Evaluation of the USAID/South Africa Tuberculosis (TB)Programme

Home » Evaluation of the USAID/South Africa Tuberculosis (TB)Programme

Objective


USAID/South Africa contracted Khulisa to conduct an end-of-project program evaluation of the
USAID/South Africa TB project for developing a follow-on project to support South Africa’s National
TB Programme (NTP).
The evaluation is to answer five evaluation questions:

  1. To what extent did the project achieve its intended results as stated in the contract’s
    objectives? What were the reasons for any shortfalls?
  2. To what extent is the design of this project valid? How successful have been the
    programmatic and management approaches, structures and systems in carrying out the
    project’s activities?
  3. Did the project strengthen the capacity of NTP sufficiently to ensure its sustainability?
  4. What role has the Small Grants program played in improving TB, TB/HIV and MDR TB
    programs?
  5. What strategies were used to reach vulnerable populations? E.g. Mines and work place
    programs.
  6. How has the project integrated technology e.g. mobile health work in KZN, Active TB case
    finding?
    In answering these questions, the evaluation sought to: (i) assess the quality of the project’s design,
    technical inputs, and implementation to improve TB outcomes; (ii) determine which approaches and
    activities were employed, which were successful and why; (iii) assess the effectiveness of the project
    in strengthening TB prevention and control in the Republic of South Africa (RSA);(iv) identify actual
    outcomes achieved; and (v) summarize key results and effectiveness of the project in achieving its
    intended objectives.


    Approach

    To answer the evaluation objectives, the Khulisa team used a non-experimental design and a mixed
    methods approach to collect both primary and secondary data and to ensure that the evaluation
    questions were answered comprehensively. The methods employed included document and data
    review; analysis of TB performance in project supported areas vs non-supported areas; key
    informant interviews; and an online survey.

Pre-fieldwork

Fieldwork

Impact:

The evaluation served as a critical feedback mechanism to refine program strategies, enhance
sustainability, and ensure alignment with national and global TB control goals. The evaluation
identifies several impacts resulting from conducting this evaluation:

  1. Informed Planning for Future Projects: The evaluation provided insights to inform the
    design of a follow-on project to support South Africa’s National TB Program (NTP). This
    includes recommendations for better resource allocation, strengthening capacity building,
    and improving community-based interventions.
  2. Improved Understanding of Project Outcomes: The evaluation assessed the project’s
    effectiveness in achieving its goals, such as improved TB treatment success rates and
    integration of HIV and TB services. It highlighted areas of success and gaps, helping
    stakeholders understand the project’s contributions and limitations.
  3. Enhanced Stakeholder Collaboration: The evaluation process involved extensive
    engagement with stakeholders, including government officials, healthcare workers, and
    community organizations. This fostered collaboration and encouraged collective efforts to
    address TB challenges.
  4. Identification of Best Practices: The evaluation documented successful strategies and
    approaches, such as the use of small grants for community engagement and innovative tools
    for TB management. These practices can be scaled or adapted for similar health programs.
  5. Capacity Building: The evaluation process itself contributed to capacity building by training
    local stakeholders in monitoring, evaluation, and data analysis.
  6. Policy and Strategic Recommendations: The evaluation provided actionable
    recommendations, such as including the National Health Laboratory System (NHLS) as a
    formal partner and pursuing technological innovations for TB management.