Institute of Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK.
Int J Health Policy Manag. 2023;12:7643. doi: 10.34172/ijhpm.2022.7643. Epub 2023 Jan 18.
Tuberculosis (TB) still represents a major public health problem in many regions of the world. TB control can only be achieved through a comprehensive and inclusive response which takes into account both upstream and downstream coordinated interventions related to structural determinants such as poverty, nutrition, sanitation, housing and access to healthcare as well as timely diagnosis and support throughout the course of treatment. Several social and financial support strategies have been proposed to improve TB treatment adherence, including conditional cash transfers (CCTs). In this context, demonstrating that social protection directly improves a specific health outcome using routinely collected data, incomplete registries or surveillance reports brings about many methodological challenges. We briefly discuss this paper and some limitations, describe main findings from our own research in this area and make a call to expand social protection interventions to address structural conditions of those most affected.
结核病(TB)在世界许多地区仍然是一个主要的公共卫生问题。结核病控制只能通过全面和包容的应对措施来实现,这些措施考虑到与结构性决定因素(如贫困、营养、卫生、住房和获得医疗保健)相关的上下游协调干预,以及在整个治疗过程中的及时诊断和支持。已经提出了几种社会和财务支持策略来提高结核病治疗的依从性,包括有条件现金转移(CCTs)。在这种情况下,使用常规收集的数据、不完整的登记册或监测报告证明社会保护直接改善特定的健康结果,这带来了许多方法学上的挑战。我们简要讨论了这篇论文及其一些局限性,描述了我们在这一领域的研究的主要发现,并呼吁扩大社会保护干预措施,以解决受影响最严重人群的结构性条件。