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  • 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.

  • Bio-Behavioral Surveillance Survey among People Who Inject Drugs in 7 cities of 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 People Who Inject Drugs (PWIDs) in Georgia (Bio-BBS surveys among PWIDs have been implemented since 2002).  Study also was looking at HCV prevalence among PWIDs. CIF implemented this study together with partner organisations – Bemoni Public Union and Georgian AIDS and Clinical Immunology Research Center.

    The study used a cross-sectional study design. A sample of 2037 injecting drug users 18 years and older were recruited using respondent-driven sampling in seven major cities of Georgia: Tbilisi, Gori, Telavi, Zugdidi, Batumi, Kutaisi and Rustavi.

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

    Major findings:

    Socio-demographic characteristics
    • The vast majority of participants reported being unemployed, and 51% of PWIDs mentioned having a monthly income of less than 300 GEL;
    • The median age of initiating non-injection drug consumption and injection drug use has not changed since 2012 and equals 15-16 years and 18-20 years, respectively.
    Drug Scene and other contextual factors
    • Non-injecting drugs consumption has not changed  radically since 2012. About a quarter of young PWID who reported non-injection drug use mentioned use of new psychoactive drugs.
    • Injected drug scene has significantly changed during last years. Heroin is the most frequently used substance among drug users in Georgia followed by buprenorphine. Heroin use dropped in 2012 and then increased to the same level in 2015 (58.1%).  Buprenorphine use also dropped in 2012 and increased up to 26% in 2014-2015. Alternatively, lower proportion of PWID reported use of homemade opioid-type drugs like Desomorphine and Amphetamine type stimulants (so called “Vint”, “Jeff”) compared to 2012.
    HIV knowledge and HIV testing practice
    • Knowledge of HIV/AIDS among PWID remains relatively good. The majority is aware of primary transmission risks associated with injection and sexual behavior.
    • There is significant increase in proportion of PWID who were tested during last 12 months and know their status. Increase is observed across all cities. In general one in four injecting drug user has been recently tested on HIV.
    Sexual behavior
    • More drug injectors have safe sexual contacts with occasional partners than in previous years in some study locations, although protective behavior remains at alarmingly low levels and needs special attention.
    Access to and coverage of treatment and harm reduction interventions
    • The majority of PWIDs have never attended drug treatment facilities. Only 6% underwent or was still under any kind of treatment.
    • Coverage of preventive programs (minimal coverage) has increased from 24% to 32.4% since 2012.
    • While awareness about syringe exchange programs has improved in Telavi, Batumi, and Zugdidi, in general, knowledge about the program remains low and needs to be improved. Substitution therapy programs are much better known among PWIDs.
    HIV and HICV prevalence
    • The combined dataset analysis of all seven cities shows that HIV prevalence in 2015 was 2.2% (95% CI 1.53-2.99) and has not changed since 2012, when HIV prevalence was  3.0% (95% CI 2.20-4.04) because of overlapping confidence intervals. An estimate for PWID living with HIV varies from the lowest 0.9% (95%CI, 0%-4.3%) in Rustavi to the highest 4.8% in Zugdidi (95%CI, 0.2%-11%). Batumi and Zugdidi remain the cities with highest HIV prevalence rates.
    • The study revealed alarmingly high HCV prevalence (66.2% – in all seven cities).

    Full study report is available here.

  • TB Community Systems Strengthening in Georgia

    We are glad to announce that Curatio International Foundation has been selected to be Round 7 Challenge Facility for Civil Society (CFCS) grantee under the Stop TB partnership financial support.

    TB Community Systems Strengthening (TBCSS) project in Georgia aims – to build up integrated and comprehensive response to TB that is patient-centered and includes strong partnership with communities and civil society.

    The project will have 3 main objectives:

    1. Assess legal and social environment and civil society capacity, gaps and needs for engaging civil society in TB community response;
    2. Organizational strengthening for sustainable development of civil society in the TB field and
    3. Improve linkages, coordination and networking of TB constituencies, civil society organizations, state and other actors and those objectives will be achieved in two phases.

    Updated information about activities and achievements will be provided and share through social media during the project lifecycle.

  • What can be done to improve treatment adherence among tuberculosis patients in Georgia: Looking through health systems lens

    Curatio International Foundation  has started implementation of new research project with the aim to provide a more in-depth understanding of the factors associated with loss to follow-up among TB patients.  The project is funded under the Joint TDR/EURO Small Grants Scheme for Implementation Research in Infectious Diseases.

     

    The project aims to address the following objectives:

    • To generate evidence that will inform policy on measures to reduce loss to follow-up among TB patients
      • To identify, determine and describe factors that enhance or undermine treatment adherence among TB patients
      • To develop recommendations based on research evidence aimed at policy makers and involved stakeholders.
    • To disseminate the study findings to the wider audience in the Eastern European Region for its further application.

    The study outcomes will inform policy makers and provide evidence based recommendations and the results will be disseminated regionally trough events dedicated to TB.

    CIF will provide information about all key activities and results during the study implementation.

  • Summer Internship Program 2016

     

    The Summer internship program is now open! Master and PhD students from around the world are invited to apply and use the possibility to develop advanced research skills, meet leading experts in the field and become a coauthor of a scientific paper.

    “What’s great about this internship is that I get to do all of this cool research in a pretty cutting-edge area for public health,” Alex Krengel – Read more here.

    We offer four different research directions for this summer:

    1. HIV/AIDS, Hepatitis C and Behavioral Issues
    2. Size estimation among Key Population
    3. Health Expenditure Survey
    4. Maternal and Child Health Research

    If you are interested in any of the research topics and would like to find out more about working with our research team please fill in and submit the application form.

    Deadline for application is March 7, 2016. Notification about selection will be sent within 10 days after the deadline.

    Since 2002 CIF attracts interns from around the world, who are interested to have the first-hand experience in the real-life setting and to contribute to the research projects implemented by the organization.

    For any further queries, please contact Internship Program Coordinator Maia Uchaneishvili or send us E-mail at internship@curatio.com

  • BioBehavior Surveillance Survey results were represented to the members of Parliament of Georgia

    Curatio International Foundation together with BEMONI PUBLIC UNION (BPU) represented BioBehavior Surveillance Survey results to the Members of Parliament of Georgia.

     

    The study was conducted in seven major cities of Georgia (Tbilisi, Gori, Telavi, Zugdidi, Batumi, Kutaisi and Rustavi) with a sample of 2037 injecting drug users 18 years and older. The current study describes the most recent wave of Bio-BBS surveys among PWIDs in Georgia (Bio-BBS surveys among PWIDs have been undertaken since 2002).  The study was funded by the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM).

    Study Findings

    Socio-demographic characteristics

    • The median age of initiating non-injection drug consumption and injection drug use has not changed since 2012 and equals 15-16 years and 18-20 years, respectively.

    Drug Scene and other contextual factors

    • Non-injecting drugs consumption did not demonstrate major changes since 2012. CNS depressants and hallucinogens were reported as the most popular drugs for consumption with a slight decrease observed since 2012. About a quarter of young PWID who reported non-injection drug use mentioned use of new psychoactive drugs.
    • Injected drug scene has significantly changed during last years. Heroin is the most misused substance among drug users in Georgia followed by buprenorphine. Alternatively, lower proportion of PWID reported use of homemade opioid-type drugs like Desomorphine and Amphetamine type stimulants (so cold “Vint” and “Jeff”) compared to 2012. Thirty-five percent of the survey participants are active opioid-dependent.
    • Injection in other countries has dramatically grown across all survey locations and this trend is notable since 2009. HIV risk behaviors increase while abroad, as exhibited by the four-fold increase in rates of sharing injection equipment in other countries compared to Georgia.

    HIV knowledge and HIV testing practice

    • Knowledge of HIV/AIDS among PWID remains relatively good. The majority is aware of primary transmission risks associated with injection and sexual behavior.
    • There is significant increase in proportion of PWID who were tested during last 12 months and know their results. Increase is observed across all cities. In general one in four injecting drug user has been recently tested on HIV.

    Sexual behavior

    • High risk sexual behavior remains one of the major problems among PWIDs.
    • Although, more drug injectors have safe sexual contacts with occasional partners than in previous years, but in Kutaisi, Batumi and Rustavi, however, protective behavior remains at alarmingly low levels and needs special attention.

    Access to and coverage of treatment and harm reduction interventions

    • The majority of PWIDs have never accessed drug treatment facilities. Only 6% underwent or was still under any kind of treatment.
    • Coverage of preventive programs (minimal coverage) defined as knowing where to get an HIV test and receiving at least one of the following program commodities: sterile injecting equipment, condom, brochure/leaflet/booklet on HIV/AIDS, and qualified information on HIV has increased from 24% to 32.4% since 2012.
    • While awareness about syringe exchange programs has improved in Telavi, Batumi, and Zugdidi, in general, knowledge about the program remains low and needs to be improved. Substitution therapy programs are much more well-known among PWID.

     HIV and HICV prevalence

    • The combined dataset analysis of all seven cities shows that HIV prevalence is 2.2% (95% CI 1.53-2.99) with no change since 2012 when HIV prevalence was 3.0 (95% CI 2.20-4.04). An estimate for PWID living with HIV varies from the lowest 0.9% (95%CI, 0%-4.3%) in Rustavi to the highest 4.8% in Zugdidi (95%CI, 0.2%-11%). Batumi and Zugdidi remain the cities with highest HIV prevalence rates.
    • The study revealed alarmingly high HCV prevalence (66.2% – in all seven cities).

    Presentation is avalable in Georgian. 

  • Announcing Winter Internship Program 2016

    Curatio International Foundation invites Master and PhD international students to apply on Winter Internship Program. Through the program, students have the possibility to develop advanced research skills, meet leading experts in the field and become a coauthor of a scientific paper.

    For Winter Internship Program 2016, Curatio International Foundation (CIF) offers three different research topics:

    1. HIV/AIDS and Behavioral Issues
    2. Adherence to TB treatment
    3. Maternal and Child Health Research

    Applicants should submit a resume (the template is available below), cover letter indicating the selected research topic and supporting letter from the university or the working place.
    Interested students with good literature review OR quantitative analysis skills OR scientific paper writing skills will strongly benefit from participating in this program.
    Deadline for application is November 5, 2015. Notification about selection will be sent within one week period after the deadline.

    All necessary Information and documents are available on the links below:

    Since 2002 CIF attracts interns from around the world, who are interested to have the first-hand experience in the real-life setting and to contribute to the research projects implemented by the organization.

    For any further queries, please contact Internship Program Coordinator Maia Uchaneishvili or send us E-mail at internship@curatio.com

  • Regional High Level Dialogue 'Road to Success', Tbilisi, Georgia

    On September 28-30, 2015 Regional High Level Dialogue took place in Tbilisi, Georgia on Successful Transition to Domestic Funding of HIV and TB Response in EECA. The 320 delegates from 31 countries have agreed to work together in creating and implementing national transition plans from donor to national funding of HIV and tuberculosis (TB) response as well as ensuring the accountability of all stakeholders in the implementation of these plans. High-level ministerial representatives of the EECA countries, international donor organizations, and civil society activists have concluded the event by adopting the resolution on shared responsibility and partnership ensuring the prevention and care of HIV and TB in the EECA region.

    The event was hosted by the Ministry of Labor, Health and Social Affairs of Georgia and organized together by Eurasian Harm Reduction Network (EHRN), The Global Fund to Fight AIDS, TB and Malaria, United Nations Office for Drugs and Crime (UNODC), UNAIDS and World Health Organization (WHO) acting as the event co-organizers, and United Nations Development Program (UNDP) and World Bank as supporting agencies.

    Among other speakers at the Dialogue Ketevan Chkhatarashvili, president of the Curatio International Foundation has presented findings and reccomendations of  a study: Transition fromTGF support and programmatic sustainability in four EECA countries. The Study was funded by The Global Fund and implemented by CIF in: Belarus, Bulgaria, Georgia and Ukraine.

    You can watch the presentation video here:

  • CIF study results on 8th IAS Conference on HIV Pathogenesis, Treatment and Prevention

    Findings of population size estimation study among Man who have Sex with Men (MSM) was presented to the 8th International Aids Association conference on HIV Pathogenesis, Treatment and Prevention in Vancouver, Canada in July, 2015.

    The study was conducted by Curatio International Foundation in the capital city of Georgia, in 2014. In the study, the research team applied a novel modified capture-recapture method based on network sampling, which was first time used among MSM, with few modifications.

    Modified capture-recapture method provides reasonable population size estimates for the MSM when compared to the median estimates and their boundaries of other more established methods.

    Estimating size of MSM through modified capture-recapture method appeared to be feasible, simple, cost-saving and effective method that is valuable for future application.

    For more information, please see the presentation and CIF banner presented on the conference.

    Estimating the size of Men who have Sex with Men (MSM) using modified Capture-Recapture method based on net…

     

     

     

  • Response to the “Final evaluation of GAVI support to Bosnia and Herzegovina"

    Gavi, the Vaccine Alliance published response to the “Final evaluation of Gavi support to Bosnia and Herzegovina” conducted by Curatio International Foundation.

    Gavi assess the final evaluation and the given recommendations as an important document for the transition country program development.

    “We view these evaluations as particularly important to help inform how we can better help countries transition away from Gavi support in the future and to provide lessons learned and recommendations that could inform Gavi’s Graduation Policy going forward.” – Read the full document.

    The evaluation assessed both financial and programmatic sustainability through an in-depth analysis of BiH’s experiences and immunization program performance before, during and after the conclusion of Gavi’s period of support for the country. The evaluation also identified factors contributing to the sustainability of these programs and their achievements and gives five key recommendations to Gavi.

    To read the final evaluation report, please follow the link.