|
| Health facility expected performance indicators or guidelines | Actual performance level | Source of data | Performance score |
|
| Structural performance guidelines/indicators |
| All health workers participate in identification of TB suspects | 1 = Yes
2 = No | Interviewed health facility heads, TB focal persons, and in-charges ART | 1 = good
2 = poor |
Waiting times for; (i) Receiving laboratory results
(ii) Receiving treatment | (i) 1 = 24 hours
2 => 24 hours (50% and above of clients getting results after 24 hours)
(ii) 1 = immediate
2 => 1 day | Interviewed patients | 1 = good
2 = poor |
|
| Process performance guidelines/indicators |
| Two sputum samples should be collected for diagnosis | All suspects should have two ZN smears done | Reviewed laboratory register data for 2010 | 1 = 81–100% = good
2 = 70–80% = fair
3 =< 70% = poor |
| The health facility in conjunction with the sub-county health worker, and community volunteers should trace all clients who have disappeared without getting treatment, and any other category of interest | 1 = Yes
2 = No | Interviewed health facility heads, in-charges ART, and TB focal persons | 1 = good
2 = poor |
| All TB suspects should be assessed using a symptom based approach | Percentage of TB suspects who were assessed by the laboratory with at least one ZN test | Reviewed the laboratory register and identified patients who were registered but no test done for them at all | 1 = 0 patients = very good
2 = 1–3 patients = good
3 = 4 & > patients = poor |
| To assess and foster adherence to treatment, a patient-centered approach to administration of drug treatment, based on the patient’s needs and mutual respect between the patient and the provider, should be developed for all patients. Supervision and support should be individualized and should draw on the full range of recommended interventions and available support services, including patient counseling and education | Each TB positive patients should be on community based-DOTs | Reviewed the unit TB treatment register | 1 = all patients = good
2 = some patients not on DOTs = poor |
|
| Process performance guidelines/indicators |
| HIV testing and counseling should be recommended to all patients with, or suspected of having, tuberculosis | Every TB suspect should be advised to test for HIV | Interview with patients | 1 = all patients = good
2 = some patients not advised = poor |
| Each healthcare facility caring for patients who have, or are suspected of having, infectious tuberculosis should develop and implement an appropriate tuberculosis infection control plan | Presence of a system of identifying coughing patients from waiting areas and other places | Interviewed health facility heads, in-charges ART, and TB focal persons | 1 = good
2 = poor |
|
| Outcome performance guidelines/indicators |
| Cured | Percentage declared cured | Reviewed data in the treatment register for 2010 | 1 = 85–100% = good
2 = less than 85% = poor |
| Treatment failures | Number declared as failures | Reviewed data in the treatment register for 2010 | 1 = 0 patients = good
2 = 1 or > patients = poor |
| Defaulters | Percentage defaulters, no patient should default | Reviewed data in the treatment registers for 2010 | 1 = 0 patients = good
2 = 1–7 patients = fair
3 = 8 and > patients = poor |
| Died | Percentage died, no patient is expected to die | Reviewed data in the treatment register for 2010 | 1 = 0 = good
2 = 1–5 patients = fair
3 = 5 and > patients = poor |
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