Abstract
The Control and Prevention of Tuberculosis (CAP-TB) project aim is to reduce the incidence of and mortality due to multi-drug resistant tuberculosis (MDR-TB). To achieve this, FHI 360 and its implementation partners focus on the following objectives: (1) develop, implement, and evaluate local models for MDR-TB prevention and management that can be scaled up; (2) increase detection of MDR-TB cases and treatment successes in areas where the model MDR-TB program is implemented; and (3) build local systems and capacity to sustain these models beyond CAP-TB's active presence. A key priority for CAP-TB is to develop capacity among local organizations in each of the three countries. This midterm evaluation focused on answering the following 5 key questions posed: (1) to what extent and how has CAP-TB strengthened multi-drug resistant tuberculosis (MDR-TB) management; (2) to what extent and how has the CAP-TB community-based approach contributed to TB and MDR-TB prevention, diagnosis and treatment; (3) are the management arrangements optimal for achieving project objectives efficiently and effectively; (4) to what extent and how has the strategic information generated by the project and knowledge gateway information been used; and (5) what measures/mechanisms have been put in place to achieve sustainability and which still need to be addressed? Overall conclusions summarized results stating that CAP-TB represents an appropriate regional focus on prevention and control of MDR-TB. The project is appropriately focused on the highly vulnerable strata of the populations, although their screening lacks effectiveness. The comprehensive approach was adapted in each country according to local needs. CAP-TB has been successful in strengthening MDR-TB program management in all focus countries, but much less in data management. CAP-TB has successfully piloted community supporters, and demonstrated effectiveness and creativity while organizing their training. Additional specific evaluation findings, conclusions and recommendations are provided with detailed analysis for each evaluation question. (Excerpt, modified)