The identification, analysis of, and
addressing social determinants of TB
should be prioritised
Delia Boccia
delia.boccia@lshtm.ac.uk
World TB Day 2015: what do we need to know,
to reach, treat and cure everyone with TB?
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Interventions addressing the social
determinants of TB: a framework
Objective
PREVENTION:
to reduce vulnerability
to TB infection and
disease progression
TREATMENT:
to enhance case
finding and
treatment
SUPPORT:
to mitigate TB-related costs
Target
population
Vulnerable groups
People living with TB
TB-affected households
Tools
Cash/food transfers
Vocational training
Livelihood support
Housing / slum upgrading
Cash/food transfers
Health insurance
Cash/food transfers
Health insurance
Temporary disability grants
Employment laws
Mechanism
Transfers to very poor
households or
income generation or
microfinance to reduce risk
of exposure to TB for poor
key population groups
Transfers to incentivise
access and adherence
and improve outcomes
Transfers to mitigate income loss.
Economic
empowerment to TBaffected individuals to
reduce stigma
Income generating activities,
livelihood strengthening,
microfinance to increase financial
productivity of healthy household
members
Legal protection for affected
(widows, orphans, unemployed)
Actor
Beyond health care sector
National TB control
programs with crosssectoral support
National TB control programs with
cross-sectoral support