Designup

Category: Project

  • Technical Assistance to Evaluate HIV Monitoring and Evaluation System in the Republic of Moldova

    Introduction and Overview

    The evaluation is expected to comprehensively assess the HIV Monitoring and Evaluation (M&E) system aimed to standardizing the reporting forms, build the national information flow within HIV related organizations, developing the national M&E System and Plan. The evaluation has to provide recommendations for improvement of M&E System, enhance its quality and comprehensiveness, including coordination and sustainability of the system.

    The evaluation will assess the HIV/AIDS M&E system, type of indicators and data flows starting from the first service contact level up to the national level, between different sectors and with particular emphasis on Prednestrovya region. The evaluation will last by the end of November, 2017.

    Organizations involved in the research

    Public Institution “Coordination, Implementation and Monitoring Unit of the  Health  System Projects” is implementing the project, funded by The Global Fund. Partners of the project are Ministry of Health (MoH) and other sectorail ministries under the leadership of the National Coordination Council of Moldova.

    The HIV Monitoring and Evaluation is one part of the project fulfilled by Curatio International Foundation.

    Expected Results

    The Program Management structure, regional health authorities, health and other service providers will largely benefit from enhanced and comprehensive M&E system, for which the evaluation will formulate recommendations.

  • Results4TB: Designing and evaluating provider Results Based Financing for Tuberculosis in Georgia

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    Introduction and Overview

    Curatio International Foundation in partnership with Queen Margaret University (UK), London School of Hygiene and Tropical Medicine (UK) and Antwerp Institute of Tropical Medicine (Belgium) is implementing a study “Designing and evaluating provider results-based financing for tuberculosis care in Georgia: understanding costs, mechanisms of effect and impact”.[/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]The 48-month duration research project will assist the Government of Georgia in developing a provider incentive payment scheme for Tuberculosis (as a pilot intervention) and will generate evidence on its effects on adherence and treatment success rates and costs.

    The research will seek to answer the following research questions:

    (1) What is the impact of provider-focused Results-Based Financing (RBF) on patients’ adherence to tuberculosis treatment and treatment outcomes of both Drug-Susceptible (DS) and Multi Drug Resistant (MDR) patients in Georgia?

    (2) Is the RBF intervention cost-effective?

    (3) How does it work, for whom and in which conditions? and

    (4) How should RBF be modified to optimize national roll-out for this and possibly other health services?

    Project has launched in March 2017 and will run till March 2021[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column width=”1/1″][ultimate_spacer height=”30″][vc_column_text]

    Organizations involved in the research

    The project is funded through the Joint Health Systems Research Initiative which is jointly funded by the Department of International Development (DFID), the Economic and Social Research Council (ESRC), the Medical Research Council (MRC) and the Wellcome Trust (WT).

    The study will be implemented by CIF (Georgia), Queen Margaret University (UK), London School of Hygiene and Tropical Medicine (UK) and Antwerp Institute of Tropical Medicine (Belgium).

     

    Expected Results and Their Application

    The beneficiaries of this research will be TB patients, nurses and physicians involved in TB care, health facility managers, policy-makers, community members and the scientific community in Georgia, in the region and globally.

    The research will narrow the knowledge gap existing around RBF interventions, such as their application in public/private settings and their cost-effectiveness, the conditions of success and the wider (negative and positive) consequences of the scheme.

    The research will also produce methodological innovation regarding the use of realist evaluation alongside cost-effectiveness analysis.

    The evidence produced through this research will be used by national policy-makers to reform the financing of primary health schemes in a way that improves efficiency, quality, and sustainability of services. Additionally, findings will be beneficial for other LMICs, particularly for those with a similar vertical organization of TB services (most of the former Socialist countries of Eastern and Central Europe and Central Asia) and for countries where private providers play an important role in the provision of TB services

     

    Would you like to be updated about the project achievements?

    The Results4tb project has its own website. Visit the page to learn more about the project.[/vc_column_text][/vc_column][/vc_row]

  • Designing and evaluating provider results-based financing for tuberculosis care in Georgia (RBF4TB)

    Introduction and Overview

    CIF in partnership with Queen Margaret University (UK), London School of Hygiene and Tropical Medicine (UK) and Antwerp Institute of Tropical Medicine (Belgium) is implementing a study “Designing and evaluating provider results-based financing for tuberculosis care in Georgia: understanding costs, mechanisms of effect and impact”. The 48-month research project will assist the Government of Georgia in developing a provider incentive payment scheme for Tuberculosis. It will generate evidence on its effects on adherence and treatment success rates and costs.

    The research will seek to answer the following research questions:

    (1) What is the impact of provider-focused Results-Based Financing (RBF) on patients, adherence to tuberculosis treatment and treatment outcomes of both Drug-Susceptible (DS) and Multi Drug Resistant (MDR) patients in Georgia?

    (2) Is the RBF intervention cost-effective?

    (3) How does it work, for whom and in which conditions?

    (4) How should RBF be modified to optimize national roll-out for this and possibly other health services?

    Project has launched in March 2017 and will run till March 2021.

    Organizations involved in the research

    The project is funded through the Joint Health Systems Research Initiative, which is jointly funded by the Department of International Development (DFID), the Economic and Social Research Council (ESRC), the Medical Research Council (MRC) and the Wellcome Trust (WT).

    The study will be implemented by CIF (Georgia), Queen Margaret University (UK), London School of Hygiene and Tropical Medicine (UK) and Antwerp Institute of Tropical Medicine (Belgium).

    Expected Results and Their Application

    The beneficiaries of this research will be TB patients, nurses and physicians involved in TB care, health facility managers, policy-makers, community members and the scientific community in Georgia, in the region and globally.

    The research will narrow the knowledge gap existing around RBF interventions, such as their application in public/private settings and their cost-effectiveness, the conditions of success and the wider (negative and positive) consequences of the scheme.

    The research will also produce methodological innovation regarding the use of realist evaluation alongside cost effectiveness analysis.

    National policy-makers will use the evidence produced through this research to reform the financing of primary health schemes in a way that improves efficiency, quality and sustainability of services. Additionally, findings will be beneficial for other LMICs, particularly for those with a similar vertical organization of TB services (most of the former Socialist countries of Eastern and Central Europe and Central Asia) and for countries where private providers play an important role in the provision of TB services.

     

  • Patronage (home visits) System Assessment With Equity Analysis In The Republic Of Uzbekistan

    Status: Closed project

    Introduction and Overview

    The overall purpose of the consultancy is to provide technical assistance to the Ministry of Health of Uzbekistan and the UNICEF Country Office in conducting an assessment of the Patronage/Home Visiting (HV) System. The main purpose of the assessment will be to identify the main strengths and weaknesses of the patronage system. This will help determine what concrete actions and changes to make in order to strengthen its quality and increase its coverage. The home visiting services aim to identify vulnerable children and families in a timely manner, and address the disparities and inequities in basic mother and child assistance/support services.

    In order to deliver the assignment, the CIF team will work jointly under the guidance of the UNICEF Country Office, and in close cooperation with the Ministry of Health and other partners. The project activities will be undertaken in 15 districts located in three select regions.

    The CIF team will consist of a Technical Team Leader – Tamar Gotsadze and a Researcher – Natia Shengelia. The team is supported by a local research company and a local research consultant for data collection.

     

    Organizations involved in the research

    UNICEF Uzbekistan, the Ministry of Health of Uzbekistan, Ministry of Finance of Uzbekistan, as well as regional social services offices, and regional primary healthcare facilities.

     

    Expected Results and Their Application

    As a result of Curatio’s consultancy services, UNICEF CO will have:

    1. The Report on Assessment of the existing Patronage System (P(HV)S), including an equity analysis in utilization and quality of these services.
    2. Recommendations for the improvement of the existing services
    3. Feasibility assessment for implementing a “blended” home visiting model
    4. Recommendations for the implementation of the “blended” home visiting model.

  • 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.

  • Final Evaluation of Gavi’s Support to Albania

    After the conclusion of Gavi’s support period (2014) to the Albania, Curatio International Foundation conducted the evaluation study and assessed financial and programmatic sustainability through an in-depth analysis of Albania’s experiences and immunization programme performance before, during and after the conclusion of Gavi’s support period to the country.

    The evaluation also identified factors contributing to the sustainability of these programs and their achievements. The evaluation considered the types and quality of support received and the way in which Gavi’s support to Albania was considered.

    Main Findings:
    • The coordination mechanism between partners  established at the time of Gavi support continues to operate, although the frequency of the meetings has decreased
    • All Gavi supported activities have been continued : The Hep B and pentavalent vaccines and Auto-Disable (AD) syringes are fully financed by the Government, and are safeguarded in the MoH budget
    • Stable and high immunization coverage rates (> 95%) for all antigens included in the national immunization schedule have been sustained as of today at the national and district levels
    • Achievements in safe injection have been sustained in Albania
    • After Gavi support ended, Albania has continued to introduce new vaccines
    • The budget planning mechanism used for vaccine procurement during the Gavi support period has been maintained and institutionalized
    • The use of the UNICEF procurement mechanism for purchasing all vaccines in the immunization schedule has been sustained.

    The full report of the evaluation is now available on the GAVI’s website, please visit the page for more information.

  • Bio-Behavioral Surveillance Survey among Men who have Sex with Men in two major cities of Georgia, 2015

    Bio-Behavioral Surveillance Survey among Men who have Sex with Men in two major 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 Men who have Sex with Men (MSM) in Georgia (Bio-BBS surveys among MSM have been implemented since 2007).  Study also was looking at HCV and STI (Syphilis) prevalence among MSM. 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 cross-sectional design and respondent‐driven sampling methodology (RDS). A sample of 415 MSM18 years and older were recruited in the survey in two major cities of Georgia: Tbilisi and Batumi.

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

    Major findings:

    Socio-demographic characteristics

    • The median age was 28 years in Tbilisi and 29 – in Batumi, majority had secondary level education, had never been married, big proportion of MSM had permanent work, and majority’s monthly income was less than 500 GEL.
    • The study did not reveal high proportion of heavy alcohol use or injecting drug use, indicating that there is no overlap with key populations such as MSM and PWID.

    Sexual behavior

    • MSM had different types of both male and female sex partners (regular, occasional and commercial).  The median number of male partners (anal/oral partners) in the last 12 months 6 in Tbilisi and 5 – in Batumi. Tbilisi number is higher than that of 2010.
    • Out of MSM that reported anal partner during the last year, 63.2% in Tbilisi and 78.8% – in Batumi used a condom during their last anal sexual contact. Condom use at last AI in Tbilisi in 2015 slightly higher compared to 2010 (61.7%).
    • Overall more than 50% of MSM reported having female sex partner  (regular, occasional or paid) during the last 12 months- 55.4% in Tbilisi and 53% in Batumi. More than two thirds (71.2% in Tbilisi and 65.9% in Batumi) said they used a condom at last sexual intercourse with their female partner.Since 2010 there is increase in condom use at last sex with female partners in Tbilisi. As for Batumi, this rate is also high.

    Condoms and lubricants

    • There was a slight increase in the proportion of MSM who reported receipt of condoms from preventive programs during the last 12 months in Tbilisi from 40.3% in 2010 to 43.5% in 2015.
    • Awareness about condoms stays high.
    • Awareness about the lubricants as well as their reported use during the last AI has improved vastly in Tbilisi and is also high in Batumi. These are higher indicators compared to the previous surveys, which can be explained by provision of free lubricants by preventive programs, started since 2014.

    HIV knowledge and HIV testing practice

    • Knowledge and testing on HIV showed significant improvement in Tbilisi since 2010 – from 19.9% in 2010 to 30.4% in 2015 (p (2-tailed), 0.001). In Batumi this indicator was measured the first time and reached 35.2%.
    • During the recent five years there is statistically significant improvement in MSM awareness where to get HIV test in case of necessity (p < 0.001), as well as in the proportion of MSM who were tested during the last 12 months and received results (p< 0.001). This can be explained by sustainable use of HIV rapid (finger prick) testing in the outreach under preventive programs, which makes HIV testing easily accessible to the target group.
    • Researchers also measured increase in testing uptake from 2012 to 2015, and it was also statistically significant (p (2tailed) – 0.07).

    Violence

    • Survey participants reported that they have experienced violence because of sexual orientation or homosexual behaviour in the last 12 months (32% in Tbilisi and 4.7% in Batumi). In Tbilisi violence rate has increased significantly compared to 2012.

    Program coverage / media

    • Coverage by preventive intervention measured by awareness of where to get a HIV test and receipt of a condom during the last 12 months increased from 20.9% in 2010 to 43.5% in 2015 in Tbilisi. In Batumi coverage is quite high – about 40%.
    • NGOs, internet and friends seem to be the major and best way for conveying messages to MSM.

    HIV, HCV and Syphilis prevalence

    • The most alarming finding of this study is increase in HIV prevalence in Tbilisi from 6.4% in 2010 to 25.1% in 2015. During last five years we observe three-fold increase of HIV prevalence. Batumi HIV prevalence is also very high – 22.3%.
    • Syphilis was detected in 35% of the MSM in Tbilisi and 24.6% – in Batumi.As for syphilis, its prevalence is quite high but does not show difference compared to 2010 results.
    • Hepatitis C prevalence was 7% in Tbilisi but much higher in Batumi – 18.9%

    Full study report 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.