TB REGIONAL EASTERN EUROPE AND CENTRAL ASIA PROJECT ON STRENGTHENING HEALTH SYSTEMS FOR EFFECTIVE TB AND MDR TB CONTROL IN EASTERN EUROPE AND CENTRAL ASIA (TB REP)
Together we are strong
ABOUT THE PROJECT
The goal of the project is to promote improved access to early TB detection and treatment using the outpatient treatment model and providing TB care to key populations. In the first year of the project, the Stop TB Partnership, Tajikistan reviewed the current state of outpatient care and the barriers impeding its expansion in pilot districts. After this review and desktop analysis of documents, the Stop TB Partnership, Tajikistan developed an advocacy strategy presented both at national level and in pilot districts. The organization actively engaged community and religious leaders in creation of an innovative people-centered model — sponsorship for the benefit of TB-affected people, based on treatment outcomes, and involving businessmen, local authority officials and members of parliament/local councils in providing support to people affected by TB. An important component of the project is assistance in creating favorable conditions in communities using campaigns to inform the general public, decrease the level of stigma against people affected by TB and reduce their social isolation. For this purpose, a media center was established under the Secretariat of Stop TB Partnership, Tajikistan. The media center started producing video and information materials based on the results of the situational review conducted in the first year of the project.
ACHIEVEMENTS IN PROMOTING PEOPLE-CENTERED TB CARE
Tajikistan is among 27 countries with the highest MDR-TB prevalence. Presently, about 50% of people with TB in the country are receiving outpatient treatment. Expanding coverage of the outpatient treatment model was to a great extent impeded by lack of awareness of the benefits of people-centered models, as well as of understanding of the importance of implementation of the outpatient treatment model at national level, and the lack of realization of obstacles to its large-scale implementation. To study such obstacles, a review of the national legal framework and a sociological study of the situation with implementation of the outpatient TB treatment model involving 400 respondents were conducted. The results of the study were then used to develop, in collaboration with stakeholders, joint operational plans including TB-related activities in 4 pilot regions. In addition, the TB-REP project included activities aimed at creating community support systems.
The most successful examples of effective collaboration under the project were:
Implementation of the results-based sponsorship model in partnership with the Committee on Religion and Regulation of National Traditions, Festivities and Ceremony of the Republic of Tajikistan, which improved adherence indicators. In particular, since October 2017, in five regions, 13 agreements on cooperation between the regional religious union and people with MDR-TB have been signed, with the latter now receiving monthly financial support from mosques, helping them to adhere to the treatment. Imams also work on raising the awareness of the faithful about TB symptoms and the need to be tolerant to people affected by TB.
Holding an essay contest dedicated to the issue of tuberculosis, among schoolchildren together with the Ministry of Education and Science of the Republic of Tajikistan and the National TB Program. The essay contest involved 10,131 high-school pupils from 111 schools in the pilot regions of the project. It helped to significantly improve awareness of the disease and to reduce stigma aimed at people affected by TB.
Creating a Media Center equipped with audio and video materials and tools for TB awareness raising activities among a broad public. Operation of the Center, in time, helped to significantly improve the knowledge of TB and reduce stigma against people affected by TB. An expert group operates at the Media Center developing and approving informational materials. Besides, Stop TB Partnership, Tajikistan have set up collaboration with the national TV channel and professional fi lm/theater actors for joint work on the creation and broadcasting of educational videos on TB.
Training 23 support group volunteers together with the National TB Program. The goals of the volunteers are to provide psychological support, promote adherence to treatment, establish communications between official health care facilities and communities, and support TB response activities.
Development of social entrepreneurship and supporting establishment of the car service center “Helping Hand to End TB”. This project generates income to support the continuous work of volunteers and provide direct aid to people affected by TB and their families, contributing substantially to adherence of people affected by TB.
Stop TB Partnership, Tajikistan plans to continue systemic work on strengthening and supporting the community of people affected by tuberculosis, expanding the scope of aid provided by the regional religious unions to people with MDR-TB, raising awareness of TB among the general population, holding the annual TB essay contest among pupils, and creating social enterprises. All these measures facilitate provision of information to society about the disease and the benefits of people-centered care, and help to improve the adherence rate among people affected by TB.