Ten Steps to Develop National Strategic Plans that Work

Tuberculosis (TB) is a global health crisis. Over 10 million people fell ill with TB and 1.5 million died in 2020, according to the World Health Organization (WHO). Despite progress in reducing TB rates, the COVID-19 pandemic has disrupted TB prevention, diagnosis, and treatment services, leading to an expected increase in TB cases. To address this problem, it’s essential to develop effective National Strategic Programs (NSPs) for TB control and strengthen Global Fund applications. Use the people-centred Framework (PCF) approach to achieving this.

1. NSP Roadmap: Agree on activities, timelines, and funding sources: To develop an effective NSP for TB control, agree on the activities, timelines, and funding sources for the program. This involves assessing the current TB situation in the country, including the epidemiology of the disease, the existing TB control measures, and the available resources. Use this information to create a comprehensive plan of action that outlines specific activities, timelines, and funding sources needed to achieve the goals of the NSP.
2. Data Consolidation: Consolidating data is an important step in the PCF approach. It involves collecting and analyzing data from various sources to gain a comprehensive understanding of the TB situation in the country. This data includes information on TB incidence, mortality, and treatment outcomes, as well as data on the performance of the existing TB control measures. Identify gaps in service delivery and target interventions where they are most needed. Use an analytical framework such as the PCF dashboard to examine the data and indicators thoroughly, interpret the data, and turn it into evidence.
3. Program Evaluation: Use the evidence to evaluate the effectiveness of the existing TB control measures and identify areas for improvement.
4. Consultative Workshop: Organize a stakeholder consultative workshop to gather stakeholder consensus on the evidence collected along the care continuum. Use this information to prioritize problems, identify causes, and optimize interventions. Include representatives from different sectors, such as healthcare providers, community groups, and government agencies, to ensure a wide range of perspectives is considered.
5. Sub-national Validation and Planning: To develop effective interventions and collect information on gaps in service delivery along the care continuum. Focus on specific themes and compare sub-national levels within a template you can compile and review later. Identify areas where interventions are most needed and target resources where they will have the most significant impact.
6. Intervention Costing: Identifying the unit costs of interventions is an essential step in the PCF approach. Use the revised Integrated Health Tool (IHT) (ongoing by WHO) or custom excel tools to determine the unit costs. Use these unit costs as building blocks for the overall cost of the NSP.
7. Intervention Optimization: Once you have identified the unit costs of the interventions, create an investment business case by modeling the impact and cost of the prioritized interventions for optimization. Use simple modeling tools to do this. This will help identify the most cost-effective interventions and target resources where they will have the greatest impact.
8. NSP Writing: Once you have consolidated, analyzed, and reviewed the data, and consulted with stakeholders, take the next step to support the writing or updating of the NSP. This process should include the evidence, findings, and prioritizations along the care continuum. The National Tuberculosis Program (NTP) should lead this process, taking into account the specific TB situation in the country, as well as the goals and objectives of the NSP. The NSP should include detailed information on the interventions to be implemented, the expected impact of the program, and the resources required to implement the program. It should also have a monitoring and evaluation plan to track the program’s progress and make adjustments as necessary. The NSP should be written clearly and concisely and easy to understand by a wide range of stakeholders, including policymakers, healthcare providers, and community groups.
9. National Consensus & Endorsement: Once the NSP has been written, it is crucial to support the National Tuberculosis Program (NTP) in summarizing the NSP and translating it for a wider non-technical audience. This will help to ensure that the NSP is easily understandable and can be effectively communicated to a wide range of stakeholders, including policymakers, healthcare providers, and community groups.
10.  Global Fund Application: Finally, supporting the writing of the Global Fund application to include the evidence, findings, and prioritizations along the care continuum is an essential step in the PCF approach. This process should also be led by the NTP and should include information on the need for funding, the proposed interventions, and the expected impact of the program. This makes for a strong application.