1. Promoting Adoption and Implementation of WHO recommendations
INAT 12 November 2010
Summary guidance for
National TB Programmes

2. Background
Many new advances (solutions to programmatic constraints)
Country enthusiasm for new tools & approaches
Country assessment of bottlenecks to progress
How to link gaps to solutions?
Proposal: Simple tools that pulls together WHO recommendations for new approaches and tools; presents rationale for when to use / how to roll-out

3. New approaches and tools
WHO Endorsed
FDCs
ACSM
Community TB care
Public Private Mix
Three I’s
BCG
PAL
Diagnostic approaches
Front-loading, 3-to-2 smears, case definition
Diagnostic technologies
LED, LPA, liquid culture, rapid speciation, GeneXpert?

4. Problem-solving approach
Primary Objective:
Provide practical information to support decision-making regarding the introduction of new approaches and tools; and planning for introduction
Secondary objectives:
Facilitate strategic assessment of constaints to progress and consideration of approaches and tools that may offer solutions
Identify potential technical assistance needs
Introduce tracking of progress with introduction of new tools

5. Content For each approach/tool
Problems the approach / tool can help to resolve
Context in which the approach is relevant
(e.g. level of health system, any prerequisites)
Summary of the approach; technical overview
Implementation considerations
Training needs
Cost
How to integrate with other technologies, approaches (e.g. diagnostic algorithms)
Other (e.g. power supply)
Alternatives (e.g. for FDCs, consider blister packs; for liquid culture, various methods)
Monitoring and evaluation considerations