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Optimizing Investments in the Tuberculosis Response in Blantyre, Lilongwe, and Mzimba Districts, Malawi : Results of a TB Allocative Efficiency Study (English)

This brief summarizes the findings of an allocative efficiency analysis using the Optima TB model and highlights opportunities to improve Malawi’s TB response. The study adopted an innovative design by focusing on three typified districts - Blantyre, Lilongwe, and Mzimba - in order to capture the breath of local TB situations relevant for decentralized decision-making. The selected districts represent different TB burdens, HIV prevalence rates and urbanization levels, and are located in the three regions of Malawi – North, Centre and South. Our analysis shows a continuing declining trend in incidence and deaths nationally as well as in the three selected districts Blantyre, Lilongwe and Mzimba. Factors contributing to these achievements include high TB treatment success rates (over eighty percent) and high HIV testing and ART coverage (>95 percent) among TB cases, as well as improved treatment and detection rates of drug resistant TB. However, challenges remain, including low overall TB case detection rates, high prevalence of TB cases diagnosed on clinical basis only, lack of rapid diagnostic tests, and uneven progress across different geographical regions of the country. improving TB diagnoses is most critical in reaching NTP targets. Specifically, this can be done by increasing the average number of contacts traced per notified case, screening all PLHIV during their routine outpatient visits, and focusing on the community outreach activities among key populations

Details

  • Author

    Vu,Lung Duy, Fraser-Hurt,Nicole, Pradhan,Elina, Cheikh,Nejma, Shubber,Zara, Mutasa,Ronald Upenyu, Sunkutu,Musonda Rosemary, Görgens, Marelize, Wilson,David

  • Document Date

    2020/12/17

  • Document Type

    Brief

  • Report Number

    155207

  • Volume No

    1

  • Total Volume(s)

    1

  • Country

    Malawi,

  • Region

    Africa East,

  • Disclosure Date

    2020/12/18

  • Disclosure Status

    Disclosed

  • Doc Name

    Optimizing Investments in the Tuberculosis Response in Blantyre, Lilongwe, and Mzimba Districts, Malawi : Results of a TB Allocative Efficiency Study

  • Keywords

    allocative efficiency; preventive treatment; Infection Prevention and Control; case findings; monitoring and evaluation system; allocation of resource; short course; infection control practice; cause of death; health care settings; government health expenditure; allocation model; national poverty line; amount of fund; rapid testing methods; tb control; privileges and immunity; diagnosis and treatment; healthcare worker; drug regimen; program coverage; available data; optimal allocation; sputum collection; Health Workers; Death rates; rural district; innovative design; health finance; urban districts; human suffering; recent years; several times; preventive therapy; high sensitivity; urbanization level; data quality; budget levels; Health Service; clinical decisions; pandemic start; local situation; data limitation; commercial purpose; active cases; state resources; urban setting; external source; respiratory infection; care seeking; operational aspect; persistent gaps; science research; rural setting; nosocomial transmission; health needs; local monitoring; diagnostic testing; case detection; pilot site; Learning and Innovation Credit; health resource; health facility; street scene; outpatient department; fund allocations

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Citation

Vu,Lung Duy Fraser-Hurt,Nicole Pradhan,Elina Cheikh,Nejma Shubber,Zara Mutasa,Ronald Upenyu Sunkutu,Musonda Rosemary Görgens, Marelize Wilson,David

Optimizing Investments in the Tuberculosis Response in Blantyre, Lilongwe, and Mzimba Districts, Malawi : Results of a TB Allocative Efficiency Study (English). Washington, D.C. : World Bank Group. http://documents.worldbank.org/curated/en/324181608277996482/Optimizing-Investments-in-the-Tuberculosis-Response-in-Blantyre-Lilongwe-and-Mzimba-Districts-Malawi-Results-of-a-TB-Allocative-Efficiency-Study