Tuberculosis Health Action Learning Initiative [THALI]

Tuberculosis Health Action Learning Initiative (THALI) initiative was started in 2016, with the support of the United States Agency for International Development (USAID) as a four-year patient-centric family focused TB prevention and care initiative to facilitate quality TB services to vulnerable populations. THALI was implemented by the Karnataka Health Promotion Trust (KHPT) in Karnataka in collaboration with the National Tuberculosis Elimination Programme (NTEP).

The project focused on behaviour change, primarily among communities of the urban poor. The population with co-morbidities such as HIV-AIDS, diabetes and undernutrition were prioritized under THALI. KHPT piloted this project from June 2019-July 2020 in four high-burden HIV districts in the intervention states. In Karnataka, it was launched in Belgaum and Bagalkot.

Best practices that can be learned from this initiative are:

1. Integrating TB-HIV activities by capacitating providers and officials, and advocacy.     
2. Raising awareness about direct benefit transfer (DBT) and how to acquire it. 
3. Supporting patient support groups (PSGs) to help patients overcome unpleasant side-effects and stigma, follow healthy nutritional practices and adhere to treatment with a goal to improve TB treatment experiences within government TB facilities.      
4. Capacity building of TB champions.     
5. Partnering with the care and support centres (CSC) teams to conduct awareness-raising meetings for people living with HIV (PLHIV) at the anti-retroviral (ART) centres, and advocate with the district health officer (DHO), district TB officer (DTO) and state TB office to increase isoniazid preventive therapy (IPT) supply. 

While there is still a lot to be done to address the remaining gaps consistently and cohesively, the intervention has been successful in helping the stakeholders recognize the value of an integrated approach and understand the problems better. Among other key and vulnerable population, THALI has made a start with data (there is no screening data from the past) and other activities. THALI has demonstrated pathways through a collaborative approach involving the NTEP and PLHIV networks that, if sustained, will enable the success of future efforts.

Resources

 Tuberculosis Health Action Learning Initiative (THALI) - Best Practices and Lessons in TB-HIV Integration from Bagalkot, USAID, KHPT, 2020.

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