Innovation to Strengthen Social Protection and Nutritional Support within a Tuberculosis Control Program : Evidence and Emerging Lessons from India

Eliminating tuberculosis (TB) as a public health concern is not only about saving lives, but also equally an important economic investment. In line with this, the Government of India (GOI) has a target of elimination of TB by 2025, through innovative measures, including providing multiple direct benefit transfer (DBT) schemes for patients and providers and using technology to strengthen service delivery. The GOI has implemented DBT for more than 300 social protection schemes, including eleven in the health sector. This policy brief explicitly focuses on the DBT scheme for TB patients. The four supporting DBT schemes for TB include: (i) under the Ni-Kshay Poshan Yojana (NPY), monetary incentives are provided for each notified TB patient until the completion of the treatment; (ii) Ni-Kshay monetary incentives are provided for the private providers and informants for the notification and until completion of the treatment of patients treated by private providers; (iii) transport monetary incentive for TB patients in notified tribal areas; and (iv) honorarium to treatment supporters who may be individual volunteers or non-profit organizations providing support to TB patients. This policy brief documents and distills lessons from NPY's early implementation of DBT in three states and six districts in India