Subject: Drug-resistance
Subject: Europe
Subject: health systems
Subject: MDR-TB
Subject: Moldova
Subject: The Former Yugoslav Republic of Macedonia
Subject: Тuberculosis.
Year: 2016
Type: Article
Title: Multidrug-resistant tuberculosis in Moldova and the Former Yugoslav Republic of Macedonia: The importance of health system governance
Author: R. Gregory Thomas-Reilly
Author: Fimka Tozija
Author: Viorel Soltan
Author: Dance G Nikovska
Author: Valeriu Crudu
Author: Rifat Atun
Author: Martin McKee
Abstract: Aim: Multidrug-resistant tuberculosis (MDR-TB) arises where treatment is interrupted or inadequate, when patients are treated inappropriately, or when an individual has impaired immune function, which can lead to a rapid progression from infection with an MDR-strain to disease. This study examines the role of health systems in amplifying or preventing the development of MDR-TB. Methods: We present two comparative studies, which were undertaken in The Former Yugoslav Republic of Macedonia (TFYR Macedonia) and Moldova. Results: The findings reveal several health systems-level factors that contribute to the different rates of MDR-TB observed in these two countries, including: pre-existing burden of disease; organization of the health system, with the existence of parallel systems; power dynamics among policy makers and disease programmes; and the accountability & effectiveness of programme oversight. Conclusions: The findings do not offer a universal template for health system reform but do identify specific factors that may be contributing to the epidemic and are worthy of further attention in the two countries.
Publisher: Jacobs Verlag
Relation: Multidrug-Resistant Tuberculosis and Health System Failures Project. London School of Hygiene and Tropical Medicine. London. 2011-2012
Identifier: oai:repository.ukim.mk:20.500.12188/9977
Identifier: http://hdl.handle.net/20.500.12188/9977Identifier: https://doi.org/10.4119/seejph-1820
