<i>Ni-kshay Poshan Yojana</i> : receipt and utilization among persons with TB notified under the National TB Elimination Program in India, 2022
Kathiresan Jeyashree, Jeromie Wesley Vivian Thangaraj, Devika Shanmugasundaram, G. Sri Lakshmi Priya, Sumit Kumar Pandey, Venkateshprabhu Janagaraj, Prema Shanmugasundaram, R. Sabarinathan, Joshua Chadwick, Sivavallinathan Arunachalam, Rahul Sharma, Vaibhav Shah, Aniket Chowdhury, Swati Iyer, Raghuram Rao, Sanjay K. Mattoo, Manoj Murhekar, NPY Evaluation Group
Abstract
BACKGROUND: (NPY), a direct benefit transfer scheme under the National Tuberculosis Elimination Program (NTEP) in India, provides a monthly benefit of INR500 for nutritional support of persons with TB (PwTB). OBJECTIVES: To determine the proportion of PwTB receiving atleast one NPY instalment and pattern of utilisation; to ascertain factors associated with NPY non-receipt and association of NPY receipt with TB treatment outcome. METHODS: In our cross-sectional study, we used multi-stage sampling to select PwTB whose treatment outcome was declared between May 2022 and February 2023. A cluster-adjusted, generalized linear model was used to identify factors associated with the non-receipt of NPY and determine association between NPY receipt and TB treatment outcome. RESULTS: Among 3201 PwTB, 2888 (92.7%; 95% CI 89.8%, 94.8%) had received at least one NPY instalment, and 1903 (64.2%; 95% CI 58.9%, 69.2%) self-reported receipt of benefit. The median (IQR) time to receipt of first instalment was 105 (60,174) days. Non-receipt was significantly higher among PwTB from states with low TB score (aPR = 2.34; 95%CI 1.51, 3.62), who do not have bank account (aPR = 2.48; 95%CI 1.93, 3.19) and with unknown/missing diabetic status (aPR = 1.69; 95%CI 1.11, 2.55). Unfavorable treatment outcomes were associated with non-receipt of NPY (aPR 4.93; 95%CI 3.61,6.75) after adjusting for potential confounders. CONCLUSION: Majority of the PwTB received atleast one NPY instalment, but they experience significant delays. Most of the recipients utilised NPY for nutrition. Longitudinal follow-up studies are required to study the impact of NPY on treatment outcomes.