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  • Direct Benefit Transfer(DBT) under NTEP

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    Direct Benefit Transfer (DBT) is a major initiative of Government of India (GoI) whereby any government subsidy or benefit is to be transferred directly into the beneficiary's bank accounts. Intermediary government agencies only manage the process of payments, without handling actutal money.

    NTEP is one of the first health programmes in India to use a fully adopt DBT. It uses an end to end electronic system, to digitise beneficiary information and transfer monetary benefits. In NTEP to process benefits, two electronic systems are used, Ni-kshay (operated by NTEP) and PFMS (Public Finance Management System, operated by the Ministry of Finance). Ni-kshay enables Direct Benefit Transfer by digitizing the beneficiaries(bank account details of patients, treatment supporters and providers) and calculates of incentives/ benefits (eligible payment) and processes them for payment through PFMS under various schemes. The various schemes operational under NTEP are:

    • Nikshay Poshan Yojana(NPY)
    • Tribal Support Scheme
    • Treatment supporter’s Honorarium
    • Incentive for Notification and Outcome

  • Stakeholders/Systems for DBT under NTEP

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    • Beneficiary: These are the individuals who get benefits from payments under a particular scheme. E.g., all notified TB patients are beneficiaries under the Ni-kshay Poshan Yojana. An individual may be eligible for multiple payments under one scheme or may be eligible for multiple schemes. Only individuals with bank accounts will receive these benefits. Also, beneficiaries and their bank accounts need to be approved by a district-level authority to receive any of the benefits from Ni-kshay.
    • Processing authorities: The DBT maker and checker are designated personnel in the health system for in processing benefits. They are responsible for the two levels of verification in Ni-kshay; confirming and approving each benefit under their jurisdiction. Both maker and checker are roles that are assigned to any personnel  in NTEP as decided by the District TB Officer. They perform their role through a special staff login in Ni-kshay with the designation “DBT Maker” or “DBT Checker,” created under the staff management module of Ni-kshay.
      1. DBT Maker: Maker acts at the TU level. All benefits created are assigned to the maker, who has to reconfirm the eligibility manually, update necessary details if required and send the benefit to the checker for approval.DBT maker is created by the District Tuberculosis Officer (DTO) upon request from the Medical Officer Tuberculosis Center (MOTC).
      2. DBT Checker: DBT checker acts at the district level. Checker is responsible for approving all beneficiaries under the district once it has been created by the DBT makers at TU levels. DBT checker role in Ni-kshay app is created by the State TB Officer (STO).

     

    Resources

     

    Assessment

    Question  Answer 1  Answer 2  Answer3  Answer 4  Correct Answer  Correct explanation 
    An individual is only eligible for a benefit under NTEP at one point in time.    True  False      2  An individual may be eligible for multiple payments under one scheme or may be eligible for multiple schemes.

     

     

  • DBT Schemes in NTEP

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    Schemes Beneficiary Benefit Amount
    Nikshay Poshan Yojana(NPY)
    • All Notified TB Patients in Nikshay from the point of diagnosis
    		 Rs. 1000 at the time of Notification and Rs 500 per treatment month there after paid in advance as installments.
    Tribal Support Scheme Confirmed TB Patients residing in Tribal TU Rs 750(one time) at the time of notification 
    Treatment supporter’s Honorarium Treatment supporters of patients who have achieved outcome of treatment success
    • Rs 1,000 in the case of DS TB patients and Rs 5,000 in the case of patients, paid at the time of treatment completion.
    Incentive for informants,  Notification and Outcomes

    Private Health Facilities: including Practitioner /Clinic etc.(Single), Hospital/Clinic/Nursing Home etc.(Multi), Laboratories and Chemists

    Any citizen reporting TB patients to public health facility or a self-reporting by patient may also be incentivized as an informant
    • Rs 500 for Notification or informant
    • Rs. 500 for Outcome declaration to health facilities.

  • Other Local DBT Schemes

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    There may be other Central or State government schemes and programmes that beneficiaries related to the TB program are eligible for, over and above the 4 schemes provided by the central government through NTEP. Some examples are:

    These schemes are paid through their respective payment processing channels and not through Ni-kshay.

  • Criteria for availing DBT Scheme benefits under NPY

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    1. All TB patients notified on or continues treatment after 1st April 2018 including all existing TB patients under treatment are eligible to receive incentives.
    2. For availing DBT scheme benefits under NTEP Programme, TB patients have to provide their bank details to the nearest NTEP Health facility.
    3. The patient must be registered\notified on the NIKSHAY portal.
    4. Each beneficiary can be linked to unique savings bank account belonging to him/her. Beneficiaries without bank accounts need to be facilitated to open bank accounts in any bank as convenient.
    5. If a Beneficiary does not have a bank account and is unable to open a new bank account, his/her relative’s bank account may be used(immediate family member such as parents, spouse, siblings).
    6. If a relative’s bank account is used, written consent should be taken from beneficiary.
    7. If a bank account has already been used for another beneficiary, it cannot be re-used for another beneficiary. If a new Bank account needs to be opened, it’s easy to open a zero-balance account with Indian Post Payments Bank.


     

  • Transport Support for TB Patients in Notified Tribal Areas

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    Special provisions have been made in the tribal, hilly and difficult to reach areas of the country under the National TB Elimination Programme (NTEP) to expand diagnosis and treatment centres, improve access for TB patients and coverage of TB services.

    To provide access to diagnosis and treatment centres for people in the tribal areas, NTEP has initiated transport support for TB patients in notified tribal areas from the year 2019.
     

    Transport support is available for patients receiving treatment from both the private and public sectors.

    This is a one-time benefit of Rs. 750, provided to a TB patient notified from a health facility registered under a TB Unit (TU) that is flagged as “Tribal TU” on Nikshay to be eligible for this transport support.

    To receive the benefit, the patient should be identified as unique by the Nikshay system or approved by the District TB Officer (DTO).

     

    Resources

    Direct Benefi­t Transfer Manual for National Tuberculosis Elimination Programme, CTD, 2020.

    Guidelines for Programmatic Management of Drug-resistant TB in India, 2021.

     

    Assessment

    Question​  Answer 1​  Answer 2​  Answer 3​  Answer 4​  Correct answer​  Correct explanation​ 
    TB patients in tribal areas are eligible for transport support for every visit to the nearest health facility.  True False     2 Transport support for TB patients is a one-time benefit for a notified TB patient registered under Tribal TU.

     

     

  • Treatment Supporter Honorarium Eligibility

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    Treatment supporters are eligible for Honorarium at the end of TB patients treatment, only if the patient's treatment outcome has been declared either as "Cured “or "Treatment Complete".

     

    The eligible amount of honorarium is

    • Rs. 1,000 for DSTB Patients and for
    • Rs. 5,000 for DRTB patients. 

     

    These benefit amount are processed through Nikshay and below are the prerequisite conditions that needs to be met in Nikshay, for generating incentive

    • Treatment supporter should be registered and enabled for receiving honorarium from Nikshay.
    • Bank details of Treatment supporter should be submitted to the nearest NTEP health facility staff.
    • In Nikshay, this is the only scheme where benefits are generated manually by TU users - STS
    • Nikshay will allow NTEP TU users to generate benefits, only if
      • ​Treatment Outcome has been declared as "Cured “or "Treatment Complete"
      • Patient duplication status should be Unique i.e. Nikshay marks the patient duplicate based on Gender and Mobile Number
    • For DSTB patient, one benefit of maximum amount of Rs. 1,000 can be created if outcome is updated as “Cured” or “Treatment Completed
    • For DR TB patients two benefits can be generated in Nikshay:
      • First benefit of maximum amount Rs. 2,000 can be created at end IP - Intensive Phase (i.e. Initiation Date + 6 months)
      • Second benefit of maximum amount Rs. 3,000 can be created if Outcome is updated as “Cured” or “Treatment Completed”

  • Incentives for Private Providers and Informants

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    Private health providers are an inevitable part of the TB treatment and support in the country. These private providers include:

    • Practitioner / Clinic etc. (Single)
    • Hospital/ Clinic/ Nursing Home etc. (Multi)
    • Laboratories
    • Chemists

     

    To improve complete reporting and ensure support care for patients in the private sector, the facilities will receive an incentive of:

    • Rs 500 as Informant or Notification Incentive
    • Rs. 500 for Outcome declaration

    For patients seeking healthcare from a facility in a different district, Nikshay enables the feature of linking a health facility (HF) in addition to the current HF. This enables the private facilities to enter treatment outcomes and become eligible for the incentive.

    Private health providers are also eligible for treatment supporter incentives of Rs. 1000 for DS-TB patients and Rs 5000 for each DR-TB patient for ensuring support for the entire course of treatment.

    Resources

    Guidelines for Programmatic Management of Drug-resistant TB in India, 2021.

     

    Assessment

    Question​  Answer 1​  Answer 2​  Answer 3​  Answer 4​  Correct answer​  Correct explanation​ 
    What incentive does a private sector facility receive for every TB patient notified?  Rs. 1000 Rs. 700  Rs.500  Rs. 250 3 A private facility will receive an incentive of Rs. 500 for every TB patient notified.