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Free Content Tuberculosis control in Samara Oblast, Russia: institutional and regulatory environment

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SETTING: Tuberculosis control programme in Samara Oblast, Russia, funded in part by the government of the United Kingdom.

OBJECTIVE: To identify and evaluate institutional and regulatory influences as well as incentives and disincentives that might be amenable to change in the promotion of the DOTS strategy.

DESIGN: Multidisciplinary situational analysis through in-depth interviews of stakeholders and review of official federal and oblast documents.

RESULTS: Interpretation of traditional notification data is complex because classification and reporting systems differ from World Health Organization principles. Regulations governing financing encourage lengthy hospitalisations and interventions, and provide few incentives to shift policy to ambulatory care.

CONCLUSION: Accurate comparability of epidemiological trends and programmatic successes requires equivalent classification and reporting systems. If the DOTS strategy is to be sustainable, changes to financing systems will be needed.

Keywords: Russia; situational analysis; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK 2: Department of Microbiology and Infection, King's College, Denmark Hill, London, UK 3: Centre for Health Management, The Business School, Imperial College London, South Kensington Campus, London, UK 4: Samara Oblast Health Department, Samara, Russia 5: GUIN (Glavnoe Upravlenie Ispolneniia Nakasanii), Samara, Russia

Publication date: 2003-10-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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