Abstract
ABSTRACT: In order to tackle NCDs, early detection and screening for the disease plays a vital role to initiate treatment at the earliest and ultimately reduce the premature mortality due to NCDs. In Tamil Nadu, a community-based NCD intervention program, Makkalai Thedi Maruthuvam (MTM) was launched in August 2021, an initiative taken to provide health care services at people’s doorsteps, aimed to screening for NCDs as a measure of Population based screening and distributing medicines for patients suffering from NCDs in order to reduce their out-of-pocket expenditure. These services were delivered through Woman Health Volunteers (WHV), who were identified from the community with minimum qualification of higher secondary education. Even though the Tamil Nadu Public Health department has a broad base at field level, the screening coverage needs to be improved. So, as part of the Makkalai Thedi Maruthuvam program, the Department of Public Health & Preventive Medicine piloted multiple screening strategies on outreach mode to improve screening of HT & DM with focus to improve the coverage and quality of screening in selected districts. We proposed to do the secondary data analysis of the pilot data to analyse the effect of the strategies on coverage and quality and also to understand the feasibility of expanding the strategies on a wider scale. Proportions were calculated for screening coverage, positivity rate and detection rate. Our study resulted higher coverage among community-based strategy whereas higher positivity rate, follow-up confirmation and detection rate among screening strategies involving medical and para medical staff in the screening team. Conventional data collection tools were easier to implement whereas have challenges in follow-up monitoring. Newer digital tools which may be more effective than manual tools need additional resource mobilisation for implementation. In the 15 years of implementation of NCD intervention programme, MTM line list portal, the recent digital tool for the MTM program has created a better platform for tracking all the diagnosed NCD cases and ensuring their follow-up visits, compliance to drugs and adherence to treatment. The same plaform can also be expanded to capture the screening details thus aiding in assuring higher detection rate and decreased dropout rate of screened positives of NCDs.
KEYWORDS : Mass screening, Screening on outreach mode, screening coverage