Measuring sustainability of opioid agonist therapy programmes in the context of transition from Global Fund support
- 25.01.2024 15:18
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Published at: Harm Reduction Journal (2024) 21:7 https://doi.org/10.1186/s12954-024-00931-0
Authors: Raminta Stuikyte, Ivan Varentsov, Catherine Cook & Sergii Dvoriak
Background: Programmatic and financial sustainability of health responses dependent on donor funding has risen as a major concern. In the HIV field in particular, it generated a number of instruments and assessments on sustainability and processes related to donor transition planning. The authors aimed to develop an instrument specific to opioid agonist therapy (OAT) programmes as they were addressed only marginally by the HIV-specific assessments.
Methods: The development of the OAT sustainability instrument used desk review of existing HIV sustainability concepts and tools, an International Advisory Board, and piloting to validate the instrument.
Results: The new OAT sustainability instrument is comprised of the three parts: the conceptual framework, methodological guidelines and a practical implementation tool for assessing the degree of OAT sustainability at the country level. It measures sustainability in the three broad areas for sustainability measuring – Policy & Governance; Finance & Resources; and Services. The selection of indicators and their composites for the three sustainability areas extensively used the United Nations and World Health Organization’s guidance on health system building blocks, on care and prevention among people using opioids and for opioid dependence, and the definition of access to health framed by the United Nations Convent on Economic, Social and Cultural Rights. The instrument’s methodological guidelines require the engagement of a national consultant to conduct desk review, key informant interviews and focus groups for measuring discrete milestones and adding qualitative information for interpretation of the data, progress and opportunities. The guidelines advise engaging a country-specific multi-stakeholder advisory group for planning, validation and follow up of the assessment. The pilot of the instrument in 3 countries in 2020 validated it and required minor adjustments in the instrument. By mid-2023, the instrument has been successfully applied in 5 countries.
Conclusions: The developed instrument enables a comprehensive review of the resilience of OAT programs and their ability to scale up and to inform a roadmap for improved sustainability. While developed in the EECA context, it has been reviewed by a global advisory panel and could be easily adapted outside this regional context.
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Services for migrants and refugees from Ukraine – HIV/TB care with a focus on key populations
Due to the increasing flows of refugees from Ukraine because of Russia’s invasion of Ukraine, the EECA Regional Platform created a spreadsheet to fill contacts details of face-to-face and online services for refugees and migrants (with a focus on HIV/TB care and key population groups).
If you provide such services or know verified providers, please fill out the spreadsheet at your earliest convenience, and, please, update it as more verified information is available. These can be services for national citizens if they are also accessible to international migrants and refugees.
Regional Platform – EECA
This web-resource is a part of new regional communication and coordination project “Regional Civil Society and Community Support, Coordination and Communication Platform - EECA”, implemented by Eurasian Harm Reduction Association (EHRA).
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