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Expanding Tuberculosis Detection, Treatment, and Prevention in Ukraine

The Strengthening Tuberculosis Control in Ukraine project worked through specific quality assurance programs and systems to strengthen measures for routine health services in targeted areas of the country.

According to the World Health Organization (WHO), Ukraine is the second-highest-priority country for tuberculosis (TB) control in Europe. To counter this prevalence, the USAID-funded Strengthening TB Control in Ukraine project worked in partnership with the Ukrainian government and NGOs to improve the way health care providers detect, treat, and prevent TB.

Chemonics focused on a variety of health services in eight targeted regions of Ukraine. The project worked to expand the availability of Directly Observed Treatment Short course (DOTS)-based TB services, improve the quality of laboratory practices for correct diagnosis, and introduce infection control practices in health facilities. By promoting safe patient practices, the project helped health facilities more effectively manage multi-drug-resistant TB cases and contribute to better treatment outcomes.

An additional health risk to patients who have contracted HIV is TB co-infection. The project provided on-the-job mentoring to build health care workers' capacity to address co-infection, such as improved TB screening for HIV-positive patients and HIV testing and referrals for TB patients. Thanks to the project's efforts, X-ray screening of people living with HIV increased from 61 percent in June 2013 to 72.5 percent in June 2014.

Those TB patients with drug-susceptible TB who are at high risk of treatment default also received special attention from the project: in 2013, the project issued a grant to the Ukrainian Red Cross Society, and during the first year and a half of the grant over 550 patients received their full course of TB treatment.

The project consistently worked to institutionalize international best practices in TB control, advocating that updated national clinical protocols correspond with WHO standards and training 2,250 doctors, nurses, and laboratory technicians on the latest in TB prevention, detection, and care. Additionally, STbCU’s promotion of evidence-based practices tripled timely detection of TB among people living with HIV. STbCU also established an online Training and Information Resource Center, in partnership with the Ukrainian Center for Disease Control (UCDC). To support Ukraine’s reform efforts, the project studied patient benefit and health system cost savings by switching from in-patient treatment to out-patient care in the industrial city of Kryvyi Rih.

Project Results

  • Piloted the DOTS-based ambulatory care model, which increased treatment adherence and reduced treatment costs for patients and the government
  • Created a safer medical environment for improved infection control
  • Built capacity to implement programs for multi-drug-resistant and extremely drug resistant TB
  • Improved access to TB/HIV co-infection services

Project Duration: 2012 - 2017

Final Report
 

    impact

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