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MONITORING & EVALUATION PLAN COLLABORATIVE TB/HIV ACTIVITIES
M i n i s t r y o f H e a l t h C o m m u n i t y D e v e l o p m e n t G e n d e r E l d e r l y a n d C h i l d r e n i
Ministry of Health Community Development Gender Elderly and Children
MONITORING & EVALUATION PLAN FOR COLLABORATIVE TB/HIV ACTIVITIES
APRIL 2018
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MONITORING & EVALUATION PLAN COLLABORATIVE TB/HIV ACTIVITIES
M i n i s t r y o f H e a l t h C o m m u n i t y D e v e l o p m e n t G e n d e r E l d e r l y a n d C h i l d r e nii
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MONITORING & EVALUATION PLAN COLLABORATIVE TB/HIV ACTIVITIES
M i n i s t r y o f H e a l t h C o m m u n i t y D e v e l o p m e n t G e n d e r E l d e r l y a n d C h i l d r e n iii
TABLE OF CONTENTS
TABLE OF CONTENTS ........................................................................................... iii
ABBREVIATIONS....................................................................................................iv
1 INTRODUCTION ................................................................................................. 1
1.1 Purpose of this Monitoring and Evaluation plan .................................................................... 1
1.2 Target audience ....................................................................................................................... 1
1.3 TB/HIV situation in Tanzania ................................................................................................ 1
2 COLLABORATIVES TBHIV ACTIVITIES ..............................................................3
3 MONITORING AND EVALUATION FRAMEWORK ............................................. 4
4 DATA MANAGEMENT ........................................................................................ 9
4.1 Overview ..............................................................................................................................9
4.2 Data Flow ............................................................................................................................9
4.3 NACP Data Flow .................................................................................................................9
4.4 TB Data ..............................................................................................................................10
4.5 Data Recording .................................................................................................................10
4.6 Data Reporting System .....................................................................................................10
4.7 Data Storage .......................................................................................................................11
4.8 Feedback, Dissemination and Use of Data ........................................................................11
4.9 Use of Data ........................................................................................................................ 13
5 DATA QUALITY ASSURANCE MECHANISMS AND RELATED SUPPORTIVE SUPERVISION ................................................................................................... 13
6 M&E COORDINATION AND CAPACITY BUILD ................................................. 14
7 REFERENCES .................................................................................................... 15
8 ANNEXES .......................................................................................................... 16
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ABBREVIATIONS
AIDS Acquired Immunodeficiency SyndromeART Antiretroviral TherapyCDC Centre for Disease Control and PreventionCHMT Council Health Management TeamCPT Cotrimoxazole Preventive TherapyCTC Care and Treatment ClinicsDMO District Medical OfficerDTLC District Tuberculosis and Leprosy CoordinatorHBC Home Based CareHIV Human Immunodeficiency VirusIPT Isoniazid Preventive TherapyMOHCDGEC Ministry of Health Community Development Gender Elderly and Children. M&E Monitoring and EvaluationNACP National AIDS Control ProgrammeNGO Non Governmental OrganizationNTLP National Tuberculosis and Leprosy ProgrammePLHIV People Living with HIVPMTCT Prevention of Mother-to-Child TransmissionPWID People Who Inject Drugs RMO Regional Medical OfficerRTLC Regional Tuberculosis and Leprosy CoordinatorTB/HIV Tuberculosis and Human Immunodeficiency Virus Co-infectionTB TuberculosisTHMIS Tanzania HIV/AIDS and Malaria Indicator SurveyUSAID United States Agency for International DevelopmentVCT Voluntary Counseling and TestingWHO World Health Organization
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1 INTRODUCTION
1.1 Purpose of this Monitoring and evaluation plan
The overall goal of this plan is to guide the ministry through the respective programs and other TBHIV stakeholders and implementing partners to track and assess the results of the TB/HIV collaborative activities. This plan is an extension of the collaborative TBHIV Policy Guideline, 2017 which is the guide for these activities in the country.
It is a living document that should be referred to and updated on a regular basis. The plan demonstrate the roadmap to the successful implementation collaborative TB/HIV activities in the country.It is intended to facilitate performance monitoring against the set targets and provide a guide on interpretation and dissemination of the information for programme improvement at all levels. It also aims to ensure consistency of recording and reporting systems across all the partners and stakeholders involved in HIV, TB and collaborative TB /HIV activities.
This plan outlines the indicators as per the performance framework which addresses targets as outlined in the National Strategic plans and the Collaborative TBHIV policy guideline. It is also developed based on the 2015 WHO Collaborative TBHIV Monitoring and evaluation guide
1.2 Target audience
This plan is intended for TBHIV implementers within ministries of health and other institutions, and stakeholders at all levels; national, subnational and district TB/HIV coordinators or members of coordinating bodies; and staff of development and technical agencies, nongovernmental organizations (NGOs), and civil society and community-based organizations (CBOs) involved in supporting collaborative TB/HIV activities.
People living with the Human Immunodeficiency Virus (HIV) are 29 times (26-31) more likely to develop tuberculosis (TB) disease as people without HIV living in the same country. TB is a leading cause of death among people living with HIV, accounting for one in five HIV-related deaths globally. The World Health Organization (WHO) has recommended the package of interventions collectively called “collaborative TB/HIV activities” since 2004 (Table 1). There has been significant progress in both global and national implementation of this package, which contributed to an estimated 1.3 million lives saved between 2005 and 2011.
Ongoing monitoring of implementation of collaborative TB/HIV activities and evaluation of their impact is critically important. An effective and efficient National monitoring and evaluation system is a prerequisite of this in order to track the program’s performance.
1.3 TB/HIV situation in Tanzania
The United Republic of Tanzania is among 30 high TB and TB/HIV burden countries in the world. The First National TB Prevalence Survey final report, September 2013 estimated bacteriologically confirmed pulmonary TB in adults to be 295/1000001, with an estimated case detection rate of 42%. WHO estimates shows decreasing trends for both prevalence and incidence with point estimates for TB prevalence (all forms), incidence and case detection rates at 528/100000, 306/100,000 and 36% respectively in 2015, with rather wide confidence Intervals. A total of 64,404 cases were notified in 2016, higher than in 2015 (60,895) for new and relapse cases, reversing a trend of decline for the first time since 2003.
The country has endured a severe HIV epidemic for almost three decades and remains among the 1 The First National Tuberculosis Prevalence Survey in the United Republic of Tanzania Final Report, page 10
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high burden countries in Sub-Saharan Africa. The HIV prevalence among adults in Tanzania is estimated at 4.7% among adults aged 15 - 49 years in a nation-wide HIV impact survey in 2016-2017, but with marked heterogeneity among age groups, geographical regions and socio-demographic subgroups.
HIV prevalence peaks at 12 percent among females aged 45 to 49, as compared to a peak of 8.4 percent among males aged 40 to 44. Prevalence among 15 to 24 years old is 1.4 percent (2.1 percent among females and 0.6 percent among males). The disparity in HIV prevalence between males and females is most pronounced among younger adults, with women in age groups 15 to 19, 20 to 24, 25 to 29, 30 to 34 and 35 to 39 all having prevalence more than double that of males in the same age groups
HIV infection remains the most important risk factor and driver for TB in the country. With an estimated 1.4 million PLHIVs, 31% of whom are without ART, this is the largest group vulnerable for TB. Other noted vulnerable groups for TB infection identified by the country include children under-5, mine workers and mining communities, the elderly, prisoners, people with diabetes, Injecting drug users2 and health workers
The HIV co-infection rate amongst TB patients has decreased from 37% in 2013 to 34% in 2016.In 2016 data shows that 63,753 (97%)f notified cases were tested for HIV and 21720 (34%) were HIV and TB co-infected cases. Among all the co-infected, 20709 (95%) were registered for HIV care services, 20,895(96%) were started on CPT and 19814 (91%) were on or started ART at time of diagnosis.
The Collaborative TBHIV activities are under the mandate of the MOHCDEC through its two programs i.e National Aids control and National Tuberculosis and Leprosy control. The Management of the co infected patient through these programs are guided by the Collaborative policy guideline.
2 (Refer to National Strategic Plan V for TB & Leprosy programme)
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2 COLLABORATIVES TBHIV ACTIVITIES
Table 1. Adopted TB/HIV Collaborative activities
A. Strengthen the mechanism of collaboration and joint management between HIV programmes and TB control programmes for delivering integrated TB and HIV services
A.1 Set up and strengthen a coordinating body for collaborative TB/HIV activities functional at all levels
A.2 Determine HIV prevalence among TB patients
A. 3 Determine TB prevalence among people living with HIV
A.4 Carry out joint TB/HIV planning to integrate the delivery of TB and HIV services
A.5 Engagement of NGOs and CBOs in implementation of TB/HIV services
A.6 Establish an integrated national M&E system for collaborative TB/HIV activities that informs both NTLP and NACP annual operational plans.
A.7 Addressing the need of Key populations for HIV and TB
B. Reduce the burden of TB in people living with HIV and initiate early anti-retroviral therapy (The three I’s for TBHIV)
B.1 Intensify TB case findings implemented at all HIV care and treatment and all other healthcare facility settings.
B.2 Provide high quality TB treatment for HIV infected TB patients
B.3 Initiate TB prevention therapy (IPT) for both adults and children
B.4 Initiate TB prevention through early initiation of ART as per national guidelines
B.5 Ensure control of TB infection in health facilities
B.6 Ensure control of TB infection in congregate settings
C. Reduce the burden of HIV in patients with presumptive and TB diagnosis
C.1 Provide HIV testing and counselling to patients with presumptive and diagnosed TB
C. 2 Provide HIV testing and counselling to patients diagnosed with drug-sensitive TB and drug resistant TB
C.3 Provide HIV prevention interventions for patients with presumptive and diagnosed TB
C.4 Provide co-trimoxazole preventive therapy for TB patients living with HIV
C.5 Ensure HIV prevention interventions, treatment and care for TB patients living with HIV
C.6 Provide antiretroviral therapy for TB patients living with HIV irrespective of CD4 count as per national guidelines
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3 MONITORING AND EVALUATION FRAMEWORK
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Tabl
e 2.
CO
LLA
BO
RA
TIV
E T
BH
IV M
ON
ITO
RIN
G A
ND
EV
ALU
ATI
ON
PLA
N
No
Indi
cato
rB
asel
ine
Targ
etSo
urce
Freq
uenc
yR
espo
nsib
le
Pro
gram
20
1620
1720
1820
1920
2020
21
Cor
e gl
obal
and
nat
iona
l ind
icat
ors
1 Pr
opor
tion
of re
gist
ered
ne
w a
nd re
laps
e TB
pat
ient
s w
ith d
ocum
ente
d H
IV
stat
us
97%
100%
100%
100%
100%
100%
DH
IS2
Qua
rter
ly
NTL
P
2*P
ropo
rtio
n of
regi
ster
ed
new
and
rela
pse
TB p
atie
nts
with
doc
umen
ted
HIV
-po
sitiv
e st
atus
34%
33%
32%
31%
30%
29%
DH
IS2
Qua
rter
ly
NTL
P
3**
Prop
ortio
n of
peo
ple
livin
g w
ith H
IV n
ewly
en
rolle
d in
HIV
car
e w
ith
activ
e TB
dis
ease
0%0.
13%
0.13
%0.
13%
0.13
%0.
13%
CTC2
Dat
abas
eAn
nual
lyN
ACP
4Pr
opor
tion
of H
IV-p
ositi
ve
new
and
rela
pse
TB
patie
nts o
n AR
T du
ring
TB
trea
tmen
t
95%
100%
100%
100%
100%
D
HIS
2Q
uart
erly
NTL
P
5**
*Pro
port
ion
of p
eopl
e liv
ing
with
HIV
new
ly
enro
lled
in H
IV c
are,
star
ted
on T
B pr
even
tive
ther
apy
- 6
0% 6
5% 7
0% 7
5% 7
5%CT
C2 D
atab
ase
Annu
ally
NAC
P
A.6
Mor
talit
y am
ong
HIV
-po
sitiv
e ne
w a
nd re
laps
e TB
pa
tient
s
8%7%
6%5%
4%4%
DH
IS2
Annu
ally
NTL
P
Indi
cato
rs to
mea
sure
the
casc
ade
of in
tens
ified
TB
cas
e fi
ndin
g
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No
Indi
cato
rB
asel
ine
Targ
etSo
urce
Freq
uenc
yR
espo
nsib
le
Pro
gram
20
1620
1720
1820
1920
2020
21
1Pr
opor
tion
of p
eopl
e liv
ing
with
HIV
who
are
scre
ened
fo
r TB
in H
IV c
are
or
trea
tmen
t set
tings
88%
98%
100%
100%
100%
100%
TB S
cree
ning
qu
estio
nnai
re ,
CTC2
,
Qua
rter
ly
NAC
P
2Pr
opor
tion
of p
eopl
e liv
ing
with
HIV
who
are
pr
esum
ptiv
e TB
out
of
thos
e w
ho a
re sc
reen
ed fo
r TB
TBD
100%
100%
100%
100%
100%
TB S
cree
ning
qu
estio
nnai
re
, CTC
2,
Pres
umpt
ive
TB
regi
ster
,
Annu
ally
NAC
P/N
TLP
3Pr
opor
tion
of p
eopl
e liv
ing
with
HIV
who
are
in
vest
igat
ed( i
.e sp
utum
, x-
ray,
Gen
expe
rt, s
core
ch
art e
tc) f
or T
B ou
t of
thos
e w
ho a
re sy
mpt
om
scre
en p
ositi
ve
TBD
100%
100%
100%
100%
100%
TB S
cree
ning
qu
estio
nnai
re
, CTC
2,
Pres
umpt
ive
TB
regi
ster
,
Annu
ally
NAC
P
4Pr
opor
tion
of p
eopl
e liv
ing
with
HIV
who
are
star
ted
on
TB tr
eatm
ent o
ut o
f tho
se
diag
nose
d as
hav
ing
activ
e TB
TBD
100%
100%
100%
100%
100%
TB S
cree
ning
qu
estio
nnai
re
, CTC
2,
Pres
umpt
ive
TB
regi
ster
,
Annu
ally
NAC
P
Indi
cato
rs to
mea
sure
acc
ess
to T
B d
iagn
osti
c te
st fo
r pe
ople
livi
ng w
ith
HIV
5 P
ropo
rtio
n of
peo
ple
livin
g w
ith H
IV h
avin
g TB
sy
mpt
oms w
ho re
ceiv
e a
rapi
d m
olec
ular
test
as a
fir
st te
st fo
r dia
gnos
is o
f TB
TBD
30%
55%
70%
85%
90%
CTC2
, pr
esum
ptiv
e TB
re
gist
ers
Annu
ally
NAC
P an
d N
TLP
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No
Indi
cato
rB
asel
ine
Targ
etSo
urce
Freq
uenc
yR
espo
nsib
le
Pro
gram
20
1620
1720
1820
1920
2020
21
Indi
cato
rs to
mea
sure
acc
ess
to e
arly
AR
T fo
r H
IV-p
osit
ive
TB p
atie
nts
6 P
ropo
rtio
n of
HIV
-pos
itive
ne
w a
nd re
laps
e TB
pat
ient
s de
tect
ed a
nd n
otifi
ed o
ut
of th
e es
timat
ed n
umbe
r of
inci
dent
HIV
-pos
itive
TB
case
s
TBD
10
0%10
0%10
0%10
0%CT
C2An
nual
lyN
ACP
7 P
ropo
rtio
n of
HIV
-pos
itive
ne
w a
nd re
laps
e TB
pat
ient
s w
ho re
ceiv
e co
-tri
mox
azol
e pr
even
tive
ther
apy
TBD
CT
C2An
nual
lyN
TLP
8 P
ropo
rtio
n of
hea
lth c
are
faci
litie
s pro
vidi
ng se
rvic
es
for p
eopl
e liv
ing
with
HIV
th
at h
ave
TB in
fect
ion
cont
rol p
ract
ices
TBD
10
0%10
0%10
0%10
0%An
nual
repo
rts
Annu
ally
NAC
P/N
TLP
09 P
ropo
rtio
n of
peo
ple
livin
g w
ith H
IV w
ho c
ompl
ete
a co
urse
of T
B pr
even
tive
ther
apy
TBD
10
0%10
0%10
0%10
0%CT
C2An
nual
lyN
ACP
Indi
cato
rs fo
r ex
pand
ed in
terv
enti
on 2016
2017
2018
2019
2020
2021
1Pr
opor
tion
of p
resu
mpt
ive
TB p
atie
nts h
avin
g do
cum
ente
d H
IV st
atus
-
-
100%
100%
100%
100%
Pres
umpt
ive
TB
re
gist
erAn
nual
lyN
TLP
2Pr
opor
tion
of p
eopl
e liv
ing
with
HIV
cur
rent
ly o
n AR
T w
ho d
evel
op T
B di
seas
e
0.50
%2.
00%
2.00
%2.
00%
2.00
%
CTC
-2 D
atab
ase
Annu
ally
NAC
P
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No
Indi
cato
rB
asel
ine
Targ
etSo
urce
Freq
uenc
yR
espo
nsib
le
Pro
gram
20
1620
1720
1820
1920
2020
21
3 P
ropo
rtio
n of
peo
ple
livin
g w
ith H
IV in
car
e w
ho e
ver
rece
ived
a c
ours
e of
TB
prev
entiv
e th
erap
y
10%
12%
51%
34%
16%
CT
C-2
Dat
abas
eAn
nual
lyN
ACP
& N
TLP
Indi
cato
rs to
mea
sure
inte
grat
ion
and
opti
miz
atio
n of
ser
vice
s fo
r im
plem
enta
tion
of c
olla
bora
tive
TB
/HIV
act
ivit
ies
4Pr
opor
tion
of h
ealth
fa
cilit
ies p
rovi
ding
TB
serv
ices
that
als
o pr
ovid
e AR
T se
rvic
es
TBD
10
0%10
0%10
0%10
0%An
nual
repo
rtAn
nual
lyN
TLP
5 P
ropo
rtio
n of
HIV
car
e an
d tr
eatm
ent f
acili
ties t
hat a
lso
prov
ide
TB p
reve
ntio
n an
d ca
re se
rvic
es
100%
100%
100%
100%
100%
100%
Annu
al re
port
Annu
ally
NAC
P &
NTL
P
6 P
ropo
rtio
n of
mat
erna
l an
d ch
ild h
ealth
car
e fa
cilit
ies a
lso
impl
emen
ting
inte
nsifi
ed T
B ca
se fi
ndin
g
100%
100%
100%
100%
Annu
al re
port
An
nual
lyN
TLP
7Pr
opor
tion
of o
pioi
d su
bstit
utio
n th
erap
y ce
nter
s al
so p
rovi
ding
TB
and
HIV
se
rvic
es
TBD
100%
100%
100%
100%
100%
Annu
al R
epor
tAn
nual
lyN
TLP
8 P
ropo
rtio
n of
pri
son
heal
th
cent
ers a
lso
prov
idin
g TB
an
d H
IV se
rvic
es
TBD
10
0%10
0%10
0%10
0%An
nual
repo
rtAn
nual
lyN
TLP
Indi
cato
rs to
mea
sure
com
mun
ity
enga
gem
ent
9 P
erce
ntag
e of
TB
patie
nts
regi
ster
ed a
nd re
ferr
ed b
y co
mm
unity
hea
lth w
orke
rs
and
volu
ntee
rs
10%
17%
18%
19%
20%
21%
DH
IS2
Qua
rter
lyN
TLP
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4 DATA MANAGEMENT 4.1 Overview
It is important that the dimensions of quality data are maintained at each stage of data recording and compilation process for both paper and electronic base records. It is the responsibility of the data management team at each level to ensure that the appropriate recommended tools and procedures are in place to obtain quality data.
4.2 Data Flow
The Collaborative TBHIV activities data are managed by both programs i.e NACP and NTLP.The main type of data are generated from routine surveillance but also from other sources such as surveys from all health care levels. The Program’s follows the general government healthcare structure from which the data flows at different levels for reporting and feedback. The system of recording is a hybrid of paper and electronic systems for both programs.Data are collected at the facilities, where they are aggregated into a summary report and sent to the council for entry into the DHIS2 database for the National HIMS and NTLP and NACP through CTC2.
The programs ensures that the dimensions of quality data are maintained at each stage of the data recording and compilation process and in both paper-based and electronic records. Standard of operating procedures are available to guide the Health care workers on recording and compilation of data
4.3 NACP Data Flow
HIV Data is collected at facility and community. At facility level, data is documented in service specific registers (can be paper based or electronic based registers). Data in the registers is used to prepare monthly and quarterly HIV reports. Reports are validate at the facility level and submitted to the District Medical Officer (DMO) by date of 7th of the next month.
All facilities’ reports are received and validated at DMO office. Validate data is entered in DHIS2 where all level can easily access it.
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4.4 TB Data
HIV Data is also collected at facility and community. At facility level, data is documented in the TB forms, cards and registers and at district level the data is aggregated into a district register and entered into DHIS2 system. The program is currently rolling out a case based system from which a facility data (from a Unit register) will be entered directly into DHIS2
4.5 Data Recording
Data recording and reporting systems include:
• Paper-based systems (patient cards, log books, registers, summary forms, etc.)
• Electronic databases (e.g DHIS2, CTC2, etc.)
Standard Operating Procedures for Data Collect are available to guide the HCWs on how to collect data
Data collation and validation
An important step in the data flow process is data collation or aggregation and validation. Data collation is done at the facility by the focal person for each programme and is counter checked by the facility in-charge before being sent to the council for entry into the DHIS2 system.
4.6 Data Reporting System
Electronic data capture
At the center of the national HMIS system is the DHIS2 system, which is an electronic data capture platform for aggregate data. Monthly summary forms from facilities are sent to the council where they are entered into the system in accordance with national HMIS guidelines, under the supervision of the DHIS2 focal person. Once data are entered into the DHIS2 system they are available to council, regional, and national authorities.
For TB and Leprosy Program data are sent to the council-DTLC on quarterly basis and are entered as an aggregate data into the DHIS2, and for the NACP the electronic data recording is through the CTC data base. The DHIS2 for the NTLP is currently under piloting of the case base instead of aggregate data.
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4.7 Data Storage
The coordinators at all levels are responsible to ensure appropriate storage maintenance security and archiving of the programs record. The primary data sources are stored in secured place for the paper based records and for the electronic data security is assured through user level of accessibility, but also the maintenance of the hardware, and maintenance of the national server
4.8 Feedback, Dissemination and Use of Data
4.8.1 Feedback
Feedback of the Collaborative TBHIV follows the data flow as described above shall consider quality of received data, progress of their performance and action to be taken.
• In charge of facilities provide feedback to the district coordinators (CHMT) as well as to the community
• The CHMT provides written feedback to facilities, partners and communities
• The RHMT provide written feedback to CHMTs, facilities, Partners and community
• The National level : ie NTLP and NACP provide feedback to RHMTs, facilities and Partners
4.8.2 Dissemination
Dissemination of data is done at all levels in order to share and use information for informed decision making as well as for reporting purposes.
MOHCDGEC has already issued data dissemination tool for district level; the District Health Profile Template (DHP).It is in the process of developing dissemination model for regional levels. Description on how to use DHP is provided in the template.
The ministry through the Programs also disseminate information internationally through meetings, publications and conferences. Electronic dissemination is also done through Ministry and Program’s websites, and the Ministry HIMS portal.
The common means of dissemination are :
• At the health facility level, TB and HIV monthly/quarterly reports together with interventions progress updates are shared and discussed in the monthly facility technical meetings and in other platforms (e.g. ward development committee, village health committee, Uhuru torch rallies, etc.). The health facility in charge is responsible for the data dissemination.
• At the council level, monthly/quarterly reports are presented and discussed in the monthly CHMT meetings. Additionally, HIV and TB indicators are included in the optional indicator section of the annual DHP report and submitted to the comprehensive council health plans meetings for use. During the quarterly district data review meetings, monthly and quarterly HIV and TB reports are discussed and other platforms such as HIV and TB district committee meetings. Monthly and quarterly reports are disseminated to specific facilities during CHMT supportive supervisions.
• At the regional level, monthly/quarterly HIV and TB reports and progress updates are presented and discussed in the regional quarterly data review meetings. Other platforms which can be used for data dissemination are RHMT supportive supervisions, council multi-sectorial HIV and TB committee (CMAC), etc.
• At the national level, MOHCDGEC is responsible for data dissemination both vertically and horizontal to various stakeholders including partners, donors and other government entities.
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4.9 Use of Data
Aggregate or individual level data available at health facility level and are used for :
• To monitor and identify patients/clients in need of extra interventions, referrals or care and to alert or remind HCWs on clients/patients with particular needs, thus improve HIV and TB services.
• To detect alarming trends and highlight successes
• For administrative purposes to improve access, coverage, quality of services, and efficient use of resources.
• For quantification and ordering of drugs and supplies.
• As basis for planning, developing, and ongoing improvement of TB and HIV Interventions
At the council level, only aggregate data from facilities will be available for use:
• For acquisition and distribution of resources• To make decisions related to construction, expansion of facilities and whether or not to
increase human resource at facilities.• For budgeting and allocation of resources.• To assists the council authorities to plan interventions, monitor activities at the heath
Service delivery point, ward and village levels. • To make decisions related to construction, expansion of facilities, employment and
deployment of human resourcesNB: The council can effectively incorporate ward and village HIV and TB control plans into the overall council plans.
At regional level, data from districts will be available and used to know the extent/coverage:
• To acquire and distribute resources accordingly.• To assess regional performance• To plan for future interventions according to trend seen from the indicators.• To make decisions related to construction, expansion of facilities and whether or not to
increase human resource at facilities.• Budgeting and allocation of resources.• The data assists the regional authorities to plan interventions, monitor activities at the
district levels. • The region can effectively incorporate district HIV and TB control plans into the overall
region plans.
At the national level data should be used for: • Monitoring the trends of HIV and TB epidemic• Commodities quantification• Planning• Policy formulation • Resources mobilization, acquisition and allocation
• Inform strategic decisions for improvement of interventions
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5 DATA QUALITY ASSURANCE MECHANISMS AND RELATED SUPPORTIVE SUPERVISION
The two programs have in place the data quality assessment guidelines which are being adopted and customised from the Ministry Data quality assessment guideline.
The guidelines have described all the data quality assurance measures for each level and also the system of conducting the routinely data quality assessment at every level
There are Regional and National data review meetings which are conducted quarterly and annually respectively in order to discuss data management matters
Each Program has the general supportive supervision schedules guided by the Programs guidelines and the focus is supervising the progress of all program activities including collaborative TBHIV. This supervision is cascading from National, Regional and district In addition at least biannually the Programs conducts joints supportive supervision specifically for the collaborative TBHIV activities in all regions.
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6 M&E COORDINATION AND CAPACITY BUILD
The Monitoring and evaluation of the collaborative TBHIV activities is coordinated by the Ministry though its two respective programs. The Program Managers are responsible for all M&E activities through the M&E units which have dedicated officers who oversees the operations.
At Regional and Council levels the Program’s coordinators are the responsible for all M&E activities of the Program including the Collaborative TBHIV activities and at facility level the HCWs at the TB and HIV clinic are responsible for this.
Capacity building of the M&E for the programs is a continuous process which is being provided through government and partners support and is being guided by the Strategic and operational plans
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7 REFERENCES
1. NTLP (2015): National Policy Guidelines for Collaborative TB/HIV Activities
2. WHO (2012): WHO policy on collaborative TB/HIV activities: Guidelines for national programmes and other stakeholders.
3. WHO (2015): A guide to monitoring and evaluation for collaborative TB/HIV activities
4. NACP(2014): National Guidelines for clinical Management of HIV/AIDS, Dar es Salaam, Tanzania
5. NTLP (2013): Manual of the National Tuberculosis and Leprosy Programme, Dar es Salaam, Tanzania.
6. UNAIDS (2013) unpublished Spectrum estimates
7. NTLP (2016) Annual Report
8. NTLP (2015) Annual report
9. Mmbaga EJ, Moen K, Mpembeni R, Kirei N, Mbwambo J, Leshabari M. HIV prevalence and risk profile of men who have sex with men and people who inject drugs in Dar es Salaam, Tanzania (2014)
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8 A
NN
EXES
Ann
ex 1
: Ind
icat
ors
Ref
eren
ce
Indi
cato
rD
efini
tion
Num
erat
orD
enom
inat
orP
urpo
seR
atio
nale
Met
hodo
logy
Prop
ortio
n of
regi
ster
ed
new
and
re
laps
e TB
pa
tient
s with
do
cum
ente
d H
IV st
atus
Num
ber o
f ne
w a
nd
rela
pse
TB
patie
nts w
ho
had
an H
IV
test
resu
lt re
cord
ed
in th
e TB
re
gist
er
expr
esse
d as
a
perc
enta
ge
of th
e nu
mbe
r re
gist
ered
du
ring
the
repo
rtin
g pe
riod
.
Num
ber o
f ne
w a
nd
rela
pse
TB
patie
nts
regi
ster
ed
duri
ng th
e re
port
ing
peri
od w
ho
had
an H
IV
test
resu
lt re
cord
ed in
the
TB re
gist
er
Tota
l num
ber o
f ne
w a
nd re
laps
e TB
pat
ient
s re
gist
ered
in
the
TB re
gist
er
duri
ng th
e re
port
ing
peri
od
To m
easu
re
the
abili
ty o
f H
IV a
nd T
B pr
ogra
mm
es
to e
nsur
e th
at th
e H
IV
stat
us o
f TB
patie
nts
is
asce
rtai
ned.
HIV
infe
ctio
n ra
tes a
re h
ighe
r am
ong
TB p
atie
nts t
han
in th
e ge
nera
l pop
ulat
ion.
K
now
ledg
e of
HIV
stat
us
help
s pro
mot
e sa
fe b
ehav
iour
, re
duce
HIV
tran
smis
sion
, and
im
prov
e ac
cess
to a
ppro
pria
te
HIV
car
e an
d su
ppor
t for
TB
pat
ient
s, in
clud
ing
earl
y AR
T. A
ll TB
pat
ient
s with
un
docu
men
ted
HIV
stat
us
shou
ld b
e off
ered
an
HIV
test
, pr
efer
ably
at t
he ti
me
of T
B di
agno
sis a
nd w
ithin
the
sam
e se
ttin
gs w
here
they
rece
ive
TB
care
. Alte
rnat
ivel
y, a
wel
l-fu
nctio
ning
refe
rral
syst
em
shou
ld b
e in
pla
ce to
ens
ure
coun
selli
ng, t
estin
g an
d fe
edba
ck o
f HIV
test
ing
data
to
the
refe
rrin
g TB
uni
t.
Num
erat
or: C
ount
the
tota
l num
ber o
f ne
w a
nd re
laps
e TB
pat
ient
s add
ed to
th
e TB
regi
ster
of t
he b
asic
man
agem
ent
unit
duri
ng th
e re
port
ing
peri
od w
ho h
ad
thei
r HIV
stat
us d
ocum
ente
d as
pos
itive
or
neg
ativ
e, in
clud
ing
thos
e pr
evio
usly
do
cum
ente
d to
be
HIV
-pos
itive
(for
ex
ampl
e, d
ocum
ente
d ev
iden
ce o
f en
rolm
ent i
n H
IV c
are)
. HIV
-neg
ativ
e TB
pat
ient
s are
thos
e w
ho h
ad a
neg
ativ
e H
IV te
st re
sult
at th
e tim
e of
cur
rent
TB
diag
nosi
s.
Den
omin
ator
: Cou
nt th
e to
tal n
umbe
r of
new
and
rela
pse
TB p
atie
nts r
egis
tere
d in
the
TB re
gist
er d
urin
g th
e re
port
ing
peri
od.
of T
B pa
tient
s (10
). Th
e hi
stor
y of
pr
evio
us T
B tr
eatm
ent s
houl
d al
so b
e do
cum
ente
d sy
stem
atic
ally
to id
entif
y ne
w a
nd re
laps
e TB
pat
ient
s.
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Indi
cato
rD
efini
tion
Num
erat
orD
enom
inat
orP
urpo
seR
atio
nale
Met
hodo
logy
Prop
ortio
n of
regi
ster
ed
new
and
re
laps
e TB
pa
tient
s with
do
cum
ente
d H
IV-p
ositi
ve
stat
us
Num
ber o
f re
gist
ered
ne
w a
nd
rela
pse
TB
patie
nts w
ho
are
foun
d to
be
HIV
-po
sitiv
e ex
pres
sed
as
a pe
rcen
tage
of
the
num
ber
regi
ster
ed
with
do
cum
ente
d H
IV st
atus
du
ring
the
repo
rtin
g pe
riod
.
Tota
l num
ber
of n
ew a
nd
rela
pse
TB
patie
nts
regi
ster
ed
duri
ng th
e re
port
ing
peri
od w
ho a
re
docu
men
ted
as
HIV
-pos
itive
Tota
l num
ber o
f ne
w a
nd re
laps
e TB
pat
ient
s re
gist
ered
du
ring
the
repo
rtin
g pe
riod
hav
ing
a do
cum
ente
d H
IV st
atus
, po
sitiv
e or
ne
gativ
e.
To a
sses
s the
pr
eval
ence
of
HIV
am
ong
regi
ster
ed T
B pa
tient
s.
Mea
sure
men
t of t
he
prop
ortio
n of
HIV
-pos
itive
TB
patie
nts d
efine
s a p
opul
atio
n gr
oup
elig
ible
fo
r spe
cific
inte
rven
tions
ai
med
at r
educ
ing
the
burd
en
of H
IV a
mon
g TB
pat
ient
s,
such
as c
otri
mox
azol
e pr
even
tive
ther
apy
and
ART,
and
als
o pr
ovid
es a
de
nom
inat
or fo
r mea
sure
men
t of
upt
ake
of th
ese
inte
rven
tions
. It a
lso
help
s in
targ
etin
g of
reso
urce
s,
stra
tegi
c pl
anni
ng a
nd
mon
itori
ng th
e eff
ectiv
enes
s of
HIV
pre
vent
ion
inte
rven
tions
ov
er ti
me.
Doc
umen
ted
HIV
st
atus
als
o in
fluen
ces p
atie
nt c
are,
for
exam
ple
part
ner t
estin
g,
refe
rral
to su
ppor
t gro
up, a
nd
prov
isio
n of
cot
rim
oxaz
ole
prev
entiv
e th
erap
y an
d AR
T
HIV
stat
us is
doc
umen
ted
usin
g th
e H
IV te
st re
sults
. Thi
s may
incl
ude
TB
patie
nts p
revi
ousl
y do
cum
ente
d to
be
HIV
-pos
itive
(doc
umen
ted
evid
ence
of
enro
lmen
t in
HIV
car
e), t
hose
new
ly
dete
cted
pos
itive
or t
hose
hav
ing
a ne
gativ
e H
IV te
st re
sult
at th
e tim
e of
TB
diag
nosi
s. T
he H
IV st
atus
of a
ll TB
pat
ient
s sho
uld
be re
cord
ed in
TB
regi
ster
s at t
he b
asic
man
agem
ent u
nit
as so
on a
s pos
sibl
e an
d pr
efer
ably
at
the
time
of T
B di
agno
sis,
alo
ng w
ith
the
info
rmat
ion
on p
ast h
isto
ry o
f TB
trea
tmen
t Num
erat
or: C
ount
the
tota
l nu
mbe
r of n
ew a
nd re
laps
e TB
pat
ient
s ad
ded
to th
e TB
regi
ster
dur
ing
the
repo
rtin
g pe
riod
who
hav
e th
eir H
IV
stat
us d
ocum
ente
d as
pos
itive
, inc
ludi
ng
thos
e pr
evio
usly
doc
umen
ted
to b
e H
IV-p
ositi
ve (f
or e
xam
ple,
doc
umen
ted
evid
ence
of e
nrol
men
t in
HIV
car
e).
Den
omin
ator
: Cou
nt th
e to
tal n
umbe
r of
new
and
rela
pse
TB p
atie
nts a
dded
to th
e TB
regi
ster
dur
ing
the
repo
rtin
g pe
riod
w
ho h
ave
thei
r HIV
stat
us d
ocum
ente
d as
pos
itive
or n
egat
ive,
incl
udin
g th
ose
prev
ious
ly d
ocum
ente
d to
be
HIV
-po
sitiv
e (f
or e
xam
ple,
doc
umen
ted
evid
ence
of e
nrol
men
t in
HIV
car
e).
HIV
-neg
ativ
e TB
pat
ient
s inc
lude
thos
e ha
ving
a n
egat
ive
test
resu
lt at
the
time
of T
B di
agno
sis.
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Indi
cato
rD
efini
tion
Num
erat
orD
enom
inat
orP
urpo
seR
atio
nale
Met
hodo
logy
Prop
ortio
n of
peo
ple
livin
g w
ith
HIV
new
ly
enro
lled
in
HIV
car
e w
ith a
ctiv
e TB
dis
ease
Tota
l num
ber
of p
eopl
e liv
ing
with
H
IV h
avin
g ac
tive
TB
expr
esse
d as
a
perc
enta
ge o
f th
ose
who
ar
e ne
wly
en
rolle
d in
H
IV c
are
duri
ng th
e re
port
ing
peri
od.
Tota
l num
ber
of p
erso
ns w
ho
have
act
ive
TB
dise
ase
duri
ng
the
repo
rtin
g pe
riod
out
of
thos
e ne
wly
en
rolle
d in
H
IV c
are
Tota
l num
ber o
f pe
rson
s new
ly
enro
lled
in H
IV
care
dur
ing
the
repo
rtin
g pe
riod
(p
re-A
RT
plus
AR
T).
To m
easu
res
the
burd
en
of a
ctiv
e TB
am
ong
peop
le
livin
g w
ith
HIV
who
ar
e ne
wly
en
rolle
d in
H
IV c
are.
It
also
indi
rect
ly
mea
sure
s th
e ex
tent
of
effo
rt to
de
tect
HIV
-as
soci
ated
TB
earl
y.
The
prim
ary
aim
of i
nten
sifie
d TB
cas
e fin
ding
in H
IV c
are
sett
ings
and
pro
vide
r-in
itiat
ed
HIV
test
ing
and
coun
selli
ng in
TB
pat
ient
s is e
arly
det
ectio
n of
HIV
-ass
ocia
ted
TB a
nd
prom
pt p
rovi
sion
of A
RT
and
TB tr
eatm
ent.
Alth
ough
in
tens
ified
TB
case
find
ing
shou
ld b
e im
plem
ente
d am
ong
all p
eopl
e liv
ing
with
H
IV a
t eac
h vi
sit t
o H
IV c
are
and
trea
tmen
t fac
ilitie
s, it
is
part
icul
arly
impo
rtan
t at t
he
time
of e
nrol
men
t in
HIV
car
e an
d tr
eatm
ent,
as th
e ri
sk
of u
ndet
ecte
d TB
is h
ighe
r am
ong
new
ly e
nrol
led
patie
nts
than
am
ong
thos
e al
read
y on
AR
T. A
lso,
new
ly e
nrol
led
peop
le li
ving
with
HIV
may
be
less
aw
are
abou
t TB
sym
ptom
s an
d th
e im
port
ance
of e
arly
de
tect
ion
and
trea
tmen
t, an
d he
nce
may
not
seek
ca
re fo
r gen
eral
or s
peci
fic
TB sy
mpt
oms.
Inte
nsifi
ed
TB c
ase
findi
ng th
us o
ffers
an
opp
ortu
nity
to e
duca
te
peop
le li
ving
with
HIV
and
de
tect
TB
earl
y. A
ll pe
ople
liv
ing
with
HIV
thus
det
ecte
d w
ith T
B di
seas
e sh
ould
be
star
ted
on a
nti-T
B tr
eatm
ent
imm
edia
tely
The
outc
ome
of T
B in
vest
igat
ions
in
pres
umpt
ive
TB c
ases
am
ong
peop
le
livin
g w
ith H
IV sh
ould
be
reco
rded
on
ART
card
(“in
vest
igat
ions
” col
umn
in
the
“enc
ount
ers”
sect
ion)
and
in C
TC2
Dat
abas
e.
Num
erat
or: A
t the
end
of t
he re
port
ing
peri
od, c
ount
the
tota
l num
ber o
f peo
ple
livin
g w
ith H
IV n
ewly
enr
olle
d in
the
HIV
car
e w
ho h
ave
activ
e TB
dis
ease
. D
enom
inat
or: C
ount
the
tota
l num
ber o
f pe
ople
livi
ng w
ith H
IV n
ewly
enr
olle
d in
H
IV c
are
duri
ng th
e re
port
ing
peri
od.
COLLABORATIVES TBHIV M&E PLAN.indd 18 6/11/18 6:38 PM
MONITORING & EVALUATION PLAN COLLABORATIVE TB/HIV ACTIVITIES
M i n i s t r y o f H e a l t h C o m m u n i t y D e v e l o p m e n t G e n d e r E l d e r l y a n d C h i l d r e n 19
Indi
cato
rD
efini
tion
Num
erat
orD
enom
inat
orP
urpo
seR
atio
nale
Met
hodo
logy
Pr
opor
tion
of H
IV-
posi
tive
new
an
d re
laps
e TB
pat
ient
s on
AR
T du
ring
TB
trea
tmen
t
Num
ber o
f H
IV-p
ositi
ve
new
and
re
laps
e TB
pa
tient
s who
re
ceiv
e AR
T du
ring
TB
trea
tmen
t ex
pres
sed
as
a pe
rcen
tage
of
thos
e re
gist
ered
du
ring
the
repo
rtin
g pe
riod
.
Tota
l num
ber
of H
IV-
posi
tive
new
an
d re
laps
e TB
pat
ient
s st
arte
d on
TB
trea
tmen
t du
ring
the
repo
rtin
g pe
riod
who
ar
e al
read
y on
AR
T or
star
ted
on A
RT
duri
ng
TB tr
eatm
ent
Tota
l num
ber
of H
IV-p
ositi
ve
new
and
rela
pse
TB p
atie
nts
regi
ster
ed
duri
ng th
e re
port
ing
peri
od.
To m
easu
re
the
exte
nt
to w
hich
H
IV-p
ositi
ve
TB p
atie
nts
rece
ive
ART
duri
ng T
B tr
eatm
ent.
HIV
-pos
itive
TB
patie
nts
are
dete
cted
eith
er th
roug
h in
tens
ified
TB
case
find
ing
at H
IV c
are
and
trea
tmen
t ce
ntre
s or p
rovi
der-
initi
ated
H
IV te
stin
g an
d co
unse
lling
am
ong
TB p
atie
nts.
Pro
mpt
TB
trea
tmen
t and
ear
ly A
RT
are
criti
cal f
or re
duci
ng
the
mor
talit
y du
e to
HIV
-as
soci
ated
TB
and
mus
t be
the
high
est-
prio
rity
act
ivity
fo
r bot
h th
e N
ACP
and
NTL
P.
All H
IV-p
ositi
ve n
ew a
nd re
laps
e TB
pat
ient
s det
ecte
d du
ring
the
repo
rtin
g pe
riod
shou
ld b
e co
unte
d fo
r m
easu
rem
ent o
f the
pro
port
ion
rece
ivin
g AR
T du
ring
TB
trea
tmen
t. N
umer
ator
: Cou
nt th
e to
tal n
umbe
r of
HIV
-pos
itive
new
and
rela
pse
TB
patie
nts w
ho w
ere
star
ted
on T
B tr
eatm
ent D
enom
inat
or: T
otal
num
ber
of p
atie
nts o
n H
IV c
are
in th
at re
port
ing
peri
od
Prop
ortio
n of
peo
ple
livin
g w
ith H
IV
rece
ivin
g H
IV c
are,
st
arte
d on
TB
prev
entiv
e th
erap
y
Num
ber o
f pa
tient
s who
ar
e st
arte
d on
trea
tmen
t fo
r lat
ent
TB in
fect
ion
expr
esse
d as
a
perc
enta
ge
of th
e to
tal
num
ber n
ewly
en
rolle
d in
H
IV c
are
duri
ng th
e re
port
ing
peri
od.
Tota
l num
ber
of p
eopl
e liv
ing
with
H
IV re
ceiv
ing
HIV
car
e w
ho
are
star
ted
on tr
eatm
ent
for l
aten
t TB
infe
ctio
n du
ring
the
repo
rtin
g pe
riod
Tota
l num
ber
of p
erso
ns
rece
ivio
ng H
IV
care
, tha
t is,
re
gist
ered
in th
e pr
e-AR
T or
AR
T re
gist
er d
urin
g th
e re
port
ing
peri
od.
To m
easu
re
the
exte
nt to
w
hich
peo
ple
livin
g w
ith
HIV
new
ly
regi
ster
ed in
H
IV c
are
are
star
ted
on
the
trea
tmen
t fo
r lat
ent T
B in
fect
ion.
All p
erso
ns in
HIV
car
e sh
ould
be
scre
ened
for T
B at
eve
ry
visi
t usi
ng a
clin
ical
alg
orith
m
reco
mm
ende
d by
WH
O.
Adul
ts a
nd a
dole
scen
ts li
ving
w
ith H
IV w
ho d
o no
t rep
ort
any
one
of th
e sy
mpt
oms o
f cu
rren
t cou
gh, f
ever
, wei
ght
loss
or n
ight
swea
ts a
re
unlik
ely
to h
ave
activ
e TB
and
sh
ould
be
offer
ed T
B pr
even
tive
ther
apy,
that
is
, tre
atm
ent f
or la
tent
TB
infe
ctio
n. S
imila
rly,
chi
ldre
n w
ho d
o no
t hav
e po
or
wei
ght g
ain,
feve
r or c
urre
nt
coug
h sh
ould
be
offer
ed th
is
ther
apy
to re
duce
the
risk
of
dev
elop
ing
activ
e TB
in
pers
ons o
n AR
T
TB p
reve
ntiv
e th
erap
y sh
ould
be
star
ted
in a
ll el
igib
le p
erso
ns a
nd th
e da
te o
f st
artin
g sh
ould
be
reco
rded
on
CTC2
Ca
rd (e
ncou
nter
sect
ion)
. N
umer
ator
: Cou
nt th
e to
tal n
umbe
r of
peop
le li
ving
with
HIV
rece
ivin
g H
IV
care
dur
ing
the
repo
rtin
g pe
riod
who
ar
e st
arte
d on
trea
tmen
t for
late
nt T
B in
fect
ion.
D
enom
inat
or: C
ount
the
tota
l num
ber
of p
eopl
e liv
ing
with
HIV
rece
ivin
g H
IV
care
regi
ster
ed in
HIV
car
e du
ring
the
repo
rtin
g pe
riod
.
COLLABORATIVES TBHIV M&E PLAN.indd 19 6/11/18 6:38 PM
MONITORING & EVALUATION PLAN COLLABORATIVE TB/HIV ACTIVITIES
M i n i s t r y o f H e a l t h C o m m u n i t y D e v e l o p m e n t G e n d e r E l d e r l y a n d C h i l d r e n20
Indi
cato
rD
efini
tion
Num
erat
orD
enom
inat
orP
urpo
seR
atio
nale
Met
hodo
logy
Mor
talit
y am
ong
HIV
-po
sitiv
e ne
w
and
rela
pse
TB p
atie
nts
Num
ber o
f de
aths
am
ong
docu
men
ted
HIV
-pos
itive
ne
w a
nd
rela
pse
TB
patie
nts
expr
esse
d as
a
perc
enta
ge
of th
ose
regi
ster
ed
duri
ng th
e re
port
ing
peri
od.
Tota
l num
ber
of H
IV-
posi
tive
new
an
d re
laps
e TB
pa
tient
s who
di
ed b
efor
e th
e st
art o
r dur
ing
the
cour
se o
f TB
trea
tmen
t
Tota
l num
ber
of H
IV-p
ositi
ve
new
and
rela
pse
TB p
atie
nts
regi
ster
ed
duri
ng th
e re
port
ing
peri
od
To m
easu
re
the
impa
ct o
f co
llabo
rativ
e TB
/HIV
ac
tiviti
es o
n m
orta
lity
due
to H
IV-
asso
ciat
ed
TB.
Mor
talit
y am
ong
HIV
-pos
itive
TB
pat
ient
s is s
igni
fican
tly
high
er th
an a
mon
g H
IV-
nega
tive
TB
patie
nts.
The
risk
of d
eath
is
high
er if
HIV
-ass
ocia
ted
TB is
de
tect
ed la
te o
r tre
atm
ent i
s de
laye
d.
To m
inim
ize
this
risk
, clo
se
colla
bora
tion
betw
een
the
NTL
P an
d N
ACP
is n
eces
sary
fo
r pro
visi
on o
f op
timal
clin
ical
car
e in
the
form
of e
arly
dia
gnos
is a
nd
prom
pt tr
eatm
ent o
f bot
h H
IV
and
TB.
HIV
-pos
itive
TB
patie
nts s
houl
d be
re
cord
ed in
the
TB re
gist
er a
t the
bas
ic
man
agem
ent u
nit N
umer
ator
: Cou
nt th
e nu
mbe
r of H
IV-p
ositi
ve n
ew a
nd re
laps
e TB
pat
ient
s who
se T
B tr
eatm
ent
outc
ome
is re
cord
ed a
s “di
ed” i
n th
e TB
U
nit r
egis
ter,
trea
tmen
t. Pa
tient
s los
t to
follo
w-u
p m
ay a
lso
be a
dded
to th
e nu
mer
ator
if in
-cou
ntry
evi
denc
e su
gges
ts th
at a
larg
e pr
opor
tion
of th
ese
patie
nts a
re lo
st d
ue to
dea
th.
Den
omin
ator
: Cou
nt th
e to
tal n
umbe
r of
new
and
rela
pse
TB p
atie
nts a
dded
to
the
TB U
nit r
egis
ter d
urin
g th
e re
port
ing
peri
od th
at e
nded
12 m
onth
s pre
viou
sly
who
hav
e th
eir H
IV st
atus
doc
umen
ted
as p
ositi
ve, i
nclu
ding
thos
e pr
evio
usly
kn
own
to b
e H
IV-p
ositi
ve (f
or e
xam
ple,
do
cum
ente
d ev
iden
ce o
f enr
olm
ent i
n H
IV c
are)
. Exc
lude
pat
ient
s tra
nsfe
rred
in
from
ano
ther
TB
unit
and
thos
e fo
und
to h
ave
rifa
mpi
cin-
resi
stan
t TB
or m
ultid
rug-
resi
stan
t TB
who
wer
e st
arte
d on
a fu
ll m
ulti
drug
resi
stan
t TB
trea
tmen
t reg
imen
.
COLLABORATIVES TBHIV M&E PLAN.indd 20 6/11/18 6:38 PM
MONITORING & EVALUATION PLAN COLLABORATIVE TB/HIV ACTIVITIES
M i n i s t r y o f H e a l t h C o m m u n i t y D e v e l o p m e n t G e n d e r E l d e r l y a n d C h i l d r e n 21
No
Indi
cato
rN
umer
ator
Den
omin
ator
Purp
ose
Rat
iona
leM
etho
dolo
gy
Indi
cato
rs to
mea
sure
acc
ess
to T
B d
iagn
osti
c te
st fo
r pe
ople
livi
ng w
ith
HIV
6 P
ropo
rtio
n of
pe
ople
livi
ng
with
HIV
ha
ving
TB
sym
ptom
s who
re
ceiv
e a
rapi
d m
olec
ular
test
as
a fi
rst t
est
for d
iagn
osis
of
TB a
t HIV
care
an
d tr
eatm
ent
faci
litie
s
Tota
l num
ber o
f pe
ople
livi
ng w
ith
HIV
hav
ing
TB
sym
ptom
s who
w
ere
inve
stig
ated
us
ing
a ra
pid
mol
ecul
ar te
st a
sa
first
test
Tota
l num
ber
peop
le li
ving
w
ith H
IV h
avin
g TB
sym
ptom
s (id
entifi
ed
thro
ugh
inte
nsifi
ed
case
find
ing)
at
HIV
care
an
d tr
eatm
ent
faci
litie
s dur
ing
the
repo
rtin
g pe
riod
To a
sses
s the
ex
tent
of a
cces
s to
rapi
d m
olec
ular
te
sts a
s a fi
rst
test
for d
iagn
osis
of
TB
amon
g pe
ople
livi
ng w
ith
HIV
; alte
rnat
ivel
y,
acce
ss to
liqu
id
TB cu
lture
may
be
mea
sure
d
Sput
um m
icro
scop
y ha
s low
sens
itivi
ty
for d
iagn
osis
of T
B am
ong
peop
le
livin
g w
ith H
IV. W
HO
reco
mm
ends
us
e of
Xpe
rt M
TB/R
IF a
s the
in
itial
dia
gnos
tic te
st fo
r TB
amon
g pe
ople
livi
ng w
ith H
IV, a
s it i
s mor
e se
nsiti
ve a
nd sp
ecifi
c for
dia
gnos
is o
f pu
lmon
ary
TB th
an th
e co
nven
tiona
l sp
utum
mic
rosc
opy.
The
refo
re p
eopl
e liv
ing
with
HIV
hav
ing
pres
umed
TB
shou
ld h
ave
acce
ss to
faci
litie
s usi
ng
rapi
d m
olec
ular
test
s suc
h as
Xpe
rt
MTB
/RIF
or l
iqui
d cu
lture
faci
litie
s.
The
NAC
P an
d N
TP sh
ould
m
aint
ain
an in
vent
ory
of H
IV
care
and
trea
tmen
t cen
tres
ha
ving
acc
ess t
o X
pert
MTB
R
if or
liqu
id cu
lture
faci
litie
s.
Coun
trie
s are
enc
oura
ged
to
esta
blis
h a
mec
hani
sm fo
r co
nsol
idat
ion
and
repo
rtin
g of
this
info
rmat
ion
to
natio
nal a
nd su
bnat
iona
l lev
el
regu
larly
.
COLLABORATIVES TBHIV M&E PLAN.indd 21 6/11/18 6:38 PM
MONITORING & EVALUATION PLAN COLLABORATIVE TB/HIV ACTIVITIES
M i n i s t r y o f H e a l t h C o m m u n i t y D e v e l o p m e n t G e n d e r E l d e r l y a n d C h i l d r e n22
7 P
ropo
rtio
n of
HIV
-po
sitiv
e ne
w
and
rela
pse
TB p
atie
nts
dete
cted
and
no
tified
out
of
the
estim
ated
nu
mbe
r of
inci
dent
HIV
-po
sitiv
e TB
ca
ses
Tota
l num
ber
of H
IV- p
ositi
ve
new
and
rela
pse
TB p
atie
nts
regi
ster
ed d
urin
g th
e re
port
ing
perio
d
Estim
ated
num
ber
of in
cide
nt T
B ca
ses a
mon
g pe
ople
livi
ng w
ith
HIV
(with
low
and
hi
gh u
ncer
tain
ty
boun
ds)
To a
sses
s the
eff
orts
for T
B ca
se fi
ndin
g am
ong
peop
le
livin
g w
ith H
IV
unde
rtak
en b
y th
e N
ACP
and
NTP
This
indi
cato
r hel
ps e
valu
atio
n of
TB
case
find
ing
effor
ts, w
hich
invo
lves
pr
ovid
er-in
itiat
ed H
IV te
stin
g an
d co
unse
lling
am
ong
TB p
atie
nts,
in
tens
ified
TB
case
find
ing
at a
ll H
IV
care
and
trea
tmen
t fac
ilitie
s at e
very
pa
tient
vis
it, o
ptim
al a
cces
s to
serv
ices
fo
r key
pop
ulat
ions
such
as d
rug
user
s,
sex
wor
kers
and
pris
oner
s, an
d st
rong
lin
kage
s bet
wee
n th
e N
ACP
and
NTP
.
Num
erat
or: C
ount
tota
l nu
mbe
r of n
ew a
nd re
laps
e TB
pat
ient
s add
ed to
TB
regi
ster
dur
ing
the
repo
rtin
g pe
riod
havi
ng th
eir H
IV st
atus
do
cum
ente
d as
pos
itive
, in
clud
ing
thos
e pr
evio
usly
kn
own
to b
e H
IV-p
ositi
ve.
Also
NTP
and
NAC
P sh
ould
en
sure
that
TB
regi
ster
is
upda
ted
and
all t
he p
eopl
e liv
ing
with
HIV
in p
re-A
RT
care
or o
n AR
T ha
ving
a
reco
rded
TB
diag
nosi
s dur
ing
repo
rtin
g pe
riod
are
also
re
gist
ered
and
acc
ount
ed fo
r. D
enom
inat
or: E
stim
ated
nu
mbe
rs o
f inc
iden
t TB
case
s liv
ing
with
HIV
(whi
ch is
pu
blis
hed
with
un
cert
aint
y bo
unds
by
WH
O
for n
atio
nal l
evel
usi
ng
the
best
ava
ilabl
e da
ta).
It
shou
ld b
e ap
plie
d on
ly a
t na
tiona
l lev
el a
nd in
terp
rete
d co
nsid
erin
g th
e un
cert
aint
y of
es
timat
ed in
cide
nce.
COLLABORATIVES TBHIV M&E PLAN.indd 22 6/11/18 6:38 PM
MONITORING & EVALUATION PLAN COLLABORATIVE TB/HIV ACTIVITIES
M i n i s t r y o f H e a l t h C o m m u n i t y D e v e l o p m e n t G e n d e r E l d e r l y a n d C h i l d r e n 23
8 P
ropo
rtio
n of
H
IV-p
ositi
ve
new
and
re
laps
e TB
pa
tient
s who
re
ceiv
e co
-tr
imox
azol
e pr
even
tive
ther
apy
Num
ber o
f H
IVpo
sitiv
e ne
w a
nd re
laps
e TB
pat
ient
s re
gist
ered
dur
ing
the
repo
rtin
g pe
riod
who
ar
e st
arte
d or
co
ntin
ued
on co
-tr
imox
azol
e pr
even
tive
ther
apy
durin
g TB
trea
tmen
t
Tota
l num
ber o
f H
IVpo
sitiv
e ne
w
and
rela
pse
TB
patie
nts r
egis
tere
d du
ring
the
repo
rtin
g pe
riod
To m
easu
re th
e ca
paci
ty o
f the
N
TP a
nd N
ACP
to p
rovi
de
co-t
rimox
azol
e pr
even
tive
ther
apy
to
HIV
-pos
itive
TB
patie
nts
Co-t
rimox
azol
e pr
even
tive
ther
apy
redu
ces m
orbi
dity
and
mor
talit
y am
ong
HIV
-pos
itive
TB
pat
ient
s. It
shou
ld b
e pr
ovid
ed
imm
edia
tely
to a
ll H
IV-p
ositi
ve T
B pa
tient
s irr
espe
ctiv
e of
CD
4 co
unt a
nd m
ay b
e st
oppe
d w
hen
CD4
coun
ts a
re h
ighe
r tha
n 35
0 or
500
ce
lls p
er cu
bic m
illim
etre
, de
pend
ing
on n
atio
nal p
olic
y.
Prov
isio
n of
co-t
rimox
azol
e pr
even
tive
ther
apy
shou
ld b
e re
cord
ed in
the
TB re
gist
er a
t th
e ba
sic m
anag
emen
t uni
t.
COLLABORATIVES TBHIV M&E PLAN.indd 23 6/11/18 6:38 PM
MONITORING & EVALUATION PLAN COLLABORATIVE TB/HIV ACTIVITIES
M i n i s t r y o f H e a l t h C o m m u n i t y D e v e l o p m e n t G e n d e r E l d e r l y a n d C h i l d r e n24
9 P
ropo
rtio
n of
hea
lth
care
faci
litie
s pr
ovid
ing
serv
ices
for
peop
le li
ving
w
ith H
IV
that
hav
e TB
infe
ctio
n co
ntro
l pr
actic
es
Num
ber o
f he
alth
care
fa
cilit
ies h
avin
g “d
emon
stra
ble”
TB
infe
ctio
n co
ntro
l pra
c-
tices
that
are
co
nsis
tent
with
in
tern
atio
nal
guid
elin
es
Tota
l num
ber o
f he
alth
ca
re fa
cilit
ies
eval
uate
d fo
r TB
infe
ctio
n co
ntro
l pr
actic
es d
urin
g th
e re
port
ing
perio
d
To a
sses
s th
e ex
tent
of
impl
emen
tatio
n of
TB
infe
ctio
n co
ntro
l pr
actic
es
at H
IV a
nd
TB ca
re a
nd
trea
tmen
t fa
cilit
ies
All h
ealth
care
faci
litie
s in
gene
ral
shou
ld h
ave
a TB
infe
ctio
n co
ntro
l po
licy.
Whi
le it
is cr
itica
l to
impl
emen
t it
in a
ll he
alth
faci
litie
s in
coun
trie
s ha
ving
hig
h H
IV p
reva
lenc
e, a
s in
sub-
Saha
ran
Afric
a, it
shou
ld b
e im
plem
ente
d at
leas
t in
HIV
and
TB
care
faci
litie
s in
coun
trie
s hav
ing
low
or
co
ncen
trat
ed H
IV e
pide
mic
s.D
emon
stra
ble
min
imum
TB-
infe
ctio
n co
ntro
l mea
sure
s con
sist
ent w
ith
inte
rnat
iona
l gui
delin
es in
clud
e:
1. a
writ
ten
infe
ctio
n co
ntro
l pla
n;
2. a
des
igna
ted
pers
on re
spon
sibl
e fo
r im
plem
entin
g in
fect
ion
cont
rol
prac
tices
; 3.
wel
l ven
tilat
ed w
aitin
g ar
ea (e
.g.
win
dow
s and
doo
rs o
pen)
and
clea
r di
spla
y of
mes
sage
s on
coug
h hy
gien
e;
4. p
atie
nts w
ith p
resu
mpt
ive
TB
iden
tified
on
arriv
al a
t the
faci
lity
and
sepa
rate
d fr
om o
ther
pat
ient
s to
be fa
st-t
rack
ed th
roug
h al
l wai
ting
area
s, in
clud
ing
cons
ulta
tion,
in
vest
igat
ions
and
dru
g co
llect
ion;
5.
TB
sym
ptom
s occ
urrin
g am
ong
heal
th ca
re w
orke
rs a
re im
med
iate
ly
inve
stig
ated
and
, if d
iagn
osed
w
ith T
B, tr
eate
d, re
gist
ered
and
re
port
ed.
As fo
r Ind
icat
or n
umbe
r 8
COLLABORATIVES TBHIV M&E PLAN.indd 24 6/11/18 6:38 PM
MONITORING & EVALUATION PLAN COLLABORATIVE TB/HIV ACTIVITIES
M i n i s t r y o f H e a l t h C o m m u n i t y D e v e l o p m e n t G e n d e r E l d e r l y a n d C h i l d r e n 25
Oth
er In
dica
tors
10 P
ropo
rtio
n of
pe
ople
livi
ng
with
HIV
who
co
mpl
ete
a co
urse
of T
B pr
even
tive
ther
apy
Tota
l num
ber
of p
erso
ns w
ho
com
plet
ed
the
cour
se
of tr
eatm
ent
for l
aten
t TB
infe
ctio
n du
ring
the
repo
rtin
g pe
riod
Tota
l num
ber o
f pe
rson
s in
HIV
ca
re w
ho w
ere
new
ly st
arte
d on
trea
tmen
t for
la
tent
TB
infe
ctio
n 12
to 15
mon
th
earli
er
To a
sses
s the
ad
here
nce
of
peop
le li
ving
w
ith H
IV d
urin
g th
e co
urse
of
TB p
reve
ntiv
e th
erap
y
Reg
ular
and
com
plet
e tr
eatm
ent o
f la
tent
TB
infe
ctio
n is
nec
essa
ry fo
r pr
otec
tion
agai
nst
deve
lopm
ent o
f act
ive
TB a
mon
g pe
ople
livi
ng w
ith H
IV.
The
colle
ctio
n of
dat
a fo
r thi
s in
dica
tor w
ill b
e fa
cilit
ated
th
roug
h CT
C2 d
atab
ase.
COLLABORATIVES TBHIV M&E PLAN.indd 25 6/11/18 6:38 PM
MONITORING & EVALUATION PLAN COLLABORATIVE TB/HIV ACTIVITIES
M i n i s t r y o f H e a l t h C o m m u n i t y D e v e l o p m e n t G e n d e r E l d e r l y a n d C h i l d r e n26
No
Indi
cato
rN
umer
ator
Den
omin
ator
Pur
pose
Rat
iona
leM
etho
dolo
gy
Indi
cato
rs fo
r ex
pand
ed I
nter
vent
ion
or m
easu
rem
ent
1 P
ropo
rtio
n of
pr
esum
ptiv
e TB
pa
tient
s hav
ing
docu
men
ted
HIV
st
atus
Tota
l nu
mbe
r of
pres
umpt
ive
TB p
atie
nts
who
hav
e a
docu
men
ted
HIV
test
resu
lt
Tota
l num
ber
of p
resu
mpt
ive
TB p
atie
nts
who
are
in
vest
igat
ed
for T
B du
ring
th
e re
port
ing
peri
od
To e
nhan
ce
dete
ctio
n of
HIV
-infe
cted
in
divi
dual
s and
ea
rly
dete
ctio
n of
H
IVpo
sitiv
e TB
pat
ient
s
A la
rge
prop
ortio
n of
peo
ple
livin
g w
ith H
IV a
re u
naw
are
of th
eir
HIV
stat
us. H
IV te
stin
g am
ong
pres
umpt
ive
TB c
ases
offe
rs a
n en
try
poin
t to
the
cont
inuu
m o
f H
IV p
reve
ntio
n, c
are,
supp
ort a
nd
trea
tmen
t.
All p
resu
mpt
ive
TB c
ases
(pul
mon
ary
and
extr
apul
mon
ary)
shou
ld b
e off
ered
an
HIV
test
dur
ing
thei
r vi
sit t
o he
alth
faci
litie
s. H
IV te
st
resu
lts sh
ould
be
docu
men
ted
in th
e pr
esum
ptiv
e TB
regi
ster
2Pr
opor
tion
of
peop
le li
ving
with
H
IV c
urre
ntly
on
ART
who
dev
elop
TB
dis
ease
Tota
l num
ber
of p
eopl
e liv
ing
with
H
IV c
urre
ntly
on
AR
T w
ho
deve
lop
TB
dise
ase
duri
ng
the
repo
rtin
g pe
riod
Tota
l num
ber
of p
eopl
e liv
ing
with
HIV
en
rolle
d in
HIV
ca
re w
ho a
re
curr
ently
on
ART
To m
easu
re th
e bu
rden
of a
ctiv
e TB
am
ong
peop
le
livin
g w
ith H
IV
whi
le o
n AR
T.
It in
dire
ctly
m
easu
res
the
exte
nt o
f TB
tran
smis
sion
am
ong
peop
le
livin
g w
ith H
IV
whi
le th
ey a
re
on A
RT
Peop
le li
ving
with
HIV
hav
e a
high
er b
asel
ine
risk
of a
cqui
ring
TB
than
HIV
-neg
ativ
e pe
rson
s.
ART
redu
ces t
his r
isk
sign
ifica
ntly
, th
ough
it re
mai
ns h
ighe
r tha
n H
IV-n
egat
ive
pers
ons.
In h
igh
TB
and
HIV
sett
ings
this
risk
incr
ease
s du
e to
ong
oing
tran
smis
sion
. Ea
rly
iden
tifica
tion
of T
B, p
rom
pt
initi
atio
n of
AR
T, T
B in
fect
ion
cont
rol i
n he
alth
faci
litie
s and
tr
eatm
ent o
f lat
ent T
B in
fect
ion
can
help
redu
ce th
e ri
sk. A
stab
le
or in
crea
sing
pro
port
ion
of p
eopl
e liv
ing
with
HIV
dev
elop
ing
activ
e TB
whi
le o
n AR
T, o
ver
a pe
riod
of t
ime,
poi
nts t
o w
eak
impl
emen
tatio
n of
thes
e in
terv
entio
ns.
This
indi
cato
r sho
uld
be fa
cilit
ated
th
roug
h CT
C2 d
atab
ase
COLLABORATIVES TBHIV M&E PLAN.indd 26 6/11/18 6:38 PM
MONITORING & EVALUATION PLAN COLLABORATIVE TB/HIV ACTIVITIES
M i n i s t r y o f H e a l t h C o m m u n i t y D e v e l o p m e n t G e n d e r E l d e r l y a n d C h i l d r e n 27
3 P
ropo
rtio
n of
pe
ople
livi
ng
with
HIV
in
care
who
eve
r re
ceiv
ed a
cou
rse
of T
B pr
even
tive
ther
apy
Tota
l num
ber
of p
erso
ns
who
rece
ived
at
leas
t one
co
mpl
ete
cour
se o
f tr
eatm
ent
for l
aten
t TB
infe
ctio
n ev
er,
by th
e en
d of
th
e re
port
ing
peri
od
Tota
l num
ber
of p
erso
ns
curr
ently
in
HIV
car
e at
th
e en
d of
re
port
ing
peri
od
To a
sses
s the
ov
eral
l co
vera
ge o
f TB
prev
entiv
e th
erap
y am
ong
peop
le
livin
g w
ith H
IV in
ca
re
The
NAC
P sh
ould
ens
ure
acce
ss to
TB
pre
vent
ive
ther
apy
usin
g po
tent
an
ti-TB
dr
ugs f
or a
ll el
igib
le p
eopl
e liv
ing
with
HIV
in c
are,
incl
udin
g th
ose
new
ly e
nrol
led.
A h
igh
leve
l of
cove
rage
of b
oth
ART
and
TB
prev
entiv
e th
erap
y m
inim
izes
the
risk
of i
ncid
ent T
B am
ong
peop
le
livin
g w
ith H
IV a
nd h
ence
redu
ces
mor
talit
y.
The
colle
ctio
n of
dat
a fo
r thi
s in
dica
tor w
ill b
e fa
cilit
ated
usi
ng
CTC2
dat
abas
e
Ind
icat
ors t
o m
easu
re in
tegr
atio
n an
d op
timiz
atio
n of
serv
ices
for i
mpl
emen
tatio
n of
col
labo
rativ
e TB
HIV
act
iviti
es
4Pr
opor
tion
of
heal
th fa
cilit
ies
prov
idin
g TB
se
rvic
es th
at a
lso
prov
ide
ART
serv
ices
Num
ber
of h
ealth
fa
cilit
ies
prov
idin
g TB
se
rvic
es
whi
ch a
lso
prov
ide
ART
serv
ices
(AR
T in
itiat
ion
and
man
agem
ent)
Tota
l num
ber
of
heal
th fa
cilit
ies
prov
idin
g TB
se
rvic
es d
urin
g th
e re
port
ing
peri
od
To a
sses
s the
ex
tent
of
inte
grat
ion
of
ART
serv
ices
with
in
TB
care
sett
ings
HIV
clin
ical
serv
ices
incl
udin
g AR
T in
itiat
ion
and
man
agem
ent c
an b
e pr
ovid
ed
thro
ugh
stan
d-al
one
ART
faci
litie
s or
by
inte
grat
ion
of th
e se
rvic
es
into
gen
eral
hea
lth o
r TB
faci
litie
s. T
he N
ACP
and
NTL
P sh
ould
pro
mot
e su
ch in
tegr
atio
n to
en
hanc
e ac
cess
. Int
egra
tion
may
fall
into
one
of t
hree
ca
tego
ries
: fac
ilitie
s whe
re p
atie
nts
rece
ive
both
HIV
and
TB
serv
ices
in
th
e sa
me
room
; fac
ilitie
s whe
re
patie
nts r
ecei
ve b
oth
HIV
and
TB
serv
ices
in d
iffer
ent r
oom
s but
in
the
sam
e pr
emis
es; a
nd fa
cilit
ies
whe
re p
atie
nts h
ave
to tr
avel
to
anot
her f
acili
ty fo
r eith
er H
IV
or T
B se
rvic
es.
Dat
a sh
ould
be
colle
cted
from
eac
h fa
cilit
y du
ring
the
supe
rvis
ory
visi
ts
or in
tern
al
and
exte
rnal
pro
gram
me
revi
ews o
f TB
/H
IV se
rvic
es. T
he N
TLP
and
NAC
P sh
ould
mai
ntai
n an
in
vent
ory
of fa
cilit
ies p
rovi
ding
bot
h TB
and
AR
T se
rvic
es a
nd u
se th
e in
form
atio
n to
cal
cula
te
the
num
erat
or fo
r thi
s ind
icat
or.
Info
rmat
ion
on n
umbe
r of h
ealth
fa
cilit
ies p
rovi
ding
TB
serv
ices
sh
ould
be
prov
ided
by
the
NTL
P.
COLLABORATIVES TBHIV M&E PLAN.indd 27 6/11/18 6:38 PM
MONITORING & EVALUATION PLAN COLLABORATIVE TB/HIV ACTIVITIES
M i n i s t r y o f H e a l t h C o m m u n i t y D e v e l o p m e n t G e n d e r E l d e r l y a n d C h i l d r e n28
5 P
ropo
rtio
n of
HIV
car
e an
d tr
eatm
ent
faci
litie
s tha
t al
so p
rovi
de T
B pr
even
tion
and
care
serv
ices
Num
ber o
f H
IV c
are
and
trea
tmen
t fa
cilit
ies
havi
ng
at le
ast o
ne
mem
ber
of st
aff
capa
cita
ted
to p
rovi
de
TB sy
mpt
om
scre
enin
g,
prov
isio
n of
TB
pre
vent
ive
ther
apy
and
anti-
TB
trea
tmen
t
Tota
l num
ber
of H
IV c
are
or
trea
tmen
t fa
cilit
ies
exis
ting
duri
ng
the
repo
rtin
g pe
riod
To a
sses
s the
ex
tent
of
im
plem
enta
tion
of T
B pr
even
tion
and
care
se
rvic
es
with
in H
IV c
are
and
trea
tmen
t se
ttin
gs
The
WH
O-r
ecom
men
ded
thre
e I’s
(int
ensi
fied
TB c
ase
findi
ng,
ison
iazi
d pr
even
tive
ther
apy
and
infe
ctio
n co
ntro
l fo
r TB)
shou
ld b
e im
plem
ente
d ro
utin
ely
at a
ll H
IV c
are
and
trea
tmen
t fac
ilitie
s to
min
imiz
e bu
rden
of T
B am
ong
peop
le li
ving
w
ith H
IV. A
t lea
st o
ne st
aff
mem
ber a
t the
hea
lth fa
cilit
y sh
ould
be
trai
ned
and
regu
larl
y su
perv
ised
for i
mpl
emen
tatio
n of
th
ese
serv
ices
.
The
data
shou
ld b
e co
llect
ed fr
om
each
faci
lity
duri
ng su
perv
isor
y vi
sits
or
inte
rnal
an
d ex
tern
al p
rogr
amm
e re
view
s of
TB /
HIV
serv
ices
. Th
e N
ACP
and
NTL
P sh
ould
m
aint
ain
a da
taba
se o
f ava
ilabl
e st
aff
at a
ll H
IV c
are
and
trea
tmen
t fa
cilit
ies a
nd th
eir t
rain
ing
stat
us a
nd
use
the
info
rmat
ion
to c
alcu
late
the
num
erat
or fo
r thi
s in
dica
tor.
6 P
ropo
rtio
n of
m
ater
nal a
nd
child
hea
lth c
are
faci
litie
s als
o im
plem
entin
g in
tens
ified
TB
case
find
ing
Tota
l num
ber
of
mat
erna
l and
ch
ild h
ealth
ca
re fa
cilit
ies
impl
emen
ting
inte
nsifi
ed T
B ca
se fi
ndin
g
Tota
l num
ber
of
mat
erna
l and
ch
ild h
ealth
si
tes (
ante
nata
l ca
re, m
ater
nity
, po
stpa
rtum
cl
inic
s, fa
mily
pl
anni
ng
clin
ics,
wel
l ch
ild a
nd si
ck
child
clin
ics)
ex
istin
g du
ring
th
e re
port
ing
peri
od
To a
sses
s the
ex
tent
of
inte
grat
ion
of
inte
nsifi
ed T
B ca
se
findi
ng
activ
ities
with
in
mat
erna
l and
ch
ild
heal
th c
are
sett
ings
TB in
HIV
-pos
itive
pre
gnan
t w
omen
is a
ssoc
iate
d w
ith a
dver
se
preg
nanc
y ou
tcom
es
and
high
er m
ater
nal a
nd c
hild
m
orta
lity.
It a
lso
incr
ease
s the
risk
of
mot
her-
to-c
hild
tran
smis
sion
of
HIV
. Pro
vide
r-in
itiat
ed H
IV
test
ing
and
coun
selli
ng a
nd
inte
nsifi
ed T
B ca
se fi
ndin
g sh
ould
be
im
plem
ente
d in
mat
erna
l and
chi
ld
heal
th se
ttin
gs fo
r ear
ly d
etec
tion
of H
IV-a
ssoc
iate
d TB
. Ch
ildre
n, e
spec
ially
thos
e ex
pose
d to
HIV
or T
B, sh
ould
als
o be
sy
stem
atic
ally
scre
ened
.
NTL
P sh
ould
est
ablis
h a
mec
hani
sm
for r
ecor
ding
and
repo
rtin
g th
is in
dica
tor
COLLABORATIVES TBHIV M&E PLAN.indd 28 6/11/18 6:38 PM
MONITORING & EVALUATION PLAN COLLABORATIVE TB/HIV ACTIVITIES
M i n i s t r y o f H e a l t h C o m m u n i t y D e v e l o p m e n t G e n d e r E l d e r l y a n d C h i l d r e n 29
7Pr
opor
tion
of o
pioi
d su
bstit
utio
n th
erap
y (
Ther
apy)
cen
tres
al
so p
rovi
ding
TB
and
HIV
serv
ices
Num
ber o
f ce
ntre
s hav
ing
at le
ast o
ne
mem
ber o
f st
aff
capa
cita
ted
to
unde
rtak
e in
tens
ified
TB
case
find
ing
and
trea
tmen
t an
d H
IV
test
ing
and
coun
selli
ng
Tota
l num
ber o
f op
ioid
su
bstit
utio
n th
erap
y ce
ntre
s ex
istin
g du
ring
the
repo
rtin
gper
iod
To a
sses
s the
ex
tent
of
inte
grat
ion
of in
tens
ified
TB
cas
e fin
ding
an
d H
IV te
stin
g an
d co
unse
lling
se
rvic
es in
se
ttin
gs
havi
ng
popu
latio
ns
vuln
erab
le fo
r bo
th T
B an
d H
IV
Peop
le W
ho in
ject
dru
gs (P
WID
), In
ject
ion
drug
us
ers a
re m
ore
vuln
erab
le to
HIV
in
fect
ion
and
henc
e TB
. The
hea
lth
faci
litie
s cat
erin
g to
thes
e po
pula
tions
shou
ld b
e eq
uipp
ed to
im
plem
ent T
B/H
IV in
terv
entio
ns
thro
ugh
trai
ning
of s
taff,
lin
kage
s with
dia
gnos
is a
nd
trea
tmen
t ser
vice
s, a
nd o
ther
m
easu
res.
The
NAC
P an
d N
TLP
shou
ld
incl
ude
thes
e po
pula
tions
as
prio
rity
gro
ups f
or p
rogr
amm
e im
plem
enta
tion.
NTL
P an
d N
ACP
are
enco
urag
ed to
es
tabl
ish
mec
hani
sms f
or re
cord
ing
and
repo
rtin
g th
is in
dica
tor
8 P
ropo
rtio
n of
pr
ison
hea
lth
cent
res a
lso
prov
idin
g TB
and
H
IV se
rvic
es
Num
ber o
f ce
ntre
s hav
ing
at le
ast o
ne
mem
ber
of st
aff
capa
cita
ted
to u
nder
take
in
tens
ified
TB
case
find
ing
and
trea
tmen
t an
d H
IV
test
ing
and
coun
selli
ng
Tota
l num
ber
of p
riso
n he
alth
cen
tres
ex
istin
g du
ring
th
e re
port
ing
peri
od
To a
sses
s the
ex
tent
of
inte
grat
ion
of in
tens
ified
TB
cas
e fin
ding
an
d H
IV te
stin
g an
d co
unse
lling
se
rvic
es in
se
ttin
gs
havi
ng
popu
latio
ns
vuln
erab
le fo
r bo
th T
B an
d H
IV
Pris
ons a
re k
now
n to
hav
e hi
gh
burd
en o
f bot
h TB
and
HIV
. The
he
alth
faci
litie
s cat
erin
g to
thes
e po
pula
tions
shou
ld b
e eq
uipp
ed to
im
plem
ent T
B/H
IV in
terv
entio
ns
thro
ugh
trai
ning
of s
taff,
lin
kage
s with
dia
gnos
is a
nd
trea
tmen
t ser
vice
s, a
nd o
ther
m
easu
res.
The
NAC
P an
d N
TLP
shou
ld
incl
ude
thes
e po
pula
tions
as
prio
rity
gro
ups f
or p
rogr
amm
e im
plem
enta
tion.
NTL
P an
d N
ACP
are
enco
urag
ed to
es
tabl
ish
mec
hani
sms f
or re
cord
ing
and
repo
rtin
g th
is in
dica
tor
Indi
cato
rs to
mea
sure
com
mun
ity e
ngag
emen
t
COLLABORATIVES TBHIV M&E PLAN.indd 29 6/11/18 6:38 PM
MONITORING & EVALUATION PLAN COLLABORATIVE TB/HIV ACTIVITIES
M i n i s t r y o f H e a l t h C o m m u n i t y D e v e l o p m e n t G e n d e r E l d e r l y a n d C h i l d r e n30
9 P
erce
ntag
e of
TB
patie
nts
regi
ster
ed
and
refe
rred
by
com
mun
ity
heal
th w
orke
rs
and
volu
ntee
rs
Num
ber o
f re
gist
ered
TB
pat
ient
s w
ho
wer
e re
ferr
ed
by c
omm
unity
he
alth
wor
kers
or
vol
unte
ers
to th
e he
alth
fa
cilit
ies
for T
B di
agno
sis
Tota
l num
ber
of
TB p
atie
nts
regi
ster
ed
in th
e ba
sic
man
agem
ent
unit
duri
ng th
e re
port
ing
peri
od
To m
easu
re th
e co
ntri
butio
n of
com
mun
ity
heal
th w
orke
rs
and
volu
ntee
rs
in
dete
ctio
n of
TB
pat
ient
s
Com
mun
ity h
ealth
wor
kers
and
vo
lunt
eers
who
are
syst
emat
ical
ly
sens
itize
d ab
out
TB p
reve
ntio
n an
d ca
re b
y N
GO
s and
CBO
s sho
uld
refe
r TB
sym
ptom
-pos
itive
per
sons
for T
B in
vest
igat
ion
to a
hea
lth fa
cilit
y.
The
refe
rral
s fro
m c
omm
unity
hea
lth
wor
kers
and
vol
unte
ers s
houl
d be
sy
stem
atic
ally
reco
rded
at t
he h
ealth
fa
cilit
y on
TB
trea
tmen
t car
ds a
nd in
th
e pr
esum
ptiv
e TB
S
imila
rly,
the
TB re
gist
er s
houl
d al
so d
ocum
ent “
refe
rral
s by
com
mun
ity h
ealth
wor
kers
and
co
mm
unity
vol
unte
ers”
at t
he ti
me
of
regi
stra
tion
to a
llow
stan
dard
ized
re
cord
ing
of th
e co
ntri
butio
n fr
om
the
com
mun
ity.
COLLABORATIVES TBHIV M&E PLAN.indd 30 6/11/18 6:38 PM