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
|
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:
In 2012-2013, under the USAID project “Enhanced TB Control in Ukraine”, the following trainings were held:
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. |
MOH
|
31.01.15
|
4. The capacity for human resources development under the NTP should be enhanced by: |
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. |
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.