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Tuberculosis Contact Tracing

Partner

Indonesian Ministry of Health

Challenge

In Indonesia, tuberculosis (TB) infection rates are among the world's highest, and diagnosis and treatment targets are falling well behind what is needed to address this crisis. The latest research shows that only 21% of TB index cases in Indonesia complete contact tracing.

 

The Indonesian Ministry of Health tasked Praekelt.org with finding a way to empower index patients to conduct early contact tracing via an innovative mobile solution.

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Research

Before we could dive into creating a chat-based service that encouraged and enabled contact tracing, we needed to understand why TB continues to devastate Indonesia. This meant research – lots and lots of research.

 

We had to understand which criteria affected someone's likelihood of completing contact tracing. We found that a person's level of knowledge on the infection (their TB literacy), as well as their age and gender played a significant role in whether or not they'd perform contact tracing.

 

We also discovered that stigma lies at the heart of the Indonesian people's reluctance to share their TB diagnosis and perform contact tracing, and that the particular stigma they're concerned about differs depending on the criteria listed above.

 

In order to deliver a personalised user experience, we needed to understand not only who the index patient was (this was taken care of during onboarding), but what beliefs they hold around TB.

 

We did this by asking one question:

 

How do you think TB is spread?

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Content segmentation

By knowing who each user is and their level of TB literacy, we're able to lead them through journeys that are highly personalised. For example, a married woman is more likely to be concerned about being rejected and isolated from her family and community than a man, whose main concern is likely being unable to work and provide for his family – leading him to opt for denial rather than confronting his diagnosis and completing contact tracing.

 

By addressing barriers and stigma that are specific to each user, we're able to alleviate their individual concerns and ensure they're not inundated with content that doesn't resonate with them, thus reducing drop-off and increasing contact tracing fulfilment.

 

The prototype will be going into its first round of user testing in Indonesia in early 2023.

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