In India, the estimated incidence of tuberculosis cases for the year 2018 was 2.69 million. According to WHO, it was responsible for 32 deaths/100,000 population. India also faces a dual burden of tuberculosis and malnutrition which represents an alarming situation. With this backdrop, the current study tries to assess the change in weight and BMI among active TB patients in selected intervention and control site. The study also measures the treatment success rate of the patients. This pilot study was conducted among 282 active TB patients in Dhar district of Madhya Pradesh state of Central India and the results were compared with a control site. The intervention included, providing the identified TB patients with monthly nutrition food baskets, nutrition counselling, linking to treatment and promoting its adherence, community mobilization and management and linkages to government schemes. The data for this study was taken from the project Management Information System (MIS).The results indicate that the mean weight for both male and female TB patients increased significantly during each food distribution episode. At the beginning of the intervention the mean weight of the TB patient was 42.9 kg which increased gradually to 49.3 kgs at the end of the intervention. Treatment success rate in the intervention group was recorded as 95% whereas in the control group it was 83.5%.The study strongly confirms that the nutritional supplements and regular counselling can help TB patients gain weight and have greater treatment success rate.
Background: Urban poor face a disproportionate burden of ill health and high out-of-pocket expenditure (OOPE), creating a severe unmet need for affordable and quality health care. This article highlights the impact of health insurance on OOPE and catastrophic healthcare expenditure among the urban poor of India. Methods: The study uses randomly collected household data from a baseline survey conducted in the states of Rajasthan and Uttar Pradesh. Separate Insurance impact models have been generated for the analysis. Results: Mean out-of-pocket health expenses is higher in the private health facility for the inpatient care but in case of outpatient care, the expenditure was more in public. Expenditure on medicine constitutes the largest part of the total OOPE. Insurance impact model shows that coverage on medicine alone can reduce medical impoverishment by 85% in the case of Outpatient Deparment (OPD) and 71% in the case of Inpatient Department (IPD). The urban poor preferred private facility for treatment in case of illness, albeit when it comes to delivery, they prefer public facility Conclusions: Study findings indicate overt reliance on private health care must be regulated, to reduce OOPE among the urban poor. Also, effective universal health insurance can go a long way in reducing the OOPE with availability of free medicines and diagnostics in the public health facilities.
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