Evaluation of the Tuberculosis Control Assistance Program (TB CAP)

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Impact on Patients and TB epidemiology ...................................................................................... 36Results and Impact by Intermediate Result (IR1) .......................................................................... 36Impact by Intermediate Result (IR2) ............................................................................................. 36Impact by Intermediate Result (IR3) ............................................................................................. 37Impact by Intermediate Result (IR4) ............................................................................................. 37Results and Impact by Intermediate Result (IR5) .......................................................................... 37Cross-cutting Results and Impact ................................................................................................. 38Operations Research ................................................................................................................... 38ANNEXESAnnex I. Scope of Work ......................................................................................................................... 39Annex II. TB CAP Desk Audit ................................................................................................................. 53Annex III. Evaluation Questionnaires ..................................................................................................... 55Annex IV. Field Visit Itineraries .............................................................................................................. 57Annex V. Washington Telephone Interview Schedule ............................................................................ 63Annex VI. Field interviews and Interviews with TB CAP Stakeholders .................................................... 67Annex VII. Proposed TB Cap Indicators ................................................................................................. 81Annex VIII. References .......................................................................................................................... 85viEVALUATION OF THE TUBERCULOSIS CONTROL ASSISTANCE PROGRAM (TB CAP)
EXECUTIVE SUMMARYIn the 1990s the United States Government began to increase its funding for international tuberculosis(TB) control through the United States Agency for International Development (USAID). The USAID TBCoalition for Technical Assistance (TBCTA) project, begun in 2000, demonstrated that US assistancecould have a tangible positive impact by channelling USAID support through a partnership of highlyexperienced TB control organizations to deliver technical assistance (TA) in small-scale projects.The successor TB Control Assistance Program (TB CAP) was intended to expand on this with TA onadditional aspects of TB control (such as country-level drug management systems and TB/HIVintegration) and greater capacity building in more countries.In 2009 USAID commissioned the Global Health Technical Assistance (GH Tech) Project to conduct atwo-month evaluation of TB CAP by a four-person team of independent consultants. The team analyzedpast and present TB CAP activities and management through a desk review of TB CAP documents andmaterials, field visits to four countries, meetings with technical agencies and donors, and interviews withstakeholders in 16 other TB CAP countries, including Mission, TB CAP partner, and national TBprogram staff. It found thatIn countries it directly supported, TB CAP has improved capacity to provide better-quality services tocontrol TB and has indirectly strengthened other countries through its contributions to global TBcontrol efforts.There was near-universal praise for the quality of TA provided by TB CAP and its partners, and formany of the tools that TB CAP has helped create, test, and disseminate.There were varying degrees of satisfaction with in-country coordination of TB CAP activities,although the perception of most Missions was that coordination issues were quickly and effectivelyresolved.National TB control programs (NTPs) and Missions would like to see USAID continue to supportTA, are concerned about the impact on their TB control efforts if the support ends, and hope that therange, quality, and convenience of current TB CAP services are maintained.Missions are increasingly using TB CAP to implement their TB programs, and the President’sEmergency Plan for AIDS Relief (PEPFAR) has increased its funding through TB CAP for TBrelatedHIV activities.The organizational model of TB CAP (a partnership of cooperating agencies with a programmanagement unit providing administrative and management oversight) is functioning well, althoughit does not always rigorously adhere to its own policies and procedures. 1TB CAP support would be more efficient and have more impact if it were better aligned andharmonized at the Mission level with the activities of PEPFAR and the Global Fund to Fight AIDS,TB, and Malaria.The impact and management of TB CAP is hampered by the one-year focus of its workplans andlengthy delays in workplan development and approval, compounded by the need to create andapprove a new workplan each year.1 TB CAP Operational Manual, Version January 2009EVALUATION OF THE TUBERCULOSIS CONTROL ASSISTANCE PROGRAM (TB CAP)vii
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Other Skills: The following general
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. Develop a work plan, which will i
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March 19, SurabayaVisit to Puskesma
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DateThursday, April 2, 2009Intervie
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TreatmentDrugsM&EMDRNumber of suspe
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Global Health Technical Assistance
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