Alliance for Public Health with support of the Global Fund to Fight AIDS, Tuberculosis and Malaria launches a new pilot project “Result-Based Financing (RBF) for DOT Provision to TB Patients at the Ambulatory Phase”. The main aim of this project is to pilot new ambulatory treatment financing models to focus healthcare professionals on the results: bringing down the number of drop-outs and improving treatment success rates. Such approach will surely contribute to a higher transparency in funds utilization and will allow identifying challenges in directly-observed treatment (DOT) of tuberculosis. Involving primary health care institutions is equally important as it will be a good incentive for medical personnel of such institutions.
On 22–23 December 2016, presentation of this project was held in Odesa attended by chief physicians of primary health care centers, district TB treatment doctors and leading specialists of the Odesa regional TB treatment center. The participants discussed the prerequisites of transition to ambulatory TB treatment models, challenges existing in the region and the ways to overcome them.
The project will be implemented in 2017 in 14 districts of Odesa oblast. Districts to implement the pilot project were selected based on the high TB prevalence, the need to considerably improve the existing treatment success rates for patients with sensitive TB and multidrug-resistant TB (hereinafter – MDR-TB) and, at the same time, high commitment of the regional administration to fighting the TB epidemic, implementation of new projects, cooperation with international and non-governmental organizations and readiness of primary health care institutions to take upon the functions of directly-observed treatment of TB patients at the ambulatory phase.
The results of this pilot project may form a solid basis for the general strategy of ensuring sustainability of TB programs, contributing to the achievement of the goals set forth in the Global Plan to End TB.
Within this project, health care institutions will provide directly-observed ambulatory TB treatment within any format of care (DOT offices at TB treatment centers or primary health care institutions, home care, day care, etc.), keeping relevant records.
For the goals of this project, 380 patients with both sensitive and drug-resistant TB will be enrolled in treatment. This pilot project stipulates a new way of financing ambulatory DOT. Implementing partners will receive financing for each ambulatory patient, which will contribute to increasing treatment success rates (treatment completion with such results as “cured” or “treatment completed”) and working with patients to form adherence to treatment (the higher the adherence of a patient, the less funds are to be spent to retain such patient in treatment). If target indicators are met, incentive bonuses will be paid, which health care institutions will be free to spend at their own discretion within certain limits, which will boost their interest in this project.