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.
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).
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.
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.
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.
As a result of Curatio’s consultancy services, UNICEF CO will have:
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.
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.
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.
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
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.
Curatio International Foundation conducts the fifth wave of the survay that is supported by the World Bank.
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.
The Global Fund is one the major donor organization for TB, AIDS and Malaria programs management worldwide. It has operated in Georgia since 2003. Many achievements have been met thanks to the Global Fund. These include malaria elimination (since 2011), as well as universal HIV and TB diagnosis and treatment.
However, beginning in July of 2016, the Global Fund halted the funding of those active programs in Georgia, and transitioned to the New Funding Model (NFM), which will last for up to a three-year period. After the transition, Georgia will be responsible for increasing the financing for those program components, which were covered by the GF funding. Taking this into account, it is crucial to have a detailed plan for the transition period and its sustainability, which will describe the whole transition process from the donor in detail.
The main goal of this project is the development of Transition and Sustainability Plan (TSP) for TB and AIDS management programs, and to achieve the commitments taken from the Global Fund established for the period of 2012-2017. The Curatio International Foundation assists multiple countries in the assessment of their transition ability from the Global Fund. CIF also assesses the transition and sustainability plan development process. CIF’s existing experience and background in this capacity, gives us an opportunity to conduct this project successfully in Georgia.
The Curatio International Foundation is the main implementer of the project. NCDC&PH represents the main stakeholder. The project also involves the Country Coordinating Mechanism (CCM) and Policy and Advocacy Committee (PAAC), which discusses and comments on the project deliverables.
We expect the following outputs:
After achieving these results, Georgia will have a detailed action plan for the transition from Global Fund funding, and the sustainability of TB and AIDS programs management, without donor support. The plan will be evaluated at the end of 2017, and will be revised if necessary.
The Curatio International Foundation has been designated a Round 7 Challenge Facility for Civil Society (CFCS) grantee. CFCS, funded by the Stop TB partnership, is a mechanism that provides grants to technically sound, innovative interventions, to support the engagement of communities in national tuberculosis (TB) responses. With the following objectives, the goal for CFCS Round 7 is to strengthen community responses that are integrated and part of a comprehensive response to TB.
Curatio International Foundation implements the study funded by the Stop TB partnership.
CIF will implement the TB Community Systems Strengthening (TBCSS) project in Georgia. The overarching goal of the TBCSS project is to build-up integrated and comprehensive responses to TB that are patient-centered, and include a strong partnership with communities and civil society. The project will have three main objectives.
1: To assess the legal and social environment, the capacity of civil society, and the gaps and needs for engaging civil society in the TB community response; 2: to improve organizational strength for the sustainable development of civil society in the TB field; 3: Improve the links, coordination and networking of TB constituencies, civil society organizations, as well as state and other actors. These objectives will be achieved in two phases. In addition, we will provide updated information about the activities and achievements obtained throughout the lifecycle of the project.
The Curatio International Foundation has implemented a new research project that aims to provide an in-depth understanding of the factors associated with loss in follow-up among TB patients.
The project has two main objectives. The first is to generate evidence that will inform policy on measures to reduce loss to follow-up among TB patients. The project also has two sub objectives: Objective 1.1 is to identify, determine and describe factors that enhance or undermine treatment adherence among TB patients, and Objective 1.2 is to develop recommendations based on research evidence aimed at policymakers and involved stakeholders. The second main objective aims to disseminate the study findings to a wider audience in the Eastern European Region for its further replication. The study outcome will inform policymakers and provide evidence-based recommendations. The results will be disseminated regionally via events dedicated to TB. CIF will provide information about all key activities and results during the study’s implementation.
The project is funded under the Joint TDR/EURO Small Grants Scheme for Implementation Research in Infectious Diseases. This scheme funds specific research projects in diseases of poverty, which cover infectious diseases, and the culture and environment that contribute to these problems. It also supports the development of individuals and institutions in the countries where these diseases are prevalent.