Many DOTS-based programs throughout the world are seeking to improve tuberculosis (TB) case detection and cure rates through the provision of a variety of incentives and enablers (I&E) to patients and/or providers. Since 2001, RPM Plus, in collaboration with Stop TB, WHO and the World Bank, has been studying I&E in a variety of contexts. The goal of this study is to expand the evidence base of whether, how, and how much I&E can improve the performance of TB control programs. Follow these links to learn more: The Growing Global Interest in I&E and TB Program Performance
The partners' study of I&E has been prompted by a growing global interest in the potential of incentives and enablers in improving TB (and other) program performance, matched by the widespread application of a variety of I&E schemes by national TB programs, partners, and projects supporting TB control.
Currently, the evidence base on the benefit of using incentives or enablers in TB control is very limited. Therefore, it is difficult to draw overall conclusions on the effectiveness of I&E relative to other measures to improve DOTS performance in high-burden settings.
Therefore, evaluations to assess the feasibility, incremental cost-effectiveness, and management frameworks for different schemes in varying DOTS settings are urgently needed.
Principal Activities of the I&E Partnership
The collaborative work program of RPM Plus, StopTB/WHO and the World Bank seeks to support strengthening the global evidence regarding the contributions of I&E to TB control goals. Principal activities of the partnership include— - Stimulation of country-level operations research and evaluation to assess the impact of incentive or enabler schemes
- Global-level workshops—
Presentation during symposium titled “Incentives for DOTS Performance: Enabling or Corrupting?” (UNION Conference, Paris, Fall 2004) » View Presentation [PDF - 177 KB]
Workshop on Evaluating TB Enablers and Incentives (UNION Conference, Paris, Fall 2003) » View Agenda and Presentations Workshop on the Use of Incentives and Enablers to Improve TB Program Performance (UNION Conference, Paris, Fall 2001) » View Agenda and Presentations
» View Workshop Report [PDF - 43 KB] - Regional workshops-
El Uso y la Evaluación de Incentivos en Latinoamérica y el Caribe [Use and Evaluation of Incentives in Latin America and the Caribbean] (Tegucigalpa, Honduras, Spring 2004) » View Agenda and Presentations
» View Workshop Report [PDF - 10.2 MB] - Country-level workshops held in collaboration with national TB programs to “map,” or identify, motivational challenges in achieving optimal performance and interventions to overcome these challenges. Interventions may include introduction of incentives or enablers.
To date, "mapping" workshops have been held in China [PDF - 30 KB] (with funding from the World Bank), Uganda [PDF - 27 KB] and Tanzania [PDF - 127 KB] (both with funding from Stop TB/WHO and the World Bank).
- In-country case studies, such as assessing the impact of food support on increased case detection and cure rates in Cambodia [PDF - 75 KB]
- Desktop research
Key Tools to Assist in Implementing I&E Activities. To assist in implementation of these activities, the team is developing two key tools— - Motivations Mapping Tool. This tool, which is used in a workshop setting, assists in identifying current performance problems, the underlying motivators to those problems, and potential interventions (including incentives and enablers) that can address these motivational challenges.
» View mapping tool [PDF - 1.3 MB]
- Operations Research and Evaluation (OR&E) Protocol Development Guide. This guide facilitates the implementation of studies that can contribute hard evidence on the incremental impact of incentive and enabler activities on TB program performance.
» View 2003 presentation on OR&E framework and guide [PDF - 68 KB] -
| | |
