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National tuberculosis programme review: experience over the period 1990-95

A Pio1, F Luelmo, J Kumaresan

  • 1National Programme Support, Global Tuberculosis Programme, World Health Organization, Geneva, Switzerland.

Bulletin of the World Health Organization
|January 1, 1997
PubMed
Summary

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The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease·2017

Comprehensive program reviews by the WHO Global Tuberculosis Programme (GTB) strengthened national tuberculosis control efforts. These reviews, focusing on directly observed treatment, short-course (DOTS), improved government commitment and policy reorientation for better tuberculosis management.

Area of Science:

  • Public Health
  • Infectious Disease Control
  • Global Health Policy

Background:

  • The WHO Global Tuberculosis Programme (GTB) has guided national tuberculosis program revisions since 1990.
  • Focus has been on directly observed treatment, short-course (DOTS) and close monitoring of treatment outcomes.
  • Comprehensive program reviews were supported by WHO between 1990-1995 for selected countries.

Purpose of the Study:

  • To evaluate the effectiveness of comprehensive program reviews in reorienting national tuberculosis control strategies.
  • To identify key lessons learned from WHO-supported program reviews.
  • To provide recommendations for improving tuberculosis program implementation and evaluation.

Main Methods:

  • Conducted 12 comprehensive program reviews in countries with large populations, potential for model programs, or advanced implementation stages.
Keywords:
Developing CountriesDiseasesInfectionsInternational AgenciesOrganization And AdministrationOrganizationsPlanningProgram ActivitiesProgram EvaluationProgramsTreatmentTuberculosis--prevention and controlUnWhoWorld

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  • Reviews involved multidisciplinary expert teams (15-35 members) and a structured 3-phase process (documentation review, field visits, recommendations).
  • Data included tuberculosis incidence, HIV prevalence, and program management aspects.

    • Main Results:

    • Program reviews secured government commitment, reoriented policies, and facilitated replanning.
    • Involvement of diverse institutions ensured broad support for new policies.
    • Centralized direction with decentralized implementation via primary healthcare was crucial for success.
    • Effective monitoring relies on accurate case classification and cohort reporting.
    • Quality diagnosis and treatment are essential for program expansion.
    • Inclusion of private and social security sectors is vital for achieving control targets.

    Conclusions:

    • Comprehensive program reviews are valuable tools for tuberculosis program reorientation and policy development.
    • The methodology is recommended for countries needing program reform and for periodic evaluations.
    • Sustained government commitment and multi-sectoral collaboration are key to effective tuberculosis control.