Mobile phones and financial incentives help Karachi hospital double case detection rates
1 June 2011 - Karachi, Pakistan - The Indus Hospital has reported a dramatic increase in case detection following the start of a new programme that uses mobile phone technology and financial incentives to track down people with tuberculosis (TB).
Supported by a grant from the Stop TB Partnership's TB REACH initiative, the hospital has doubled the number of TB cases it reports since the programme started in January 2011. Doctors reported a total of 420 cases in the first quarter of 2011, up from 200 in the last quarter of 2010.
Increased case detection is a crucial step towards getting more people treated for TB and preventing further infections. For every 10 additional cases detected, an estimated 5 lives are saved and 100 infections are prevented.
The hospital attributes their improved results to an incentive scheme that rewards family doctors and community health workers for screening patients and referring suspected cases to TB centres. Participants are rewarded based on both the number of sputum samples that they collect and the number of patients that test positive for active TB.
The incentive system operates using mobile banking facilities that have emerged recently in Karachi. Doctors or health workers report their activities using their mobile phones on the Indus Hospital TB Reach mobile data collection system and receive a text message which tells them how many cases they have helped to detect.
At the end of each month, these data are used to calculate the incentives earned by each person. Then their incentive amount is transferred to their mobile banking account, allowing them to pick it up at a local shop or outlet.
A variety of local partners have signed up to the incentive scheme. In private clinics, Indus health workers are training general practitioners (GPs) on TB screening and Indus has provided free advertising boards to promote their TB services. GPs have also joined TB camps where whole communities are screened.
To reach further into towns, case workers hired by Indus are tracking down new cases on a house-by-house basis. Lady health workers have added TB screening to their regular services.
In addition, Indus has launched a communications campaign with billboards, posters and local cable television adverts that encourage people to get tested for TB.
Following impressive early results, Indus will continue the scheme throughout the year, enrolling more GPs and recruiting more case workers.
"We are delighted with the programme's early impact and hope that this will become a model for adoption across Pakistan," says Dr. Zafar Zaidi, Medical Director of the Indus Hospital.
The main objective of TB REACH is to promote early and increased case detection of TB cases and ensure their timely treatment. The initiative encourages the development and application of ground-breaking and efficient approaches, interventions, and activities that result in increased TB case detection, reduced transmission and prevention of the emergence of drug-resistant forms of TB.
In its first 18 months, TB REACH has committed nearly $50 million to 75 projects in 36 countries aiming to find and treat more than 140,000 people with TB who would otherwise have gone undiagnosed.