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Key elements to develop a national strategic plan for TB control

Key elements to develop a national strategic plan for TB control. Soleil Labelle Salah Ottmani Technical Support and Coordination Unit Stop TB Department, WHO, Geneva Annual TBTEAM Meeting , 20 and 21 June 2012. Objectives. Explain the need for an NSP

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Key elements to develop a national strategic plan for TB control

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  1. Key elements to develop a national strategic plan for TB control Soleil Labelle Salah Ottmani Technical Support and Coordination Unit Stop TB Department, WHO, Geneva Annual TBTEAM Meeting, 20 and 21 June 2012

  2. Objectives • Explain the need for an NSP • Describe the key principles in an NSP for TB • Understand the 5 key components of the NSP • Conclusions

  3. To reach goals and strategic objectives for the NTP To set strategic interventions To specify activities to be implemented Which activities? What are the targets of these activities? Where to implement these activities? When to implement these activities? Who will implement these activities? To set a budget and identify funding availability To operationalize the activities' implementation To monitor and evaluate the strategic interventions To identify and plan the TA needs Why is a strategic plan needed?

  4. What are the key principles of a NSP? A NSP should be in line with the National Health Plan A NSP should include 5 components The 5 components of a NSP should be consistent The gaps, the objectives and the interventions should be consistent

  5. What are the components of a strategic plan?

  6. 1st component: the core • Situation analysis: • - Analysis of TB burden • - Intervention measures undertaken to date • - Outcomes of these intervention measures - Strengths • - Weaknesses • - Opportunities • - Threats • Identification of the gaps

  7. Example of a gap analysis (appropriate formulation) • In the Tubercoland NSP, the following weaknesses were highlighted in the gap analysis: • 1. The managerial capacity of the NTP is insufficient: • The NTP central unit includes the NTP manager, 1 medical officer, 1 statistician and 2 clerks. Given their small number, they cannot cope with the requirements needed for strategic planning, management of NTP resources, guidelines’ development, training programmes’ development, supervision, development of surveillance capacities, monitoring and evaluation, and other tasks. As a result, the managerial and technical support capacities of the central unit are insufficient. • There are 125 health districts; all of them are assumed to be supervised and technically assisted by the small team of the NTP central unit which cannot fully play this role. There is no intermediate administrative level between the Ministry of Health and health districts.

  8. Example of a gap analysis (inappropriate formulations) • In the Tubercoland NSP, the following weaknesses were highlighted in the gap analysis: • 1. The managerial capacity of the NTP should be strengthened : • More staff should be recruited at central level. • Cars should be purchased for supervision • 2. PPM activities should be implemented • 3. There is no community DOTS

  9. 1st component: the core (cont…) • Definition of clear goals in line with SMARTcriteria • Specification of operational objectives: • - Should match with the situation analysis • - Should be defined in SMART criteria terms • Identification of strategic interventions • Each intervention should: • - be clearly specified • - have target(s) defined in SMART criteria • - match with at least one strategic objective • - include specific activities

  10. Example of activities • The NSP of Tubercoland has specified the following delivery areas to meet objectives • Objective 1:To improve the managerial and the technical capacities of the NTP through the presence of appropriate and competent staff in the Central Unit by 2012 and to ensure functional and effective managerial links within the NTP network by 2013 • 1.1. Improving and strengthening the capacities of the NTP Central Unit • 1.1.1. Clear definition of the mission of the NTP Central Unit • 1.1.2. Recruitment or reassignment of the appropriate staff according to the post descriptions in the Central Unit • 1.1.3. Procurement of computers, printers and didactic material • 1.1.4. Appropriate training of the staff • 1.1.5. External technical support • 1.2. Implementation of managerial units for TB control in each of the 20 Administrative Regions • 1.2.1. Recruitment/reassignment for each regional unit of 1 manager, 1 TB laboratory technician and 1 statistician • 1.2.2. Appropriate training of the staff of the regional unit • 1.2.3. Computer and printer for each regional unit • 1.2.4. Didactic material to ensure training at regional level • 1.2.5. Availability of a car and gas for each regional unit for supervision • etc…

  11. 2nd component: the budgeting plan • Should refer to each strategic objective, each strategic intervention and each activity identified in the strategic core plan • be established for each year of the plan • be fully consistent with the strategic core plan • establish the cost • identify the funding contribution of the government and of each partner for every year and for the overall period covered by the plan • identify the funding gap for every year and for the overall period covered by the plan – Use WHO budget tool

  12. Example of consistency within the plan Goal 1: (to specify) Objective 1.1: …… Strategic intervention 1.1.1: ……. 1.1.1.1. specify the 1st activity 1.1.1.2. specify the 2nd activity 1.1.1.3. specify the 3rd activity 1.1.1.4. …………… Strategic intervention 1.1.2: ……. 1.1.2.1. specify the 1st activity 1.1.2.2. specify the 2nd activity 1.1.2.3. specify the 3rd activity 1.1.2.4. …………… Objective 1.2: ……… Strategic intervention 1.2.1: ……. 1.2.1.1. specify the 1st activity 1.2.1.2. specify the 2nd activity 1.2.1.3. specify the 3rd activity 1.2.1.4. …………… ……..

  13. 3rd component: the monitoring and evaluation plan Should be fully consistent with strategic core plan, the budgeting plan and the operational plan Refer to each strategic objective and each strategic intervention identified in the strategic core plan include: Impact indicators (for the overall goals) Outcome indicators (for the strategic objectives) Output indicators (for the strategic interventions) Process indicators (for some key activities)

  14. Example of indicators

  15. 4th component: the operational plan • Should clearly identify the activities (and sub-activities) that need to be implemented along with the strategic interventions they belong to • refer to the operational objectives associated with these strategic interventions (and activities) • be consistent with the strategic core plan, the budgeting plan and the monitoring and evaluation plan: the activities, the strategic interventions and the operational objectives highlighted in the operational plan must be the same as those identified in the strategic core plan and the budgeting plan

  16. 4th component: the operational plan (cont…) • The operational plan should be established and detailed for the coming 1 or 2 years of the period covered by the NSP • The implementation of the activities should be indicated on quarterly basis • The operational plan should show for the activity to be implemented the following information: • Clear specification of the activity (unit) • When will it be implemented? • Where will it be implemented? • Who will be the implementer?

  17. 4th component: the operational plan (cont…) • The operational plan should show for the activity to be implemented the following information: • How much will the implementation cost? • What is the source of funding of the implementation of this activity? • How this implementation will be monitored and evaluated? (usually process indicator, possible output indicator, or other) • Other relevant detail, depending on the activity; ex.: need for technical assistance

  18. 5th component: the technical assistance plan Should be based on the operational plan (implementation of) focus on the >1 year and include details: Task: Briefly describe activity, terms of references Estimated cost: estimated cost of the mission Available funding & source: NTP, GF grants, partner budgets, etc. for this activity? Funding gap: Is there a funding gap needed to implement the activity Expert: national or international? expert identified? HR gap? Responsible officer/partner in country Timeframe: crucial to secure funding and best consultants Global Fund grant activity reference and service delivery area: Global Fund TA plan can be a subset of the national comprehensive TA plan

  19. Example of TA plan template (on TBTEAM)

  20. 6th component: the preparedness plan • This 6th component needs to be seriously considered in countries with fragile status or in protracted states • The preparedness plan should be established for the acute phase of any complex emergency, including natural disaster • The plan should focus on ensuring the availability and access to TB treatment for the patients who were treated for TB before the acute phase(Appendix 11, TB care and control in refugee and displaced populations, http://www.who.int/tb/publications/2007/en/index.html)

  21. Conclusion Country ownership Clear identification of priorities in TB control needs and inherent interventions Estimates of budget needed Resource mobilization from government and local and international partners/donors Efficient involvement and contribution of GF in the implementation of the NSPs through relevant funding mechanisms

  22. Conclusion (cont…) • Establishment of sound TA plan based on operational plan • TA plan will particularly provide an early warning for GF grant implementation • Efficient interventions of TBTEAM

  23. Thankyou! http://www.stoptb.org/countries/tbteam/default.asp

  24. Why? • NSP planning approach is not new. • Recent analysis shows a varying degrees to the content of current NSPs and especially that operational and technical assistance plans (and accompanying budgets) are not always properly developed or not at all visible. • Given the developments and the new strategic approach of the Global Fund: • TBTEAM is working with all regions, countries, consultants on providing appropriate TA for NSP development • Strategic planning are important in the GF grant cycle (reprogramming, renewals and /phase II) • Leads to improved collaboration and identification of needs by the country taking the lead

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