National TB policy addresses links between TB and HIV

Export Indicator

National TB control policy, endorsed by government, addresses the link between TB and HIV, and the potential impact that HIV may have on TB control throughout the country
What it measures

Input indicator to measure government commitment to TB/HIV collaboration by evaluating whether government TB policy assesses and addresses the potential impact that HIV may have on TB control

Rationale
Numerator

Not applicable

Denominator

Not applicable

Calculation
Method of measurement

National TB control policy should reflect international policy guidance on collaborative TB/HIV activities. A content analysis of the government’s TB policies, plans and/or guidelines should be conducted and matched against the checklist of key policy components (see below). The measurement of this indicator is yes/no; the national policy is either complete or incomplete.
A policy is considered to be complete if it contains all of the following eight key components:
• Explicit recognition of the potential impact of HIV on TB control
• Inclusion of NACP representative in planning process of NTP
• Surveillance of HIV prevalence among TB patients that is consistent with international recommendations
• IEC strategy for TB that includes appropriate information about HIV
• Training for those working in TB that includes appropriate information about HIV
• Intensified TB case-finding recommended in all who test positive for HIV
• HIV-infected TB patients eligible for ART when indicated as per national protocols
• TB patients who are HIV-infected to have full access to the continuum of care for PLWHA.
Additional components required for countries with a generalized HIV epidemic (>1% in the general population):
• Establishment of a national TB and HIV coordinating body, technical advisory committee or task force
• HIV testing and counselling routinely offered to all patients diagnosed with TB
• CPT for all HIV-positive TB patients and all PLWHA consistent with international guidelines.
Supporting documentation should include the policy/plan/guideline itself and should state where and by whom it was issued.

Measurement frequency

Every 3-5 years

Disaggregation

Age group:

Education: N/A

Gender: N/A

Geographic location: N/A

Pregnancy status: N/A

Sector: N/A

Target: N/A

Time period: N/A

Type of orphan: N/A

Vulnerability status: N/A

Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

A national TB control policy is an official government statement that establishes goals for TB control, includes strategies for attaining them and guides implementation of a comprehensive TB control programme. The magnitude of the impact of HIV on TB control makes it essential for governments to accept the link between TB and HIV and explicitly address, within the national TB control policy, the potential impact of HIV on TB control in their setting. Measuring political commitment and policy analysis involves some subjective judgement and limits use in cross-national comparisons and for capturing trends over time. This indicator goes a step beyond measuring the simple existence of a TB prevention and control policy by defining standards that must be met in order to have a “complete” policy that addresses the issue of HIV according to international guidelines, thus eliminating some, though not all,  subjective judgement. This indicator is useful in identifying countries that lack a formal and complete policy and that are therefore in most need of policy development work.

Further information