TB extremely affects the poorest and most vulnerable populations. Unfortunately, a number of patients who seek TB care do not complete diagnostic evaluation and the principal reason is the failure to address their social and economic barriers. Notably, patients who develop TB spend >20% household income(catastrophic costs) just to obtain a diagnosis because of the high direct and opportunity costs related to accessing TB diagnostic services. This significant financial burden makes them less likely to complete testing and initiate treatment, leading to increased transmission, morbidity and mortality. For this reason therefore, feasible and scalable social protection interventions that address known barriers to completion of TB diagnostic evaluation are urgently needed.
The ExaCT TB study aims to evaluate the effectiveness of a social protection intervention incorporating cash transfers and social support for patients suspected of having TB in Uganda.
All eligible patients undergoing clinical evaluation for pulmonary TB at 10 community health centers receive a Cash Transfer (CT) of UGX 20,000 at the time of sputum submission via a local mobile money service provider approved by the Uganda Communications Committee.
CTs may facilitate completion of TB diagnostic evaluation by mitigating common financial barriers among patients accessing TB care in Uganda.