TB-MIG Project

Enhancing gender-sensitive TB detection, surveillance, treatment and prevention among mobile populations from the Republic of Moldova

The Republic of Moldova is among WHO European Region’s 18 high priority countries for TB and among the world’s 30 high burden countries for MDR TB.3  The estimated TB incidence (in thousands of the population) of Moldova was 3.9 (3.3-4.5) in 2017. Although the infection is more prevalent among men 2.8 (2.2-3.3), it also affects women 1.1 (0.88-1.3). MDR/RR-TB is diagnosed in 28 per cent of the new TB cases and in 55 per cent of the previously treated cases. In migrant women, MDR/RR-TB is deemed to be at an even higher rate, even if the evidence base is weak.4 In the country, the influence of migration and specifically gender on the TB burden has been a neglected research and policy area. 

Moldovan migrant workers are shouldering a much higher tuberculosis (TB) burden than the general population due to their mobility pattern, as many Moldovans seek work in high-TB burden countries such as the Russian Federation. Moreover, migrants are facing barriers in accessing healthcare and TB treatment due to their mobility, language barriers, limited social support systems to facilitate healthcare access and possible discrimination by health workers. In this context, migrants are unable to fulfil their full potential as development actors.
 
The fear and stigma associated with TB have different impacts on men and women, often due to women living in more precarious social and economic conditions than men.1 A deficient health system coupled with the lack of access to treatment and irregular migration make patients, particularly migrant women, default on their treatment and drive them into developing multi-drug resistant TB (MDR-TB).2 However, the intersecting factors of gender and migration have been generally neglected in TB research and policy interventions. 

The 24-month proposed project aims to institute good migration and health governance in the Republic of Moldova by developing effective migrant-centered and evidence-based policies, and mainstreaming gender and migrant-sensitive TB interventions throughout the Moldovan National TB Programme, while contributing to empower TB affected migrants and their families as development actors.

IOM stresses its extensive experience 10 in empowering governments, migrants and communities to prevent, detect and respond to health threats along the mobility continuum, whilst advocating for migrant-inclusive approaches. IOM’s migration health programs take place among migrants and crisis-affected populations, on communicable disease prevention such as TB, early diagnosis, treatment, health service availability and sensitization against stigma and discrimination. This relevant expertise makes IOM in the Republic of Moldova the best suited to implement the proposed project. 

Beneficiaries: Phthisiopneumology Institute “Chiril Draganiuc” (PPI); National Tuberculosis Program (NTP); Ministry of Health, Labour and Social Protection (MHLSP) of the Republic of Moldova 

Direct beneficiaries: Phthisiopneumology Institute; TB health providers and administrative staff; migrant TB patients; circular migrant women and men; women and men TB survivors; women and men caretakers of patients with TB. 

Indirect beneficiaries: Moldovan citizens and foreigners at Moldovan border crossing points; healthcare providers and health workers.

Partners: Ministry of Health, Labour and Social Protection (MHLSP) of the Republic of Moldova ; National TB Program (NTP);  Phthisiopneumology Institute “Chiril Draganiuc” (PPI)

Donor: IOM IDF (IOM Development Fund)

Budget: 300,000.00  US Dollar 

Duration: 24 months ( 01.11.2020- 01.11.2022)