Evidence is essential as a starting point in order to plan effective measures for TB response, as well as plan to reform it based on local conditions and needs.
Such data can be collected using the TB Community, Rights and Gender (CRG) tools as part of assessment based on human rights and focused on the needs of people with tuberculosis. For example, the assessment tools developed by the STOP TB Partnership encourage countries, communities affected by TB and civil society to explore public, human rights and gender barriers for people with TB. The results of such an assessment can contribute to the development of more effective, non-stigmatizing and gender-sensitive policies, strategies and concrete actions.
An assessment using CRG tools developed by the Stop TB Partnership (http://www.stoptb.org/communities) was recently conducted in Georgia. The assessment was carried out by the New Vector Union as part of the TB-REP 2.0 project and was completed in 2020 (the full assessment report can be found at http://www.stoptb.org/assets/documents/communities/CRG/TB%20CRG%20Assessment%20Report-%20Georgia.pdf ).
The main objective of the study in Georgia was to assess community, rights, gender and stigma regarding the TB response to improve strategies for finding missing people with TB who are not covered by the health system. It was also important to involve decision-makers and relevant stakeholders in the CRG assessment process and to identify and subsequently remove barriers related to CRG and stigma faced by people with TB.
The study protocol, including all instruments, was approved by the Bioethics Council of the National Center for Disease Control and Public Health of Georgia. An important factor in the success of the assessment was the developed methodology and the involvement of a wide range of partners.
“At the beginning of the study, a multi-stakeholder meeting of the working group was held, at which the priorities of the assessment, its goals, methods, target groups, as well as the expected results were identified,” said Konstantin Labartkava, Director of the New Vector Union in Georgia, about the CRG assessment. – “The second meeting was aimed at discussing the results and developing an action plan to overcome the identified obstacles. To date, a permanent working group has been formed in Georgia to guide and monitor the implementation of the CRG assessment”.
The assessment began with a desk review that examined the legal context of TB issues in the country and in particular the situation with risk groups. Based on several medical, social and epidemiological parameters, three risk groups were identified for assessment: people who use drugs, former prisoners and internally displaced persons. The field stage of the study consisted interviews and data collection for further detailed analysis.
“We conducted a qualitative survey, including 56 face-to-face interviews with representatives of risk groups, representatives of NGOs, people with tuberculosis and their families, as well as service providers. We also organized ten focus groups, each of which was attended by 6-10 people. The focus groups included people who had recovered from tuberculosis or were on treatment. There were also general focus groups and focus groups with medical professionals.” – Konstantin Labartkava shared the details of the study.
Based on these results, identifying current barriers Union “New Vector” among other activities carried out an information campaign to raise awareness of the target groups regarding TB symptoms and the algorithm for assistance, as well as gender issues. In addition, as a result of the assessment, the cooperation of the New Vector Union with government and non-profit organizations was strengthened.
For more information on how to use the Stop TB Partnership’s core assessment tools in practice, please see the brochure for civil society organizations and communities affected by TB prepared by the TB Europe Coalition under the Strategic Initiative Communities, Rights and Gender – Meaningful Engagement and Capacity Development of Key and Vulnerable Populations”.
Such assessments in countries are strongly supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria, which proposes to include them in country proposals to collect and further use the relevant evidence base.