|ASSESSMENT AND MONITORING OF NATIONAL TUBERCULOSIS
|SS Nair: Indian J TB 1971, 18, 131-34.
Assessment of a programme is the measurement of
the extent to which its objectives have been fulfilled. This may
be called assessment of efficacy. For this the objectives
have to be defined in quantifiable terms i.e., the extent and period
of time problem of tuberculosis will be reduced. This is yet to
be done for the National Tuberculosis Programme (NTP). Assessment,
of efficacy is difficult as the impact of Tuberculosis Programme
is felt only after a fairly long period of time during which other
socio-economic factors etc., also influence the problem. Any early
assessment of problem reduction will only be a very costly attempt
at proving the obvious and will possibly lead to frustration. Hence,
a different methodology of assessment has to be adopted.
Assessment of Efficiency: Measurement of the extent
to which the expectations for various activities under the programme
are being fulfilled is referred to as assessment of efficiency.
This seems to be a practicable solution to the problem of assessment
of NTP. Realistic expectations for output and coverages under
different activities can be set up on the basis of potentials on
one hand and performance of programmes with reasonable efficiency
on the other. Achievements of the programme could then be matched
against these expectations. There is a need to define stages of
programmes as different districts will have the programmes developed
to different levels. Any overall assessment of such a heterogeneous
programme situation may give a confusing picture. Advantages of
this method are; i) number of districts which qualify to do from
one stage to other will itself indicate the progress achieved; ii)
after assessment attention can be concentrated on the corrective
actions required. A detailed stage by stage assessment could
be supplemented by monitoring i.e., a continuous watch on
some key indices of the programme calculated from the periodic reports.
This requires reasonably efficient reporting machinery. The key
indices are: i) achievement of activities: Case-finding, treatment
completion and BCG vaccinations against the expectations; ii) contribution
from Peripheral Health Institutions; iii) No. of cases diagnosed
against the prevalence of cases in the district.
Assessment should be objective enough to inspire
confidence and its findings should be accepted or at least appreciated
by the persons in-charge of the actual functioning of the programmes.
For this, a proper climate for assessment should be created so that
assessment is welcomed by programme organisers and corrective actions
are taken soon after completion of assessment.
|KEY WORDS: ASSESSMENT, MONITORING CONTROL PROGRAMME.