Enhancing Gender-Sensitive TB Detection, Surveillance, Treatment and Prevention Among Mobile Populations from the Republic of Moldova

Enhancing Gender-Sensitive TB Detection, Surveillance, Treatment and Prevention Among Mobile Populations from the Republic of Moldova

Republic of Moldova
Health Promotion and Assist for Migrants

Moldovan migrant workers are shouldering a much higher tuberculosis (TB) burden than the general population due to their mobility pattern, as many Moldovans seek work in high-TB burden countries such as the Russian Federation. Moreover, migrants are facing barriers in accessing healthcare and TB treatment due to their mobility, language barriers, limited social support systems to facilitate healthcare access and possible discrimination by health workers. In this context, migrants are unable to fulfil their full potential as development actors.

The fear and stigma associated with TB have different impacts on men and women, often due to women living in more precarious social and economic conditions than men. [1] A deficient health system coupled with the lack of access to treatment and irregular migration make patients, particularly migrant women, default on their treatment and drive them into developing multi-drug resistant TB (MDR-TB). [2] However, the intersecting factors of gender and migration have been generally neglected in TB research and policy interventions.

Therefore, the proposed project will generate a comprehensive and holistic understanding on the migrant and gender-specific barriers to access TB medical care, and improve the formulation and implementation of effective, evidence-based and gender-sensitive migrant health policies, in order to improve migrant health governance in the Republic of Moldova and to ensure that healthy migrants can positively contribute to sustainable development and healthy communities. It will be conducted in close collaboration with the National TB Program (NTP), the Phthisiopneumology Institute “Chiril Draganiuc” (PPI), and the Ministry of Health, Labour and Social Protection (MHLSP) of the Republic of Moldova.

The first part of the project aims to improve TB detection, surveillance, treatment and prevention through research and data collection. This will be achieved through developing a designated migration module for processing comprehensive migration data in the existing Information Monitoring and Evaluation system of TB patients in the Republic of Moldova (SIME TB) and the completion of a comparative qualitative study on gender differences in health care seeking behaviour and access to TB treatment. Moreover, the project will raise awareness and build capacity of government officials as well as health workers by supporting an interregional workshop and capacity building activities on TB control and care among the migrant population with a focus on gender. In a second component, the project will also support a national information campaign on the access to TB diagnostics and treatment for circular migrants. The organisation of community-based programmes through trainings and empowering women TB survivors and TB caretakers in forming peer/community support groups will promote the exchange of experiences of dealing with a disease and its treatment, which in turn will enable self-management behaviours among the migrant community.

[1] (http://www.euro.who.int/en/publications/html/report-on-the-health-of-re…) [2] Multi-drug-resistant tuberculosis (MDR-TB) is a form of tuberculosis (TB) infection caused by bacteria that are resistant to treatment with at least two of the most powerful first-line anti-TB medications (drugs), isoniazid and rifampin. The Republic of Moldova has a relatively high prevalence of TB, and migrants are specifically vulnerable, particularly with regards to MDR/RR-TB strains due to the high level of outward migration to the Russian Federation and other high TB burden countries and interrupted treatment cycles.