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The present document was completed as part of the “Together for TB Control” project initiated by the Moldovan National Association of Tuberculosis Patients “SMIT” (Th e Moldovan Society against Tuberculosis) and supported by the Center for Health Policies and Studies with funding from Th e Global Fund to Fight AIDS, Tuberculosis and Malaria through the regional program EECA (TB-REP). Th e opinions expressed here do not necessarily refl ect those of the donor or other partners.
Authors: Oxana Rucșineanu, Program Director, Moldovan National Association of Tuberculosis Patients “SMIT” Jonathan Stillo, PhD in anthropology, Wayne State University Veronica Ateș, MA in sociology, iDATA: Date inteligente.
Editors: Ilinca Diaconu-Stillo, PhD in literary and cultural studies, Rhetoric and Composition instructor Wayne State University Inga Sorocean, PhD in philology, the Moldovan Academy of Sciences High School.
Although the Republic of Moldova faces serious challenges related to both TB and especially drug-resistant TB burden, having one of the highest rates of MDR-TB in the WHO European Region, it has also made signifi cant strides in reducing TB incidence and improving access to diagnostics and DR-TB treatment. In recent years, it has even piloted fully ambulatory MDR-TB treatment and strengthened peer and community-based support. Th ere is still much to be done, but there are many promising collaborations and projects which show that Moldova is not only taking the problem of TB seriously, but is open to innovative, patient-centred approaches.
Th is report was completed as part of the “Together for TB Control” project initiated by the Moldovan National Association of TB Patients (SMIT) and supported by Th e Centre for Health Policies and Studies with funding from the Global Fund to Fight AIDS, Tuberculosis, and Malaria through the regional program EECA (TB-REP). It provides important information that is oft en not solicited, namely what is working and what needs improvement in TB services from the perspective of people who are currently being treated for TB. Th e report is intended for decision makers in Moldova from the national to local levels. It should also be of interest to other countries in the region as it complements already existing data regarding the experiences of patients and their feedback on how to improve TB services, including data recently collected in Romania.
The data presented in this report were gathered using survey and focus group methodologies. Data were collected on a variety of issues, from basic demographic information to the challenges of having the disease and completing treatment. Th e report even includes data on the challenges that follow completed treatment, such as the inability to return to one’s former occupation due to a loss of lung capacity, or permanent adverse reactions such as hearing loss caused by injectable antibiotics used for the treatment of drug-resistant TB. Th ough this research is based on a relatively large sample size, additional, in-depth research in Moldova will be necessary to better understand the problems aff ecting people with TB, particularly their struggles with adverse reactions, and the fi nancial and emotional toll that hospitalization causes especially for the poorest people, and what types of support will be the most useful to ensure that everyone in Moldova has access to quality, patientcentred TB care.
In order to achieve the best treatment outcomes and the least disruption Moldovan National Association of Tuberculosis Patients “SMIT” Qualitative and Quantitative Study 2017 6 7 to people’s lives, eliminate the catastrophic economic consequences that frequently accompany TB disease, and make the Moldovan public health system as eff ective and cost-effi cient as possible, we sought the perspectives of aff ected communities. Th eir input is necessary to ensure that care is meaningfully accessible and that the right to health is respected. Th is right is guaranteed by the International Covenant on Economic, Social, and Cultural rights (ICESCR), of which Moldova is a signatory.