COUNTRY LOCATOR - INTERMEDIATE RESULTS

Intermediate Results

TB CAP will achieve its objectives by focusing on five key components the so-called intermediate results (IRs):

• IR 1: Increased political commitment for DOTS (as a response to weak or wavering political commitment). TB CAP ’ s strategic approach is to create an enabling policy environment for TB control. Under this IR, TB CAP aims to increase the number of countries where appropriate level of government funding is sustained and political legal frameworks ensured.
• IR 2: Strengthened and expanded DOTS programs (as a response to weak laboratory services, failure of drug supplies, inconsistent drug quality and inadequate drug policies, poor monitoring and evaluation). DOTS expansion to improve access to timely and quality assured diagnosis and treatment is a strategic approach of TB CAP. This will be achieved by improving laboratory systems, community-based DOT, PPM, and DOTS+.
• IR 3: Increased public and private sector DOTS participation and collaboration (as a response to failure to engage private practitioners and other public providers in DOTS). TB CAP aims to increase NTP coordination and collaboration with public and private sectors. The strategic approach of TB CAP is to work in close collaboration with The Stop TB Partnership's global PPM DOTS sub group. This collaboration will provide an overall global strategic framework for public and private participation (PPP) activities and help to develop generic tools and guidance to assist TB CAP countries as well as other countries.
• IR 4: Increased and strengthened TB and HIV/AIDS coordinated activities (as a response to absence of effectively coordinated TB-HIV/AIDS programs and ineffective program coordination). TB CAP aims to improve national policies and coordination between National TB and HIV programs and improve access to HIV and TB services for HIV positive TB patients and persons living with HIV. TB CAP’s main strategy for achieving these expected results is to work with national governments and partners to improve the policy environment for coordinated TB and HIV/AIDS activities. TBCTA sees its role as a catalyst acting in a complementary manner to influence policy and practice through promotion and training, while leveraging resources for funding the HIV/AIDS care services required for TB patients
• IR 5: Improved human and institutional capacity (as a response to lack of qualified staff and lack of management skills at all levels). TB CAP views Human Resource Development (HRD) as an essential component of any comprehensive TB control strategy to achieve and sustain the global TB control targets and reach the Millennium Development Goals (MDGs). TB CAP aims to improve competence and availability of staff in countries at different levels of the health system and will focus both on improving human resource capacity and improving institutional capacity. The ultimate goal of HRD for comprehensive TB control is to ensure that:

1. Staff at different levels of the health system has the skills, knowledge, attitudes (professional competence) and motivation, necessary to successfully plan, implement, evaluate and sustain comprehensive TB control services including the implementation of new and revised strategies and tools and in relation to HIV and MDR TB management
2. There is a sufficient number (relative to the overall human resources available in a country) of all staff categories involved in comprehensive TB control (clinical and managerial) at all levels of the health system with the needed support systems to motivate staff to use their competencies to provide quality preventive and curative services for all aspects of comprehensive TB control to the entire population according to their needs.

For these intermediate results mentioned above the following measurable outputs have been identified;

IR	Expected Outputs
1 Increased Political Commitment for DOTS	Sustained appropriate level of government funding Ensured political legal framework
2 Strengthened And Expanded DOTS programs	Strengthened TB program leadership and management Strengthened integration of DOTS services in general health services Improved diagnostic capacity Strengthened culture and DST Strengthened sputum smear microscopy Improved quality of chest x-ray diagnosis Improved prevention and management of MDR TB Improved equitable access to quality TB care for vulnerable populations
3 Increased public and private sector DOTS participation and collaboration	Increased NTP coordination and collaboration with public and private sectors
4 Increased and strengthened TB and HIV/AIDS coordinated activities	Improved national policies and coordination between National TB and HIV programs Improved access of HIV positive TB patients to HIV services Improved access of persons living with HIV to TB services
5 Improved human and institutional capacity	Improved competence of staff at different levels of the health system Improved availability of staff of all categories involved in comprehensive TB control

TB CA ’s main strategy is to develop knowledge and expertise by building capacity, designing and adapting new tools, guidelines, methods and approaches using core funded projects and then gradually shifting and implanting this knowledge into TB CAP and other USAID priority country programs. TB CAP has focused on five key strategies:

1. Address the needs and priorities of USAID missions and regional bureaus to scale up country programs by adapting TBCT ’s successful model to individual needs.  
2. Provide Global Leadership as a strategy for non-country specific funded activities.
3. Leverage resources to increase impact using TBCT ’s reputation and global network and by expanding TB program partners.
4. Integrate TB control into country-level health strengthening programs.
5. Provide Global Leadership to to all TB programs, encouraging them to include gender considerations and gender equity in their program planning and evaluation systems

The figure below illustrates TB CAPs vision towards achieving the goals and IRs.

TB CAP Conceptual Framework