Implementation Support for Alternative TB Services Delivery Models in Ukraine

Project Description:

The World Bank supports the Government of Ukraine in strengthening TB control. The strategic approach is intended to be outpatient based TB service delivery.

For the first phase of the programme, the World Bank has contracted the consortium of management4health GmbH (m4h) and Project HOPE to conceptualize a pilot project for community-based TB service delivery.

Under this contract, Management4health and its partner Project HOPE, supported the Government of Ukraine to pilot out-patient TB treatment models and evaluate them for efficiency, effectiveness, patient satisfaction. An outline of a new service delivery model has been presented and uses directly observed (DOT) therapy based on two different modalities: home-based care and facility-based care.

Proposed patient-centred strategy defines the patient as an individual placed at the centre of the health care system and services. This means that the health system and services are designed with respect to patient’s rights, preferences, values and needs.

Scope of work

The pilot project built local, regional and national governmental support for TB control based on several models that have an outpatient treatment delivery in common. Three objectives that have been formulated are strategically focused on achieving the following:

1. Building Human and Systems Capacity for TB Control

• Integration of TB control within a reformed health system, through involvement of PHC providers into TB treatment, care and support by providing directly observed treatment;
• Build on and strengthen psychosocial support services;
• Strengthen the TB laboratory logistics by improving laboratory access by streamlining samples delivery and feedback of results during monitoring of treatment outcomes;
• Strengthen Human Resource Capacity by increasing staff competences in modern TB control to involve them more actively in TB treatment, care and support;
• Create a Rational Drug Management Systems in the pilot area to prevent stock-outs of first and second line drugs;

2. Community Advocacy and Mobilization

• Develop IEC/BCC Strategy;
• Improve communication for patients and families by developing IE/BCC materials for health providers;
• Communication for the general population: Mass media, training and tools for health providers;
• Advocacy, mobilization and communication for targeted high risk communities;
• Advocacy for policy makers.

3. Building political support for TB Control and Sustainable Financing

• Improve program management, supervision and surveillance by training management staff in data management and evidence based decision making
• Providing support and technical assistance in the revision of key policy documents, approval of key legislation and the development of a new model of resource allocation;

Project duration: 03/2015 – 04/2016