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http://hdl.handle.net/20.500.12188/9977
Наслов: | Multidrug-resistant tuberculosis in Moldova and the Former Yugoslav Republic of Macedonia: The importance of health system governance | Authors: | R. Gregory Thomas-Reilly Fimka Tozija Viorel Soltan Dance G Nikovska Valeriu Crudu Rifat Atun Martin McKee |
Keywords: | Drug-resistance Europe health systems MDR-TB Moldova The Former Yugoslav Republic of Macedonia Тuberculosis. |
Issue Date: | 19-апр-2016 | Publisher: | Jacobs Verlag | Проект: | Multidrug-Resistant Tuberculosis and Health System Failures Project. London School of Hygiene and Tropical Medicine. London. 2011-2012 | Journal: | South Eastern Journal of Public Health (SEEJPH) | 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. | URI: | http://hdl.handle.net/20.500.12188/9977 | DOI: | https://doi.org/10.4119/seejph-1820 |
Appears in Collections: | Faculty of Medicine: Journal Articles |
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