他们收到了吗？印度恰蒂斯加尔邦拉伊加尔县结核病患者的直接福利转移--一项混合方法研究

IF 2.3 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health Pub Date : 2024-09-19 DOI:10.1016/j.cegh.2024.101790

Santosh Patoda , Tanu Anand , Sairu Philip , Palanivel Chinnakali , Abinash Mishra , Pruthu Thekkur , Pallavi Indwar , Jaykumari Choudhary , Sofia Noor , Pradip Kumar Jana

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引用次数: 0

摘要

背景营养支持在以患者为中心的结核病护理中发挥着至关重要的作用。印度于 2018 年推出了一项直接福利计划 Nikshay Poshan Yojana (NPY)。目标确定接受 NPY 奖励的比例、其及时性以及与不支付和延迟相关的因素，并评估受益人对直接福利转移（DBT）的利用模式。方法这是一项混合方法研究，包括定量部分（横断面）和定性部分（描述性）。研究人员从 Nikshay-Portal 中提取了印度恰蒂斯加尔邦赖加尔 2021 年 4 月至 2022 年 3 月期间所有肺结核患者的数据。此外，还联系了 2021-2022 年最后一个季度登记接受治疗的受益人，以评估 DBT 的使用模式。对 18 名医疗保健提供者（HCPs）进行了一对一访谈，以评估他们对实施 NPY 所面临挑战的看法以及可能的解决方案。在至少获得一项补助的肺结核患者中，超过一半（59.6%；1140/1912）的患者在接到通知后 56 天内获得了第一项补助。在回答 DBT 使用模式的 255 人中，近三分之一（n = 73，28.6%）的人报告说，他们使用 DBT 购买食物。未领取/延迟领取福利的主要挑战是：银行开户困难；"休眠 "账户政策；农村和国有合并银行的印度金融系统代码（IFSC）变更；互联网连接不畅；人力资源短缺或劳动力未按地理位置分布。然而，其治疗用途的利用率有限。与银行、病人和提供者有关的因素对该计划的顺利实施构成了重大挑战。为了扩大该计划的覆盖面，需要制定具有离线 Nikshay-Portal 功能的灵活开户政策。

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Did they receive it? Direct Benefit Transfer to tuberculosis patients in Raigarh district, Chhattisgarh, India - A mixed methods study

Background

Nutrition support plays critical role in patient centered care of TB. India launched a direct benefit scheme Nikshay Poshan Yojana (NPY) in 2018. However, there is sparse evidence of its implementation status in Chhattisgarh.

Objectives

To determine the proportion receiving the NPY incentives, its timeliness and factors associated with non-payment and delays, and to assess utilization patterns of Direct Benefit Transfer (DBT) among the beneficiaries.

Methods

It was a mixed-method study, with quantitative component of (Cross-sectional) followed by qualitative component (Descriptive). The data of all tuberculosis patients notified during April 2021toMarch 2022 in Raigarh, Chhattisgarh, India, were extracted from Nikshay-Portal. Beneficiaries registered for treatment in last quarter of 2021–2022, were also contacted to assess the utilization patterns of DBT. Eighteen health care providers (HCPs) were interviewed one-on-one to assess their perception regarding challenges in implementation of NPY and possible solutions.

Results

Of 2161 TB patients started on TB treatment, 1912(88.8 %) received at least one benefit. More than half (59.6 %; 1140/1912) of the TB patients who received at least one benefit, received their first benefit within 56 days of notification. Among 255 who responded for utilization pattern of DBT, nearly one third (n = 73,28.6 %) reported to have utilized DBT for buying food. The main challenges for non-receipt/delay in benefits were: difficulty opening bank accounts; “dormant” account policy; changing of Indian Financial System Code (IFSC) of rural and nationalized merged banks; poor internet connectivity; and shortage of human resources or workforce not distributed according to geographic location.

Conclusion

Nearly nine out of ten patients received at least one benefit under NPY. However, its utilization for treatment purposes was limited. Bank related, patient related and provider related factors posed major challenges in smooth implementation of the scheme. To improve the scheme's coverage, flexible account opening policies with offline Nikshay-Portal features are required.

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来源期刊

Clinical Epidemiology and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.60

自引率

7.70%

发文量

218

审稿时长

66 days

期刊介绍： Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.