Key elements to develop a national strategic plan for TB control

Key elements to develop a national

strategic plan for TB control

Salah Ottmani and Soleil Labelle

Stop TB Department WHO, Geneva, Switzerland

Regional workshop on national strategic planning

for TB control

Why is a strategic plan needed?

• To reach goals and operational objectives for the NTP • To set strategic interventions

• To specify activities to be implemented

• To set a budget and identify funding availability

• To monitor and evaluate the strategic interventions • To operationalize the activities' implementation

– Where to implement these activities? – When to implement these activities? – Who will implement these activities? – How to monitor their implementation?

•

A NSP should be in line with the

National Health Plan

•

The 5 components of a NSP should

be consistent

•

A NSP should include 5 components

•

The gaps, the objectives and the

interventions should be consistent

What are the key principles of a NSP?

What are the components of a

strategic plan?

The description of the core plan

The budget plan

The monitoring and evaluation plan

The operational plan

1

_{component: the core plan}

• Situation analysis:

- Socio-economic and demographique information - Health and health system context

- Analysis of TB burden

- TB control interventions undertaken to date

1

_{component: the core plan (cont…)}

• Situation analysis (cont…):

- Strengths

- Weaknesses

- Opportunities

- Threats

Inappropriate formulations of gap analysis

1. The managerial capacity of the NTP should be strengthened : More staff should be recruited at central level.

Cars should be purchased for supervision 2. PPM activities should be implemented 3. There is no community DOTS

1

_{component: the core plan (cont…)}

• Definition of clear goals in line with SMART criteria • Specification of operational objectives:

- Should match with the situation analysis

- Should be defined in SMART criteria terms

• Identification of strategic interventions Each intervention should:

- be clearly specified

- have target(s) defined in SMART criteria

- match with at least one operational objective - include specific activities

2

_{component: the budgeting plan}

Should:

• be fully consistent with the strategic core plan

• refer to each operational objective, each strategic intervention and each activity identified in the core plan • be established for each year of the plan

• establish the cost

• identify the funding contribution of the government and of each partner for every year and for the overall period covered by the plan

• identify the funding gap for every year and for the overall period covered by the plan – Use WHO budget tool

Numbering system to ensure consistency in the plan

Goal: To decrease TB mortality to one death per 100,000 population by 2020.

Objective 1: To increase TB cure rate from 50% to 90% by 2017 onwards. 1.1. Improving and strengthening the managerial capacities at district level

1.1.1. Clear definition of the role of the managerial unit for TB control at

district level

1.1.2. Reassignment and recruitment or of the appropriate staff according to the post descriptions in the Central Unit

1.1.3. Appropriate training of the managerial staff at district level 1.1.4. Organization of supervision activities from the district level

1.1.5. Organization of training activities for health workers at district level 1.2. Implementation of TB drug treatment services in health facilities and community

1.2.1. Appropriate drug supply and management

1.2.2. Involvement of local community volunteers in treatment supervision 1.2.3. Enablers for the patient to come to the health facility for monitoring and after hospitalization

1.2.4. Provision of mobility means to the PHC workers to catch up identified

3

component:

the monitoring and evaluation plan

• Should be fully consistent with the strategic core plan, the budgeting plan and the operational plan

• Refer to each operational objective and each strategic intervention identified in the core plan

– include:

• Impact indicators (for the overall goal(s))

• Outcome indicators (for the operational objectives) • Output indicators (for the strategic interventions) • Process indicators (for some key activities)

4

_{component: the operational plan}

• Should clearly identify the activities (and sub-activities) that need to be implemented along with the strategic

interventions they belong to

• refer to the operational objectives associated with these strategic interventions (and activities)

• be consistent with the strategic core plan, the budgeting plan and the monitoring and evaluation plan: the

activities, the strategic interventions and the operational objectives highlighted in the operational plan must be the same as those identified in the strategic core plan and the

4

_{component: the operational plan (cont…)}

• The operational plan should be established and detailed for the coming 1 or 2 years of the period covered by the NSP

• The implementation of the activities should be indicated on quarterly basis

• The operational plan should specify detailed information on each activity to be implemented

• The activities that need technical assistance should be highlighted

5th component: the technical assistance plan

• Should be based on the operational plan (implementation of)

• focus on the >1 year and include details:

– Task: Briefly describe activity, terms of references

– Estimated cost: estimated cost of the mission

– Available funding & source: NTP, GF grants, partner budgets, etc.

for this activity?

– Funding gap: Is there a funding gap needed to implement the

activity

– Expert: national or international? expert identified? HR gap?

– Responsible officer/partner in country

– Timeframe: crucial to secure funding and best consultants

– Global Fund grant activity reference and service delivery area:

6

_{component: the preparedness plan (optional)}

• This 6th _{component needs to be seriously considered} in countries with fragile status or in protracted states • The preparedness plan should be established for the

acute phase of any complex emergency, including natural disaster

• The plan should focus on ensuring the availability and access to TB treatment for the patients who were

treated for TB before the acute phase (Appendix 11, TB care and control in refugee and displaced populations,

Conclusion

• Clear identification of priorities in TB control needs and inherent interventions

• Estimates of budget needed

• Resource mobilization from government and local and international partners/donors

• Efficient involvement and contribution of GF and

potential donors in the implementation of the NSPs through relevant funding mechanisms

• Establishment of a sound TA plan based on operational plan

Thank you!