Scaling Intensified TB Screening in Tertiary Hospital Ecosystems

Bridging the Detection Gap through Intensified OPD/Inpatient Screening and AI-Driven Triage in Medical Colleges and District Hospitals

Medical colleges and district hospitals serve as a strong, yet underexplored, opportunity to identify missing cases, and integrate them into the care cascade. Medical colleges and district hospitals in India serve as tertiary referral hubs, witnessing massive daily footfalls in Outpatient Departments (OPDs) and high bed-occupancy in wards, contributing 15-20% of total notifications consistently for decades. Despite the high potential, medical colleges, for example, face massive pre-testing attrition, with 67% of symptomatic patients dropping out between the initial screening and the laboratory.

Current data also reveals a stark contrast in screening efficiency in both OPD and IPD settings. One study, using symptom-based screening in an OPD setting, showed a modest yield of 0.14% (NNS ≈ 737). However, targeted screening in IPD settings was highly effective, with a Number Needed to Screen (NNS) of only 48. Furthermore, targeted screening in diabetic clinics using the 4-symptom complex (cough, fever, weight loss, night sweats) yields an NNS between 65 and 147.

Along with the institutional fast-tracking, there is a compelling opportunity to deploy a robust Intensified Case Finding (ICF) operational model in OPD and Indoor facilities of the tertiary care settings. By transitioning from symptom-based screening to CAD-supported Chest X-Ray (CXR) screening, medical institutions can bypass the low sensitivity of symptom-only protocols and eliminate pre-testing attrition via dedicated "Fast-Track" channels.

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Section I: Contact Details

Organization name

Organization’s registered address

Applicant type:

Indian nongovernmental organization legally registered with FCRA.

International organization legally registered in India.

For-profit organization with mandatory registrations (PAN, TAN, GST number) and fulfilling all statutory criteria to receive foreign funds.

Foreign Contribution Regulation Act number

Goods and Services Tax number, if applicable.

Unique Entity Identifier (UEI) number, if available (guidance for creating a UEI number to be provided).

Name and title of point of contact for applicant.

Mailing address of point of contact.

Telephone number of point of contact.

Email address of point of contact.

Confirm email

Name and title of authorized signatory for grant.

Section II: Organizational Eligibility

Note your organization’s ability to meet the following:

The chief executive of the organization is willing to sign an agreement and receive funds from JSI, the Washington-based partner.

Yes

Describe your organization’s experience managing interventions aligned with the proposed scope of work or a similar scope of work.

(1,000-character limit)

Detail your organization’s established, active liaison capabilities with the Central TB Division (CTD), State Tuberculosis Centres (STC), and District TB Officers (DTOs), and effective collaboration with hospital leadership (Deans and Medical Superintendents).

(1,000-character limit)

Section III: Proposal Description

Provide your organization’s overall strategy for implementing the activities outlined in the scope of work, taking into account the proposed goal and results you’d like to achieve.

(3,000-character limit)

Describe your strategy for implementing intensified OPD/inpatient screening and triage in medical colleges and district hospitals. Detail the specific activities required to achieve universal screening (100%) in high-footfall tertiary facilities, establishing coordination within departments, scaling efficient workflows, and eliminating pre-testing attrition between screening and confirmatory Molecular Testing (NAAT) without disrupting routine admissions or standard OPD investigation panels.

(3,000-character limit)

Describe your organization's prior experience with health information systems, including work with state ICT teams (including Ni-kshay, if available), work on record integration or other digital interventions which may be relevant for this assignment.

(2,000-character limit)

Describe your organization's agency’s ability to prepare and execute a transition plan to sustain the majority of the project services within the existing public health system, including scale-up support for the states to replicate activities in other health facilities.

(2,000-character limit)

Describe your organization's track record of meeting timelines and the skills and experience of key organizational personnel proposed for this project.

(1,000-character limit)

Download RFA

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