TB-REP 2.0 team redesigned of project activities to reshape a sustainable response within Covid-19 context
In the context of the exceptional international situation created by the COVID-19 pandemic and the restrictions set in place by many countries in the EECA region, the Center for Health Policies and Studies, together with TB-REP 2.0 partners has taken actions to reorganize project activities to suit changing circumstances.
Under the influence of the COVID-19 pandemic, we had to cancel or reschedule a number of planned activities to a certain extent, at the same time we have become more flexible in planning. We have absolutely adapted to the online trends of the new time and have become more robust. I would say that we were able to accelerate and become even more result-oriented.” said Svetlana Nicolaescu the Programme Coordinator at the Center for Health Policies and Studies (PAS Center). - COVID-19 represents an unprecedented risk in terms of public health. Patients with TB and people vulnerable to TB are particularly at risk to this disease. Therefore, it is extremely important for us to continue to work effectively to provide maximum support to TB systems in the health care of the countries of the region in order to ensure the uninterrupted eradication of TB and other diseases. The main changes are aimed at continuing the implementation of the program and achieving results in 2020 at the international and national levels.”
Proposed adjustments to the designs and approaches aim to ensure the continuation of project implementation and delivery of the project results during international and national level COVID-19 crisis and restrictions’.
Thus following activities planned under TB-REP 2.0 were redesigned, with more focus on tele-working and virtual interaction:
- Regional capacity building events (1, 4, 5, 6);
- Country missions/visits for technical assistance (3, 7);
- Country missions for data collection (2);
- Country visits for multi-stakeholder meetings (8, 11);
- Country activities planned by local partners (CSOs) (10).
In addition, the context defined by the COVID-19 crisis and restrictions prompted project partners to build a shared virtual space for delivery of project activities (9)
- The “Regional Monitoring and Evaluation (M&E) Workshop for Capacity Building of National Tuberculosis (TB) Surveillance Focal Points on Data Collection and Reporting to the Global TB Database” planned for March 18-19 in Istanbul, was redesigned as country focused mentoring assistance provided remotely to national TB surveillance focal points in collecting data, including TB financial data, and reporting to the global TB database. The technical assistance is provided currently by PAS Center consultant, under WHO Euro guidance.
- TB patient pathway analysis - the approach has been adjusted by PAS Center to conduct data collection remotely, using various methods and tools, including virtual interviews. In this context, national consultants are pivotal and are teamed-up with international consultants.
- Country specific TA to review the current provider payment arrangements for TB services – the WHO Euro has changed the approach from country visits to online TA. Consultants are engaged with countries remotely, with both technical meetings and multi-stakeholder consultation events being hold on the virtual platforms.
- The Pharmacovigilance course that was planned to be conducted by WHO in March in Turkmenistan, for CA countries and Azerbaijan is currently redesigned and is planned to be delivered, at least partially, through the virtual option. The complexity is that the topics are quite technical and require face-to-face interaction as some point.
- Barcelona course scheduled for November – is currently under the revision to be provided in a hybrid format.
- The regional training on the operational role of the CSOs in the service delivery in the countries, planned by TBEC for June 2020 is redesigned to an online 4 days course to build the advocacy and operational capacity of civil society.
- The coaching visits for CSO partners, conducted by TBEC, were successfully translated to online coaching visits. The first visit took place in Ukraine, two more for Kyrgyzstan and Tajikistan are planned till July 2020.
- Global TB Caucus is organizing calls using virtual platforms with Parliamentarians to discuss changes in access and quality of TB services, predicted due to the likely redistribution of resources to combat COVID-19 and assess how efforts can be consolidated to protect people affected by TB as part of the vulnerable groups at risk for Covid-19. Such calls were organized already in Ukraine and Tajikistan and are planned for all TB-REP 2.0 countries. The upcoming one is in Azerbaijan on May 13th, 2020.
- A number of project activities are shifting and/or expanding to the online mode and need virtual platforms to be delivered. In this regard, the project aims to create a shared virtual space with the one platform being used by all partners for their content sharing. PAS Center is currently working on an IT solution that will host under one umbrella E-learning course for TB communities and CSOs (developed together with TB People and where TBEC course will be also added); virtual networks of professionals from countries working on access to TB medicines; e-consilium for TB clinicians; other possible platforms based on partners’ needs.
- Upon assessing the activities at risks that were planned for implementation by country CSOs, PAS Center worked individually with each of them. In the majority of cases, the scheduled face to face events shifted to online format (in Moldova, Tajikistan), some others have been cancelled and replaced with new activities such as informational materials, online informational campaigns, trainings for patients facilitated by trained medical staff (Moldova, Tajikistan, Georgia, Azerbaijan, Ukraine, Kyrgyzstan).
- Two other activities - National Dialogues (TBEC) and online bilateral visits (GTBC) – are currently in focus and PAS Center is closely working with TBEC and GTBC to assess the options for conducting them online.
Additionally, to project planned and redesigned activities, new activities determined by Covid-19 were implemented to sustain country efforts in reducing effects of Covid-19 on continuity of services:
- PAS Center developed and shared with stakeholders in TB-REP 2.0 countries a risk assessment and contingency planning tool, to use in rapid risk assessment and planning, as for the purpose of Global Fund grants, as well for assessing effects on the full continuum of services and the health system functions that support service delivery. This activity was done in the light that particularly people affected by TB and People Living with HIV are considered groups with higher risk in case of Covid-19 and need to be particularly protected from potential exposure to the new Covid-19, the tool was developed to help countries to systematically assess risks and plan possible mitigation measures, changes in service delivery, estimate additional resources and source of funding,
- PAS Center will collect data from TB-RE 2.0 countries and document measures taken by countries to avoid interruption of essential services for people with TB during the COVID-19 pandemic.
- Other two documents developed by PAS Center together with the National TB Programme in Moldova and shared with partners and stakeholders across the region were: 1) set of operating instructions for medical and non-medical TB care providers in context of Covid-19 and 2) set of operating instructions for NGOs acting in TB care delivery in context of Covid-19.
The activities planned for the upcoming period are reorganized based on existing experience and taking into account the restrictions that may remain in force.