Cure Tuberculosis Project

OVERVIEW

The USAID Cure Tuberculosis project assists the Kyrgyz government to diagnose, treat, and cure people with drug-resistant tuberculosis. The project works to strengthen systems, tools, resources, and human capacity to improve the Kyrgyz Republic’s response to tuberculosis in line with international recommendations.

KEY RESULTS 

Increase drug-resistant tuberculosis (DR-TB) case detection. Strengthen laboratory and diagnostic services and expand case detection and contact investigation capabilities in communities and health facilities.

• The project improved TB diagnosis by restructuring and optimizing the work of laboratories in Chui, Naryn, Talas, and Batken Oblasts and Leninsky district of Bishkek. The project supported the establishment of a quality management system and a TB transportation system of biological samples while easing the switch from paper-based to digital technologies. This resulted in the delivery and testing of 90% of sputum samples within the three-day standard.
• Cure Tuberculosis introduced new-generation testing technology and diagnostic tools by supporting the National Reference Laboratory (NRL) validation of a stool test protocol for TB diagnostics among children. This makes testing for TB in children easier and more child-friendly.
• The NRL received ISO 15189 accreditation and became the first accredited lab in Central Asia to perform microscopy, drug susceptibility testing, and molecular genetic tests thanks to the project support.
• USAID continues to support the implementation of digital solutions across the healthcare system to manage medical information more effectively. Through the project's support, 131 health facilities nationwide now have access to the laboratory data management information system to capture and share real-time TB test results. Cure Tuberculosis additionally adapted the system for COVID-19 testing, which contributed to the fight against the pandemic. The Kyrgyz government recognized its input and adaptability and adopted the system for implementation across the health care system, starting with the National Hospital, which is the largest medical facility in the country.
• The project continues supporting national efforts to effectively detect TB cases. An active case-finding protocol has been implemented in 12 general hospitals in Chui, Naryn, and Batken Oblasts to identify signs of TB among admitted patients and refer them for testing: 100% of admitted patients were tested for TB, and all diagnosed patients initiated treatment.
• The project expanded the enhanced contact investigation process in Chui, Naryn, and Batken Oblasts to detect cases among those in contact with TB patients, resulting in 100% of index cases covered with the epidemiological investigation.
• Cure Tuberculosis trained over 30,800 health promotion specialists, community and religious leaders, and volunteers in target geographical areas on TB-related issues. Those trained then conducted information sessions to raise TB awareness and reduce stigma and discrimination against patients, reaching almost 1.4 million people nationwide.

Cure more patients of DR-TB. Ensure all patients receive correct treatment regimens with high-quality drugs and complete their treatment as directed.

• Cure Tuberculosis helped develop clinical protocols, guidelines, and strategies on DR-TB management, drug management, adverse events management, infection control, and work with patients (TB case management) institutionalized by the Ministry of Health.
• TB patient management improved through the reformed TB Concilium, new guidelines and protocols, and continuous clinical monitoring of TB cases.
• All TB hospitals and 91 primary health care facilities store electronic patient records in the medical information systems developed by the project. The Ministry of Health adopted the electronic system to store patient medical history for implementation in hospitals across the health care system.
• Over 2,100 TB patients received psychosocial support, food and hygiene packages, and/or financial assistance through civil society organizations and the engagement of local government and communities.

Prevent DR-TB Infections. Improve infection prevention and control in health facilities and laboratories and improve patient, provider, and at-risk people’s behaviors around preventing, detecting, and treating TB.

• Cure Tuberculosis pioneered the development of clinical guidelines related to latent TB management and the revision of guidelines on infection prevention and control for the first time in 10 years.
• The project assisted TB Centers in Talas, Naryn, and Batken to strengthen their infection control measures. The length of hospital stays in pilot areas decreased by an average of 12% and is 15% lower than the country average.
•  The project is working to change the behaviors of patients and their communities by encouraging TB patient testing, treatment, and support. As part of these efforts, the project developed 28 videos showcasing stories of patients, their families, and communities or providing educational content on TB. These videos target audiences through project partners and sub-grantees in mass media and social media.

Improve the Enabling Environment. Improve TB-related policies, optimize financing for TB services, enhance the use of TB data for decision-making, and reduce stigma and discrimination.

• Cure Tuberculosis is working with the government to improve TB treatment and prevention policies, including financing mechanisms. The project helped adopt 31 different regulatory documents, reform TB services in four oblasts and Bishkek, develop the National Program Tuberculosis-VI for 2022-2026,  and revise the Public Health Law with new provisions on TB.
• Since 2019, the project has collaborated with the state Mandatory Health Insurance Fund (MHIF) to develop financing mechanisms for different aspects of TB treatment, such as the transportation of sputum samples to labs, the coordination of TB services at the primary level, and incentive payment for successfully treated TB cases. These financing methods have been institutionalized and secured through the MHIF budget law. As a result of project advocacy, the money saved from optimizing TB services was reinvested in the national TB program.
• The project provides technical support to the National TB Program (NTP) and Republican Health Promotion Center to develop an annual work plan on social and behavior change. This aids in the dissemination of TB information and efforts to reduce stigma and discrimination through the NTP and other stakeholders.

Gender Equality and Female Empowerment

• During training sessions, Cure Tuberculosis highlights gender aspects affecting TB diagnosis and treatment, such as barriers to health care and approaches to counseling women and men. More than 5,100 health care workers participated in training sessions in the past three years that include different approaches to counseling women and men on TB. The project also trained over 30,800 village health committee members, health promotion unit specialists, community and religious leaders, volunteers, and others. The majority of participants in project-led training sessions are women.

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Project Duration:  July 2019 – July 2024
Budget: $20.2 million
Implementing Partner: JSI in partnership with the University Research Co., LLC (URC), and U.S. Pharmacopeia (USP)
Key Partners: Ministry of Health (MOH), National Tuberculosis Program (NTP), Mandatory Health Insurance Fund (MHIF)
Contact information: Ainura Ibraimova, ainura_ibraimova@kg.jsi.com