Nikshay Poshan Yojana utilization among tuberculosis patients in a tertiary care hospital in New Delhi
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20250621Keywords:
Directly observed treatment short course, Drug sensitive tuberculosis, Nikshay Poshan YojanaAbstract
Background: Tuberculosis is causing significant mortality Globally and in India. Treating malnutrition and alleviation of poverty are only effective ways to reduce the number of deaths due to tuberculosis. Nikshay Poshan Yojana (NPY) was launched in India in 2018 to provide nutritional support for patients with TB. This study assessed the utilisation of Nikshay Poshan Yojana among TB patients.
Methods: We conducted a descriptive cross-sectional study in a DOTS centre attached to a tertiary care hospital in New Delhi. Patients with drug-sensitive TB in the continuation phase were enrolled in the study. A self-designed pre-tested questionnaire was used to assess the coverage of the scheme, the knowledge and attitude of patients towards the scheme, and the barriers to utilisation of the incentive received. Data was analysed in proportions, mean and median wherever applicable.
Results: A total of 42 participants were enrolled in the study. Over half (59.5%) of patients had extrapulmonary TB, while 17 (40.5%) had pulmonary TB. Almost all patients (92.9%) were enrolled in the scheme (NPY). The first instalment was received by 35 (95%) patients as per the Nikshay portal and by 19 (47.5%) as per patients’ interviews. The median (IQR) time to receipt of the first instalment to the patient’s bank account from the date of treatment initiation as per the Nikshay portal was 4.1 (2-5.8) months. All patients were aware of the procedure of enrolment. Barriers to utilisation of NPY by TB patients were unawareness regarding the purpose of the scheme, unawareness about the receipt of instalments, lack of need to receive monetary support (35.7%) and bank account-related issues (7.1%).
Conclusions: Coverage for Nikshay Poshan was high but there was a disparity between the patient's interview and Nikshay portal data at some points. Awareness of the purpose of the scheme was low and needed intervention. Communication between DOTS provider and patient needs to increase.
Metrics
References
World Health Organization. Global tuberculosis report, 2023. Available at: https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2023. Accessed 01 December 2024.
World Health Organisation. The END TB Strategy, 2015. Available at: https://www.who.int/teams/global-tuberculosis-programme/the-end-tb-strategy. Accessed 01 December 2024.
Central TB Division. Ministry of Health and Family Welfare. India TB Report, 2023. Available at: https://tbcindia.mohfw.gov.in/2023/06/06/india-tb-report-2023/. Accessed 01 December 2024.
Bhargava A, Chatterjee M, Jain Y, Chatterjee B, Kataria A, Bhargava M, et al. Nutritional Status of Adult Patients with Pulmonary Tuberculosis in Rural Central India and Its Association with Mortality. PloS one. 2013;8(10):e77979. DOI: https://doi.org/10.1371/journal.pone.0077979
Ministry of Health and Family Welfare G of I. Gazette notification for DBT with NIKSHAY. New Delhi, India, 2017. Available at: https://TBcindia.gov.in/showfile.php?lid=3304. Accessed 30 October 2022.
Singh SP, Khokhar A, Gupta NK. Enrolment under of Nikshay Poshan Yojana among tuberculosis patients in a tertiary care hospital of Delhi. Ind J Tubercul. 2022;69(4):546-51. DOI: https://doi.org/10.1016/j.ijtb.2021.08.032
Chandra A, Kumar R, Kant S, Krishnan A. Costs of TB care incurred by adult patients with newly diagnosed drug-sensitive TB in Ballabgarh Block in Northern India. Transact Royal Soci Trop Medi Hyg. 2021;116(1):63-9. DOI: https://doi.org/10.1093/trstmh/trab060
Begum J, Neelima Y, Ali SI, Pattnaik S, Sharma D. Utilisation of nutritional support scheme among the patients of tuberculosis: A myth or a truth. J Fam Med Prim Care 2020;9(12):6109-6114. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1229_20
Patel BH, Jeyashree K, Chinnakali P, Vijayageetha M, Mehta KG, Modi B, et al. Cash transfer scheme for people with tuberculosis treated by the National TB Programme in Western India: a mixed methods study. BMJ open. 2019;9(12):e033158. DOI: https://doi.org/10.1136/bmjopen-2019-033158
Nirgude AS, Kumar AMV, Collins T, Naik PR, Parmar M, Tao L, et al. 'I am on treatment since 5 months but I have not received any money': coverage, delays and implementation challenges of 'Direct Benefit Transfer' for tuberculosis patients - a mixed-methods study from South India. Glob Health Action. 2019;12(1):1633725. DOI: https://doi.org/10.1080/16549716.2019.1633725
Kumar R, Khayyam KU, Singla N, Anand T, Nagaraja SB, Sagili KD, et al. Nikshay Poshan Yojana (NPY) for tuberculosis patients: Early implementation challenges in Delhi, India. Ind J Tubercul. 2020;67(2):231-7. DOI: https://doi.org/10.1016/j.ijtb.2020.02.006
State Election Commission, NCT of Delhi. Delimitation, 2022. Available at: https://sec.delhi.gov.in/sec/delimitation-2022. Accessed 07 June 2024.