Sophie Witter, Professor of International Health Financing and Health Systems at Queen Margaret University, Edinburgh, shares her reflections on the gains and pains of the first 18 months of the Results4TB programme in Georgia.
In workshops in May and July 2017, we worked in groups with national and local level participants to understand what might work to improve adherence to TB treatment, considering bottlenecks for patients and providers. We used a lot of sticky pads and developed complex diagrams! No intervention can tackle all of the challenges in one go, but in the end, we decided to address two core emerging problems: 1) the lack of integration of primary and TB care and 2) the lack of motivation of providers in the area of TB services (where TB doctors face low salaries and are an aging cohort).