Health system frailties in tuberculosis service provision in Russia: an analysis through the lens of formal nutritional support

Objective. The aim of this study was to describe health system challenges faced by tuberculosis (TB) treatment facilities in Russia through an analysis of format institutional dietary provisions to patients in an inpatient facility that provides care for poor patients. Methods. Analysis of format dietary provisions by institutions and financing data from TB hospitals in Samara Oblast, Russia. Results. Format dietary provision for inpatients with TB has fallen substantially in recent years. In a hospital providing inpatient care for the poorest patients with fewest social support networks, this has been very pronounced. The Likely reason for this is that financial support for other budget lines, principally salaries, has required protection. Conclusion. Format institutional nutritional support in institutions providing care for the poorest patients with TB is unlikely to be enhancing the speed of recovery, or reducing the duration of infectiousness. Furthermore, the rote that hospital may have played in the past in enabling patients to regain weight lost before admission may have been limited by reductions in format financing. Reductions in state provision of food for patients may serve as an important illustration of wider TB control system frailties in the Russian Federation. (c) 2005 The Royal Institute of Public Health. Published by Elsevier Ltd. All rights reserved.