Grant: Project Grant

Tuberculosis (TB) is a disease that thrives on poverty. Poverty, illiteracy, undernutrition, crowding and limited healthcare access contribute majorly to the high TB burden in the countries that continue to battle with TB. India has the highest number of persons with TB accounting for more than 25% of the world's TB burden. The country is also home to over 75 million people living in extreme poverty. India has implemented the world's largest social protection benefits (like cash transfers, food support, and public-funded health insurance) program for persons with TB. Given the huge investments that go into these initiatives, it is essential to understand if, and to what extent, they impact the individual, the household and the community at large. Our study will follow a representative sample of people with TB in India and their household contacts. We will check if social protection benefits are reaching these households and if they are impactful. Are the benefits adequate? Are they reaching people in a timely manner? Are the poorest patients most likely to receive the benefits? Do the benefits translate into better treatment outcome for the person with TB and lesser TB burden in the household and community? These are critical questions we will answer. We will compare the characteristics and outcomes of persons in households that have received social benefits with those that have not received benefits to answer these questions. The study results will provide evidence on which interventions or sub-populations need more attention and investment to reduce TB burden. Such evidence is useful to policymakers in India, and potentially other high TB burden countries and pockets of high TB burden in developed countries like the indigenous communities in Canada.