C: Programme Formulation
P Mercenier & J O'Rourke: Maharashtra Med J 1965, 12, 569-73.

Tuberculosis Control Programme in the cities should be a component of the National Programme which ensures that the patients diagnosed anywhere should be treated in their own villages through a smooth transfer and efficient referral system. With this objective analysis of a large scale work done in Delhi Tuberculosis Centre (Annual Report 1962-63) and Lady Willingdon TB Demonstration & Training Centre, Bangalore in 1961 was made to identify the role of State TB clinics in the National Control Programme. The following observations were made: (i) Case-finding activity can be easily carried out as seen in Bangalore city. 17100 (47.5%) smear positive patients were diagnosed during 61-63 from the estimated prevalence of 3600. (ii) It was further observed from both New Delhi & Bangalore TB programmes that they have the heavy burden on their curative services leading to constant flow of rural patients to the city TB clinics. This will deprive the legitimate development of the rural health institutions in carrying out the TB control activities and decrease the efficiency of urban clinics. (iii) From both epidemiological and sociological point of view it is important to provide tuberculosis services in the rural areas to avoid the heavy burden on the urban clinics providing curative services. (iv) Existing facilities for tuberculosis services and beds are adequate if proper co operation and coordination inside and outside city is maintained. (v) Within cities similar coordination and uniformity is maintained through central case index system. (vi) The services and anti TB drugs are provided free of cost. (vii) Treatment of bacteriologically confirmed cases, recording and defaulter retrieval are more necessary than hospital beds and mass Case-finding. (viii) BCG vaccination has to be pursued intensively within the city and elsewhere in the country. House to house vaccination, neonatal vaccination in the hospitals should be attempted.