Paper: GS – I, Subject: Society and Social Justice, Topic: Social Sector – Health, Issue: Nutrition – Led Strategy against TB.
Context:
The strategies employed by Chhattisgarh and Puducherry to reduce tuberculosis (TB) mortality rates. Both regions have prioritized early nutritional support for undernourished TB patients through direct cash transfers and food baskets.
Key Highlights:
Prioritizing Nutritional Support for TB Patients:
The Challenge: Undernutrition and TB Mortality:
- Studies indicate a strong correlation between undernutrition and TB mortality.
- Severely undernourished TB patients face a 4-5 times higher risk of death.
- Most TB deaths occur within the first two months after diagnosis, highlighting the need for immediate intervention.
Problem with the national TB programme:
- Under the National TB Elimination Programme (NTEP):
- All TB patients are eligible for ₹1,000 per month (Nikshay Poshan Yojana).
- However, cash transfers often begin after several months, reducing impact during the critical early phase.
Chhattisgarh and Puducherry’s Proactive Approach:
- Both regions prioritize early nutritional support for undernourished patients.
- This involves direct cash transfers and food baskets.
Comparative Table: TB Nutrition Support Models:
| Aspect | Chhattisgarh Model | Puducherry Model |
| Objective | Reduce TB mortality by prioritising severely undernourished patients. | Improve treatment outcomes through early nutrition support for high-risk groups |
| Identification of Patients | Formal government order to identify undernourished TB patients | Systematic identification at diagnosis |
| Nutritional Criteria: Body Mass Index (BMI) | Severely undernourished: BMI <16 Very severely undernourished: BMI <14 | BMI <18.5 Drug-resistant TB Below Poverty Line (BPL) |
| Target Group | TB patients at highest mortality risk | TB patients with clinical or socio-economic vulnerability |
| Monitoring & Reporting | Districts report TB cases by BMI category | Notified TB patients tracked through programme records |
| Key Monitoring Indicators | No. of patients with BMI <14 & <16 Food basket received within first month ₹1,000 DBT received within first month | Time taken to deliver first food basket Number of baskets received during treatment |
| Addressing Delays (Earlier Situation) | <33% received DBT in first 2 months 20% received food baskets | Only 49% received ≥3 baskets Avg delay of 41 days for first basket |
| Current Strategy | Prioritisation at block, district, and state levels | Immediate nutrition delivery to priority patients |
| Administrative Reforms | Paperwork fast-tracked to next level within 48 hours | Logistics strengthened via buffer stock |
Major TB schemes:
- National TB Elimination Programme (NTEP): Free diagnosis, treatment, DST, private-sector integration; target TB elimination by 2025.
- Nikshay Poshan Yojana: ₹1,000/month DBT for nutrition during treatment.
- Nikshay Mitra Initiative: Community/NGO adoption of TB patients.
- Nikshay Portal: Digital case tracking, DBT, outcomes.
Chhattisgarh and Puducherry show that early, targeted nutrition support for undernourished TB patients improves treatment outcomes, reduces mortality, and offers a replicable model for strengthening tuberculosis control nationwide.
Source: (The Indian Express)
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