Development of home-based malnutrition management tool for patients with tuberculosis

Mortality remains high among undernourished patients with tuberculosis (PwTB). This study aims to improve the utilization of "Nikshay Poshan Yojana" by providing a reference tool for PwTB and their household contacts.

The present study developed a malnutrition management tool in the form of recipes, formulated from the ration available in the household, designed within the patient's financial incentives to meet the nutritional requirements. A daily meal plan comprising three major (550 kcal, 18g protein) and three minor meals (300 kcal, 8g protein) were formulated. Energy and nutrient-dense recipes were planned and standardized for cultural acceptability. Each recipe was evaluated by an expert panel for sensory attributes using a 5-point Likert scale. Subsequently, one of the Nikshay-Mitra implemented the recipes with patients. The patients' feedback was recorded using a structured questionnaire. Cost analysis was performed to assess the affordability across socioeconomic groups.

Nutrient-dense recipes (N = 57) were planned and standardized to address the dietary needs of PwTB. Considering nutritional adequacy, palatability, and patient acceptability, the recipes were divided into 11 categories. Ingredients were selected based on their contribution to nutrient requirements, with a focus on affordability (Rs.5-30) and seasonal availability. Recipe evaluation ensured high acceptability, leading to the development of a patient-friendly tool (ISBN: 978-81-963616-00). One of the Nikshay-Mitra implemented the recipes with 6 PwTB and found them to be affordable, easily accessible, and simple to prepare.

PwTB need empowerment through tested, culturally-accepted, cost-effective home-based nutrition strategies. This tool is a self-reliant resource for patients, their household contacts, and policymakers to utilize benefits under Nikshay Poshan Yojana.