Food support for tuberculosis care: coverage, outcomes, and implementation lessons from the Ni-kshay Mitra scheme in India.

IF 1.6 Q4 RESPIRATORY SYSTEM

Public Health Action Pub Date : 2026-08-24 eCollection Date: 2026-08-01 DOI:10.5588/pha.26.0031

P Chavda, R Patel, K Mehta, K C Prajitha, K Davara, K Shah, J Tankariya, H Nakshiwala, N Panchal, S Nayak, A M V Kumar

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Abstract

Setting: Vadodara City (Gujarat, India) has a mixed public-private tuberculosis (TB) care landscape. Since 2022, the city has implemented 'Ni-kshay Mitra' scheme, where individuals and organisations voluntarily 'adopt' persons with TB (PwTB) and provide food kits (distributed at monthly camps) during treatment.

Objective: To assess coverage (received at least one kit) and effectiveness of Ni-kshay Mitra on treatment outcomes, and explore implementation facilitators, barriers, and solutions from the stakeholders' perspective.

Design: Explanatory mixed-methods study: quantitative cohort analysis of secondary programme data followed by qualitative interviews and focus group discussions with donors (n = 3), programme staff (n = 18), and PwTB (n = 35).

Results: Among 2,068 PwTB notified between January and June 2025, 1,238 (60%) consented to the scheme, 666 (32%) received ≥1 food kit, and 68 (3%) received complete package (≥6 kits). Median kits received were 2 (interquartile range: 2-4). Unsuccessful treatment outcomes were 7% (2022, pre-scheme) and 6% (2023, post-scheme), not statistically significant. Donor non-availability and opportunity costs of attending camps were the major barriers; presence of dedicated non-profit organisations was a key facilitator.

Conclusion: Coverage of Ni-kshay Mitra remains suboptimal, largely due to donor participation gaps, possibly explaining limited effectiveness on outcomes. Strengthening donor engagement and alternate delivery models are essential to enhance reach and effectiveness.

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粮食支持结核病治疗：印度Ni-kshay Mitra计划的覆盖面、结果和实施经验教训。

环境：Vadodara市（印度古吉拉特邦）拥有公私混合的结核病治疗环境。自2022年以来，该市实施了“Ni-kshay Mitra”计划，个人和组织自愿“收养”结核病患者，并在治疗期间提供食品包（每月在营地分发）。目的：评估Ni-kshay Mitra的覆盖率（至少收到一个工具包）和治疗效果，并从利益相关者的角度探讨实施的促进因素、障碍和解决方案。设计：解释性混合方法研究：对二级项目数据进行定量队列分析，然后与捐助者（n = 3）、项目工作人员（n = 18）和PwTB （n = 35）进行定性访谈和焦点小组讨论。结果：在2025年1月至6月通报的2068例PwTB中，1238例（60%）同意该方案，666例（32%）获得≥1个食品包，68例（3%）获得完整包装（≥6个）。收到的试剂盒中位数为2个（四分位数范围：2-4）。不成功的治疗结果为7%（2022年，方案前）和6%（2023年，方案后），无统计学意义。没有捐助者和参加营地的机会成本是主要障碍；专门的非营利组织的存在是一个关键的推动因素。结论：Ni-kshay Mitra的覆盖率仍然不够理想，主要是由于捐助者参与的差距，这可能解释了结果的有效性有限。加强捐助者的参与和替代交付模式对于提高覆盖面和有效性至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Public Health Action RESPIRATORY SYSTEM-

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期刊介绍： Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.