Annexures
Annexures7.1 Draft Workplace Policy for ending TB
ABC ORGANIZATION
Policy Number
Authorization
Next Review Date
Responsible Officer
Policy Owner
Total Pages
INTRODUCTION
In 2022, an estimated 10.6 million people fell ill with TB globally. India carries an estimated 27% of the global TB incidence with an estimated 28.2 lakh people contracting the disease and approximately 3.4 people succumbing to the disease every year. TB is known to cause a decline in workers’ productivity on the order of $13 billion every year.
It has become essential to create a work environment where TB is addressed and provision of TB services for the workers is made available. A healthy workforce results in higher productivity, making supportive workplace policies mutually beneficial for the industry and its employees. Institutional policies for TB can play a pivotal role in spreading awareness, creating a culture of support and inclusion and helping in the prevention and spread of TB. Every organization assume an accountability to adopt and implement a policy to end TB in their workplace. The following points outline the main pillars that set the standard for TB care at the workplace.
ORGANISATION’S POLICY
• Organization shall foster a culture of care towards workers who are afflicted with Tuberculosis.
• Continuous efforts will be made to make workers aware of Tuberculosis.
• Pre-employment and periodic screening for Tuberculosis will be done for all workers
• Air-borne Infection Control measures will be promoted to prevent transmission of Tuberculosis among the workers.
• The organization will not discriminate against workers based on known or presumed status of Tuberculosis.
• The management will respect the right of confidentiality about the health status of workers with respect to Tuberculosis.
• Counselling services will be ensured for workers and their family members seeking help on issues related to Tuberculosis.
• Support for adherence and completing treatment will be provided to all workers affected with TB.
• Employment protection and leave benefits for persons affected with TB will be provided to the best possible extent.
• Information of all workers diagnosed with TB will be updated in Ni-kshay.
Date :
Approved by :
7.2 Draft Terms of Reference for TB Free Workplace Committee
TB Free Workplace Committee
ABC Organization
Introduction of the ABC Organization
The economic burden of TB in terms of loss of lives, income and workdays is substantial. A large section of the population affected by TB also belong to the economically productive age group that results in a significant loss of working days, pushing people with TB further into the vortex of poverty due to catastrophic costs. Therefore, it is essential to create a work environment where TB is addressed and provision of TB services for the workers is made available. Every organization assume an accountability to adopt and implement a policy to end TB in their workplace. Ongoing efforts are required to engage different departments and individuals for diversified representation. A workplace committee is formed to ensure proper planning, implementation, and monitoring of ending TB interventions in the workplace.
I. The Purpose of TB Free Workplace Committee
The TB Free workplace committee will help the management in planning and implementation of TB and workplace activities. The Committee will ensure equitable and gender sensitive approach to the implementation of TB prevention, treatment and care activities in the workplace.
II. Roles & Responsibilities of the Committee
TB Free Workplace Committee would
1. Initiate and strengthen organization’s response to TB in the workplace.
2. Draft organization’s workplace policy/guidelines on ending TB.
3. Develop annual action plan and mobilize support including required resources for implementation
4. Organize TB awareness activities at/around the workplace premises
5. Address negative attitudes towards people with TB and increase awareness among the workers regarding TB
6. Ensure availability and display of relevant IEC materials at strategic locations across the workplace premises.
7. Ensure every health facility associated with ABC Organization has a Ni-kshay ID and every TB case detected in the organization to be enrolled in Ni-kshay Portal.
8. Facilitate linkage with the government’s social protection schemes so that the workers, particularly the contractual workers may avail the benefits.
9. Conduct periodic TB screening and ensure all workers with presumed TB are tested/evaluated.
10. Develop linkages with public or private diagnostic centres for referral of workers with presumed TB.
11. Ensure that list of local testing and treatment services for TB in Government and private sector is made available to all workers and their families.
12. Develop a mechanism to monitor the implementation of the policy/guidelines and activities for ending TB.
13. Document and disseminate good practices and learnings.
14. Publish a one-page annual report regarding the TB status and efforts to end TB in the workplace.
III. Proposed Composition of TB Free Workplace Committee
The Committee would have representative from senior management as chair. Other members include representatives from Human Resource Department, Medical Unit, CSR wing, Welfare Department and representatives of workers. A person cured from TB/TB Champion may also be included in the committee. Additionally, committee’s gender balance may be maintained.
IV. Frequency of meetings
The committee may meet once in a quarter.
The minutes of the meetings need to be maintained.
_____________ Date: ___________ Chair, TB Workplace Committee
ABC Organization
7.3 Checklist for implementing TB Free Workplace Interventions
Suggested activity and monitoring framework for workplace response to becoming a ‘TB Free Workplace’:
S. No
INDICATORS
MEANS OF VERIFICATION
1. For smaller workplaces (Up to 100 workers):
a nodal person from the organization is nominated to oversee planning and implementation of workplace intervention on TB.
For larger workplaces (More than 100 workers):
TB free workplace committee is established with clear terms of reference Letter of management/Written document on constitution of committee and/or a nodal person
2 Policy/guidelines on workplace interventions for TB Written policy/guidelines document
3 IEC materials are available and displayed Information, Education, Communication (IEC) materials regarding TB, its prevention, treatment and NTEP facilities for TB, are displayed at strategic locations in the workplace
4 Periodic awareness generation activities on TB is organized with all the workers Documentation of awareness generation activities (Class/ Seminar/ emails/ social media groups/virtual platform/videos etc.)
5 TB screening may be done at least twice a year for all workers. In case of occupations like mining, textile, glass, TB screening may be done once in every quarter Documentation of screening process revealing more than 90% of workers screened in the last 6 months
6 Ensure all workers with presumed TB are completely tested/evaluated Case based documentation of presumed TB with results of test/evaluation (More than 95% of people with presumed TB are tested/evaluated in the last 6 months)
7 Ensuring all workers diagnosed with TB are reported to NTEP and initiated on treatment Verify in Ni-kshay
8 Welfare mechanism for all workers affected with TB may be introduced (like leave benefits, travel support, nutrition supplements etc.) Documentation of support provided to workers with TB/ Interviewing workers with TB
9 Airborne Infection Control systems are in place AIC assessment report and compliance report.
7.4 Role of ‘NTEP’ at state and district level in implementing workplace intervention
State and District TB Cells play a crucial role in engaging workplaces to establish a TB free workplace setting. Their role includes:
• Garnering political and administrative support for collaborating with different workplaces to initiate workplace intervention for TB.
• Mapping of key industries and leading business association/s in the state and district.
• Developing state specific guidelines to influence different workplaces to adopt interventions for establishing a TB Free Workplace.
• Providing technical support to engage workplaces in the TB space
• Supporting capacity building of management, workplace committee, peer educators, and health staff of workplace.
• Ensuring pprovisions for TB evaluation/testing, treatment initiation, and public health actions for the workers in collaboration with the workplace committee.
• Developing IEC materials and organize awareness generation activities on TB in the workplaces.
• Documenting and disseminating best practices on workplace interventions for TB.
7.5 Guidelines and Resources for Workplace TB Intervention
Several guidelines and training modules developed by Central TB Division and partners organization are extremely useful for reference.
• Guidance Document on Partnership
(https://tbcindia.gov.in/WriteReadData/l892s/9531588006Guidance%20Doucum…)
• Policy Framework to address Tuberculosis, TB related co-morbidities and HIV in the World of Work in lndia
(https://labour.gov.in/sites/default/files/framework.pdf)
• Employer Led Model for Tuberculosis Prevention and Care (https://tbcindia.gov.in/WriteReadData/Reach%20ELM%20Operational%20Manua…)
• Statement of Commitment of India Employer Organization on addressing TB and HIV in the World of Work
(https://www.ilo.org/wcmsp5/groups/public/---asia/---ro-bangkok/---sro-n…)
• National Framework for a Gender Responsive Approach to TB in India
(https://tbcindia.gov.in/showfile.php?lid=3496)
• Standards for TB Care in India
(https://tbcindia.gov.in/showfile.php?lid=3061)
• Training Curriculum for Peer Educators
Course for Health Volunteers and Treatment Supporters in NTEP | Knowledge Base
7.6 Air-borne Infection Control Check-list
SL No Workplace checklist for Airborne infection control Yes No Remark
Administrative
1 Workers are encouraged to self-screen for cough before entering the workplace.
2 Signage for cough etiquette are present and adequately displayed across the workplace.
3 Workers with cough are provided with masks and educated on its correct use & disposal.
4 Workers affected with TB are reassigned to a more convenient workspace on request.
5 Airborne Infection control assessment is conducted at least annually
6 Facility design and workers seating has been assessed for the best use of space and ventilation
Environmental
7 Hand washing facility with running water and soap accessible to all workers.
8 Workplace areas have good cross-ventilation in all areas and total areas of windows and doors >20% of floor area in each floor.
9 Wherever cross-ventilation is not possible, mechanical ventilation (for e.g. exhaust fans) is properly used to ensure minimum six air change per hour
10 Signages in place to keep doors and windows open when feasible.
11 Regular cleaning and maintenance of directional and extractor fans is conducted.
12 Servicing documentation of Air conditioners is maintained and is available for review.
8. References
• India TB Report 2023, CTD, MoH&FW, Govt. of India
(https://tbcindia.gov.in/WriteReadData/l892s/5646719104TB%20AR-2023_23-%…)
• Global tuberculosis report 2023 (https://www.who.int/publications/i/item/9789240083851)
• Guidance Document on Partnership 2019, CTD, MOH&FW
(https://tbcindia.gov.in/WriteReadData/l892s/9531588006Guidance%20Doucum…)
• Policy Framework to address Tuberculosis, TB related co-morbidities and HIV in the World of Work in lndia, MoLE, Govt. of India.
(https://labour.gov.in/sites/default/files/framework.pdf)
• National Multi sectoral action framework for TB Free India. (https://tbcindia.gov.in/WriteReadData/l892s/57479351National%20Multisec…)
• Employer Led Model for Tuberculosis Prevention and Care, CTD, MoH&FW
(https://tbcindia.gov.in/WriteReadData/Reach%20ELM%20Operational%20Manua…)
• Operational Guidelines for Employer Led Model, Department of AIDS Control
(http://naco.gov.in/sites/default/files/Operationa_Guidelines_ELM.PDF)
• Corporate TB pledge: https://www.corporatetbpledge.org/