Every morning, Ms V. Sasikala and Ms H. Hemalatha embark on their mission to bring primary health services directly to the doorsteps of 25 households in Chennai. Clad in bright pink jackets and equipped with biodegradable jute bags filled with diagnostic kits and medicines, these trained women health volunteers are part of Tamil Nadu's Makkalai Thedi Maruthuvam (MTM) initiative. Their purpose is to screen individuals over the age of 30 for non-communicable diseases (NCDs) such as diabetes, hypertension, mental health disorders, tuberculosis (TB), and nutrition-related issues. Through this initiative, they also provide essential medicines to around 20 beneficiaries daily and ensure their adherence to prescribed medications for effective disease management and treatment.
Ms Vanitha, a resident of Makkaram Thottam in Kolathur, Chennai, is among the many beneficiaries benefiting from the MTM scheme. Despite having high blood pressure and diabetes, she receives regular medical care and treatment without having to leave her home. Ms V. Sasikala and Ms H. Hemalatha visit her personally to measure and record her blood pressure and blood glucose levels, deliver her monthly dose of prescription medicines, and inquire about her overall health, including any discomfort, disease symptoms, diet, sleep patterns, and mental well-being. Additionally, they conduct screenings for her son, Mr Murali Mohan, aged 39, who, despite not having a diagnosed disease, is eligible for NCD screening as he is over 30 years old.
The MTM initiative aims to integrate services for managing NCDs, TB, undernutrition, and mental health, ensuring a comprehensive continuum of care for patients. Individuals with diabetes face a higher risk of TB and often experience poorer treatment outcomes. Women health volunteers play a crucial role in screening for hypertension, diabetes, mental health issues, as well as collecting sputum samples from symptomatic individuals for TB testing at the Urban Primary Health Centre (UPHC). All UPHC diagnostic labs are equipped for sputum testing, with results typically available within a day.
Global data highlights the association between diabetes and TB, revealing that individuals with diabetes face a twofold to threefold risk of developing TB disease, a twofold risk of death during TB treatment, a fourfold risk of TB relapse after completing treatment, and a twofold risk of multidrug-resistant TB. The Global Tuberculosis Report of 2021 estimated that around 370,000 new TB cases worldwide in 2020 were attributable to diabetes. In line with the WHO Collaborative Framework for care and control of TB and diabetes, mechanisms for collaboration, detection, and management of TB in patients with diabetes are recommended.
The tireless efforts of MTM volunteers, trained by the Tamil Nadu Corporation for Development of Women, are at the forefront of this collaborative endeavor. To enhance community-based health services and provide integrated care for TB patients with comorbidities, the Tamil Nadu State Tuberculosis Cell has trained and incentivized these women health volunteers to actively detect TB cases. For every positive TB case they identify, the volunteers receive a reward of Rs 500. Furthermore, MTM volunteers offer counseling and support to ensure patients adhere to the complete course of TB treatment, minimizing instances of treatment discontinuation.
All 140 UPHCs within the Greater Chennai Corporation area extend diagnostic and treatment services to individuals screened by MTM volunteers. Thanks to the dedication of woman health volunteer Ms Kanchana, two suspected TB cases were identified and subsequently tested positive. These individuals are now undergoing six months of treatment under the supervision of medical s…
