Transcript Introduction to the Compendium of Indicators for Monitoring and

Compendium of Indicators for
Monitoring and Evaluating
National Tuberculosis Programs
Objectives of Session
• Provide an overview of the development of
Compendium
• Explain the organization of the
Compendium and how indicators are used
• Provide examples of how each subheading
for an indicator guides selection/use of
indicators
What is the Compendium?
A comprehensive and standardized collection
of the most widely used and recommended
indicators for monitoring and evaluation of
National TB Programs.
Who is it for?
• NTP managers, data managers, regional and
district officers
• NGO program managers/data managers
involved in TB programming
• Evaluation specialists
• Health-system planners (HMIS, etc.)
Anyone with responsibility for collecting,
processing, analyzing, and presenting data
on tuberculosis programs.
Specific Objectives
• Standardize M&E terminology across indicators
and programs
• Encourage consistent use of indicators to monitor
and evaluate programs
• Provide guidance for the development of
comprehensive evaluation plans
• Serve as a resource for the different components
of the monitoring and evaluation process
Current status of TB M&E
• Patient follow up/case management using
WHO standardized forms
• Small number of indicators focusing on
outcomes of DOTS implementation
• Project-specific monitoring forms
• Periodic assessment visits at facility level
Why a new TB M&E Guide? (1)
• Need for a broader view of M&E
• Inputs-processes-outputs-impact: allows
better understanding of how to achieve
impact
• Standardized guidance for global use
• Program-based to complement casemanagement
• Program-specific indicators for different
settings, types of programs
M&E Framework for TB programs
INPUT
PROCESS
OUTPUT
OUTCOME
IMPACT
Policy
environment
Management
Diagnostic
services
Case detection
Prevalence of
TB infection
Human and
Financial
Resources
Infrastructure
Training
Drug
management
Laboratories
Communication
Advocacy
Treatment success
Treatment
services
Prevalence of
TB disease
Improved
knowledge,
attitudes, and
practices
TB morbidity
TB mortality
Reduced
stigma
p7, Compendium of Indicators for Monitoring and Evaluating National Tuberculosis Programs
USAID, MEASURE, CDC, WHO, IUATLD, KNCV, MSH. WHO/HTM/TB/2004.344, August 2004
M&E Framework for TB Programs
INPUT
PROCESS
OUTPUT
OUTCOME
IMPACT
Policy
environment
Management
Diagnostic
services
Case detection
Prevalence of
TB infection
Human and
Financial
Resources
Infrastructure
Training
Drug
management
Laboratories
Communication
Advocacy
Treatment success
Treatment
services
Prevalence of
TB disease
Improved
knowledge,
attitudes, and
practices
TB morbidity
TB mortality
Reduced
stigma
p7, Compendium of Indicators for Monitoring and Evaluating National Tuberculosis Programs
USAID, MEASURE, CDC, WHO, IUATLD, KNCV, MSH. WHO/HTM/TB/2004.344, August 2004
Why a new TB M&E Guide? (2)
New Global Initiatives
• Global Fund for AIDS, TB, & Malaria
• STOP TB Partnership
• Increased USAID involvement
• TB/HIV initiatives
• DOTS Plus
Compendium Development
• Step 1: Assessment of existing M&E systems
within National TB programs and MOH
• Step 2: Create an international TB M&E working
group to develop and review indicators
• Step 3: Field test indicators in selected countries
• Step 4: Build capacity in M&E to collect,
disseminate and use information
Step 1: Assessment of current
M&E systems
• Field visits to examine M&E systems: data
collection forms, reporting, supervision,
data use
• South Africa, Russia, Honduras, Philippines
• Met with NTPs, USAID missions, WHO,
CDC, local implementing partners
• Review of literature on TB indicators
Results from assessment visits
• Substantial amount of data collected at
facility level that is not reported
• Weakness in reporting mechanisms for
facility level data
• Few indicators on political commitment,
IEC activities, drug supply, and TB/HIV
• Lack of data from private-sector
physicians
Step 2: Creation of international
working group
• Similar goals to develop more informative
indicators on program implementation
• Bring expertise from a wide variety of
sources:
Stop TB, WHO, UNION, KNCV, CDC,
USAID, World Bank, MSH,
MEASURE/Evaluation
Results of TB M&E Working Group
• Indicators for DOTS: Measure key aspects
of the TB epidemic in a country and the
programmatic response
• Based on WHO recommendations and
collected through existing systems
• External and expert review
Step 3: Field testing
• Peru, Kazakhstan, Haiti, and Thailand
• Revision of indicators based on field-testing
results
Step 4: Building capacity
• Egypt (March ‘05), Mexico (April ‘05),
Tanzania (September ‘05), India (this
workshop), Eastern Europe (TBD ‘06)
• Technical assistance
Indicators (1)
• Global indicators (5)
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–
–
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Case detection
Treatment success
DOTS coverage
HIV seroprevalence among TB cases
Surveillance of MDR-TB
• Routinely reported program outcomes
– Case detection
– Smear conversion
– Treatment outcome
Indicators (2)
• Indicators to measure DOTS
implementation under expanded framework:
– Political commitment (12)
• NTP annual workplan and budget
– Diagnosis (7)
• Existence of comprehensive laboratory network
– Case management, including DOT (2)
• Proportion of patients with correct prescription
– Drug management (8)
• Existence of a quality assurance system for drug
management
Indicators (3)
• Indicators to measure DOTS
implementation under expanded framework:
– Recording and reporting (2)
• Accuracy of reports sent to NTP
– Supervision (2)
• Existence of supervision guidelines
– Human resources development (3)
• Proportion of health centers with at least one
professional trained in the DOTS strategy
– Health systems (1)
• Equitable distribution of DOTS