Research protocol for a mixed-methods study to characterise and address the socioeconomic impact of accessing TB diagnosis and care in Nepal

Dixit, Kritika, Rai, Bhola ORCID: 0000-0002-7421-4891, Prasad Aryal, Tara, Mishra, Gokul, Teixeira de Siqueira-Filha, Noemia, Raj Paudel, Puskar, Levy, Jens W ORCID: 0000-0002-5676-2990, van Rest, Job, Chandra Gurung, Suman, Dhital, Raghu
et al (show 6 more authors) (2020) Research protocol for a mixed-methods study to characterise and address the socioeconomic impact of accessing TB diagnosis and care in Nepal. Wellcome Open Research, 5. p. 19.

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<ns4:p><ns4:bold>Background: </ns4:bold>WHO’s 2015 End TB Strategy advocates social and economic (socioeconomic) support for TB-affected households to improve TB control. However, evidence concerning socioeconomic support for TB-affected households remains limited, especially in low-income countries.</ns4:p><ns4:p> </ns4:p><ns4:p> <ns4:bold>Protocol: </ns4:bold>This mixed-methods study in Nepal will: evaluate the socioeconomic impact of accessing TB diagnosis and care (Project 1); and create a shortlist of feasible, locally-appropriate interventions to mitigate this impact (Project 2). The study will be conducted in the Chitwan, Mahottari, Makawanpur, and Dhanusha districts of Nepal, which have frequent TB and poverty.</ns4:p><ns4:p> </ns4:p><ns4:p> The study population will include: approximately 200 people with TB (Cases) starting TB treatment with Nepal’s National TB Program and 100 randomly-selected people without TB (Controls) in the same sites (Project 1); and approximately 40 key in-country stakeholders from Nepal including people with TB, community leaders, and TB healthcare professionals (Project 2).</ns4:p><ns4:p> </ns4:p><ns4:p> During Project 1, visits will be made to people with TB’s households during months 3 and 6 of TB treatment, and a single visit made to Control households. During visits, participants will be asked about: TB-related costs (if receiving treatment), food insecurity, stigma; TB-related knowledge; household poverty level; social capital; and quality of life.</ns4:p><ns4:p> </ns4:p><ns4:p> During Project 2, stakeholders will be invited to participate in: a survey and focus group discussion (FGD) to characterise socioeconomic impact, barriers and facilitators to accessing and engaging with TB care in Nepal; and a one-day workshop to review FGD findings and suggest interventions to mitigate the barriers identified.</ns4:p><ns4:p> </ns4:p><ns4:p> <ns4:bold>Ethics and dissemination: </ns4:bold>The study has received ethical approval. Results will be disseminated through scientific meetings, open access publications, and a national workshop in Nepal. </ns4:p><ns4:p> </ns4:p><ns4:p> <ns4:bold>Conclusions: </ns4:bold>This research will strengthen understanding of the socioeconomic impact of TB in Nepal and generate a shortlist of feasible and locally-appropriate socioeconomic interventions for TB-affected households for trial evaluation.</ns4:p>

Item Type: Article
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 10 Jun 2021 08:29
Last Modified: 18 Jan 2023 22:35
DOI: 10.12688/wellcomeopenres.15677.1
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