Changing the agenda of tuberculosis control: the impact of social protection on tuberculosis prevention, care and support. (360G-Wellcome-104473_Z_14_Z)

The post-2015 tuberculosis (TB) control strategy claims for the adoption of social protection interventions to address TB social determinants. Cash transfers are form of social protection based on the provision of cash incentives to poor households. Although increasingly popular in public health, very limited is known on the impact of cash transfer interventions on TB prevention, care and TB-related costs mitigation and ultimately TB control. Building upon a partnership with Brazil, a high TB-bu rden country with one of the largest cash transfer program in the world(i.e. Bolsa Familia), this proposal aims to contribute to address this research gap through: 1. A retrospective cohort study, comparing TB patients receiving Bolsa Familia transfers for at least 2/3 of treatment duration with patients receiving benefits for less than 1/3 of treatment (to assess the impact of financial support on treatment adherence and TB-related costs mitigation). 2. A mathematical model to explore whethe r Bolsa Familia can have an impact on TB incidence rates under different scenarios of Bolsa Familia and TB control program performance (to assess the impact of financial support on prevention).