Impact of the COVID-19 pandemic on implementation of national tuberculosis elimination programme (NTEP) in Goa: A mixed method study

• Author Details:   
• Frederick Satiro Vaz ^*
• Anish Ashok Shyadligeri
• Manish Gaunekar
• Manisha Kankonker
• Sudeep Ramdas Lokapure

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Background: The National Tuberculosis Elimination programme suffered major setback during the COVID-19 pandemic. The lockdown, restrictions and COVID scare severely affected programme implementation at the Peripheral Health Institution (PHI) level. This study quantified the impact of the COVID-19 Pandemic on implementation of NTEP in Goa, identified key challenges and key modifications by the Peripheral Health Institutions (PHIs) in Goa to address these challenges.
Materials and Methods: A mixed method study was conducted with prior approval of the Institutional Ethics Committee. In the quantitative component, NTEP programmatic indicators obtained from Nikshay portal were compared between pandemic (2020-21) and non-pandemic years (2018-19 & 2022-23). For the qualitative component, an open-ended questionnaire was used to collect narrative, descriptive in-depth information from NTEP nodal officers at Peripheral Health Institutions (PHI) on challenges faced and modifications or innovations implemented to alleviate the challenges. Quantitative data was analysed using R programming. For the qualitative data a descriptive thematic analysis was conducted and codes and themes were generated.
Results: There was a decrease in TB notification rates, notification achievement rates, Active Case Finding and an increase in TB death rates.  Sentiment analysis was predominantly negative. Thematic analysis identified staff shortages, challenges in TB testing/diagnosis, Challenges in active case findings, challenges in TB notifications and modification and innovations to alleviate challenges as the main themes.
Conclusion: COVID 19 pandemic severely disrupted the NTEP programme implementation. Resilience shown by PHIs to implement the NTEP despite the pandemic was a remarkable and an excellent case study.

Keywords: Tuberculosis, Programme, COVID-19, Impact, Mixed-methods