March 28-30th, 2012, Helsinki

World Vision Bosna i Hercegovina

Bosnia and Herzegovina TB Overview

Bosnia and Herzegovina on Map

Bosnia and Herzegovina

• Political and administratively complex framework in B&H - state, entity and regional levels

• TB surveillance is weak due to the shortage of allocated human resources

• TB recording and reporting - due to communication problems there are reasons to believe that the reported data are not entirely reliable

• No systematic approach for MDR TB management in the country

• No data about TB and IDU relation

• Access to TB treatment is free but it is usually difficult to achieve for vulnerable population groups, in first place ethnic minority groups Roma

• In 2010, incidence rate was 50 per 100 000 population and prevalence rate 60 per 100 000 population. The mortality rate was 3, MDR rate was 0,4% in new TB cases, and rate 3 in relapse TB cases. (www.who.int/tb/data 2011)

Bosnia and Herzegovina TB

Overview

Overview 2010 B&H

• 1996 - political commitment was made to DOTS Strategy

• 2007 - GF TB Grant was awarded to BiH - Further Strengthening of DOTS Strategy in Bosnia and Herzegovina

• Main Objectives of GF project:

– Increased capacity for case detection;

– Ensure and maintained access to TB programme for vulnerable groups;

– Maintained control of Drug resistance through early detection and effective treatment of new cases and appropriate management of drug resistant cases;

– New Stop TB strategy adopted and strengthens DOTS all over the Country;

• 2010 - World Vision B&H start with implementation of SSF GFATM TB Project

– Objective 1: Increase Capacity for Case Detection

– Objective 5: Improve TB Control in Roma and Other Vulnerable Population

Bosnia and Herzegovina

• Objective of TB project: Increase Capacity for Case Detection

• Engagement of:

– 2 National TB M&E Coordinators

– 27 Regional/Cantonal Coordinators

– 75 Patronage Nurses/Technicians

– 2 Trainers nominated by entity health ministry

• Organization of the trainings for 800 health care profesions including:

– TB staff doctors/specialists

– TB Family doctors

– TB laboratory staff

– TB staff nurses

World Vision B&H - SSF GFATM TB Project

• Training topics:

– TB basis

– DOTS strategy

– Role and significance of medical doctors/ family doctors in the implementation of DOTS

– QA/QC theoretical and practical aspects

– Practical aspects of work in the lab

– Templates for registration, reporting and data gathering

• Trained health professionals until the end of 2011:

– TB staff doctors/specialists 167

– TB Family doctors 247

– TB laboratory staff 56

– TB staff nurses 199

– Total 669

World Vision B&H - SSF GFATM TB

Project

Objective 5 of TB project: Improve TB Control in Roma and Other Vulnerable Population

• Establishment of 4 Roma Regional TB Centres

• Engagement 4 Roma coordinators, 16 outreach workers, and 14 nurses

• Engagement of Roma coordinator

• Development of the program model and the plan of implementation strategy of DOTS TB

in Roma communities

• Sensitization and mobilization of the Roma population on the prevention of TB-a

• Sensitization, mobilization and training of social and health workers in Roma issues

• Screening and monitoring of TB in Roma communities with medical examinations in

health institutions

• TB patients on DOT supervised by polyvalent patronage nurses/technicians

World Vision B&H - SSF GFATM TB

Project

• The Roma are de facto the largest national minority in Bosnia and Herzegovina, app 80 000

• The largest number of Roma in BiH is in social need - health, housing, education, housing and employment

• No health insurance

• The percentage of Roma employed within the public sector in BiH is extremely adverse and ranges between 2-3%

• The most common source of income for Roma today is self-employment, specifically in the sector of secondaryraw materials collection and waste recycling.

World Vision B&H - SSF GFATM TB

Project

• 54 nurses nominated by health institutions for work in Roma community together with 16 outreach workers

• Trainings organized for sensitizing and mobilizing social/health-care professionals on Roma issues

World Vision B&H - SSF GFATM TB

Project

• 2500 Roma community members went thru various sets of trainings

• 1509 Roma community members reached with TB sessions by outreach workers

• 44 TB patients on DOT supervised by polyvalent patronage nurses/technicians

• 1377 combined food-hygienic parcels, and one voucher for nine months of treatment for MDR patients delivered to the patients

World Vision B&H - SSF GFATM TB

Project

World Vision B&H - SSF GFATM TB

Project