Ni-kshay SETU – A Digital Intervention for enhancing the capacity of healthcare professionals for evidence-based management of TB

In India, Ni-kshay SETU web and mobile app addresses the critical issue of keeping healthcare staff updated with evolving TB care guidelines amidst constant changes in treatment protocols and newer program updates. This problem was identified through research that involved over 450 healthcare professionals and 900 persons with TB (PwTB), highlighting gaps in knowledge and training.

Data from the knowledge assessments and feedback revealed difficulties accessing timely updates and comprehensive training, affecting frontline workers, clinicians, and program managers. The problem persisted due to the lack of a centralized, real-time platform for disseminating updated guidelines, which previous conventional solutions failed to address effectively.

Simultaneously, in India, there is a large workforce working across different health structure; Public and Private and with any new update into the policy and clinical protocol, the dissemination of information can be fast-tracked with this initiative.

The inbuilt repository of the resource materials comprised of guidelines, videos – learning, informative, presentations, government orders -provide immediate resolution of the query raised during their day to day work if one wants the evidences or to guide the patients/ family for the care during disease period.

Ni-Kshay SETU is an innovative digital mhealth platform designed to empower healthcare providers with the knowledge and tools, necessary for effective Tuberculosis (TB) care and management. It is an Interventions for healthcare providers as per WHO digital health interventions classification addresses the health system challenges 1.5 Lack of access to
information or data, 3.2 and 3.7 related to Quality of health care and 6.4 Efficiency.

Developed by the Indian Institute of Public Health Gandhinagar, with support from The Union under “iDEFEAT TB” project funded by USAID and aligned with the National Tuberculosis Elimination Program (NTEP) India, the app offers a robust and user-friendly interface, enabling informed decision-making, capacity building, and adherence to the latest guidelines.

Key Features:

1. Knowledge-Based Interactive Chatbot
   • Offers real-time access to India’s NTEP guidelines, diagnostic algorithms, and treatment protocols.
   • Simplifies complex clinical information for efficient decision-making.
2. Decision Support System (DSS) – ManageTB India
   • Assists in selecting appropriate Drug-Resistant TB (DR-TB) regimens based on NTEP standards.
   • Minimizes errors and enhances treatment precision.
   • Provides evidence-based recommendations to support clinical decisions.
3. Quiz-Driven Learning Modules
   • Engages users with interactive quizzes to assess and expand their TB knowledge.
   • Personalized feedback highlights areas for improvement and strengthens skills.
   • Supports continuous professional development for health workers.
4. Clinical Query Resolution System
   • Enables healthcare providers to submit clinical questions and receive expert-reviewed answers.
   • Facilitates knowledge sharing and builds confidence in decision-making.
   • Enhances clarity on complex cases and rare scenarios.
5. Positive Enablers of Ni-kshay SETU
   • Aligned with NTEP Guidelines: Ensures healthcare workers provide standardized, high-quality care.
   • Capacity Building Focus: Identifies knowledge gaps and supports targeted skill enhancement.
   • User-Friendly Design: Simplifies navigation, making it ideal for professionals at all levels.
   • Multilingual and Inclusive: Designed to cater to diverse users across India.
   • Secure and Compliant: Does not store sensitive patient data, ensuring privacy and ethical use.
   • Regular Updates: Keeps pace with evolving TB protocols and recommendations.
6. Target Audience
   • Ni-kshay SETU is tailored for healthcare providers engaged in TB care, including:
   • Sub Health Center and PHC health workers.
   • Peripheral Health Institution (PHI) staff and Tuberculosis Unit (TU) officers.
   • Field staff of NGOs and private sector healthcare professionals.
   • District and state-level TB program officers and technical teams.

Ni-kshay SETU is more than an app—it’s a comprehensive bi-directional solution to enhance TB care efficiency, accuracy, and consistency across all levels of India’s healthcare system. By combining cutting-edge technology with the latest NTEP guidelines, the app supports healthcare providers in delivering patient-centric, evidence-based TB care.

Several digital platforms, such as Ni-kshay, TB Aarogya Sathi, WHO TB Guide, Swasth e-Gurukul, etc., support TB care. However, Ni-kshay SETU stands out by addressing knowledge gaps among healthcare providers and offering innovative features tailored to healthcare providers’ needs.

1. Cadre-Specific Modules:
   • Existing apps provide generalized guidelines without customization for different healthcare roles.
   • Ni-kshay SETU offers tailored modules based on user cadre, ensuring role-specific guidance and relevance.
2. Decision-Support Tools:
   • Other apps focus on delivering static reference materials, course curricula, or storing patient data.
   • Ni-kshay SETU integrates patient-centric algorithms and decision-support tools, enabling healthcare providers to make informed decisions on diagnosis, treatment, and referrals in real-time.
3. AI-Powered Chatbot and Voice Assistance:
   • Most existing apps lack interactive features for query resolution.
   • Ni-kshay SETU’s AI-powered chatbot provides instant answers to user-specific queries, enhancing operational efficiency and reducing delays in care.
4. Centralized, Easy-to-Navigate Repository:
   • Platforms like Swasth e-Gurukul and TB Aarogya Sathi require users to filter through lengthy documents or presentations.
   • Ni-kshay SETU simplifies access with a ready reckoner, audiovisual resources, and multilingual support, ensuring quick reference and better comprehension.
5. Continuous Learning through Assessments:
   • Existing apps generally lack mechanisms to evaluate and enhance user knowledge systematically.
   • Ni-kshay SETU introduces proactive and planned assessments that identify knowledge gaps and reinforce learning, aiding in continuous professional development.
6. Monitoring and Analytics:
   • Most other solutions do not offer insights into user engagement or knowledge gaps.
   • Ni-kshay SETU’s backend dashboard allows program managers to monitor app usage and training needs, fostering data-driven decision-making.
7. Multilingual and Inclusive Design:
   • Existing platforms often prioritize English, limiting accessibility in linguistically diverse regions.
   • Ni-kshay SETU supports multiple languages, ensuring inclusivity and better usability for healthcare providers across India.
8. Scalability and Integration:
   • While other apps primarily focus on data management or training courses, Ni-kshay SETU complements such platforms by enhancing capacity building, bridging the knowledge gap, and integrating seamlessly with ongoing TB programs.

By combining these advanced features with user-centric design, Ni-kshay SETU addresses the critical shortcomings of existing solutions. It adds value and establishes itself as a comprehensive tool for empowering healthcare workers and strengthening TB elimination efforts.