PRD for "STOP TB Application"- Community Screening Application

Document Revision History

Date	Version Number	Author	Approved By	Document change reference
		Dr Vanshika	Madhav	Initial draft
23.4.2026		Dr Vanshika	Madhav	Beneficiary Registration, TB screening, Vitals after feedback and several updates done
24.4.2026		Dr Vanshika	Madhav	Mock ups and flow diagram
		Dr Vanshika	Madhav	TPT screening module in progress

1. Document Overview

This document defines the functional requirements for the TB Screening mobile application developed under the TB Mukt Janjati Abhiyan: A community-driven TB elimination initiative targeting tribal populations across India. The application is purpose-built for field use by community volunteers in tribal areas where connectivity, literacy, and device familiarity may be limited.
The application should be simple to use, comprehensive and must work in low/no-connectivity environments.

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TB Screening modules	Enlisted in the PRD
Nikshay integration	External dependency
Integration of AI enabled hand- held chest Xray (digital)	External technical dependency
Lab testing device integration (sputum testing)- Truenat	External technical dependency
Hypertension and Random Blood Sugar testing (NCDGeneral NCD Screening module (Vital check-up)	Enlisted in the PRD
General OPD module	Enlisted in the PRD
Dashboard indicators	Enlisted in the PRD. Can be added more as per the requirement.
Pre Camp Work Plan Preparation Module	Subjected to requirement

1.4 Workflow

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2. Login Page

Login Page Name should be "NikshayMitra STOP TB" Application".
It must be followed by "NikshayMitraSTOP TB" Logo.
It must have both Online and Offline capabilities. ("Offline capabilities feature to exchange data between Mobile devices in a closed environment in real-time without internet")For online- Mobile number OTP based with 5 min expiry. For offline- 4-digit PIN which can be set during the first login.
It must have Multilingual Feature with English, Hindi and other Indian languages enabled, and must be configurable to accommodate all the Indian languages as and when required in future.

UI Field Name	Field Type	Options	Validations
"STOP TB"

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Application

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Logo	<Placeholder>		Image Modified
Please Select your Language	Radio Button	English Hindi	The fields and labels must populate in the language selected by the user
Username	Textbox
Password	Textbox
Remember Me	Checkbox		When 'Remember Me' checkbox is selected, next time directly allow user to login just by authenticating with fingerprint
Powered by Piramal Foundation	Text		Display on the bottom of the screen

2.1 Landing page

This page must have a hamburger icon (side drawer), "NikshayMitraSTOP TB" text, sync button, and "Language Translation" button on the Top row.
There should be a hamburger icon on the left side, which on clicking should have following details-

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Landing page should have 2 tabs- "Home" and "Dashboard".
In home tab floating "Registration" button on the right bottom corner.

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2.2 Home Page- "Home tab"

Should contain four three modules/ Cards- All Beneficiaries, TB screening, NCD screening, Referrals written on these cards.
On clicking "All Beneficiaries" card- open the "Beneficiary module" form documented below (section 2.2.1) for registering the beneficiary by giving the floating "Registration" button in the right corner.
On clicking "TB" card- open the "Tuberculosis module" (section 2.2.2). On clicking the next screen, it should have 3 cards titled "TB Screening", "Suspected TB cases" and ""Confirmed TB cases".
On clicking

"NCD" card-

open the

"

Non Communicable Disease (NCD) module" (section 2.2.3). On clicking the next screen, it should have 3 cards titled "NCD eligible list", "NCD priority list", and "NCD non-eligible list".

On clicking "Referrals"- The next screen should have 4 cards titled"AI Cough Assessment", "Digital Chest X-ray", "Sputum CollectionTruenat", "Liquid Culture"NAAT". These , "Health and Wellness Centre". These cards will enlist patients for a particular type of testing. Beneficiaries who are pregnant will be shown directly in "Truenat". All beneficiaries who are not pregnant are shown in "Digital Chest X-ray" and if any abnormality is detected on chest x-ray then that beneficiary is further referred for Truenat testing. All beneficiaries who have high blood pressure and high random blood sugar will be shown in "Health and Wellness Centre" card.

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2.2.1 Module - Beneficiary Registration

On clicking Registration button the user will be navigated to Beneficiary Registration Page
Show a pop up for Consent form "I have been explained, the purpose for which the information and findings is being collected from me, in a language I understand and I give my consent to collect the information and findings on my personal health profile."
This page has "All Beneficiaries" Text displayed on top with "Home" Icon on the right corner to Navigate to Home page in the 1st row
The card below should be visible after the registration of beneficiary.
If the beneficiary does not have ABHA ID, give one clickable button on the ABHA ID area of the card to initiate ABHA ID generation.

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Photo of the beneficiary	Name	Beneficiary ID
	Age (Years)	Village Name-
	Phone Number	ABHA ID (ABHA registration)- Clickable

Field Name	Field Type	Value/ Options	Validation/ Logic
Date of registration			Should be auto selected and updated when the volunteer logs in the application to do the screening.
Beneficiary ID (AMRIT ID)			Unique ID auto generated by the system
Photo	Camera	Optional	Should have face detection/ Facial recognition Camera should identify & capture human face but not any objects Show an Alert if Photo is not captured, just as reminder but Not Mandatory Alert: "Do you like to Take Photo", Yes or No If "Yes", open Camera; If "No", go to next
First Name	Text		Mandatory Speech to text feature
Last Name			Optional Speech to text feature
Beneficiary Status	Radio Button	· Alive · Death	· Enable only in the “Edit” Beneficiary screen · Auto-populate, if ‘Death’ is reported from any module

(eg: Tuberculosis)

· Default value is “Alive” · If “Death” is selected, enable below four fields and mark it mandatory- 1. Date of Death 2. Time of Death 3. Reason for Death 4. Place of Death or Other Place of Death
Date of Death	Date picker		· Enable if “Beneficiary status”= “Death” · Mandatory if enabled · By default, date is null · Not greater than Today’s Date · Accept ‘Date of Death’ after date of registration · Auto-populate, if ‘Death’ is reported from any module (eg: Tuberculosis)
Time of Death	Time picker		· Show only if above value is “Death” · Optional
Reason for Death (Type of Death)		· Maternal Death · Natural Death · Accident · Infectious Disease · Animal Bite Death · Suicide · Undetermined	· Enable if “Beneficiary status”= “Death” · Mandatory if enabled Show only above value is “Death” and it is Mandatory If Gender is Female, and Age is 15-49 Years, show “Maternal Death” in dropdown list otherwise hide
Place of Death		Home Subcenter PHC CHC District Hospital Medical College Hospital Private Hospital In Transit Other Place of Death	· Enable if “Beneficiary status”= “Death” · Mandatory if enabled If ‘Place of Death’ is selected as “Other Place of Death” then enable below field “Other Place of Death” and is mandatory.
Other Place of Death	Textbox		Enable if “Beneficiary status”= “Death” Mandatory if enabled
Age	Number (Years)		Mandatory If DOB unknown, approximate age allowed
Date of Birth	Date Picker		Populate automatically if entered Auto Calculate 'Date of Birth' based on the Age entered
Gender	Dropdown	Male Female Transgender Prefer not to say	Mandatory

Speech to text feature


Mobile Number	Number

Optional

Mandatory
Speech to text feature

Village/ Hamlet

Whose mobile number	dropdown
Marital Status

radio button

dropdown

Unmarried
Married
Divorced
Separated
Widow
Widower

Conditionally Mandatory if gender= female, age>= 15 years and single selection allowed
Not Applicable for Newborn/ Child/ Adolescent (Age 0 to less than 15 Years)

editable

optional

Based on the 'Gender' values in this dropdown list should change as follows:
In case of 'Gender' = "Female" show "Widow" and hide "Widower"
In case of 'Gender' = "Male" show "Widower" and hide "Widow"

Husband's/ Wife's

Are you Pregnant	radio button	Yes No	Enabled if "Marital status"= "Married" Mandatory if enabled If ""Are you pregnant"= "Yes", then referral to Truenat and not digital chest x-ray.
Husband's/ Wife's Name	Textbox		Input method: Speech to Text feature Optional Should be enabled if "Marital status"= Married Based on the Gender show label name as: 'Husband's' or 'Wife's Name' Accept alphabets only Character limit 50 All letter should be in caps
Father's Name	Textbox		Input method: Speech to Text feature Optional Accept alphabets only Character limit 50 All letter should be in caps
Mother's Name	Textbox		Input method: Speech to Text feature Optional Accept alphabets only Character limit 50 All letter should be in caps
Community	radio button	General SC ST OBC OC Not Given	should be editable optional
Religion	radio button	Hindu Muslim Christian Sikhism Buddhism Jainism Parsi Other Not disclosed	should be editable optional
Economic Status	radio button	APL BPL Don't know	optional
Type of Residential area	radio button	Rural Urban Tribal Tea Garden Other	optional
Other Type of Residential area	Textbox		Enable if other is selected above Allow Alphanumeric Character and special Characters Character limit 100
Occupation	free text		Default value is unknown

Cancel

Optional

Button

Village/ Hamlet

Yes

dropdown

No

If cancel is selected,

	Single selection allowed This must auto fetch the dropdown values (Villages) with which the user is aligned.
Sub Centre	dropdown		Single selection
Capture Geolocation			Capture current location details (latitude, longitude, address)
Cancel	Button	Yes No	If cancel is selected, a pop up message "Are you Sure?" with options "Yes" and "No" will come. If selected "yes" navigate back to home page If selected "no" then do not erase the patient health data and let the page remain open so it can be submitted by volunteer as sometime by mistake cancel button is clicked.

Capture Geolocation

Capture current location details (latitude, longitude, address)


Submit			On clicking this, it must display the Pop up msg "Patient Registered successfully" This must store the data of the patient and display the required fields over the Beneficiary card.

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Continue next to "TB Screening" Screen

2.2.2 Module- Tuberculosis

2.2.2.a TB Screening

In this section show all beneficiaries irrespective of any age group and gender.

This module should open in continuation after beneficiary registration.

* If "Yes" is selected for any one of the questions below with "*" ; "Refer for "digital chest x-ray" or "Collecting the sputum sample".
If "Yes" is selected for any one of the questions below with "" ; "Advise tracing and screening of all family members".
TB Screening
Date	Calendar Date Picker	Is Mandatory	Default value Today's Date Not greater than Today's Date Accept date greater or equal to Date of beneficiary registration should not allow to update in edit or once submitted
Coughing More than 2 weeks *	radio button	Yes No	Mandatory
Blood in Sputum *	radio button	Yes No	Mandatory
Fever > 2 weeks *	radio button	Yes No	Mandatory
Rise of fever in evening*	radio button	Yes No	Mandatory
Loss of Appetite*	radio button	Yes No	Mandatory
Loss of Weight *	radio button	Yes No	Mandatory
Night Sweats *	radio button	Yes No	Mandatory
History of TB *	radio button	Yes No	Mandatory
Are you currently taking Anti TB drugs **	radio button	Yes No	Mandatory
Anyone in Family Currently Suffering from TB **	radio button	Yes No	Mandatory
Submit	Button		Continue next to "General Examination"

General Examination

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Fields	Validation
Anthropometric (Optional)
Weight (Kgs)	-
Height (cms)	-
BMI=Weight/(Height/100) ²	Should be auto calculated if height and weight details are entered
Vitals (Optional)
Temperature (Degree Fahrenheit)	Also give free textbox for manual entry. Give predefined options (Normal range= 97-99 F) a) 97.5 b) 98.5 c) 99.5 d)>= 100 If option d)>= 100 is chosen, show alert "Refer to Health and Wellness Centre" and show such beneficiaries in "Referral" card in Home
Pulse Rate (beats per minute)	Also give free textbox for manual entry. Give predefined options (Normal range= 60-90 BPM) a) less than 60 b) 60-70 c) 70-80 d) More than 90 If "less than 60" or "more than 90" option is chosen, show alert "Refer to Health and Wellness Centre" and show such beneficiaries in "Referral" card in Home
Systolic Blood Pressure (mmHg)	Give space to write measurement If >=140 mmHg (High BP) or <90 mmHg (low BP) show alert "Refer to Health and Wellness Centre" and show such beneficiaries in "Referral" card in Home
Diastolic Blood Pressure (mmHg)	Give space to write measurement If >=90 mmHg (High BP) or <60 mmHg (low BP) show alert "Refer to Health and Wellness Centre" and show such beneficiaries in "Referral" card in Home
Random Blood sugar (mg/dl)	Give space to write measurement If >=100 mm/dl show alert "Refer to Health and Wellness Centre" and show such beneficiaries in "Referral" card in Home
Skip Button
Submit Button	Continue next to "Diagnostics" Screen

Diagnostics

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All Beneficiaries List- All beneficiaries Should be visible in "All beneficiaries" and "TB Screening" modules.
NCD Eligible List: All Beneficiaries both Male and Female whose age > = 30 years and excluding Pregnant Women; with CBAC Form access.
NCD Priority List: Beneficiary age > = 30 years and CBAC assessment score is greater than 4
NCD Non-Eligible List: Beneficiary age > = 30 years and CBAC assessment score is less or equals to 4

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2.2.2.a TB Screening

In this section show all beneficiaries irrespective of any age group and gender.

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TB Screening

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* If "Yes" is selected for any one of the questions below with "*" auto select "yes" for "Referral Required."

Show these beneficiaries to 'Suspected TB cases' section

Show these beneficiaries to 'Referral list module in the Home' section as per the test selected ("AI Cough Assessment", "Digital Chest X-ray", "Sputum Collection", "NAAT")

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** If "Yes" is selected for any one of the questions below with "**" auto select "yes" for "Referral Required."

Show these beneficiaries to 'Suspected TB cases' section

Show these beneficiaries to 'Referral list module in the Home' section as per the test selected ("AI Cough Assessment", "Digital Chest X-ray", "Sputum Collection", "NAAT")

Screen all the family members and contacts of the beneficiary

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Date

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Calendar
Date Picker

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Is Mandatory

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Default value Today's Date

Not greater than Today's Date

Accept date greater or equal to Date of beneficiary registration

should not allow to update in edit or once submitted

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Symptomatic Screening

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Coughing More than 2 weeks *

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radio button

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Yes
No

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Mandatory

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Blood in Sputum *

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radio button

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Yes
No

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Mandatory

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Fever > 2 weeks *

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radio button

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Yes
No

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Mandatory

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Rise of fever in evening*

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radio button

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Yes
No

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Mandatory

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Loss of Appetite*

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radio button

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Yes
No

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Mandatory

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Loss of Weight *

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radio button

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Yes
No

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Mandatory

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Night Sweats *

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radio button

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Yes
No

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Mandatory

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History of TB *

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radio button

...

Yes
No

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Mandatory

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Are you currently taking Anti TB drugs **

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radio button

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Yes
No

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Mandatory

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Anyone in Family Currently Suffering from TB **

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radio button

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Yes
No

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Mandatory

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Asymptomatic Screening

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Age more than 60

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radio button

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Yes
No

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Mandatory
Should automatically get selected based on age from the beneficiary registration.

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Diabetic

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radio button

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Yes
No

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Mandatory

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Tobacco user

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radio button

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Yes
No

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Mandatory

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Contact with TB patient on treatment

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radio button

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Yes
No

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Mandatory

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Referral Required

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radio button

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Yes
No

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"Yes" Should be auto selected if any of the "*" or "**" field is "yes"
If "Yes" is selected, show these beneficiaries in Suspected TB module

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Referral for

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AI Cough Assessment",
"Digital Chest X-ray",
"Sputum Collection",
"NAAT

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Multiple option selection possible.
Mandatory if "Referral required"= "Yes"

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Capture Geolocation

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Capture current location details (latitude, longitude, address)

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Submit

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Button

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Diagnostics
Is Digital chest x-ray conducted		Yes No	To be enabled for everyone except "Are you pregnant" = "Yes"
Digital Chest X-Ray Test Result		Positive Negative	Enable only if "Is Digital Chest X-ray conducted"=“Yes” If "Positive" is selected, move this case to Confirmed TB cases module and also enable sputum test fields for further testing.
Is Sputum sample collected		Yes No	To be enabled in the following conditions- If "History of TB" = "Yes" If "Are you pregnant= yes" If "Are you currently taking Anti TB drugs" = "yes"
Recommended for Truenat test		Yes No	To be enabled if "Are you pregnant= yes"
Truenat test result	radio button	Positive Negative	Enable only if "Is Truenat conducted"=“Yes” Option to edit/ select after submission of the form If "Positive" is selected, move this case to Confirmed TB cases module.
Recommended for liquid culture test		Yes No	To be enabled only if "History of TB" = "Yes", "Currently on Anti-TB drugs" = "Yes"
Liquid Culture test result	radio button	Positive Negative	If "Positive" is selected, move this case to Confirmed TB cases module. Option to edit/ select after submission of the form

2.2.2.b Suspected TB cases
This section should contain all beneficiaries If "referral required "= "Yes"beneficiaries in the following scenario-

Scenario 1- If not a single symptom is presented in a beneficiary but chest x-ray is positive, show the case here.

Scenario 2- If any symptom or symptoms reported "yes" then show the case here even if chest x-ray/ Truenat is negative.

Name of data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
Date	Calendar Date Picker	Mandatory	Default value Today's Date Not greater than Today's Date Accept date greater or equal to Date of beneficiary registration should not allow to update in edit or once submitted
Name	Textbox		Auto fill from Beneficiary details Show: First Name + Last Name Read only
Age	Textbox		Auto fill from Beneficiary details Read only
Gender	Textbox		Auto fill from Beneficiary details Read only
Is Sputum sample collected?	radio button	Yes No	To be enabled if "Referral for" = "Sputum Collection" Mandatory if enabled If “Yes” is selected enable ‘Nikshay Id’

Nikshay ID	Textbox		Sputum sample submitted at	radio button	MC DH CHC PHC HWC	Enable if "Yes" is selected for 'Is Sputum sample collected. Enable if "Yes" is selected for "Digital Chest X-ray conducted"	Enable if "Yes" is selected for 'Is Sputum sample collected? HWC= Health and Wellness Centre, PHC= Primary Health Centre, CHC= Community Health Centre, DH= District hospital, MC= Medical College	Sputum Test result	radio button	Positive Negative	Enable if "Yes" is selected for 'Is Sputum sample collected?' If positive, move this case to Confirmed TB cases module. "NAT conducted"
Is Digital Chest X-ray conducted		Yes No	To be enabled if "Referral for" = "Digital Chest X-ray"If “Yes” is selected enable ‘Nikshay Id’ auto selected "Yes" if "Is Digital chest x-ray conducted = yes"
Digital Chest X-Ray Test Result		Clinically Diagnosed TB Positive TB Not suspected Negative	Enable only if "Digital Chest X-ray conducted"=“Yes” If "Clinically diagnosed TB Auto select the result if "Digital Chest X-Ray Test Result" is already captured in the diagnostics screen. Also give option to do manual selection If "Positive" is selected, move this case to Confirmed TB cases module and also enable sputum test fields for further testing.
AI Cough Assessment conductedSputum Test		Yes	No To be enabled if "Referral for" = "AI Cough Assessment"
AI Cough Assessment result		Positive Negative	Enable if "Yes" is selected for 'AI Cough Assessment conducted?' If positive, move this case to Confirmed TB cases module.
NAAT conducted		Yes No	To be enabled if "Referral for" = "NAAT"
NAAT result		Positive Negative	Enable if "Yes" is selected for "NAAT conducted?" If positive, move this case to Confirmed TB cases module.
Nikshay ID	Textbox		Enable if "Yes" is selected for 'Is Sputum sample collected. Enable if "Yes" is selected for "Digital Chest X-ray conducted" Enable if "Yes" is selected for "AI Cough Assessment conducted" Enable if "Yes" is selected for "NAAT conducted"
Type of suspected TB case	Radio button	New case of TB Previously treated TB case DR-TB case	Mandatory
Reason for suspected TB case	Dropdown	Treatment failure TB Relapse/ Recurring symptoms Contact with DR-TB case Treatment after LFU (Lost to Follow-up) Other	Enable this field only if “Type of TB case” is “Previously treated TB case” or “DR-TB case”
Other	textbox		Mandatory if enabled To be enabled if “Reason for suspected TB case” = “Other”
in the following conditions- a) If "Digital Chest X-Ray Test Result"= "Positive" b) If "History of TB" = "Yes" c) If "Are you pregnant= yes" d) If "Are you currently taking Anti TB drugs" = "yes"
Is Sputum sample collected?	radio button	Yes No	To be auto selected "Yes" if "Is Sputum sample collected= yes"
Sputum Sample submitted at	dropdown	DMC DH CHC PHC SC	Optional
Is Truenat conducted	radio button	Yes No	To be auto selected "Yes" if "Is Truenat conducted = yes" and "Sputum Sample Collected" = "Yes" or if "Digital Chest X-Ray Test Result" = "Positive"
Truenat test result	radio button	Positive Negative	Enable only if "Is Truenat conducted"=“Yes” Option to edit/ select after submission of the form Auto select the result if "Truenat test result" is already captured in the diagnostics screen. Also give option to do manual selection If "Positive" is selected, move this case to Confirmed TB cases module.
Is Liquid culture conducted	radio button	Yes No	To be auto selected "Yes" if "Is liquid culture conducted = yes" and "Sputum Sample Collected" = "Yes" To be enabled only if "History of TB" = "Yes", "Currently on Anti-TB drugs" = "Yes"
Liquid Culture test result	radio button	Positive Negative	Auto select the result if "Liquid Culture test result" is already captured in the diagnostics screen. Also give option to do manual selection If "Positive" is selected,	Has the diagnosis of DR-TB been confirmed?	Radio button	Yes No	Enable this field only if “type of suspected TB case”= “Previously treated TB case” or “DR-TB case” Default value is “No” If “Yes” is selected then move this case to Confirmed TB cases module. Option to edit/ select after submission of the form
Capture Geolocation			Capture current location details (latitude, longitude, address)
Submit	Button

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Name of data field	Field Type	Value/ Options	Validation/ logic/ condition
Name of the contact	Text Box
Age of the contact
Gender	Dropdown	Male Female Transgender Prefer not to say	Mandatory Speech to text feature
Mobile Number	Number		Optional Speech to text feature
TPT (TB Preventive Treatment) Screening Status		Not Started Pending Completed	Mandatory Single selection allowed Default option is Pending
Referral Facility for screening		HWC PHC CHC District Hospital	Mandatory. Single selection allowed From here it can directly go to submit option as the contact first needs to get tested and confirmed if he/ she have to take TPT.
Screening done at the referral facility		Yes No	Mandatory
Is it confirmed TB case		Yes No	If yes, move the card to confirmed TB list. If no, continue ahead.
Are you advised to take (TPT)		Yes No	If yes, continue with the next field. If no, then directly go to submit option.
TPT initiated		Yes No	Mandatory Enable next fields if selected Yes.
TPT start date	Date picker	=<Today’s date	Mandatory if enabled Cannot be future date Cannot be before the date of screening
Treatment duration of TPT		1 Month 3 month 6 month
Expected completion date	date	Auto calculated	Auto calculated= TPT start date + regimen duration Non editable
Follow up visit number	Numeric	Auto increment (1-6)	Non editable Automatic calculation by system
Follow up visit date	Date picker	=<Today’s date	Mandatory if enabled Cannot be future date Cannot be before the TPT start date
TPT completion status		Completed Incomplete Lost to follow up Developed active TB during TPT Died during TPT other	Mandatory If selected “Completed” then enable date of completion field If selected “developed active TB during TPT” then redirect volunteer to create new case record for active TB and close the TPT case. If selected “died during TPT” then enable date of death field and cause of death field
Other	Free text
Date of completion	Date picker	=<Today’s date	Mandatory if enabled Cannot be future date
Date of death	Date picker		To be enabled if “TPT completion status” = Died during TPT Mandatory if enabled
Cause of death	Free text		To be enabled if “TPT completion status” = Died during TPT Mandatory if enabled
Capture Geolocation			Capture current location details (latitude, longitude, address)
Submit

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Module - Referrals

This module should contain the list of names/ cases referred to health facilities.

2.3

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Home Page- Dashboard

Flip feature between "Home" and "Dashboard".
Put a field for filter with 2 selection options-

Time Period- based on "today and previous months" This filter should show all the data cards in the dashboard pertaining to the time period selected. (eg: today, Jan, Feb etc)
Village Name- Dropdown options to be populated with names of village/ hamlets

Field Name	Field Type	Options	Validation
Filter/ Selection option	Dropdown	The Dropdown Values are Today January February March April May June July August September October November December	If this filter is selected, then show all the values of the dashboard indicators pertaining to the time period selected.
Filter/ Selection option	Dropdown	Village/ Hamlet names to be put here	If this filter is selected, then show all the values of the dashboard indicators pertaining to the particular village selected.
Total TB screenings Total Positives/ Negatives Male- Positives/ Negatives Female- Positives/ Negatives Children (<15 yrs)- Positives/ Negatives Others		Card must be yellow in colour	It must auto populate based on the filter selected. Total number should be shown in bold with sex aggregated data- male, female, Children, others
Total TB suspected cases Total Positives/ Negatives Male- Positives/ Negatives Female- Positives/ Negatives Children (<15 yrs)- Positives/ Negatives Others		Card must be yellow in colour	It must auto populate based on the filter selected. Total number should be shown in bold with sex aggregated data- male, female, Children, others
Total TB confirmed cases Total Positives/ Negatives Male- Positives/ Negatives Female- Positives/ Negatives Children (<15 yrs)- Positives/ Negatives Others		Card must be yellow in colour	It must auto populate based on the filter selected. Total number should be shown in bold with sex aggregated data- male, female, Children, others
Total Digital Chest X-Rays conducted Total Positives/ Negatives Male- Positive/ Negative Female- Positive/ Negative Children (5-15 years)- Positives/ Negatives Others Age>= 60 years- Positives/ Negatives			It must auto populate based on the filter selected. Total number should be shown in bold with sex aggregated data- male, female, Children, others
Total Sputum collection conducted Total- Positives/ Negatives Male- Positives/ Negatives Female- Positives/ Negatives Children (<15 yrs)- Positives/ Negatives Others Age>= 60 years- Positives/ Negatives			It must auto populate based on the filter selected. Total number should be shown in bold with sex aggregated data- male, female, Children, others
Total Truenat tests conducted Male- Positives/ Negatives Female- Positives/ Negatives Children (<15 yrs)- Positives/ Negatives Others Age>= 60 years- Positives/ Negatives

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Note: The common questions in CBAC Part B1 and TB screening form, if either of the form is filled and submitted first, then responses in the other form should be automatically selected.

Community Based Assessment Checklist (CBAC) Form

NCD (Non-Communicable Diseases) Eligible List:
Show all Beneficiary both Male and Female whose age > = 30 years and excluding Pregnant Women.
And this CBAC Form is applicable to screen these Beneficiaries.
This CBAC Form, assessment check should be done yearly once, Maintain the history of submitted CBAC Form for viewing, year wise

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Name of Data Field

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Field Type

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Value/ Options

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Validation/ Logic/ Condition

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CBAC Form

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Date

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Calendar
Date Picker

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Is Mandatory

Choose the date from the calendar

Format: dd-mm-yyyy

Default value Today's Date

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Not greater than Today's Date

Accept date greater or equal to Date of beneficiary registration

should not allow to update in edit or once submitted

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Name

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Textbox

...

Auto fill from Beneficiary details
Show: First Name + Last Name
Read only

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Age

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Textbox

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Auto fill from Beneficiary details
Read only

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Sex

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Textbox

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Auto fill from Beneficiary details
Read only

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Part A: Risk Assessment

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What is your Age? (in Age)

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radio button

...

Is Mandatory
Choose:

30 – 39

40 - 49

50 – 59

60 and Above

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Auto-populate Age from 'Beneficiary' registration:
Score Logic:
"Score" is a variable whose Default Score value is "0".
If 30 <= Age <= 39 then display "1"If 40 <= Age <= 49 then display "2"If 50 <= Age <= 59 then display "3"If 60 <= Age then display "4"

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Do you smoke or consume smokeless products such as gutka or khaini

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radio button

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Is Mandatory
Choose:

Never

Used to consume in the past sometime now

Daily

...

Score Logic:
If option selected "Never" then display "0"If option selected "Used to consume in the past sometime now" then display "1"If option selected = "Daily" then display "2"

...

Do you consume alcohol daily

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Score Logic:
If "No" then display "0" or If "Yes" then display "1"

...

Measurement of Waist (in cm)

...

radio button

...

Is Mandatory
Condition:
Show values in the radio button based on Gender:
For Male:
Choose:

90 cm or less

91 - 100 cm

More than 100 cm

For Female:
Choose:

80 cm or less

81 - 90 cm

More than 90 cm

...

Score Logic:
If "Gender" = "Female" and "Waist length" <= 80 then display "0"If "Gender" = "Female" and 81 <= "Waist length" <= 90 then display "1"If "Gender" = "Female" and "Waist length" > 90 then display "2"If "Gender" = "Male" and "Waist length" <= 90 then display "0"If "Gender" = "Male" and 91 <= "Waist length" <= 100 then display "1"If "Gender" = "Male" and "Waist length" > 100 then display "2"

...

Do you under take any physical activity for minimum of 150 minutes in a week

...

radio button

...

Is Mandatory
Choose:

At least 150 min in a week

Less than 150 min in a week

...

Score Logic:
If "At least 150 min in a week" then display "0" or
If "Less than 150 min in a week" then display "1"

...

Do you have any family history (any one of your parents or siblings) of high BP / Diabetes / Heart Disease

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Score Logic:
If "No" then display "0" or If "Yes" then display "2"

...

Total Score

...

Label

...

Total Score Formula:
Sum of all above score.
Based on the "Total Score" display a message in pop-up as show below:

If score is > 4
"Refer to NCD screening day / VHSND/ HWC for NCD screening (Priority)"

If score is < = 4
"Refer to NCD screening day / VHSND/ HWC for NCD screening (Less Priority)"

...

Part B1: Early Detection
Ask if Patient has any of these symptoms

...

If "Yes" is selected below then display a pop-up message, "Suspected NCD case, please visit nearest HWC or call 104."

...

* If "Yes" is selected for any one of the questions below with "*" then show a pop-up message "Refer to MO and collect the Sputum sample"

...

** If "Yes" is selected for any one of the questions below with "**" then show a pop-up message "Refer to MO or inform ANM/MPW to tracing of all family members"

...

Shortness of Breath

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Coughing More than 2 weeks *

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Blood in Sputum *

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Fever > 2 weeks *

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Loss of Weight *

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Night Sweats *

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Are you currently taking Anti TB drugs **

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Anyone in Family Currently Suffering from TB **

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

History of TB *

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Recurrent of ulceration on Palm or Sole

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Recurrent of tingling on Palm or Sole

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Cloudy or Blurred Vision

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Difficulty in reading

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Pain in eyes lasting for more than weeks

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Redness in eyes for more than weeks

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Difficulty in Hearing

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

History of Fits

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Difficulty in Opening Mouth

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Ulcers in Mouth Not Healed in 2 weeks

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Growth in Mouth Not Healed in 2 weeks

...

radio button

...

Is Mandatory
Choose:

...

Any white or red Patch in Mouth Not Healed in 2 weeks

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Pain while chewing

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Any change in Tone of Voice

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Any hypo pigmented patches or discolour lesions with loss of sensation

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Any thickened skin

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Any nodules skin

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Any Patch or Discoloration on Skin

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Recurrent numbness on palm or sole

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Clawing of fingers in hand or feet

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Tingling and numbness in hand / or feet

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Inability to close eye lid

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Difficulty in Holding Objects in hands or Fingers

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Weakness in feet that cause difficulty in walking

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Part B2: Women Only

...

Lump in the Breast

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Bleeding after Menopause

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

If option selected is "Yes" then display "Inform ASHA Facilitator."

...

Blood Stained Discharge from the Nipple

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Bleeding after intercourse

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

Part B3: Elderly Specific

...

Feeling unsteady while standing or walking

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

If option selected is "Yes" then display "Send the patient to MOIC of nearest health center for treatment "

...

Suffering from any physical disability that restrict movement

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

If option selected is "Yes" then display "Send the patient to MOIC of nearest health center for treatment "

...

Needing help from others to perform every day activities such as eating, getting dressed, grooming, bathing, walking, or using the toilets

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

If option selected is "Yes" then display "Send the patient to MOIC of nearest health center for treatment "

...

Forgetting names of yours, near ones or your own home address

...

radio button

...

Is Mandatory
Choose:

Yes

No

...

If option selected is "Yes" then display "Send the patient to MOIC of nearest health center for treatment "

...

Part C: Risk factor for COPD

...

Type of Fuel Used for Cooking

...

radio button

...

Choose:

Wood, Crop Residue, Gobar Gas, Coal, Kerosene oil, LPG

...

Occupational Exposure

...

radio button

...

Choose:

Crop residue burning / burning of garbage – leaves/working in industries with smoke, gas and dust exposure such as brick kilns and glass factories etc.

...

Part D: PHQ2

...

Over the last two weeks bothered by the following problem?

...

Little interest or pleasure in doing things?

...

radio button

...

Choose:

Not at all

several days

more than half the days

nearly every day

...

Score Logic:
If option selected is "Not at all" then display "0"If option selected is "several days" then display "1"If option selected is "more than half the days" then display "2"If option selected is "nearly every day" then display "3"

...

Feeling down, depressed or hopeless?

...

radio button

...

Choose:

Not at all

several days

more than half the days

nearly every day

...

Score Logic:
If option selected is "Not at all" then display "0"If option selected is "several days" then display "1"If option selected is "more than half the days" then display "2"If option selected is "nearly every day" then display "3"

...

Total Score

...

Label

...

Total Score formula: Sum of all the above score
If "Total Score" is more than "3" then display pop up message "Refer the person to MOIC for treatment."

...

Capture Geolocation

...

Capture current location details (latitude, longitude, address)

...

Submit

...

2.2.4 Module - Referrals

This module should contain the list of names/ cases referred to health facilities.

2.3 Home Page- Dashboard

Flip feature between "Home" and "Dashboard".
Put a field for filter with 2 selection options-

Time Period- based on "today and previous months" This filter should show all the data cards in the dashboard pertaining to the time period selected. (eg: today, Jan, Feb etc)
Village Name- Dropdown options to be populated with names of village/ hamlets

Module cards should be placed below the filter selection option.

Field Name

Field Type

Options

Validation

Filter/ Selection option

Dropdown

The Dropdown Values are

Today
January
February
March
April
May
June
July
August
September
October
November
December

If this filter is selected, then show all the values of the dashboard indicators pertaining to the time period selected.

Filter/ Selection option

Dropdown

Village/ Hamlet names to be put here

If this filter is selected, then show all the values of the dashboard indicators pertaining to the particular village selected.

Total TB screenings
Male
Female
Children (<15 yrs)
OthersCard must be yellow in colour

	It must auto populate based on the filter selected. Total number should be shown in bold with sex aggregated data- male, female, Children, others
Total

TB suspected cases

sputum samples sent for liquid culture

Male- Positives/ Negatives
Female- Positives/ Negatives
Children (<15 yrs)- Positives/ Negatives
Others

Card must be yellow in colour
Male

Age>= 60 years- Positives/ Negatives			It must auto populate based on the filter selected. Total number should be shown in bold with sex aggregated data- male, female, Children, others
Total

TB confirmed cases

cases referred to Health and Wellness Centres

Male

Female
Children (<15 yrs)
Others

Card must be yellow in colour

It

Age>= 60 years		It must auto populate based on the filter selected. Total number should be shown in bold with sex aggregated data- male, female, Children, others
NIKSHAY IDs	Card must be yellow in colour	Total number of NIKSHAY IDs made in the selected time period or Village
ABHA IDs	Card must be yellow in colour	Total number of ABHA IDs made in the selected time period or Village

Space shortcuts

Page tree

Versions Compared

Old Version 59

New Version Current

Key

PRD for "STOP TB Application"- Community Screening Application

1. Document Overview

1.4 Workflow

2. Login Page

2.1 Landing page

2.2 Home Page- "Home tab"

2.2.1 Module - Beneficiary Registration

2.2.2 Module- Tuberculosis

Module - Referrals

2.3

Home Page- Dashboard

2.2.4 Module - Referrals

2.3 Home Page- Dashboard

Space shortcuts

Page tree

Page History

Versions Compared

Old Version 59

New Version Current

Key

PRD for "STOP TB Application"- Community Screening Application

1. Document Overview

1.4 Workflow

2. Login Page

2.1 Landing page

2.2 Home Page- "Home tab"

2.2.1 Module - Beneficiary Registration

2.2.2 Module- Tuberculosis

Module - Referrals

2.3

Home Page- Dashboard

2.2.4 Module - Referrals

2.3 Home Page- Dashboard