Perspectives on multisectoral accountability framework to end tuberculosis in the Eastern Europe and Central Asia region: a mixed-methods study
Chorna Y. Lukash I.-G. Kalancha Y. Tonkonoh L. Abdullaeva M. Adenov M. Chuprynska M. Hasanova S. Ibragimova O. Jazybekova P. Kamenska N. Klymenko O. Koroieva I. Kravets L. Kryshtafovych N. Pirtina L. Skrahina A. Terleeva Y. Vilc V. Zakrevska H. Zhurkin D. Malar J. Daftary A.
December 2025BioMed Central Ltd
BMC Global and Public Health
2025#3Issue 1
Background: Sectors beyond health are essential to combatting a social disease such as tuberculosis (TB). The engagement of the community and civil society sector in Eastern Europe and Central Asia was assessed as part of a broader baseline assessment of multisectoral engagement in national TB responses. Methods: This was a mixed-methods community-based study. Surveys, interviews, and focus groups were conducted online with TB-engaged community and civil society representatives in Belarus, Kazakhstan, Moldova, Tajikistan, and Ukraine from January to June 2021. Quantitative data, analyzed using descriptive statistics, were triangulated with thematic qualitative analysis. A multisectoral accountability framework and community, rights, and gender framework for TB were used to triangulate the findings and inform data interpretations. Results: Participants (n = 160) included leads, service providers from 74 organizations, and TB survivors. Of 53 survey respondents, most (n = 41, 77·4%) indicated strong/complete agreement to participating in TB service delivery and gender, stigma, and/or legal assessments (n = 27, 50·9%) and research processes (n = 30, 56·6%). However, few indicated inclusion in operational planning and budgeting (n = 13, 24·5%), or political and program impact of community-led monitoring (n = 16, 30·2%), and almost none (n = 2, 3.8%) confirmed dedicated budgets for their TB-related work. Inquiry into the dimensions and criteria for multisectoral actions and accountability revealed their key, yet limited, role in attending to social determinants, with wider engagement hindered by precarious funding. Several organizations balanced building partnerships with other sectors engaged in the TB response against advocacy activities. Inherent obligations toward TB-affected communities were at times overshadowed by obligations to donors and state actors. Coordinating bodies for donor funds, which were multisectoral by design, presented an opportunity to bolster accountability actions within the TB response. Conclusions: Multisectoral engagement and accountability for TB are a laudable and necessary goal to end TB. Sustainable mechanisms to support the meaningful involvement of TB-affected communities and civil society are needed, particularly in the context of donor transitions.
Accountability , Civil society engagement , Community perspectives , Donor relations , MAF-TB assessment , Multisectoral collaboration , Qualitative methods , Survey , Tuberculosis
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TB Europe Coalition, Kyiv, Ukraine
Dahdaleh Institute for Global Health Research, York University, Toronto, Canada
Faculty of Social Sciences and Social Technologies, National University of Kyiv-Mohyla Academy, Kyiv, Ukraine
Departments of Epidemiology and Infectious Diseases, Tajik National University, Dushanbe, Tajikistan
National Scientific Centre of Phthisiopulmonology, Ministry of Health, Almaty, Kazakhstan
Joint Infectious Disease Unit, WHO Regional Office for Europe, Copenhagen, Denmark
Kazakhstan Union of People Living with HIV, Almaty, Kazakhstan
TBPeopleUkraine, Kyiv, Ukraine
The National Council on TB and HIV/AIDS (Country Coordinating Mechanism, Ukraine), Joint Project of UNDP and the Ministry of Health of Ukraine, Kyiv, Ukraine
Republican Public Association Defeat Tuberculosis Together, Minsk, Belarus
Center for Health Policies and Studies (PAS Center), Chisinau, Moldova
Republican Research and Practical Center for Pulmonology and Tuberculosis, Minsk, Belarus
TB Management and Counteraction Department, Ministry of Health, Kyiv, Ukraine
Institute of Phthisiopulmonology Chiril Draganiuc, Chisinau, Moldova
Country Coordinating Mechanism Secretariat, UNDP, Minsk, Belarus
Country and Community Support for Impact, Stop TB Partnership Secretariat, Geneva, Switzerland
School of Global Health, York University, Toronto, Canada
TB Europe Coalition
Dahdaleh Institute for Global Health Research
Faculty of Social Sciences and Social Technologies
Departments of Epidemiology and Infectious Diseases
National Scientific Centre of Phthisiopulmonology
Joint Infectious Disease Unit
Kazakhstan Union of People Living with HIV
TBPeopleUkraine
The National Council on TB and HIV/AIDS (Country Coordinating Mechanism
Republican Public Association Defeat Tuberculosis Together
Center for Health Policies and Studies (PAS Center)
Republican Research and Practical Center for Pulmonology and Tuberculosis
TB Management and Counteraction Department
Institute of Phthisiopulmonology Chiril Draganiuc
Country Coordinating Mechanism Secretariat
Country and Community Support for Impact
School of Global Health
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