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Dashboard About UsNI-KSHAY-(Ni=End, Kshay=TB) is the web enabled patient management system for TB control under the National Tuberculosis Elimination Programme (NTEP). It is developed and maintained by the Central TB Division (CTD), Ministry of Health and Family Welfare, Government of India, in collaboration with the National Informatics Centre (NIC), and the World Health Organization Country office for India.
Ni-kshay is used by health functionaries at various levels across the country both in the public and private sector, to register cases under their care, order various types of tests from Labs across the country, record treatment details, monitor treatment adherence and to transfer cases between care providers. It also functions as the National TB Surveillance System and enables reporting of various surveillance data to the Government of India.
For queries regarding the use of Ni-kshay, you may use the training materials provided(Click here), or call our National Help Desk 1800-11-6666 or write to us at
For more details about the National TB Elimination Program(NTEP) you may visit the program website at (www.tbcindia.gov.in), or contact us at the following addressCentral TB Division
Ministry of Health & family welfare
New Delhi - 110 011, IndiaE-mail:NI-KSHAY Helpdesk:
Early implementation challenges in electronic referral and feedback mechanism for patients with tuberculosis using Nikshay – A mixed
Diagnosis, notification and timely initiation of treatment is an important cornerstone for the elimination of tuberculosis (TB). The referral and feedback mechanism under National Tuberculosis Programme of India has been changed from paper-based to web-based ...
J Family Med Prim Care. 2021 Apr; 10(4): 1678–1686.
Published online 2021 Apr 29. doi: 10.4103/jfmpc.jfmpc_1360_20
PMCID: PMC8144801 PMID: 34123912
Early implementation challenges in electronic referral and feedback mechanism for patients with tuberculosis using Nikshay – A mixed-methods study from a medical college TB referral unit of Delhi, India
Reema Arora,1 Ashwini Khanna,2 Nandini Sharma,3 Vishal Khanna,4 Kalpita Shringarpure,5 and Soundappan Kathirvel6
Author information Article notes Copyright and License information Disclaimer
Diagnosis, notification and timely initiation of treatment is an important cornerstone for the elimination of tuberculosis (TB). The referral and feedback mechanism under National Tuberculosis Programme of India has been changed from paper-based to web-based electronic system (Nikshay) since 2018. The current study was carried out to assess the effect of Nikshay in referral and receipt of feedback on treatment initiation and to understand the early implementation challenges.
A mixed-methods study was conducted in a medical college referral unit (MCRU) of Delhi, India. The electronic TB notification data for July 2018–March 2019 were abstracted from Nikshay portal and analysed. Unadjusted and adjusted relative risk (aRR) was calculated to assess the factors associated with the receipt of feedback. Themes and subthemes were generated from qualitative data obtained through key-informant interviews of healthcare providers.
Of the total 4395 patients handled by MCRU during the study period, 3315 (75.4%) were referred out within and outside Delhi for treatment. Feedback was received among 797 (24.0%) of the patients who were referred out. Patients with extrapulmonary TB (aRR: 1.3, confidence interval (CI): 1.1–1.8), previously treated (aRR: 1.2, CI: 1.2–1.3) and registered for drug-resistant TB care (aRR: 1.4, CI: 1.1–1.8), had high chance of receiving feedback. Four broad themes emerged, namely, (a) awareness of programme and Nikshay; (b) tracking of patients; (c) user-friendly portal and (d) workload.
The low feedback on treatment initiation of patients with TB needs further research after health system-level quality improvement interventions. Real-time tracking of patients is the need of the hour towards the path for TB elimination.Keywords: Disease notification, feedback, Nikshay, referral, tuberculosis
Tuberculosis (TB) is the most common infectious cause of mortality globally. It was always in the developmental agenda as part of 'Stop TB strategy' under Millennium Development Goals and 'End TB Strategy' under Sustainable Development Goals. Providing integrated, patient-centred care for all patients with TB is one of the components of END TB Strategy.
Globally, more than one-third of patients with TB missed notification as estimated in 2017. India, one of the high TB burden countries, also missed the notification of nearly 30% cases, which amounts to 26% of global missed cases.[3,4] The country is tackling the TB burden through its Revised National TB Control Programme (RNTCP), which covered all the districts of the country. RNTCP planned to achieve 90% and 95% treatment initiation among notified patients by 2015 and 2020, respectively, as envisaged under the National Strategic Plan for TB elimination 2017–2025. However, only 79% of patients notified in the public health facilities of India were initiated on treatment in 2017. This pretreatment loss to follow-up (LTFU) varied from 0% to 84% across districts of India. Factors like male sex, migration, older individual and living in urban area are found to be associated with pretreatment LTFU.[6,7] This has been reported to be high among patients diagnosed at medical colleges or tertiary care hospitals.
Medical colleges share nearly 15% of the total TB cases notified in India. However, most of the patients diagnosed with TB are referred to respective district TB centres (DTCs) for the initiation, follow-up and completion of treatment, as patients seek tertiary care services from different parts of the country (both inside and outside the district and outside the state). RNTCP has established a referral mechanism by sending a 'referral for treatment' form to DTC after confirmation of diagnosis from the medical college referral units (MCRUs). The MCRU receives feedback in paper-based format, which is to be filled and sent by the DTC. The reported receipt of feedback was 54%, 74% and 75% in referral units of medical colleges situated in Puducherry, Hyderabad and Delhi, respectively.[8,9,10] Status of treatment initiation could not be verified in one-fourth to half of the referred TB patients due to wrong address, wrong phone number, the treatment being initiated outside RNTCP and migration.
In May 2012, the Government of India had rolled out the case-based, web-based TB notification portal (Nikshay) for digitalizing and tracking the patients with TB. One of the key features of 'Nikshay' is the generation of a unique Nikshay ID for each TB patient at the site of diagnosis, which can help in tracking the patient from diagnosis till treatment outcome. Similarly, the programme has started using Nikshay to refer out the patients to other parts of the country from the place of diagnosis. Once referred from any designated microscopy centre (DMC) after diagnosis, the DTC to which the patient is referred will receive a message with patient details (name, age, sex, and phone number including village and tehsil) in the Nikshay inbox. Treatment is initiated after verification (either patient visit or healthcare worker's visit) and the DTC will send feedback along with the date of initiation of treatment via Nikshay.
KBC 2022| Ni-kshay is a web portal run by the Indian government to help eliminate which disease?
By Udit Lakhoria - September 23, 2022
KBC 2022| Choose the correct option
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Ques: Ni-kshay is a web portal run by the Indian government to help eliminate which disease?
A. Polio B. Tuberculosis C. AIDS D. Malaria
Ans : B. Tuberculosis