Evaluation of the Tuberculosis Control Assistance Program (TB CAP)

C. PARTNERS AND PARTNER COORDINATIONThe TB CAP partnership model is unusual for USAID but is working well and allows for flexibility,innovation, strength-in-diversity, and acceptability to countries. Missions and NTPs appreciate the rangeand flexibility of TB CAP TA. There is a consensus that TB CAP’s current partners represent the rightmix of capabilities, although some areas need strengthening.Partners reported that working together in TB CAP has benefited them by increasing their own capacities,amplifying the impact of their work, and providing them with an entry point into regions and countrieswhere they otherwise might not have operated. They also felt that TB CAP had improved cooperationbetween agencies and reduced competition. TB CAP support has brought these organizations to the sametable and catalyzed consensus on standards and approaches so that they are increasingly speaking withone voice. New synergies between partners likely would not exist if the activities if there were nopartnership.While the technical quality and relevance of its assistance was highly praised, several individuals reportedinsufficient coordination of TB CAP activities in some countries, particularly in the first years of theproject. One common issue was that the country coordinating partner had been ineffective. This wasusually addressed by finding a coordinating partner that was more capable of carrying out the work, but insome cases implementation was delayed. In countries where the TB CAP coordinating partner could havebenefitted from senior support from the home office, this is often not recognized or is insufficient.The USAID brand is associated with TB CAP activities, as is the TB CAP brand itself. Still, there is someconfusion about what TB CAP is (donor or project), the role of USAID, and whether TB CAP or thepartner is implementing the project. This is likely unavoidable given the high profile of the partnersimplementing TB CAP. In the countries visited, the USAID brand was prominent.RecommendationsThe board should define clear policies and criteria for the selection of collaborating partners, such asconstraints on the number of partners involved in particular types of projects, to ensure optimalcomposition of project teams.The board should set a minimal acceptable amount of visiting supportive supervision for TB CAPfield officers, and partners should maintain that level of support for all programs they coordinate,increasing the amount based on the needs and capacity of field officers.The board should establish base criteria for measuring the performance of coordinating andcollaborating partners and set a policy for responding to both underperformance and unwillingness tocarry out agreed-upon responsibilities, and the PMU should develop systems for monitoring andregularly reporting on such issues to the board for action.Some partners are less effective than others at coordinating country or core projects. These partnersshould remain collaborating partners and not be responsible for coordination.D. ADMINISTRATION AND MANAGEMENTThe PMU based within KNCV in The Hague facilitates meetings and discussion among TB CAPgoverning bodies (the board and working groups) and relies on the strategic guidance and decisions ofthese bodies to select TB CAP activities, balanced by direction received from Missions, NTPs, and theTB CAP Cognizant Technical Officer (CTO) in Washington, D.C.The PMU routinely monitors TB CAP activities and payment to agents for work performed. Clear andaccurate details of these activities must be communicated to USAID throughout each year in specificformats, ranging from qualitative information (project achievements) to technical data (performance and8 EVALUATION OF THE TUBERCULOSIS CONTROL ASSISTANCE PROGRAM (TB CAP)