title: Addressing poverty through disease control programmes: examples from Tuberculosis control in India.
abstract: BACKGROUND
  Tuberculosis remains a major public health problem in India with the country accounting for one-fifth or 21% of all tuberculosis cases reported globally. The purpose of the study was to obtain an understanding on pro-poor initiatives within the framework of tuberculosis control programme in India and to identify mechanisms to improve the uptake and access to TB services among the poor.
  
  
  METHODS
  A national level workshop was held with participation from all relevant stakeholder groups. This study conducted during the stakeholder workshop adopted participatory research methods. The data was elicited through consultative and collegiate processes. The research study also factored information from primary and secondary sources that included literature review examining poverty headcount ratios and below poverty line population in the country; and quasi-profiling assessments to identify poor, backward and tribal districts as defined by the TB programme in India.
  
  
  RESULTS
  Results revealed that current pro-poor initiatives in TB control included collaboration with private providers and engaging community to improve access among the poor to TB diagnostic and treatment services. The participants identified gaps in existing pro-poor strategies that related to implementation of advocacy, communication and social mobilisation; decentralisation of DOT; and incentives for the poor through the available schemes for public-private partnerships and provided key recommendations for action. Synergies between TB control programme and centrally sponsored social welfare schemes and state specific social welfare programmes aimed at benefitting the poor were unclear.
  
  
  CONCLUSIONS
  Further in-depth analysis and systems/policy/operations research exploring pro-poor initiatives, in particular examining service delivery synergies between existing poverty alleviation schemes and TB control programme is essential. The understanding, reflection and knowledge of the key stakeholders during this participatory workshop provides recommendations for action, further planning and research on pro-poor TB centric interventions in the country.
authors.affiliation: International Union Against Tuberculosis and Lung Diseases (The Union), South-East Asia Regional Office, New Delhi, India. vkamineni@theunion.org
authors.forename: Vishnu Vardhan
authors.initials: VV
authors.lastname: Kamineni
authors.forename: Nevin
authors.initials: N
authors.lastname: Wilson
authors.forename: Anand
authors.initials: A
authors.lastname: Das
authors.forename: Srinath
authors.initials: S
authors.lastname: Satyanarayana
authors.forename: Sarabjit
authors.initials: S
authors.lastname: Chadha
authors.forename: Kuldeep Singh
authors.initials: KS
authors.lastname: Sachdeva
authors.forename: Lakbir Singh
authors.initials: LS
authors.lastname: Chauhan
mesh_terms: D000288:Administrative Personnel; D002391:Catchment Area, Health / Q000191:economics; D018672:Community Health Planning; D055812:Community-Based Participatory Research; D003159:Community-Institutional Relations; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D023801:Directly Observed Therapy / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends; D006293:Health Promotion / Q000191:economics / Q000379:methods*; D006801:Humans; D007194:India; D017053:Infection Control / Q000191:economics / Q000379:methods*; D058436:Knowledge Management; D017146:Models, Organizational; D009026:Mortality / Q000639:trends; D017063:Outcome Assessment, Health Care / Q000191:economics / Q000379:methods; D011203:Poverty / Q000706:statistics & numerical data*; D019984:Quality Indicators, Health Care; D012424:Rural Population; D014376:Tuberculosis / Q000191:economics / Q000517:prevention & control*