Owing to Rinat Akhmetov Foundation 40 patients are receiving home TB treatment in Kramatorsk

Since August 2014 Rinat Akhmetov Foundation has been implementing a project in Kramatorsk: "Ambulatory model of TB patients’ treatment". The project is part of the Foundation's "Stop TB in Ukraine" program.

The project objective: develop and start-up the pilot ambulatory model of treatment for TB patients through organized medical and social case management. The background of transition from in-patient treatment to out-patient care is not conditioned by international recommendations only, but also by the lack of effective budget management model at anti-TB institutions of Ukraine.

The current financing model "by number of hospital beds" (the more hospital beds at in-patient departments, the higher the funding is) dates back to the Soviet period and has lost its efficiency, being a dead weight for tax payers. It stimulates the hospital management to increase bed occupancy, instead of searching for optimal organization of patients' treatment, and cannot secure the qualitative maintenance and timely repairs at the departments of anti-TB institutions. Poor conditions of stay in tuberculosis dispensary lead to often refusal of treatment and cross contamination of hospital patients with resistant strains of mycobacterium tuberculosis.

The project on the out-patient care must prove that it is much more effective for a patient and a lot cheaper for a medical institution to organize a controlled treatment at home, without long-term in-patient treatment.

The Foundation provides technical and financial support for the project implementation. For example, owing to the allocated funds they purchased ZAZ Lanos, a car for a mobile team that works in two shifts. The mobile team includes: a phthisiatrician (for severe cases, to consult the patients on side effects etc.), a nurse, who is responsible for medication provision and control over its intake, and a driver.

"Today, thanks to the project, 40 patients with different TB forms are getting an out-patient care. These patients mainly belong to the most vulnerable groups of people and those, who refused the in-patient treatment at TB dispensary.  The medications are delivered to the patients according to agreed schedule 6 times a week. Those patients who take medication in the nurse's presence during the whole month get 300 UAH bonus on their card account. Financial encouragement of TB patients for continuous treatment is used in other countries (such as Estonia and Latvia) for a long time and has proved its effectiveness. So far, it is too soon to talk about the results of our patients' treatment, but the preliminary results are quite optimistic", - says Inna Motrich, the Project Supervisor and the Manager for national Monitoring and Evaluation of "Stop TB in Ukraine" Program.