The National TB Elimination Programme (NTEP) expenditures are organised under 19 heads. These are:
1. Civil works - Initial establishment/ refurbishment costs and maintenance of civil works costs for Designated Microscopy Centres (DMC), Tuberculosis Units (TU), District TB Centres (DTC), Drug-resistant TB (DR-TB) centres and State Drug Stores (SDS).
The preparation of a research and evidence-based Programme Implementation Plan (PIP) is vital for conducting effective Advocacy, Communication and Social Mobilisation (ACSM) activities under the National TB Elimination Programme (NTEP). The plan for ACSM activities should be made based on the needs of the community.
Needs Assessment through Situation Analysis
Situation analysis should start at the TB Unit (TU) level. The Senior Treatment Supervisor (STS) should take the initiative under the guidance and supervision of the District TB Officer (DTO).
Advocacy, Communication and Social Mobilization (ACSM) activities must place the individual at the centre and bring in the family, community and society to bring about sustained changes in TB perceptions and behaviours. ACSM activities must target these 4 groups accordingly:
The stages of the change model in behaviour change communication include:
The correct message and its effective delivery to intended audiences is key to the success of Advocacy, Communication and Social Mobilisation (ACSM). Content is the most important aspect of communication.
An effective TB related message must have the following characteristics:
There are several communication channels for the effective dissemination of messages.
Below are various channels with their advantages and disadvantages listed.
Once Advocacy, Communication and Social Mobilisation (ACSM) objectives are designed, linking them with activities strengthens the overall programme effectiveness. Several ACSM approaches can be considered for TB. Decisions on which approach or combination of approaches to use should take into account the benefits and risks, the time frame and the expertise and financial resources needed for effective implementation.
There are two parameters to determine:
(1) What ACSM activities to conduct?
(2) Which channels of communication to use?
After the situation analysis, barrier identification and audience analysis, the next step is to define the ACSM objectives.
The ACSM objectives should be SMART i.e. specific, measurable, achievable, realistic and time-based.
Specific: The objective has a single focus or result and does not overlap with other objectives. It describes exactly what we will accomplish, with whom, where and when.
Key question: Does the objective specify what it aims to achieve? Does it cover only one activity versus multiple activities?
Advocacy, Communication and Social Mobilization (ACSM) strategies are directed at achieving specific goals in terms of TB elimination.
They are:
Social Mobilisation (SM) is the process of bringing together different stakeholders and building partnerships to prevent, detect and cure TB. It generates dialogue, negotiation and consensus among a range of players that includes decision-makers, the media, Non-government Organisations (NGOs), opinion leaders, policy-makers, the private sector, professional associations, TB-patient networks and religious groups.
At the heart of social mobilisation is the need to involve people who are either living with active TB or have suffered from it at some time in the past.