Social Protection for Tuberculosis-affected households in Vietnam
Tuberculosis (TB) remains one of the most severe infectious diseases globally, particularly affecting low- and middle-income countries such as Vietnam, which ranks 11th among the 30 highest TB-burden countries in the world. TB not only impacts physical health but also imposes significant socioeconomic and psychological burdens on affected individuals and their communities, including financial hardship, stigma, and mental health issues.
We have three ongoing projects in Vietnam focusing on creating person-centered solutions for TB affected households including:
ASPECT - “Assessing Social Protection in Vietnam to End catastrophic Costs in Tuberculosis.” This project is focused on strengthening health system capacity to identify and support vulnerable TB-affected households through a novel, evidence-based tool: TB-PROTECT. Conducted in collaboration with Viet Nam’s National TB Program (NTP), the project aims to refine, validate, and implement a practical, user-friendly tool to help NTP staff predict the risk of catastrophic costs during TB care and target socioeconomic support. The study includes a multi-phase evaluation of the TB-PROTECT tool’s predictive performance and feasibility for integration into routine practice. It also assesses the acceptability of delivering socioeconomic support packages to people with TB.
EPIC - " Enhancing Programmatic Implementation and Capacity for BPaL in Viet Nam." This project builds on ASPECT and develops and validates a risk assessment tool (PROTECT ME) to identify households affected by drug-resistant TB (DR-TB) at high risk of catastrophic costs. The study will pilot an intervention in five districts of Ho Chi Minh City, where DR-TB affected households will receive differentiated support packages based on their level of need. These included income generation assistance, short-term cash transfers, and subsidized social health insurance. The pilot's effectiveness will be evaluated through costing surveys and qualitative research will explore perceptions of the intervention, guided by frameworks on healthcare access and intervention acceptability.
UPLIFT - “Understanding Psycho-socioeconomic Linkages through an Intervention providing enhanced Financial and social support during Tuberculosis treatment”. This project is a randomized control trial aimed at improving treatment outcomes and reducing financial hardship for TB-affected households in Vietnam through an intervention providing cash transfers conditioned on participation in peer-led support meetings (TB Clubs). The trial is being conducted across 12 districts across seven provinces in Vietnam, targeting areas with lower TB treatment success rates. This will be the first study of its type conducted in the WHO Western Pacific Region, marking a significant milestone in addressing the psycho-socioeconomic challenges faced by people with TB and contributing to the future development of similar policies in other high TB-burden low- and middle-income countries.
Funding and duration – ASPECT received funding from the Swedish Research Council (2022-00727). EPIC was funded by the TB REACH initiative at the Stop TB Partnership (STBP/TBREACH/GSA/W9-9110), while UPLIFT is funded through the Re-imagining TB Care initiative of the Stop TB Partnership (STBP/EASI/2024-01), with funding from the Korea International Cooperation Agency (KOICA). It will take place between 1 January 2022 and 31 December 2027.