The authors present a framework for assessing levers used in implementing communicable disease control programs within changing health systems, and aims to assist those designing future interventions. This framework was developed based on lessons learned from tuberculosis control components of health projects financed by the World Bank as well as other recent experiences in launching and/or expanding the WHO-recommended DOTS (Directly-observed Treatment, Short-course) strategy in high-prevalence countries. Demographic and health system variables, TB control program characteristics, partnerships and use of incentives are examined and compared. The authors suggest that the operational strategies used to draw on health system strengths or compensate for system weaknesses may be as important to articulate and promote as the technical strategy. Some key issues considered include the relationship between referral and primary care facilities, as well as incentives required in decentralized or partially privatized systems. The authors conclude with recommendations for how global efforts, including the Stop TB Initiative, can improve critical analysis of strategies and knowledge sharing.
Learning Objectives: N/A
Keywords: Tuberculosis,
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.