Strengthening Tuberculosis Control in Ukraine: Annual Report

The project focused on routine TB services, multidrug-resistant TB, and TB/human immunodeficiency virus co-infection. Key accomplishments in Year 4 (October 1, 2015 – September 30, 2016) included the completion of an outpatient model pilot in Kryvyi Rih, which helped local decision makers develop a strategic vision for TB and HIV service reform. The project also established the TB Training and Information Resource Center, which became a part of the Ukrainian Center for Socially Dangerous Diseases Control's portal, providing a large-scale Ukrainian resource on TB with interactive learning opportunities and online communication. The project performed mentoring visits in 95 percent of raions in the project-supported oblasts, providing on-the-job training to 2,095 health care workers on TB diagnostics, treatment, and case management. Additionally, 462 health workers received training on TB and TB/HIV case detection, diagnostics, and management in TB and primary health care facilities. The project also supported external quality assurance of Level 1 laboratories in all regions, with 100 percent of laboratories covered by panel testing, 93 percent by blinded re-checking, and 92 percent by monitoring visits. In terms of creating a safer medical environment, the project helped the Ukrainian Center for Socially Dangerous Diseases Control develop a road map of TB infection control, which was submitted to the Ministry of Health for endorsement. The project also drafted six national infection control regulatory documents and provided technical assistance to start implementation of infection control practices in 21 healthcare facilities. The project built capacity to implement PMDT programs for multidrug-resistant/extensively drug-resistant TB by developing guidelines for tertiary medical care for TB, which were approved by the head of the State Penitentiary Service and State Criminal Executive Service Health department of Ukraine. The project also trained 388 TB specialists, nurses, and state penitentiary service health professionals on managing the side effects of TB drugs and organizing TB drug management. Finally, the project improved access to TB/HIV co-infection services by developing capacity among specialists in TB and HIV facilities to analyze results of self-assessment tools and improve the quality of TB/HIV services. The project also supported joint mentoring visits to health facilities of primary and secondary levels of care, discussed findings with facility management and health professionals, and developed a guide on counseling to establish treatment adherence in TB/HIV co-infected patients in TB facilities.