Status of implementation of recommendations for section Other vulnerable populations and social determinants
| Recommendations | Status | Implementation | Institution responsible for implementation | Deadlines |
| Other vulnerable populations and social determinants | ||||
| General recommendations | ||||
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1. Vulnerable populations should be defined by level of TB risk and type of vulnerability. Based on this analysis, adequate interventions should be designed and implemented. |
Implemented
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| Special recommendations | ||||
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2. Each intervention adopted to improve TB case detection and treatment outcome should be analysed for effectiveness and cost–effectiveness. |
Partially
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The unified clinical protocol of primary, secondary (specialized) and tertiary (highly specialized) medical care “Tuberculosis” approved with the Order of the Ministry of Health of Ukraine dated 21.12.2012 No. 1091 was developed with the consideration of international recommendations relying on an evidential basis (page 117). Moreover, implementation of only TB diagnosis and treatment measures with proved efficacy must be reflected in the regional local protocols. There is a vital need for calculation of economic effectiveness of measures being implemented on the national level and for regulatory approval of procedures for such analytical calculations. |
State Service
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On an ongoing basis |
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3. Treatment procedures and access to disability benefits schemes should be coordinated so as to avoid perverse incentives to interruption of treatment and overall prolongation of the duration of treatment. |
Partially
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TB patients may be given a disability status if such patients comply with the criteria set forth in the applicable guidelines on disability status approved with the Order of the Ministry of Health of Ukraine dated 05.09.2011 No. 561. However, a disability status does not solve, in practice, the issue of social vulnerability of TB patients. In particular, it would be more efficient to develop a system of material compensation for the patient`s treatment period (this may be motivational sets of food or personal hygiene products, reimbursement for transport costs, social and psychological support during the treatment, incentive payments for positive attitude to treatment or any other social guarantees). |
State Service
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On an ongoing basis |
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4. Nongovernmental organizations should be supported, including with advocacy, to work with TB vulnerable groups. |
Implemented
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The National Targeted Social Program on Combating Tuberculosis for 2012-2016 provides complying with the indicator “Number of regions where non-governmental organizations cooperate with TB facilities”, which aims to improve access to hard-to-contact or vulnerable population groups with the participation of non-governmental organizations. Within the framework of Global Fund grant, active TB identification among risk groups, social support and persuading persons inclined to interrupt treatment to proceed with it (in particular, former prisoners as well) are carried out by the grant sub-recipients, such as All-Ukrainian Charity Fund “Coalition of HIV Service NGOs”, International Charitable Foundation “International HIV/AIDS Alliance in Ukraine”, Ukrainian Red Cross Society and other regional non-governmental organizations. |
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The unified clinical protocol of primary, secondary (specialized) and tertiary (highly specialized) medical care “Tuberculosis” approved with the Order of the Ministry of Health of Ukraine dated 21.12.2012 No. 1091, sets forth the categories of adults and children with increased TB risk (Annex 1, page 118, Annex 6, page 127). However, no analysis which could identify additional risk groups, specific for TB epidemics in Ukraine, has been carried out.