Results4TB: Designing and evaluating provider results-based financing for tuberculosis care in Georgia: understanding costs, mechanisms of effect and impact.

(01 March 2017 - present)

Country: Georgia

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Tuberculosis (TB) is still a leading cause of death worldwide, and Georgia is a country where the rates for this disease are high. Reasons for this include patients not seeking treatment or sticking to it. Additionally, staff don’t always detect TB quickly enough and their motivation is poor due to low salaries.

Results4TB is a collaborative project researching the impact of a pilot financial incentive scheme for health care providers working with TB patients in Georgia.

This 4-year project will help design this pilot results-based financing (RBF) scheme with Georgian policy-makers and programme managers, examine its impact and cost effectiveness and give further evidence to RBF and TB programming around the globe.

QMU's role in this project

Researchers from the Institute for Global Health and Development at QMU are supporting the design of the pilot RBF intervention and will assess the impact it has on TB detection and treatment rates.

Using these results, recommendations for fine-tuning and modification will be discussed with policy makers in order to develop a roll out of the intervention across all of Georgia.

For information on the full Results4TB project visit the Results4TB website.

  • About this project
  • Partners
  • Funding
  • Project objectives
  • Project publications

Georgia has a high burden of tuberculosis, with almost 1 in a thousand people becoming infected in 2015. Despite improvements in TB detection and treatment, the Georgian treatment success rates remain low which shows that many people may not be completing treatment, posing a threat to their own health as well as that of their families and communities.

Although the Georgian government has introduced incentives for patients to encourage continuous treatment, adherence remains low. Therefore, new results-based financing incentive scheme has been introduced with an aim to motivate health service providers, thus improving patient adherence and treatment outcomes.

Results4TB is helping to develop the pilot intervention with policy makers and programme managers and provide evidence of its impact and cost-effectiveness. The project will make suggestions for fine-tuning and modification if the RBF scheme is to be rolled out nationally in Georgia.

Results4TB will provide valuable evidence on a health systems intervention for TB, and will contribute to a better understanding of RBF for practitioners, donors and researchers.

The Results4TB research project is a partnership between Curatio International Foundation, Queen Margaret University, the Institute of Tropical Medicine (Antwerp) and The London School of Hygiene & Tropical Medicine.

For more information, please refer to http://results4tb.curatiofoundation.org/index.php/partners/

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The project is funded through the Joint Health Systems Research Initiative which is jointly funded by the Department of International Development (DFID), the Economic and Social Research Council (ESRC), the Medical Research Council (MRC) and the Wellcome Trust (WT).

 

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To support the design of a pilot RBF intervention which is meant to address the current supply side weaknesses of TB service delivery and to document the joint development of the intervention with policy makers.

To examine the impact, cost-effectiveness and underlying mechanisms and the wider effects of the RBF intervention using a theory-informed controlled trial design.

To assess and provide insights for policy makers on how the RBF intervention could be fine-tuned and modified, if necessary, to optimise a potential national roll-out and extension.

From a methodological perspective, to develop understanding of how the realist evaluation approach can be used to inform intervention trials and costs-effectiveness analysis.

July 2017: Performance based financing for tuberculosis care: Are provider incentives the answer? This evidence summary provides a summary of evidence for performance-based financing specifically for TB.

Read this Evidence Summary

For the full repository of publications and resources connected to this project, please see: http://results4tb.curatiofoundation.org/index.php/products/

IGHD will be presenting at and participating in the 5th Global Symposium on Health Systems Research #HSR2018

For information about sessions related to this project and other #HSR2018 sessions, see more at IGHD at #HSR2018.

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