OpiniãoMoving to decentralized, family-centred, integrated services requires careful planning and regular monitoring of implementation against the plan. The capacity needs of NTPs for implementing the proposed interventions need to be identified and addressed.
Enhanced data collection around child and adolescent TB potentially takes a substantial amount of additional time and detailed data collection may only be feasible in specific operational research settings. Programmes generally have registers in place for contact investigation, treatment registration and outcomes, as well as TPT registers. The use of these (preferably electronic) tools is important as programmes move to a more decentralized and family-centred, integrated approach, to ensure comprehensive management and treatment. The use of these tools needs to be evaluated and enhanced, including through operational research.
It will be important to monitor the number of children diagnosed at different levels of the health system, including the proportion of children that have bacteriological confirmation, the proportion who were clinically diagnosed as well as the number of children initiated on and completing TPT. Disaggregation of data by sex will be important to evaluate the impact on gender equity. Evaluating the quality of services (covering the quality of all steps in the patient pathway, from screening, to diagnosis and treatment) as well as client satisfaction are important components as well.