Nikshay Poshan Yojana utilization among tuberculosis patients in a tertiary care hospital in New Delhi

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.