Ni-kshay SETU

Introduction

Ni-kshay SETU is an innovative digital platform developed by the Indian Institute of Public Health Gandhinagar (IIPHG) under the iDEFEAT TB project, implemented by The Union. It is designed to strengthen the capacity of healthcare providers engaged in tuberculosis (TB) care by offering accessible, role-specific, and evidence-based digital learning and decision-support tools. The platform is aligned with the objectives of the National Tuberculosis Elimination Program (NTEP) and supports India’s goal of ending TB by 2025.

Context and Rationale

India bears the highest burden of TB globally, accounting for approximately 27% of the world’s TB cases. According to the Global TB Report 2024, the country reported 2.78 million new TB cases and 320,000 TB-related deaths in 2023. Managing TB—particularly drug-resistant forms and TB with comorbidities such as HIV, diabetes, and undernutrition—requires consistent adherence to evolving national guidelines. However, many healthcare providers at the grassroots level struggle with limited access to updates, inadequate refresher training, and constrained decision-support infrastructure.

Field studies in Gujarat and Jharkhand revealed that over 80% of TB healthcare providers required updated knowledge, particularly regarding extrapulmonary TB, MDR-TB, and pediatric TB. The COVID-19 pandemic further disrupted in-person training, highlighting the urgent need for scalable, flexible, and cost-effective capacity-building mechanisms. Ni-kshay SETU was conceptualized in response to this gap.

Platform Objectives

• • • To enhance the knowledge and clinical skills of healthcare providers in TB care.
    • To provide real-time decision-support aligned with NTEP guidelines.
      To facilitate cadre-specific and multilingual learning.
    • To support scalable, cost-effective, and sustainable capacity-building solutions.
    • To empower the health system in delivering timely, quality-assured, and guideline-compliant TB care.

Key Features of Ni-kshay SETU

1. 1. Interactive Learning Modules
      The platform offers over 40 structured learning modules tailored for various cadres, including frontline workers (ASHAs, ANMs), lab technicians, medical officers, and private practitioners. These modules are available in eight Indian languages and include both textual and audiovisual content to support flexible and self-paced learning, even in low-connectivity settings.
   2. AI-Powered SETU Chatbot
      The SETU chatbot uses natural language processing to answer TB-related queries in real-time via voice or text. Trained on over 1,70,000 TB queries, it helps healthcare providers resolve doubts instantly during patient interactions, improving care efficiency and adherence to protocols.

   3. Clinical Decision Support System (CDSS)
      A dynamic, algorithm-driven tool enables healthcare providers to navigate complex diagnostic and treatment pathways, including those for MDR-TB, extrapulmonary TB, and pediatric TB. The system ensures decisions align with the latest NTEP protocols.

   4. Knowledge Connect Plugin
      This plugin allows users to search NTEP guidelines and materials using keywords or voice input. The system provides personalized, context-aware results sourced from the official NTEP Knowledge Base (KBase), ensuring accuracy and relevance.

   5. Gamified Knowledge Quiz
      To promote continuous learning, Ni-kshay SETU includes role-specific quizzes with instant feedback and performance dashboards. The gamified approach has led to over 17,000 assessments, helping users and program managers identify knowledge gaps and monitor progress.

   6. Symptom-Based Screening Tool
      The tool enables healthcare workers to identify presumptive TB cases based on entered symptoms such as cough duration and weight loss. This early screening feature supports proactive community-level case identification.

   7. Health Facility Referral Mapper
      Linked with Google Maps, this tool allows users to locate the nearest TB diagnostic and treatment centers. Covering over 75,000 public and private facilities and 6,200 TB units, it improves timely linkage to care.

   8. TB Care Message Hub
      The platform includes pre-drafted, stage-specific SMS messages that providers can send to patients for treatment reminders, follow-ups, and health education. This enhances communication, treatment adherence, and patient engagement.

Technology Architecture and Integration

Ni-kshay SETU is a cross-platform application available on Android, iOS, and the web. It features a mobile-first, user-friendly interface with offline functionality and voice-enabled inputs. Built using a cloud-based, modular backend, the system is capable of regular content updates and real-time analytics. The platform is open-source (licensed under GPL-3.0) and does not store any personal health data, ensuring user privacy and compliance with ethical standards.

The platform interfaces with key systems including the NTEP Knowledge Base and Google Maps, and future integration with Ni-kshay Mitra and Ayushman Bharat Digital Mission (ABDM) components is planned.

Target Users 

Ni-kshay SETU is intended for a broad spectrum of healthcare professionals, including: 

• • Frontline health workers (ASHAs, ANMs, Senior Treatment Supervisors)
  • Medical officers, national and state TB consultants
  • Laboratory technicians, pharmacists, and program officers
  • Private healthcare providers, faculty, and medical students

Currently, more than 74% of users are frontline health workers, indicating successful penetration at the grassroots level.

Implementation and Scale-Up
Since its launch in September 2021, Ni-kshay SETU has undergone pilot testing in Gujarat and Jharkhand and is now deployed nationwide. As of September 2024, the platform has achieved the following:

• • Over 44,500 registered users across 35 states and union territories and 80% districts of India are covered
  • More than 1.57 million platform visits
  • Over 18,900 assessments completed
  • Integrated use by state and district TB program managers for workforce training

The platform follows an iterative development model incorporating user feedback, state TB office inputs, and evidence-based refinements. Training models include blended approaches with physical, digital, and hybrid components.

Impact and Recognition 

Evaluation and user feedback indicate that Ni-kshay SETU improves knowledge retention, guideline compliance, and clinical decision-making. A majority of users report reduced delays in diagnosis and faster patient referral. The platform has been recognized by:

• • WHO Digital Health Atlas
  • 2025 Atlas of TB Innovations
  • India TB Innovation Summit
  • National and state-level NTEP consultations

Sustainability and Future Directions

Ni-kshay SETU is designed as a cost-effective, scalable solution with long-term sustainability. It operates on an open-source model with minimal maintenance costs. The future roadmap includes:

• • Expansion to more regional languages
  • Enhancement of chatbot intelligence using colloquial terms
  • Integration with national digital health initiatives
  • Development of programmatic dashboards for real-time data insights

Conclusion

Ni-kshay SETU represents a paradigm shift in TB capacity-building through digital innovation. By bridging knowledge gaps, enhancing real-time decision-making, and enabling accessible learning at scale, the platform contributes meaningfully to India’s mission of eliminating TB by 2025. It serves as a model for digitally empowered public health systems, particularly in resource-limited settings.

Ni-Kshay SETU Brochure Download 

Ni-kshay-SETU-A-Digital-Intervention – iCheckDH

Resources for Ni-kshay SETU applications: