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

Abstract

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.

Ni-kshay Poshan Yojana : receipt and utilization among persons with TB notified under the National TB Elimination Program in India, 2022

“…Though received late, 88.8% of the PwTB reported fully utilising the NPY benefit for their nutrition. Similar to our results, earlier studies reported, 76% [ 34 ] and 64% [ 24 ] of the PwTB had utilised the benefits for their nutritional requirements. The possible reasons for the remaining 10.2% of PwTB not using the benefit for nutritional requirements could be the delay in receipt, lack of awareness about the purpose of the NPY benefit, and prioritising other household needs over their nutrition.…”

“…Earlier studies have also reported that PwTB who had not received the instalment were more likely to experience unfavourable treatment outcome such as loss of follow-up and death during treatment [ 15 , 39 ]. Timely receipt of instalment enables the PwTB to procure additional nutrition [ 24 ] in the form of protein-rich foods, supplements which improve tolerance to medication [ 40 ] and reduce loss to follow-up [ 15 ]. The better nutrition boosts immunity, also influences the pharmacodynamics and pharmacokinetics of the anti-TB drugs improving bacteriological clearance [ 41 ].…”

“…One of the DBT initiatives is the ‘Ni-kshay Poshan Yojana’ (NPY), which was launched in 1 April 2018 [ 21 , 22 ] to provide nutritional support to all PwTB. Under NPY, all notified PwTB receive INR 500 per month (~US$7) throughout the period of ATT [ 23 , 24 ]. The benefit is credited directly to the bank or post office accounts of the PwTB [ 20 ] through Public Financial Management System (PFMS).…”