Tuberculosis Social Network Project Impact Evaluation 2016-2017
India, 2016 - 2017
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Reference ID
IND_2016-2017_TBSNP-IE_v01_M
Producer(s)
Jessica Goldberg, Mario Macis, Pradeep Chintagunta
Metadata
Created on
Oct 11, 2023
Last modified
Oct 11, 2023
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135718
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Identification
Survey ID number
IND_2016-2017_TBSNP-IE_v01_M
Title
Tuberculosis Social Network Project Impact Evaluation 2016-2017
Country/Economy
| Name | Country code |
|---|---|
| India | IND |
Study type
1-2-3 Survey, phase 2 [hh/123-2]
Series Information
This impact evaluation took place between January 2016 and October 2017. It consists of a baseline survey and an endline survey. Both surveys are documented here.
Abstract
Globally, tuberculosis (TB) affects some 8.7 million people. Women and children in the developing world are particularly vulnerable. The disease has high mortality rates, but even for survivors, the consequences can be debilitating, with long-term health consequences. Highly effective treatments are free and available to patients in developing countries, but many of those infected with TB are neither diagnosed nor in treatment. The under-detection of TB represents a key challenge for health officials in developing countries because identifying those who have the disease is crucial to the success of any treatment program.
Kind of Data
Sample survey data [ssd]
Unit of Analysis
Individuals
Version
Version Description
v2.1: Edited, anonymous dataset for public distribution
Scope
Notes
This study covers the following topics:
Baseline Survey: includes questions about demographics, household information, respondent/child TB test and/or treatment, social contacts, and the referral scheme
Endline Survey: includes questions about TB treatment, the referral scheme, and mental health
Referral Survey: includes questions about demographics, household information, the referral scheme, respondent/child TB test and/or treatment, social contacts, the interaction with the provider at the health centre, and mental health
New Patient Survey: includes questions about demographics, household information, respondent/child TB test and/or treatment, social contacts, the interaction with the provider at the health centre, and mental health
Keywords
Tuberculosis, Social Networks, Health, Randomized Controlled Trial, Incentives, India
Coverage
Geographic Coverage
10 cities across three states (Delhi National Capital Region, Madhya Pradesh, and Rajasthan)
Geographic Unit
City
Universe
Operation ASHA patients receiving treatment for drug-susceptible TB who were at least two weeks into their course of medication when the baseline surveys commenced. The sample was expanded to include patients who had completed their six-month treatment in the three months before the start of the baseline surveys as well.
Producers and sponsors
Primary investigators
| Name | Affiliation |
|---|---|
| Jessica Goldberg | University of Maryland |
| Mario Macis | Johns Hopkins University |
| Pradeep Chintagunta | University of Chicago |
Producers
| Name | Affiliation |
|---|---|
| Strategic Impact Evaluation Fund | The World Bank Group |
Funding Agency/Sponsor
| Name |
|---|
| Strategic Impact Evaluation Fund |
Sampling
Sampling Procedure
This study consisted of a randomized controlled trial implemented in 122 Directly Observed Treatment Short Course (DOTS) centers in 10 cities across three states (Delhi National Capital Region, Madhya Pradesh, and Rajasthan). The intervention was implemented by JPAL-South Asia in five waves between January 2016 and October 2017.
We augmented Operation ASHA's established use of community health workers and DOTS treatment by incorporating various types of referrals of new suspects by existing patients. Specifically, we used a cross-randomized design to test, respectively, three types of incentives for referrals and three types of outreach to prospective TB patients. The baseline sample included all Operation ASHA patients receiving treatment for drug-susceptible TB who were at least two weeks into their medication course when the baseline surveys commenced. We expanded the sample to include patients who had completed their six-month treatment in the three months before the start of the baseline surveys. Existing patients were either in the intensive phase (IP) of treatment, where they came to the clinic three times per week, or in the continuing phase (CP) of treatment (typically following IP), which required them to come to the clinic once a week. In cases where the patient was a minor, the survey questions and interventions were addressed to the legal guardian. The experiment was rolled out in five waves between March 2016 and October 2017. To address the possibility of spillover effects between patients, we randomized by center. A total of 3,176 patients were included in our study.
We augmented Operation ASHA's established use of community health workers and DOTS treatment by incorporating various types of referrals of new suspects by existing patients. Specifically, we used a cross-randomized design to test, respectively, three types of incentives for referrals and three types of outreach to prospective TB patients. The baseline sample included all Operation ASHA patients receiving treatment for drug-susceptible TB who were at least two weeks into their medication course when the baseline surveys commenced. We expanded the sample to include patients who had completed their six-month treatment in the three months before the start of the baseline surveys. Existing patients were either in the intensive phase (IP) of treatment, where they came to the clinic three times per week, or in the continuing phase (CP) of treatment (typically following IP), which required them to come to the clinic once a week. In cases where the patient was a minor, the survey questions and interventions were addressed to the legal guardian. The experiment was rolled out in five waves between March 2016 and October 2017. To address the possibility of spillover effects between patients, we randomized by center. A total of 3,176 patients were included in our study.
Survey instrument
Questionnaires
Four survey instruments were used for this study:
Baseline Survey:
- Section A: General Information
- Section B: PII Information
- Section C: Demographics
- Section D: Household Information
- Section E: Health
- Section F: Information Sharing
- Section G: Referrals
- Section H: Survey Status Code
- Section I: Re-Entering Unique ID Code
- Section J: Comments
- Section Y: Record GPS Coordinates
Endline Survey:
- Section AAA: General Information
- Section AA: PII Information
- Section A: TB Treatment
- Section B: Referral Cards
- Section C: Reward Information
- Section D: Optimism and Happiness
- Section E: Buy-Back Scheme
- Section F: Comments
- Section G: Survey Status Code
- Section H: Re-Entering Unique ID Code
- Section Y: Record GPS Coordinates
- Section Z: Survey Accompaniment
New Patient Survey:
- Section A: General Information
- Section B: PII Information
- Section C: Demographics
- Section D: Household Information
- Section E: Health
- Section F: Information Sharing
- Section G: Quality of Care
- Section H: Optimism and Happiness
- Section I: Survey Status Code
- Section J: Re-Entering Unique ID Code
- Section K: Comments
- Section Y: Record GPS Coordinates
- Section Z: Survey Accompaniment
Referral Survey:
- Section A: General Information
- Section B: PII Information
- Section C: Demographics
- Section D: Household Information
- Section X: Referral Scheme Related Information
- Section E: Health
- Section F: Information Sharing
- Section G: Quality of Care
- Section H: Optimism and Happiness
- Section I: Survey Status Code
- Section J: Re-Entering Unique ID Code
- Section K: Comments
- Section Y: Record GPS Coordinates
The questionnaires are provided in English and Hindi and are made available for download.
Baseline Survey:
- Section A: General Information
- Section B: PII Information
- Section C: Demographics
- Section D: Household Information
- Section E: Health
- Section F: Information Sharing
- Section G: Referrals
- Section H: Survey Status Code
- Section I: Re-Entering Unique ID Code
- Section J: Comments
- Section Y: Record GPS Coordinates
Endline Survey:
- Section AAA: General Information
- Section AA: PII Information
- Section A: TB Treatment
- Section B: Referral Cards
- Section C: Reward Information
- Section D: Optimism and Happiness
- Section E: Buy-Back Scheme
- Section F: Comments
- Section G: Survey Status Code
- Section H: Re-Entering Unique ID Code
- Section Y: Record GPS Coordinates
- Section Z: Survey Accompaniment
New Patient Survey:
- Section A: General Information
- Section B: PII Information
- Section C: Demographics
- Section D: Household Information
- Section E: Health
- Section F: Information Sharing
- Section G: Quality of Care
- Section H: Optimism and Happiness
- Section I: Survey Status Code
- Section J: Re-Entering Unique ID Code
- Section K: Comments
- Section Y: Record GPS Coordinates
- Section Z: Survey Accompaniment
Referral Survey:
- Section A: General Information
- Section B: PII Information
- Section C: Demographics
- Section D: Household Information
- Section X: Referral Scheme Related Information
- Section E: Health
- Section F: Information Sharing
- Section G: Quality of Care
- Section H: Optimism and Happiness
- Section I: Survey Status Code
- Section J: Re-Entering Unique ID Code
- Section K: Comments
- Section Y: Record GPS Coordinates
The questionnaires are provided in English and Hindi and are made available for download.
Data collection
Dates of Data Collection
| Start | End | Cycle |
|---|---|---|
| 2016-01 | 2017-10 | Baseline and Endline |
Data Collection Mode
- Computer Assisted Personal Interview [capi]
Data Collectors
| Name |
|---|
| The Abdul Latif Jameel Poverty Action Lab |
Data Collection Notes
For treatment and control centers, each existing patient was visited by a survey enumerator in a private location such as the patient's home. Enumerators obtained informed consent and administered a baseline survey. Information was collected on the existing patient's socioeconomic characteristics, physical and psychological health, and TB treatment, as well as on information-sharing networks. At the end of the survey, patients at treatment and control centers were prompted to think about individuals outside their households who they believed might be affected by TB ("Please think of people you know who have TB symptoms.") According to RNTCP protocol, immediate family members of TB patients are automatically tested for TB, and as such, were excluded from our referral schemes because they were already known to the system. Then, for treatment centers only, all patients were told, "We are promoting outreach for tuberculosis to encourage more people to get tested and treated, and we invite you to join this effort." They could do this by recommending TB testing for people they knew socially and believed to have symptoms; these new suspects would receive referral cards with information about the screening process. The cards contained information about Operation ASHA, names and addresses of local providers and treatment clinics, a list of TB symptoms, and an ID number used by Operation ASHA and the research team to link the card to the referrer and to distribute incentives according to the study design. New suspects were asked to bring these referral cards to Operation ASHA centers, where they would be screened by health providers and sent for further testing (if required) as per RNTCP mandates.
This process, from a suspect's arrival at an Operation ASHA health center to testing and, if necessary, treatment, was recorded in a referral register at the center that was updated with the relevant outcome at each step, including the result of the screening, whether the new symptomatic got tested, the results of the test (for symptomatics who got tested), and whether the newly identified TB-positive individual enrolled in treatment.
New suspects were always told that they had been targeted for outreach by someone who knew them personally, and shown where their information would be recorded on the card that linked them back to the contact who provided the referral. While they were asked to bring referral cards with them to Operation ASHA, they - like any other individual - could seek care at Operation ASHA (or a public sector facility) without providing a referral card or other documentation. Operation ASHA continued to conduct outreach, screening, and enrollment of new patients following its regular procedures throughout the duration of the study, including enrolling new patients who did not have referral cards. Any new suspect who was approached by or on behalf of an existing patient in this study, but who was concerned about having their visit to Operation ASHA linked to the contact who referred them, could present for screening and receive identical care without submitting the referral card. To the extent that this occurred, we will underestimate the extent of case finding as a result of the outreach and incentive conditions tested in this study.
After the intervention, endline surveys were conducted with existing patients to capture information on health outcomes and satisfaction with Operation ASHA. Intake surveys were also administered to the new suspects identified through the schemes: these measured their characteristics and history of care for TB.
This process, from a suspect's arrival at an Operation ASHA health center to testing and, if necessary, treatment, was recorded in a referral register at the center that was updated with the relevant outcome at each step, including the result of the screening, whether the new symptomatic got tested, the results of the test (for symptomatics who got tested), and whether the newly identified TB-positive individual enrolled in treatment.
New suspects were always told that they had been targeted for outreach by someone who knew them personally, and shown where their information would be recorded on the card that linked them back to the contact who provided the referral. While they were asked to bring referral cards with them to Operation ASHA, they - like any other individual - could seek care at Operation ASHA (or a public sector facility) without providing a referral card or other documentation. Operation ASHA continued to conduct outreach, screening, and enrollment of new patients following its regular procedures throughout the duration of the study, including enrolling new patients who did not have referral cards. Any new suspect who was approached by or on behalf of an existing patient in this study, but who was concerned about having their visit to Operation ASHA linked to the contact who referred them, could present for screening and receive identical care without submitting the referral card. To the extent that this occurred, we will underestimate the extent of case finding as a result of the outreach and incentive conditions tested in this study.
After the intervention, endline surveys were conducted with existing patients to capture information on health outcomes and satisfaction with Operation ASHA. Intake surveys were also administered to the new suspects identified through the schemes: these measured their characteristics and history of care for TB.
Access policy
Access conditions
Public Access
Citation requirements
Use of the dataset must be acknowledged using a citation which would include:
- the identification of the Primary Investigator
- the title of the survey (including country, acronym and year of implementation)
- the survey reference number
- the source and date of download
Example:
Jessica Goldberg (University of Maryland), Mario Macis (Johns Hopkins University) and Pradeep Chintagunta (University of Chicago). India - Tuberculosis Social Network Project Impact Evaluation 2016-2017. Ref: IND_2016-2017_TBSNP-IE_v01_M. Dataset downloaded from [URL] on [date].
- the identification of the Primary Investigator
- the title of the survey (including country, acronym and year of implementation)
- the survey reference number
- the source and date of download
Example:
Jessica Goldberg (University of Maryland), Mario Macis (Johns Hopkins University) and Pradeep Chintagunta (University of Chicago). India - Tuberculosis Social Network Project Impact Evaluation 2016-2017. Ref: IND_2016-2017_TBSNP-IE_v01_M. Dataset downloaded from [URL] on [date].
Access authority
Location of Data Collection
World Bank Microdata Library
Depositor information
Depositor
| Name | Affiliation |
|---|---|
| Laura Natalia Becerra Luna | The World Bank Group |
Disclaimer and copyrights
Disclaimer
The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.
Contacts
Contacts
| Name | Affiliation | |
|---|---|---|
| Strategic Impact Evaluation Fund | The World Bank Group | siefimpact@worldbank.org |
Metadata production
DDI Document ID
DDI_IND_2016-2017_TBSNP-IE_v01_M_WB
Producers
| Name | Affiliation | Role |
|---|---|---|
| Development Economics Data Group | The World Bank Group | Documentation of the study |
Date of Metadata Production
2023-09-28
Metadata version
DDI Document version
Version 01 (September 2023)