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A 2023 United Nations General Assembly resolution called for all TB-affected people to receive a social benefits package by 2027. Cash transfers have been shown to improve health outcomes; however, operational evidence on their implementation and effectiveness in reducing catastrophic costs due to TB is limited. This pilot study sought to assess the feasibility of delivering cash transfers to people affected by drug-susceptible TB to inform the design of a future trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A longitudinal, non-randomized cohort study was conducted in Ho Chi Minh City, Vietnam. Half of the participants received unconditional cash transfers (UCTs) while the other half received conditional cash transfers (CCTs) after monthly appointment attendance and completion of 85% of scheduled doses. We analyzed pilot data to assess rates of participant enrollment, adherence and retention in the intervention, TB treatment success, and catastrophic cost incurrence. A 22-day time and motion study quantified the distribution of time pilot staff spent administering the cash transfer intervention by cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Delivering cash transfers was feasible, with 60\/70 (85.7%) and 60\/66 (90.9%) of eligible individuals in the CCT and UCT cohorts agreeing to participate, respectively. Only 12.3% of CCT participants had one or more transfers withheld and 5.8% of the total expected CCTs were withheld. Delivering CCTs in the observation period took twice as much time as UCTs (32.4 hours for 43 CCT participants vs. 16.0\u00a0hours for 47 UCT participants). There were no significant differences in TB treatment success rates between the cohorts (91.7% CCT vs. 93.3% UCT). Cash transfers caused catastrophic cost incurrence to decline by 12.9% in the CCT cohort (44.2% to 38.5%) and 26.9% in the UCT cohort (26.8% to 19.6%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cash transfers are a feasible way to mitigate the economic burden of TB in Vietnam. The conditionality assessed was not associated with any quantifiable benefits to TB-affected people, and required more effort to implement. A larger trial utilizing similar methods and outcomes is warranted. Our findings inform the design of a slightly modified approach of cash transfer delivery for the larger trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12913-026-15248-w","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:03:42Z","timestamp":1785431022000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Why condition cash transfers? 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The implementation of the work described in this study was approved by the Ho Chi Minh City People\u2019s Committee (214\/QDUBND, 2138\/QD-UBND, 2878\/QD-UBND). Ethical approvals were granted by the National Lung Hospital Institutional Review Board (114\/19\/CT-H\u0110KH-\u0110\u0110) in Ha Noi, Vietnam. Vietnam's National TB Program approved use of programmatic treatment data. We provided a written participant information sheet, a verbal explanation of the study and an opportunity to ask questions before enrollment. Following this engagement, all participants provided informed written consent. All data were anonymized prior to analysis.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Twelve of the authors received salary support to implement the pilot and its evaluation from the funding body. However, the authors have declared that no competing interests exist.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1056"}}