A recent study conducted in Pune district sheds light on the challenges of implementing the Direct Benefit Transfer (DBT) scheme under the National Tuberculosis Elimination Programme (NTEP). The study, published in the Indian Journal of Tuberculosis, reveals encouraging coverage of 76.81% but also highlights significant hurdles faced by healthcare providers and beneficiaries ¹.
The DBT program, “Nikshay Poshan Yojana,” launched on April 1, 2018, aims to provide nutritional support to TB patients. Researchers from Dr DY Patil Medical College, Hospital & Research Centre, Pimpri-Chinchwad Municipal Corporation, and Pune’s district tuberculosis centre collaborated on the study, which involved 3,373 participants from August 2020 to September 2022.
The team included Prerna Verma, Sudhir Jadhav, S Johnson, Deepu Palal, Shweta Gangurde, Kavita Vishwakarma, Hetal Rathod, Gracia Sohkhlet, Vallari Jadav, Nirankush Borah, Sandeep Nallapu, Anil Mahajan and Suman Ray from Dr DY Patil Medical College, Hospital & Research Centre. The researchers also included Dr Anjali Dhone from Pimpri-Chinchwad Municipal Corporation (PCMC) and Dr Sanjay Darade from Pune’s district tuberculosis centre.
The study was conducted between August 2020 and September 2022 on 3,373 participants, and the findings of the same were published in Indian Journal of Tuberculosis last month.
As per the study, the overall coverage was determined to be 76.81%. Patients reported concerns about being scammed. While the DBT process was seen as lengthy and complex, software-related issues were also identified as major hurdles in implementing the scheme.
Key Challenges:
• Lack of Awareness and Scepticism: Beneficiaries reported limited knowledge and trust issues regarding the scheme.
• Bank-Related Issues: Absence of bank accounts or necessary documents hindered access.
• Financial Challenges: Job insecurity, loans, and financial instability affected beneficiaries.
• Physical Challenges: Weakness and health issues impacted daily life.
• Software-Related Issues: Technical glitches caused delays in receiving benefits.
Implementation Hurdles:
• Lengthy and complex DBT process
• Software-related issues
• Scams and fraudulent activities
Dr. Sanjay Darade emphasized these challenges, underscoring the need for improved awareness, streamlined processes, and enhanced support for TB patients.
The study’s findings align with existing research on DBT programs. For instance, a study published in the International Journal of Health Policy and Management highlights the positive impact of DBT on treatment outcomes among TB patients. However, it also notes challenges, such as delayed payments and insufficient assistance.
He said that tuberculosis (TB) patients faced significant challenges with the Direct Benefit Transfer (DBT) scheme, including a lack of awareness and skepticism about the program, banking barriers such as absent or inaccessible bank accounts, financial strains like job insecurity and loans, physical weakness impacting daily life and treatment adherence, and technical delays due to software errors. These obstacles resulted in delayed or missed treatments, increased stress and anxiety, and decreased trust in the DBT scheme and healthcare system.
“To effectively support TB patients, it is crucial to address these challenges through improved awareness and education, simplified banking requirements, enhanced financial support and job security measures, physical rehabilitation resources and upgraded software infrastructure to minimize errors,” Dr Darade said.
