Extensive volunteer network improves TB services among tribal populations in India

The Union’s Project Axshya is working with an active network of 15,000 volunteers, mobilised throughout the country to address the needs of vulnerable populations with regards to tuberculosis (TB) information, screening, treatment and support.

The Project Axshya volunteers, called ‘Axshya Mitras’, work with at-risk groups and service remote areas to increase understanding of TB and encourage and facilitate testing and treatment when necessary. ‘Mitra’ means ‘friend’; and these community volunteers base their service on that principle, functioning as integrated and trusted members of the communities where they work. Their actions have resulted in the diagnosis and treatment of 18,000 TB patients in 2016.

Axshya Mitras are indispensable in India’s remote tribal areas, where populations are some of the poorest in India and rates of malnutrition and tobacco use are higher than in other areas of the country. Both these risk factors, combined with the remote location of many of the villages, pose significant challenges for TB control and access to healthcare services.

In Jharkhand, a state in the eastern part of India, tribal groups make up 28 percent of the population.  Axshya Mitras are well known and trusted in the communities in the district of Sahibganj, which is located within a conflict area and has many remote tribal settlements. They convene regular public meetings with the village health and sanitation committees and go door-to-door to conduct TB screenings and share information.

Raphael Hansdak is an Axshya Mitra who has been working here since 2011. In that time, he has collected 245 sputum samples for testing; nearly 10 percent of those patients tested positive for TB and were put on treatment.  

Hansdak’s work also extends beyond testing and screening. As a member of the community, his role often involves providing emotional support to patients going through testing and treatment. He accompanies patients to health centres and follows up with them to ensure they complete treatment.

Community-centred initiatives such as this are central to Project Axshya’s design. The initiative works in partnership with seven civil society groups in India to design creative solutions to expand access to TB information and services, increase the accountability of service providers and empower communities in 285 districts and 40 urban sites across 19 states.  

Project Axshya is funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria.