Implementing standardised community-based service package to improve TB outcomes in six countries.

Abstract

Background: Although the need for community-based support services as part of TB care is reaffirmed in various strategies, there are no data on the implementation progress of the recommended standardised package of community-based support services to improve TB outcomes developed by a consortium of partners in 2021.

Methods: The study describes country adaptation and initial planned implementation of the community-based packages in six countries of Eastern Europe and Central Asia - Azerbaijan; the Republic of Belarus (Belarus); the Kyrgyz Republic (Kyrgyzstan); the Republic of Moldova (Moldova); Tajikistan; and Ukraine - using programme review and qualitative data.

Results: An analysis of the package adaptation and initial implementation is presented from the perspective of the country implementers with a focus on country-specific approaches and lessons learned. The analysis framework is focused on the following specific areas: 1) adaptation practices; 2) ensuring quality and supervision of the services; and 3) securing funding. Commonalities and differences in each of these areas are analysed.

Conclusion: In all countries, standardised community-based service packages were adapted and gradually introduced to support clinical TB care. Proper costing and monitoring of the services delivered at the community levels and integrating the budgeted packages into national TB programmes are recommended to ensure sustainability.