Collaborative evaluation series. Russia site visit report.

This report presents the methodology findings and conclusions of an evaluation of the HIV / AIDS Treatment Care and Support (TCS) Collaborative in Russia. The evaluation included individual and group discussions with about 25 actors in the health care systems addressed by the collaborative; document review of plans memos reports indicator data job aids and other types of documents; and observations of clinics (not patient consults) and health ministry offices a learning session for representatives of facility teams participating in the collaborative and a training session on voluntary counseling and testing. The collaborative started in June 2004 (involving one district of St. Petersburg and limited regions in three oblasts) and the evaluation took place in March-June of 2007. Findings reveal broad-based successes and point to areas where additional strides could be made to improve the quality of care for PLWHA in Russia. Within TCS the collaborative addressed four topic areas: access to care and patient retention coordination of care patient management and adherence to treatment and coordinated HIV and TB detection and treatment. All four topics were addressed by all sites which were not facilities but rather larger administrative systems of care involving polyclinics AIDS centers and other specialty providers. Briefly findings reveal significant achievements in each topic (the text provides details including run charts showing the speed of achievements and an appendix provides data on 30 indicators defined by the project USAID or PEPFAR). Other important accomplishments were: re-organizing the referral systems and communication channels between facilities creating case management positions and integrating them into existing systems creating a TB specialist position at one oblasts AIDS centers enhancing the role of polyclinics in the medical follow-up of HIV-infected patients expanding screening for TB among HIV patients at the polyclinic level and initiating isoniazid preventive therapy among HIV-infected patients.