Agecare Foundation serves marginalized and hard-to-reach communities in the remote blocks of Delhi and Bhiwandi(Thane,Maharashtra). We work to eradicate Tuberculosis (TB) in these regions
WHO estimates about ‘3 million missing’ TB cases in the world, with India bearing a fifth of the global burden. If left undiagnosed and untreated, each infected case has the potential to infect 12-15 others annually, thereby worsening the situation. The primary reason for these cases to remain missing is lack of awareness about TB and its symptoms. Even if people become aware, the stigma associated with the disease and the resulting fear of discrimination, stops people from seeking treatment.
TB is also a serious socio-economic problem. World Economic Forum states, “nearly 1/3rd of over 11,000 (business leaders worldwide) expect TB to affect their business … seriously”. In India alone, indirect economic loss is US$23bn annually. Not only that, 100,000 female patients are thrown out by families every year to die of disease and starvation. 300,000 youngsters join the rank of child labour annually mostly because a parent is suffering from TB, loses a job, and the child needs to support the family (Government of India). TB is undoubtedly the biggest health crisis in India.
How do we do it?
Agecare Foundation focus is to work as an extension to the Indian government’s Revised National Tuberculosis Programme (RNTCP). Agecare Foundation has developed a unique care delivery model that expands access to facilities operated by the RNTCP, by delivering last mile connectivity to underserved and disadvantaged communities for TB treatment. We bring identification, diagnosis, counselling and treatment services for tuberculosis to the doorsteps of the people we serve.
Our unique model
The basic premise of our model is ‘community empowerment’. Going by the old adage- “for the people, ……by the people….” ; we look for local youth from the community, who were previously engaged in health or social work, to be trained and hired as ‘community health workers (CHWs)’ of Agecare Foundation. After undergoing rigorous 10 day training module, they are sent out in the community to conduct door-to-door surveys and identify TB suspects. These CHW are paid an incentive based salary on achievement of the following tasks: i. Identifying a TB symptomatic ii. Collecting his sputum and facilitating a sputum test at a government run lab iii. Collecting the test result and delivering it to the patient iv. Scheduling a clinical examination with a qualified physician to get a prescription v. Providing primary counselling to the patient and the bread winner of the family to continue the treatment till completely cured vi. Lastly, administering the first dose from the medicine box provided by the government
Each CHW takes care of a cluster of villages and works full time to ensure adherence to treatment till complete, and “turn off the tap” on drug resistance i.e. treat normal TB completely to prevent Multiple Drug Resistant TB (MDR-TB) / Extremely Drug Resistant TB (XDR TB)
Why are we successful?
Agecare Foundation model has been succesful due to two main reasons i. Better health care delivery at the door steps: DOTS mandates the administering of TB drugs under the supervision of a provider at a TB centre who is not a family member of the patient. Patients refrain from accessing the government run TB centres due to accessibility issues and costs involved in travelling to them. Hence we employ an army of CHW’s who visit each family door-to-door to deliver the entire gamut of services, required for TB prevention and treatment. ii. Improving Case notification: The historical case notification data underlines that the case notification has increased by 60% in one year. This can be attributed to identification of patients amongst tribal population which was not done earlier because of socio-cultural limitations;