Patient Perspectives and Willingness to Accept Incentives for Tuberculosis Diagnostic Evaluation in Uganda
Loading...
Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Value in Health Regional Issues
Abstract
We assessed attitudes and perceptions and willingness to accept (WTA) varying incentive structures for
completing tuberculosis (TB) diagnostic evaluation among patients in Uganda.
Methods:We surveyed 177 adult patients undergoing TB evaluation at 10 health centers between September 2018 and March
2019. We collected household sociodemographic information and assessed attitudes and perceptions of incentives. We
surveyed patients regarding their willingness to complete TB diagnostic evaluation in exchange for incentives ranging in
value from 500 Ugandan shillings (USh) to 25 000USh (~$0.15-$6.75). We compared associations between WTA and patient
characteristics using ordered logistic regression.
Results: Participant willingness to return to the health center to complete TB diagnostic evaluation increased proportionally
with incentive amount. The median participant accepted between 2000 and 5000 USh. Cash (52%) and transportation
vouchers (34%) were the most popular incentive types. Half of respondents preferred unconditional incentives; for a multiday
evaluation, 84% preferred conditioning incentive receipt upon returning to the health center. In multivariate models, we
found the pairwise difference between the third and lowest income quartile (aOR = 2.38, 95% CI: 1.20-4.69; P = .01), younger
age, and difficulty returning to the health center to be significantly associated with WTA higher incentive thresholds.
Conclusions: In Uganda, incentives such as cash transfers or transportation vouchers are an acceptable intervention for
facilitating adherence to TB diagnostic evaluation. Household income is associated with preferred incentive structure and
amount, especially for those at the cusp of the poverty threshold who are more likely to prefer unconditional and higher
valued incentives. Targeted and context-specific socioeconomic supports for at-risk patients are needed to optimize
outcomes.
Description
Keywords
Tuberculosis, Incentives, Social protection, Willingness to accept
Citation
Kadota, J. L., Nabwire, S., Nalugwa, T., White, J. S., Cattamanchi, A., Katamba, A., & Shete, P. B. (2021). Patient perspectives and willingness to accept incentives for tuberculosis diagnostic evaluation in Uganda. Value in Health Regional Issues, 25, 48-56.