Public health experience has shown that undernutrition and TB form a vicious cycle. Poor nutritional status predisposes an individual to get infected by the disease, or have a dormant disease manifest clinically. TB leads to depletion of nutrient reserves and aggravation of undernutrition.
Optimum nutritional support to TB patients improves weight gain, adherence to therapy, muscle strength, quality of life, robust recovery and reduced mortality. Good nutrition also prevents relapse of the disease.
Direct cash benefits
With a sharper focus on the nutritional improvement among TB patients, the Union Health Ministry launched the Ni-kshay Poshan Yojana in 2018 as part of National TB Elimination Programme (NTEP) which provides direct cash benefit transfer of ₹500 per month to TB patients on treatment.
Large-scale country-wide health programmes such as smallpox and polio eradication became a success only through jan bhagidari (people’s participation). Community participation plays a key role in mass awareness, behaviour change, demand creation, clearing myths and convincing the reluctant to embrace services. The success of these health programmes reinforced our belief that a further augmentation of multi-sectoral approach involving community and institutional-stakeholder support in TB elimination is required. This can play a pivotal role in addressing the social and nutritional determinants, thereby contributing toward the attainment of national goal.
Jan bhagidari forms the core principle of the recently launched Pradhan Mantri TB Mukt Bharat Abhiyaan to provide additional support to TB patients.
The Ni-kshay mitras
Under this, Ni-kshay Mitras can adopt and care for TB patients. Ni-kshay Mitras are volunteers who could be individuals, NGOs, co-operative societies, corporates, and even political parties.
They commit to help the TB patients through nutritional support, nutritional supplements, additional investigations and vocational support.
This public health initiative has already shown good uptake. Within three months of its launch, more than 52,000 Ni-kshay Mitras have registered.
Helping a TB patient could avert ruinous downslide of a family due to wage loss. Humanitarian support from people could save the life of a TB patient.
(Vinod K. Paul is Member (Health), NITI Aayog and a Nikshay-Mitra. Views expressed are personal)
