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

DOI:

https://doi.org/10.56801/seejph.vi.75

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.

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Published

2023-01-24

How to Cite

Thomas-Reilly, R. G., Tozija, F., Soltan, V., G. Nikovska, D., Crudu, V., Atun, R., & McKee, M. (2023). Multidrug-resistant tuberculosis in Moldova and the Former Yugoslav Republic of Macedonia: The importance of health system governance. South Eastern European Journal of Public Health. https://doi.org/10.56801/seejph.vi.75

Issue

Section

Original Research