Belarus pilots new financial model to strengthen ambulatory tuberculosis care
A WHO/Green Light Committee mission visited Belarus on 1–5 December 2014, to monitor the treatment of multidrug-resistant tuberculosis (MDR-TB) and review a pilot financing project.
International experts from Latvia (the head of a WHO collaborating centre and the head of the MDR-TB department at a TB hospital) visited the republican TB prison in Orsha, Vitebsk region and TB facilities in the Vitebsk and Mogilev regions. Special attention was given to scaling up rapid diagnostic testing (Xpert MTB/RIF assay) for early detection and programmatic management of drug-resistant TB.
Reallocation of funds from hospital beds to ambulatory care
One of the experts met with primary health care (PHC) workers involved in a pilot project in Mogilev to test a new financial mechanism that strengthens ambulatory TB care by reallocating funds otherwise dedicated to hospital beds. A working group supported by WHO has developed guidelines, approved by the Ministry of Health and Mogilev regional health care authorities, that provide additional incentives to PHC staff supervising directly observed therapy.
In the initial phase of the pilot project, the reduction of 5 TB hospital beds at Mogilev regional TB dispensary freed funds used as financial incentives for PHC staff, who earned US$ 1–4 per patient visit. 3 people with drug-susceptible TB and 10 with MDR-TB from distant rural areas received care under this scheme. According to data provided by the regional TB dispensary, all of the enrolled TB patients have been kept for treatment follow-up since the start of the pilot project in early 2014. Net savings for the Mogilev regional TB dispensary during this period have been US$ 10 270.
The Ministry of Health has decided to expand the project to at least one district in each region in 2015.
Source: WHO/Europe
