Strengthening TB Programme
The fifth objective addresses a critical prerequisite for effective TB control, namely TB programme management capacity. Effective TB programmes require sufficient financing, appropriate legislation and regulatory control, and well-planned human resource development strategies. In many countries, national TB programmes face the challenge of expanding programme operations and increasing financial resources without the capacity or skills to manage the workload. Surprisingly, however, this crucial component of the Regional Strategy is often absent from other strategy documents.
"Programme management capacity" is inherently cross-cutting requiring cross-sector collaboration and, in some instances, (national, regional, global) policy development or change. As a result, strengthening programme management capacity is a challenge at all levels. Integration of TB control within the primary health care networks should ensure that cross cutting issues, such as infection control are being addressed. Quality surveillance systems and operational research should provide the evidence base for sound programme management.At the same time, this inadequacy undermines rational planning, timely implementation of activities, disbursement of donor funds, accountability, programme performance monitoring, supervisory activities, and quality data collection and reporting.
In order to strengthen programme management capacity, countries should:
- Ensure sufficient and sustainable financing for National TB Programmes and activities;
- Improve overall management skills at national level;
- Develop an integrated, comprehensive Human Resource Development using the Health Action Framework (below) as a guide;
- Integrate TB control into primary health care networks;
- Treat infection control as a cross-cutting issue;
- Ensure political commitment and regulatory approaches to support rational use of drugs;
- Improve programme outcomes through monitoring & evaluation and operational research;
- Plan ahead for technical assistance needs to ensure sufficient funding and the best quality experts; and
- Develop evidence-based, feasible plans for Advocacy, Communication and Social Mobilization (ACSM).