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Center For Health Policies and Studies

OneImpact: итоги работы в странах ВЕЦА и знакомство с новым рамочным документом для усиления внедрения мониторинга под руководством сообществ

OneImpact: results of EECA countries activities and the presentation of a new framework document to strengthen implementation of community-led monitoring

8/2/2021 10:45 AM
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On July 20, 2021, a meeting of TB-REP 2.0 partners implementing community-led monitoring projects was held with the participation of the Stop TB Partnership.

The first part of the event was devoted to experience exchange, problems, solutions and results achieved by working with the OneImpact mobile application in the EECA region. TB-REP 2.0 partners from Azerbaijan (Saglamliga Khidmat), Belarus (Let's Defeat Tuberculosis Together), Georgia (TBpeople Network), Kazakhstan (Kazakhstan Union of People Living with HIV), Kyrgyzstan (AIDS Foundation East-West in the Kyrgyz Republic)  and Ukraine (TBPeopleUkraine) shared their reports.

An overview of applying OneImpact in TB-REP 2.0 countries

Over the entire period of OneImpact implementation in 6 countries of the EECA region, almost 5000 users in total have signed in to the applications. More than 3000 requests were received in total, of which more than 87% have already been processed and solved.

The TB-REP 2.0 regional partner team continues to build the capacity of community-led TB monitoring and in 2021 the application was launched in Georgia by the TBpeople Network team. As for Belarus, the application is already working on the national hosting and the funding for next year is included in the application to the Global Fund. In Ukraine, in 2021, the OneImpact mobile application is undergoing transition on a local server.

Among the key challenges that organizations are facing in the implementation of OneImpact in EECA countries are the following:

  • lack of smartphones and Internet access for potential users,
  • low level of skills in using the phone or difficulty in understanding modern technologies  among patients,
  • difficulties in accessing confidential information about patients when processing requests through the application,
  • the need to develop trust in the application by developing successful cases.

But experience with the app has allowed the country teams to come up with a number of solutions. For example, to increase the trainings effectiveness, they began to organize smaller groups of participants or enter into partnerships with doctors in medical institutions who conduct trainings on an individual basis, so that they could pay more attention to each patient whenever possible. In some countries, they began to conclude agreements with patients to obtain the right to transfer their confidential data from medical institutions. Also, countries began to practice telephone consultations for patients and involved doctors as expert consultants to promote the application.

Strengthening the implementation of community-led monitoring and a new supporting framework document

A separate block of the meeting included the presentation of the Framework Document on the concept and implementation of community-led monitoring with OneImpact, which was developed based on the existing experience, lessons learned and is intended to further strengthen the implementation of community-led monitoring (CLM). It was presented by Caoimhe Smyth, Program Manager for the Community, Rights and Gender Support Group (CRG) of the Stop TB Partnership team. In her introduction, she noted that community-based monitoring, which is implemented through OneImpact, is very important in addressing the burden of tuberculosis.

One of the main reasons why TB continues to be an issue today is because people affected by TB are not significantly involved in all aspects of the disease control, she said. Community-led monitoring with OneImpact gives TB affected people the opportunity to access health and support services, assert their rights, and identify and reduce stigma.

OneImpact focuses on barriers linked to TB and services, human rights violations, TB stigma, and barriers to TB support services, Caoimhe said. The key assessment indicators collected by the app use are the following:% of people who reported a TB problem at least once (age, gender, key population group), TB problems and the status of their solution, and the level of satisfaction with the solution ( from community perspective).

As one of the successful examples of advocacy based on information obtained through the application, she cited the case of TBpeopleUkraine, who used information on TB stigma to advocate for TB stigma assessment. The project was scaled up with the Global Fund, USAID, Johnson and Johnson support and the CFCS grant mechanism.

Talking about the lessons learned, she also highlighted that literacy and language barriers are key factors limiting the maximum reach of communities, and therefore innovations such as support module, AI system - virtual interlocutor, social media integration, 2G channel integration will increase the efficiency of the platform.

And of course, the OneImpact platform is flexible, as demonstrated by how quickly it has transformed to meet the needs of COVID and HIV, summed up Caoimhe.

OneImpact helps to heal, study and live: country cases

Another subject of discussion among the participants of the meeting was the use of information received by the means of OneImpact in identifying problems and options for their solutions.

Kyrgyzstan, case of the AIDS Foundation East-West in the Kyrgyz Republic

Problem: An issue was reported by the OneImpact app: The doctor was rude and unfriendly. He also refused to see the patient and insisted on referring him to another medical institution near the patient’s official home residence. But the patient's actual place of residence was situated in a completely different area close to that specific medical institution.

Solution: A street lawyer was brought in to solve the problem. To reconcile the parties, he held a conversation with the patient and the attending doctor with the participation of the deputy chief doctor of the medical institution, at which he constructively explained the rights and obligations of each of the parties.

Result: the person continues the treatment in a health care facility which is territorially convenient to the patient and a constructive doctor-patient dialogue was established.

Ukraine, case TBpeople Ukraine

Problem: the mother of a girl with a "closed" form of tuberculosis contacted the mobile application. The girl was preparing to start the school year at a new school, but daughter and mother did not have local residence registration, which the school administration insisted on. Also, the woman was worried about the status of the child, because the schools insisted on the need for "the commission's confirmation act that the child is not contagious."

Solution: TBpeopleUkraine, having received a request through OneImpact, contacted the local free legal aid center and agreed to a consultation.

Result: after receiving high-quality legal support, which was provided by an employee of the legal aid center, the girl was not only admitted to school, but also supported in mastering the school curriculum. At the moment, the child plans to go to school in September 2021 and to begin her journey into the future.

 


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