Mogilev district, Belarus
The Ministry of Health of Belarus, in collaboration with the WHO Regional Office for Europe, has initiated a pilot project in Mogilev district to follow up on the national action plan to improve ambulatory models for TB care. It provides additional incentives to primary care staff involved in TB care in remote rural areas.
Additional resources were gained from reducing the number of hospital beds in the Mogilev Regional TB clinic. The Ministry of Health also approved new contracts for primary health care staff to provide them with additional remuneration for every TB patient visit in an ambulatory setting, either at home or in a primary care facility. It is expected that this reallocation of funds from TB hospitals to primary care settings, will increase the treatment outcomes for TB and multi drug-resistant TB (MDR-TB) patients and enable them to be discharged early from TB hospitals.
It is expected that new financial mechanisms for strengthening ambulatory models developed in the pilot project, will be rolled out country- wide from 2015. In addition to this, the Ministry of Health has committed to providing additional support from the state budget directly to TB patients by reimbursing them for transportation, starting from January 2015.
National TB specialists organized a field mission for monitoring the launch of the pilot scheme in the Mogilev district on 24 June 2014. Dr Alena Skrahina, deputy head of the National TB programme participated in the meeting with primary care workers and visited patients involved in the pilot project.
WHO Regional Office for Europe also offers technical assistance in providing new models to incentivize primary care workers with the United States Agency for International Development (USAID) funding under the umbrella grant, “Enhancement of STOP TB strategy in Belarus, 2010-2013”.