KOSOVO: Tuberculosis Control
The wars and displacement resulting from the dissolution of the former Yugoslavia had a devastating impact on health care services in Kosovo. Health facilities were destroyed while tuberculosis (TB) spread rapidly with increasing poverty and treatment interruptions, leaving Kosovo with a TB rate three times that of the rest of the former Yugoslavia.
Fueling the spread of TB
During the war, both health care professionals and patients suffered human rights violations. Denied continuing education during ten years of educational apartheid, Kosovar health workers were not trained in the most effective methods of TB treatment, and without treatment, half of all TB patients were expected to die within five years. Moreover, many Kosovars with TB were afraid to seek diagnosis or treatment because the stigma associated with TB often meant being ostracized by neighbors and colleagues. Patients frequently did not complete their course of medication and subsequently were at risk for developing drug-resistant TB.
A partnership to build capacity for TB control
HealthRight International initiated the Tuberculosis Control Partnership Project in Kosovo in 1999 in response to the high rates of TB-related morbidity and mortality. The Project stressed the implementation of and compliance with the WHO recommended Directly Observed Treatment, Short-Course (DOTS). To improve case detection and treatment rates for TB, HealthRight implemented active TB case finding in minority (Roma and Serb) communities, and conducted knowledge, attitude, and practice surveys. Focusing on building the capacity of the local health system and community to treat and prevent the spread of TB, HealthRight provided trainings for health workers as well as school teachers, patients and families.
Successful handover to local government
As the leading non-governmental organization addressing TB in Kosovo, HealthRight played a major role in the administration of TB control programs coordinated by the WHO under the UN Mission in Kosovo. HealthRight’s final activities in the TB Control Partnership Program focused on preparing for the successful handover of our TB control programs to the National Tuberculosis Program (NTP) and local civil society. HealthRight provided ongoing management training and support to NTP and civil society staff to ensure capacity for successful TB control activities and assisted the NTP and local civil society in its work plan to receive ongoing funding from the Global Fund for AIDS, TB and Malaria. In 2005, HealthRight successfully transferred oversight of all activities to the NTP, run by the Kosovo Ministry of Health, as well as local civil society.