC
officers)
12-16 days/month
(1-2 days per visit)
Supervision of
Programme
Performance.
Cover all districts
in the state every 6
month
DTC, TUs, DMCs,
PHIs, DOT Centre,
Drug Store, DOTS
Plus Site, ICTC
Centre, CCC, ART
Centre
State State Internal
Evaluation
Upto 30 million - 2
districts per quarter;
30-100 million - 3
districts per quarter;
>100 million - 3-4
districts per quarter.
Aim to cover all
districts at least once
in 3-4 years.
Evaluation of
Programme
Performance
including all aspects
such as data
validation etc…
DTC, TUs, DMCs,
PHIs, DOT Centre,
Drug Store, DOTS
Plus Site, ICTC
Centre, CCC, ART
Centre
State Intermediate
Reference
Laboratory
All districts to be
visited at least once
a
year
Supervision and
Evaluation of
External Quality
Assurance activities
DTC, TUs, DMCs,
PHIs, DOT Centre,
Drug Store, DOTS
Plus Site, ICTC
Centre, CCC, ART
Centre

9. Levels Category of
Supervisor
Field visits
(No. of
days/month)
Objective Facilities to be
visited
State Joint visit by
SACS and STC
officials
One district per
quarter
Supervision of
TB-HIV
collaborative
activities
District AIDS
Control office, DTC,
TUs, DMCs, PHIs,
DOT Centre, Drug
Store, DOTS Plus
Site, ICTC Centre,
CCC, ART Centre
District District Health
Society Members
(District
Magistrate,
RNTCP inclusive as
a
supervisory agenda
in
their routine field
visits
for supervision.
Supervision of
Programme.
District AIDS
Control office, DTC,
TUs, DMCs, PHIs,
DOT Centre, Drug
Store, DOTS Plus
Site, ICTC Centre,
CCC, ART Centre
District DTO (including
visits by MODTC)
20 Supervision of
Programme, Cover
all TU every month
and all DMC every
Quarter.
District AIDS
Control office, DTC,
TUs, DMCs, PHIs,
DOT Centre, Drug
Store, DOTS Plus
Site, ICTC Centre,
CCC, ART Centre

10. NATIONAL AIDS CONTROL
PROGRAMME

11. ADMINISTRATIVE STRUCTURE:
Three entities oversee NACO, they are:
 National Council on AIDS
o National Council of AIDS is the most recently formed, though
hierarchically supreme.
o The Prime Minister chairs the Council and Union Health Minister serves
as Co-chairman.
o Its membership comprises of 22 Union Ministers, 7 StateChief Ministers
and selected representatives from Civil Society
 National AIDS Committee
o The Union Minister of Health chairs the Committee.
o Its members include health ministers of 5 states and senior officers of
related central ministries/departments.
o The Committee also comprises of representatives from industry, trade
unions, IMA and Salvation Army as non-official members

12.  National AIDS Control Board
 The Board reviews the policies laid down by NACO, grants sanction to
various projects, undertakes procurement and awards to private
agencies.
 The Board exercises all financial powers which are beyond
 the powers of the Project Director, NACO and which the Department of
Health, Government of India, can exercise with the approval of the
Department of Expenditure, Ministry of Finance

15. COMPARISON:
ADMINISTRATIVE STRUCTURE
RNTCP NATIONAL AIDS CONTROL
PROGRAMME
CENTRAL LEVEL
• Tuberculosis Division in the Directorate General
Health services
• National Tuberculosis Institute, Bangalore
• Tuberculosis Research centre at Chennai
STATE LEVEL
 Health Minister
 Health Secretary
 MD NRHM
 Director Health Services
 Additional / Deputy / Joint Director
 (State TB Officer)
 State TB Cell
 Deputy STO, MO, Accountant,
 State Training and Demonstration
 Center (TB)
 Director, IRL Microbiologist, MO,
 Epidemiologist/statistician, IRL LTs etc.,
CENTRAL LEVEL
Director General
Additional Seceratory
Dir. Admin & Project
DDG(M&E)
ADG(CST)
SO(Admin)
DirectorFinance
Accounts Officer
STATE LEVEL
State Council of HIV/AIDS(Chaired by Chief Minister)
Governing Body
Executive Committee
TSU
SACS Project director and staff

16. COMPARISON:
ADMINISTRATIVE STRUCTURE(CONT..)
RNTCP NATIONAL AIDS CONTROL
PROGRAMME
DISTRICT LEVEL
District Magistrate/District Collector
Chief Medical Officer and other supporting staff
DTO, MO-DTC (15%), LT, DEO, Driver, Urban TB
Coordinators, TBHVs, Communication Facilitators
Medical Officer, paramedical staff And Laboratory
Technician (20-50%)
TB Health Visitors (TBHV), DOT Provider (MPW,
NGO, PP, ASHA, Community Volunteers)
DISTRICT LEVEL
District Collector/deputy Commisioner Chairperson
CEO Zilla Parishad ,vice chairperson
Chief Medical Officer
Medical Superitendent
District Aids Control Manager
District Program Manager
District IEC Officer
Medical Officer
One representative of targeted intervention
program
Representative of relative department

17. COMPARISON
COMPONENTS:
RNTCP NATIONAL AIDS CONTROL
PROGRAMME
Pursue quality DOTS expansion and
enhancement
Enable and promote research
Contribute to health system strengthening
Directly observed treatmentshort-course
DOTS strategy
Intensifying and Consolidating Prevention
services with a focus on HRG and vulnerable
populations
Strengthening institutional capacities
Comprehensive Care, Support and Treatment
Expanding IEC services for general
population and high risk groups with a focus on
behavior change and demand generation