Towards a TB-free India, village by village

Village chief Ms Joram Mach and gram panchayat (village council) member Mr Joram Chilly with Ms Gida Sangeeta, senior nurse officer at Primary Health Centre Yachuli. Yachuli was declared a “TB Free Panchayat” in 2023 (Photo: Sanchita Sharma / © WHO India)

Yachuli, a town panchayat in Keyi Panyor district in Arunachal Pradesh, was declared tuberculosis (TB) free in 2023. “TB screening is continuing, but there have been zero cases for two years. Upper respiratory tract infections are very common, and we are continuing TB screening, but there have been no TB case for close to two years,” said Dr Tana Taht, medical officer, Primary Health Centre Yachuli, which serves 21 surrounding villages.

National Health Mission Arunachal Pradesh, with support from World Health Organization and other developmental partners, has empowered tribal communities to take ownership of TB elimination efforts, integrating it with the management of co-morbidities such as diabetes and hypertension, among others. The TB Mukt Panchayat (TB-free village) initiative lead awareness campaigns, organize screenings, and encourage referrals, making TB elimination a community priority. The state declared 70 villages TB Free in 2023. 

WHO Representative to India Dr Roderico H. Ofrin (left) discusses quality of surveillance and data with (left to right) senior nursing officer Ms Gida Sangeeta, medical officer Dr Tana Taht and nursing officer Hage Yakii during a field visit to Primary Health Centre Yachuli. (Photo: Sanchita Sharma / © WHO India)

The health workforce works closely with ASHAs (health volunteers) and the gram panchayat (village council). “An auxiliary nurse midwife attends all gram sabha meetings and ASHAs work closely with the community to prioritise health. The gram sabha has decided to allocate funds to build a shed for the PHC ambulance, which is also used to take pregnant women to the district hospital on the nineth of every month for sonography, ultrasounds and other services, as needed,” said Ms Joram Mach, gram head (village head), who was facilitated for achieving TB-free panchayat in 2024.

Community trust is further strengthened with the PHC staff organizing health camps during festivals and fairs, including public holidays. “We never miss. People turn up in huge numbers, including young people, so we make the most of the opportunity to provide health services like screening for diabetes, hypertension, TB, among others. We provide free essential medicines and health information, including tobacco cessation and healthy behaviours to young people. Since it’s a holiday for our families too, we take our families along so we can work and also spend time together,” said Dr Taht.

Deputy WHO Representative Ms Payden and WHO Representative to India Dr Roderico H. Ofrin at Primary Health Centre Yachuli. Community engagement has led to the PHC achieving 94% full immunization coverage of children at nine months across the 21 villages it serves. (Photo: Sanchita Sharma / © WHO India)

Strategies such as improved access to advanced diagnostics, no delay in initiation of treatment, nutritional support and preventive treatment for close contacts under National TB Elimination Programme (NTEP) have led to significant reduction in TB in Arunachal Pradesh. Post the COVID-19 pandemic, the state has maintained its TB notification rate above 75% of the target set by the Central TB Division (CTD) and has successfully treated over 80% of people diagnosed with TB.

“Community engagement is key to strengthening public health delivery services. Health-seeking behaviour thrives when communities trust their healthcare providers and have uninterrupted access to high quality primary health services close to home, as is available as PHC Yachuri,” said Dr Roderico H. Ofrin, WHO Representative to India. WHO India’s TB Technical Support Network provides technical and field assistance to the Government of India for developing technical protocols, data collection software, supervision and monitoring, and field planning and trainings for subnational estimation of the disease burden and certification of TB-free claims of 201 districts and 10 state/UTs.