STS

After the assigned Checker/ Approver Ni-kshay user clears benefits, Nikshay sends groups/ batches of benefits to PFMS as a "Payment Request" (DBTPayReq). PFMS processes these Payment Requests it receives from Ni-kshay before executing the request. Processing involves checking for any inconsistencies/ errors in the payment request at the batch level and at the benefit level. On processing:

Direct Benefit Transfer (DBT) Maker and Checker are responsible for the 2-level benefit approval in Ni-kshay, which must be repeated for every benefit.

Ni-kshay automatically generates benefi­ts as per the scheme guidelines. All bene­fits are linked to the patient's episode irrespective of the benefi­ciary.

Benefi­ciaries for any scheme need to be ­first informed about the scheme details, its benefi­ts and the process of receiving the benefi­ts.

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:

• 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.

Figure: Components of Ayushman Bharat Yojana

In the National Sample Survey Office (NSSO) 68th round 2011-2012, India was reported to have the highest out-of-pocket expense on healthcare, of which over 67% was spent on drugs. Recognising the importance of essential drugs being available and accessible to the general public, the Ministry of Health & Family Welfare, Govt. of India, implemented the Free Drugs Service Initiative (FDSI) under the National Health Mission (NHM) in 2015.

Objectives

The government of India introduced Direct Benefit Transfer (DBT) to ensure that the benefits and subsidies are reaching the beneficiaries directly and to fasten the process. Through the process, money is directly transferred to the beneficiaries' bank account keeping the intermediary agencies and stakeholders only to manage the process of payment.

National TB Elimination Programme (NTEP) transfers all benefits to patients using the two systems:

• Nikshay
• Public Finance Management System (PFMS)

Eliminating the catastrophic expenditure on TB patients and their families has been an important goal of the World Health Organisation's (WHO’s) END TB strategy.