تعليقMonitoring, evaluation and review provide the means to assess the quality, effectiveness, coverage and delivery of collaborative TB/HIV activities. It promotes a learning culture within and across programmes and ensures continuous improvement of interventions. Evidence from operational research (130, 131) has shown the importance of standardized monitoring and evaluation of collaborative TB/HIV activities to determine the impact of the activities and to ensure implementation and effective programme management. This section provides a brief overview of the monitoring and evaluation actions to support the implementation of collaborative TB/HIV activities. The section on HIV-associated TB within the accompanying operational handbook on TB and comorbidities provides further details, including a list of currently recommended core indicators to monitor collaborative TB/HIV activities (7). These indicators are drawn from WHO’s guidance on TB surveillance ([WHO Consolidated guidance on tuberculosis data generation and use. Module 1 – tuberculosis surveillance], [WHO], in press [2023]) and from the WHO guidance on HIV strategic information (132). Further indicators can be found in A guide to monitoring and evaluation for collaborative TB/HIV activities - 2015 revision (133).
The monitoring and evaluation system for collaborative TB/HIV activities should be based on a strategy that includes clear goals, targets and guidelines for implementation of activities, as well as specific indicators to measure progress. It should also include plans for data collection and management, analysis and dissemination, and use of results for programme improvement (133). Recording and reporting formats for HIV-associated TB should be standardized and aligned with existing monitoring and surveillance systems. Standardized indicators should be measured regularly, in both the private and public health sectors, to inform decision-making for programme implementation. Electronic health records and the use of unique identifiers can greatly enhance recording and reporting processes, facilitate analysis and minimize duplication (132).
The national TB/HIV coordination mechanism plays a vital role in coordinating monitoring and evaluation, as well as in convening stakeholders for regular review at all levels of the healthcare system. The review process should include steps to (i) convene a body of stakeholders to review data at specified intervals; (ii) develop simple, standard core analysis plans for routinely collected data; (iii) adjust service delivery, supervision and resource allocation according to review findings and conclusions; and (iv) track the effect of these adjustments by ongoing regular review. The frequency with which reviews are carried out will vary with level of the healthcare system; at facility level, reviews should be conducted at least monthly, while at national level, reviews may be conducted quarterly or annually (132).
