ROMANIA: TB Control Partnership Project

Romania TB Control
Following the 1989 overthrow of the communist regime, much of Romania’s public health system deteriorated due to insufficient resources and support, leading to large gaps in health care coverage. This situation had particularly negative consequences for urban and rural poor as well as marginalized populations such as the Roma. Subsequently, rates of communicable diseases such as tuberculosis (TB) reached alarming levels throughout Romania, leading to one of the highest TB rates in Europe. 
From 2003 to 2007, HealthRight International implemented a TB control program in partnership with Romania’s National TB Program, addressing the needs of the most hard-to-reach and vulnerable groups. HealthRight programs improved both access to and quality of care, raised awareness through national and local media campaigns, and created a national TB education strategy. Outreach in Roma communities also focused on training Peer Health Educators (PHEs) and leading advocacy activities with local and national health authorities. 
Reaching out to the excluded
Historically, the Roma have been socially and economically marginalized throughout Europe. Consistently denied access to health services, the Roma endure severe health problems, including disproportionately high rates of TB. HealthRight’s programs over four years have improved the accessibility and quality of health services available to the Roma. HealthRight-trained Roma PHEs led community education sessions to raise awareness about TB within vulnerable populations, and referred people with TB symptoms for further care. HealthRight also devised an incentives model and provided nutritional support to encourage the poor to complete lengthy, complicated treatment regiments, aiming to avoid relapse and the potential development of drug-resistance. 
Engaging health care providers
HealthRight initiated comprehensive training programs for doctors and nurses to update their knowledge of TB, its treatment, and current directions in the field. Following the training, these providers possessed the skills and knowledge to provide up to date information, better follow-up care, and greater support to TB patients to complete treatment. Heath education aids were also developed and supplied to each participating health facility.
Partnership for a lasting solution
In cooperation with the Ministry of Public Health (MoPH), HealthRight developed a national TB and DOTS health education strategy and implemented a mass media campaign to increase TB knowledge and improve treatment adherence and completion rates. Components included radio spots, a television commercial for national broadcast, World TB Day press conferences, and printed TB informational materials. All local stakeholders were also engaged in a workshop to develop the national Advocacy, Communication, and Social Mobilization (ACSM) Plan which built on HealthRight’s experience implementing TB education activities for over three years. Through its partnerships with national ministries, providers, and local health authorities, HealthRight helped build the long-term capacity of the Romanian health care system to treat and prevent the spread of tuberculosis. 


Roma Health Advocacy