progress report - global bridges...namely ajmer, churu, jaipur, tonk and jhunjhunu on 8th, 21st,...
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PROGRESS REPORT
January 2016
PROGRESS REPORT | January 2016
Project: Strengthening Tobacco Cessation Capacity of Primary Care Professionals
(SCCoPE)
India is the world’s second largest producer and consumer of tobacco. Tobacco related diseases cause around one million deaths per year in India. To combat the tobacco epidemic, the National Tobacco Control Programme (NTCP) has been launched by the Government of India. An important component of the programme is to provide tobacco cessation services at the state and district level by building capacity of health care providers in brief interventions. However, less than half of the states under the NTCP programme have established tobacco training programmes. There is a lack of preparedness of health care providers to deliver brief interventions in tobacco cessation in Primary care in India. There is also limited evidence that training primary health care providers in tobacco cessation training translates into provision of brief interventions by health care providers. Designing and evaluating a training programme in brief interventions will thus help strengthen capacity in evidence-based tobacco cessation interventions. We aim to address this critical gap of effective population-based cessation services through strengthening the cessation component of India’s National Tobacco Control Programme (NTCP) by building capacity in primary care providers in evidence-based tobacco cessation interventions. The project is ongoing in two states of India; Rajasthan and Odisha. We are training health care personnel drawn from NTCP, state health department, training division of the National Health mission, faculty of reputed medical and dental colleges and regional cancer societies. We will be training about 500 such personnel from the two intervention states. The training will initially develop a cadre of 50 master trainers in tobacco cessation in each state/ region who will further train other health care providers in tobacco cessation through a cascade training method. We intend to provide a bouquet of online-course options ranging from brief interventions to three months intensive cessation certificate courses. The trainings are conducted through a hybrid model comprising of both face to face contact classes and online webinars and classes. The trainings are designed in a way so that they provide an opportunity for a stimulating exchange of ideas and experiences among participants working in tobacco cessation regionally and nationally. This project is innovative and will help in overcoming a significant gap in tobacco control in the country by creating a network of cessation experts. Through this project, a group of master trainers will be nurtured and champions in tobacco cessation under the NTCP will be prepared. These trained personnel will also be trained to advocate for prioritization of cessation in tobacco control programmes across the country. We also aim to produce evidence on effective intervention for smokeless tobacco which is not well known. Considering the huge burden of smokeless tobacco in the country the training will create new resources to address the burden. We are also in the process of establishing a research and practice platform which will connect researchers with policy makers and program managers. This will help in the creation of a “community of practice” in tobacco control.
PROGRESS REPORT | January 2016
SCCoPE – A brand in itself!
SCCoPE has turned out to be a brand in itself in this short time span. With contributions from cessation
experts from India and abroad, SCCoPE is a unique program in itself. The support from Barts and London
School of Medicine and Dentistry has added to the quality of SCCoPE. Having the SCCoPE trainings in the
distance learning portal of PHFI helped increase its spread.
The project was launched in the states of Odisha and Rajasthan with support of the respective state
governments. This hybrid training model was launched with a lot of apprehension, since it was the first
time that this mode of training was being followed for a tobacco cessation training in the country. After
several brainstorming session with government officials of both the states we got the green signal to
officially launch project SCCoPE. At present project SCCoPE enjoys support from officials and primary
care physicians of both the states.
Resources developed for the Physician’s training: - A resource pack was designed to support trainers
in the delivery of the training program in brief intervention in tobacco control. The brief
intervention includes 5A’s approach (Ask, Assess, Advice, Assist and Arrange), which is the most
commonly used intervention in tobacco cessation.
A variety of aids including the recorded presentation by experts, counselling guide, IEC/BCC materials used during this training. Counselling guide is an easy to use resource which presents evidence based tobacco cessation techniques through pictorial depiction. This has been developed by a team of tobacco cessation experts across India. The training of Master Trainers as well as physicians conducted in a hybrid format which comprises of both online and face-to-face training.
SCCoPE team has developed following resource materials as a part of resource pack for the tobacco
cessation training.
a. Training Manual for Tobacco cessation in primary care
b. Counselling Guide
c. Patient education materials
d. Education posters
PROGRESS REPORT | January 2016
a. Counselling guide b. Patient education material
C. Poster developed to put at different ward at facility,1 OPD,2 ANC ward/clinic and 3,waiting area for
patients
PROGRESS REPORT | January 2016
Dr.Lipika Nanda, Director IIPHB; Dr.K C Das, Director, Directorate
Public Health, Government of Odisha; Dr.Rajmohan Panda, Senior
Public Health Specialist; Dr.Hayden McRobbie, Prof of Public Health
Interventions, Queen Mary University of London (Left to Right)
Trainings in project SCCoPE
State Level Master Training
The second state level training programme of master trainers at Rajasthan was organized on 8th
September at Jaipur. In Odisha it was organized in two rounds, in first round it was on 24th-25th
August and in second round on 30th October 2015 at Bhubaneswar.
The training programme marked the official launch of the project – SCCoPE in the state of Rajasthan
and Odisha. Joint Secretary (JS), Medical & Health Department & Additional Mission Director,
National Health Mission (NHM) of Rajasthan formally inaugurated the programme. Director Public
Health (DPH), Government of Odisha formally inaugurated the programme. The JS, highlighted the
rising burden of tobacco and the need for capacity building of physicians. He also explained the
pivotal role of doctors to reduce this burden of tobacco use.
The training programme spanned over 8 hours with 10 interactive sessions on burden of tobacco,
various approaches of tobacco cessation and patient follow-up mechanism. The training also
highlighted ways to develop a tobacco cessation center. The sessions were highly interactive and
participants were encouraged to discuss actively on each of the topics. The participants were also
introduced to the online portal and oriented to use the web portal. By end of the training all the
participants were successfully registered to our online training portal. A pre and post training
evaluation was also conducted before and after the training respectively. Number of Primary Care Physicians trained as a master trainer against the target: - 81/100
State Number of Participants
Odisha 47
Rajasthan 34
The participants comprised of government officials, faculty of reputed cancer research institute, medical, dental colleges of Odisha and Rajasthan.
Odisha Resource persons:
Dr. P.K.B.Pattnaik, Jt. Director NCD-cum-(SNO) NTCP, Government of Odisha
Dr. NilamadhavRath, Prof. & HOD, MHI and SCB Medical College, Cuttack, Odisha.
Dr.B.K.Kindo, Additional Director, NCD, Government of Odisha
Dr. Lipika Nanda, Director, IIPH Bhubaneswar
Dr. Sanghamitra Pati, Additional Professor, IIPH Bhubaneswar
Dr. Hayden McRobbie
Dr. Rajmohan Panda
Officials attending the training program
PROGRESS REPORT | January 2016
Rajasthan - Resource persons:
Dr. Sunil Singh, Additional Director, Rural Health(RH),Rajasthan
Dr. Aditya Atreya, State Nodal Officer, NTCP &Joint Director (RH),Rajasthan
Dr. Rakesh Gupta, President, Rajasthan
Cancer Foundation, Jaipur, Rajasthan, India
Dr. Rajmohan Panda, Senior Public Health Specialist, PHFI
Dr. Vijay Mathur, Additional Professor, Centre for Dental Education & Research, All India Institute of Medical Sciences (AIIMS), New Delhi
Dr. Manu Raj Mathur, Research Scientist and Assistant Professor, PHFI Mr. Kumar Gaurav,
Programme Manager, PHFI
District Level Training
The first district level training commenced in December 2015 at both states. The district level training
programme of primary care physicians has been completed at all intervention districts of Rajasthan
namely Ajmer, Churu, Jaipur, Tonk and Jhunjhunu on 8th, 21st, 22nd, 23rd of December and 8th January
2016 respectively and in Bolangir, Khorda and Cuttack at Odisha respectively on 18th-19th and 22nd-
23rd.Trainings were organized at district’s head quarter. Chief Medical & Health Officer of respective
districts formally inaugurated the programme. CMHO, highlighted the rising burden of tobacco and the
need for capacity building of physicians. He also explained the pivotal role of doctors to reduce this
burden of tobacco use.
The training was highly interactive and witnessed healthy discussion on tobacco cessation. Post training,
the participants were enrolled into the online portal for further capacity building.
Project launch and Release of counselling guide and IEC materials by Dr. Niraj K.
Pawan (IAS),Joint Secretary, Medical & Health Department & Additional Mission
Director, National Health Mission (NHM), Rajasthan, Dr. Rajmohan Panda, Senior
Public Health Specialist, PHFI, Dr. Sunil Singh, Additional Director (RH), Rajasthan, Dr.
Rakesh Gupta, President, Rajasthan Cancer Foundation, Jaipur, Rajasthan, India (Right
to Left)
Dr. Aditya Atreya, State Nodal Officer, NTCP &Joint Director (RH), Rajasthan interacting
with participants
PROGRESS REPORT | January 2016
(Left) Chief district health officer (CMHO) inaugurating the training and Deputy CMHO Dr. Lal explaining the importance of the tobacco cessation to
participants at Ajmer.(Right)Dr. Rakesh Gupta, Explaining the Pharmacological approaches for cessation at Tonk Training
- Total Primary Care Physicians Trained against the target: 329/400
State-Rajasthan, District
Number of Participants
Ajmer 22
Churu 55
Jaipur 47
Tonk 47
Jhunjhunu 41
State-Odisha District
Number of Participants
Bolongir 37
Khorda 42
Cuttack 35
koraput 22
Odisha
Additional Director, NCD addressing the physicians in Bolangir (left), participants during the session (right)
PROGRESS REPORT | January 2016
-Confidence in Counselling of Patients on Tobacco Cessation (Master Trainers) Odisha Rajasthan
(Source: - From the analysis of pre-post data)
It was reported after the master training that confidence level of primary care physicians has increased
significantly for counselling the tobacco users.
-Distribution of trained Primary care Physicians
THE TRAINING PROGRAMME HAS CHANGED MY ATTITUDE
TOWARDS TOBACCO USER, THEY ARE SICK AND NEED HELP FROM
HEALTH CARE PROFESSIONAL
DR.JAI PRAKSH SINGH,PRIMARY CARE PHYSICIAN,
JAIPUR
NOW I AM CONFIDENT THAT I CAN PRESCRIBE AND
CAN COUNSEL TO THE PATIENT FOR TOBACCO
CESSATION
PRIMARY CARE PHYSICIANS
JHUNHJUNU
Out of total Primary care Physicians those
attended the SCCoPE training programme,
52% from Community Health center (CHC),
39% from Primary health center (PHC), 5%
from Urban health center and 4% from
district tobacco control cell (DTCC).
PROGRESS REPORT | January 2016
Standard Agenda followed for training
DAY 1 Sessions
10.00 AM– 10.15 AM Registration and Tea
10.15 AM – 10.30 AM Welcome to participants and overview of the course, Pre-training Assessment
10.30 AM – 10.45 AM Opening remarks
10.45 AM– 11.00 AM Tobacco and Health
11.00 AM – 11.20 AM Introduction to Tobacco Cessation
11.20 AM– 12.00 PM Theories of Addiction
12.00 PM – 12.45 PM Behavioral and psychological approaches for cessation
12.45 PM – 02.30 PM Pharmacological approaches for cessation
02.30 PM – 02.45 PM How to develop a tobacco cessation center?
02.45 PM – 03.15 PM Patient follow-Up & Introduction to Vignettes
03.15 PM – 04.00 PM Evaluation of cessation practices
04.00 PM – 04.20 PM Role of Physicians & Pedagogy
04.20 PM– 04.30 PM How to use the online training program and Registration
04.30 PM – 04.45 PM Closing Remarks
PROGRESS REPORT | January 2016
Media Coverage
Odisha,
Project SCCoPE has received ample media attention since its launch in the state of Odisha and
Rajasthan. Leading newspapers of the state have written about the launch of project and successive
trainings in both states. A wide variety of local and regional newspapers reported the event highlighting
the cessation trainings offered. Here some of the media coverage reports.
Picture 12, 13, 14 (left, centre and, right) TIMES OF INDIA,
PROGRESS REPORT | January 2016
PRAMEYA NEWSPAPER
DHARITRI NEWSPAPER
Knowledge will lead to tobacco cessation
Bhubaneswar, 23 Oct.: Tobacco is a leading cause of death
in the state. Lack of awareness has led to such uncontrolled
use. Awareness form primary level of care can help make
Odisha tobacco free. More than 40 percent people
consuming tobacco wish to quit. Training primary care
professionals on tobacco cessation so that they can further
advice patients to quit will make Odisha tobacco free and
will emerge as a model state, said Director of Public Health,
Odisha during a tobacco cessation training program at a
regional Public Health institute where he was invited as the
chief guest. The meeting was attended by Director Indian
Institute of Public Health director Dr. Lipika Nanda, Dr. Raj
Mohan Panda, London’s Queen Mary University Prof.
Hayden McRobbie and IIPHB associate Prof. Dr.
Sanghamitra Pati.
Awareness can keep the state tobacco free
Summary:
People are not aware about the dangers of tobacco cessation.
Lack of awareness has led many people to use tobacco. ‘’If the
tobacco cessation advice is given right from the primary care
level, the state can become tobacco free’’ said K C Das, Director
Public Health. He was the chief guest at regional Public Health
institute during a training program on Tobacco Cessation. The
training was attended by Director Indian Institute of Public
Health director Dr. Lipika Nanda, Dr. Raj Mohan Panda, London’s
Queen Mary University Prof. Hayden McRobbie and IIPHB
associate Prof. Dr. Sanghamitra Pati.
PROGRESS REPORT | January 2016
SAMBAD
SAMBAD KALINGA
Tobacco cessation training program inaugurated
Summary: A state level training on tobacco cessation was inaugurated
at Indian Institute of Public Health, Bhubaneswar. This 2 day workshop
will train master trainers for training the district level primary care
physicians on tobacco cessation. This workshop was attended by Dr. K C
Das, Director Public Health, Government of Odisha as the chief guest. ‘’
More than 40 percent people consuming tobacco wish to quit. If the
tobacco cessation advice is given right from the primary care level, the
state can become tobacco free’’ said K C Das, Director Public Health.
Training primary care professionals on tobacco cessation so that they
can further advice patients to quit will make Odisha tobacco free and
will emerge as a model state among other states in the country. Dr.
Lipika Nanda, Director, Indian Institute of Public Health, Bhubaneswar
was among the dignitaries for the workshop.
Tobacco cessation training program inaugurated at Indian
Institute of Public Health Bhubaneswar
Summary: A two day tobacco cessation training program was
organized at Indian Institute of Public Health, Bhubaneswar. The master
trainer who will further train the primary care physicians, will be trained
in this training. Director Public Health, Dr. K C Das who was the chief
guest at the event inaugurated the training program. During this
addressing the gathering Dr. Das said that lot of people are dying in our
state due to tobacco use. To get rid of it, people should be made aware
of its harmful effects and it should start from the primary care level.
Government is taking various steps to control use of tobacco through
NTCP. Along with this various cessation activities are also being
undertaken at the district level. More than 40 percent people
consuming tobacco wish to quit. Training primary care professionals on
tobacco cessation so that they can further advice patients to quit will
make Odisha tobacco free and will emerge as a model state. The training
was attended by Director Indian Institute of Public Health director Dr.
Lipika Nanda, Dr. Raj Mohan Panda, London’s Queen Mary University
Prof. Hayden McRobbie and IIPHB associate Prof. Dr. Sanghamitra Pati.
PROGRESS REPORT | January 2016
DAINIK BHASKAR 8th September’2015
Rajasthan,
Ajmer Patrika, 9th December 2015
Dainik Jyoti, 9th December 2015
Training programme was organized for doctors on
Tobacco cessation
Summary: - Public Health foundation (PHFI), New Delhi has organized one day training programme for government doctors on tobacco cessation. Training was inaugurated by Chief district health Officer, Ajmer, During training sessions different aspects of tobacco cessation was covered by the experts from PHFI like behavioral and pharmacological aspects of tobacco cessation, theory of addiction, Expert has also explained the online portal course and its importance.
Training programme was organized for control of
tobacco product consumption
Summary: - Public Health foundation (PHFI), New Delhi and health and family welfare department Ajmer jointly organized one day training programme for government doctors on control of tobacco product consumption. Training was inaugurated by Chief district health Officer, Ajmer, During training sessions different aspects of tobacco cessation was covered by the experts from PHFI like behavioral and pharmacological aspects of tobacco cessation, theory of addiction, Expert has also explained the online portal course and its importance. Dr. Manu Mathur from PHFI has explained different methods of consumptions of tobacco product in details.
Doctors will get training on how to advice tobacco
user to quit tobacco at SWATHYA BHAWAN
Summary: - Training programme on how to advice tobacco user to quit tobacco will organize in five district of Rajasthan including Jaipur. On Tuesday in SWASTHYA BHAWAN, State tobacco cell and PHFI will launch this training programme. For this initiative, master trainers will get training about the different aspect of tobacco cessation. In this training programme, doctors from Jaipur, Jhunjhunu, Churu ,Tonk and Ajmer will participate. In this training programme, State Nodal officer, NTCP has explained the importance of this programme in detail.
.
PROGRESS REPORT | January 2016
Churu Patrika, 23rd December 2015
Churu Patrika, 23rd December 2015
Training programme was organized for doctors
about the control of tobacco product consumption
Summary: - Public Health foundation (PHFI), New Delhi and health and family welfare department Ajmer jointly organized one day training programme for government doctors on control of tobacco product consumption. Training was inaugurated by Chief district health Officer, Churu, During training sessions different aspects of tobacco cessation was covered by the experts from PHFI like behavioral and pharmacological aspects of tobacco cessation, theory of addiction, Expert has also explained the online portal course and its importance. Dr. Manu Mathur from PHFI has explained different methods of consumptions of tobacco product in details.
Harm effects of smoking and Gutkha was explained
Summary: - Ten lacs people die due to smoking and use of tobacco product (GUTKHA) in country.Public Health foundation (PHFI), New Delhi and health and family welfare department Churu jointly organized one day training programme for government doctors on control of tobacco product consumption at Town hall Ratangadh. Training was inaugurated by Chief district health Officer, Churu, During training sessions different aspects of tobacco cessation was covered by the experts from PHFI like behavioral and pharmacological aspects of tobacco cessation, theory of addiction, Expert has also explained the online portal course and its importance. Dr. Manu Mathur from PHFI has explained different methods of consumptions of tobacco product in details.
PROGRESS REPORT | January 2016
Times of India, 8th September 2015
DAILY NEWS 9th September 2015
Trainers Trained for Tobacco Control
Summary: Training programme on how to advice tobacco user to quit tobacco will organize at Jaipur. On Tuesday in SWASTHYA BHAWAN, State tobacco cell and PHFI has organized a one day training programme to train a master trainers. In this training programme, Additional Mission Director, NHM and Joint Secretary Health and family welfare, Rajasthan has explained the importance of this programme in detail. He mentioned that to curb the problem arising due to tobacco consumptions, State government.During training sessions different aspects of tobacco cessation was covered by the experts from PHFI like behavioral and pharmacological aspects of tobacco cessation, theory of addiction, Expert has also explained the online portal course and its importance. Dr. Manu Mathur from PHFI has explained different methods of consumptions of tobacco product in details.
PROGRESS REPORT | January 2016
PANJAB KESRI 9th September 2015
SAMACHAR JAGAT 8th September 2015
Master Trainers Trained for Tobacco Control
Summary: Training programme on how to advice tobacco user to quit tobacco will organize at Jaipur. On Tuesday in SWASTHYA BHAWAN, State tobacco cell and PHFI has organized a one day training programme to train a master trainers. In this training programme, Additional Mission Director, NHM and Joint Secretary Health and family welfare, Rajasthan has explained the importance of this programme in detail. He mentioned that to curb the problem arising due to tobacco consumptions, State government.During training sessions different aspects of tobacco cessation was covered by the experts from PHFI like behavioral and pharmacological aspects of tobacco cessation, theory of addiction, Expert has also explained the online portal course and its importance. Dr. Manu Mathur from PHFI has explained different methods of consumptions of tobacco product in details.
Training for Tobacco Control
Summary: - Training programme on how to advice tobacco user to quit tobacco will organize in five district of Rajasthan including Jaipur. On Tuesday in SWASTHYA BHAWAN, State tobacco cell and PHFI will launch this training programme. For this initiative, master trainers will get training about the different aspect of tobacco cessation today at 10 AM.
Master Trainers Trained for Tobacco Control
Summary: -Training programme on how to advice tobacco user to quit tobacco will organize in five district of Rajasthan including Jaipur. On Tuesday in SWASTHYA BHAWAN, State tobacco cell and PHFI will launch this training programme. For this initiative, master trainers will get training about the different aspect of tobacco cessation
PROGRESS REPORT | January 2016
Tracking of Patient:- A tobacco user register is being piloted at some facilities. Feedback from the pilot will help in
improvising it. Our local team will then do the follow up of tobacco users who have been registered. This
register will be filled by medical officer in charge of the primary care facilities.
Key Challenges
Active support from government stakeholders
Building confidence of the stakeholders on the online/hybrid mode of training.
Maintaining the compliance of the participants post training.
Conducting trainings in harsh weather and limited infrastructure in primary care
Key Learnings
Bringing change in attitudes and practices of primary care physicians requires a comprehensive
and holistic effort, over and above the training program.
Tobacco user surveillance recording register finalized for patient follow up
PROGRESS REPORT | January 2016
Commitment and support from the government is of utmost importance. Having premier
institutes as partners can help.
The training of support staffs of NTCP (Psychologist, frontline health worker) will help sustain
the programme
Branding is important for long term sustainability
Certification is important for effective participation in the program.
A second round of follow-up, face to face training may be fruitful after 9-12 months to maintain
the momentum and motivational level of primary care professionals