Category: Health Systems Strengthening

Building Institutional Capacity for HPSR and Delivery Science- CIF is Europe region HUB
General Overview

The evidence-informed decision making in health still remains a major challenge. To strengthen institutional capacity in different countries around the globe the Alliance for Health Policy and Systems Research (AHPSR) launched the new program to strengthen the capacity of local teaching/research and policy institutions in six low- and middle- income countries in each WHO region, to embed high-quality training in HPSR, target both researchers and decision makers. The Knowledge to Policy (K2P) Center at American University of Beirut is lead mentor institution who will guide 6 mentee institutions around the world, Curatio International Foundation (CIF) acts as mentee institution for the European region.

Purpose of the Program

Strengthen the capacity of researchers and policymakers and their respective institutions to support evidence-informed decision-making in health.

Expected outputs
- Institutions that have the systems, processes and the right culture to support and facilitate evidence-informed decision-making in health in LMICs
- Policymakers who recognize the role of evidence in informing different stages of the policymaking process and capacity to access, appraise and use evidence to inform decision-making in health
- Researchers who understand the policymaking process and who have the skills and competencies to provide relevant, context-sensitive and timely HPSR and evidence to inform decision-making in health.
Expected impact
- A cadre of sustainable policymaking and research/knowledge institutions that champion the use of evidence in health policymaking, and that can serve as focal mentors to develop the capacity of other institutions within their respective countries and regions (i.e., ripple effect)
- Strengthened evidence-informed decision-making in health in LMICs
- Ultimately, by promoting the use of research, evidence, and data in policymaking and practice, the program will contribute to strengthening health systems, improving population health outcomes, reducing health care expenditures, and accelerating the attainment of the sustainable development goals (SDGs)
- Establish and nurture critical links and collaborations between and researchers and policymakers
Donors and Partners

Lead partner: Knowledge to Policy (K2P) Center (American University of Beirut)
Donor: WHO, the Alliance for Health Policy and Systems Research (AHPSR)

Geographical Coverage

Georgia and Europe Region (as defined by WHO).

Project Timeline

The project started in September 2018 and will run until May 2020.
October 29, 2018
Embedding Rapid Reviews in Health Systems Decision-Making (ERA)
General Overview

As a result of the constitutional amendments passed at the end of 2017, Georgia became a parliamentary republic. It increased the role of the legislature in policy development and supervision. As a result of these amendments, the Committee on Health and Social Affairs of Georgia has taken over more authority and powers to monitor the activities and policy implementation by the government, to regularly request reports maintained at the Ministry of Health and other agencies in order to analyze their performance and to develop recommendations. Consequently, the Committee has become more actively involved in reforming healthcare sector and in solving public policy issues.

The platform – ERA / REM introduction in healthcare policy development – has been established to facilitate the ongoing process. The establishment of the platform is in line with the recent trends and provides for the possibility to promote evidence-based policy-making in the country.

About the project

Curatio International Foundation has been implementing the project initiated by the Alliance for Health Policy and Systems Research (AHPSR) since July 2018.

The project aims at building capacities of evidence-based and sustainable decision-making in the field of healthcare policy development

Project goals
- Identification of pressing health policy topics/ issues
- Introduction of evidence-based rapid evaluation methods
- Preparation of REM evaluations on selected topical issues
- Facilitation of evidence-based decision-making.
Donors and Parents

The project is financially supported by the World Health Organization and the Alliance for Health Policy and Systems Research. The project is implemented by Curatio International Foundation in cooperation with the Committee on Health and Social Affairs of the Parliament of Georgia. Technical support to the project is also provided by St. Micheal’s Hospital-Knowledge Translation Program (Canada), Makerere University (Uganda)

Geographical Coverage

Georgia

Project Timeline

The project has been implemented since July 2018 and will run until November 2019.
October 11, 2018
Webinar: Integrating gender into health system strengthening in conflict and crisis-affected settings; what’s in our toolkit?

This webinar took place on June 22, 2018. However, if you missed the webinar or would like to listen to it again, you can watch the recording and download the slides.

In 2016, HSG held the first webinar on gender, asking the question, “What part should gender play in reconstructing post-conflict health systems?” Two years on and much has changed. There is a growing interest in applying gender frameworks and analysis in health systems research. The #metoo movement and other popular feminist actions have driven greater attention to gender equity. New conflicts and health crises have arisen in various settings prompting humanitarian emergency responses.

This webinar does not seek to make the argument that we should focus on gender in post-conflict health systems. We feel that argument has been settled. Rather we describe how the process of focusing on gender has unfolded in different settings and share a range of tools that interested researchers, policymakers and practitioners could use and adapt to stimulate progress towards gender equity.

We also want to hear from you. What challenges are you facing in taking forward this agenda? How can our global community of health systems researchers help in constructing the kind of evidence base that would guide good decision makers and facilitate best practice? Help us to shape the presentations by completing this short survey. It takes about three minutes.

Panelists

Introduction and survey results – Egbert Sondorp, the Thematic Working Group on Health Systems in Fragile and Conflict-Affected States

An overview of useful tools and approaches – Val Percival and Amber Warnat, Carleton University

Country case studies – Justine Namakula (School of Public Health, Makerere University, Uganda), Haja Wurie (College of Medicine and Applied Health Sciences, Sierra Leone)

The webinar is sponsored by RinGs, the ReBUILD Research Programme Consortium, and the Building Back Better project. It will be facilitated by Health Systems Global.

Curatio International Foundation hosts Health Systems Global Secretariat. Health Systems Global (HSG) is the first international membership organization fully dedicated to promoting health systems research and related knowledge translation. HSG brings together researchers, policy-makers, funders, implementers, civil society and other stakeholders from all over the world. Around 1900 HSG members work together to create, share and apply knowledge necessary for strengthening health systems globally.

Check the announcement on HSG website.

June 1, 2018
Closing Project: Tuberculosis Community Systems Strengthening in Georgia
The Curatio International Foundation has fulfilled a Tuberculosis Community Systems Strengthening (TBCSS) Project in Georgia, funded by the Stop TB partnership in the frame of Challenge Facility for Civil Society (CFCS) round 7 program. The goal for the project was to strengthen community response that is integrated and a part of a comprehensive response to TB in Georgia.

The Curatio International Foundation studied CSO engagement in patient-centered quality TB community care in the country and developed directory of civil society organizations (CSOs) and TB communities that have been enrolled in providing TB education, prevention, support, treatment adherence and care services among various target groups in recent past.

Project revealed major challenges for community engagement in the TB response in Georgia:

Limited funding opportunities for CSOs: Donor-funds are of limited scale; and the Government of Georgia has never funded TB CSOs for delivering TB services.

Limited capacity of CSOs: The mapping of CSOs has demonstrated that CSOs, and particularly less experienced TB-specific community-based groups, lack capacity for organizational management, fundraising, program financial management, leadership, etc.

Uneven geographic distribution of CSOs: There are only few CSOs that are engaged in TB services and mostly they are operational in Tbilisi, the capital city. Community based system for TB is not developed in regions and the number of CSOs is not evenly distributed geographically.

Within the project we had number of significant achievements addressing the challenges:
1. TB Georgia Coalition (TBGC) was registered as a non-profit, nongovernmental organization on October 30, 2017. That has generated new expectations among member organizations and increased their motivation to become more active in the field.
2. Member organizations of TBGC have benefited from each training organized under the CFCS Rd7 grant. CSOs representatives underwent intensive training on organizational management and leadership; program management cycles; program planning and budgeting, communication and presentation skills.
3. The Patients’ Union for the first time ever received funding under the Global Fund TB grant and was contracted as a sub-sub recipient organization in a consortium with the community-based organization (CBO) – New Vector. The Memorandum of Understanding between the National Center for Tuberculosis and Lung Diseases and local CBO – New Vector and the Patient Union, has been signed on November 9, 2017, with the aim to improve treatment adherence for TB patients.
4. Visibility of TB CSOs has increased through CFCS mapping and assessment results dissemination at the Country Coordination Mechanism (CCM) meeting, and national consultation meetings.
Since its establishment TBGC participated in several high level meetings and actively has been engaged in the discussions on critical issues regarding patient centered TB care in Georgia. Significant progresses has been made in this direction, however, involvement of civil society and TB communities in the national TB program is in its initial stage.

TB CSO directory document is available here.
March 22, 2018
Primary Health Care Systems: Georgia case study

Curatio International Foundation publishes Georgia case study of primary health care system (PRIMASYS). The PRIMASYS case study covers key aspects of primary health care system, including policy development and implementation, financing, integration of primary health care into comprehensive health systems, scope, quality and coverage of care, governance and organization, and monitoring and evaluation of system performance.

The PRIMASYS case study applied a framework looking at how the primary health care system works and what factors (both contextual and related to policy changes) have influenced access to and performance of primary health care in Georgia since 1994. Documents review and in-depth interviews with key stakeholders were conducted in 2017 in order to understand barriers and facilitators of the system reforms in Georgia.

Georgia PRIMASYS case study emphasizes that Georgia’s health care system has undergone radical reforms over the last two decades, significantly influenced by external drivers such as political dynamics, macroeconomic factors, international partners’ involvement and internal processes.

The current PHC system in Georgia offers accessible and affordable services to the population, with differentiated benefits to those in greater need. However, the system still requires significant improvements to achieve its ultimate goal of delivering comprehensive, continuous and people-centered care.

Georgia PRIMASYS case study was part of the series of 20 PRIMASYS case studies globally developed with the support of the Alliance for Health Policy and Systems Research in collaboration with the Bill & Melinda Gates Foundation. The case studies will serve as the basis for a multi-country analysis of primary health care systems, to understand the systems-level determinants of primary health care performance, and to draw cross-cutting lessons learned in the implementation of primary health care policies and systems reforms and interventions.

Download the full report.

March 16, 2018
Empowering civil society for engagement in and monitoring the decision making in health sector in Georgia

Introduction and Overview

The project aims to strengthen CSOs working on Health Systems to participate in the decision-making process, to assume watchdog functions, monitor enforcement of policies and advocate for better health for all. The project is funded by Open Society Foundation through proactive cooperation with Open Society Georgian Foundation.

Organisations Involved

Open Society Foundation (via OSGF); More than 20 local organizations, including Civil Society, Media, and Academy.

Expected Results and Their Application

To strengthening local CSOs to enable them to participate in the decision-making process, to assume watchdog functions, to monitor enforcement of policies and to advocate for better health for all regardless of the ability to pay.

1. To conduct mapping exercise to a) identify NGOs/CSO organizations working in the health sector as well as organizations working on transparency, human rights and budget monitoring issues in Georgia, b) explore existing potentials of health‐related civil society organizations; d) explore their interest in participating in the proposed project;

2. To strengthen health‐related civil society organizations to uncover and challenge nondemocratic, non‐transparent and non‐accountable policy decisions in health sector through training on a range of topics related to health policy cycle, health budget development processing Georgia and principles of budget monitoring, current landscape for overall health care system in Georgia, as well as landscape of pharmaceutical market etc.

3. To strengthen networking, coordination, and communication among civil society organizations and community groups.

February 21, 2018
Population Size Estimation of People who Inject Drugs in Georgia 2016-2017
Bemoni Public Union together with Curatio International Foundation conducted a population size estimation study among injecting drug users in Georgia during 2016-2017.

Also available: HIV risk and prevention behaviors among People Who Inject Drugs in six cities, Georgia, 2017

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.

Full report is available here.

Related Content:
February 1, 2018
HIV risk and prevention behaviors among People Who Inject Drugs in seven cities of Georgia, 2017
Curatio International Foundation together with Bemoni Public Union has conducted HIV prevalence and risk behaviors survey among People Who Inject Drugs in Georgia.

Also available: Population Size Estimation of People who Inject Drugs in Georgia 2016-2017

Current study represents the latest wave of Bio-Behavioral Surveillance Surveys among People Who Inject Drugs. Objective of the study was to measure prevalence of HIV and Hepatitis C among PWID, provide measurements of key risk behaviors and generate evidence for advocacy and policy-making.

The study used a cross-sectional study design. 2 050 injecting drug users aged 18 years or more were recruited using respondent-driven sampling in seven major cities of Georgia: Tbilisi, Gori, Telavi, Zugdidi, Batumi, Kutaisi and Rustavi.

The document represents the research results in the following directions:
- Socio-Demographic Characteristics
- Drug Use History
- Drug Use Risk Behavior
- Knowledge of HIV/AIDS, Testing Practice and Self-Risk Assessment
- Sexual Behavior
- Exposure to Drug and HIV Prevention Programs and Social Influence
- Prevalence of HIV and Hepatitis C
In addition the study measured facilitating and hindering factors related to Hepatitis C testing and treatment. Also, the study estimated Opioid dependence among PWID.

Full report is available here.

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

Related Content:
February 1, 2018
Conference paper: The Study of Barriers and Facilitators to Adherence to Treatment among Drug Resistant Tuberculosis Patients in Georgia to Inform Policy Decision

The abstract has been submitted and accept for oral presentation at The Union 2017 – 48th Union World Conference on Lung Health, 11 – 14 October, 2017 Guadalajara, Mexico

The study outlines different health system factors as long as some social and economic elements influencing the adherence behavior to TB treatment among MDR-TB patients in Georgia. The study concludes that factors are closely interlinked and self-reinforcing.

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 can be found here.

Download the abstract here.

November 16, 2017
Network Coordination Partner: The Learning Network for Countries in Transition
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Introduction and Overview

According to a new Gavi strategy for 2016-2020 one of the strategic goals for Gavi is to assure that EPI programs are sustainable in a long-term, especially within the group of countries transitioning out of Gavi financial support during the next five-year period. A large number of countries receiving support from Gavi, are transitioning or expected to transition out of support in the next few years.[/vc_column_text][/vc_column][vc_column width=”1/2″][vc_column_text]

Visit the project website

[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column width=”1/1″][vc_column_text]As transition is a new challenge middle-income countries are faced, it is crucial to capture experiences of countries go through the transition process and utilize country-to-country peer learning to address common challenges in immunization financing and programming. For this purposes a new initiative, the Learning Network for Countries in Transition was launched in May 2017. Results for Development (R4D) is leading network coordination and technical facilitation, drawing on partners and experts as needed.

Specific objectives of the project are following:
1. Facilitate knowledge exchange on technical topics;
2. Build community and sustain the collaborative process;
3. Co-develop clear and agreed output(s) related to priority technical topics;
4. Support LNCT country core groups;
5. Help with broader dissemination of LNCT messages, approaches, and lessons.
Organizations Involved in the Research

Project is implemented by Results for Development Institute, Inc. “R4D” in partnership with Learning Network for Countries in Transition, middle-income countries in transition from GAVI support.

The project is funded by Bill&Melinda Gates Foundation.

Expected Results

CIF will support R4D in conducting scoping literature review and interviews with partner organizations and country stakeholders to a) better understand current country processes, b) identify other country experiences regionally/ globally that would provide good learning opportunities; c) explore existing approaches, tools, and resources on identified technical topics; d) refine identified topics through understanding of country demand, experiences, and gaps in knowledge.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column width=”1/1″][/vc_column][/vc_row]
September 27, 2017