The Performance-Based Monitoring and Evaluation Framework (PBMEF) is a key component of USAID’s efforts to ensure effective accountability of investments in TB at global, regional, and country levels to accelerate progress to end the TB epidemic. The framework streamlines and prioritizes indicators for monitoring progress toward reaching global TB milestones and targets in USAID TB priority countries.
The framework is fully aligned with existing strategies, such as the U.S. Government’s Global TB Strategy; the National Action Plan for Combating Multidrug- Resistant Tuberculosis (National Action Plan); the Stop TB Partnership’s Global Plan to End TB; the World Health Organization’s (WHO) End TB Strategy; and the United Nations General Assembly High-Level Meeting (UNGA HLM) on TB’s Political Declaration on TB. Ultimately, implementation of the framework by country programs, ministries of health (MOHs), donors, and other partners will help with the standardization, analysis, and use of information to inform existing or new TB strategies and interventions, strengthen national monitoring and evaluation (M&E) systems and capacity, ensure efficient use of resources, and promote investments-for-results approaches. One can also use the framework as a tool to advocate for resources, strengthen policies, and expand the scope of collaboration and coordination among partners. Complementing the framework is an online TB Data Hub and communication repository (www.tbdiah.org) that harnesses TB data and expands sharing of TB information at global and national levels.
This guide provides an overview of USAID’s strategic M&E framework to achieve global targets, describes standard core and extended indicators to monitor progress toward reaching TB targets in USAID-supported countries, and encourages consistent use of indicators to monitor and evaluate USAID investments in TB programs. The main intent for this standardized approach is to strengthen the use of data for decision making by the national programs. USAID staff, national TB program (NTP) managers, M&E staff, and embedded TB advisors and implementing partners (IPs) are the main audience for this guidance document.
The guide covers the following:
- Provides an overview of USAID’s Global Accelerator to End TB and TB targets
- Explains what the PBMEF is and how it can be used as a data management tool
- Introduces the performance-based core and extended indicators, along with comprehensive indicator reference sheets for the core indicators
- Describes how the indicator data will be reported
- Provides an overview on data quality
- Demonstrates how to view TB data collection through a cascade approach
Performance-Based Monitoring and Evaluation Framework
The PBMEF is a comprehensive indicator tool organized into 14 technical areas. In addition to helping USAID Missions successfully report on key TB data, the PBMEF will also help to ensure optimal demand, analysis, and use of routine and nonroutine TB data in order to help inform the decisions of USAID, national governments, MOHs, and NTPs on appropriate interventions, policies, and performance management. Additionally, the PBMEF will aid in USAID’s efforts to ensure effective accountability of the U.S. Government's TB investments at global, regional, and country levels. The PBMEF helps policymakers, program managers, and stakeholders address some critical questions of whether programmatic gaps are being bridged and performance goals are achieved.
As the lead U.S. Government agency for global efforts to control TB, USAID’s TB support is guided by the following objectives that are aligned with the U.S. Government’s Global TB Strategy:
- Improve access to high-quality, patient-centered services for TB, DR-TB, and TB-HIV to address challenges to access, such as cost of services, distance to facilities, hours of operation, and social stigma.
- Increase prevention of TB transmission and progression of TB infection (TBI), through early diagnosis and effective treatment.
- Strengthen key service delivery platforms, by helping countries identify populations at high risk of TB and improve healthcare settings, including strengthening drug policy and management.
- Increase country commitment and capacity to plan, finance, and implement effective TB solutions.
These four objectives have well-defined outcomes and impacts that, if implemented effectively, will lead to achievement of the global targets, as shown in the following PBMEF (see Figure 1). This framework shows the logical progression from the implementation of strategic objectives and technical interventions to improved outcomes (both health and system) that collectively achieve the desired impacts to reach country and global targets. These objectives and impacts will be measured along a continuum that includes inputs, processes, outputs, outcomes, and impact indicators. The indicators used to measure this progress are described in more detail in this guidance document. Input, process, and output indicators will be determined for each country, based on their national strategic plans (NSPs) as they adapt this framework to their local context.