Nikshay Poshan Yojana (NPY) for tuberculosis patients: Early implementation challenges in Delhi, India

Kumar, Rajesh; Khayyam, Khalid Umer; Singla, Neeta; Anand, Tanu; Nagaraja, Sharath Burugina; Sagili, Karuna D.; Sarin, Rohit

doi:10.1016/j.ijtb.2020.02.006

Cited by 24 publications

(15 citation statements)

References 8 publications

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“…Although NPY is a notable initiative to encourage improvement in health status of TB patients, studies have recorded many implementation challenges such as lack of bank account and Aadhaar card specially among the migrant population in cities or marginalized communities, delays in processing, and technological challenges. [20][21][22] To lay emphasis on ending TB in India by the year 2025 which is 5 years ahead of the global target, RNTCP in the year 2020 was renamed as Nation Tuberculosis Elimination Program (NTEP).…”

Section: Tb Interventions In Indiamentioning

confidence: 99%

Improving tuberculosis treatment success rate through nutrition supplements and counselling: Findings from a pilot intervention in India

Singh¹,

Siddhanta²,

Goswami³

2021

Clinical Epidemiology and Global Health

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In India, the estimated incidence of tuberculosis cases for the year 2018 was 2.69 million. According to WHO, it was responsible for 32 deaths/100,000 population. India also faces a dual burden of tuberculosis and malnutrition which represents an alarming situation. With this backdrop, the current study tries to assess the change in weight and BMI among active TB patients in selected intervention and control site. The study also measures the treatment success rate of the patients. This pilot study was conducted among 282 active TB patients in Dhar district of Madhya Pradesh state of Central India and the results were compared with a control site. The intervention included, providing the identified TB patients with monthly nutrition food baskets, nutrition counselling, linking to treatment and promoting its adherence, community mobilization and management and linkages to government schemes. The data for this study was taken from the project Management Information System (MIS).The results indicate that the mean weight for both male and female TB patients increased significantly during each food distribution episode. At the beginning of the intervention the mean weight of the TB patient was 42.9 kg which increased gradually to 49.3 kgs at the end of the intervention. Treatment success rate in the intervention group was recorded as 95% whereas in the control group it was 83.5%.The study strongly confirms that the nutritional supplements and regular counselling can help TB patients gain weight and have greater treatment success rate.

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Section: Tb Interventions In Indiamentioning

confidence: 99%

Improving tuberculosis treatment success rate through nutrition supplements and counselling: Findings from a pilot intervention in India

Singh¹,

Siddhanta²,

Goswami³

2021

Clinical Epidemiology and Global Health

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“…In study conducted by Kumar et al, 52.6% of patients received incentives. 14 Study conducted by Begam et al showed that only 22% patients received incentive. 15 In our study, only the patients registered in December received incentive in 1 st month of treatment.…”

Section: Discussionmentioning

confidence: 99%

Utilization of Nikshay Poshan Yojna in tuberculosis patients in two tuberculosis units of North India

Sharma¹,

Raina²,

Sharma

2023

Int J Contemp Pediatr

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Background: Nikshay Poshan Yojana (NPY) was launched in 2018 aiming to provide nutritional incentive of INR 500 per month to all tuberculosis (TB) patients till they complete their treatment. Aim of present study is to determine the number (proportion) of patients being treated for tuberculosis who received the beneﬁts of NPY and to explore the ways incentives were utilized by the patients. Methods: This cross-sectional study was conducted in two tuberculosis units of North India from June 2022 to Dec 2022. All newly diagnosed TB patients registered and receiving treatment in these two Units were included in the study. Defaulters, relapse, failure and multidrug-resistant TB cases were excluded. Data was collected from Nikshay portal. All the patients were contacted telephonically to know whether the incentive was utilized for nutrition. Results: Total 189 patients were included in the study. All patients received benefit under NPY. But only 26 (13.7%) received incentive in scheduled time. Out of 189 patients 56 refused to give telephonic interview about the utilization of incentives. Out of 133 patients who gave interview 85 (64%) patients utilized incentive entirely for nutrition. Conclusions: Government should assure timely availability of funds so that patients can be benefitted timely particularly during initial months of their treatment. Also, there is a need of counselling of patients receiving treatment for tuberculosis about the importance of nutrition in their treatment so that they can utilize financial incentive for nutrition.

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“…Studies assessing the DBT in the initial months of the launch of the program in 2018, reported the coverage to be as low as 29%, 13 which increased to 53%-79% 14 , 23 , 32 in the next few months of rollout. The present study found 91% of the patients with TB receiving DBT during the study period of January-September 2019 suggesting an improvement in the cash transfer process in due course of time.…”

Section: Discussionmentioning

confidence: 99%

Does Direct Benefit Transfer Improve Outcomes Among People With Tuberculosis? – A Mixed-Methods Study on the Need for a Review of the Cash Transfer Policy in India

Dave

Rupani

2022

Int J Health Policy Manag

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Background: A direct benefit transfer (DBT) program was launched to address the dual epidemic of under-nutrition and tuberculosis (TB) in India. We conducted this study to determine whether non-receipt of DBT was associated with unfavorable treatment outcomes among patients with TB and to explore the perspectives of patients and program functionaries regarding the program. Methods: We conducted a retrospective cohort study among 426 patients with drug-sensitive pulmonary TB on treatment during January-September 2019 to determine the association between non-receipt of DBT and unfavorable treatment outcomes, which was followed by in-depth interviews of nine patients and eight program functionaries to explore their perspectives on challenges and suggestions regarding the DBT program. Multivariate logistic regression was applied to determine whether non-receipt of DBT was independently associated with unfavorable treatment outcomes, while the in-depth interviews were transcribed to describe them as codes and categories. Results: Among the 426 patients, nine percent of the patients did not receive DBT and 91% completed their treatment. Non-receipt of DBT was associated with a 5 (95% CI: 2-12) times higher odds of unfavorable treatment outcomes on multivariable analysis. Patients not owning a bank account was the primary challenge perceived by the program staff. The patients perceived the assistance under DBT to be insufficient to buy nutritious food throughout the course of treatment. The program functionaries as well as the patients suggested increasing the existing assistance under DBT along with the provision of a monthly nutritious food-kit. Conclusion: Direct benefit transfer improved the treatment completion rates among patients with TB in our setting. Provision of a monthly nutritious food-kit with an increase in the existing assistance under DBT might further improve the treatment outcomes. Future research should determine the long-term financial sustainability for ‘DBT plus food-kit’ vs. universal cash transfers in India.

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Nikshay Poshan Yojana (NPY) for tuberculosis patients: Early implementation challenges in Delhi, India

Cited by 24 publications

References 8 publications

Improving tuberculosis treatment success rate through nutrition supplements and counselling: Findings from a pilot intervention in India

Improving tuberculosis treatment success rate through nutrition supplements and counselling: Findings from a pilot intervention in India

Utilization of Nikshay Poshan Yojna in tuberculosis patients in two tuberculosis units of North India

Does Direct Benefit Transfer Improve Outcomes Among People With Tuberculosis? – A Mixed-Methods Study on the Need for a Review of the Cash Transfer Policy in India

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