Perspectives on multisectoral accountability framework to end tuberculosis in the Eastern Europe and Central Asia region: a mixed-methods study
Background Sectors beyond health are essential to combatting a social disease such as tuberculosis (TB). The engagement of the community and civil society sector in Eastern Europe and Central Asia was assessed as part of a broader baseline assessment of multisectoral engagement in national TB respon...
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| Published in: | BMC global and public health Vol. 3; no. 1; pp. 20 - 13 |
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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BioMed Central
05.03.2025
BMC |
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| ISSN: | 2731-913X, 2731-913X |
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| Abstract | Background
Sectors beyond health are essential to combatting a social disease such as tuberculosis (TB). The engagement of the community and civil society sector in Eastern Europe and Central Asia was assessed as part of a broader baseline assessment of multisectoral engagement in national TB responses.
Methods
This was a mixed-methods community-based study. Surveys, interviews, and focus groups were conducted online with TB-engaged community and civil society representatives in Belarus, Kazakhstan, Moldova, Tajikistan, and Ukraine from January to June 2021. Quantitative data, analyzed using descriptive statistics, were triangulated with thematic qualitative analysis. A multisectoral accountability framework and community, rights, and gender framework for TB were used to triangulate the findings and inform data interpretations.
Results
Participants (
n
= 160) included leads, service providers from 74 organizations, and TB survivors. Of 53 survey respondents, most (
n
= 41, 77·4%) indicated strong/complete agreement to participating in TB service delivery and gender, stigma, and/or legal assessments (
n
= 27, 50·9%) and research processes (
n
= 30, 56·6%). However, few indicated inclusion in operational planning and budgeting (
n
= 13, 24·5%), or political and program impact of community-led monitoring (
n
= 16, 30·2%), and almost none (
n
= 2, 3.8%) confirmed dedicated budgets for their TB-related work. Inquiry into the dimensions and criteria for multisectoral actions and accountability revealed their key, yet limited, role in attending to social determinants, with wider engagement hindered by precarious funding. Several organizations balanced building partnerships with other sectors engaged in the TB response against advocacy activities. Inherent obligations toward TB-affected communities were at times overshadowed by obligations to donors and state actors. Coordinating bodies for donor funds, which were multisectoral by design, presented an opportunity to bolster accountability actions within the TB response.
Conclusions
Multisectoral engagement and accountability for TB are a laudable and necessary goal to end TB. Sustainable mechanisms to support the meaningful involvement of TB-affected communities and civil society are needed, particularly in the context of donor transitions. |
|---|---|
| AbstractList | Sectors beyond health are essential to combatting a social disease such as tuberculosis (TB). The engagement of the community and civil society sector in Eastern Europe and Central Asia was assessed as part of a broader baseline assessment of multisectoral engagement in national TB responses.BACKGROUNDSectors beyond health are essential to combatting a social disease such as tuberculosis (TB). The engagement of the community and civil society sector in Eastern Europe and Central Asia was assessed as part of a broader baseline assessment of multisectoral engagement in national TB responses.This was a mixed-methods community-based study. Surveys, interviews, and focus groups were conducted online with TB-engaged community and civil society representatives in Belarus, Kazakhstan, Moldova, Tajikistan, and Ukraine from January to June 2021. Quantitative data, analyzed using descriptive statistics, were triangulated with thematic qualitative analysis. A multisectoral accountability framework and community, rights, and gender framework for TB were used to triangulate the findings and inform data interpretations.METHODSThis was a mixed-methods community-based study. Surveys, interviews, and focus groups were conducted online with TB-engaged community and civil society representatives in Belarus, Kazakhstan, Moldova, Tajikistan, and Ukraine from January to June 2021. Quantitative data, analyzed using descriptive statistics, were triangulated with thematic qualitative analysis. A multisectoral accountability framework and community, rights, and gender framework for TB were used to triangulate the findings and inform data interpretations.Participants (n = 160) included leads, service providers from 74 organizations, and TB survivors. Of 53 survey respondents, most (n = 41, 77·4%) indicated strong/complete agreement to participating in TB service delivery and gender, stigma, and/or legal assessments (n = 27, 50·9%) and research processes (n = 30, 56·6%). However, few indicated inclusion in operational planning and budgeting (n = 13, 24·5%), or political and program impact of community-led monitoring (n = 16, 30·2%), and almost none (n = 2, 3.8%) confirmed dedicated budgets for their TB-related work. Inquiry into the dimensions and criteria for multisectoral actions and accountability revealed their key, yet limited, role in attending to social determinants, with wider engagement hindered by precarious funding. Several organizations balanced building partnerships with other sectors engaged in the TB response against advocacy activities. Inherent obligations toward TB-affected communities were at times overshadowed by obligations to donors and state actors. Coordinating bodies for donor funds, which were multisectoral by design, presented an opportunity to bolster accountability actions within the TB response.RESULTSParticipants (n = 160) included leads, service providers from 74 organizations, and TB survivors. Of 53 survey respondents, most (n = 41, 77·4%) indicated strong/complete agreement to participating in TB service delivery and gender, stigma, and/or legal assessments (n = 27, 50·9%) and research processes (n = 30, 56·6%). However, few indicated inclusion in operational planning and budgeting (n = 13, 24·5%), or political and program impact of community-led monitoring (n = 16, 30·2%), and almost none (n = 2, 3.8%) confirmed dedicated budgets for their TB-related work. Inquiry into the dimensions and criteria for multisectoral actions and accountability revealed their key, yet limited, role in attending to social determinants, with wider engagement hindered by precarious funding. Several organizations balanced building partnerships with other sectors engaged in the TB response against advocacy activities. Inherent obligations toward TB-affected communities were at times overshadowed by obligations to donors and state actors. Coordinating bodies for donor funds, which were multisectoral by design, presented an opportunity to bolster accountability actions within the TB response.Multisectoral engagement and accountability for TB are a laudable and necessary goal to end TB. Sustainable mechanisms to support the meaningful involvement of TB-affected communities and civil society are needed, particularly in the context of donor transitions.CONCLUSIONSMultisectoral engagement and accountability for TB are a laudable and necessary goal to end TB. Sustainable mechanisms to support the meaningful involvement of TB-affected communities and civil society are needed, particularly in the context of donor transitions. Background Sectors beyond health are essential to combatting a social disease such as tuberculosis (TB). The engagement of the community and civil society sector in Eastern Europe and Central Asia was assessed as part of a broader baseline assessment of multisectoral engagement in national TB responses. Methods This was a mixed-methods community-based study. Surveys, interviews, and focus groups were conducted online with TB-engaged community and civil society representatives in Belarus, Kazakhstan, Moldova, Tajikistan, and Ukraine from January to June 2021. Quantitative data, analyzed using descriptive statistics, were triangulated with thematic qualitative analysis. A multisectoral accountability framework and community, rights, and gender framework for TB were used to triangulate the findings and inform data interpretations. Results Participants (n = 160) included leads, service providers from 74 organizations, and TB survivors. Of 53 survey respondents, most (n = 41, 77·4%) indicated strong/complete agreement to participating in TB service delivery and gender, stigma, and/or legal assessments (n = 27, 50·9%) and research processes (n = 30, 56·6%). However, few indicated inclusion in operational planning and budgeting (n = 13, 24·5%), or political and program impact of community-led monitoring (n = 16, 30·2%), and almost none (n = 2, 3.8%) confirmed dedicated budgets for their TB-related work. Inquiry into the dimensions and criteria for multisectoral actions and accountability revealed their key, yet limited, role in attending to social determinants, with wider engagement hindered by precarious funding. Several organizations balanced building partnerships with other sectors engaged in the TB response against advocacy activities. Inherent obligations toward TB-affected communities were at times overshadowed by obligations to donors and state actors. Coordinating bodies for donor funds, which were multisectoral by design, presented an opportunity to bolster accountability actions within the TB response. Conclusions Multisectoral engagement and accountability for TB are a laudable and necessary goal to end TB. Sustainable mechanisms to support the meaningful involvement of TB-affected communities and civil society are needed, particularly in the context of donor transitions. Background Sectors beyond health are essential to combatting a social disease such as tuberculosis (TB). The engagement of the community and civil society sector in Eastern Europe and Central Asia was assessed as part of a broader baseline assessment of multisectoral engagement in national TB responses. Methods This was a mixed-methods community-based study. Surveys, interviews, and focus groups were conducted online with TB-engaged community and civil society representatives in Belarus, Kazakhstan, Moldova, Tajikistan, and Ukraine from January to June 2021. Quantitative data, analyzed using descriptive statistics, were triangulated with thematic qualitative analysis. A multisectoral accountability framework and community, rights, and gender framework for TB were used to triangulate the findings and inform data interpretations. Results Participants ( n = 160) included leads, service providers from 74 organizations, and TB survivors. Of 53 survey respondents, most ( n = 41, 77·4%) indicated strong/complete agreement to participating in TB service delivery and gender, stigma, and/or legal assessments ( n = 27, 50·9%) and research processes ( n = 30, 56·6%). However, few indicated inclusion in operational planning and budgeting ( n = 13, 24·5%), or political and program impact of community-led monitoring ( n = 16, 30·2%), and almost none ( n = 2, 3.8%) confirmed dedicated budgets for their TB-related work. Inquiry into the dimensions and criteria for multisectoral actions and accountability revealed their key, yet limited, role in attending to social determinants, with wider engagement hindered by precarious funding. Several organizations balanced building partnerships with other sectors engaged in the TB response against advocacy activities. Inherent obligations toward TB-affected communities were at times overshadowed by obligations to donors and state actors. Coordinating bodies for donor funds, which were multisectoral by design, presented an opportunity to bolster accountability actions within the TB response. Conclusions Multisectoral engagement and accountability for TB are a laudable and necessary goal to end TB. Sustainable mechanisms to support the meaningful involvement of TB-affected communities and civil society are needed, particularly in the context of donor transitions. Sectors beyond health are essential to combatting a social disease such as tuberculosis (TB). The engagement of the community and civil society sector in Eastern Europe and Central Asia was assessed as part of a broader baseline assessment of multisectoral engagement in national TB responses. This was a mixed-methods community-based study. Surveys, interviews, and focus groups were conducted online with TB-engaged community and civil society representatives in Belarus, Kazakhstan, Moldova, Tajikistan, and Ukraine from January to June 2021. Quantitative data, analyzed using descriptive statistics, were triangulated with thematic qualitative analysis. A multisectoral accountability framework and community, rights, and gender framework for TB were used to triangulate the findings and inform data interpretations. Participants (n = 160) included leads, service providers from 74 organizations, and TB survivors. Of 53 survey respondents, most (n = 41, 77·4%) indicated strong/complete agreement to participating in TB service delivery and gender, stigma, and/or legal assessments (n = 27, 50·9%) and research processes (n = 30, 56·6%). However, few indicated inclusion in operational planning and budgeting (n = 13, 24·5%), or political and program impact of community-led monitoring (n = 16, 30·2%), and almost none (n = 2, 3.8%) confirmed dedicated budgets for their TB-related work. Inquiry into the dimensions and criteria for multisectoral actions and accountability revealed their key, yet limited, role in attending to social determinants, with wider engagement hindered by precarious funding. Several organizations balanced building partnerships with other sectors engaged in the TB response against advocacy activities. Inherent obligations toward TB-affected communities were at times overshadowed by obligations to donors and state actors. Coordinating bodies for donor funds, which were multisectoral by design, presented an opportunity to bolster accountability actions within the TB response. Multisectoral engagement and accountability for TB are a laudable and necessary goal to end TB. Sustainable mechanisms to support the meaningful involvement of TB-affected communities and civil society are needed, particularly in the context of donor transitions. |
| ArticleNumber | 20 |
| Author | Kalancha, Yuliia Kravets, Lyubov Kryshtafovych, Nataliia Vilc, Valentina Pirtina, Lucia Kamenska, Nataliia Skrahina, Alena Tonkonoh, Lesia Ibragimova, Oxana Chorna, Yuliya Jazybekova, Panagul Chuprynska, Mariia Adenov, Malik Klymenko, Olya Malar, James Terleeva, Yana Daftary, Amrita Hasanova, Sayohat Zakrevska, Hanna Koroieva, Iryna Zhurkin, Dmitry Abdullaeva, Marifat Lukash, Ievgeniia-Galyna |
| Author_xml | – sequence: 1 givenname: Yuliya surname: Chorna fullname: Chorna, Yuliya organization: TB Europe Coalition, Dahdaleh Institute for Global Health Research, York University – sequence: 2 givenname: Ievgeniia-Galyna surname: Lukash fullname: Lukash, Ievgeniia-Galyna organization: TB Europe Coalition, Faculty of Social Sciences and Social Technologies, National University of Kyiv-Mohyla Academy – sequence: 3 givenname: Yuliia surname: Kalancha fullname: Kalancha, Yuliia organization: TB Europe Coalition – sequence: 4 givenname: Lesia surname: Tonkonoh fullname: Tonkonoh, Lesia email: tonkonog@tbcoalition.eu organization: TB Europe Coalition – sequence: 5 givenname: Marifat surname: Abdullaeva fullname: Abdullaeva, Marifat organization: Departments of Epidemiology and Infectious Diseases, Tajik National University – sequence: 6 givenname: Malik surname: Adenov fullname: Adenov, Malik organization: National Scientific Centre of Phthisiopulmonology, Ministry of Health – sequence: 7 givenname: Mariia surname: Chuprynska fullname: Chuprynska, Mariia organization: TB Europe Coalition – sequence: 8 givenname: Sayohat surname: Hasanova fullname: Hasanova, Sayohat organization: Joint Infectious Disease Unit, WHO Regional Office for Europe – sequence: 9 givenname: Oxana surname: Ibragimova fullname: Ibragimova, Oxana organization: Kazakhstan Union of People Living with HIV – sequence: 10 givenname: Panagul surname: Jazybekova fullname: Jazybekova, Panagul organization: National Scientific Centre of Phthisiopulmonology, Ministry of Health – sequence: 11 givenname: Nataliia surname: Kamenska fullname: Kamenska, Nataliia organization: TB Europe Coalition – sequence: 12 givenname: Olya surname: Klymenko fullname: Klymenko, Olya organization: TBPeopleUkraine – sequence: 13 givenname: Iryna surname: Koroieva fullname: Koroieva, Iryna organization: The National Council on TB and HIV/AIDS (Country Coordinating Mechanism, Ukraine), Joint Project of UNDP and the Ministry of Health of Ukraine – sequence: 14 givenname: Lyubov surname: Kravets fullname: Kravets, Lyubov organization: The National Council on TB and HIV/AIDS (Country Coordinating Mechanism, Ukraine), Joint Project of UNDP and the Ministry of Health of Ukraine – sequence: 15 givenname: Nataliia surname: Kryshtafovych fullname: Kryshtafovych, Nataliia organization: Republican Public Association Defeat Tuberculosis Together – sequence: 16 givenname: Lucia surname: Pirtina fullname: Pirtina, Lucia organization: Center for Health Policies and Studies (PAS Center) – sequence: 17 givenname: Alena surname: Skrahina fullname: Skrahina, Alena organization: Republican Research and Practical Center for Pulmonology and Tuberculosis – sequence: 18 givenname: Yana surname: Terleeva fullname: Terleeva, Yana organization: TB Management and Counteraction Department, Ministry of Health – sequence: 19 givenname: Valentina surname: Vilc fullname: Vilc, Valentina organization: Institute of Phthisiopulmonology Chiril Draganiuc – sequence: 20 givenname: Hanna surname: Zakrevska fullname: Zakrevska, Hanna organization: Country Coordinating Mechanism Secretariat, UNDP – sequence: 21 givenname: Dmitry surname: Zhurkin fullname: Zhurkin, Dmitry organization: Republican Research and Practical Center for Pulmonology and Tuberculosis – sequence: 22 givenname: James surname: Malar fullname: Malar, James organization: Country and Community Support for Impact, Stop TB Partnership Secretariat – sequence: 23 givenname: Amrita surname: Daftary fullname: Daftary, Amrita organization: Dahdaleh Institute for Global Health Research, York University, School of Global Health, York University |
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| Cites_doi | 10.4103/jehp.jehp_1312_20 10.1186/s12879-017-2230-2 10.1002/14651858.CD008133 10.1016/S1473-3099(13)70042-2 10.1080/09540120500101757 10.1007/s10488-010-0314-z 10.1186/1471-2288-13-117 10.1183/20734735.020218 10.5588/pha.15.0026 10.1080/17441692.2021.1990372 10.1371/journal.pone.0199513 10.1186/s12992-021-00778-1 10.1177/1609406917733847 10.1093/heapol/czh052 10.4300/JGME-D-21-00752.1 10.1016/j.socscimed.2009.03.041 10.1186/s12992-020-00628-6 10.4300/JGME-5-4-18 10.1183/13993003.03300-2020 10.1093/intqhc/mzm042 |
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| Keywords | Civil society engagement Qualitative methods Survey Tuberculosis Accountability Community perspectives MAF-TB assessment Donor relations Multisectoral collaboration |
| Language | English |
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Sectors beyond health are essential to combatting a social disease such as tuberculosis (TB). The engagement of the community and civil society... Sectors beyond health are essential to combatting a social disease such as tuberculosis (TB). The engagement of the community and civil society sector in... Background Sectors beyond health are essential to combatting a social disease such as tuberculosis (TB). The engagement of the community and civil society... |
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| StartPage | 20 |
| SubjectTerms | Accountability Civil society engagement Community perspectives Donor relations Environmental Health Epidemiology Health Policy Medicine Medicine & Public Health Multisectoral collaboration Public Health Quality of Life Research Tuberculosis |
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| Title | Perspectives on multisectoral accountability framework to end tuberculosis in the Eastern Europe and Central Asia region: a mixed-methods study |
| URI | https://link.springer.com/article/10.1186/s44263-025-00136-y https://www.ncbi.nlm.nih.gov/pubmed/40045393 https://www.proquest.com/docview/3174458772 https://pubmed.ncbi.nlm.nih.gov/PMC11884184 https://doaj.org/article/3df54c96893a4447960442d7ea973e3c |
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