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Food support for tuberculosis care: coverage, outcomes, and implementation lessons from the Ni-kshay Mitra scheme in
1Department of Community Medicine, GMERS Medical College, Gotri, Vadodara, India.
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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