Overview

The review of a formal national tuberculosis (TB) programme (or the efforts that countries make to control the disease regardless of the existence of a formal “programme”) is an important exercise to evaluate the implementation and impact of TB prevention, care and control. It should be jointly undertaken by the government together with the relevant national and international partners that are involved in TB efforts.

A TB programme review assesses the performance of the strategy implemented to fight TB and identifies the strengths and weaknesses of interventions that have been put in place. An appropriate review must, then, describe specific recommendations on the strategic orientations that need to be adopted and developed to overcome the gaps identified in the way that TB prevention, care and control are being implemented. These recommendations provide the foundation for improving the strategy adopted to control TB and for revising or developing a national strategic plan. Moreover, the review of a TB programme provides an important opportunity to advocate for TB prevention, care and control among policy makers, to strengthen the engagement of national health authorities and key stakeholders, and to enhance the mobilization of resources from both domestic and international sources.

The first WHO guidelines on how to review a TB programme were published in 1998, and were designed to support the assessment of, and improvements to, the implementation of the DOTS strategy. Since then, there have been major evolutions in the WHO strategy for prevention, care and control of TB. Important new interventions have been defined, developed and implemented: for example, collaborative TB/HIV activities and the programmatic management of drug-resistant TB. Therefore, this new guidance takes into consideration all strategic approaches that are part of the current WHO strategy for TB control. In 2013, WHO began developing a post-2015 global tuberculosis strategy. Thus, this guidance will be further updated once the new strategy is fully translated into operational language.

The main purpose of this document is therefore to provide guidance on how to organize a review of a national TB programme. It identifies the keys steps needed to plan and prepare the review and specifies how to carry out field visits. It also describes the process of using the findings of the field visits, formulating recommendations and developing a review report. The document also includes, in annexes and in web-based format, checklists that can be adapted and used to assess key areas of TB prevention, care and control such as TB surveillance system, the management of the TB programme, and the process of TB case finding.

Contents

• Contributors
• Abbreviations
• Foreword
• 1. Introduction
  • 1.1 Definition
  • 1.2 Purpose
  • 1.3 Objectives
  • 1.4 Target audiences
  • 1.5 Process of reviewing a national TB programme
• 2. Phase 1: planning and preparing for the review
  • 2.1 Appoint review coordinators
  • 2.2 Establish a task force for the review
  • 2.3 Define the review's objectives
  • 2.4 Set the dates for the review
  • 2.5 Select the members of the review teams, and define their roles and responsibilities
  • 2.6 Select sites for the field visits
  • 2.7 Plan the logistics
  • 2.8 Prepare a budget and arrange funding for the review
  • 2.9 Prepare the assessment checklists and background documents
  • 2.10 Identify a lead writer to prepare the report
• 3. Phase 2: conducting the review
  • 3.1 Briefing the review teams, and having team members meet with national authorities
  • 3.2 Making field visits
  • 3.3 Presenting the reports of the field visits to the entire review team
  • 3.4 Presenting and debriefing the findings and recommendations to the national authorities
• 4. Phase 3: finalizing the report of the review, and the next steps
  • 4.1 Finalizing the report of the TB programme review
  • 4.2 Disseminating the final report of the TB programme review
  • 4.3 Supporting the implementation of recommendations made in the final report
• Annexes
  • Annex 1 Checklist for preparing and conducting a review of a national tuberculosis programme
  • Annex 2 General information and documents to be collected before the review of the national tuberculosis programme and to be made available to the reviewers
  • Annex 3 Terms of reference for the TB epidemiological and impact analysis component of a national programme review
  • Annex 4 Checklists for assessing selected areas of tuberculosis activities during a review of a national programme
  • Annex 5 Selected references

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 expressed 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.