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How to read this report

The report consists of two parts: one multi-country systems analysis with the key findings and recommendations, and much more detailed information on the individual countries. You may read through the first part of the report by scrolling down and selecting sections of the report while the second part can be accessed through the country report section at the top banner or by selecting the country flags.

Audience of this report

The primary audience of the report is the NTP and IT cells within the Ministry of Health of each country. The assessment report also targets a broader audience that includes donor organizations, implementation organizations, NGOs and CSOs, among others.

How it will benefit

National TB Program: Devise operational strategies to achieve real-time case-based surveillance and plan and advocate for resources.

Ministry of Health: Make policy decisions on integrated surveillance, data security, use of technologies and budgets.

Donors/Funding Organizations: Make high-impact investments for rapid transitions to real-time TB surveillance systems.

Country IT Teams/ Tech Solution Providers: Learn from best practices from all countries to further enhance existing digital offerings to countries.

Public Health Researchers: Better understand the data ecosystem in the countries that can be leveraged for epidemiological and other public health research.

Implementation Partners/NGOs: Converge different digital innovations being implemented by NGO partners to complement the existing national data ecosystem through integration and data harmonization.

Civil Society Partners /Advocacy/ CLM partners: Promote evidence-based CLM and advocacy by harnessing and integrating with national data systems.

The report has primarily divided into two parts, one a multi-country system analysis with the its key findings and recommendations and another part dwells deep into individual country digital TB surveillance status report.

You may read through the first part of the report by scrolling down and selecting sections while the second part can be accessed from the top banner tab or after the multi-country report section at the bottom of this web report.

The report has primarily divided into two parts, one a multi-country system analysis with the its key findings and recommendations and another part dwells deep into individual country digital TB surveillance status report.

You may read through the first part of the report by scrolling down and selecting sections while the second part can be accessed from the top banner tab or after the multi-country report section at the bottom of this web report.

The primary audience of the report is the National TB Program and IT cells within the Ministry of Health in each country. The assessment report also targets a broad group of audiences such as donor organizations, implementation organizations and NGOs, Civil Society organizations etc.

FOREWORD

Dr.Lucica Ditiu

Executive Director

Stop TB Partnership

The clock is ticking, and we are approaching the deadlines for the 2018 United Nations High-Level Meeting targets, the Sustainable Development Goals (SDGs) and End TB targets. The chaotic biennium of the COVID-19 pandemic has challenged the resilience of health systems since 2020 and has been partially responsible for slowing down the rapid progress in the TB response post-2015. However, the pandemic has also opened new doors in terms of the prevention of airborne infection, and peripheral availability of molecular diagnostics and facilities for differentiated care. It has also unveiled the highest political commitment of national governments and unprecedented global collaborations for health. I believe that the COVID-19 pandemic has demonstrated the power of the human race to conquer epidemics, and shown that funding can be made available and actions taken rapidly, if there is the will.

Since March 2020, we have had access like never before to data about the COVID-19 pandemic – people tested, diagnosed and cured, disaggregated by age, gender, small administrative units and so on. The daily reporting has been the most critical enabler of the global response to COVID-19.

For many years already, we at Stop TB Partnership have been of the strong belief that what we need to strengthen in our response is the availability of real-time temporospatial TB epidemiological information for precise, local rapid response with high-efficiency resource management and concurrent monitoring. It is encouraging to see that a small number of countries have started to report TB notification monthly and a few daily – we need many more.

Stop TB Partnership is working to contribute to and strengthen the TB response. One of the areas of interest is to strengthen the local TB surveillance systems to rapidly advance towards real-time, case-based and digital modes so that there is zero gap in timely information for action. The Global Fund, WHO and technical partners have been fortifying the Partnership’s efforts. It is therefore an amazing step forward for all partners to have the current assessment of real-time digital case-based TB surveillance systems in 19 priority countries in order to support these systems to rapidly evolve into perfect response-drivers. To the best of my knowledge, this is the first assessment of its kind, and it is encouraging for all of us to see that the local digital systems are at various stages of evolution, set out for the final war-room.

I want to thank the national leaderships for their vision, work and commitment to make their digital TB surveillance systems more sensitive, timely, intelligent and responsive, and I am looking forward to working together to use the latest available data and information for action. It is 2022 – we need rapid action based on reliable and timely information. We saw it done for COVID-19; we need the same approach for TB (as an airborne disease) and all infectious diseases.

MESSAGE

Marijke Wijnroks

Chief of Staff

The Global Fund

Real-time digital case-based surveillance systems play a key role in the proper management of people with TB across the continuum of care. They also ensure the timely availability of people-centric data that supports the monitoring of notification results and treatment outcomes, and facilitates prompt decision-making. The Global Fund recognizes this importance and, together with other donors, technical partners and stakeholders, has continuously supported ministries of health and national disease programmes to build and strengthen in-country digital surveillance systems.

Through the Global Fund Strategic Initiative on Data and in synergy with the TB Strategic Initiative, the Stop TB Partnership has assessed the TB surveillance systems in 19 of the 20 Global Fund high-priority TB countries, with a special focus on the real-time digital TB surveillance systems. Understanding the digital case-based TB surveillance systems and challenges in these 19 countries is critical, as they account for 82% of the TB burden and about 66% of the TB funding in Global Fund-supported countries in the 2020–2022 cycle.

It is our hope that the findings and recommendations from this assessment facilitate knowledge transfer between country programmes on the health and TB data needs, inform stakeholder collaboration and help to catalyse the progressive transition from paper-based to functional digital case-based surveillance systems in countries. The Global Fund also acknowledges the valuable role of the World Health Organization, Stop TB Partnership, and other technical partners and donors in moving this priority forward.

ACKNOWLEDGEMENT

This work was conceived and led by Sreenivas A Nair (Stop TB Partnership), supported by Shibu Balakrishnan (Consultant, Stop TB Partnership). Technical support was provided by the team led by Sabyasachi Das and supported by Shital Thakkar, Varun Chauhan, Viplove Dutta and Nida Yamin (Dure Technologies). The core advisory team for the project was made up of Nnamdi Nwaneri, Mohammed Yassin, Michelle Monroe (The Global Fund to Fight AIDS, Tuberculosis and Malaria), Sismanidis Charalampos (World Health Organization) and Viorel Soltan (Stop TB Partnership). The team acknowledges with gratitude the contributions from all national tuberculosis programme managers, monitoring and evaluation and digital surveillance team members, and partners from the 19 countries (listed in Annex 1) Andrei Mosneaga, Enos Masini, Thandi Katlholo and Caoimhe Smyth (Stop TB Partnership) facilitated interviews with country teams and Lalli Marek (World Health Organization) contributed to review of study protocol. The critical review was provided by Suvanand Sahu, Jacob Creswell and Zhi Zhen Qin (Stop TB Partnership), along with Puneet Dewan (Bill & Melinda Gates Foundation) and Kiran Rade (World Health Organization).

Funding support: The Global Fund - Data Strategic Initiative

About Stop TB Partnership

The Stop TB Partnership is a unique United Nations-hosted entity based in Geneva, Switzerland, committed to revolutionizing the TB space to end the disease by 2030. The Stop TB Partnership’s various teams and initiatives take bold but measured risks to identify, fund and support innovative approaches, ideas and solutions to ensure the TB community has a voice at the highest political levels and that all TB-affected people have access to affordable, high-quality and people-centred care. Learn more at www.stoptb.org

About The Global Fund Strategic Initiative

The Global Fund Data Strategic Initiative (Data SI) aims to improve monitoring and evaluation systems in countries, collection, collation, analysis and use of such data for decision-making and quality improvement. Stop TB Partnership (STBP) and WHO are among the implementers of this SI. As part of the first phase of this SI, STBP assess and report country status on availability, readiness and requirements for real-time case based TB surveillance system for TB in the 19 TB SI countries in consultations with NTPs/MOHs & in-country stakeholders, WHO and other relevant technical partners. This assessment will be followed with necessary facilitation for transition to digital real-time case based TB surveillance systems in the TB SI countries

NTP MANAGER VISION BOARD

The value for real time digital TB surveillance system is well accepted by all National TB programs across all 19 countries that were assessed. All 19 countries in their best capacity have created a TB surveillance platform. However, each country differs in terms of maturity of these tools and scale of implementation, which is a function of resource availability, access to existing digital ecosystem, political will and enabling digital environment. The map shows the level of maturity of the digital case based TB surveillance system in the 19 countries during the assessment period.

While countries like India and Philippines have fully matured TB digital surveillance systems in operation, Indonesia, Ukraine, Viet Nam, South Africa, Nigeria and Bangladesh have fairly advanced systems and with some additional efforts can quickly move to fully functional digital TB surveillance system. Cambodia, DR Congo, Kenya and United Republic Of Tanzania have digital case-based systems and with additional support for scale and IT support systems including data entry tools are on the way for a mature system. Countries like Cameroon, Ethiopia, Ghana, Mozambique, and Pakistan have a strong vision and political will for creating a comprehensive case-based TB surveillance system and need additional support in system development and scale up.

Composite Digital TB Surveillance Score

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Composite Digital TB Surveillance Score

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The designations employed and the presentation of the material on this map do not imply the expression of any opinion whatsoever on the part of the Stop TB Secretariat concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. White discontinuous lines are used to represent boundaries under dispute and to approximately show the line of control in Jammu and Kashmir agreed upon by India and Pakistan. The final status of Jammu and Kashmir has not yet been agreed upon by the parties. This map is based on UN Map No. 4170 Rev. 15 (July 2018). Every effort is made to ensure this map is free of errors but there is no warrant the map or its features are either spatially or temporally accurate or fit for a particular use. This map is provided without any warranty of any kind whatsoever, either express or implied.

Composite Digital TB Surviellance Score

09
16
24

Disclaimer

The designations employed and the presentation of the material on this map do not imply the expression of any opinion whatsoever on the part of the Stop TB Secretariat concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. White discontinuous lines are used to represent boundaries under dispute and to approximately show the line of control in Jammu and Kashmir agreed upon by India and Pakistan. The final status of Jammu and Kashmir has not yet been agreed upon by the parties. This map is based on UN Map No. 4170 Rev. 15 (July 2018). Every effort is made to ensure this map is free of errors but there is no warrant the map or its features are either spatially or temporally accurate or fit for a particular use. This map is provided without any warranty of any kind whatsoever, either express or implied.

Resource Library

Case-based TB surveillance. In: Global tuberculosis report 2021. Geneva: World Health Organization; 2021

Digital, case-based, real-time surveillance for TB: status of progress Tuberculosis (TB) surveillance is the continuous and systematic collection, analysis and reporting of data related to TB infection and TB disease in the population. To support countries to implement national surveillance systems for TB in a consistent and comparable way worldwide, the World Health Organization (WHO) has, since the mid-1990s, provided guidance with standardized definitions, forms, registers and reports (1). There were major updates to this guidance in 2006 (2) and 2013 (3).

Read More
Agarwal S, Jalan M, Pandya S, Ferguson R, Moustafa D, Ng C, et al. Digital solutions for COVID-19 response: an assessment of digital tools for rapid scale-up for case management and contact tracing. Baltimore: John Hopkins Global mHealth Initiative – Johns Hopkins Bloomberg School of Public Health; 2020
Read More
Nikshay reports: dashboard. Delhi: Ministry of Health & Family Welfare, Government of India
Read More
Tuberculosis data. In: Global Tuberculosis Programme. Geneva: World Health Organization

Global Tuberculosis Programme: The WHO Global Tuberculosis Programme works towards the goal of a world free of TB, with zero deaths, disease and suffering due to the disease. The team’s mission is to lead and guide the global effort to end the TB epidemic through universal access to people-centred prevention and care, multisectoral action and innovation.

Read More
WHO Toolkit for routine health information systems data. Modules. Geneva: World Health Organization

WHO Toolkit for Routine Health Information Systems Data This effort is led by WHO and its Collaborating Centre on Innovation and Implementation Research for Health Information System Strengthening at the University of Oslo, with support from Health Data Collaborative partners, including UNICEF, Global Fund, GAVI and PEPFAR. For questions or comments, please contact healthinfo@who.int Health service data are essential for patient management, facility management, disease surveillance and monitoring of service provision and resource use. Countries also need reliable facility data to assess the performance of their health services as they work towards the UHC targets and the SDGs.

Read More
A new digital platform for timely analysis and use of TB data. Geneva: World Health Organization; 2019

The WHO Global TB Programme has developed and is supporting country implementation of a new digital platform to store, analyze and visualize national and subnational TB surveillance data. The platform will facilitate timely planning and programmatic action.

Read More
Mapping the technology landscape of national TB programs: report. Geneva: The Global Fund to Fight AIDS, Tuberculosis and Malaria; 2021

Harnessing the power of digital health technologies is essential to driving progress in the fight against tuberculosis (TB). The COVID-19 pandemic has further underlined the importance of digital tools and international cooperation and collaboration for global health. This report, produced in collaboration with our partners Microsoft and the Stop TB Partnership, shows that there is a need for countries, donors and procurers to use their purchasing power and influence to promote market shaping for these tools. Shortcomings of financing, policies and appropriate resources need to be addressed in order to make digital health tools available in each country and realize the full potential of existing innovations. Different countries use different infrastructures as the backbone of their health systems, making it difficult to distribute new tools and digital subsystems globally.

Read More
Stop TB field guide 9: strengthening information systems and linkages to care. Geneva: Stop TB Partnership; 2018

This document is one in a series of 11 field guides produced by Stop TB Partnership in collaboration with the Global Fund to Fight AIDS, Tuberculosis and Malaria, KIT Royal Tropical Institute, Interactive Research and Development Global (IRD), and multiple global experts and implementation partners.

Read More
TB Data Hub – Enhance data. Expand data analysis. End tuberculosis. Chapel Hill: TB DIAH Project, University of North Carolina

The TB Data, Impact Assessment and Communications Hub (TB DIAH) project, funded by the United States Agency for International Development (USAID), is associated with USAID’s Global Accelerator to End Tuberculosis (TB). The Accelerator is USAID’s new business model to focus on performance-based measures for combating TB. We will work to strengthen the capacity of national TB programs to reach every person with TB, including vulnerable groups; cure those who need treatment; and prevent the spread of new infections. TB DIAH will also help foster country commitment to policies and action for inclusive and accountable governance of TB programs with strong information systems, infrastructure and financial support, and participation of all of civil society.

Read More
Guideline: Recommendations on Digital Interventions for Health System Strengthening

The key aim of this guideline is to present recommendations based on a critical evaluation of the evidence on emerging digital health interventions that are contributing to health system improvements, based on an assessment of the benefits, harms, acceptability, feasibility, resource use and equity considerations. This guideline urges readers to recognize that digital health interventions are not a substitute for functioning health systems, and that there are significant limitations to what digital health is able to address.

Read More
A new digital platform for timely analysis and use of TB data

The WHO Global TB Programme has developed and is supporting country implementation of a new digital platform to store, analyze and visualize national and subnational TB surveillance data. The platform will facilitate timely planning and programmatic action.

Strengthening Information systems and linkages to care - StopTB Field Guide

Finding and treating people with tuberculosis (TB) is a multi-step process involving awareness generation, prevention, screening, testing, diagnosis, treatment initiation, multiple follow-ups and finally a successful treatment outcome.

A new digital platform for timely analysis and use of TB data

The WHO Global TB Programme has developed and is supporting country implementation of a new digital platform to store, analyze and visualize national and subnational TB surveillance data. The platform will facilitate timely planning and programmatic action.

Strengthening Information systems and linkages to care - StopTB Field Guide

Finding and treating people with tuberculosis (TB) is a multi-step process involving awareness generation, prevention, screening, testing, diagnosis, treatment initiation, multiple follow-ups and finally a successful treatment outcome.

Guideline: Recommendations on Digital Interventions for Health System Strengthening

Digital, case-based, real-time surveillance for TB: status of progress Tuberculosis (TB) surveillance is the continuous and systematic collection, analysis and reporting of data related to TB infection and TB disease in the population. To support countries to implement national surveillance systems for TB in a consistent and comparable way worldwide, the World Health Organization (WHO) has, since the mid-1990s, provided guidance with standardized definitions, forms, registers and reports (1). There were major updates to this guidance in 2006 (2) and 2013 (3).

Read More
Classification of Digital Health Interventions

The classification of digital health interventions (DHIs) categorizes the different ways in which digital and mobile technologies are being used to support health system needs.

Read More
National eHealth Strategy Toolkit

Nikshay reports: dashboard. Delhi: Ministry of Health & Family Welfare, Government of India

Read More
Global Digital Health Index

The Global Digital Health Index is an interactive digital resource that tracks, monitors, and evaluates the use of digital technology for health across countries.

Read More
Digital Implementation Investment Guide

This practical Guide serves as a companion to the “WHO guideline: recommendations on digital interventions for health system strengthening”

Read More
Digital Health Platform : Building a Digital Information Infrastructure (Infrostructure) for Health

This practical Guide serves as a companion to the “WHO guideline: recommendations on digital interventions for health system strengthening.

Read More
Data Collection Tools

Health service data are essential for patient management, facility management, disease surveillance and monitoring of service provision and resource use. Countries also need reliable facility data to assess the performance of their health services as they work towards the UHC targets and the SDGs.

Read More
Metadata Package Downloads

Metadata packages for TB programmes contain modular components to support case notification, treatment outcomes, prevention activities, drug resistance monitoring, and monitoring stock levels at service delivery sites.

Read More
TB Aggregate System Design

This document describes the system design for the TB configuration package for aggregate reporting, focusing on how the data collection part of the configuration has been designed in DHIS2 (i.e. data sets and data elements).

Read More
TB Case Surveillance Program (Tracker)

The TB Case Surveillance Tracker digital data package for DHIS2 is based on the WHO recording and reporting framework from 2013. It provides a set of recommended metadata (data elements, program rules, etc) to enable electronic capture of individual/case-based TB surveillance data

Read More
A new digital platform for timely analysis and use of TB data

The WHO Global TB Programme has developed and is supporting country implementation of a new digital platform to store, analyze and visualize national and subnational TB surveillance data. The platform will facilitate timely planning and programmatic action.

Strengthening Information systems and linkages to care - StopTB Field Guide

Finding and treating people with tuberculosis (TB) is a multi-step process involving awareness generation, prevention, screening, testing, diagnosis, treatment initiation, multiple follow-ups and finally a successful treatment outcome.

A new digital platform for timely analysis and use of TB data

The WHO Global TB Programme has developed and is supporting country implementation of a new digital platform to store, analyze and visualize national and subnational TB surveillance data. The platform will facilitate timely planning and programmatic action.

Strengthening Information systems and linkages to care - StopTB Field Guide

Finding and treating people with tuberculosis (TB) is a multi-step process involving awareness generation, prevention, screening, testing, diagnosis, treatment initiation, multiple follow-ups and finally a successful treatment outcome.

Progress Report

When Ms. Ramadhani Bernadina Developed A Fever And Cough That Lasted For Months, He Began Purchasing Over-The-Counter Antibiotics In Hopes Of Ridding Himself Of The Illness. To His Dismay, His Health Continued To Deteriorate, Forcing Him To Move In With His Sister And Extended Family. Bernadina Was Unaware He Was Experiencing Early Symptoms Of Tuberculosis (TB) And Exposing Those He Now Lives With To The Disease.

Thankfully, His Sister Acted – Taking Him To The Kigwa B Dispensary, Where Bernadina Would Learn More About TB Signs And Symptoms. A Health Care Worker, Trained Through The Afya Jumuishi Project, Provided TB Counseling, And Administered A TB Test. Next, The Test Sample Trekked Over 37Kms (23 Miles) To The Kitete Regional Hospital For Laboratory Testing Where Bernadina Was Finally Diagnosed With TB Disease.

When Ms. Ramadhani Bernadina Developed A Fever And Cough That Lasted For Months, He Began Purchasing Over-The-Counter Antibiotics In Hopes Of Ridding Himself Of The Illness. To His Dismay, His Health Continued To Deteriorate, Forcing Him To Move In With His Sister And Extended Family. Bernadina Was Unaware He Was Experiencing Early Symptoms Of Tuberculosis (TB) And Exposing Those He Now Lives With To The Disease.

Thankfully, His Sister Acted – Taking Him To The Kigwa B Dispensary, Where Bernadina Would Learn More About TB Signs And Symptoms. A Health Care Worker, Trained Through The Afya Jumuishi Project, Provided TB Counseling, And Administered A TB Test. Next, The Test Sample Trekked Over 37Kms (23 Miles) To The Kitete Regional Hospital For Laboratory Testing Where Bernadina Was Finally Diagnosed With TB Disease.

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