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Category: Health Systems Research

  • Barriers and Facilitators to Adherence to Treatment Among Drug Resistant TB Patients in Georgia

    [vc_row][vc_column][vc_column_text]Tuberculosis is a global challenge to public health throughout the world. Poor adherence to treatment remains a significant problem that prevents countries from obtaining high treatment success rates that is essential for health systems to control the epidemic and decrease spread of the disease.

    In 2016 Curatio International Foundation conducted a qualitative study to investigate factors that enhance or hinder treatment adherence among Drug Resistant TB patients (DR-TB) in Georgia. The study revealed different types of factors affecting treatment adherence among DR-TB patients and grouped them into structural, social, personal and health system factors according to the study conceptual framework. The study made it clear that all factors are closely interlinked and mutually influence each other.

    The study provides evidence that may help policy-makers develop effective strategies for improving treatment outcomes among DR-TB patients. The study findings might be helpful for other countries in the region where TB burden is also high.

    The study report and policy brief is downloadable below:[/vc_column_text][vc_empty_space][/vc_column][/vc_row][vc_row parallax_image=”” columns_type=”default” section=”” full_screen=”” vertical_centering=”” full_width=”” full_height=”” background=”” bg_color_info=”” img=”” parallax=”” parallax_bg_width=”110″ parallax_reverse=”” video=”” bg_type=”” parallax_style=”” bg_image_new=”” layer_image=”” bg_image_repeat=”” bg_image_size=”” bg_cstm_size=”” bg_img_attach=”” parallax_sense=”” bg_image_posiiton=”” animation_direction=”” animation_repeat=”” video_url=”” video_url_2=”” u_video_url=”” video_opts=”” video_poster=”” u_start_time=”” u_stop_time=”” viewport_vdo=”” enable_controls=”” bg_override=”” disable_on_mobile_img_parallax=”” parallax_content=”” parallax_content_sense=”” fadeout_row=”” fadeout_start_effect=”” enable_overlay=”” overlay_color=”” overlay_pattern=”” overlay_pattern_opacity=”” overlay_pattern_size=”” overlay_pattern_attachment=”” multi_color_overlay=”” multi_color_overlay_opacity=”” seperator_enable=”” seperator_type=”” seperator_position=”” seperator_shape_size=”” seperator_svg_height=”” seperator_shape_background=”” seperator_shape_border=”” seperator_shape_border_color=”” seperator_shape_border_width=”” icon_type=”” icon=”” icon_size=”” icon_color=”” icon_style=”” icon_color_bg=”” icon_border_style=”” icon_color_border=”” icon_border_size=”” icon_border_radius=”” icon_border_spacing=”” icon_img=”” img_width=”” ult_hide_row=”” ult_hide_row_large_screen=”” ult_hide_row_desktop=”” ult_hide_row_tablet=”” ult_hide_row_tablet_small=”” ult_hide_row_mobile=”” ult_hide_row_mobile_large=””][vc_column text_color=”” animate=”” animate_delay=”” width=”1/2″][vc_column_text]

    Barriers and Facilitators to Adherence to Tuberculosis Treatment Among Drug Resistant TB Patients in Georgi… by CuratioCIF on Scribd

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    Factors Associated Adherence to TB Treatment in Georgia_Report_Eng by CuratioCIF on Scribd

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  • New Study Findings About Tuberculosis

    Curatio International Foundation together with the Partnership for Research and Action for Health organized a meeting at the National Center for Disease Control and Public Health on 26th of December, where two different study findings were represented. Studies aimed to reveal Referral Delay from Primary Care facilities to specialized TB centers and Health System Factors Affecting Adherence to Tuberculosis (TB) Treatment in Georgia. The project was implemented by financial support of the TDR,  the Special Programme for Research and Training in Tropical Diseases, hosted at the World Health Organization (WHO).

    CIF prezented qualitative research findings about adherence to Drug Resistant TB treatment and led discussion around the findings – what can be done to improve treatment adherence among TB patients, looking through health system lens. The study report will be available by the end of January, 2017.

    CIF inventorised all civil society organizations (CSO) working on Tuberculosis issues in Georgia, with the financial support of Stop TB Partnership through the CFCS round 7.  In the frame of this project TB CSO informational directory has been developed which is available here.

  • Article: Privilege and inclusivity in shaping Global Health agendas

    Health Policy and Planning published an article Privilege and inclusivity in shaping Global Health agendas.  CIF director George Gotsadze co-authors the paper together with Kabir Sheikh, Sara Bennett and Fadi el Jardali.

    The article discusses lack of inclusivity in Global Health and possible actions to promote inclusivity and diversity in the field.

    “Northern voices dominate Global Health discussions. Of recent Lancet Commissions, excluding representatives from international organizations, 70% of commissioners on the Women and Health commission came from the global North, and likewise, 71% of the Health and Climate Change commission, 72% of the Global Surgery commission and 73% of the Global Health commission (Lancet 2016). Only two out of the 16-member Board of Directors of the Consortium of Universities of Global Health come from the global South (CUGH 2016). No current or past president and only one current member of the World Health Summit’s scientific committee is from the global South (WHS 2016). Only one of the 17 advisory board members of the journal Global Health Governance is based in a low/middle income country (LMIC) institution (GHG 2016).

    Only 15% of the world’s population lives in high-income countries. Yet Global Health conferences continue to be dominated by invited Northern speakers and important committees on Global Health composed mainly of Northerners. The words of a few from the global North wield a disproportionate power that carries …”

    The full text is downloadable here.

  • Barriers and Facilitators to Screening and Treatment of HCV among IV drug-users in the Republic of Georgia: A Formative Qualitative Study

    Status: Closed

    Introduction and Overview

    In Georgia HCV treatment has become accessible to the population through a new government initiative. This initiative entails the provision of costly HCV treatment drugs at a lower cost (60% lower than the market price) to the patients who have completed HCV diagnostic testing. The hepatitis C program has been placed high on the country’s political agenda, which demonstrates the priority of this public health problem. Since 2008, harm reduction programs operating in all major cities of Georgia provide free HCV antibody testing to PWIDs along with other preventive interventions. On average 2,000 IDUs get tested, and around 50% screen positive for exposure to HCV annually. Although preventive programs encourage HCV positive individuals to continue with further diagnostic procedures and treatment, the care and treatment outcomes for these individuals is unclear. Greater knowledge regarding the facilitators and barriers to diagnosis and care is urgently needed to ensure the country provides the most effective coverage of the population, and to help guide the implementation and refinement of the government’s new hepatitis C program.

    Organizations involved in the research

    The Curatio International Foundation (leading), Public Union Bemoni (partner) and New York University College of Nursing have considerable experience in the field of public health research, qualitative research methods, HCV research and studies with PWIDs.

    Expected Results and Their Application

    The implementation of this research will generate evidence that will in turn inform the future design of the Hepatitis C program. Specifically, the research findings will help to identify the barriers and facilitating factors to providing adequate HCV care and treatment. Additionally, it will assist in guiding the design of strategies to remove these barriers and enhance enabling factors, thus increase the effective coverage of the program.

    Sustainability Implementation Plan

    In Georgia there is no evidence regarding the factors that influence PWIDs decision to take the HCV test and to seek treatment following a positive test. Moreover, since the introduction of the government’s Hepatitis C program, there is a changing context (a decrease in the financial barriers), the influence of which, is interesting to investigate. Therefore, the findings of this research will be unique

    Read the report >>

     

  • CIF Pharmaceutical Price and Availability Study in Georgia

    Status: Closed project

    Introduction and Overview

    The goal of this project is to generate evidence and information on pharmaceutical prices and their availability at pharmacies; the enforcement of regulations regarding prescriptions; as well as pharmaceutical industry practices, in order to inform and strengthen health policy.

    Organizations involved in the research

    Curatio International Foundation conducts the fifth wave of the survay that is supported by the World Bank.

    Expected results and their application

    The objective of this study is to continue the series of Pharma surveys. The fifth round employs the same international methodology for measuring medicine prices that was used in the previous rounds, and attempts to collect information on medicine prices and the physical availability of a pre-selected list of medicines (brand and lowest price generics, with and without prescription requirements).

    The data allows international comparisons as well, using an external standard for the evaluation of local prices recommended by Management Sciences for Health (MSH) ‘International Drug Price Indicator Guide’. In addition, the survey also helps to determine and present an affordability trend among population.

    Furthermore, customs data on import prices for survey medicines (except of local production) is obtained from the Ministry of Labour, Health and Social Affairs (MoLHSA). This allows for the calculation of retail mark-up percentages for survey medicines for both brands and generics.

     

  • Assessment of GAVI Alliance HSS support to Tajikistan

    In August 2014, Curatio International Foundation conducted an assessment of GAVI Alliance HSS support to Tajikstan to provide solid evidence of to what extent the support achieved its objectives and contributed to strengthen the health system of the country.

    The assessment aimed to identify successes, key challenges and lessons learned that may help GAVI Alliance to improve the design and implementation of future HSS support to Tajikistan and other countries. The assessment covered the period of GAVI’s HSS grant to Tajikistan from 2008-2014.

    The full report of the assessment is now available on GAVI’s website. Please visit the page for more information.

    You can also download the full report here.

  • Infographic: HIV/AIDS in Georgia

    Though preventive programs are focused on the high risk population, we face slightly but growing tendency of HIV/AIDs among general population.

  • HIV risk and prevention behaviours among Prison Inmates in Georgia, 2015

    Curatio International Foundation continues implementation of Bio-Behavioral Surveillance Surveys (BBS) among Key Affected Populations (KAP’s) with the aim to measure HIV prevalence among KAP’s, monitor risk behaviors among these groups and generate evidence for advocacy and policy-making.

    The current study describes the most recent wave of BBS surveys among prisoner population in Georgia (Bio-BBS surveys among prisoner population have been implemented since 2008).  Study also was looking at STI (Syphilis) prevalence. CIF implemented this study together with partner organisations – Center for Information and Counseling on Reproductive Health – Tanadgoma and the Infectious Diseases, AIDS and Clinical Immunology Research Center.

    The study used a Simple Random Sampling (SRS) Method. A sample of 300 prisoners were recruited in the survey from 3 penitentiary establishment located in Tbilisi, Rustavi and Kutaisi.

    The study was financially supported by the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM).

    Major findings:

    Socio-demographic characteristics

    • The median age of prisoners was 34, with the age ranging from 18 to 78 years, majority (74.1%) were with the secondary education. Less than half (46.8%) of the inmates were married.
    • Median duration of imprisonment is 1.5 years years, ranging from 0.08 to 19 years.

    Sexual behavior

    • Sexual practices among prisoners was not high (35.2%). However, mostly heterosexual contacts were being reported (95.3%), only 4 respondents reported having both heterosexual and homosexual contacts and only 1 inmate said it was homosexual contact.
    • As for the condom use during the last anal intercourse, 3 out of 5 respondents said it was used, and other reported not using condom due to the trust towards the partner.

    Drug Use Behavior and Additional Risks

    • Slightly more than half of the respondents (52.2%) reported having used drugs in their lives. Out of those, who have ever used drugs, 87.9% reported use of injecting drugs and 68.8% – use of non-injecting drugs.
    • Only 10.3% of the respondents reported using non-injecting drugs during the last 12 months, and only 8 inmates reported having used injecting drugs. It is noteworthy that none of the inmates reported needle/syringe sharing during the last 12 months.
    • Additional risks related to HIV exposure were found to be also small. Almost one third of the prisoners (31.6%) reported having done tattoo while in prison. Only five prisoners reported using shared syringes for treatment purposes and 3% used razors that were used by the others. Alcohol use is extremely low in prisons – 3% reported using it during the last 12 months.

    HIV knowledge and HIV testing practice

    • The majority of the respondents (91.4%) report that they have heard about HIV/AIDS.
    • Knowledge about HIV, measured by the Global AIDS Response Progress Report Indicator, was low – 23.3%. In general, level of knowledge on HIV has not changed from 2011 to 2015.
    • HIV testing offer in prisons as well as uptake by the prisoners has increased, which demonstrated successfulness of the HTC cabinets established by the prevention programs within the penitentiary system.

    Sexually Transmitted Infections (STI)

    • Awareness on STIs in general is high. Majority (91.0%) of the respondents have heard about STIs, knowledge or health-seeking behavior of the prisoners has not changed since 2012.

    Interventions/Media

    • Prisoners have various sources of getting information on HIV and STIs, the most trustful of them being TV, booklets, NGO representatives as well as healthcare workers.
    • The study revealed statistically significant increase in the percentage of the respondents (25.2% in 2015 vs 18.3% in 2012, p<0.05) who were covered by preventive program.

    HIV and Syphilis prevalence

    • The HIV prevalence found by the survey was 2%. In the previous survey the prevalence was 0.3%. However, this increase is statistically not significant.
    • Prevalence of syphilis was low. Comparison of syphilis prevalence with the data of 2012 survey demonstrated statistically significant decrease (p<0.001).

    Full study report is available here. 

  • EPIC Studies – Governments Finance, On Average, More Than 50 Percent Of Immunization Expenses, 2010–11

    Journal Health Affairs publishes a new Article EPIC Studies: Governments Finance, On Average, More Than 50 Percent Of Immunization Expenses, 2010–11 coauthored by CIF team member Keti Goguadze.

    Abstract: Governments in resource-poor settings have traditionally relied on external donor support for immunization. Under the Global Vaccine Action Plan, adopted in 2014, countries have committed to mobilizing additional domestic resources for immunization. Data gaps make it difficult to map how well countries have done in spending government resources on immunization to demonstrate greater ownership of programs. This article presents findings of an innovative approach for financial mapping of routine immunization applied in Benin, Ghana, Honduras, Moldova, Uganda, and Zambia. This approach uses modified System of Health Accounts coding to evaluate data collected from national and subnational levels and from donor agencies. We found that government sources accounted for 27–95 percent of routine immunization financing in 2011, with countries that have higher gross national product per capita better able to finance requirements. Most financing is channeled through government agencies and used at the primary care level. Sustainable immunization programs will depend upon whether governments have the fiscal space to allocate additional resources. Ongoing robust analysis of routine immunization should be instituted within the context of total health expenditure tracking.

    The online version of the Article is available here.

  • Population Size Estimation of People Who Inject Drugs in Georgia, 2015

    Bemoni Public Union together with Curatio International Foundation conducted a population size estimation study among injecting drug users in Georgia in 2015.

    This study estimated the size of People Who Inject Drugs using different estimation methods to provide the most plausible estimates. The study was carried out in conjunction with the Bio Behavioral Surveillance Survey among injecting drug users.

    The study was financially supported by the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM).

    Full report is avalable here.