Human resources development

Status of implementation of recommendations for section Human resources development

Recommendations Status Implementation Institution responsible for implementation Deadlines
Human resources development
General recommendations        

1. Understanding of and compliance with the Stop TB Strategy should be improved. Despite official adoption of the Strategy, there is widespread scepticism about its appropriateness and potential for successful implementation. Most doctors have their own personal approaches, resulting in a mixture of old and new interventions which may harm the clinical management of the individual patient and the overall public health impact of the NTP. The Ministry of Health should provide ample information on the do’s and don’ts in TB control – more than can be contained in a letter or a ministerial order. Doctors need an explanation of why the Ministry of Health is promoting a certain approach. A manual with guidelines and training are also necessary.

Not implemented

The unified clinical protocol of primary, secondary (specialized) and tertiary (highly specialized) medical care “Tuberculosis” was revised, which was approved with the Order of the Ministry of Health of Ukraine dated 21.12.2012 No. 1091, does not conform to all components of “Stop TB” strategy. In particular, it provides for a possibility to hand over the drugs to a patient for a term of up to 10 days in case of very positive attitude to treatment (page 17). This contradicts the definition of DOT services according to WHO (WHO: Implementing WHO Stop TB Strategy: a handbook for national tuberculosis control programmes. 2008 (page 32) available at WHO web-site.

MOH
UCDC
State Service
On an ongoing basis
Special recommendations        

2. A strategic plan for the development of human resources should be drawn up, based on an assessment by the TB Human Resource Working Group and including a task analysis, the consequent development of job descriptions, changes in the legal and normative bases and the development of an annual implementation plan.

Not implemented

HR operational research planned within the framework of the phase I of the Global Fund grant was rescheduled for the phase II (2014, responsible – WHO).

UCDC
31.01.15

3. Pre- and postgraduate curricula should be reviewed and modernized by moving from knowledge- to competence-oriented training and including teaching on the Stop TB Strategy and the Practical Approach to Lung Health.

Partially

Within the framework of the Phase 1 of the Global Fund grant, training modules for TB and MDR-TB diagnosis, treatment, monitoring and evaluation were developed. From 2011 to 2013, trainings were held in the following directions:

  • laboratory diagnosis and external quality control (269 laboratory specialists were trained);
  • managing a TB case and/or providing support to patients (2389 doctors and nursing staff were trained);
  • managing MDR-TB cases and/or infection control measures (589 doctors, nursing staff and infection control specialists were trained);
  • TB prevention in HIV-infected and HIV-vulnerable population groups (326 psychologists, nursing staff and social workers were trained);
  • M&E: systems of accounting and reporting and/or data and strategic information management (386 doctors and M&E specialists were trained).

In 2012-2013, under the USAID project “Enhanced TB Control in Ukraine”, the following trainings were held:

  • management of TB and MDR-TB cases for phthisiatricians, general practitioners, nursing staff (589 specialists were trained in total);
  • laboratory diagnosis (137 laboratory network specialists were trained);
  • infection control (103 specialists were trained);
  • training for pilot regions which are included to the drug resistance study (45 specialists were trained);
  • consultancy of patients and HIV-testing upon an initiative of a healthcare professional (26 specialists were trained).

At the premises of P.L. Shupyk Kyiv Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine, MDR-TB trainings are held on a regular basis (Phthisiology and Pulmonology Chair), as well as HIV/TB trainings (Institute of Epidemiology and Infectious Diseases named after L.V. Hromashevskyi of the Academy of Medical Sciences of Ukraine). MDR-TB and TB/HIV trainings are scheduled to be held in 2015 at the Phthisiology and Pulmonology Chair of P.L. Shupyk Kyiv Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine, during two-week advanced courses for phthisiatricians.
Starting from the phase II of the Global Fund grant (2014) and with its financial support, MDR-TB trainings are held at the Phthisiology and Pulmonology Chair of P.L. Shupyk Kyiv Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine; however such training modules are not approved by the mentioned educational establishment.
Training modules in laboratory diagnosis of TB were approved by P.L. Shupyk Kyiv Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine; such trainings are scheduled to be started since June 2014.

MOH
31.01.15

4. The capacity for human resources development under the NTP should be enhanced by:
a) establishing a training resource centre;
b) revising existing training curricula;
c) moving from ad hoc to institutionalized in-service training courses according to standardized and accredited curricula.

Implemented

a) TB training of specialists is coordinated at the national level by the training department of the state institution “Ukrainian Centre for Socially Dangerous Diseases Control of the Ministry of Health of Ukraine”.

Moreover, under the project launched by the Charity Foundation for Development of Ukraine, a training centre for fighting TB epidemics was established in Donetsk in 2010.

b) Training curricula are revised on an annual basis with a possibility of amendments to the information (15% per year) in accordance with the amendments to the regulations. Revised and updated modules are taught within the framework of advanced courses for phthisiatricians.

c) Specialists of the national and regional levels carry out on-the-job training during their respective monitoring visits.

архів новин