Event

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In the era of the End TB Strategy, the Sustainable Development Goals, and recent COVID-19 pandemic, national tuberculosis (TB) programmes are under increasing pressure to balance demands for ambitious programme targets with limited/diminishing resources. The resulting requirement for prioritisation and 'hard choices' threatens to curtail effective TB programming. Rwanda, Uganda and Ethiopia, early adopter countries, share their experiences applying the people-centred framework in their latest NSP development. The people-centred framework was designed to help countries to better streamline and utilise increasingly available evidence/data for decision making along the care continuum (including utilisation of mathematical impact and cost-effectiveness modelling), and facilitate evidence-based, optimised, people-centred responsive and resilient strategic planning and programming.

12:30 - 12:35: Introduction

12:35 - 12:47: Introduction to the people-centred framework for TB planning and programmingThe people-centred framework (PCF) for tuberculosis (TB) programming encourages us to rethink our approach to analysis, planning, implementation and evaluation of TB programmes. The presentation will introduce the philosophy, concept, approach, elements and some initial experiences (when and how to employ it). A future is envisioned in which evidence is reviewed and analysed in a patient-centred manner. Priority gaps are identified and closed ensuring access for all to high-quality services for prevention, diagnosis, treatment and care of TB, including post-treatment follow-up care. Data consolidation along the TB care continuum, impact optimisation of interventions, subnational validation and health service delivery optimisation form the four cornerstones of the PCF-based national strategic plan (NSP) 2.0. PCF will help countries to decide how best to allocate resources and use pre-populated data and automated data visualisations to continuously and critically assess the performance of TB-NSP implementation.
Emmy van der Grinten

12:47 - 12:59: Using the people-centred framework for national strategic plan development while on lockdown due to COVID-19The COVID-19 pandemic and lockdown to mitigate spread impacted the finalisation of the national strategic plan (NSP) and development of the NSP-based TB & HIV combined Global Fund funding request. Under unprecedented circumstances, how did Rwanda manage to adopt the people-centred framework (PCF), data consolidation and visualisation along the care continuum and TIME modelling, to support prioritisation and optimisation, before the lockdown? And also a patient pathway analysis to assess the alignment of care-seeking and service availability, with distant support from consultants due to international travel restrictions? Plus the intervention package scenarios to compare budget to best impact and the GFFR development, with a mix of in-country and distant TA? Patrick Migambi will share challenges, experiences, creative solutions and lessons learned.
Patrick Migambi

12:59 - 13:11: Developing an evidence-informed national strategic plan using epidemiological, people-centred and systems-related dataUganda is one of the early adopter and approach shaper countries for the people-centred framework for tuberculosis (TB) programming. The development of the Uganda national TB strategic plan (2020/21-2024/5) employed a patient-centred approach and was informed by the evidence gathered through a data consolidation process along the TB care continuum. The process included a patient pathway analysis (PPA) that was carried out to assess the alignment between country-level service provision and initial care-seeking by the population. Data was consolidated into an excel tool with automated data visualisations based on key performance indicators that provided evidence on epidemiology, people and systems. The evidence generated provided a basis for problem identification, prioritisation, root cause analysis, intervention identification and optimisation. 
Stavia Turyahabwe

13:11 - 13:23: Developing an optimised national strategic plan using TIME Impact & TIME EconomicsEthiopia, under the now ending national tuberculosis strategic plan, has made significant strides to achieve the End TB goals. By the end of 2018, 96% of public hospitals and health centres; 71% of private hospitals; 6.5% of private specialised clinics; and 22% of private medium clinics were providing TB diagnostic and/or treatment services. However, the country still remains among the top 30 high TB, TB-HIV and multidrug-resistant TB burden countries, and over a third of estimated 165,000 TB cases were missed in 2018. The country’s TB programme had about 60% funding gap in 2018. In an effort to address the remaining challenges, we analysed policy, programmatic and implementation gaps and did root cause analyses using the people-centred framework (PCF). We combined our in-house modelling capacity with support form external consultants to develop an optimised national strategic plan. We share our experience with the PCF approach with particular focus on TIME Impact and TIME Economics modelling.
Taye Letta

13:23 - 13:50: Q&A session