Empowering Tuberculosis Patients in slum settings of South Delhi: A Strategic Approach to reduce out-of-pocket expenditure and link TB patients to government schemes

In partnership with the World Health Organization (WHO), this project aims to improve access to TB-related social welfare benefits among the urban poor in Delhi. The overarching goal is to enhance treatment outcomes and reduce out-of-pocket expenditure by integrating social protection with TB care. The project focuses on raising awareness among frontline health workers (FLWs) and TB patients about key welfare schemes available in Delhi, ensuring that the most vulnerable populations receive the support they are entitled to. Through a targeted intervention, this initiative seeks to empower patients and health workers by facilitating access to crucial welfare schemes and government benefits. By addressing the financial and social barriers to TB care, the project contributes to improved treatment adherence, completion rates, and overall well-being of TB-affected households in urban slum settings.

The schemes include: Old Age Pension Scheme; Widow Pension Scheme; Financial Assistance to Persons with Special Needs; Delhi Family Benefit Scheme; Delhi Arogya Kosh. Beyond these social benefit schemes, the project also identifies and engages Nikshay Mitras while mobilizing community influencers and local leaders to actively participate in the Pradhan TB Mukt Bharat Abhiyan (PMTBMBA).

The project uses a pre-post intervention approach, mobilizing FLWs, community leaders, and Nikshay Mitras to link patients to available benefits and improve adherence. By integrating social protection with TB care, the initiative aims to demonstrate scalable strategies for reducing financial barriers and supporting treatment completion in urban slum settings.

Progress as of September 2025: 302 TB patients and 41 FLWs have been reached to generate awareness on TB and various social benefit schemes. 37 FLWs have been trained on TB and the processes for linking TB patients with relevant social welfare schemes.

Engaging Informal Providers to Increase Presumptive TB Cases and the introduction of tongue swabs for TB detection

This McGill University-supported study evaluates the impact of training Informal Providers (IPs) and introducing oral swab-based TB diagnostics on presumptive TB case referrals and diagnoses in South Delhi. Using a mixed-methods design, the study includes a quantitative pre-post component with interrupted time-series analysis and a post-intervention qualitative assessment through interviews with IPs, patients, and stakeholders. Conducted over a year in two phases, the first phase involves general TB screening and referral training, followed by tracking referral and diagnosis outcomes. In the second phase, IPs receive additional training on tongue swab collection using the TrueNAT test. Primary outcomes include changes in the number of confirmed TB cases diagnosed; secondary outcomes include presumptive TB referrals and successful referral rates. Qualitative findings will assess the intervention's acceptability, feasibility, and perceived impact.

Progress till September 2025: the project has mapped 180 informal providers including AYUSH and, trained all of them on cases with chest symptoms, presumptive case registration in Nikshay and appropriate referral of patients to the nearest government testing facilities for diagnosis.

Out of total trained, 88% (158) providers are active and registered 512 symptomatic cases and 205 referred for diagnosis. As a result, 11 individuals diagnosed as TB positive and initiated on treatment.

---