NCTB - CHINA

Incentives for TB patients and providers project evaluation Shanxi Province, China.

A Fidelis project was implemented in 50 counties of Shanxi province from Nov 2004 to Oct 2005, covering 684 townships, 15992 villages and a population of 16 million. Twenty-seven out of the 50 counties are among the poor counties of the country and 35 counties are mountainous. The Shanxi Fidelis project aimed to 1) increase case detection through an established financial incentive mechanism to encourage TB suspects being transferred, and their travelling to county TB dispensaries for diagnosis, and to 2) maintain a high cure rate through providing extra incentives for village doctors directly observing TB treatment. In addition to the incentives provided by the Fidelis project, doctors also received the routine government incentives. Specifically, the project provided:

• US$1 for any poor patient for their first time seeking diagnosis at the county TB dispensaries;
• US$3 for doctors (in the village clinic, township of county general hospitals) referring an NSP patient to the county dispensaries;
• US$8 for a village doctor directly supervising an NSP patient taking anti-TB drugs;
• US$1 per year to village leaders broadcasting TB knowledge to their local villages;
• Health promotion through broadcast, TV and primary school pupils (to give pamphlets to their parents) on symptoms of TB suspects, free treatment and travel reimbursement policy for poor patients to county TB dispensaries.

The NTP has requested collaboration with the Nuffield to evaluate the effectiveness of the intervention project in terms of cost; to assess its acceptability by different stakeholders (TB doctors, village doctors, TB patients, TB suspects and village leaders), financial cost and routine TB outcome data were used for evaluation.