Dec. 2014—The chronic threat of tuberculosis (TB) infection is ubiquitous throughout Ukraine, with risks particularly high in hubs such as stores, marketplaces, schools, churches and offices. Ukraine’s hospitals and penitentiaries, however, play disproportionate roles in spreading TB.

Maintaining high sanitary standards is key to preventing TB infection in closed areas. USAID supports Ukraine’s state agencies and regional health authorities to improve TB infection control measures and create a safer environment in Ukraine’s health facilities.

In less than two years, USAID has helped improve evidence-based TB infection control practices in 34 health care facilities. At the Zaporizhzhia Oblast TB Dispensary, simple measures will significantly reduce transmission risk such as isolating undiagnosed drug-susceptible patients from multi-drug-resistant TB patients, providing respirators to medical staff, and making proper use of UV lamps.

To improve the situation in hospitals and prisons, USAID initially urged changes on two levels: first, training and advocating changes within governmental agencies that are responsible for infection control, and second, encouraging health care providers to focus on infection control. Project interventions included training for 824 health care workers and supporting government in forming a national TB infection control expert group. Through direct mentoring visits and consultations, the group promoted the implementation of up-to-date TB infection control measures, lobbied for national and regional policies, and provided support to regional health care staff.

“We’ve made a good start in changing our approaches from punitive functions to monitoring implementation of TB infection control,” said Anatoly Ponomarenko, head of the State Sanitary and Epidemiology Service, the national agency responsible for TB infection control.

As a result of USAID support, Ukraine is moving toward a more collaborative and supportive approach, emphasizing technical assistance, to build TB hospitals’ implementation of infection control measures. In Luhansk oblast, for example, the local department of the State Sanitary and Epidemiology Service incorporated mentoring of health providers on TB infection control into local personnel job descriptions and initiated mentoring visits to all TB facilities to ensure their compliance with infection control requirements recommended by the World Health Organization.

The USAID Strengthening TB Control in Ukraine project is designed to decrease TB morbidity and mortality, and represents successful cross-sectorial cooperation between the health care and social services systems and the local oblast government. The project runs from April 2012 to April 2017.

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