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Challenge TB - India
Year 3
Quarterly Monitoring Report
January – March 2017
Submission date: April 30, 2017
2
Table of Contents
1. YEAR 3 ACTIVITY PROGRESS 7
3. CHALLENGE TB’S SUPPORT TO GLOBAL FUND IMPLEMENTATION IN YEAR 3 25
4. SUCCESS STORIES – PLANNING AND DEVELOPMENT 27
5. QUARTERLY REPORTING ON KEY MANDATORY INDICATORS 30
6. CHALLENGE TB-SUPPORTED INTERNATIONAL VISITS (TECHNICAL AND MANAGEMENT-RELATED TRIPS) 32
7. QUARTERLY INDICATOR REPORTING 35
Cover photo: Shri J P Nadda, Health Minister, launched TB- Free India multi-media campaign featuring Mr. Amitabh Bachchan on World TB Day, 2017. Photo Courtesy: The Union, USEA
This report was made possible through the support for Challenge TB provided by the United States Agency for International Development (USAID), under the terms of cooperative agreement number AID-OAA-A-14-00029.
Disclaimer The authors’ views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government.
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Country India
Lead Partner The Union
Other partners PATH, KNCV, FIND (Sub-Recipient)
Work plan timeframe October 2016 – September 2017
Reporting period January – March 2017
Most significant achievements:
A. Challenge TB (CTB) provided communication support for active TB case-
finding drive by Government of India (GOI) and made 360-degree
campaign on TB/MDR TB leveraging $1.5 million resources for airing by
GOI CTB provided communication support for active case finding drive (Jan 15-Jan
30th, 2017): CTB provided communication support to The Central TB Division (Ministry of
Health & Family Welfare, Government of India) in the Active TB Case Finding (ACF) drive
launched in 50 districts in 17 states across the country. The drive was launched from
January 15- January 30th, 2017. CTB developed the active case finding
communication campaign. The campaign was developed in Hindi and five regional
languages. The ACF communication campaign with awareness raising messages about TB
symptoms was disseminated through media channels across a population of nearly 9.2
million people in 50 districts). During the time that the campaign aired, the Ministry of
Health and Welfare conducted 48,291 sputum examinations and 2,513 patients (5%)
were diagnosed with TB in the period January 15-- 30, 2017.
CTB develops new 360-degree mass media campaign featuring iconic actor and
TB survivor, Amitabh Bachchan: As part of technical assistance provided to GOI,
Challenge TB developed a new 360-degree mass media campaign on TB/MDR TB. The TB-
Free India Campaign was launched by Shri J P Nadda, Minister of Health and Family
Welfare, Government of India on World TB Day, 24 March 2017. The campaign was
directed by the national award-winning director Shoojit Sirkar, and featured Mr Bachchan.
It focuses on tackling TB as a social issue, not just a medical disease, highlighting
symptoms and the importance of treatment completion and prevention of MDR-TB. GOI is
spending ten crores (approx. US$1.5 million) in airing the campaign nationally through
National TV & Radio (National Television i.e., Doordarshan and AIR FM), from 24 March,
2017 till June 2017.
Mr. Bachchan, as the ambassador for the Call to Action for a TB Free India also
highlighted the campaign on social media through his Facebook page (26,329,933
followers) and on Twitter (534,000 followers). On social media, the campaign received
9100 likes, 171 shares, 277 comments on FB, 18 retweets and 1,332 likes on Twitter.
The campaign videos can be accessed at:
https://www.youtube.com/watch?v=UX1ZBJxQKs0
https://www.youtube.com/watch?v=aP6RHLU7uic
https://www.youtube.com/watch?v=mh0qZ1QK-wI
B. CTB helped facilitate Bedaquiline access to 377 eligible patients in 6
sites across the country:
The National TB Programme of India has developed implementation guidelines for use of
Bedaquiline, under PMDT, in accordance with WHO policies. Bedaquiline has been made
available through the Conditional Access Programme (CAP) at 6 identified sites across the
country. This rollout is being facilitated by the Challenge TB project. The support includes
provision of additional human resource including a medical officer, site coordinator and
outreach workers for coordinating enrolment of patients, counseling, monitoring
adherence and pharmacovigilance. CTB supported essential investigations and equipment
(such as ECG machines) which are critical for initial evaluation and follow up of the
4
patients on Bedaquiline. CTB provided technical support and facilitated review meetings
and training activities to ensure quality implementation of the access program. By 31st
March, there were 377 patients on Bdq, and a total of 435 new patients eligible for Bdq
have undergone pre-treatment evaluations. CTD has also taken a decision to expand
access to Bdq throughout the country and CTB will continue to assist with the scale-up.
C. CTB launched the India TB Caucus, a part of Global TB Caucus Through support from CTB, the India TB Caucus, a network of elected representatives
committed to END TB in India was launched on 8 March 2017 in New Delhi. Four co-
chairs were appointed: Mrs. Viplove Thakur (Rajya Sabha MP, Indian National Congress),
Mr. Majeed Memon (Rajya Sabha, MP, Nationalist Congress Party), Dr. Kirit Solanki
(Loksabha MP, Bharatiya Janta Party), and Dr. Boora Narsaiah Goud (Loksabha MP,
Telenaga Rashta Samithi) and Prof. P. J. Kurien, Deputy Chairman - Rajya Sabha was
appointed as Patron of the Caucus. Twenty-six members of the parliament from both
Rajya Sabha and Lok Sabha, including two former MPs and four Members of the
Legislative Assembly became active members of the Caucus and agreed to a) advocate
with the Prime Minister’s Office and Ministry of Finance for increased resources for TB; b)
raise awareness among PRIs (Panchayati Raj Institution members) in their constituencies;
c) fight stigma against TB patients/ families by addressing it in their public gatherings.
The Union was asked to act as the secretariat for the India TB Caucus and the seven
founding organizations (IAPPD, CLRA, GHS, Reach, GCAT, Aequitas, and The Union) will
be part of the Advisory Group. After the Caucus launch, members of the Caucus have
taken measures in their constituencies to increase awareness of TB and raise questions in
parliament. Shri Viplove Thakur invited the Health Minister of HP, Shri Kaul Singh Thakur
to be part of the panchayat sensitization on TB in Nurpur, Kangra district, which is
included in the group of 100 highest prevalence districts in the country. A total of 300
local elected representatives were sensitized as a result. Two members of the Caucus
attended the Berlin TB summit sponsored by the Global TB Caucus and on their return
raised questions in parliament on need for vaccines/ research and nutritional support for
patients on TB.
D. CTB provided technical assistance to launch 4 large TB projects with
businesses and Rotary India As part of the Call to action, CTB did advocacy and sensitization efforts with businesses through the Mumbai and Delhi Dialogues in the previous year and engaged with various corporate/other partners to launch projects on TB. As a result, these partners have
announced projects in their selected geographies.
1. GAIL, the largest gas transmission and marketing public sector undertaking
company in India launched a TB project worth INR 1.12 crore ($165,000) for
awareness, screening, diagnosis and nutritional support for TB patients in
Pata (where GAIL has a petrochemical plant) and surrounding areas of
Auraiya district (Uttar Pradesh). The project will have provision for a Mobile
Medical Unit (MMU) with a trained team including a medical officer, technician and
outreach workers; digital microscopy and cartridge-based nucleic acid amplification
test (CBNAAT) testing service for 2 years. In the first year, the van will provide both
awareness and screening services. It will operate on a fixed day at a fixed venue
basis for 6 days a week.
2. DLF Foundation launched “TB-Free Delhi/ NCR” project to establish an MDR-TB
rapid diagnosis center and to provide nutritional support to the identified MDR-TB
patients in Delhi and adjoining areas. Key components of the project include i.)
awareness generation campaigns (est. INR 23 lakhs or $35,000), ii.) CBNAAT
machine with required cartridges (CBNAAT machine-one-time cost of INR 15.50 lakhs
5
or $23,000; cartridges for a year- INR 15.12 lakhs or $23,000, approximately 120
tests/ month costing INR 1050 or $17 each), iii.) Lab Technician for the CBNAAT
machine (INR 5 lakhs/year or $7,352), and iv.) Nutritional support to the identified
MDR patients. DLF sponsored the installation of CBNAAT machine at Wazirabad
Primary Health Centre (PHC). The screening through CBNAAT machine will be
done free of cost at the PHC - the referral centre for 7 sub-centers that caters to an
estimated population of 30,000. The move is expected to reduce workload on the lone
CBNAAT machine installed at Civil Hospital, Gurgaon (serving a population
of 1,514,085, Census 2011) and also help in early diagnosis of the disease.
3. Institute of Driving & Traffic Research (IDTR- joint venture between the
Department of Transport of State Governments and Maruti Suzuki India Ltd.) Under
this partnership, IDTR (through its 6 centers) will reach out to 300,000 drivers
applying for new license/ renewal of license annually and raise TB awareness along
with HIV & Tobacco use. IDTR will also issue advisory directives to all its branches and
training institutes to integrate elements of TB prevention and care in its trainings
modules and display all materials of the TB-Free India Campaign.
4. Rotary India conducted TB awareness and screening drives to commemorate
World TB Day: Rotary districts conducted 6 awareness and sensitization meetings
reaching approximately 1,200 people; 3 health camps reached 480 people in urban
slums in Delhi and Gurgaon; 1 mass media activity to increase TB awareness was
conducted in Chennai. The Rotary District 3080 organized a sensitization meet in
Ambala, Punjab, covering 6 states and 76 clubs. Rotary National TB Control
Committee committed INR 30 lakhs ($44,000) for TB Activities and a Rotary
Trophy for best performing clubs was announced. Out of 480 who came for health
camps in Delhi and Gurgaon (camp provided other health services too). A total of 106
chest symptomatic TB cases screened. 45 patients had Chronic Obstructive Airway
disease, Bronchial Asthma, Interstitial Lung disease. One suspected lymph node TB
(child case) referred to All India Institute of Medical Sciences (results not yet known).
But so far no cases of tuberculosis identified.
Comprehensive, high quality diagnostics (FIND) During the reporting period, a total of 10,792 presumptive pediatric TB and DR TB patients were
tested. Of the total tested, 739 (6.8%) cases were diagnosed as Xpert-positive under the project
with 68 (9.2%) patients being diagnosed with rifampicin resistance. As observed in the previous
quarter, more than half of (52.5%) non-sputum specimens were tested on Xpert reflecting better
utility of the test. In line with Year 3 objectives, focus remained on detailed analysis of project
data to identify areas for improvement as well as the broadening of continued medical education
(CMEs) on pediatric TB including specimen collection and treatment regimens. In addition, as per
the plan, four initial sites (Delhi, Hyderabad, Chennai and Kolkata) were transitioned to the
National TB Program (NTP) by the end of the quarter in a smooth phased-in manner.
Patient-centered care and treatment Under CTB, PATH implemented GIS mapping of the private health sector through mobile phone-
based application called I-Monitor in Mumbai, Thane and Pune. State level consultation was
conducted in Maharashtra on February 9, 2017 for sensitization of public officers from state TB
cell, State AIDS Control Society, WHO and district officers. The operational road map was
discussed in consultation with state officers with commitment from corporation offices for support
in the field. In Uttar Pradesh and Odisha, the state Project team for Global Health (GH), including
the program officers, treatment coordinators, sputum collecting agents and data management
staff have been established and training of the project field team (as mentioned above) on skills
and capacity building for private sector engagement as well as the DRTB implementation model
has been completed. Sensitization of leading chest physicians/physicians and office bearers of
professional medical bodies was completed in- Odisha by Champion Provider from Mumbai-Dr
Vikas Oswal at a state level annual conference.
6
Progress on CTB end-of-project SMART expected achievements:
CTB end-of-project SMART expected achievement
Baseline
2014
Actual Result
2015
Actual Result
2016
Remarks (progress
to date, challenges, achievements)
By 2019, 10 comprehensive partnerships will be
established that leverage Challenge TB technical assistance (and act as private sector cost share to CTB
efforts) to address early detection of TB/DR-TB
0 2 17
The amount of money these partnerships have leveraged will be shared annually.
By 2017, 50,000 presumptive pediatric TB patients will be tested with GeneXpert
6,732
15,345 30,977 We are on track to
reach the target for year 3; 20,626 patients have been tested until 31st 17
By 2017, 1,600 eligible patients will be started on bedaquiline as a part of their treatment regimen in 15
sites, and by 2019, 7,600 patients will be started on
bedaquiline-containing regimens (cumulatively in all 35 sites) in the country
0 N/A 377 Since site expansion to new sites besides 6 is still awaited, it is difficult to estimate if
we will be on track. however, this has
been announced and should rapidly expand once the sites have been selected.
Technical/administrative challenges and actions to overcome them:
Delay in process of sub-contract between FIND and KNCV. It is planned to be signed in April 2017. This led to a delay in initiation of new activities at the project sites. We will be expediting our efforts once MoU is signed.
During the process of workplan approval, CTB PATH team initiated the preparatory activities (i.e. selection of the state project team for UP, Odisha and Maharashtra, coordination with the state government officials in the TB and HIV cell, sensitization of the district officers and private providers) to be able to kick off the activities as soon as
possible after the approval is received. PMDT Unit- There is delay in establishing the PMDT Unit, as the National program /
Central TB Division (CTD) is still in the process of getting the selections approved by the health ministry. While the candidates have been selected by the CTD, they are yet to get clearance from the Ministry of Health.
The proposed expansion to 20 Sites for Bedaquiline this year, is also delayed as CTD has
not yet shared the list of sites that they want CTB to support.
7
1. Year 3 activity progress
Sub-objective 2. Comprehensive, high quality diagnostics
Planned Key Activities for the Current Year
Act. #
Planned Milestones Milestone status Milestone met? (Met, partially, not met)
Remarks Oct-Dec 2016 Jan-Mar 2017 Apr-Jun 2017
Jul-Sep 2017
Year end Oct 2016 – Mar 2017
Operations of the rapid diagnostics
2.4.1 All field staff in place.
All 18 GeneXpert
machines functional
All 18 GeneXpert machines functional
All 18 GeneXpert machines functional
All 18 GeneXpert
machines functional
All 18 GeneXpert machines are functional
Met
Introduction of
GXAlert to connect Xpert and other TB diagnostics in 3 states
2.4.2 GXAlert
introduced in 3 states
Not in FIND’s scope of work N/A As per our
discussions with the CTD, we will not be supporting implementation of GX Alert and in the
year 3 sub contract, no funds have been allotted for this activity to FIND. Instead, as
requested by CTD,
we will be supporting CTD in implementing the Machine to Nikshay Connectivity solution which will perform the same
function as GX-Alert while hosting
the server in country on the Govt website. Concurrence from
8
USAID/India was sought and the
same has received for initiating this activity using available funds under APA3.
Laboratory preparatory
activities including AC/ UPS and upgrading
2.4.3 All sites renovated
Sites have been renovated Met All 9 sites were operational in year
2 of the CTB project and no major additional activity was undertaken in year 3. Overall, we have undertaken
need based maintenance of
existing equipment under the project at the sites
Laboratory consumables, ancillary
equipment, and other miscellaneous items,
Development of ICT innovations
2.4.4 25,000 GX cartridges procured
Increase referral sites from 575 to 2,000;
We have adequate cartridges to carry out project activities and additional cartridges will
be procured before the end of quarter 3.
Referral sites as of 31st March, 2017 were 1,106.
Partially met
Advocacy
meetings / CMEs, media briefings and outreach activities
2.4.5 1,000
providers reached
1,000
providers reached
1,000
providers reached
2,000
providers reached
5,000
providers reached
2,299 providers approached (Oct 2016 to Mar 2017)
Met
Documentation of project findings
2.4.6
Draft manuscript developed
Submission of at least
one
4 manuscripts have been drafted
Met Draft manuscripts will be shared as
soon as they are
9
manuscript for Publication
finalized after inputs from all
authors
ICT Innovations
2.4.7 Use of GIS/GPS mapping and analytical
tools operationalized
ICT applications for rapid reporting developed
/adapted to local needs and piloted
E-modules developed for remote
learning
ICT applications and e-modules developed
and piloted
We have planned to connect all
Xpert machines to Nikshay and
we have initiated this activity
under the project. We will shortly
be sending a formal request to
KNCV PMU for reallocation of
the budget under ICT innovations
to allow us to carry out this
activity.
Not met The sub-agreement for Year 3 has been signed in April 2017 and we have already
initiated ICT innovation activity
Review
meeting for Project staff
2.4.8 Review
meeting for project staff
Review
meeting for project staff
2 Review
meetings for the project staff
Not met The MoU for Year 3
has been signed in April, 2017 and review meeting will be conducted in May, 2017
Transition of project sites to NTP
2.4.9 Handing over Lab logistics
(supply of consumables) to NTP by RNTCP for 4 sites;
Lab activities
(key lab operations, including conducting tests, reporting of results,
advocacy
with providers) to be supported
Phasing out of support for lab
activities for 4 labs and labs fully handed
over to NTP
Lab logistics and
activities handed over to NTP for remaining 5 sites
Handing over of all Project sites to NTP
Initial 4 project sites have been transitioned to NTP smoothly in a phased manner on 31st March, 2017
Met
10
in the form of HR
Access,
operation and utilization of rapid diagnostics (i.e. Xpert) ensured for
priority populations and Expedient laboratory specimen transport and results
feedback system operational
2.6.1 22,000
children tested
36,000
children tested
50,000
children tested
Upfront
Xpert MTB/Rif testing for 50,000 children with presumptive
TB
20,626 (93,8%) children were tested
Partially met
At Guwahati site,
there were issues related to biomedical waste which led to halt of activities for almost a month.
Currently, the site is functional. Further, we were redirecting the samples from the initial 4 transitioned sites’
providers/facilities to nearest RNTCP
Xpert lab in order to sustain the referrals beyond the project
Sub contract to FIND
2.6.2 Sub contract awarded
screening of 50,000
symptomatic TB patients, covering more than
5,000 provider through CME's
Subcontract for Year 3 is awaited
Not met The sub-contract planned to be
signed in April 2017
Sub-objective 3. Patient-centered care and treatment
Planned Key Activities for the Current Year
Act. #
Planned Milestones Milestone status Milestone met? (Met, partially, not met)
Remarks (reason for not meeting milestone, actions to address challenges)
Oct-Dec 2016
Jan-Mar 2017 Apr-Jun 2017 Jul-Sep 2017 Year end Oct 2016 – Mar 2017
11
BCC campaign for TB/MDR TB
3.1.1 Agencies hired/
Contracts extended
Materials developed
Materials developed
Materials developed
CTB developed active TB case finding campaign, featuring
Shri Amitabh Bachchan to support GOI’s Active TB Case Finding (ACF) drive in 50 districts across the country. The ACF communication campaign with awareness
raising messages about TB
symptoms was disseminated through media channels across a population of nearly 9.2 million people in 50 districts. ). During the time that the campaign aired, the
Ministry of Health and Welfare conducted 48,291 sputum examinations and 2,513 patients (5%) were diagnosed
with TB in the period January 15-- 30, 2017.
The TB-Free India Campaign was launched by Shri J P Nadda, Minister of Health and Family Welfare, Government of India on World TB Day 2017, 24 March 2017. GOI
will spend $1.5 Million in
airing through Doordarshan and AIR FM, from 24 March, 2017.
Mr. Bachchan also shared the campaign on his Facebook page reaching 26,329,933 followers and twitter 534,000 twitter followers ; the
campaign received 9.1 K
likes,171 shares, 277 comments on FB, 18 retweets & 1332 likes on Twitter.
Met
12
Map the private sector doctors,
hospitals and laboratories, Networking with engaged private providers and
notifications for
TB patients into Nikshay from private sector
3.1.6 Mapping and
selection of private sector providers
Mapping and
selection of private sector providers, Engage 15% of the
selected
private provider. Notification from the engaged providers
Engage 70% of
selected private providers. Notification from the engaged providers
Engage 100% of
selected private providers. Notification from the engaged providers
Mapping and selection of
private sector providers
- Mapping training on GIS tools and I-Monitor
software was completed. 30 field staff (15 Females,15 Males) were trained to conduct the mapping activity in Thane, Mumbai and Pune
- 24 private facilities in
Mumbai have been engaged for RDT in the private sector for TB patients
Partially met
The approval on work plan was
delayed by 1 quarter. The subcontracting with the Mapping agency was also delayed and thus
all mapping related
activities are delayed by 1 quarter. The field team has started mapping on April 1 and the target will
be achieved by the end of 3rd quarter
Sub-
contracting and hiring of local NGO, Hire staff for the PATH Project support
unit, and hiring staff for the DR-TB centre in Thane
3.1.7 Selection
process of the NGO
Orientation
and sensitization of NGO staff
1 workshop
2 workshops
Both local NGOs: Maharashtra
Janavikas Kendra and Alert India were selected and respective work localities geographies were assigned. (Alert: NMMC, 5 wards of
Mumbai, Cuttack and Bhubaneshwar)
MJK: Allahabad, Moradabad, Thane municipal corporation and 7 wards of Mumbai
2 orientation and sensitization workshops were conducted to sensitize project directors of ALERT and MJK about the :
DRTB model in Maharashtra, Odisha and U.P
Data collection tools and
techniques Roles and responsibilities
of the PMU staff Administrative procedures
Met
13
of designing the MoU, Vouchers and trainings for
private sector engagement
CBO staff have been on-boarded in all three states.
Testing presumptive
TB cases GeneXpert (private and public), Reimburse the PTE test costs to private
networked laboratories,
Notify DR-TB patients
3.1.8 2,000 presumptiv
e DR-TB cases tested w/ Xpert;
160 RR-TB cases diagnosed by Xpert;
144 RR-TB patients received PTE
3,000 presumptiv
e DR-TB cases tested w/ Xpert;
180 RR-TB cases diagnosed by Xpert;
200 RR-TB patients received PTE
5,000 presumptiv
e DR-TB cases tested w/ Xpert;
360 RR-TB cases diagnosed by Xpert;
324 RR-TB patients received PTE
136 presumptive DR-TB cases received Expert testing from
4 wards of Mumbai from IPAQT accredited laboratories.
16 Rifampicin-resistant (RR-
TB) cases were diagnosed (12%)
All 16 RR- TB patients
received Pre- treatment evaluation, 10 patients were referred to Hinduja lab for Drug sensitivity test. 11 patients were initiated on treatment. (11 were started on treatment. Field operations
began on 23rd March 2017. This data is from 23rd March to 31st March only)
Partially met
After an accelerated
start-up of activities, field operations in Mumbai began on March 23rd 2017. GH component is
implemented in 4 out of 24
wards of Mumbai: S, N, T and R wards
All 136 received Xpert testing and hence registered as presumptive
DRTB cases
1. Workshop at State level for public sector to sensitize referral
mechanisms of private sector,
2. Workshops for private sector practitioners,
3.1.9 2 workshops for public and private sector to
be conducted
5
4 workshops for public and private sector to
be conducted
6
Total 17 workshops conducted.
1 workshop conducted in Maharashtra.
1 workshop for sensitization of private chest physicians was conducted in Odisha in Bhubaneshwar.
Champion provider from Mumbai delivered the session and 45 doctors from public
Partially met
1 more workshop was scheduled in Odisha but is postponed due to the unavailability
of the state TB officer
The remaining 15
14
office of Indian Medical
Association (IMA) and TB champion providers from Mumbai,
3. Community mobilization activities for community empowerment
collaborative/impleme
ntation workshops
collaborative/impleme
ntation workshops
and private sector attended the training. 16 doctors were
from private sector out of which 6 were females and 10 were males. The training was on diagnosis and treatment of TB and DRTB and utilization of PATH’s model for early
diagnosis and initiation of treatment.
Participants included officials
from RNTCP, NACO, MCGM, other corporations, State TB Cell, MSACS and MDACS, WHO, USAID, PATH and other academic institute and hospitals. The discussion was
focused on Expansion of
TB/HIV and DR-TB services across 3 districts in Maharashtra in alignment and coordination with the state and district officials from RNTCP and NACO
workshops will be conducted in UP,
Odisha and Maharashtra.
2 state level workshops with TB departments in UP and Odisha in 3rd quarter.
2 inter departmental coordination workshops for
social linkages in each state. So 6 workshops in 3rd and 4th quarter.
5 more workshops for private sector sensitization : 2 in UP, 2 in Maharashtra and 1 in Odisha
2 workshops for
district level coordination in U.P and Odisha
Training of project staff Operation model of the project in selected cities
Facilitating
3.2.6 2 trainings
4 workshops for CMCs
1 training
4 workshops for CMCs
The team prepared 4 trainings with marketing associates for private sector engagement, and 4 staff were recruited under PATH.
The CBOs recruited a team of 20 field staff in UP and 20 in
Odisha for counseling, patient
tracking and coordination on field. Preparation for training the CBO staff was conducted by PATH team through
State officials in Odisha: government medical college HOD, PMDT
department officers, attended GeneXpert sites
In the first week of April, 50 CBO staff and 4 marketing associates across
15
sensitization of Community
Mobilization Co-coordinators in Uttar Pradesh
developing training modules and communication materials in this quarter.
Odisha and UP were trained
Create linkages in public sector,
Providing treatment adherence
support to DR-TB patients
Linking DR-TB patients with social and
economic support schemes of various
departments and ministries
Reminder SMS and calls for treatment
adherence to TB patients
3.2.7 64 DR-TB patients linked for
treatment,
64 DR-TB patients to be
provided treatment adherence services,
15 patients to be enlisted
120 DR-TB patients to linked for
treatment,
120 DR-TB patients to be
provided treatment adherence services
40 patients to be enlisted
12 DR-TB (of the 16) patients in Mumbai (4 wards) were linked to district TB officers
for initiation of treatment under RNTCP (Remaining 4 are in process for registration at the DRTB center since they were diagnosed during the end of quarter. This data is only from 23rd
March to 31st March. Updated data will be shared
in the next QMR)
Profiling for eligibility of all 16 DR-TB patients have been conducted for establishing linkages to social schemes.
Linkages to social schemes
will be established in the next quarter.
Adherence support through calls (once in 15 days) and home visits (LFU patients) is provided to all patients initiated on DR-TB treatment in public sector
Met
(over-achieved): According to the workplan targets,
GH PATH team were not expected to begin with testing and treatment in 2nd quarter, however we have registered
cases in this quarter due to the
preparatory work completed.
MIS for tracking of the patients
3.2.8 N/A Assess existing data
Develop data manageme
Establish data manageme
Develop, supervise and improve
MIS tracking format for DR-TB work plan has been
Met The tools and techniques for data management will
16
detected in private sector
and registered at DOTS plus site, project tracking and monitoring
management systems
in private and public sector
nt systems for
tracking and monitoring program activities and
information sharing
nt systems for
tracking and monitoring program activities and
information sharing
an established
internal data management systems for tracking and monitoring program
activities and
information sharing
developed.
Data collection tools for treatment coordinators and sputum collecting agents are developed
be rolled out in UP Odisha and Thane,
Mumbai in the third quarter after kick starting the DR-TB diagnosis and treatment model
PMDT review meetings and introduction TA on BDQ/ Shorter
regimen from KNCV/ The Union
3.2.1 1 of 4 TA visits and meetings for BDQ introduction
2 of 4 TA visits and meetings for BDQ introduction
3 of 4 TA visits and meetings for BDQ introduction
4 of 4 TA visits and meetings for BDQ introduction
1 of 4 TA conducted Partially met
Dr. Fraser Wares visited India with specific objective to Assess progress in introduction of
bedaquiline for drug-resistant TB
in two BCAP implementing sites in Delhi, India Review and discuss the progress in
introduction of new drugs and regimens for DR-TB patients in India with RNTCP
officials, USAID
and the Union
Training for BDQ/ Shorter regimen
3.2.2 1 of 2 trainings conducted
2 of 2 trainings conducted
2 Trainings conducted
No training conducted Not met New PMDT guidelines, including guidelines on Shorter Regimen
have been released by CTD; 4 Regional ToT have
been conducted by CTD/WHO between February & April. Dr Neerja Arora
participated in one
17
ToT workshop. CTB proposes to
organize sub regional/ state level ToT trainings in next quarter
1 workshop
with RNTCP and Tibetan
DoH in Dharamshala for strengthening linkages + 5
day MDR TB Course for Tibetan Health care providers by The Union .
STTA provided by Pepe
3.2.3 1
Workshop conducted
1 MDR TB
Course conducted
0 Workshop conducted
Not met Dr Pepe Caminero
was unavailable and this activity
has been deferred until December 2017
Establishment
of PMDT unit / provision of technical support for shorter regimen and
BDQ roll out
3.2.4 5 PMDT
consultants hired
Technical
consultants hired and PMDT activities conducted under
guidance of CTD & CTB
0 PMDT consultants hired
though recruitment was initiated, interviews held and candidates selected. Five successful applicants are now awaiting the MOHFW-CTD approval.
Not met Recruitment
process ongoing. Selection of candidates completed. CTD (Central TB Division) is
processing their candidature for approval from MOHFW. It is anticipated that all 5 consultants will have assumed duty by Q4.
Support for BDQ sites
3.2.5 6 BDQ
sites staffed and equipped with ECG
Total 10
BDQ sites staffed and equipped with ECG
Total 15
BDQ sites staffed and equipped with ECG
Total 20
BDQ sites staffed and equipped with ECG
20 sites staff
hired, equipment and tests conducted
6 BDQ sites staffed and linked
to districts equipped with 100 ECG machines
Partially met
18
machines.
250 BDQ cases undergo
Pre-evaluation tests
machines.
300 new BDQ cases undergo
Pre-evaluation tests
machines.
500 new BDQ cases undergo
Pre-evaluation tests
machines.
500 new BDQ cases undergo
Pre-evaluation tests
435 eligible BDQ cases underwent pre-evaluation tests including ECG and/or Lab investigations
Note: GH. – Update will be provided in Q2 since approval was not received until Dec 31, 2016
PEPFAR Updates Year 3:
Sub-objective 3. Patient-centered care and treatment
Planned Key Activities
for the Current Year
Activity
#
Planned Milestones Milestone status Milestone met? (Met,
partially, not met)
Remarks Oct-Dec 2016
Jan-Mar 2017
Apr-Jun 2017
Year end Oct 2016-Jun 2017
Map the private sector doctors, hospitals and laboratories, Networking with
engaged private providers and notifications for TB patients into Nikshay from private sector
3.1.1 Mapping and selection of private
sector providers
24 private facilities engaged
Mapping and selection of private
sector providers, Notification from the engaged providers
33 private facilities engage
Notification from the engaged providers
40 private
facilities engaged
Notification from the engaged providers
48 private facilities engaged
Mapping activity in Thane, Pune and Mumbai began on March 8th. Training of
field staff on I-Monitor, procurement of tablets, and module on GIS training through I-Monitor was
completed in march
24 facilities in Mumbai are engaged and are notifying TB patients for TB/HIV testing
Partially met
Late start of implementation of activity, led to delay in subcontracting the
Mapping agency. As a part of preparatory activities recruitment of field staff, identifying agency for GIS training and development of software prototype for
I-Monitor was completed
during this quarter. The field team started mapping on April 1 and the target will be achieved by the end of 3rd quarter.
Provide free HIV screening test to TB patients and reimburse the cost of the test
3.1.2 175 TB patients receiving free RDT
535 TB patients receiving free RDT
825 TB patients receiving free RDT
975 TB patients receiving free RDT
1,709 TB patients were screened for HIV from October 2016-March 2017 in 24
private facilities in Mumbai. 30 out of 1709 (1.8%) tested
positive on the rapid
Met The work plan approval was received on January 6th 2017. Prior to this approval, PATH was only
able to test patients in 17 facilities. Now that we are able to expand our
operations and network we
19
diagnostic test. Total number of TB
registered patients were 2,000 and remaining 291 are being followed up by the Link counselors to be tested. 30 HIV
positive patients were
provided post-test counseling by the link counselors and linked to nearest Integrated counseling and testing center for
confirmation. Ward wise report of these 1,709 patients is shared with MDACS
for notification into national data systems
expect the number of patients tested and placed
on free RDT to significantly increase.
MIS for tracking of the patients detected in private sector and project tracking and monitoring
3.1.3 3 review meetings
3 review meetings
3 review meetings
Data collection tools were improved based on APA 2 experience. 4 review meetings, 2 with each of the CBOs
(MJK and ALERT) for reviewing, adding
variables as per new work plan and disseminating the data tools. The meetings
included the project director, MIS assistant, operations manager. MIS officer is yet to
be recruited for both CBOs PATH has
facilitated sharing of monthly reports with
Met Data systems have been strengthened. PATH and CBOs are evaluating to introduce an ICT based system for data collection
through tablets. An update on this activity
will be provided in the next quarter. This activity also resulted in establishing information
sharing on HIV screening from the private facilities to Government of India (MDACS in Mumbai) under existing national private
sector engagement guidelines.
20
MDACS for Oct to March 2017
Capacity building of providers on TB - HIV screening Guidelines
3.1.4 4 sensitization sessions/trainings to be
conducted 2
implementation workshop with public
sector
4 sensitization sessions/trainings to be
conducted 2
implementation workshop with public
sector
4 sensitization sessions/tra
inings to be conducted
2 implementation
workshop with public sector
4 sensitization sessions/tr
ainings to be conducted
2 implementation workshop
with public sector
1 training for 3 days was conducted on mapping techniques with I-Monitor. 12
females and 18 males from both CBOs were trained. Total 30 field
staff were trained on GIS techniques, mapping indicators, and I-Monitor
software
Partially met
Implementation workshops with public sector such as ART and ICTC sensitization
workshops in Thane, Mumbai and Pune are targeted in the third and
fourth quarter.
Establish appropriate counseling and referral services at engaged
facilities
3.2.1 3 TB patients tested
positive on HIV test Post test counseling conducted:
3 HIV patients (100%)
90% of HIV positive patients
linked to ICTC for confirmation
10 TB patients tested
positive on HIV test Post test counseling conducted:
10 HIV patients (100%)
90% of HIV positive patients
linked to ICTC for confirmation
16 TB patients tested
positive on HIV test Post test counseling conducted:
16 HIV patients (100%)
90% of HIV positive patients
linked to ICTC for confirmation
19 TB patients tested
positive on HIV test Post test counseling conducted:
19 HIV patients (100%)
90% of HIV positive patients
linked to ICTC for confirmation
30 TB patients tested HIV positive in private sector
All positive patients were provided post test counseling
27 patients were linked to ICTC for confirmation
Pre ART registration also completed at the ART centers
Met MDACS has linked 24 facilities to 18 stand-alone ICTC for smooth referral.
CTB ‘link’ counseling platforms are established with the ICTC counselors for confirmation of private sector TB patients and further linkages to ART
centers.
Sub-objective 7. Political commitment and leadership
Planned Key Act. # Planned Milestones Milestone status Milestone Remarks (reason for not
21
Activities for the Current Year
Oct-Dec 2016
Jan-Mar 2017 Apr-Jun 2017 Jul-Sep 2017 Year end Oct 2016 – Mar 2017 met? (Met, partially, not met)
meeting milestone, actions to address challenges)
Workplace TB Policy
7.2.1 Sub contract with ILO awarded
Meetings with businesses
and Business association
s conducted
Meetings with businesses
and Business association
s conducted
Meetings with businesses
and Business association
s conducted
Draft Workplace policy prepared
Work in progress Not met Work plan approval received on Dec 30, 2016.
Contracting with ILO was initiated in Q2 and is expected
to be completed in Q3.
TA to partners who have committed
through LOI in APA2
7.2.2 Meetings with partners
Meetings with partners
Meetings with partners
Meetings with partners
• Meetings held with:
1. TA to Businesses
a) TA meetings held with Challenge TB’s corporate partners: Essar Foundation (Male: 16; Female:08) on
January 24, 2017, in Mumbai;
Omkar Foundation (Male: 37 Female:6); IL&FS(Male: 19 Female:17) March 06, 2017 in Bilaspur, HP, and J V Gokal, March 04, 2017 in Khambhaliya, Gujarat. Meetings were also one with
GAIL India , DLF Foundation and IDTR for launching of
corporate CSR initiatives on TB in Pata , UP ( Medical Mobile Unit by GAIL) and Wazirabad , Haryana
(CBNAAT machine installed at PHC by DLF).
2. TA to Rotary
a. The Rotary District 3080
(as part of Rotary district
sensitization meet in Ambala, Punjab), covering 6 states 76 clubs, also received a commitment equivalent to Rs.
Met
22
30 lakhs from Rotary for TB Activities specially to support
campaign for active case findings.
b. As part of Rotary India’s ongoing initiatives nine awareness sensitization meets were conducted.
Through these 1200 Rotary club representatives were
sensitized, 76 clubs in district 3060 (Ambala) will be conducting awareness camps on TB this year.
Three awareness and TB screening drives reaching 480 patients were held in Delhi & Gurgaon.
c. Extensive TB awareness drive was conducted in mass media to commemorate
World TB Day in Chennai. A talk on TB in Fever 104 FM channel on the eve of World TB Day and full day program(s) covering TB on
the World TB Day. •500
students walk to raise awareness. Tamil Actor Aari also participated. • 4 TV channels (Sun TV, News 7, Puthiya thalai murai, News 18) covered the events. Six newspapers published
reports/ news pieces.
3. CTB facilitated Parliamentarian action on TB: through launch of
23
India TB Caucus on March 08, 2017 in New Delhi.
Four co-chairs and patron were elected and The Union will work as secretariat. 26 MPs & MLAs signed the letter of commitment and joined the caucus. This resulted in:
a. Co-chair doing outreach in her constituency: A
sensitization meeting of Panchyati Raj Institution members was conducted on March 26 in Nurpur Block of Kangra District in Himachal Pradesh. The
meeting was chaired by
Health Minister, Government of Himachal Pradesh, Co-chair of India TB caucus Ms. Viplove Thakur, MP, and Shri. Ajay Mahajan, MLA. 300
panchayat members comprising of Sarpanch, Panchayati Samiti Members were sensitized
as a result. b. Members India TB Caucus
Shri Ananda Bhaskar
Rapolu (MP, Rajyasabha) and Shri Nadimul Haque (MP, Loksabha) represented India in the Berlin TB Summit from 20-22 March 2017
sponsored by Global Tb
caucus. c. Post Berlin TB Summit,
Shri Rapolu highlighted the need for safe medicines, TB vaccines
24
and the possibility of linking TB patients with
Antyodayo Yojana (a government scheme) to address the problem of nutritional support for TB patients. Recording of the speech is available at
https://www.youtube.com
/watch?v=TIvT1tLBNw4&feature=youtu.be
4. Mobile Van services for TB awareness/ screening launched
through HelpAge India- civil society partner of call to action by Health Minister, Government
of Himachal Pradesh on March 26, 2017. Services include TB Awareness and
screening in the state of Himachal Pradesh through nine Mobile Medical Units (vans). The Mobile Medical Unit (MMU) comprising of medical
doctor, health worker and
an attendant will operate in 4 districts viz. Shimla. Solan, Hamirpur and Kangda in Himachal Pradesh. The van has been supported by Cipla
Foundation.
Shifted to 3.1.1 7.2.3 Choose an item.
Dissemination
of corporate and other partnerships results/
7.2.4 Meetings
with stakeholders and
Meetings
with stakeholders and
Meetings
with stakeholders and
Meetings
with stakeholders and
a) CTB shared the project’s
achievements and lessons learned/ approach in USAID partners meet held on February 22-23, 2017.
Partially met
25
achievements of CTB and C2A
partners partners partners partners b) CTB discussed
“Tuberculosis: A Growing Public Health Challenge” at 67th Annual National OCCUCON 2017, held on February 9, 2017 at New Delhi.
c) CTB disseminated project learnings in panel discussion on “Emerging TB Challenge in India: how to strengthen public private partnerships” as part of the
national workshop on "India Towards Comprehensive TB Care: Building Partnerships", held on February 15, 2017 in
New Delhi. The audience comprised leading corporates, PSUs, Civil society and
academicians in India.
3. Challenge TB’s support to Global Fund implementation in Year 3
Current Global Fund TB Grants
Name of grant & principal
recipient (i.e., TB NFM - MoH)
Average
Rating* Latest Rating
Total
Approved/Signed Amount**
Total Committed
Amount
Total
Disbursed to
Date
Providing universal access to DR-
TB control and strengthening civil
society involvement-NFM (2015) -
World Vision India
B1 B1 $6,904,741 $4,865,478 $3,704,900
Providing universal access to DR-
TB control and strengthening civil A2 A1 $23,152,396 $16,212,253 $11,182,144
26
society involvement-NFM (2015) -
The Union
Consolidating and scaling up the
revised national tuberculosis control
program (RNTCP) –NFM (2015) -
Central TB Division
B1 A2 $207,785,667 $186,585,390 $104,289,630
* Since January 2011
** Current NFM grant not cumulative amount; this information can be found on GF website or ask in country if possible Source: https://www.theglobalfund.org/en/portfolio/country/list/?loc=IND&k=7c973abd-19b9-486b-956a-8ddeb7dd3f58 accessed on 17-04-2017 In-country Global Fund status - key updates, current conditions, challenges and bottlenecks Total allocation for the next three years (Jan 2018 to Dec 2020) from the Global Fund is USD 500 million, with USD 280 million allocated for the TB component. Preparations are on track to submit India’s TB grant proposal to the Global Fund in the May 2017 submission window. The national strategic plan (NSP) for TB elimination in India 2017-2021 has been drafted and posted on the RNTCP website for public comments till 3 March 2017 at http://tbcindia.nic.in
The GF TB proposal will be based on the priority areas identified by the Global Fund and aligned with the new NSP – the three priority areas being:
Scale-up and increase in coverage of MDR-TB diagnosis and improvement in treatment outcomes; Enhanced notification of missing cases, specifically through enhancing the private sector response, including follow up on treatment outcomes; and TB care and prevention for key affected populations
India CCM had invited Expression of Interests (EoI) for non-government Principal Recipients (PRs) in (i) Private sector engagement, (ii) Active case finding, and (iii) Implementation and operational research. In addition, the government PR, Central TB Division, had issued EoI for sub-recipients under CTB in MDR-TB diagnosis/lab strengthening, patient support systems for DR-TB patients, addressing TB/HIV co-morbidity, technical assistance, and health systems strengthening. India’s CCM shortlisted four non-government PRs – The Union consortium, CHAI/FIND/PATH consortium, HIV/AIDS India Alliance and CARE India. Further
decision was made to select two of the four shortlisted applicants - The Union consortium for active case finding among key populations, and the
CHAI/FIND/PATH consortium for private sector engagement. There are ongoing discussions on the role of the two other shortlisted non-government PRs at the time of writing this report.
Challenge TB & Global Fund collaboration this quarter – Describe Challenge TB involvement in GF support/implementation Challenge TB is collaborating with the Global Fund on the TB-Free India summit which includes a charity cricket match between celebrities and parliamentarians, India v/s TB, to be held in Dharamsala, India from 7-8 April 2017. The Global Fund team introduced the CTB team to Mr. Anurag Thakur, a Member of Parliament and president of the Himachal Pradesh Cricket Association (HPCA) who will co-host the Summit, and also introduced the CTB team to a potential corporate sponsor. Dr Christoph Benn, Director of External Relations at the Global Fund will lead a four member delegation from the Global Fund.
27
4. Success Stories – Planning and Development
Planned success story title:
Challenge TB (CTB) provided communication support for active TB case-finding drive by Government
of India (GOI)
Intervention area of story: 3.1. Ensured intensified case finding for all risk groups by all care providers
Brief description of story idea:
CTB provided communication support for active case finding drive (Jan 15-Jan 30th, 2017): CTB provided
communication support to The Central TB Division (Ministry of Health & Family Welfare, Government of India) in the Active TB
Case Finding (ACF) drive launched in 50 districts in 17 states across the country. The drive was launched from January 15-
January 30th, 2017. CTB developed the active case finding communication campaign. The campaign was developed in
Hindi and five regional languages. The ACF communication campaign with awareness raising messages about TB symptoms
was disseminated through media channels across a population of nearly 9.2 million people in 50 districts). During the time
that the campaign aired, the Ministry of Health and Welfare conducted 48,291 sputum examinations and 2,513 patients (5%)
were diagnosed with TB in the period January 15-- 30, 2017.
Status update (including estimated date of
completion):
During the time that the campaign aired, the Ministry of Health and Welfare conducted 48,291 sputum examinations and 2,513 patients (5%) were diagnosed with TB in the period January 15-- 30, 2017.
Planned success story title: CTB helps establish India TB Caucus, part of Global TB Caucus with members of parliament
Intervention area of story: 7.2. In-country political commitment strengthened
Brief description of story idea:
Through support from CTB, the India TB Caucus, a network of elected representatives committed to END TB in India was
launched on 8 March 2017 in New Delhi. Four co-chairs were appointed: Mrs. Viplove Thakur (Rajya Sabha MP, Indian
National Congress), Mr. Majeed Memon (Rajya Sabha, MP, Nationalist Congress Party), Dr. Kirit Solanki (Loksabha MP,
Bharatiya Janta Party), and Dr. Boora Narsaiah Goud (Loksabha MP, Telenaga Rashta Samithi) and Prof. P. J. Kurien, Deputy
Chairman - Rajya Sabha was appointed as Patron of the Caucus. Twenty-six members of the parliament from both Rajya
Sabha and Lok Sabha, including two former MPs and four Members of the Legislative Assembly became active members of
the Caucus and agreed to a) advocate with the Prime Minister’s Office and Ministry of Finance for increased resources for TB;
b) raise awareness among PRIs (Panchayati Raj Institution members) in their constituencies; c) fight stigma against TB
patients/ families by addressing it in their public gatherings.
. After the Caucus launch, members of the Caucus have taken measures in their constituencies to increase awareness of TB
and raise questions in parliament. Shri Viplove Thakur invited the Health Minister of HP, Shri Kaul Singh Thakur to be part of
the panchayat sensitization on TB in Nurpur, Kangra district, which is included in the group of 100 highest prevalence districts
in the country. A total of 300 local elected representatives were sensitized as a result. Two members of the Caucus attended
the Berlin TB summit sponsored by the Global TB Caucus and on their return raised questions in parliament on need for
vaccines/ research and nutritional support for patients on TB.
28
Status update (including
estimated date of completion):
The Union was asked to act as the secretariat for the India TB Caucus and the seven founding organizations (IAPPD, CLRA, GHS, Reach, GCAT, Aequitas, The Union) will be part of the Advisory Group for period of 2 years.
Planned success story title: GeneXpert Services of USAID’s CBNAAT Project Move Closer to Pediatric Population: Transition to National TB Programme
Intervention area of story: 2.1. Access to quality TB diagnosis ensured
Brief description of story idea:
Under the guidance of Revised National TB Control Programme of India (RNTCP), FIND began implementing a novel pediatric initiative in 2014 with funding support from USAID for the diagnosis of TB in children in four cities, namely, Delhi, Kolkata, Chennai, and Hyderabad. Based on the project findings, the project was extended to 5 more cities in 2016. The project provides a comprehensive diagnostic solution for pediatric TB in the intervention cities through various low-cost advocacy
interventions. In addition, for the first time under RNTCP, both sputum and extra-pulmonary pediatric specimens were tested on Xpert, including gastric aspirate, gastric lavage, broncho-alveolar lavage, cerebrospinal fluid, pleural fluid, and pus etc. So far, the project has been able to cater to more than 72,000 presumptive pediatric TB patients. Further, the project has facilitated prompt access to quality diagnostic services with more than 90% of the specimen results being reported within 24
hours of specimen collection. Along with this, more than 1,100 facilities/providers have been linked with the project with significant proportion of private sector (approximately 40%) who have been sending referrals to the project sites.
Since the activities at the initial 4 sites have now gained significant momentum, with an increasing number of providers being engaged in each successive quarter, it was planned to transition these site activities and other logistics to the National Programme. All the major contributing providers/facilities were explained about the transition plan from January, 2017
onwards and their patient samples were redirected to the nearest RNTCP GeneXpert lab so that the providers become accustomed to sending samples to these labs as well as to sustain the referrals. On 31st March, 2017, the activities and other processes at 4 initial sites were handed smoothly over to the RNTCP in a phased manner. The engaged providers have been sensitized about the specimen collection and referral which will continue to address to the needs of the pediatric population.
Status update (including
estimated date of completion):
N/A As stated above, transition of the 4 initial sites to the National TB Control has been completed by 31st March 2017. The
transition of the remaining 5 sites would be carried out at the end of the project (30th September 2017)
Planned success story title: Mapping health care facilities the smartphone way
Intervention area of story: 3.2. Access to quality treatment and care ensured for TB, DR TB and TB/HIV for all risk groups from all care providers
Brief description of story idea:
Through collaboration with Dure Technologies, an Android application for smartphone users called I-Monitor was developed
according to the specifications in the CTB work plan.
The application has a feature for capturing evidence-based information about the geo-location of the provider, date and time
29
of the mapping and crucial indicators on the profile of the private provider, such as type of provider, qualification, services offered etc. The application captures data for
Ayurveda, Yoga, Unani Siddhi and Homoeopathy (AYUSH) and informal centers, hospitals, clinics, pharmacies, laboratories and chemists and more specific to HIV, it captures ICTCs and ART centers as well.
The user-friendly interface helps capture data with ease and minimal training and
provides an interactive dashboard to get real time access to the results. The dashboard
provides both a map of the providers and the statistics by location. These statistics
include number of facilities mapped, type of facilities mapped, highest mapped area,
highest performing field staff and graphs of all indicators under mapping activity
This application ensures smooth and timely communication and decision-making for
private providers, project managers and the field staff. At a later stage, there will be a
web-based interface.
The first phase of training the field staff on the application took place on March 8-10, 2017.
Image - A glimpse of the mapping Android application, being developed by Dure Technologies
Status update (including estimated date of completion):
30
5. Quarterly reporting on key mandatory indicators
Table 5.1 RR-/MDR-TB cases notified and started on MDR-TB treatment or shorter treatment regimens (STR) in country (national data) Quarter Number of RR-TB or MDR-TB cases
notified (3.1.4) Number of RR-/MDR-TB patients started on MDR-TB treatment (3.2.4)
Of which (3.2.4), number of RR-/MDR-TB patients started on STR (9.2.4)
Comments:
Total 2014 25,652 24,073 0 CTB’s formal request to the
RNTCP to provide quarterly data on MDR-TB was declined in the absence of a MoU for data sharing with CTB. As
advised, we will report on the data that is published in the annual report by RNTCP (usually in March for the previous year).
Total 2015 28,876 26,966 0
Total 2016 33,820 32,682 0
Jan-Mar 2017
Apr-Jun 2017
Jul-Sept 2017
To date in 2017
Table 5.2 Number of patients (eligibility based on WHO/NTP criteria) started on bedaquiline (BDQ) or delamanid (DLM) in country (national data) Quarter Number of eligible patients started on BDQ
nationwide (9.2.2) Number of eligible patients started on DLM nationwide (9.2.3)
Number of BDQ or DLM treatment initiation sites
Comments:
Adults (15 yrs. or>) Child (<15yrs) Adults (15 yrs. or>) Child (<15yrs)
Total 2014
Total 2015
Total 2016 226 0 0 0 6
Jan-Mar 2017 151 0 0 0 6
Apr-Jun 2017
Jul-Sept 2017
To date in 2017 377 0 0 0 6
Table 5.3. Indicator for active tuberculosis drug-safety monitoring and management (aDSM) Quarter Total number of reported serious adverse event (SAEs)
Disaggregate by: treatment regimen (STR, BDQ-containing regimen, DLM-containing regimen)
Number of reported SAEs which led to a death Disaggregate by: treatment regimen (STR, BDQ-containing regimen, DLM-containing regimen)
Comments:
Adults (15 yrs. or >) Child (<15yrs) Adults (15 yrs. or>) Child (<15yrs) Data are as reported by CTD. CTB does not have access to data on stratifications for SAEs or deaths.
Total 2016 24 0 5 0
Jan-Mar 2017 37 0 4 0
Apr-Jun 2017
Jul-Sept 2017
To date in 2017 61 0 9 0
31
Table 5.4 Number and percent of cases notified by setting (i.e. private sector, prisons, etc.) and/or population (i.e. gender, children, miners, urban slums, etc.) and/or case finding approach (CI/ACF/ICF) (3.1.1)
Reporting period
Comments
Jul-Sept 2016 Oct-Dec 2016 Jan-Mar 2017 Apr-Jun 2017 Jul-Sept 2017 Cumulative Year 3
Overall CTB geographic areas
TB cases (all forms) notified per CTB geographic area (List each CTB area below - i.e. Province name)
Delhi, Hyderabad, Chennai, Kolkata, Nagpur, Surat, Visakhapatnam,
Bangalore and Guwahati
TB cases (all forms) notified for all CTB areas 519 761 739
All TB cases (all forms) notified nationwide (denominator) N/A N/A N/A
% of national cases notified in CTB geographic areas N/A N/A N/A
Intervention (setting/population/approach)
Children (0-14)
CTB geographic focus for this intervention
Delhi, Hyderabad, Chennai, Kolkata, Nagpur, Surat, Visakhapatnam, Bangalore and Guwahati
TB cases (all forms) notified from this intervention 519 761 739
All TB cases notified in this CTB area (denominator) N/A N/A N/A
% of cases notified from this intervention N/A N/A N/A
32
6. Challenge TB-supported international visits (technical and management-related trips)
# Partner Name of consultant
Planned quarter Specific mission objectives
Status (cancelled, pending, completed)
Dates completed Additional Remarks (Optional)
Q1
Q2
Q3
Q 4
1 UNION WLC Travel - Year 2017: Project technical staff (5 no.s) participants
x 5 travels for WLC - PD, Deputy PD + 3 CTB staff
Pending N/A
2 UNION 1. Kavita Ayyagari 2. Deputy PD (to be hired) 3. Lopamudra Paul
X 3 participants for CD meeting
Pending Lopamudra Paul Attended M&E training organized by KNCV, March 13-17, Hanoi, Vietnam (This is replacement
of CD meeting)
3 UNION 1. Kavita Ayyagari 2. Deputy PD (to be hired) 3. Jamhoih Tonsing
X 1. 3 participants to Technical meetings on TB/ HIV technical meeting travel,( including one
day with the UNION and PMU on project Challenge TB)
Pending N/A
4 UNION 1. Kavita Ayyagari
2. Deputy PD (to be hired)
3. Neerja Arora
International
courses/trainings/ conferences
Pending N/A
5 UNION 1. Riitta Dlodlo 1 monitoring visit from Union HQ
Pending N/A
6 PATH Dr Shibhu Vijayan x Country Directors Meeting- 1 travel
Pending
7 PATH Amelia Kinter X Program Officer to support Community
Mobilization activities development and implementation planning
Complete Ms. Kinter traveled to Mumbai from
February 26-March 10 and was in Delhi from March 10-March 18.
33
8 PATH Lal Sadasivan Partner Representative for IMA meetings
development and review of progress for capacity building
Pending N/A
9 PATH Moe Moore X 1 travel engaging the project staff and orient to managing CTB India funding for staff across
India.
Complete Mr. Moore was originally schedule to travel to India from March 19-
March 24; but due to inclement weather which delayed his flights he traveled from April 2-April 8, 2017
10 KNCV 4 STTA Fraser Wares
X X X X STTA for Fraser Wares - PMDT review meetings and introduction TA on
BDQ / shorter regimen from KNCV / UNION
Pending Q2 (28th March to 4th April 2017)
Dr. Fraser Wares visited India with specific objective to Assess progress in introduction
of bedaquiline for drug-resistant TB in two BCAP implementing sites in Delhi, India
Review and discuss the progress in introduction of new drugs and regimens for DR-TB patients in India with RNTCP officials, USAID and the Union
11 PATH-PEPFAR
Jalpa Thakker X UNION Conference Complete Jalpa Thakker
Attended M&E training organized by KNCV, March 13-17, Hanoi, Vietnam (Will be MOT from savings)
12 PATH-PEPFAR
Syed Imran Farooq X UNION Conference Pending
13 PATH-PEPFAR
Lal Sadasivan X 1. Review program
activities and implementation. 2. Collaborate with Government officials
3.Provide technical
Complete February 01-10,
2017
Dr. Sadasivan completed his
travel in February 01-10, 2017.
34
assistance to improve activities and identify
next steps
14 PATH-PEPFAR
Amelia Kinter X 1. Work with team in scaling-up program activities to greater geographical areas
2. Collaborate with government officials
3. Provide technical support in reviewing current data on cases and identify areas to expand
Pending
Total number of visits conducted (cumulative for fiscal year) 6
Total number of visits planned in approved work plan 27
Percent of planned international consultant visits conducted 22.2%
35
7. Quarterly Indicator Reporting
Sub-objective: 2. Comprehensive, high quality diagnostics
Performance indicator Disaggregated by
Frequency of collection
Baseline (timeframe) End of year target Results to date (Jan-Mar, 2017) Comments
2.1.2. A current national TB
laboratory operational plan exists and is used to prioritize, plan and implement interventions.
None annually 2 (Lab Operational Plan Available)
Not Applicable (CTB is not
working on this area)
N/A
2.2.6. Number and percent of laboratories
performing C/DST that are implementing a
laboratory quality management system (LQMS).
None annually 100% (33/33) per RNTCP LQMS. National LQMS
does not involve use of GLI/SLMTA scoring system.
There are 6 NRLs and 27 NRLs. Lab quality control guide line is available at http://tbcindia.nic.in/pdfs/RNTCP%20
Lab%20Network%20Guidelines.pdf
Not Applicable (CTB is not working on this area)
N/A
2.2.7. Number of GLI-approved TB microscopy network standards met
None annually Not Applicable (RNTCP has its own certificate system)
Not Applicable (CTB is not working on this area)
N/A
2.3.1. Percent of TB cases tested for RR-/MDR-TB
Partner/CTB area
annually 29% (255897/878947)
in 2015 *
Numerator: Cases tested for RR/MDR-TB =
Total: 70,000 The Union:15,000
GeneXpert tests
through private sector providers in Axshya areas
FIND sites : 20,626 (Oct 2016
to Mar 2017)
10792 tested between Jan-Mar 2017
36
255,897 Denominator:
878,947 (754,268 among new + 124,679 among relapse cases) *Source: WHO Global TB report
2016
CTB areas: The Union=0 PATH=0 FIND=15347 (Oct2014-Sept2015)
PATH: 5000 MDR TB cases will be
tested FIND: 50,000 pediatric cases will be tested
2.4.3. MTB positivity rate of Xpert test results
For CTB areas only
quarterly 7.80% 8% 6.8%
2.4.4. Rifampicin resistance rate of Xpert test results
For CTB areas only
quarterly 8% 8% 9.2%
2.4.5. % unsuccessful Xpert tests
For CTB areas only
quarterly <1% <1% <0.5%
2.4.6. #/% of new TB cases diagnosed using GeneXpert
For CTB areas only
quarterly 4000 1500 (37.5%)
(739 in Jan-Mar 2017 +
761 in Oct-Dec 2016)
2.4.8. INDIA
SPECIFIC: % of TB patients diagnosed using GeneXpert residing within project area,
initiated on treatment
For CTB areas only
quarterly 82% 85% 89.2%
2.4.10. INDIA
SPECIFIC: # of
For CTB quarterly 575 2000 1106
37
Sub-objective: 3. Patient-centered care and treatment
Performance indicator Disaggregated by
Frequency of collection
Baseline (timeframe) End of year target Results to date Comments
3.1.1. Number and percent of cases notified by setting (i.e. private sector, pharmacies, prisons, etc.) and/or
population (i.e. gender, children, miners, urban slums, etc.) and/or case
Total TB case notified in 2015= 902732 * Of total cases notified by Private sector= 184802
Source: RNTCP Annual Report 2016
1,650,000 (RNTCP NSP target)
2,109 TB cases were diagnosed from PPIA sites at 24 private facilities from Oct 2016 to March 2017
These numbers are from PPIA project implemented by PATH in Mumbai. The numbers are notified from 24 private facilities from Oct 2016 to March 2017
referring health facilities linked per diagnostic centre
areas only
INDIA Specific # of FIND sites transitioned to NTP
For CTB areas only
quarterly 0 9 4 •
INDIA Specific # ICT innovations developed
For CTB areas only
annually N/A 1 0
2.6.1. Average turnaround time from specimen
collection/submission to delivery of result to the patient (stratified by microscopy, Xpert, culture, DST)
For CTB areas only
quarterly 2 days 1 day 1 day
2.6.2. % of
laboratory results disseminated via m-health or e-health systems to the provider
For CTB areas only
quarterly 100% 100% 100%
38
Sub-objective: 3. Patient-centered care and treatment
Performance indicator Disaggregated by
Frequency of collection
Baseline (timeframe) End of year target Results to date Comments
finding approach
3.1.4. Number of RR-TB or MDR-TB cases notified
Annually Total No. of MDR-TB cases detected in 2016=33820. Source: Annual
Report RNTCP 2017. (Note: information on bacteriologically diagnosis is not available)
Not Available (NSP target only for cases tested and initiated
treatment)
3.2.1. Number and percent of TB cases successfully treated (all forms) by setting
(i.e. private sector, pharmacies, prisons,
etc.) and/or by population (i.e. gender, children, miners, urban slums, etc.).
No. of TB cases successfully treated (all form)= 1,035138 (88.9%)
, Source: RNTCP Annual Report
2016
88% (RNTCP NSP target)
NA Annually
3.2.4. Patients started on MDR-TB treatment
Gender & Age
annually Total No. of MDR-TB cases initiated
treatment in
2016= 32682. Source: RNTCP Annual Report 2017 PATH: District level baseline figures (public sector
numbers) will be added after the
project activities begin and PATH engages with the public sector at
30,000 (RNTCP NSP target)
PATH: 180 DR-TB
patients to be started on treatment by linking to public sector DR-TB centers. The Union: Target
= 600
NA DRTB patients put on
treatment from March 23rd
2017: Male: 6 Female: 6 Total: 12 Age: 0: 0
5-9: 1 10-14: 0
15-19: 2 20:24: 3 >25: 6
39
Sub-objective: 3. Patient-centered care and treatment
Performance indicator Disaggregated by
Frequency of collection
Baseline (timeframe) End of year target Results to date Comments
site level. Public sector figures will be used as baseline since
currently the selected districts
(barring Mumbai) have no private sector engagement for RR-TB. The Union:
Baseline =0
3.2.5. # health facilities w/ PMDT services
none annually NA
3.2.7. Number and percent of MDR-TB
cases successfully treated
6750/19298 (35%). Source:
RNTCP Annual Report 2016 PATH: NA
55% (RNTCP NSP target)
PATH: N/A. PATH will track, through the course of project all DR-TB patients linked on treatment to public sector. Numbers
successfully
treated cannot be defined here since the treatment for DR-TB continues for 2 years. PATH will report the
figures that public sector will make available
NA
3.2.8. #/% of PMDT
sites reporting on
treatment cohort status quarterly
6 20 6
40
Sub-objective: 3. Patient-centered care and treatment
Performance indicator Disaggregated by
Frequency of collection
Baseline (timeframe) End of year target Results to date Comments
3.2.9. % of MDR-TB patients still on treatment and culture negative 6
months after starting MDR-TB treatment
N/A annually N/A As per figures available from public sector. Cohort reports are
available in public sector on an
annual basis
N/A
3.2.22. #/% of TB patients followed by
community-based workers/volunteers during at least the intensive phase of treatment
N/A 180 DR-TB patients linked to
public sector for treatment will be followed by community based workers
NA
3.2.24. % MDR
patients who receive social or economic benefits
age and gender
55 DR-TB patients
(that is 30% of total DR-TB
patients linked for treatment to public sector) will be enlisted on the existing public social benefit schemes to
support and
empower the community. This will be achieved by supporting the DR-TB patients for all necessary
processes to avail the socio-economic benefits and by mobilizing the
state level officials for coordination
between various departments and
Profiling for eligibility of all
16 DR-TB patients have been conducted for
establishing linkages to social schemes
Linkages to social schemes will be established in the next quarter, The patients were initiated on treatment from March 23rd 2017
onwards, which gives the project 7 days for the first patient initiated
41
Sub-objective: 3. Patient-centered care and treatment
Performance indicator Disaggregated by
Frequency of collection
Baseline (timeframe) End of year target Results to date Comments
ministries and increasing awareness in the community of the existing schemes
Carry forward from year 2
Sub-objective: 3. Patient-centered care and treatment
Performance indicator
Disaggregated by
Frequency of collection
Baseline (timeframe)
End of year target Results to date Oct 2016 – Mar 2017
Comments
3.2.4. Patients started on MDR-TB treatment
Gender & Age
annually Total No. of MDR-TB cases initiated treatment in 2015= 26,966. Source: RNTCP Annual Report 2016 PATH: District level baseline figures (public sector numbers) will be added after the project activities begin and PATH engages with the public sector at site level. Public sector figures will be used as baseline since currently the selected districts (barring Mumbai) have no private
30,000 (RNTCP NSP target) PATH: 180 DR-TB patients to be started on treatment by linking to public sector DRTB centers. The Union: Target = 600
Annual
42
Sub-objective: 3. Patient-centered care and treatment
Performance indicator
Disaggregated by
Frequency of collection
Baseline (timeframe)
End of year target Results to date Oct 2016 – Mar 2017
Comments
sector engagement for RR-TB. The Union: Baseline =0
3.2.9. % of MDR-TB patients still on treatment and culture negative 6 months after starting MDR-TB treatment
N/A annually N/A As per figures available from public sector. Cohort reports are available in public sector on an annual basis
3.2.22. #/% of TB patients followed by community-based workers/volunteers during at least the intensive phase of treatment
N/A 180 DR-TB patients linked to public sector for treatment will be followed by community based workers
3.2.24. % MDR patients who receive social or economic benefits
age and gender
55 DR-TB patients (that is 30% of total DR-TB patients linked for treatment to public sector) will be enlisted on the existing public social benefit schemes to support and empower the community. This will be achieved by supporting the DR-TB patients for all necessary processes
43
Sub-objective: 3. Patient-centered care and treatment
Performance indicator
Disaggregated by
Frequency of collection
Baseline (timeframe)
End of year target Results to date Oct 2016 – Mar 2017
Comments
to avail the socio-economic benefits and by mobilizing the state level officials for coordination between various departments and ministries and increasing awareness in the community of the existing schemes
PEPFAR Indicators: Carry forward from year 2
Sub-objective: 3. Patient-centered care and treatment
Performance indicator Disaggregated by
Frequency of collection
Baseline (timeframe) End of year target Results to date Oct 2016 – Mar 2017
Comments
3.1.4. Number of
MDR-TB cases detected
None Quarterly
and Annually
National
level(Annually): Total no. of MDR-TB cases detected in 2014= 24,073. Source: Annual report RNTCP 2015 (Note: information
on bacteriologically diagnosis is not available)
PATH project sites: 329 (July-Sept
2015)
National Level
(Annually): Not Available(NSP targets only for cases tested and initiated on treatment)
PATH project sites: 160
PATH project sites: 949
RR-TB cases were notified
These numbers are from PPIA
project implemented by PATH in Mumbai. The numbers are notified from 24 private facilities from Oct 2016 to March 2017
44
3.1.5. #/% health facilities
implementing intensified case finding (i.e. using SOPs)
Private Health care
Facility
Annually Not Available 24 24
3.2.1. Number and
percent of TB cases successfully treated
(all forms) by setting (i.e. private sector, pharmacies, prisons, etc.) and/or by population (i.e.
gender, children, miners, urban slums, etc.).
None Annually National
level(Annually): No. TB cases
successfully treated (all form) = 1084185 (88.3%); Source: RNTCP annual
report 2015.
National
level(Annually): 88% (RNTCP NSP
target)
Annually notified
3.2.4. Number of MDR-TB cases
initiating second-line treatment
None Quarterly and
Annually
National level(Annually):
Total No. of MDR-TB cases initiated treatment in 2014= 24073. Source: RNTCP annual report 2015.
National level(Annually):
30,000 (RNTCP NSP target)
Annually notified
3.2.7. Number and percent of MDR-TB
cases successfully treated
None
Annually 3486/7289 (48%) Source: RNTCP
annual report 2015.
55% (RNTCP NSP target)
Annually notified
3.2.5. # health facilities w/ PMDT services
None Annually 127. Source: RNTCP Annual Report 2015
NA
3.2.26 INDIA SPECIFIC (new as of
Q2): Number of TB patients tested for HIV
Quarterly N/A Results of TB/HIV Oct 2016 to March 2017
PATH project sites:
By gender: Male=837 Female= 872
45
By Age: 0-4= 6
5-9 years=11 10-15 years=85 15-19 years=287 20 and above=1,320 HIV status:
HIV positive=30
HIV negative=1,679 Total TB patients tested for HIV: 1,709
Sub-objective: 5. Infection control
Performance indicator
Disaggregated by
Frequency of collection
Baseline (timeframe)
End of year target Results to date Comments
5.2.3. Number and % of health care workers diagnosed with TB during reporting period
None annually Not Applicable (CTB is not working on this area)
Not Applicable (CTB is not working on this area)
N/A
Sub-objective: 6. Management of latent TB infection
Performance indicator
Disaggregated by
Frequency of collection
Baseline (timeframe)
End of year target Results to date Comments
6.1.11. Number of children under the age of 5 years who initiate IPT
none annually Not Applicable (CTB is not working on this area)
Not Applicable (CTB is not working on this area)
N/A
Sub-objective: 7. Political commitment and leadership
Performance indicator Disaggregated by
Frequency of collection
Baseline (timeframe) End of year target Results to date Comments
7.2.3. % of activity budget covered by
none annually 25% cost share for materials
N/A
46
Sub-objective: 7. Political commitment and leadership
Performance indicator Disaggregated by
Frequency of collection
Baseline (timeframe) End of year target Results to date Comments
private sector cost share, by specific activity
developed / aired
7.2.9. INDIA SPECIFIC: # stories
in media
none quarterly 500 stories covered in media
Total (Oct 2016-Mar 2017) =152
Total Facebook fan ( Mar 2016-Mar 2017) :2,20,234
Total No. of twitter followers ( Sept 2015-Mar2017) : 4762
Q1 (Oct-Dec, 2016) Total 86 (Print: 3 and Online 83)
Facebook page (https://www.facebook.com/ForTBFreeIndia/): 7428 new fans added Q2 (Jan- Mar, 2017) Total: 66 (Print: 1 and Online 65)
Facebook page (https://www.facebook.com/ForTBFreeIndia/): 2892 new fans
added Twitter (@TBFreeIndia) followers (new): 50
7.2.10. INDIA SPECIFIC: # of content/ materials developed and disseminated with Challenge TB support
that are in line with
the campaign strategy
none quarterly 10 materials developed for campaign
Total (Oct 2016-Mar 2017) = 51 Electronic (Film, digital
films & videos): 11 Social media (facebook
& twitter: 18
Print (postcard, print Ad, outdoors, standees, handouts, calendar): 22
Q1 (Oct-Dec, 2016) One Short Film (4.50 min) by
Mr. Amitabh Bachchan for WLC, 2016
One Invite Postcard for Symposium at WLC, 2016
Facebook and Twitter
Posts: 8 posts with graphics 4 Videos of TB champions (2
min): Amitabh Bachchan on his experience being a TB survivor ; Dr Naresh Trehan; Prof PJ Kurien; Ms Viplove
Thakur Q2 (Jan- Mar, 2017) 4 Videos of Amitabh
Bachchan
Digital films-2 Print Ads-9
Outdoors-8 Standee-2
47
Sub-objective: 7. Political commitment and leadership
Performance indicator Disaggregated by
Frequency of collection
Baseline (timeframe) End of year target Results to date Comments
Handouts-1 (TB information:4 pager)
Facebook and Twitter posts -10
Calendar - 1
7.2.13. INDIA SPECIFIC: India TB caucus has representation from Indian Parliamentarians
None annually 0 1 (Indian TB caucus formed)
India TB caucus formed The India TB Caucus launched on 8 March 2017 in New Delhi. The India TB Caucus, part of the Global TB Caucus will work collectively and individually to End TB in India. 26MPs and MLAs signed
declaration and joined the caucus. (details section 1 under 7.2.2 h)
7.2.14. INDIA SPECIFIC: Private
sector partnerships to implement TB program
none annually 12 TA to 12 partners N/A
Sub-objective: 8. Comprehensive partnerships and informed community involvement
Performance indicator Disaggregated by
Frequency of collection
Baseline (timeframe) End of year target Results to date Comments
8.1.3. Status of
National Stop TB Partnership
None annually 0 Not Applicable
(CTB is not working on this area)
N/A
8.1.4. % of local partners' operating budget covered by diverse non-USG
funding sources
none annually TBD TBD N/A
8.2.1. Global Fund grant rating
none annually B1 A1 A1
48
Sub-objective: 9. Drug and commodity management systems
Performance indicator Disaggregated by
Frequency of collection
Baseline (timeframe) End of year target Results to date Comments
9.1.1. Number of stock outs of anti-TB drugs, by type (first and second line) and level (ex, national,
provincial, district)
none annually "Not Applicable (CTB is not working on this area)"
Not Applicable (CTB is not working on this area)
N/A
9.2.2. Number of patients (eligibility based on WHO/NTP criteria) started on bedaquiline
National and 20 CTB sites
quarterly BL = 0 as First patient was started on BDQ in June 2016.
1,600 (end of 2017)
Total (Oct, 2016-Mar, 2017)=377 Q1 (Oct-Dec, 2016)=226 Q2 (Jan-Mar, 2017)= 151
Sub-objective: 10. Quality data, surveillance and M&E
Performance indicator Disaggregated by
Frequency of collection
Baseline (timeframe) End of year target Results to date Comments
10.1.4. Status of electronic recording and reporting system
None annually Indicator value=3, In India it is known as 'Nikshay'. Source: RNTCP Report 2016
Not Applicable (CTB is not working on this area)
N/A
10.2.1. Standards
and benchmarks to certify surveillance systems and vital registration for direct measurement of TB burden have been implemented
None annually No (RNTCP has no
plans for certifications of Surveillance system)
Not Applicable
(CTB is not working on this area)
N/A
10.2.6. % of
operations research
project funding provided to local partner (provide % for each OR project)
None annually 0 (no OR funding
provided to local partners)
Not Applicable
(CTB is not
working on this area)
N/A
49
Sub-objective: 10. Quality data, surveillance and M&E
Performance indicator Disaggregated by
Frequency of collection
Baseline (timeframe) End of year target Results to date Comments
10.2.7. Operational research findings are used to change policy or practices
(ex, change guidelines or
implementation approach)
None annually Not Applicable (no OR done)
Not Applicable (CTB is not working on this area)
N/A
Sub-objective: 11. Human resource development
Performance indicator Disaggregated by
Frequency of collection
Baseline (timeframe) End of year target Results to date Comments
11.1.3. Number of
healthcare workers trained, by gender and technical area
Gender &
Technical Area
annually 20 25 0
11.1.5. % of USAID TB funding directed to local partners
None annually 22% 40% N/A