Policy and dialogue |
National Health Policy (NHP) 2017 |
NHP mentions about enabling the private sector contribution to make the health care systems more effective, efficient, rational, safe, affordable, and ethical [12]. |
National Strategic Plan (NSP) for TB elimination from 2017 to 2025 |
NSP highlights the need for private sector engagement as an important component to eliminate TB [2]. |
Standards of TB Care in India (STCI) |
STCI mentions 26 standards that every citizen should receive irrespective of the sector of treatment [13]. |
Information Exchange |
Ni-kshay (2012) |
Ni-kshay is the real-time case-based web-based management information system of NTEP [14]. Private providers can directly log in to the system using their user credentials and notify TB and report outcomes. In total, 172,068 private hospitals were registered in Ni-kshay, out of which 36,346 notified at least one patient in 2021 [15]. |
Incentive for TB notification and outcome reporting (2019) |
NTEP provides INR 500 as an incentive to the private provider to notify each TB patient and another INR 500 to report the treatment outcome [16]. |
Ni-kshay Sampark (2018) |
Ni-kshay sampark is the national call center, which supports the private sector with notification and treatment adherence support. The program currently runs a 100-seat call center and supports 14 languages [15]. |
Regulatory Measures |
Mandatory TB notification (2012) |
The Government of India has issued directives making TB notification mandatory and promulgated another directive penalizing failure to notify [17]. |
Enforcement of Schedule H1 regulation (2014) |
Anti-TB medicines are included in Schedule H1 and can only be sold on prescription from a registered medical practitioner, and details of the prescriber, the patient, and the drug sold need to be maintained by the chemists [18]. This is intended to prevent the indiscriminate use of the drug. |
Price ceiling of anti-TB drugs |
The National Pharmaceutical Pricing Authority (NPPA) has imposed a ceiling price for anti-TB drugs to be sold in the market [19]. |
Public Provision of Services |
Free drugs and diagnostics (2017) |
The NTEP has provisions for supplying free, quality-assured anti-TB drugs and free tests such as molecular tests and drug susceptibility tests to the patients reaching the private sector [2]. |
Nikshay Poshan Yojana (2018) |
The NTEP provides INR 500 per month to all TB patients, irrespective of sector, during the treatment period as a direct benefit transfer [15]. |
Support in contact investigations, treatment adherence, and preventive therapy (2017) |
Directly and through various agencies, the NTEP provides support for contact investigations and treatment adherence to all patients reaching private sector [2]. |
Training and capacity building |
Directly and through various agencies, the NTEP provides training and capacity building for the health workforce in the private sector. |
Financing |
National Partnership Guidelines (2019) |
In 2001, the first guidelines on partnerships on engagement of non-governmental organizations (NGO) and private providers (revisions in 2008, 2014, and 2019) [20]. To increase the capacity of states for strategic purchase of services, multi-disciplinary technical support units have been formed in nine high priority States. |
Pradhan Mantri Jan Arogya Yojana (PM-JAY) |
PM-JAY is a health insurance scheme that provides cashless cover of INR 500,000 per annum (USD 6700) to the eligible disadvantaged households for inpatient treatment at empaneled private hospitals for listed conditions which include management of patients with pleural, pericardial, and neuro-tuberculosis [21]. |
Subsidy |
The Initiative for Promoting Affordable and Quality Tests (IPAQT) in India provides over 130 accredited laboratories with concessionary pricing in exchange for their case notification to the NTP and passing on the price reductions to patients for WHO-endorsed TB tests [22]. |