Results4TB

Results4TB: Designing and evaluating provider results-based financing for tuberculosis care in Georgia: understanding costs, mechanisms of effect and impact.

(01 March 2017 - 2020)

Country: Georgia

Tuberculosis (TB) is still a leading cause of death worldwide, and Georgia is a country where the rates for this disease are high. Reasons for this include patients not seeking treatment or sticking to it. Additionally, staff don’t always detect TB quickly enough and their motivation is poor due to low salaries.

is a collaborative project researching the impact of a pilot financial incentive scheme for health care providers working with TB patients in Georgia.

This 4-year project will help design this pilot results-based financing (RBF) scheme with Georgian policy-makers and programme managers, examine its impact and cost effectiveness and give further evidence to RBF and TB programming around the globe.

QMU's role in this project

Researchers from the Institute for Global Health and Development at QMU are supporting the design of the pilot RBF intervention and will assess the impact it has on TB detection and treatment rates.

Using these results, recommendations for fine-tuning and modification will be discussed with policy makers in order to develop a roll out of the intervention across all of Georgia.

For information on the full Results4TB project visit the

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Project objectives
Project publications

Georgia has a high burden of tuberculosis, with almost 1 in a thousand people becoming infected in 2015. Despite improvements in TB detection and treatment, the Georgian treatment success rates remain low which shows that many people may not be completing treatment, posing a threat to their own health as well as that of their families and communities.

Although the Georgian government has introduced incentives for patients to encourage continuous treatment, adherence remains low. Therefore, new results-based financing incentive scheme has been introduced with an aim to motivate health service providers, thus improving patient adherence and treatment outcomes.

Results4TB is helping to develop the pilot intervention with policy makers and programme managers and provide evidence of its impact and cost-effectiveness. The project will make suggestions for fine-tuning and modification if the RBF scheme is to be rolled out nationally in Georgia.

Results4TB will provide valuable evidence on a health systems intervention for TB, and will contribute to a better understanding of RBF for practitioners, donors and researchers.

The Results4TB research project is a partnership between , Queen Margaret University, the and .

For more information, please refer to the page at Results4TB.

The project is funded through the Joint Health Systems Research Initiative which is jointly funded by the , the , the and the

To support the design of a pilot RBF intervention which is meant to address the current supply side weaknesses of TB service delivery and to document the joint development of the intervention with policy makers.

To examine the impact, cost-effectiveness and underlying mechanisms and the wider effects of the RBF intervention using a theory-informed controlled trial design.

To assess and provide insights for policy makers on how the RBF intervention could be fine-tuned and modified, if necessary, to optimise a potential national roll-out and extension.

From a methodological perspective, to develop understanding of how the realist evaluation approach can be used to inform intervention trials and costs-effectiveness analysis.

January 2019: Blog 'Doing embedded development and research – reflections on the start of the Results4TB programme' Prof Sophie Witter shares her reflections on the gains and pains of the first 18 months of the Results4TB programme in Georgia.

Results4TB blog

July 2017: Performance based financing for tuberculosis care: Are provider incentives the answer? This evidence summary (available on request via IGHD Email Address) provides a summary of evidence for performance-based financing specifically for TB.

For the full repository of publications and resources connected to this project, please visit the page at Results4TB.

IGHD presented at and participated in the 5th Global Symposium on Health Systems Research #HSR2018

For information about sessions related to this project and other #HSR2018 sessions, see more at IGHD at #HSR2018.