Программа "Остановим туберкулёз в Украине"

To implement the Program, important target audiences (medical staff, health care officials) should undergo a training course on contemporary principles of medical aid. For this purpose, the Program will improve post-graduate courses for medical staff on TB.

Mission of the project - to improve post-graduate courses for doctors and paramedics on medical aid to TB infected people.

Goals of the project:

To establish a system of advanced training for medical staff and health care officials in TB area
To train the doctors and paramedics (at least 80% TB doctors and at least 60% general doctors in Donetsk oblast)
To train TB service doctors in pilot oblasts of the country

Project timeline: 2008-2011

Major project partners:

PATH's US Office
Phthisiology Department, Donetsk National Medical University
Phthisiology Department, Kyiv Shupyk Medical Academy of Post-Graduate Education (KMAPE)
Yanovskiy Phthisiology and Pulmonology Institute
"Krok u maibutne" (Step into the Future), non-governmental organization
WHO's Ukrainian Office

Expected activities:

To develop education programs for medical staff on important issues.
To form a team of instructors to conduct trainings.
To equip training rooms with multimedia facilities to improve training conditions.
To hold trainings.

Results of the project:

Established instructors team to teach doctors and paramedics the principles of laboratory TB diagnostics.
Established instructors team to teach doctors and paramedics the principles of in-patient treatment.
Launch of trainings TB Diagnostics Through Swab Microscopy for labs of the first level.
Twelve specialists have undergone a training course in Riga (Latvia); two doctors have participated in International Training Course on TB Control (Tartu, Estonia).
In September 2007, high-rank leaders of Donetsk oblast went to Estonia to get familiar with a successful program of multi drug-resistant TB control
In August 2007, eight specialists from Donetsk oblast went to Tomsk (Russia) for an education tour. A training program for TB doctors regarding multi drug-resistant TB has been launched in Donetsk oblast, with 40 people having accomplished the course.

Prospects:

To continue training specialists of Donetsk oblast according to newly-developed study modules.
To launch training courses for specialists from pilot regions of Ukraine.

Project for Strategic Planning of TB Epidemic Fight in Pilot Regions – Mariupol, Horlovka, Donetsk

With the regional program developed and approved at the meeting of the Regional Council, the need emerged to create municipal programs for cities. The towns and cities of the region run programs that don't take into account situational analysis nor involve target audiences. The existing programs are poorly financed and not backed by the departments or agencies that would be interested in the program results. To establish practicable municipal programs of fighting TB epidemic, the Foundation for Development of Ukraine (FDU) has initiated the project "Strategic planning of TB Epidemic Fight in Pilot Regions - Mariupol, Horlovka, Donetsk".

Mission: To develop long-term strategic plans to combat TB based on a deep analysis of the current situation on municipal levels of the oblast.

Goals - To develop and legalize the programs of TB epidemic fighting in pilot cities and towns of the oblast with due regard to regional characteristics.

Project realization timeline: July 2008- July 2009

Major project partners:

Social and Economic Strategies and Partnerships, association of NGOs
Local authorities

Expected activities:

Situational analysis of TB situation in pilot regions.
Development of strategic plans.
Legalization of strategic plans in the local government.

Results of the project:

The working groups launched to perform situation analysis in pilot cities. The training seminars organized.
Presentations of the Project performed.

Plans for 2008-2009:

To accomplish Program's development in pilot cities and towns.
To approve the program on the level of municipal councils.
To issue a manual on development of programs to fight TB epidemic intended for the regions and the whole country.

Role of Civil and Social Journalism to Combat TB

According to social surveys, there are a lot of myths and distorted information on TB in the minds of Donetsk oblast residents. Since the media are an essential source of information for the wide public, we seek cooperation with journalists under the present project to find a mechanism of making "repelling" social problem like TB interesting for readers and journalists.

Mission: To boost the interest of readers and media to the "repelling" problem of TB.

Goals:

To boost media awareness of TB.
To encourage publications on the subject.
To boost awareness of Donetsk oblast population of TB (prevalence, symptoms, treatment, prevention, etc.).

Project realization timeline: June 2008 - March 2009т 2009

Major project partners:

Internews-Ukraine International NGO
Krok u Maibutne (Step into the Future) NGO
Donetsk Press Club
Information and Public Relations Department of Donetsk Regional State Administration

Expected activities:

To develop a manual "Role of Civil and Social Journalism to Combat TB in the Region".
To develop a training for journalists

Project results:

Developed training for journalists.
Presented training program.
One training for journalists of Donetsk oblast held

Best in Profession

Mission: To boost motivation of TB service staff in the oblast.

Goal: To award the best specialists of the oblast with cash prizes and valuable gifts.

Project realization timeline: 2008 г.

Major project partners:

Donetsk Regional In-Patient TB Hospital (DOKTMO)
Health Care Department of Donetsk Regional State Administration

Project results:

Eighteen specialists awarded with cash prizes in six nominations.

Plans for 2009

To hold Best in Profession contest on annual basis.

World TB Day project

The World TB Day is celebrated on 24 March. Starting from 2007, the Foundation for Development of Ukraine has been holding annual events and campaigns to mark this day.

Mission: To promote the importance of TB problem and the need of responsible attitude to own health among the population of Donetsk oblast.

Goals: To boost TB awareness of Donetsk oblast population (prevalence, symptoms, treatment, prevention, etc.)

Major project partners:
Sanitary and epidemiology agencies of Donetsk oblast

Donetsk Municipal Healthcare Center

Expected activities:

To publish information materials.
To develop and broadcast TV and radio programs.
To carry out awareness raising campaigns.

Project realization timeline:

February 2008 - April 2008

Project results:

Development and publication of 325,000 booklets and 2,000 posters with the motto of the Global Campaign "I Can Stop TB".
Distribution of 300,000 mailboxes, 25,000 booklets and 2,000 posters among municipal institutions: hospitals; municipal housing committees; industrial enterprises; chemists, etc.
Daily broadcasting of radio stories in March and April (8 times a day).
Wire radio (320 outlets in the oblast covering over 1m of listeners), 5 broadcasts 10 minutes each.

Comprehensive Survey of TB Awareness in Donetsk Oblast

The project targets to study TB awareness in Donetsk oblast. The present project will help develop further awareness raising campaigns properly with due regard to the views and beliefs of the oblast population.

Mission: To keep a vigilant watch over the impact awareness raising campaigns initiated by the Foundation on the awareness of Donetsk oblast population.

Goals: To identify the level of TB awareness in Donetsk oblast (prevalence, symptoms, treatment, prevention, etc.)

Project realization timeline: May 2008 - August 2008

Major project partners:

Kyiv International Institute for Social Studies
Chief Public Health Department of Donetsk Regional State Administration
Donetsk Regional In-Patient TB Hospital
Donetsk Medical Service of State Penitentiary Department of Ukraine

Project results:

Quantitative and qualitative analyses accomplished. Summary report submitted.
Assessment indicators for awareness raising campaign developed.
Report to the target audiences of the project (medical staff, media, program partners) presented.

Plans:

To hold annual polls depending on the results and changes in the awareness raising campaign.

Together Against TB Media Contest

The Foundation for Development of Ukraine supported by Department for Press and Information of Donetsk Regional State Administration holds a contest for media and regional journalists for the best coverage of TB-related problems in regional media.

Mission: To encourage the media to provide wider coverage of TB-related problems.

Goals: To increase the number of TB-related publications, as well as to raise awareness of TB among Donetsk oblast population.

Project realization timeline: July 2008-December 2008.

Major project partners:

Department of Information and Media at Donetsk Regional State Administration
Chief Public Health Department of Donetsk Regional State Administration
Donetsk Regional In-Patient TB Hospital
Donetsk Regional Sanitary and Epidemiology Agency
Donetsk Press Club

Project results:

Will be summed up in December 2008.

Plans

To hold the contest on annual basis

E-Bulletin

The project provides for a monthly release of electronic and print information bulletin of A4 paper format to be distributed among the Program partners and the interested participants as well as to be sent to over 300 e-mail addresses (local authorities, medical and preventive treatment establishments, NGOs).

Mission: To keep the interested parties informed on the Program's implementation.

Goals:

To keep the target audience informed on the implementation of Program on Fighting TB Epidemic in Donetsk Oblast
To raise the awareness of TB

Project realization timeline: March 2008-2011

Expected activities:
To prepare and send out the e-bulletin on a monthly basis.

Project results:

Eight editions of the bulletin prepared and distributed.

Hot Line

The Foundation for Development of Ukraine has set up a hot line to give answers to all TB-related questions. A person can dial 8 800 503 0 800 from a land-line phone and a hot line expert will give a counsel. The project also provides for ICQ consultations, ICQ number - 382285483

Mission: To make consultation service available for target audiences (patients, doctors, families that have TB people, etc.)

Goals:

To raise awareness of TB among Ukrainians.
To provide confidential information to people, who have faced TB
To provide psychological support to people, who have faced TB

Project realization timeline: August 2007-2011

Expected activities:

To set up material and technical basis for the hot line.
To train consultants.
To provide consultations to hot line clients.

Results:

1055 consultations have been provided within the project's run (information as of September 2008)

Stop TB Website

The Foundation for Development of Ukraine has developed a TB-related website - http://www.stoptb.in.ua/ The site contains news and information on TB-related events in Ukraine and worldwide

Mission: To raise people's awareness of the activities targeted to combat TB epidemic in Ukraine, global practices and general TB-related information

Goals: To set up a source of information on activities of combating TB epidemic in Ukraine, global practices, general TB-related data

Project implementation timeline: August 2007 - 2011

Expected activities:

To develop Stop TB website.
To update the website with materials for the general public and experts
To inform target audience on the website

Result:

The Stop TB website http://www.stoptb.in.ua/ launched.

Monitoring Center

To keep a watch over the Program implementation progress, the project has formed a team of specialists (comprising TB doctors and epidemiologists) to monitor the regions and the cities of the oblast 2-3 times per month. The team targets to control observance of the key principles of the Program and its projects, as well as provide methodology support to the participants. Besides, the monitoring center provides for regular independent monitoring visits of foreign experts.

Mission: To establish a system to monitor implementation of the Program on Fighting TB Epidemic in Donetsk Oblast..

Goals: To set up a Monitoring Center for the Program

Project realization timeline: 2007-2011.

Major project partners:

Donetsk Regional In-Patient TB Hospital
Regional Sanitary and Epidemiology Agency
Ukrainian Office of the World Health Organization

Expected activities:

To provide equipment to the Monitoring Center established on the basis of Donetsk Regional In-Patient TB Hospital and Regional Sanitary and Epidemiology Agency.
To create a monitoring team and develop the schedule of monitoring visits to the regions.
To identify key principles of the program
To provide transportation
To make monitoring visits

Results:

Two independent monitoring visits involving Russian and German experts are held.
Twelve internal monitoring visits are held
Guidelines to improve implementation of projects under the Program are developed

Plans for 2009:
To continue monitoring of the Program's progress. To hold at least 24 internal monitoring visits and 1 independent audit involving international experts.

E-Register

Keeping record of TB statistics requires ensuring a range of conditions: to provide software (e-register), teach personnel how to operate software, equip information and research centers and create an inter-dispensary network. Being well aware of the need to keep record of statistics, the Foundation participated in development of the required software (by lobbying in the Ministry of Health Care for development and legalization of the register), as well as provided technical assistance to establish information centers and train the personnel for the implementation of the register.

Mission: To establish an automated system to keep record of TB data.

Goals: To develop the software intended for the data record, as well as equip medical institutions of the oblast with facilities required to operate the software.

Project realization timeline: 2007-2011

Major project partners:

US Office of PATH
Ukrainian Ministry of Health Care
Ukrainian Office of the World Health Organization

Expected activities:

To participate in development of the e-register strategy in Ukraine.
To test the e-register of TB infected in Donetsk oblast, following the approval by the Ukrainian Ministry of Health Care.
To provide technical support to information centers of TB dispensaries in Donetsk Region.
To train the medical staff.

Results:

With the active lobbyism by the managers of the regional program and national projects, the Ministry of Health Care has adopted the plan of the e-register implementation.
Donetsk oblast has equipped information centers to be used as a basis for pilot launch of the software (to be equipped by the date of report submission).

Plans for 2009:

To introduce a system of keeping record of statistics in Donetsk oblast (e-register).
To register 100% of information about patients by the end of 2009.

Renovation of TB Dispensaries

The living conditions of patients that undergo a treatment course are below standards. Naturally enough, the poor living conditions make people leave the hospital without accomplishing the course of treatment. The project provides for renovation of major TB dispensaries of Donetsk Oblast.

Mission: To create good treatment conditions in TB establishments.

Goals: To renovate major TB dispensaries of Donetsk Oblast (Donetsk Regional In-Patient TB Hospital, as well as dispensaries in the cities of Horlovka, Shakhtyorsk, Mariupol, Yenakievo, Kramatorsk and Yelenovka settlement)

Project realization timeline: 2007-2011.

Major project partners:

Regional State Administration
Regional Council

Expected activities:

To renovate major TB dispensaries.
To supply dispensaries with required facilities.

Results:

TB departments in the cities of Horlovka, Donetsk, Shakhtyorsk, and Yelenovka settlement have been renovated.
Overhaul of multi-drug resistant TB department at Donetsk Regional In-Patient TB Hospital is almost over. The facility is expected to be completed in December 2008.

Plans for 2009:

To continue renovation of TB dispensaries in the cities of Horlovka, Mariupol, Shakhtyorsk, Kramatorsk.
To complete renovation of Donetsk Regional In-Patient TB Hospital.

Improving Diagnostics in Penitentiary System

Penal institutions show a higher level of TB morbidity compared to the civil sector. The reason for this is poor living conditions of patients and low efficiency of TB diagnostics and treatment in penitentiary system. The Foundation for Development of Ukraine has initiated the present project to improve the efficiency of TB diagnostics and treatment in prisons and pre-trial detention centers.

Mission: to create conditions needed for TB diagnostics and treatment in prisons of Donetsk oblast.

Goals: to improve efficiency of TB diagnostics and treatment in prisons of Donetsk oblast

Project realization timeline: August 2008-2011.

Major project partner: State Penitentiary Department of Ukraine

Expected activities:

to purchase laboratory equipment and supplies.
to train specialists.
to provide transportation of diagnostic materials from prisons to the central laboratories.
to purchase mobile digital chest X-ray unit.
to purchase stationary chest X-ray unit for pre-trial detention center in Donetsk.
to monitor the quality of medical aid provided in prisons of the oblast

Results:

A mobile digital chest X-ray unit needed for TB diagnostics in prisons have been purchased.
An independent monitoring involving Russian specialists has been carried out in TB hospital at Zhdanovskaya penal colony. Guidelines to raise the quality of diagnostics and treatment have been developed.

Social Support

TB treatment comprises two stages: in-patient and out-patient courses. Once a TB-infected person stops expelling TB micobacteria (i.e. stops being infectious), his treatment is promoted to an out-patient stage. An out-patient should regularly attend the hospital (at least three times a week) and take medicines under direct doctor's supervision. Sadly, but when feeling better, some patients interrupt the course (stop seeing their doctor and taking medicines). The global practice has developed the following method to encourage patients: in case a person with TB regularly sees a doctor during a week, he gets food and/or hygienic set. Moreover, the Foundation has signed an agreement with the Red Cross Society under the present project. Thus, if a patient skips medical treatment for a long time, nurses of the Red Cross search him out and persuade to renew the course, i.e. make him committed to treatment.

Mission: To make TB patients committed to the treatment course

Goals: to cut the number of treatment interruptions.

Project realization timeline: 2008-2011

Major project partner: Ukrainian Red Cross Society

Expected activities:

To purchase and hand out food sets to out-patients.
To inform the patient on the necessity to accomplish the treatment.
To encourage the patients, who have interrupted the course, to complete treatment.

Results:

17 664 food kits were handed out to TB patients taking treatment at the out-patient stage in pilot cities and districts of Donetsk oblast in 2008-2009. The food kits were given to patients and health care workers who handed them out twice a month.

Encouragement System

Salaries of medical staff do not depend on the efficiency of their work today. This is particularly true for TB doctors and general physicians. Unfortunately, most doctors feel indifferent towards the health of their patients. However, the global practices prove that financial encouragement is effective to make the doctors result-oriented. Timely diagnostics of infectious TB-carriers and their treatment are criteria of good result for a doctor providing medical aid to person with TB. The Foundation will develop the system of financial motivation for TB doctors and general physicians for timely TB diagnostics and treatment.

Mission: To make TB diagnostics and treatment more effective and delivered on time

Goals: To encourage TB doctors and general physicians to produce results in the area of diagnostics and treatment

Project realization timeline: 2008-2011.

Major project partner: Regional State Administration

Expected activities:

To develop a system of motivation (criteria, quality/result control, rewarding procedure).
To inform TB doctors and general physicians about introduction of the encouragement system.
To obtain approval of the Regional Council for the program of financial motivation .
To implement the system of motivation.

Expected results:

Higher detection of infectious patients in the general medical practice.
Higher effectiveness of in- and out-patient treatment.

Enhanced Efficiency of Laboratories

TB is diagnosed through laboratory analyses of patients. Donetsk oblast has poor material and technical facilities needed for diagnostics, while laboratories are understaffed. Doctors and paramedics of the first-level laboratories are ignorant of TB diagnostics and detection standards. Thus, efficiency of diagnostics is rather low. The present project will develop a program to enhance efficiency of laboratories in Donetsk oblast.

Mission: To raise efficiency of TB diagnostics

Goals: To establish a chain of 1-3 levels laboratories in the oblast

Project realization timeline: 2008-2010.

Major project partners:

Regional State Administration
WHO Country Office in Ukraine

Expected activities:

To construct cutting-edge laboratory of the third level.
To reduce the number of second level laboratories and equip the rest with proper facilities.
To equip first-level laboratories.
To ensure transportation of laboratory materials from bottom-line to top laboratories.
To train laboratory staff.

Expected results:

The efficiency of timely TB diagnostics and treatment will be raised.
Efficient and financially reasonable chain of laboratories will be established.
Laboratory expenses will be cut.
The number of qualified laboratory staff will be increased.

Infection Control

The infection control covers a set of standards, which should be upheld to control the infection within a hospital. The standards include, for instance, supply and exhaust ventilation (to drive the infection out of the dispensary into an open space where it will not pose any threat), personal protective facilities as well as rules for their usage, etc. No TB dispensary of the oblast complies with the standards of infection control today.

Mission: To eliminate TB contraction in TB hospitals.

Goals: To ensure conditions for TB control in key TB dispensaries of the oblast.

Project realization timeline: 2008-2009.

Major project partners:

Regional State Administration
Regional Sanitary and Epidemiology Service

Expected activities:

To install supply and exhaust ventilation in TB dispensaries of the oblast.
To equip dispensaries with required facilities (infrared recirculators, disinfection units, etc.)
To place the patients within the hospital into departments by TB form (i.e. to separate wards/department designed for infectious and chronic patients from those for patients with non-infectious TB forms)
To brief the staff on principles and standards of infection control
To provide individual protection facilities to the staff and patients.

Expected results: