All these sectors are involved in RNTCP activities like training,  research,  diagnostic facilities, DOT centers etc to scale up the services under RNTCP.

Medical College involvement - Present Status

• All the 40 Medical Colleges in the state are involved in RNTCP
• Medical Colleges with DMC cum DOT center – 40
• Medical Colleges with DOT center -40

Mechanism under RNTCP for effective Medical college involvement:
Involvement of medical colleges in the RNTCP is a high priority. Continuing success of RNTCP requires involvement of all large providers like medical colleges. Under RNTCP Medical Colleges play important roles in service delivery, advocacy, training and operational research. A National Task Force (NTF) and five zonal task forces (ZTF) have been formed for their effective involvement in RNTCP. Within each zone, nominated medical colleges have been given the responsibility to function as nodal centres. All states which have medical colleges have formed State Task Forces (STF). In each medical college, there should be a Core Committee to arrange for training and oversee the functioning of RNTCP in their respective institutions.
The NTF comprises of representatives from 7 nodal medical colleges, CTD, TRC, NTI, LRS and WHO. It has a Chairman who is selected on rotational basis from amongst the 7 nodal medical colleges. DDG(TB) is the member-secretary of the NTF. The main task of NTF is to provide leadership and advocacy, coordination, undertake monitoring, lead operational research and support policy development on issues related to effective involvement of medical colleges in RNTCP.
The ZTF has a representative from the nodal centre as Chairman, member secretary is the STO of the State where nodal centre is located and the members include representatives of the State Task forces within the zone (1 medical college per State) and STOs of the States within the zone.
The STF has a representative from a medical college in the State as Chairman, member secretary is the STO of the State and the members include representatives of each of the Medical colleges of the State, on rotation basis if required.
A Medical College Core is formed in each Medical college including least 4 members, with representatives from department of medicine, chest medicine, microbiology and community medicine. Coordination of TB control activities is done by District TB Officer (DTO). Following paragraphs detail the functions of the NTF, ZTF, STF, Deans/Directors and medical college core committee etc:
Functions of National Task Force (NTF)
1. Ensure establishment of Zonal Task Force (ZTF)
2. Provide leadership and advocacy for RNTCP
3. Formulate policy regarding medical colleges involvement in RNTCP for presentation to CTD for approval.
4. Coordinate between NTF and CTD, NTF and ZTF
5. Monitor activities of the ZTF and State Task Force (STF) through yearly review meetings
6. Facilitate in availability of funds for NTF, ZTF and STF activities
Functions of Zonal Task Force (ZTF)
1. Ensure that State Task Force (STF) are formed in all States of the respective zone
2. Compile and update the list of Medical Colleges with their RNTCP implementation status in the zone.
3. Organize ZTF meetings to review progress and draw up annual action plans
4. Ensure RNTCP training of ZTF members
5. Organize zonal level CMEs/Seminars/workshops and other academic activities for promotion of RNTCP in medical colleges and the private sector at least once a year
6. Facilitate in operational research by medical colleges
7. Field visits / attend meetings of STF, workshops etc. All States to be visited at least once every quarter. Field visits to the medical colleges to supervise and monitor implementation of RNTCP should be conducted jointly by members of ZTF and STF in coordination with the STO.
8. Disseminate information about RNTCP to medical colleges.
Functions of State Task Force (STF)
1. Ensure establishment of DMC cum DOT centres in all Medical Colleges located in the districts of the respective state.
2. Disseminate information about RNTCP to medical colleges.
3. Help organize training for core committee members of individual medical colleges
4. Visit every Medical College at least twice a year to supervise and monitor implementation of RNTCP in coordination with the STO and DTO.
5. Organize State level CMEs/Seminars/workshops and other academic activities for promotion of RNTCP in Medical Colleges and the private sector at least twice a year.
6. Hold STF meetings to review RNTCP progress / performance of medical colleges in the State.
7. Define priorities for operational research based on the national and zonal workshop. Review research proposals and facilitate in conduction of research by medical colleges.
Functions Medical College core committee
1. Establish DMC cum DOT centre in all medical college hospitals, even if the DTC is within the same premises of the medical college.
2. Organize sensitization / workshops / trainings for faculty members / PGs / UGs /Interns / paramedical staff, etc.
3. Ensure that teaching on TB/RNTCP form part of curriculum for PG students/ Residents / Interns / UG students. Teaching should include practical training through visits to DOTS centres as well as classes/lectures taken by departments of Medicine, TB & Chest Medicine, Microbiology, PSM etc.
4. Coordination between various departments so that patients get the services in respect of their TB problem under one roof.
5. Coordinate with the district TB programme for participation in the quality assurance network of sputum microscopy, referral for treatment network, management of complicated cases of TB, and submission of monthly PHI report.
6. Undertake operational research for RNTCP on the priority areas defined by the STF for the State. Encourage research on TB by faculty members as well as by students for their thesis, etc.
7. Undertake advocacy for the programme by publishing articles on TB, newsletters, giving radio / TV talks, etc.
8. Hold monthly meeting of the core committee to review performance of the DMC cum DOT centre in the hospital.
9. Submit a monthly PHI report to the DTO.
10. Submit a compiled quarterly report of the MC cum DOT centre to the STF.
11. Participate in RNTCP related activities carried out by the state/district whenever requested.
Roles of STO/DTO in strengthening involvement of medical college hospitals in the RNTCP
1. Identify all major hospitals to be involved in the RNTCP as a TU/DMC/DOT referral centre as appropriate. Prioritise those with heavy OPD attendance.
2. Coordinate with the Core Committee of the medical college to conduct sensitization workshops/training on RNTCP for faculty members where the same has not been done.
3. Coordinate with the Core Committee of the medical college to organise RNTCP training of Medical officers, Laboratory Technician and DOT providers and other staff as required.
4. Provide binocular microscopes if available wherever required and upgrade the laboratory for the RNTCP designated microscopy centres. Laboratory consumables, forms and registers required should be provided by the District TB Centre.
5. Provide 100% requirement of RNTCP drugs
6. Ensure supervision of the laboratory and treatment services and coordinate in providing feedback of the diagnosed TB patients referred to other PHIs within district/state.
7. Provide technical inputs, guidance and supervision as per programme.
8. Where required, hire additional contractual staff to implement and coordinate the activities of RNTCP in Medical Colleges/Hospitals as per provisions under the programme.
Roles of the Deans/Directors of the Medical College hospitals in RNTCP
1. Provide space for an RNTCP Designated Microscopy Centre and a DOT centre in the hospital.
2. Identify one senior faculty member, preferably from the Dept. of TB & Chest or from Medicine as a nodal person for RNTCP activities.
3. Designate 1 Laboratory Technician for sputum microscopy and 1 health worker as DOT provider (treatment observer). It should be ensured that the designated staff has sufficient time for RNTCP work.
4. Issue directions to the major OPDs of the college/hospital to refer all patients with cough of 3 weeks or more to the DMC of the hospital.
5. Ensure availability of faculty members for sensitization regarding the RNTCP and for training of key staff like the MO in charge of the MC, LT, DOT providers.
6. Issue instructions to all the doctors to follow RNTCP diagnostic algorithm for all patients and standardized treatment policies as per the RNTCP. Proper referral of patients who reside outside the district in which Medical College is situated should be undertaken with the help of the staff in the hospital DMC.
7. Stop procurement of anti-TB drugs except for those patients who are critically ill and require in-door and specialized treatment. RNTCP drugs should be used for majority of TB patients
8. Agree to supervision by RNTCP staff and submit reports as required under the RNTCP