SUMMARY OF INTERIM REPORT

Transcription

1 EUROPEAN COMMISSION HEALTH AND CONSUMERS DIRECTORATE-GENERAL EXECUTIVE AGENCY FOR HEALTH AND CONSUMERS Health unit SUMMARY OF INTERIM REPORT Title: Empowering Civil Society and Public Health System to Fight Tuberculosis Epidemic Among Vulnerable Groups Starting date: Duration of the project: 36 months Ending date: Interim report reporting period: 01/06/ /11/2012 General objective of project TUBIDU is to contribute to the prevention of IDU- and HIVrelated TB epidemic in the project area. The strategic objectives include empowerment of public health system and civil society and enhance collaboration of various stakeholders in the field in order to tackle TB. It concerns directly building up both public health systems and civil society s capacity to deal with TB, HIV, and IDU related issues. TB care and treatment systems in the project area have historically been built up as strong vertical structures involving mainly traditional health care institutions and they have had little connections with other fields of public health including programs targeting illegal drug use. Harm reduction services in the project region have developed a lot in the past decade yet they have paid relatively little attention to the threat of TB because their main focus has been on HIV prevention and social integration and rehabilitation of IDUs. Considering the high incidence of TB, drug-resistant TB, and HIV-TB co-infection in the project area there is clearly a need to involve harm reduction service providers and community based organizations in the fight against TB and develop strong connections between these structures. The project is multi-lateral in nature and therefore promotes both vertical and horizontal cooperation between various stakeholders both in governmental organizations and community based organizations thus pooling resources and guaranteeing their optimal use and ensuring shared commitment and sustainability of the activities. Project also directly aims to develop a country and culture specific model of TB prevention and care based on international guidance in community based organizations. Open borders and migration of workforce together with noticeable differences in prevalence figures between various territories in European region further emphasizes the need for international collaboration and coordinated actions in the field.

2 Target groups 1. Community based organizations personnel including program managers, health and social care and out-reach workers, will be reached through NGOs. 3. Health and social care personnel in health care institutions (TB and HIV health care service providers). Will be reached through respective health care institutions. 2. Public health specialists in governmental organizations and institutions, local municipalities and research institutions. Will be reached through national TB, HIV and drug abuse programs, local municipalities and research institutions. 4. Vulnerable groups: Injecting drug users approximately 13,800 in Estonia, 9,600 in Latvia, 16,800 in Romania, 30,000 in Bulgaria. Will be reached through national AIDS Centres and NGOs working in fields of harm reduction and substitution treatment. The number of IDUs that is planned to reach through the project People living with HIV approximately 7,000 in Estonia, 4,000 in Latvia, 15,600 in Romania, 10,500 in Bulgaria. Will be reached through HIV-positive people patient organizations and national AIDS Centres (i.e. The Network of People Living with HIV in Estonia). The number of PLWH reached Specific objectives, methods and means Specific objective 1: Enhancing horizontal, vertical and cross-border collaboration in the field of TB, injecting drug use and HIV. 2 International Network Meetings and Study Tours and 6 national (local) network meetings have been organised in order to improve collaboration on national and international level and to exchange experiences and best practices. The agenda and presentations of the International Network Meetings can be found at:

3 Specific objective 2 Describing the TB and HIV related knowledge and behaviors and identifying the barriers to access to TB and HIV related health care services among IDUs and PLHIV. Using RDS (respondent driven sampling) method a research has been carried out to describe and define TB and HIV related knowledge and risk factors and the use of and barriers to access to TB and HIV related health care services among IDUs and PLWH. Analysis of the research data is in process and will be ready by April Specific objective 3 - Raising the awareness of TB and HIV related prevention, treatment and care among vulnerable groups and PLHIV, general population and professionals on services and policy level. The drafts of information materials have been developed. Finalised materials will be distributed to IDUs and PLWH to provide information related to TB and HIV (special focus on integrated health and social care services). Information materials will be finalized after the results of research have been published. Specific objective 4 - Raising the awareness of TB and HIV among community based organizations and health care and public health institutions personnel. Training programs and materials including web-based e-learning training material are being developed and international (1) and national trainings (2) have taken place for service providers in community based organizations and health care institutions working with IDUs and PLWH. There has been one internship for CBO workers working with IDUs and PLWH in Latvia in September Training s and Internship s agendas and materials can be found at:

4 Specific objective 5 - Developing guidance for TB-prevention activities for community based organizations working with IDUs and PLHIV and providing recommendations for policy makers on future actions in the field. A desk-review of existing reports, studies, and international/national guidance on TB and HIV situation and related policies, services and practices among IDUs was conducted and this literature review has been sent for review to TUBIDU projects associated partners for comments and editing along with Country Profiles and will be ready by April 30, Based on the results of the literature review, research conducted during TUBIDU project and trainings, a country-specific guidance for TB prevention and control in community based organizations working with IDUs and PLWH will be developed which will include recommendations for specific activities as well as guidance for monitoring these activities. The guidance will serve as a starting point for providing recommendations for national public health programs on provision of TB services for IDUs on country level. Expected outcomes Through the implementation of the project activities we expect to reduce the burden of TB among IDUs and PLWH throughout the project area: Through the international networks and collaboration international evidence and experience will be discussed and distributed. This kind of networking provides a platform for more practical and detailed discussions and peer-reviewing of the programs and activities by professionals working in the field together with scientists. Through the national networks of professional s collaboration and integration of health and social care services which is required for effective response will be enhanced. Through the research conducted in the framework of the project a better understanding of the situation and scope of the problems in the project area will be gained. This is necessary in order to plan future activities, to target the sub-groups most in need, reduce the barriers to

5 access, provide high-quality services, and to evaluate the process and outcomes of the national strategies. Through the training and developing of training and information materials and other information delivery channels the capacity of the public health, health care and civil society professionals to work for TB/HIV/IDU prevention will be risen and the sustainability of the activities will be improved. Education and motivation of the personnel are important in order to provide good-quality, socially and culturally adequate and sensitive services. Through training of out-reach workers the peer-education among IDUs can be enhanced. Out-reach workers will be able to do active case finding in the community for they are the ones with the ability to reach members of the vulnerable groups who are most hidden (who have never accessed harm reduction services). They can also provide support for IDU TB patients to adhere to TB directly observed treatment (DOT). Through the networks of IDUs out-reach workers can locate IDU TB patients who have stopped the treatment and motivate them to start again. Through referral of IDUs to health care services, people with TB who have been previously undiagnosed will be diagnosed. Through the diagnosis and treatment of these cases we further reduce the TB infection transmission within the community. Trough developing the guidance for community based organizations working with IDUs and PLWH for TB prevention and control as well as for monitoring and evaluation of these activities we contribute to the sustainability and high-quality provision of these services in the future. More information about TUBIDU project can be found at TUBIDUs official website: Pictures and further information about TUBIDU project events can be found at TUBIDU Facebook account: