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Guided by:Prof. Keyur Sorathia© Himanshu sethICT Interventions for empowermentof TB patients in Rural Assam(c) Himanshu Seh
Populationcovered byRNTCPNo. ofsuspectsexaminedRate ofchange insuspectsexaminedper s+ casediagnosed(compared topreviousyea...
TB diagnosis and treatment cycle(c) Himanshu Seh
TB diagnosis and treatment cycle – Category 1(c) Himanshu Seh
TB diagnosis and treatment cycle – Category 2(c) Himanshu Seh
Patient Identity Card••(c) Himanshu Seh
• According to the guidelines of RNTCP, patientsneed to take medication under direct supervisionof the DOTS provider.• If ...
• The patients are required to take some gapsbetween every tablet. It depends upon thecondition of the patient. They are h...
TB Medications Boxes (retained by the DOTS provider)(c) Himanshu Seh
TB Medicine Blisters. Category - 1(c) Himanshu Seh
ASHA Showing the medicines taken by the patients• Patients are supposed to collect the empty blisters and submit them to t...
CONTEXTUAL USER RESEARCH(c) Himanshu Seh
10Patients6 Contextual Enquiries4 Observations(c) Himanshu Seh
5Health CareWorkers3 Health Technicians2 Asha Workers(c) Himanshu Seh
4DOTSProviders1. Bishnuram MedhiCommunityHealth Center,Haju, Kamrup2. North GuwahatiP.H.C, Guwahati3. Guwahati MedicalColl...
INSIGHTS AND OBSERVATIONS(c) Himanshu Seh
• Patients discontinue medication at their own will and do notfollow a proper treatment schedule. Reasons : A) they think ...
• Patients discontinue medication at their own will and do notfollow a proper treatment schedule. Reasons : A) they think ...
• Unawareness about the disease (its cause and prevention, whatkind of disease they suffer from etc.)• Unawareness about t...
Lack of time and unawareness among ASHA members• Asha does not have time to sit/observe medications for every patient, so ...
Unawareness, shyness and local practices• Medications have strong side effects and patients have queriesregarding the same...
• People feel awkward/shy while approaching thedoctors/professionals.• Patients want to know more about the disease• The p...
Unawarenessabout the diseasein the patient’sfamilyContextual Enquiry(c) Himanshu Seh
Lack of information• Lack of information mediums (boards, leaflets, cards etc.) at theplace of DOTS providers and in villa...
Outdated Information Board in N.G.P.H.C(c) Himanshu Seh
No Information Board in the waiting area (N.G.P.H.C)(c) Himanshu Seh
No Information Board about TB in any languageSite :: Bishnuram Medhi Community Health Center, Haju, Kamrup(c) Himanshu Seh
Information Boards are in a poor condition andin Assamesse language only.(c) Himanshu Seh
Information Boards are in Assamesse language only.(c) Himanshu Seh
Majority of the content printed in the ID cards is in EnglishOnly a little information (General Instructions and Medicatio...
Majority of the content printed in the ID cards is in EnglishOnly a little information (General Instructions and Medicatio...
RNTCP Room, N.G.P.H.CPatients are entertained in this small room and are asked to sit at a distance while talking.Absence ...
(c) Himanshu Seh
Waiting area (idle period) in hospitals• Patients spend time by sitting idle while taking the medications• Less/no interac...
Waiting area (idle period) in hospitals• Patients have are entertained from outside the window.• They have to stand in que...
Waiting area (idle period) in hospitals• Patients have to wait outside the center if the appointments get cancelled.• Pati...
Social dynamics and peer support• Patients agree to have received information through peers/villagers.• No Social Stigma i...
Technology literacy• Patients have a mobile phone and they know how to make and receive calls.• At least one family member...
Other insights• Patients prefer face to face interaction to mobile conversation.• Patients go to DOTS provider for taking ...
Unawareness of tuberculosis among the peoplesuffering from tuberculosis, leads to hesitationin medication and sometimes di...
Possible ICT enabled information system willreach to individual users and increaseinformation awareness about tuberculosis...
“ Prevention of the disease through betterknowledge and awareness is theappropriate way to keep disease awayand remain hea...
ThankYou(c) Himanshu Seh
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ICT Interventions for empowerment of Tuberculosis Patients in Rural Assam (findings and analysis)

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ICT Interventions for empowerment of Tuberculosis Patients in Rural Assam (findings and analysis)

  1. 1. Guided by:Prof. Keyur Sorathia© Himanshu sethICT Interventions for empowermentof TB patients in Rural Assam(c) Himanshu Seh
  2. 2. Populationcovered byRNTCPNo. ofsuspectsexaminedRate ofchange insuspectsexaminedper s+ casediagnosed(compared topreviousyear)Totalpatientsregisteredfor treatmentAnnualnew extrapulmonarycasenotificationrateAssam*1 302 lakh 147642 -1% 39788 18Kamrupdistrict*229,00,000 16116 8% 4016 19Tuberculosis Statistics for Assam and Kamrupdistrict*1 :: RNTCP Case Finding and Treatment Outcome Performance, 1999–2010*2 :: RNTCP Case Finding and Treatment Outcome Performance, 1999–2010(c) Himanshu Seh
  3. 3. TB diagnosis and treatment cycle(c) Himanshu Seh
  4. 4. TB diagnosis and treatment cycle – Category 1(c) Himanshu Seh
  5. 5. TB diagnosis and treatment cycle – Category 2(c) Himanshu Seh
  6. 6. Patient Identity Card••(c) Himanshu Seh
  7. 7. • According to the guidelines of RNTCP, patientsneed to take medication under direct supervisionof the DOTS provider.• If the patient lives in the vicinity of the ASHAshome, then ASHA takes the patients medicine toher home and gives her medicationpersonally(either by calling them to her home/orby going to theirs), however in rest of the casesthe patients have to visit the DOTS Provider.However, number of people visiting are morethan those attended by ASHA.TB Medication(c) Himanshu Seh
  8. 8. • The patients are required to take some gapsbetween every tablet. It depends upon thecondition of the patient. They are howeverinstructed to take after every 10 mins. Can beless / more according depending on the patientsduring the medication.(Avg. duration of medication : 30 mins)• The Health visitors/professionals are supposed tomake a home visit for every defaulter and haveto enquire about the same and providecounseling to the patient.TB Medication(c) Himanshu Seh
  9. 9. TB Medications Boxes (retained by the DOTS provider)(c) Himanshu Seh
  10. 10. TB Medicine Blisters. Category - 1(c) Himanshu Seh
  11. 11. ASHA Showing the medicines taken by the patients• Patients are supposed to collect the empty blisters and submit them to thehospital when the medication gets over.• ASHA uses the phone throughout the day for making and receiving calls.Carries her phone in her hand (signifying she is confident carrying it)(c) Himanshu Seh
  12. 12. CONTEXTUAL USER RESEARCH(c) Himanshu Seh
  13. 13. 10Patients6 Contextual Enquiries4 Observations(c) Himanshu Seh
  14. 14. 5Health CareWorkers3 Health Technicians2 Asha Workers(c) Himanshu Seh
  15. 15. 4DOTSProviders1. Bishnuram MedhiCommunityHealth Center,Haju, Kamrup2. North GuwahatiP.H.C, Guwahati3. Guwahati MedicalCollege, Guwahati4. Amingaon SubCenter(c) Himanshu Seh
  16. 16. INSIGHTS AND OBSERVATIONS(c) Himanshu Seh
  17. 17. • Patients discontinue medication at their own will and do notfollow a proper treatment schedule. Reasons : A) they think they havecompletely recovered, when the medicines start showing effect. B) they are demotivated to takemedicines (due to the strong dose and they are supposed to visit the center every time) C) somehave to take an off from.(c) Himanshu Seh
  18. 18. • Patients discontinue medication at their own will and do notfollow a proper treatment schedule. Reasons : A) they think they havecompletely recovered, when the medicines start showing effect. B) they are demotivated to takemedicines (due to the strong dose and they are supposed to visit the center every time) C) somehave to take an off from.• Patients fake symptoms in front of the professionals to escapefrom the medicines. (c) Himanshu Seh
  19. 19. • Unawareness about the disease (its cause and prevention, whatkind of disease they suffer from etc.)• Unawareness about the tests and checkups• No information about govt. policies(c) Himanshu Seh
  20. 20. Lack of time and unawareness among ASHA members• Asha does not have time to sit/observe medications for every patient, so sheleaves the medicine behind with the patient. i.e. DOTS is not practiced.• Dependence on Asha for procuring the medicines(c) Himanshu Seh
  21. 21. Unawareness, shyness and local practices• Medications have strong side effects and patients have queriesregarding the same.• Local pharmacist are consulted for medications for side effects,instead of the doctors/professionals.(c) Himanshu Seh
  22. 22. • People feel awkward/shy while approaching thedoctors/professionals.• Patients want to know more about the disease• The patients are able to read instructions on the ID card.(c) Himanshu Seh
  23. 23. Unawarenessabout the diseasein the patient’sfamilyContextual Enquiry(c) Himanshu Seh
  24. 24. Lack of information• Lack of information mediums (boards, leaflets, cards etc.) at theplace of DOTS providers and in villages.• Lack of material in regional languages.(c) Himanshu Seh
  25. 25. Outdated Information Board in N.G.P.H.C(c) Himanshu Seh
  26. 26. No Information Board in the waiting area (N.G.P.H.C)(c) Himanshu Seh
  27. 27. No Information Board about TB in any languageSite :: Bishnuram Medhi Community Health Center, Haju, Kamrup(c) Himanshu Seh
  28. 28. Information Boards are in a poor condition andin Assamesse language only.(c) Himanshu Seh
  29. 29. Information Boards are in Assamesse language only.(c) Himanshu Seh
  30. 30. Majority of the content printed in the ID cards is in EnglishOnly a little information (General Instructions and Medication dates) are printed in Assamesse.Patients hardly open the ID card for reference, but keep it safely as advised by the doctors.(c) Himanshu Seh
  31. 31. Majority of the content printed in the ID cards is in EnglishOnly a little information (General Instructions and Medication dates) are printed in Assamesse.Patients hardly open the ID card for reference, but keep it safely as advised by the doctors.(c) Himanshu Seh
  32. 32. RNTCP Room, N.G.P.H.CPatients are entertained in this small room and are asked to sit at a distance while talking.Absence of Information Boards about the disease(c) Himanshu Seh
  33. 33. (c) Himanshu Seh
  34. 34. Waiting area (idle period) in hospitals• Patients spend time by sitting idle while taking the medications• Less/no interaction with the professionals in the period of taking medicines atthe facility.(c) Himanshu Seh
  35. 35. Waiting area (idle period) in hospitals• Patients have are entertained from outside the window.• They have to stand in queues in order to talk to the doctor(c) Himanshu Seh
  36. 36. Waiting area (idle period) in hospitals• Patients have to wait outside the center if the appointments get cancelled.• Patients think that if they go to medical they will have to wait because it’s avery busy hospital , might lead to demotivation.Waiting area (idle period) in hospitals• Patients have to wait outside the center if the appointments get cancelled.• Patients think that if they go to medical they will have to wait because it’s avery busy hospital , might lead to demotivation.(c) Himanshu Seh
  37. 37. Social dynamics and peer support• Patients agree to have received information through peers/villagers.• No Social Stigma in the society• Absence of community programs• Support of family members (husband and mother)(c) Himanshu Seh
  38. 38. Technology literacy• Patients have a mobile phone and they know how to make and receive calls.• At least one family member (husband) knows how to receive and make calls.• Use of phone as a shared resource(c) Himanshu Seh
  39. 39. Other insights• Patients prefer face to face interaction to mobile conversation.• Patients go to DOTS provider for taking medicines.• Patients are given some basic but very limited instructions by the doctors inthe initial visit. (c) Himanshu Seh
  40. 40. Unawareness of tuberculosis among the peoplesuffering from tuberculosis, leads to hesitationin medication and sometimes discontinuation ofthe treatment in between, which results in achanges in their treatment category andduration.Problem Statement(c) Himanshu Seh
  41. 41. Possible ICT enabled information system willreach to individual users and increaseinformation awareness about tuberculosis andits medication, that will help them to motivateand ensure their presence during the treatment.Vision Statement(c) Himanshu Seh
  42. 42. “ Prevention of the disease through betterknowledge and awareness is theappropriate way to keep disease awayand remain healthy as illness confusionand health-seeking behavior may enhanceor interfere with the effectiveness ofcontrol measures. ”Klein RE, Weller SC, Zeissing R, Richards FO, Ruebush TK; “Knowledge, beliefand practices in relation to malaria transmission and vector control inGuatemala.” Am J TropMed Hyg 1995; 52: 383–8.(c) Himanshu Seh
  43. 43. ThankYou(c) Himanshu Seh

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