Resistance to implementing policy change: the case of Ukraine.
Tuberculosis (TB) is a major public health problem in eastern Europe. Since 1990, the incidence rates of TB have continued to increase in Belarus, the Russian Federation, the Ukraine and the central Asian republics of Kazakhstan, Kyrgyzstan, Tajikistan and Uzbekistan. Eastern Europe, and in particul...
| Publicado en: | Bulletin of the World Health Organization Vol. 86; no. 2; pp. 147 - 155 |
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| Autores principales: | , |
| Formato: | Journal Article |
| Publicado: |
World Health Organization
Feb2008
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105900221&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105900221 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00429686 BUW jtl: Bulletin of the World Health Organization issn: 00429686 maglogo: N pubinfo: dt: Feb2008 vid: 86 iid: 2 pid: 437 pub: World Health Organization artinfo: ui: 105900221 105900221 2009853080 10.2471/blt.06.034991 NLM18297170 105900221 ppf: 147 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Resistance to implementing policy change: the case of Ukraine. aug: au: Atun R Olynik I affil: Imperial College London, London, England. r.atun@imperial.ac.uk sug: subj: Attitude to Health Health Behavior Health Policy Patient Attitudes Public Health Health Promotion HIV Infections Prevention and Control Social Marketing Tuberculosis Prevention and Control Ukraine ab: Tuberculosis (TB) is a major public health problem in eastern Europe. Since 1990, the incidence rates of TB have continued to increase in Belarus, the Russian Federation, the Ukraine and the central Asian republics of Kazakhstan, Kyrgyzstan, Tajikistan and Uzbekistan. Eastern Europe, and in particular the Russian Federation and the Ukraine, also face the public health challenge of an escalating multidrug-resistant tuberculosis (MDR-TB) epidemic. Of the 17 283 global MDR-TB cases reported in 2004, over 60% (10 595) were from the European region and the vast majority of these from eastern Europe, including the Baltic states of Estonia, Latvia and Lithuania. Of particular concern is the fact that, along with Africa, treatment success for DOTS in eastern Europe is substantially below average when compared with other regions of the world, and DOTS coverage and smear-positive case detection rate remain the lowest in the world. Collectively, along with Africa, these problems in eastern Europe remain the principal obstacle to meeting the Millennium Development Goals for TB in Europe. The Ukraine has worsening epidemics of TB, MDR-TB and HIV, against a background of epidemics of sexually transmitted illness (STI) and injecting drug users (IDUs). The TB and HIV epidemics are converging. In spite of attempts, the Ukraine has failed to implement DOTS policy due to health systems organization, financing and provider payment systems that created disincentives to change while opposition by policy-makers and clinicians to DOTS strategy hindered implementation efforts. Copyright © 2008 World Health Organization pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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