Best practices & lessons learned of in country

coordination between TB REP partners

June 30, 2017

Yuliya Chorna, Project Manager: TB Advocacy (TB-REP), ICF “Alliance for Public Health”
 TB Europe Coalition/Alliance – TB-REP partners
•Regional meetings of the civil society partners from 11 countries
•Monitoring and support visits to ТВ-REP countries
•Coordination with PAS, WHO EURO, STOP TB Partnership
 Key Strategies

Experience of the patients

• The 1st regional network
• Patients’ associations and platforms in the countries
 Understanding the advocacy concept
• Civil society position paper on the
quality people-centred care:
• Informed by the experience of TB
patients
• Coordinated with other TB-REP partners

Major points:
• Prevent undesired consequences such as
disproportionate burden on the patients
shoulder
• Have necessary support systems in place
for comprehensive and tailored to the
needs care
 Life after TB diagnosis within the patient-centered model
Social service / CSOs
Primary Health Social support
Other Health Care facilities of
Care
Seems my 2nd-3rd level
integrated
treatment is Free
services really In convenient time
important !?

TB hospital
HIV service
Only when needed integrated with other

Psychologist Job

Psychological support As usual

DOT Community
in convenient place support / peer
transport costs reimbursement Family support to peer support
 What helps?
Building key partnerships

In-country:
• MoH, NTP, Parliamentarians, Reform Groups; Civil society and WHO CO -
including through the facilitation of TBEC monitoring meetings
Internationally:
• TB Europe Coalition
• Global TB Caucus
• STOP TB Partnership
• WHO EURO TB-REP team
(dialogue meetings etc.)
Coordination: PAS Center
 Global TB Caucus works with civil society being 'supportive‘:
Members of Parliaments make the commitment and civil society acts as a helping partner
 Know, have and use the support mechanisms
• TB-REP National Focal Point
• TB-REP Working group/ Blueprint on TB care
• Members of Parliament affiliated with the Global TB Caucus
• Lean upon civil society platforms
 Practical level:
Setting patterns of working together
 Introduction of the CSOs (facilitated by WHO EURO TB-REP team)
 Keeping partners informed and engaged – allocate enough time when inviting or revisions are
needed
 Being strategic –research roles, responsibilities, and allocation of benefits from the partnership
 Build consensus – wherever possible
 Highlight the added value of the civil society
 Ask what would be helpful for joint efforts
 SPEAK to each other
 Listen, not just hear
 Roles of civil society in TB response
 Prevention: awareness raising on symptoms for early diagnosis, preventive
treatment for HIV-positive patients etc.;
 Case-detection: finding patients, often through hard-to-reach groups, TB screening;
 Supporting patients through treatment: (social support, peer to peer, enhancing
social networks, promoting adherence to treatment);
 Servicing as a liason between healthcare staff and vulnerable populations;
 Decreasing stigma and discrimination;
 Engaging community leaders;
 Operational research to define system gaps and influence the decision-making to
address that gaps and to pilot and find evidence of the new models and approaches
 Advocacy.
 Specific skills
 Conflict behavior skills, with the focus on consensus building/win-win
 Negotiation (understanding interests and positions)
 Group processes & dynamic
 Facilitation
 Communication – public speaking

.
 Progress highlights:
• Strengthening and launching on of the TB-
committed NGO platforms/coalitions.
• Patient organization network development in
countries and it linkages at the regional level.
• National partnerships for development and
approval of the strategies on transition to the
ambulatory models of care.
• Influencing funding allocation – advocating for
social contracting.
• International cooperation broadened – TB People,
Global TB Caucus; EHRN, ECUO coordination.
 Dialogue for Partnerships
• With Members of Parliament – the benefits and key defining principles of
people-centered are as well as to ensure that reallocation mechanisms are in
place for savings shifted towards more ambulatory care

• With government decision-makers for extending TB care in ambulatory

settings and social contracting mechanisms for civil society engagement

• With healthcare workers – to overcome professional and employment

concerns

• With civil society organizations on their roles in advocacy and service

provision

• With Patients – for their experience, concerns and vision on how the quality
people-centered should look like
 Challenges
• Perception of the term “Advocacy” – negative connotation in many countries
• Advocacy strategies versus “joint operational plan”
• In-country coordination
• Regional coordination
• Civil society being on the ”front stage” of changes
• More strict in-countries procedures for non-governmental organizations and
grant registration
• Programmatic – TB still mostly perceived as a medical issue
• Meaningful involvement in the decision-making processes for the civil
society - from tokenism to partnership/delegated power