Monitoring and Evaluation: A Review of Terms

Goals To provide better treatment for people with tuberculosis in Country X To achieve a treatment success rate of 85% in Country X by the end of 2006

Objectives Increase the number of pharmacies with adequate supplies of drugs Increase to 100% the proportion of pharmacies implementing NTP guidelines on drug management by the end of 2005

Objectives – Be SMART Specific Measurable Achievable Realistic Time-Bound

Inputs What do you need to implement the program? Drugs and supplies Laboratories Nurses and doctors DOTS strategy Money

Process WHAT DOES THE PROGRAM DO? Meetings Training Workshops Reporting & Recording Supervision

OUTPUTS Volume of drugs distributed to regional storage facilities Number of primary health care centers implementing directly-observed therapy Number of laboratory technicians trained in smear microscopy Number of TB cases tested for HIV WHAT DID THE PROGRAM ACHIEVE?

Outcomes Case Detection Smear Conversion Treatment Outcomes WHAT IS THE GOAL OF THE PROGRAM?

Medium and Long Term OUTCOMES Outcomes for overall DOTS implementation – Case detection, Smear conversion, Treatment success Medium-term outcomes for NTP implementation – Proportion of TB cases administered using directly observed therapy

IMPACT Transmission dynamics of TB Incidence of pulmonary TB Changes in mortality due to TB Decrease in deaths due to HIV-related TB Prevention of MDR-TB WHAT IS THE EFFECT OF THE PROGRAM ON THE EPIDEMIOLOGY OF TB?

Monitoring vs. Evaluation Inputs, Process, Outputs, Outcomes:  Monitoring Impact:  Evaluation

KEY TERMS - An Example INPUT – NTP guidelines for directly observed therapy (DOT) PROCESS – NTP training workshops on how to implement DOT OUTPUT – Number of nurses trained on administration of DOT Intermediate OUTCOME – Proportion of smear positive TB cases on DOT increases Long term OUTCOME – Treatment success rate increases to 85% IMPACT – Decreased morbidity and mortality due to TB and prevention of MDR -TB