Leveraging patients' social networks to overcome Tuberculosis under-detection in India: A field experiment

In India alone, it is estimated that 3.5 million people suffer from Tuberculosis (TB). The under detection of TB represents a key challenge in developing countries because the success of any treatment program rests crucially on identifying those who have the disease. We propose to evaluate an approach with the potential to augment and strengthen the WHO’s global strategy for community engagement in the fight against TB. We will explore the use of financial incentives to encourage referrals, and focus on a specific community group with unique potential to generate referrals - current patients under treatment for TB. We will conduct a randomized controlled trial to compare the effects of different types of financial incentives to encourage TB patients to refer people from within their social networks for TB screening and testing.

We will conduct a randomized controlled trial in collaboration with Operation ASHA (OpASHA), an Indian NGO that operates 200 community-based DOTS (“Directly Observed Treatment Short Course”) centers in 13 cities/regions in six Indian states (Rajasthan, Delhi, Maharashtra, Orissa, Karnataka and Madhya Pradesh). About 4,000 existing adult (i.e., 18 years or older) TB patients (Current Patients) enrolled in OpASHA’s centers will be involved in the intervention.