Developing a locally-appropriate socioeconomic support package for TB-affected households in Nepal: a seed project to inform the END-TB trial (360G-Wellcome-209075_Z_17_Z)

Background: WHO's End TB Strategy advocates socioeconomic support for TB- affected households to improve TB control. My doctoral research in 32 Peruvian-shantytowns trialled the world's first socioeconomic intervention (including education, mutual-support, and cash-transfers) for TB-affected households, which reduced catastrophic TB-related costs and increased TB preventive therapy initiation and TB treatment success. The next exciting step is to replicate this research in diverse, including low-income, countries. One such country is Nepal. Key goals: Supported by Birat Nepal Medical Trust, world-leading researchers, and the infrastructure of the IMPACT-TB study, I aim to: \- Project-1: evaluate the socioeconomic impact of engaging with TB care through in-depth interviews during household visits with 200 TB-affected households in Nepal; and \- Project-2: conduct a workshop with 30 multisectoral stakeholders in Nepal to create a shortlist of feasible and locally-appropriate potential socioeconomic interventions to mitigate this impact. Research outputs: \- Two first-author articles in high-impact journals \- Presentations to international policy-makers including WHO Future studies: I will link the findings with data from partner-countries within the SPARKS (see proposal) network including Peru and Mozambique, to inform the design of my Wellcome Trust Research Career Development Fellowship application, “END- TB”: a multi-country, randomized-controlled trial of socioeconomic support for vulnerable TB-affected households.