TRANSITION FROM

2014 TO 2019
PARTNERSHIP
GUIDELINE
19/06/20
STATE TB CELL WEST BENGAL
OVERVIEW
Partnership Option
 engaging with a private-sector partner to improve the availability and quality of service
delivery for TB patients Steps to engage a service provider

Service Provider
 private-sector partner will be referred to as a
KEY FEATURES
Quality of care – Standards for TB Care in India
 Quality of diagnosis, treatment and public health measures with minimum out-of-pocket
expenditure
Need-based
 Partnerships based on identified needs and customized to suit the local context

Patient Centric
 Ensure the cascade of care and the partnership option is not a standalone mechanism to
address a short-term gap – use bundling, if required
Competitive and performance-based approach
 Selection of provider with competitive process for high quality services and adopting output
based financing
STEPS TO ENGAGE
A SERVICE
PROVIDER
STEPS…
UNDERTAKING
NEED
ASSESSMENT
Services for TB
SERVICES FOR TB
NEED ASSESSMENT STEPS…
NEED ASSESSMENT - Successful

EXAMPLES Microbiological
Treatment
Outcome
Confirmation

Adherence
TB case Support
notification
Testing by
microbiological
test
Patient
Engagement Support Staff
with Providers Tracking
Machine
system
Cartridges
Lab Technician
Skilled Staff
Relationship
management
Provider
Responsive
system
Patient Provider Public Health Actions Specimen Management Diagnostics
Support Agency

1. Provider 1. Counselling & 1. Sputum Sample 1. X-Ray

Engagement Adherence Support collection 2. Smear Microscopy
2. Linkage support – 2. Contact Investigation 2. Sample transport 3. Molecular
notification, free 3. Chemoprophylaxis 3. Extra-pulmonary 4. C & DST
diagnostics, drugs 4. Linkage for HIV & sample extraction 5. Pre-treatment
3. Patient Support DM investigation
5. Linkage for DR-TB
6. NPY

Treatment Centres Active TB Screening & Community Drug Access / Supply

Preventive Services Mobilization
1. Treatment Centre 1. ACF 1. Advocacy 1. Drug Supply
2. Outdoor DR-TB 2. Vulnerability mapping 2. Communication 2. Drug Access Methods
3. Indoor DR-TB 3. LTBI diagnosis 3. Community
4. Specialist DR-TB 4. LTBI treatment Empowerment
INNOVATIONS
 Cartridge Sharing Model
 Reagent Rental Model:
 Mobile TB Diagnostic Van
 Outsourced Laboratory Operations
 Air borne infection control measures
 Digital interventions
 Rehabilitation of TB patients
FRAMEWORKS USED TO DESCRIBE EACH
PARTNERSHIP OPTION
A. Eligibility criteria for Service Provider
B. Role of Service Provider
C. Role of RNTCP
D. Performance indicators and its linkage to payment
E. Verification Mechanisms
BASIC REQUIREMENT TO QUALIFY AS A SERVICE PROVIDER
 A registered entity

 Prior experience in implementing similar such projects for 3-5 years

BASIC EXPECTATIONS FROM RNTCP

 Clear understanding and expectation from provider ,

 Fortify with the required set of performance and payment indicators, standardized reporting formats

 Foster collaborative and supportive working relationship with Service Provider

 Training and sensitization of all stakeholders

 Timely review and payments

 Double-Check on discordance issues

EXPECTATIONS FROM
RNTCP
A. Pre-implementation
 Complete a detailed Needs Assessment and identify what type of Partnership options can be used to
bridge a health systems gap
 Undertake a basic market scan to benchmark prices and rates for various services
 Propose the options in the PIP with clear expectations

B. During implementation
 Clear understanding and expectation from provider ,
 Fortify with the required set of performance and payment indicators, standardized reporting formats
 Foster collaborative and supportive working relationship with Service Provider
 Provide access to Nikshay
 Training and sensitization of all stakeholders
 Timely review and payments
 Double-Check on discordance issues

Post –implementation
 Updating of web records on status and progress
 Support third party impact evaluation
VERIFICATION MECHANISMS
General Principles consistent across all Partnership options
 First level: Reviewing and cross-checking with Nikshay records/ applicable RNTCP reports for defined
time period
 Payments will be as per this verification

 Second level :Physical verification :

 Interview with 5% of program beneficiaries who availed the services

If discordance is found during the verification mechanism, the assigned penalties may be applied and
may be adjusted in payments of subsequent quarter .
EXISTING SCHEMES SUPPORTING TO
PUBLIC HEALTH FACILITY IN NTEP AS
PER 2014 GUIDELINES
Type /
No of (N0) of Design Designated TB Sputum
Culture Tuberc TOTAL
Partners Schemes ated Microscopy Control Collectio Chemo Lab
& DST DR TB Contact ulosis No of
District Name engaged for which Micros cum in n& prophyl Technic
Service Centre Tracing Unit Scheme
by NGOs/PP copy Treatment Urban Sputum axis ian
s Model s
districts engaged Centre Centre Slums Transport

MURSHIDABA
D 12 3 0 1 0 0 0 1 0 0 28 0 30

NADIA 4 2 0 0 0 0 2 4 0 0 0 0 6
HOWRAH 9 3 1 3 0 0 0 5 0 0 0 0 9
SOUTH 24 Pgs 9 4 7 0 0 0 0 8 12 0 0 2 29
TOTAL 34 12 8 4 0 0 2 18 12 0 28 2 74
 Fitting the 2014 Scheme according to 2019 Guideline

No. of Type of Contract

Scheme (Output/Input/Fee for
Sl No. Partnership Guideline-14 in WB Code services) Codes Partnership Guideline-19
i Designated Microscopy Centre 12 4 Fee for Services (F) 1 PPSA
Designated Microscopy cum Output (O)/Fee for
ii Treatment Centre 14 4&5 Services (F) 2 Public Health Action
iii Culture & DST Services 2 4 Fee for Services (F) 3 Specimen Management
iv DR TB Centre 1 5 Fee for Services (F) 4 Diagnostics
v TB Control in Urban Slums 14 7 Output (O) 5 Treatment Services
Sputum Collection & Sputum
vi Transport 48 3 Fee for Services (F) 6 Drug Access & Delivery Supplies
vii Contact Tracing 23 2 Output (O) 7 ACF & TB Prevention
Advocacy, Communication &
viii Chemoprophylaxis 4 7 Output (O) 8 Community Empowerment
ix Lab Technician 59 4 Fee for Services (F)
x Tuberculosis Unit Model 7 1 Output (O)
Total schemes in WB (As of June 20) 184
 Roadmap for Implementation Timeline Responsibility

Need Assessment- 30 th June

Selection of Scheme according to Partnership Guideline 2019 (Based on Need

Assessment) 07th July
07th July
Bundling of Scheme

Budgeting for the services 14th July

Deciding on the modality of Contracting (Input/Output/Fee for service) 14th July

Preparing a RFP 14th July

Engagement of Partner 05th August

Sensitization/Training of the Partner 10th August

Implementation 25th August

BRAIN-STORMING- IMPLEMENTATION ISSUES THAT NEEDS TO BE FLAGGED

“Partnership 2019 guideline is beyond Private Sector”

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