Utilization and operational challenges of the Ni-kshay Mitra Initiative (NMI) among people with tuberculosis in coastal Karnataka: A cross-sectional implementation study.

BACKGROUND

The Ni-kshay Mitra Initiative provides nutritional support to persons with tuberculosis. Since its launch under the Pradhan Mantri TB Mukt Bharat Abhiyaan in 2022, beneficiary-level awareness, utilization patterns, and operational challenges have been less explored. This study assessed the utilization patterns, beneficiary satisfaction, and challenges faced by vulnerable groups receiving crowdsourced nutritional support from a community-based organization in coastal Karnataka.

METHODS

A cross-sectional implementation study was conducted among 50 persons with tuberculosis who received at least one food kit during monthly nutritional support under the Ni-kshay Mitra Initiative at this community-based organization from May 2025 to March 2026. Data regarding utilization patterns, satisfaction, self-perceived health benefits, and challenges in accessing the scheme were collected using a semi-structured questionnaire using Epicollect version 5.0 and analyzed using Jamovi version 3.6. Descriptive statistics, including mean and standard deviation, median and interquartile range, frequencies, and proportions, were used to summarize the data.

RESULTS

Among the 50 participants, 34 (68.0%) were men. Pulmonary tuberculosis was documented in 39 (78.0%), with 47 (94.0%) on treatment for drug-sensitive tuberculosis. The median duration between diagnosis and first food kit receipt was 31 days (IQR: 13.8-54 days). A total of 48 (96.0%) participants reported perceived health improvement, with 43 (86.0%) Persons with Tuberculosis self-reported increased energy after nutritional support. Satisfaction with the quantity and quality of the food kits was reported by 48 (96.0%) and 50 (100%) participants, respectively. The food kit lasted for at least 4 weeks among 18 (36.0%). Common challenges included 48 (96.0%) citing lack of scheme awareness and difficulty accessing services, 24 (48.0%) facing commuting challenges, and 30 (60.0%) perceiving TB-related stigma.

CONCLUSION

High satisfaction with food kit. quality and quantity was observed among patients with tuberculosis receiving crowdsourced nutritional support from a community-based organization. However, gaps persisted in awareness, timely access, transportation to the center, and perceived stigma among recipients. The findings of this study emphasize the need to strengthen early enrolment, decentralized access, and beneficiary-oriented communication within community-based nutritional support under the Ni-kshay Mitra Initiative.