Use of a sustainable livelihood framework-based measure to estimate socioeconomic impact of tuberculosis on house-holds.

Tuberculosis (TB) disproportionally affects impoverished members of society. The adverse socioeconomic impact of TB on households is mostly measured using money-centric approaches which have been criticised as one-dimensional and risk either overestimating or underestimating the true socioeconomic impacts of TB. We propose to use the sustainable livelihood framework, which includes five household capital assets: human, financial, physical, natural and social, and conceptualises that households employ accumulative strategies in times of plenty and coping (survival) strategies in response to shocks such as TB. The proposed measure ascertains to what extent the five capital assets are available to households affected by TB as well as the coping costs (reversible and non-reversible) that are incurred by households at different time points (intensive, continuation and post-TB treatment phase). We assert that our approach is holistic, multi-dimensional and draws attention to multisectoral responses to mitigate the socioeconomic impact of TB on households.