“Our approach appeals to their conscience—emphasizes how community members hold [medicine stores] in high esteem and trust them so much. We sensitize them on the epidemiology of TB—one undetected case can infect 10 other people. We point out that the person who is coughing may have children who go to school with their children to motivate them to help. If you’re not infected, you’re affected. The best incentive for you, family members, and the community is to eradicate TB in your community.” — Ahmad Muaz, Breakthrough ACTION-Nigeria, Kano State Team Lead
The Innovation
Earlier attempts by other programs relied on store staff to complete long M&E forms when making a referral, which store staff were unlikely to do even with some form of incentive. Breakthrough ACTION-Nigeria removed the burden on the medicine store staff to fill out a form when making a referral, making them much more likely to do so. Instead, the project used serial numbers to track completed referrals from the DOTS center back to the medicine store, allowing the project to generate the M&E data it needed without relying on medicine store staff.
The Evidence
During design and testing, the project oriented medicine store staff, left the referral slips with them, and went away. Later that afternoon, “Mystery Clients” visited the same medicine store complaining of a persistent cough and asking for cough syrup. About two out of three medicine stores gave a referral slip to the Mystery Client to call the National TB hotline.
During implementation, Breakthrough ACTION found small community medicine stores were more likely to issue referrals than busy roadside pharmacies.
- 59,173 referrals issued by the stores.
- 40,608 referrals completed.
- 10% positive cases from referrals from October 2021 through June 2024.
Scale-Up & Adapt
Over 9,000 medicine stores are issuing referrals for TB testing across eight states in Nigeria.
Over 40,000 people received testing after being getting a referral from a store.
Who can I speak with about this solution?
Bolatito Aiyenigba, Deputy Project Director for Tuberculosis
Justin DeNormandie, SBC and Innovation Advisor
Jen Orkis, Senior Program Officer II
Other resources
Continue exploring breakthroughs