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July 2020 Document Number: WHO/EURO:2020-1345-41095-55826

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July 2020 Document Number: WHO/EURO:2020-1345-41095-55826 Psychosocial support for people with TB, HIV and viral hepatitis in the continuum of care in the WHO European Region Report - July 2020 Document number: WHO/EURO:2020-1345-41095-55826 ABSTRACT In spite of recent progress in ensuring access to rapid diagnostic tools, high-quality drugs and new treatment regimens for TB, HIV and viral hepatitis, the WHO European Region still faces a severe triple burden in relation to these diseases and treatment adherence remains a challenge. Psychosocial support is an important part of the continuum of care and a crucial component of integrated people-centred services to enable care and support and ensure completion of treatment. Currently, interventions related to psychosocial support for affected people, particularly in eastern European and central Asian countries, are donor-driven and provided mainly by civil society and community-based organizations. The overall aim of this report is to provide a review of existing practices in providing psychosocial support to people with TB, HIV and viral hepatitis in the WHO European Region, to discuss the general understanding of psychosocial support in the continuum of care, and to enhance and sustain psychosocial support services within country- and culture-specific settings. The report gives an overview of some literature and practices across the network of partners, assesses the impact and sustainability of these practices, and underlines relevant aspects for consideration when planning or providing psychosocial support for people with TB, HIV and viral hepatitis. KEYWORDS HIV TUBERCULOSIS VIRAL HEPATITIS PSYCHOSOCIAL SUPPORT CIVIL SOCIETY ORGANIZATIONS COMMUNITY-BASED ORGANIZATIONS KEY AND VULNERABLE POPULATIONS Address requests about publications of the WHO Regional Office for Europe to: Publications WHO Regional Office for Europe United Nations City, Marmorvej 51 DK-2100 Copenhagen Ø, Denmark Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the Regional Office website (http://www.euro.who.int/pubrequest). © World Health Organization 2020 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The views expressed by authors, editors, or expert groups do not necessarily represent the decisions or the stated policy of the World Health Organization. Contents Acknowledgements ...............................................................................................................................................iv Abbreviations ........................................................................................................................................................ v Introduction .......................................................................................................................................................... 1 Rationale ............................................................................................................................................................... 2 Aim of the review ....................................................................................................................................................................... 3 Methodology and data limitation ............................................................................................................................................ 3 Defining psychosocial support and services ........................................................................................................... 4 Psychosocial support for people-centred care........................................................................................................ 5 Global, regional and national strategies and policies on the provision of psychosocial support ............................. 7 The impact of psychosocial support ....................................................................................................................... 9 The role of families .................................................................................................................................................................. 10 Psychosocial needs and treatment adherence ..................................................................................................... 10 Premises, providers and types of psychosocial support ........................................................................................ 12 Settings of psychosocial provision ......................................................................................................................................... 12 Interventions for psychosocial support ................................................................................................................................ 12 Distinguishing between psychological and social support ................................................................................................. 14 Providers of psychosocial support ......................................................................................................................................... 16 Multidisciplinarity .................................................................................................................................................................... 17 Risks and sustainability perspectives ................................................................................................................... 18 Areas for future research ..................................................................................................................................... 21 Key aspects for consideration .............................................................................................................................. 21 Annex 1: List of organizations that provided information..................................................................................... 28 Annex 2: Consultation questionnaire ................................................................................................................... 30 Annex 3: Practices in providing psychosocial support to people affected by TB, HIV/AIDS and viral hepatitis ...... 33 iii Acknowledgements This report was produced by Masoud Dara, Coordinator, Communicable Diseases, WHO Regional Office for Europe; Sayohat Hasanova, Technical Officer, Joint Tuberculosis, HIV and Viral Hepatitis Programme, WHO Regional Office for Europe; Oxana Rucsineanu, Executive Director, Moldova National Association of Tuberculosis Patients “SMIT” (Society of Moldova against TB); and Safarali Naimov, Executive Director, Association “Stop TB Partnership, Tajikistan”. Additional contributions were made by Vittoria Gemelli, Consultant, Joint Tuberculosis, HIV and Viral Hepatitis Programme, WHO Regional Office for Europe; Jonathan Stillo, Assistant Professor, Wayne State University, Detroit, USA; Svetlana Doltu, Member, Council for Preventing and Eliminating Discrimination and Ensuring Equality in Moldova; and Yuliya Chorna, Executive Director, TB Europe Coalition. The World Health Organization would like to thank all key partners, international and national experts, and civil society organizations and representatives who contributed to the technical development of this report. iv Abbreviations ARCS Armenian Red Cross Society MDR-TB multidrug-resistant tuberculosis ART antiretroviral therapy (treatment) MSF Médecins Sans Frontières ATO anti-terrorist operation NGO nongovernmental organization CBO community-based organization OST opioid substitution therapy CHC community health committee PCC people-centred care CSO civil society organization PEPFAR President’s Emergency Plan for AIDS Relief DOT(S) directly observed therapy (short- PLHIV people living with HIV course) DAA direct-acting antiviral PO Public Organization DR-TB drug-resistant tuberculosis PWID people who inject drugs DS-TB drug-susceptible tuberculosis RCSK Red Crescent National Society of the Kyrgyz Republic Public Association EECA eastern European and central Asian RR-TB rifampicin-resistant tuberculosis HCV hepatitis C virus SGV support group volunteer GFATM Global Fund to Fight AIDS, STI sexually transmitted infection Tuberculosis and Malaria HRQoL
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