Globally, tuberculosis affects some 8.7 million people. Women and children in the developing world are particularly vulnerable. The disease has high mortality rates, but even for survivors, the consequences can be debilitating, with long-term health consequences. Highly effective treatments are free and available to patients in developing countries, but many of those infected with TB are neither diagnosed nor in treatment. The under-detection of TB represents a key challenge for health officials in developing countries because identifying those who have the disease is crucial to the success of any treatment program.
|Evaluation Sample:||3,182 patients at 128 tuberculosis (TB) treatment centers|
|Timeline:||2014 – 2017 (Completed, endline report pending)|
|Intervention:||cash transfers, information|
|Researchers:||Jessica Goldberg, University of Maryland; Mario Macis, Johns Hopkins University; Jason Farley, Johns Hopkins University|
|Partners:||J-PAL South Asia; Operation ASHA|
In India alone, about 2.8 million people were estimated to have tuberculosis in 2016, according to the World Health Organization, but close to one-third of them either haven’t been diagnosed or aren’t receiving treatment. In addition to the health effects, the impact on the Indian economy is significant: annual lost wages as a result of the disease are estimated to be some US $330 million dollars. Infected people are disproportionately from vulnerable and marginalized populations and outreach is costly in terms of time and resources. Also, those who suffer from the disease often don’t know about the availability and effectiveness of treatment.
The India-based non-governmental organization Operation ASHA, which operates 200 tuberculosis treatment centers, is part of India’s National TB Control Programme and is interested in more effective outreach approaches to identify and treat new patients. A pilot program offered cash payments to current patients who referred people who might have tuberculosis to testing centers. The pilot was structured to test different approaches for finding new TB positive people, including extra payments if the person referred tested positive, and the relative effectiveness of using current patients versus health workers to encourage people to get tested.