TB CARE I - Kazakhstan Quarterly Report Year 4 October – December 2013

The initiative was led by KNCV, with support from other partners, including the National TB Program (NTP), the Ministry of Health (MoH), and the Prison Service. The program's goal was to increase access to TB care, improve treatment outcomes, and strengthen the country's TB control system. The initiative focused on several key areas, including universal access to TB care, laboratory services, infection control, and patient management and treatment (PMDT). In the area of universal access, the program aimed to increase the number of TB patients receiving full outpatient care. In the first quarter of 2014, 82 patients in Akmola oblast and 30% of MDR-TB patients in the same oblast received full outpatient care. In East Kazakhstan oblast, 10% of MDR-TB patients received full outpatient care. The program also focused on improving laboratory services, including the introduction of GeneXpert, a rapid diagnostic test for TB. In December 2013, GeneXpert received official registration in Kazakhstan, enabling the MoH to procure cartridges with government funding in the future. In the area of infection control, the program aimed to improve the management of TB patients in prisons. In the first quarter of 2014, 86.2% of MDR-TB patients in East Kazakhstan oblast and 96% of MDR-TB patients in North Kazakhstan oblast received SLD treatment. The program also focused on improving patient management and treatment, including the introduction of outpatient care models. In Akmola oblast, the program piloted a comprehensive outpatient care model, which was supported by the MoH and NTP. The program also conducted training sessions for healthcare workers on outpatient care and patient support. The initiative faced several technical and administrative challenges, including difficulties in accessing the national TB database for research projects and delays in hiring a TB CARE I accountant. However, the program made significant progress in the first quarter of 2014, including the introduction of GeneXpert and the piloting of outpatient care models. The program's achievements were recognized by the MoH and NTP, which supported the pilot results and agreed to scale up the outpatient care model nationwide. The program's success was also reflected in the revised MoH decree draft #218, which mandated the administration of outpatient care nationwide for the first time. Overall, the TB CARE I initiative in Kazakhstan made significant progress in improving the country's TB control program, including the introduction of GeneXpert, the piloting of outpatient care models, and the improvement of patient management and treatment. The program's achievements were recognized by the MoH and NTP, and the program's success was reflected in the revised MoH decree draft #218.