The Nikshay Poshan Yojana is a centrally sponsored scheme in India that provides a monthly incentive of ₹ 500 to registered TB patients. This scheme is designed to offer nutritional support and assist in the treatment of TB.
Overview
The Central TB Division of MoHFW has introduced an incentive scheme under the National Health Mission (NHM) for Tuberculosis (TB) patients currently undergoing treatment and registered on the NIKSHAY portal. All TB patients notified on or after April 1, 2018, as well as existing TB patients undergoing treatment, are eligible for incentives. Registration on the NIKSHAY portal is a prerequisite. The scheme operates under Direct Benefit Transfer and provides incentives in cash (preferably through Aadhaar-enabled bank accounts) or in-kind.
Nikshay Poshan Yojana – Objectives
The primary objectives of the Nikshay Poshan Yojana are as follows:
- The scheme aims to create a robust platform for treating Tuberculosis (TB) patients, with a focus on monitoring their progress and providing essential financial assistance to meet their nutritional requirements during the course of their treatment.
- Another significant goal of the Nikshay Poshan Yojana is to meticulously record and maintain data pertaining to TB patients. This data collection is carried out by various Central government departments.
- The scheme seeks to enable TB patients to access nutritious food during their treatment. This nutritional assistance is crucial, as it contributes to better treatment outcomes and reduces the mortality rate associated with TB.
- The Nikshay Poshan Yojana plays a pivotal role in improving the success rates of TB treatment and significantly decreasing the mortality rates associated with the disease.
Performance of Nikshay Poshan Yojana
The performance of the Nikshay Poshan Yojana has been evaluated based on data provided in the India TB Report released by the Union Health Ministry in March 2022.
- In 2021, out of the 21 lakh registered TB cases in the country, only 62.1% of patients received at least one payment through the scheme.
- Since its launch in April 2018 until February 2022, approximately 57.3 lakh registered TB patients have received incentives amounting to Rs 1,488 crore.
- Delhi, with the highest TB burden of 747 cases per lakh population, had only 30.2% of patients receiving at least one payment through Direct Benefit Transfer (DBT).
- Some of the other states with suboptimal performance include Punjab (31.8%), Jharkhand (40.1%), Maharashtra (46.6%), Bihar (45.8%), Rajasthan (55.9%) and Uttar Pradesh (58.7%).
- In the North East, Manipur (4.2%) and Meghalaya (23.7%) were identified as the poorest-performing states.
These statistics highlight several challenges in the scheme’s implementation and its role in addressing India’s significant TB health crisis.
Benefits of Nikshay Poshan Yojana
Under the Nikshay Poshan Yojana, TB patients can reap the following benefits:
- Financial Assistance: Each notified TB patient is entitled to receive financial aid of Rs 500 per month. This support continues for the duration of the patient’s anti-TB treatment.
- Extended Assistance: Even for existing patients, the scheme offers financial support starting from April 1, 2028, provided the remaining treatment duration is at least one month.
- Incentives for Full Months: The scheme ensures that patients receive incentives for complete months of treatment and omits partial months.
- Direct Benefit Transfer (DBT): The Nikshay Poshan Yojana operates under the DBT system, allowing states the flexibility to provide assistance in either cash or in-kind.
- In-Kind Assistance: States that previously provided in-kind support can continue to do so, but the total value of the food basket should not be less than Rs 500 per month. Any state opting for in-kind assistance must obtain prior approval from the Union Health Ministry, Government of India.
Eligibility for Nikshay Poshan Yojana
- Age Criteria: Children aged between 6 months to 6 years are eligible for the program.
- Undernourished Children: Eligibility extends to children with weights falling below -3 SD of the WHO Child Growth Standards.
- Designated States: Currently, the scheme is operational in 12 states and 2 union territories.
- Income Limit: The family income of the beneficiary should not exceed ₹1 lakh per annum.
The following categories of children also qualify for the Nikshay Poshan Yojana:
- Children from families where at least one child is undernourished
- Children from tribal families
- Children from Scheduled Caste (SC) and Scheduled Tribe (ST) families
About E-Nikshay Platform
The E-Nikshay platform, an integral component of the National Tuberculosis Elimination Program (NTEP), serves as a web portal for managing TB patients. This web-based patient management system is jointly developed and managed by the Central Tuberculosis Division (CTD) of the Union Health Ministry, the National Informatics Centre (NIC) and the World Health Organization (WHO).
Documents Required for the Nikshay Poshan Yojana
The required information includes:
- Personal bank account details
- Bank account details of the parent/guardian (if the TB patient does not have their own account)
- Aadhaar number
How Do I Register for the Nikshay Poshan Yojana?
Registering for the Nikshay Poshan Yojana is a simple process. TB patients can visit the public health center where they are receiving treatment and request registration under the Nikshay Poshan Yojana. For those who have not yet started treatment, they can register as new patients by visiting a nearby health facility.
How to Login Nikshay Poshan Yojana
Health facilities registered under the Nikshay Poshan Yojana can access their Nikshay account by following these steps:
- Visit the website www.nikshay.in and click on the login button.
- A login page will appear, prompting you to enter your username and password.
- Carefully enter your login details and click on the login button. Your Nikshay account will be displayed on the screen.
Alternatively, you can also download the Nikshay mobile app to log in to your account.
Nikshay Poshan Yojana Health Facility Registration
To register a new health facility under the Nikshay Poshan Yojana, follow the steps provided below for Nikshay Poshan Yojana registration:
- Visit the official website of Nikshay at www.nikshay.in.
- Click on the ‘New Health Facility Registration’ tab.
- The registration form for new health facilities will appear on the screen.
- Fill in the required information in the form, including facility level, state, district, TU, facility name, contact person’s name, contact person’s designation, government registration number, mobile number, email ID, and address.
- Select the available services at your health facility by checking the appropriate checkboxes (e.g., microscopy service, Trunat Lab, CBNAAT Lab, X-Ray, ICTC/FICTC/HIV Screening/Confirmation Facility, etc.).
- After providing all the details, verify the captcha and click on the ‘Continue’ button.
- Follow the on-screen instructions step by step to complete the registration process.
- Create a username and password for future logins.
- Once the registration is complete, you can log in to your account and verify that your health facility is now registered under the Nikshay Poshan Yojana.
Measures Under Nikshay Poshan Yojana
The government has implemented several measures to accelerate progress in the schemes, including:
- The Ministry has provided comprehensive guidance to the State/Union Territories (UTs) on the implementation of Direct Benefit Transfer (DBT). States/UTs have been given different payment options, such as using the Public Financial Management System (PFMS) or the Nikshay PFMS interface, to facilitate convenient payments.
- Flexibility has been introduced to provide benefits through the existing bank accounts of blood relatives. States have also been encouraged to facilitate the opening of zero balance accounts for TB patients, if necessary, under the Pradhan Mantri Jan Dhan Yojana (PMJDY) and Indian Postal Bank.
- A communication campaign has been launched to raise awareness and reduce stigma among communities, utilising mass media and mid-media channels.
- Strategies such as active case finding and contact tracing are being implemented to create awareness and enable early diagnosis of TB.
- Emphasis is placed on early diagnosis of all TB patients, ensuring prompt treatment with quality-assured drugs and treatment regimens. Patient support systems are in place to promote adherence to treatment.
Progress of Nikshay Poshan Yojana
As of January 1, 2019, out of a total of 20.94 lakh eligible beneficiaries, 8.78 lakh (42%) have availed the benefits offered by the scheme.
Start date: 1st April 2018
Funding
The scheme is a centrally sponsored initiative under the National Health Mission (NHM), and the financial norms of NHM regarding cost sharing apply to this scheme.
Area of Implementation
This scheme is being implemented throughout all the states and union territories in India.
Schedule of Payment
Every TB patient, whether notified in the public or private sector, must be registered on the Nikshay platform. To facilitate the process, the following arrangement will be implemented.
| Type of patient | New | Previously treated | Drug resistant TB |
| Usual treatment duration | 6 months | 8 months | 24 months (9-12 months for shorter regimens) |
| First incentive | Upon notification | Upon notification | Upon notification |
| Second incentive | @ 2 months after completion of intensive phase follow-up | @ 3 months after completion of intensive phase follow-up | @ 2 months after follow-up result |
| Third incentive | @ 6 months after completion of treatment follow-up result | @ 5 months of treatment | @ 4 months after follow-up result |
| Fourth incentive | — | @ 8 months after completion of treatment follow-up result | @ 6 months after follow-up result |
| Subsequent incentive | — | — | Every two months until the end of treatment |
| Exception handling | For each extension of treatment: ₹ 1000/- for two months or ₹ 500/- per month for one month | For each extension of treatment: ₹ 1000/- for two months or ₹ 500/- per month for one month | For each extension of treatment: ₹ 1000/- for two months or ₹ 500/- per month for one month |
Note:
(i) The payment schedule for patients already notified on Nikshay as of 01/04/2018 will remain unchanged. However, the payment for such patients will be made for the remaining duration of their treatment.
(ii) In the case of paediatric TB patients without bank accounts, the funds will be deposited in the accounts of their parents/guardians. The necessary details of the parents/guardians will be collected and entered into Nikshay against the patient’s records.
(iii) For patients who do not have a bank account or Aadhaar number, the healthcare staff will assist in opening a bank account for the patient, preferably under the Jan Dhan Yojna scheme. They will also facilitate the patient’s Aadhaar enrollment process.
Timelines/Periodicity
The creation of the beneficiary list and the disbursement of incentives will follow the following schedule:
|
Entry of each TB patient with Bank a/c and Aadhaar in Nikshay and its follow-up details |
Realtime (same day) |
| Preparation of beneficiary list (maker) | 1st of every month |
| Checking of beneficiary details (checker) | 3rd of every month |
| Approval of beneficiary list with details (approver) | 5th of every month |
| Processing of payments | 7th of every month |
About Nikshay Mitras
The Nikshay Mitra initiative is a community participation program which aims to eliminate Tuberculosis from India by 2025. One of its core objectives is to dispel the social stigma associated with TB.
- Nikshay Mitras commit to supporting TB patients for a minimum of one year and a maximum of three years.
- The initiative covers nutritional support, additional diagnostics, and vocational assistance, providing a holistic approach to TB patient care.
- Nikshay Mitras also serve as a means to leverage Corporate Social Responsibility (CSR) opportunities to enhance TB care and support in India.
What is Tuberculosis/TB?
Tuberculosis, often abbreviated as TB, is an infectious disease caused by the bacterium Mycobacterium tuberculosis. TB predominantly affects the lungs but can also impact other body parts, including the brain, spine and kidneys.
TB is primarily transmitted through the air when individuals with active TB cough, sneeze or speak. The bacteria can remain airborne for several hours, making it possible to contract TB without direct contact with an infected person.
Two Main Types of TB:
Latent TB Infection: Individuals with latent TB have been infected with the TB bacteria but do not exhibit any symptoms. They are not contagious and cannot spread the disease to others.
Active TB Disease: This form occurs when the TB bacteria begin to multiply, leading to symptoms making the person contagious. Active TB disease can be life-threatening if left untreated.
Status of TB in India
India carries the highest burden of TB worldwide. In 2020, India accounted for 28% of all TB cases and 25% of TB-related deaths globally. Although there has been a decline in TB incidence from 2015 to 2020, India is still working towards eliminating TB by 2025.
Challenges in TB Eradication in India:
- TB is associated with a social stigma that can deter individuals from seeking treatment.
- India faces a shortage of trained health workers, affecting the quality of healthcare services.
- The overall quality of healthcare services does not live up to the standards required to meet TB control goals.
Global and India’s Initiatives to Tackle TB
Various global and national initiatives have been established to address the TB challenge:
Global Initiatives
- End TB Strategy by WHO: This scheme aims to eliminate TB with a 90% reduction in new cases and a 95% reduction in TB-related deaths by 2035.
- FIND.TREAT.ALL #ENDTB: A collaborative initiative involving WHO, the Global Fund, The Stop TB Partnership, multiple countries and partners. Its goal is universal access to TB care and prevention.
- Global Tuberculosis Report: Released by WHO, this report provides essential insights into the global TB situation.
National Initiatives
- National Strategic Plan for TB Elimination (2017-25): A comprehensive plan to eliminate TB in India.
- TB Haarega Desh Jeetega Campaign: A national campaign to raise awareness and promote TB control.
- The Saksham Project: Launched by Tata Institute of Social Sciences (TISS), focusing on TB awareness and management.
India has also developed two vaccines for TB prevention, Mycobacterium Indicus Pranii and Vakzine Projekt Management (VPM-1002), both are currently in Phase 3 of their respective clinical trials.
FAQs
What is nutrition support for TB patients?
Research has shown that offering nutritional guidance to boost calorie intake along with providing supplements at the beginning of tuberculosis treatment resulted in a notable increase in body weight, overall lean mass, and physical functioning within six weeks.
What would be the mode of payment of the incentive?
The incentives can be provided in the form of cash, preferably through Aadhaar-enabled bank accounts, or in-kind.
How long will it take for name to reflect in the list of beneficiaries?
The beneficiary list is refreshed on the first day of each month.
Can I apply offline for the incentive?
You must complete the registration process on the NIKSHAY portal.
Is there any application fee?
No, there are no charges involved in the entire application process.
If a TB patient does not have a bank account, how will the incentive be provided to him?
In the case of paediatric TB patients who do not have bank accounts, the funds will be deposited into the accounts of their parents or guardians. The necessary details of the parents or guardians will be obtained and recorded in Nikshay against the patient's records.
