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Need for operational simplicity and timely disbursal of benefits—a qualitative exploration of the implementation of a direct benefit transfer scheme for persons with tuberculosis in India

引用

Infectious Diseases of Poverty 2024年第3期13卷 58-72页

作者： Malu Mohan Jeromie W.V.Thangaraj Sumit Pandey G.Sri Lakshmi Priya Sivavallinathan Arunachalam Rahul Sharma Hemant Deepak Shewade b.Aishwarya K.Afeeq Afsana Khatoon b.gokulvijay Gude Sireesha Kavita Chandra S.Nandhakumar Prince Samuel C.Nanditha Viswanathan Devika Shanmugasundaram Raghuram Rao Manoj V.Murhekar Kathiresan Jeyashree Indian Council of Medical Research-National Institute of Epidemiology R-127TNHBAyapakkamChennaiTamil Nadu 600077India Tb Support Network WHO Country Office for IndiaNew DelhiIndia Central Tuberculosis Division Government of IndiaNew DelhiIndia

background Ni-kshay Poshan Yojana(NPY)is a direct benefit transfer scheme of the Government of India introduced in 2018 to support the additional nutritional requirements of persons with Tb(PwTb).Our recent nationwide evaluation of implementation and utilization of NPY using programmatic data of PwTb from nine randomly selected Indian states,reported a 70%coverage and high median delay in benefit *** undertook a qualitative study between January and July 2023,to understand the detailed implementation process of NPY and explore the enablers and barriers to effective implementation and utilization of the NPY *** We followed a grounded theory approach to inductively develop theoretical explanations for social phenomena through data generated from multiple *** conducted 36 in-depth interviews of national,district and field-level staff of the National Tuberculosis Elimination Programme(NTEP)and NPY beneficiaries from 30 districts across nine states of India,selected using theoretical *** analytical framework developed through inductive coding of a set of six interviews,guided the coding of the subsequent *** and themes emerged through constant comparison and the data collection continued until theoretical *** Stakeholders perceived NPY as a beneficial *** political commitment from the state administration,mainstreaming of NTEP work with the district public healthcare delivery system,availability of good geographic and internet connectivity and state-specific grievance redressal mechanisms and innovations were identified as enablers of ***,the complex,multi-level benefit approval process,difficulties in accessing banking services,perceived inadequacy of benefits and overworked human resources in the NTEP were identified as barriers to implementation and *** The optimal utilization of NPY is enabled by strong political commitment and challenged by its length

关键词： National Tuberculosis Elimination Programme Nutritional status Direct benefit transfer Implementation Cash transfer scheme Grounded theory India

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