Background
The End TB Strategy mandates that zero TB-affected households face catastrophic costs due to TB. However, evidence is limited evaluating socioeconomic support to achieve this change in policy and practice.
Objective
To investigate the economic effects of a TB-specific socioeconomic intervention.
Methods
Setting-32 shantytown-communities, Peru.
Participants-households of consecutive TB-patients throughout TB treatment administered by the national TB program.
Intervention-consisted of: social support through household-visits and community-meetings; and economic support through cash transfers conditional upon: TB-screening in household contacts; adhering to TB treatment/chemoprophylaxis; and engaging with social support.
Data collection-to assess TB-affected household costs, patient interviews were conducted at treatment initiation and then monthly for six-months.
Results
From February-2014 to June-2015, 312 households were recruited, of which 135 were randomized to receive the intervention. Cash transfer total value averaged $173 USD (3.5% of TB-affected household’s average annual income) and mitigated 20% of household’s TB-related costs. Households randomized to receive the intervention were less likely to incur catastrophic costs (30%[95%CI=22-38] versus 42%[95%CI=34-51]). The mitigation impact was higher among poorer households.
Conclusions
The TB-specific socioeconomic intervention reduced catastrophic costs and was accessible to poorer households. Socioeconomic support and mitigating catastrophic costs are integral to the End TB strategy and our findings inform implementation of these new policies.