A decrease in the rates of recent infections, a reduction in the lifetime risk of TB infection, and a reduction in the effective contact number would reflect the control of TB among the adults.
The primary target for the long-term TB control should be to reduce the high force of TB infection, particularly in densely populated sub-urban areas. This is because the effectual contact numbers and the population prevalence of the infectious TB cases are the drivers of the high force of infection for the TB epidemic. Using of antiretroviral therapy (ART) as prevention has a strategy of controlling the HIV epidemic will have a supplementary effect in the control of the TB that is HIV-associated. A full implementation of the available ART guidelines, among the HIV- infected patients, will decrease the pre-ART TB infection burden. There is a need to target high-risk communities, and accompanying a shift in priority concentration from case management to the reduction in TB transmission with the incorporation of new result measures, which reflect continuing TB transmission at the sentinel and national sites.
Section 4: The Impact
There are a number of benefits that the high-density township areas, particularly in South Africa, will receive in case they implement the above intervention strategies. The major impact of the intervention is a decrease in the number of TB cases among children and adolescents in this community. In addition, a reduction of the number of TB admissions at the hospital, and the decrease of TB transmission within and without the community will be a result that will arise from the implementation of the intervention plan. Other health outcomes to expect from the implementation of this program include an acceptance of TB treatment and prevention, patients receiving appropriate treatment for the TB, patients adhering to treatment and completing treatment in time, an increase in patients' knowledge about the disease, and an enhancement in the overall health of the population. On the other hand, the social outcomes of the program include building trust within the community, a reduction of stigma about TB, an overall improvement of the community's quality of life and patients being able to identify all of their close associates.
Section 5: Evaluation
Below is the evaluation plan that the researcher shall use to assess the effectiveness of the intervention suggestions above in achieving the expected outcomes of the program:
The major goals of this evaluation shall be:
To establish the efficacy of the program
To appraise the success and advancement toward the realization of program objectives
To examine segments of the program that are functioning optimally so as to replicate them
To help in the equitable redistribution of resources
The aim of this assessment plan is to offer the researcher, and other stakeholders in the implementation of the intervention strategies, with the necessary information that will be helpful in assessing the effectiveness and progress of the program.
The evaluation team shall comprise 10 members and a team leader. The roles of the team leader shall be:
Supervision of all evaluation activities
Coordinator of all meetings of the evaluation team
Chief analyst of the evaluation data
Principal author of the evaluation plan and reports
Top person in the distribution of evaluation materials and reports
The rest of the members of the team shall carry out the following roles:
Dissemination of findings
Use of the findings
Members of the evaluation planning committee
These people will include the program manager, epidemiologists, nurses, epidemiologists, and representatives from partner agencies.
The table below gives the list of stakeholders who will be included in the program, their perspective, or interest in the program, the function they will have in the evaluation, and how and when they will participate in the evaluation:
Perspective on or Interest in the TB program and the evaluation function in the evaluation
How and when will they be occupied in the evaluation
Interest in self-improvements and the perfection of the program
Define program processes
See program evaluation as a personal judgment
Define the problem in the program from a staff perspective
Outreach workers evidence of effects for funding and program development purposes broadcast results to agency leaders and financial support agencies
They fear an increase in workload
Fear program alteration & job loss
Identify data sources
Interest in self-improvements and the improvements of the program
Providing administrative and funding context
Health department administrators
Concerns about the HIV status of the community
Define health problem
Need for services
Define the problem in program from a client perspective
Adolescents and children
Fear or reject health system
Participate in providing their view of the program
Identify data sources
Disseminate findings to community audiences
Community planning board
Community health among underserved population
Defensive of current system
Provide operational context
Health care providers
Proof of effects for funding and program expansion purposes
Define health problem
They fear an increase in workload
The roles of the stakeholders will keep changing during evaluation, and this is not the final role appraisal for the stakeholders.
Background and Description of the TB Program
The need for this program is to address the TB problem among adolescents and children living in areas where there is a high prevalence of HIV among adults. In addition, children in this area have not been vaccinated against TB through the BCG vaccine. This problem could be arising because there are only a few health care centers to serve the densely populated community thereby making the vaccines inaccessible. The consequences of this problem include ill health among children and adolescents, high morbidity rates, rise in the treatment costs and backlash against the community's population. This poses potential for a bigger problem, but acting may lessen the problem. In this area, there are a number of trends that are occurring, which have worsened the situation including an increase in the TB incidence and change in the demographic patterns.
The factors that affect this program include:
This TB program will cooperate and coordinate with other social and health services in the community including HIV service programs, housing and food support programs, schools and hospitals among others.
The program is competing for resources with other health programs within the community.
Organization's structural factors
The program will be operating within the context of policy and political environment who may influence the effectiveness of the program
The community does not consider TB as a serious health problem
This TB program targets the following groups of people in addressing the TB concerns:
Children and adolescents
People who are infected with HIV
People living in congregate settings
Stage of Program Development
In evaluating the program, one will consider the stages of the following activities:
Design and planning
This will be useful in deciding on outcome evaluation, process evaluation, or both.
The resources for implementing the program are:
The TB program staff
Continuing education and Training staff
Infrastructure resources that are part of the health department
The following are the outputs that the evaluation shall take into account:
A strategic plan for the program
Conducting of TB Tests
Educating of providers about TB
Presenting of education sessions to community groups
The following are the probable expectations of the program, which evaluation will consider:
An increase in patient's knowledge
Acceptance by patients for TB treatment
More children receive BCG vaccine
Patients receive appropriate treatment
Patients stick to the TB treatment
A reduction in hospital admissions for TB
A reduction in the transmission of TB
Trust developed within the community
Patients name all of their close associates
Reduction of stigma about TB
Improved quality of patient's life
Patients are in good health overall
Evaluation Questions, indicators, benchmarks
1. Are there adequate resources to perform the activities of this program?
Availability of funding
Availability of personnel
Availability of physical space
Availability of enough funding for all activities
100% availability of personnel to execute the program's activities
100% availability of space for running the affairs of the program
2. Are associates named in the timeframe set by the procedures?
Patients naming of close contact between January and April 2014
An increase in the number of patients identifying their close associates
3. Have community associates been taken on to work in partnership with us to thwart TB in the high-risk populace?
Associates are already working with the implementation team
An increase in the number of associates working with the implementation team
1. How did the plan play a part in the decline of TB transmission rate…