The ASCENT project

Rethinking optimal care for TB

Historically, the most widely-implemented means of supporting people affected by TB on treatment is Directly Observed Treatment (DOT) where a healthcare worker watches the medication being taken, either at a healthcare facility or at the person’s home. The DOT approach has advanced global decline in TB incidence. However, innovations are needed to improve person-centered care, enable a more efficient health care system and empower people affected by TB and health care workers so that a greater impact in curing and preventing all types of TB can be achieved.

Challenges experienced by people living with TB with the current DOT approach:

People affected by TB are required to travel daily or frequently to the healthcare facility to receive their treatment.

People living with TB can be burdened with the expenses incurred due to constant travelling to the healthcare facility.

People living with TB might experience stigma secondary to attendance to TB specialized care facilities, or recurrent home visits by TB care providers.

Provider challenges with the current DOT approach:

Heavy workload for HCW in case of directly observing so many people living with TB.

Heavy workload for HCW in case of house visits to observe people living with TB at their home.

DOTS: Not everyone require the same level of monitoring and support.

The ASCENT project helps people affected by TB successfully complete their course of treatment through the use of digital adherence technologies and data-driven support interventions, utilizing tools such as smart pill boxes and other innovations.

These digital adherence technologies empower their users to take their daily medication at a time and place that suits them best. Additionally they provide real-time information to the TB doctor or nurse, helping to determine the most appropriate treatment approach for each individual person and by enabling focused efforts on those persons that require extra support.

At this moment, these technologies are only used on a small scale in the international fight against TB. The ASCENT project aims to make them accessible to all people living with TB worldwide.

Potential benefits for people affected by TB:

The person can decide where to take their medication (e.g. at home).

The person can be prompted by text message (SMS) to take a certain action (e.g. take their medication/doctor appointment).

The person receives individualized information about their treatment via text messages (SMS) or voice recordings on their mobile phones.

Potential provider benefits:

With the app, healthcare workers have access to real-time adherence information per person.

The adherence platform can send healthcare workers automated alerts and reports about those under their care, prompting action.

Machine algorithms on the adherence platform help to automatically identify who needs more attention/support.

The ASCENT project is implemented in:

ukraine • Ethiopia • Tanzania • South africa • the philippines