Getting More People to Test for TB

Can you increase TB medication adherence amongst vulnerable populations?

India bears one of the highest burdens of tuberculosis (TB) globally, and ensuring patients complete the full 6-month treatment is critical to preventing drug resistance. Despite free monthly health checkups offered by government health centres, many TB patients skipped visits jeopardizing their recovery and increasing public health risk. KHPT, a leading public health organisation, partnered with TinkerLabs to understand and overcome this puzzling behavior. The goal: use Behavioral Science and Design Thinking to decode why patients weren’t showing up and find a simple solution to nudge them back into the system.

A 12-week sprint during the lockdown, to arrive at a set of interesting prototypes for vulnerable populations.

• We conducted research with ~70 users, observing their current practices, enablers & barriers in adhering to their TB treatment
• The extreme users we focused on were Migrant workers - who didn’t have a fixed base, Mining & Industrial workers - who were subject to dangerous work conditions and Urban vulnerable populations & Tea tribes who were hard to reach & convince
• We focused on DSTB (Drug Sensitive Tuberculosis) patients who were seen dropping off the medicines around month 2-3, who weren’t regularly coming in for their free check-ups, and who were sometimes just forgetting to take their medication.

We realised that for most people, being on the medicine was an indicator that you still had TB. And so, they’d try to stop their medication at the 1st moment that they felt better. In most cases, this was at the point when they moved from the 2-month Intensive Phase medication (stronger, red-coloured tablets) to the 4-month Continuation Phase medication (milder, green-coloured tablets). Month 2 to 3 was seeming to be the breaking point in the journey.