Direct Benefit Transfer Scheme for Tuberculosis Patients – Performance Challenges observed by the Providers and Patients

Published

2022-03-31

DOI:

https://doi.org/10.47203/IJCH.2022.v34i01.014

Keywords:

Tuberculosis, Poverty, Government incentives, Patients, Providers

Dimensions Badge

Issue

Section

Original Article

Authors

  • Manisha Nagpal Sri Guru Ram Das Institute of Medical Sciences and Research, Sri Amritsar https://orcid.org/0000-0003-0293-3536
  • Harjot Singh Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab
  • Sarthak Chawla Kasturba Medical College, Manipal, Karnataka
  • Niharika Khunger Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab
  • Naresh Chawla District TB Officer, Amritsar
  • Priyanka Devgun Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, Amritsar

Abstract

Introduction: Government of India launched an Aadhar-linked Direct Benefit Transfer (DBT) scheme from 1st April, 2018. Under this scheme, all notified TB patients would receive Rs 500 per month (~US$7) throughout the course of their treatment for nutritional support. Aim and Objectives: To determine the challenges faced by the health providers and patients in the implementation of Direct Benefit Transfer scheme. Methods: This was a mixed method cross-sectional study conducted on all public and private TB patients notified during the year 2019 under RNTCP (now NTEP) in district Amritsar, Punjab. Quantitative data about the availability and validation of bank accounts was obtained from the Nikshay portal after having permission from the District TB Officer. Qualitative data was obtained from the focus group discussion and in-depth interviews with the involved staff members (17) and patients (20) registered in Tuberculin units of Amritsar. Results: From the Nikshay reports, it was observed that there was significant difference between the public and private sector and between rural and urban areas. Focus group discussion was done with the TB Health Visitor (TBHV) and Senior TB supervisors (STS) and asked about the hurdles they faced. Items were identified and tabulated. In-depth interviews were conducted on 20 patients, 10 each from public and private sector respectively. Data collected was transcribed and arranged as per the themes or questions and then the information was recorded under those sub-headings. Conclusion: The major challenges observed by the providers were lack of support from the private sector, lack of awareness among people, technical issues and more work burden. Patients mostly mentioned about confidentiality issues, lack of awareness, social stigma of the disease, less amount and long and complex process.

How to Cite

1.
Nagpal M, Singh H, Chawla S, Khunger N, Chawla N, Devgun P. Direct Benefit Transfer Scheme for Tuberculosis Patients – Performance Challenges observed by the Providers and Patients. Indian J Community Health [Internet]. 2022 Mar. 31 [cited 2022 Nov. 27];34(1):72 - 77. Available from: https://iapsmupuk.org/journal/index.php/IJCH/article/view/2242

Downloads

Download data is not yet available.

Author Biography

Manisha Nagpal, Sri Guru Ram Das Institute of Medical Sciences and Research, Sri Amritsar

Professor

References

WHO. India TB Report 2020. Central TB Division. Chapter 2: 11. Available at: https://tbcindia.gov.in/WriteReadData/l892s/India%20TB%20Report%202020.pdf. (Accessed on 20.03.2022).

Ministry of Health & Family Welfare, Government of India, New Delhi. National TB elimination programme central TB division. Training modules (1-4) for programme managers & medical officers. 2020 p. 147.

World Health Organization. The end TB strategy. Geneva, Switzerland; 2015 p. 1–30. Available from: http://www.who.int/tb/strategy/End_TB_Strategy.pdf?ua=1 . (Accessed on 20.03.2022).

Gopalan SS, Mutasa R, Friedman J, Das A. Health sector demand-side financial incentives in low- and middle-income countries: a systematic review on demand- and Supply-side effects. Soc Sci Med 2014; 100:72–83.

https://doi.org/10.1016/j.socscimed.2013.10.030

Ministry of Health & Family Welfare, Government of India, New Delhi. Direct Benefit Transfer Manual for National Tuberculosis Elimination Programme. 2020. Chapter1 p.10. Available at: https://tbcindia.gov.in/WriteReadData/l892s/23294204DBTManualForNTEP.pdf. (Accessed on 20.03.2022)

Yadav S, Atif M, Rawal G. Nikshay Poshan Yojana- Another step to eliminate TB from India. Indian Journal of Immunology and Respiratory Medicine 2018;3(2):28-9.

https://doi.org/10.18231/2581-4222.2018.0010

Rohit A, Kumar AM, Thekkur P, Shastri SG, Kumar RB, Nirgude AS, et al. Does provision of cash incentive to HIV-infected tuberculosis patients improve the treatment success in programme settings? A cohort study from South India. J Family Med Prim Care 2020; 9(8):3955-3964. PMID: 33110793

https://doi.org/10.4103/jfmpc.jfmpc_474_20

Ministry of Health & Family Welfare, Government of India, New Delhi. National TB elimination programme central TB division. Training modules (5-9) for programme managers & medical officers. 2020 p. 49-50. Available at: https://tbcindia.gov.in/WriteReadData/NTEPTrainingModules5to9.pdf. (Accessed on 20.03.2022)

MOHFW, GOI. NIKSHAY. Frequently asked questions on DBT. Available at: https://nikshayeverwell.blob.core.windows.net/training-materials-nikshay/Nikshay%20Documents/Nikshay-DBT-%20PFMS%20FAQs.pdf. (Accessed on 20.03.2022)

User Manual. Public financial management system Direct Beneficiary Transfer (DBT). Available at: https://welfarepension.lsgkerala.gov.in/DBTDocs/DBTusermanual.pdf. (Accessed on 20.03.2022).

Digital: A revolution in the making in India. September 2016: 12. Digital: A revolution in the making in India | Deloitte India | Technology, Media & Telecommunications. Available at: https://www2.deloitte.com/content/dam/Deloitte/in/Documents/technology-media telecommunications/in-tmt-digital-revolution-in-making-cii-noexp.pdf . (Accessed on 20.03.2022)

https://doi.org/10.1002/9781119421900.ch2

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 Family Med Prim Care 2020;9(12):6109-14.

https://doi.org/10.4103/jfmpc.jfmpc_1229_20

Dumpeti S, Jothula KY, Naidu NK. Awareness about tuberculosis and RNTCP services among rural people in Nalgonda district, Telangana. J Family Med Prim Care 2020;30(9):3281-7.

https://doi.org/10.4103/jfmpc.jfmpc_415_20

Muniyandi M, Thomas B E, Karikalan N, Kannan T, Rajendran K, Saravanan B, Vohra V, Okorosobo T, Lonnroth K, Tripathy SP. Association of Tuberculosis with Household Catastrophic Expenditure in South India JAMA Network Open. 2020;3(2):e1920973. doi:10.1001/jamanetworkopen.2019.20973.

https://doi.org/10.1001/jamanetworkopen.2019.20973

Ilangovan K and Nagaraja SB. Addressing poverty in India’s Revised National Tuberculosis Control Programme: are we failing to harness the opportunities? Current science 2019; 117(2):182-4.

Sumalata C, Rajesham A, Subba Rao V, Sahithi, Chakravarthy K, Rao J, et al. Study of Barriers in Obtaining Benefits of Nikshay Poshana Yojana in Notified TB patients in Five Districts of Telangana State. J Infect Dis Res 2020; 3(2):111-8.

Torrens AW, Rasella D, Boccia D, Ethel MLN, Joilda NS, Olson ZD, et al. Effectiveness of a conditional cash transfer programme on TB cure rate: A retrospective cohort study in Brazil. Trans R Soc Trop Med Hyg 2016; 110(3):199-206.

https://doi.org/10.1093/trstmh/trw011

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:e033158.

https://doi.org/10.1136/bmjopen-2019-033158

Nirgude AS, Kumar AMV, Collins T, 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:10.1080/16549716.2019.1633725

https://doi.org/10.1080/16549716.2019.1633725

Kumar R, Khayyam KU, Singla N, et al. Nikshay Poshan Yojana (NPY) for tuberculosis patients: Early implementation challenges in Delhi, India. Indian J Tuberc. 2020;67(2):231-237. doi:10.1016/j.ijtb.2020.02.006.

https://doi.org/10.1016/j.ijtb.2020.02.006