To be complete, evaluation should look at how well the programme functions, particularly with respect to three aspects: organization of care, established procedures and human resources. A set of quality criteria is evaluated for each of these aspects. The criteria may be either qualitative (description) or quantitative (indicators). The following tables can be used as a rough guide.
17.5.1 Organization
Criteria |
Indicators |
Goals |
---|---|---|
Access to care |
|
Easy access to care during the intensive/continuation phases |
Patient comfort |
|
|
Information and therapeutic education |
Patient interviews conducted. |
Patient understanding of treatment |
Hospital hygiene |
|
All necessary equipment is available and used. |
Constant supply of lab materials |
|
|
Constant supply of quality-assured |
|
|
Case detection |
|
Know the type, in order to interpret the quantitative results of case detection
|
Diagnosis of smear-negative PTB and EP forms |
|
|
DST |
DST possible (methods, quality control) |
Detection of DR-TB |
Treatment support |
Number of patients receiving treatment support/month |
100% of those eligible for support |
Identification of non-adherent patients |
|
|
Integrated TB/HIV care |
|
|
17.5.2 Procedures
Criteria |
Indicators |
Goals |
---|---|---|
Registers/records |
Description of the documents
|
Records reliable
|
Standard case definitions |
Percentage of patients with exact case definition out of a randomized sample of patients |
100% |
Adequate standard treatment regimens and follow-up |
|
|
HIV testing |
Percentage of new cases tested for HIV |
100% |
ART |
Percentage of HIV-positive TB cases started on ART |
100% |
Criteria for cure |
Percentage of confirmed cases declared cured who actually met the definition of cure out of a randomized sample of patients |
> 90% |
Regular monitoring of drug-susceptible TB and DR-TB |
|
|
Adherence monitoring |
|
|
Prevention of M. tuberculosis airborne transmission in TB facilities |
|
|
Standard precautions | Description | Standard precautions followed |
Laboratory quality control |
|
|
17.5.3 Human resources
Criteria |
Indicators |
Goals |
---|---|---|
Staff |
|
On average:
|
Training |
Refer to training programme evaluation criteria |
Competent staff |
Other contributors |
Description: other NGOs, local associations, etc. |
|
A grid for evaluating TB clinic operations can be found in Appendix 38.