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. Researchers are now exploring the possibility of offering TB patients cash bonuses for referring people to the testing centers in an effort to widen their reach to the most vulnerable. If successful, the patient-to-patient referral system could help public health officials around the globe better stop the spread of communicable diseases.
Research area: Health
Evaluation Sample: 200 tuberculosis clinics
Timeline: 2014 - 2017
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 3.5 million people are estimated to have tuberculosis, but 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. The pilot program will help the group understand whether this is an effective strategy for fighting the spread of TB and improving treatment in India and elsewhere.