Health system factors influencing management of multidrug-resistant tuberculosis in four European Union countries - learning from country experiences.

Background: In the European Union and European Economic Area only 38% of multidrug-resistant tuberculosis patients notified in 2011 completed treatment successfully at 24 months' evaluation. Socio-economic factors and patient factors such as demographic characteristics, behaviour and attitudes are associated with treatment outcomes. Characteristics of healthcare systems also affect health outcomes.

Viewpoint: Why and how tuberculosis control should be included in health sector reviews.

Sector-wide approaches (SWAps) are currently implemented in several, predominantly highly donor-dependent low-income countries, particularly in Sub-Saharan Africa. SWAp intends to enhance health sector performance, especially efficiency, effectiveness, coherence and sustainability. SWAps have been criticized for not being able to produce tangible results and the credibility of a SWAp would increase substantially if such results in terms of health services outputs could be demonstrated.