The Challenges of Transition From Donor-Funded Programs: Results From a Theory-Driven Multi-Country Comparative Case Study of Programs in Eastern Europe and Central Asia Supported by the Global Fund.

Introduction: In the era of declining development assistance for health, transitioning externally funded programs to governments becomes a priority for donors. However, the process requires a careful approach not only to preserve the public health gains that have already been achieved but also to expand on them. In the Eastern Europe and Central Asia region, countries are expected to graduate from support from the Global Fund to Fight AIDS, Tuberculosis and Malaria in or before 2025.

The drivers of facility-based immunization performance and costs. An application to Moldova.

Objective: This paper identifies factors that affect the cost and performance of the routine immunization program in Moldova through an analysis of facility-based data collected as part of a multi-country costing and financing study of routine immunization (EPIC).

Methods: A nationally representative sample of health care facilities (50) was selected through multi-stage, stratified random sampling. Data on inputs, unit prices and facility outputs were collected during October 3rd 2012-January 14th 2013 using a pre-tested structured questionnaire.

Determinants of risky sexual behavior among injecting drug users (IDUs) in Georgia.

Injection risk practices and risky sexual behaviors place injection drug users (IDUs) and their sexual partners particularly vulnerable to HIV. The purpose of the study was to describe and understand determinants of high-risk sexual behavior among IDUs in Georgia. A cross-sectional, anonymous survey assessed knowledge, behavior and HIV status in IDUs in five Georgian cities (Tbilisi, Gori, Telavi, Zugdidi, Batumi) in 2009.

Unsafe injection and sexual risk behavior among injecting drug users in Georgia.

Injection drug users (IDUs) are at risk for acquiring human immunodeficiency virus (HIV) through parenteral and sexual transmission. In this paper, we describe the prevalence and correlates of unsafe drug injecting and sexual behaviors among IDUs recruited across five cities in Georgia in 2009. IDUs were administered a questionnaire collecting information on demographics, drug use, sexual behaviors, and HIV testing behaviors.

Prevalence of HIV among injection drug users in Georgia.

Background: Injection drug use remains a major risk factor for HIV transmission in Georgia. The study aims to characterize the prevalence of HIV among injection drug users in Georgia.

Methods: A cross-sectional, anonymous bio-behavioural survey to assess knowledge and behaviour in injection drug users in combination with laboratory testing on HIV status was conducted in five Georgian cities (Tbilisi, Gori, Telavi, Zugdidi and Batumi) in 2009.

Reforming sanitary-epidemiological service in Central and Eastern Europe and the former Soviet Union: an exploratory study.

Background: Public health services in the Soviet Union and its satellite states in Central and Eastern Europe were delivered through centrally planned and managed networks of sanitary-epidemiological (san-epid) facilities. Many countries sought to reform this service following the political transition in the 1990s. In this paper we describe the major themes within these reforms.

Navigating the health system: diabetes care in Georgia.

Background: Effective delivery of diabetes care requires integration across specialist teams delivering recognized interventions, a reliable pharmaceutical supply, and promoting self-management. Drawing on a framework incorporating physical, human, intellectual and social resources, the paper examines how these challenges are managed in diabetes care in Georgia.

Methods: The rapid appraisal study triangulated data from interviews with users, providers and key informants from various institutions in four regions of Georgia; data on clinical and social outcomes from diabetes; legislative and policy documents.