ASD - PAKISTAN

Monitoring TB programme performance in Pakistan

In Pakistan, the quality of supervision and monitoring of tuberculosis care in health facilities is poor. Quarterly monitoring meetings held at the district, provincial and national levels, have sub-optimal impact on the quality of TB care because of their unclear objectives, processes and tools. This study was therefore aimed to develop an improved system of monitoring and supervision for the public health system in Pakistan. This project developed a systematic and linked process of supervision and monitoring at four levels of the health system. A set of procedures and tools were developed to evaluate, revise and be made available to the National TB Programme for nationwide replication after piloting their effectiveness. The new methods of monitoring and supervision were tested using a set of feasibility and effectiveness indicators selected in consultation with NTP and district partners. A mix of qualitative methods, including participant observation, record review and interviews, were used to gather the required data on these selected indicators. A total of 150 cluster meetings, 20 intra-district monitoring meetings, two provincial and two national level monitoring events with health workers were conducted to evaluate the feasibility and effectiveness of the study tools.