September 2013

Resource TB CARE II - Synthesis Report on the Inclusion of TB in National Insurance Programs
National health insurance programs are increasingly being implemented in high burden TB countries.  The impact of these insurance programs on use of TB services is unclear.  NHI programs in high burden countries include a varying degree of integration of TB services, and there is a need to explore how the use of these mechanisms can increase universal coverage for TB patients. A study has been implemented by the USAID TB CARE II project to examine the package of services covered under NHI in the Philippines, India, Thailand, and Peru against the recommended TB services for diagnosis, treatment, and follow-up care. In the four countries, data collection teams conducted semi-structured interviews with national TB program managers, insurances providers, health providers, and TB-related community organizations. The study focused on large state-subsidized health insurance programs (including PhilHealth in the Philippines and the National Health Services Organization in Thailand). In India, the assessment focused on several insurance providers for different employment sectors in Rajasthan and Uttar Pradesh.
The findings revealed the impact of insurance programs on access to TB services, service quality, health seeking behaviour, coverage gaps, and health systems. Access to TB services increased for registered members in Thailand and Philippines, but not in India. Lack of information about the benefits of using in-program providers is a barrier in Peru and Philippines. Timely reimbursement is a key motivator for providers and delayed reimbursement to DOTS centers has been a barrier in the Philippines. Lack of coverage for indirect costs–transport, loss of wages, nutritional support needs – was a disincentive for seeking care in all countries, particularly for vulnerable populations. Coverage for MDR TB is a critical gap in all countries.
NHI programs have an overall positive impact on TB control when implemented in coordination with the NTP. Stronger emphasis is needed to design coverage packages to reinforce TB control objectives including closing coverage gaps and extending services to vulnerable populations.
To view the entire report please click here or see the attachment below.
16 Sep 2013 16:21
Resource Web-Based Training on TB for Private Medical Practicioners in Georgia

The USAID TB Prevention Project in Georgia collaborated with the Ministry of Health to develop and disseminate an online training package for medical and other health practitioners. The online training modules are designed to improve diagnosis, management, and referral of tuberculosis patients in accordance with national TB guidelines. The modules are intended to reinforce initiatives geared at encouraging stronger identification and management of TB by private doctors and nurses in Georgia.

23 Sep 2013 17:56
Article FAST TB Infection Control Strategy Core Package

The TB CARE II Project has created a package of infection control strategy materials entitle the FAST TB Infection Control Strategy Core Package.  FAST can be used by health care workers as a job aid, assisting them in focusing in on effective treatment of TB to reduce transmission.  Additionally, policy makers can use the materials in this package as a framework for allocating resources to interventions that will have the greatest impact on reducing TB transmission.

The FAST package is composed of a booklet, job aids, posters, and a button which serves as a visual reminder to staff and patients of the importance of this strategy in TB control.  FAST can be implemented in both general and TB specific medical settings.

Please visit the DR TB Training Network website to read more about the FAST Core Package and other tools for managing TB. 

13 Sep 2013 16:55
Article TB CARE II - Quality Improvement Handbook for TB and MDR-TB Programs
In recent years, national health programs have expanded their focus to include not only improving access to care, but also improving the quality of care received by patients and communities. As part of quality assurance for many clinical diseases, including tuberculosis (TB),
international and national evidence-based standards and guidelines have been developed. Having explicit standards and guidelines helps ensure high-quality care, better health outcomes, and cost effective treatments. In addition, they provide a reference point for assessing provider or system performance and quality of care. It is important to note, however, that adherence to these guidelines is not just a result of the development and dissemination of them, but of integrating the guidelines as part of a quality management program.
The USAID funded TB CARE II project recently conducted assessments in Bangladesh, Zambia, and Kenya to investigate factors influencing provider compliance to evidence-based TB guidelines and standards highlighted numerous factors that affected compliance. Overall, it is clear from the findings that a number of challenges continue to affect the ability of health providers to adhere to clinical and programmatic guidelines to maintain a consistent quality of TB services.  These challenges are related to provider skills and knowledge gaps, a lack of monitoring and supervision, and regular reviews of performance data. The Quality Improvement Handbook provides key principles and operational steps that will assist in improving the quality of TB and MDR-TB services in resource-constrained settings.
This manual is intended for health personnel working in health facilities that diagnose and treat TB patients as well as for administrative staff working in the management of health services at the health facility, sub district, or district levels. The purpose of this manual is to explain how to apply quality QA improvement strategies to help decrease the gap between TB quality of care standards and actual performance. Specifically, it provides guidance to Quality Improvement Coordinators to: 1) Identify and prioritize problems based on data and 2) develop and monitor action plans to solve problems.
18 Sep 2013 14:51
Article TB CARE II Introduces Toolkit to Address Timely TB Case Detection and Treatment
18 Sep 2013 14:53
Article Media Spotlight: TB CARE II Conference Featured in News Article
The USAID funded TB CARE II Project, along with participants from the USAID TB Program South Africa, ILO, and the TB CARE I Project recently gathered together in Pretoria, South Africa to host a conference focused on improving the response to TB and TB/HIV workplace health in Southern Africa.  The conference brought together about 40 diverse stakeholders, from policy makers to members of businesses and civil society agencies, in the hopes of fostering creative discussions aimed at improving TB and TB/HIV related occupational health services.  These services include: prevention, treatment, care, and support services in workplace settings which pose a high risk of TB transmission for employees. 
In exciting news, the conference was featured in an article on, an independent online news source based in New Zealand. The article, "Are Healthcare workers Tuberculosis Proof?" highlights several speakers at the conference, including Dr. Dalene von Delft who lost her hearing as a side effect of MDR TB treatment.
To read the entire article please click here
03 Sep 2013 17:16