Acasă

Center For Health Policies and Studies

TB

This study was carried out within the program “Strengthening tuberculosis control and reducing AIDS mortality in the Republic of Moldova”, funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, implemented by the Center for Health Policy and Studies. The study allows to document the results of the engagement of civil society, strengthening the operational role of CSOs and building confidence of public TB service providers and NTP in the important roles of community, identify and explore the opportunities for government–NGO collaboration. The results would guide initiatives on community system strengthening.

The study “Tuberculosis in Moldova: knowledge, attitudes and practices” was carried out within the program “Strengthening tuberculosis control and reducing AIDS mortality in the Republic of Moldova”, funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, implemented by the Center for Health Policy and Studies. The aim of the study is to assess the level of knowledge, attitudes and practices towards tuberculosis among the general population and migrants.

This document was developed in the framework of the TB REP 2.0 project Advancing people-centered quality TB care - from the new model of care towards improving DR-TB early detection and treatment outcomes, which is funded by the Global Fund, and builds on the People-Centered Model of TB Care: Blueprint for EECA Countries. It outlines a set of recommendatory standards for community-based, non-medical services such as awareness raising about TB, support in identification of TB and early treatment engagement, assisting people with TB through the treatment process and after the completion of treatment, in order to protect and promote the health and rights of people affected by TB. It pays particular attention to key populations by recommending a set of community-based services to better engage and reach key and vulnerable groups and to meet the complex and comprehensive needs of people affected by TB.

These recommendations are intended to support non-governmental organizations active in the field of tuberculosis, in ensuring the continuity of the services provided under the conditions of the COVID-10 pandemic in safe environments for their own health and for the health of those around them.

The recommendations were elaborated in partnership with PHI FPI "Chiril Draganiuc".

The study on the optimized allocation of financial resources to maximize the results in the TB program control was conducted using the Optima TB model. The analysis reveals the potential options identified for reallocating financial resources and priority interventions to accelerate the decline in the burden of tuberculosis in the Republic of Moldova.

The assessment of capacity building needs of NGOs working with key populations and healthcare providers in Moldova was conducted under the coordination of the Ministry of Health, Labor and Social Protection, in the framework of Joint UN Plan on AIDS, based on the UBRAF Funds, in the framework of the partnership between UNAIDS, UNFPA and UNFPA Implementing Partner, Center for Health Policies and Studies (PAS Center).

The study on the optimized allocation of financial resources to maximize the results in the TB program control was conducted using the Optima TB model. The analysis reveals the potential options identified for reallocating financial resources and priority interventions to accelerate the decline in the burden of tuberculosis in the Republic of Moldova.

The Strategy is part of the Global Fund to Fight AIDS, Tuberculosis and Malaria program implemented in Moldova by the Center for Health Policies and Studies (PAS Center) and was examined by the joint meeting of representatives of Chiril Draganiuc Institute of Phthisiopulmonology, National Tuberculosis Control Program and relevant community organizations, which took place on November 22, 2017.

The Strategy was developed by Prof. Dr. habil. Constantin Marin.

This evaluation report focuses on providing more effective options for development of sustainable financing models for TB control, and provider payment mechanisms to align financial incentives to increased role in TB care for outpatient settings (home, community, primary care specialist care) and decreasing contribution of inpatient settings.

This operational research was conducted with the support from the Global Fund to Fight AIDS, Tuberculosis and Malaria. The research method was developed by the staff of the Center for Health Policies and Studies (PAS Center). The research included 318 people identified in the SYME-TB who met the chart audit criteria which included being informed of having multidrug-resistant tuberculosis (MDR-TB) in 2012 and having had the result of treatment prior to December 2015.

This report presents an assessment of the human workforce (HWF) in the health system involved in the treatment and support of tuberculosis patients in the Republic of Moldova. The evaluation referred to each stage of human workforce training in the health system, such as the prevention, diagnosis, treatment and evaluation of tuberculosis (TB), using the standard tools and terms of reference to assess HWF policies, operations, workload and working conditions. There was focus on the country's capacity to deliver integrated people-centered care by inter-disciplinary teams for outpatient patient care. This report has focus on TB personnel at services delivery level like doctors, nurses, non-medical specialists working and community centers.

Despite the fact that tuberculosis is quite known and spread, it is a stigmatizing disease in the Moldovan society, and is linked with moral prejudices, especially in rural areas, among elder people, population with lower education levels and persons with lower socio-economic status. Every fourth person considers that it is a shame to have tuberculosis and slightly more than a half of the respondents (56%) think that persons with tuberculosis would not disclose their TB status. The main reason is the fear of being avoided by community (both at work and in the community of friends, relatives and acquaintances). The majority of respondents believe that people change their attitudes towards persons who have tuberculosis (59%), and commonly try to avoid them (77%).

The goal was to identify and measure factors associated with DOT failure and default, in order to suggest suitable measures to increase the treatment success rate. The study was designed to examine qualitatively and quantitatively the factors associated with TB defaults and failures. The goal of the quantitative part of the study was to identify and measure factors associated with DOT failure and default, in order to suggest suitable measures to increase the treatment success rate. A case-control study was conducted in patients with new pulmonary smear-positive active TB case registered between January 1, 2006 - March 31, 2007, who have started treatment for TB with known or unknown outcome. The study sample consisted of 99 cases and 198 controls matched by sex and age. The study measured major risk factors including factors associated to onset of TB, model of TB care, communications between patient and physicians and patient knowledge; personal and economic factors. The qualitative study explores the opinion of providers (primary health care and TB specialists) on factors associated with poor treatment outcomes.