Introduction to tools available to cost TB National Strategic Plans. Inés Garcia Baena Monitoring and Evaluation Unit GLOBAL TB PROGRAMME

Transcription

1 Introduction to tools available to cost TB National Strategic Plans Inés Garcia Baena Monitoring and Evaluation Unit GLOBAL TB

2 Agenda (09: ) 1. Overview of available tools to budget for a TB National Strategic Plan Disseminated since 2006 by Global TB Programme Launched in 2012 Introduction What s different? The software What s different? The design and budget reports What s different? The structure What else is different? A summary Do NTPs use them? 2. Using the tools cleverly to cost TB National Strategic Plans a) Data collected vs default data b) Assumptions revised c) Single user tools but many actors involved 3. Using the tools in practice OneHealth webinar during coffee break at 15.30h today WHO TB planning and budgeting tool

3 1.Overview of available tools to budget for a TB National Strategic Plan

4 1. Overview of available tools to budget for a TB National Strategic Plan -Introduction launched in 2006 WHAT? A software tool for medium term national TB planning and budgeting at country level Links Global Plan/NSP targets to the required investments PURPOSE? Facilitate strategic planning and costing at country level Created in realisation that many National Strategic Plans included no budget BY WHOM? WHO Global TB Programme Monitoring and Evaluation FOR WHOM? National TB program managers and implementing partners WEBSITE released in 2012 WHAT: a software tool to inform national strategic health planning and costing in low- and middle-income countries. PURPOSE: Facilitate strategic planning and costing at country level attempts to link strategic objectives and targets of disease control and prevention programmes to the required investments in health systems. provides planners with a single framework for scenario analysis, costing, health impact analysis, budgeting and financing of strategies for all major diseases and health system components. Promotes the dialogue and alignment of planning cycles between Health Plan and disease plans BY WHOM: Developed by the United Nations Inter-Agency Working Group on Costing (IAWG-COSTING) incl. WHO, UNICEF, WB, UNAIDS, UNFPA, UNDP, UNWOMEN. Partner support incl. GFATM, the Global Health Workforce Alliance, IHP+, etc. Health Planners in Country Reference Group provide technical and user related inputs into model development FOR WHOM Health Sector planners (MoH Department of planning) Donors, academia, NGP and UN agencies Disease specific planners (with Health sector planners) WEBSITE

5 e.g. RWANDA planning cycle

6 1. Overview of available tools to budget for a TB National Strategic Plan - Introduction Free download Life saver function response within 2 working days

7 1. Overview of available tools to budget for a TB National Strategic Plan What do the tools do? How much will my TB plan cost? Is my expected funding sufficient? Costing as part of the planning process How much will my health plan cost? And my TB plan in particular? Costing as part of the planning process How many doctors and nurses will I need to implement my plan? Links programme plans to a health systems platform Ensures comparability A standardized costing approach across programmes How many lives could be saved? Improving population health

8 1. Overview of available tools to budget for a TB National Strategic Plan What is different? The software 2010 Excel for PC (not Mac ), free on-line 1 includes a ready made framework 2 The budget is built in line with the country s National Strategic plan and the WHO recommended strategy Last updated in February 2014 by WHO/GTB to include the most recent epidemiology and financial data Yearly updates are done by WHO/GTB Single-user desktop application (Spectrum) 1 2 includes a standard framework The costing may be mapped to the country s National Strategic plan and the WHO recommended strategy Last updated in February 2014 by WHO/GTB and Futures Institute to include the most recent epidemiology and financial data

9 1. Overview of available tools to budget for a TB National Strategic Plan What is different? The design and automatic reports Designed to cost TB National Strategic Plans Needs, available domestic and donor funding and funding gap are calculated for TB Inpatient and outpatient care costs calculated Counterpart financing can be calculated Resulting budgets are automatically produced By objectives of your TB NSP By WHO data collection items By source of funding, by intervention GLOBAL TB Designed to cost health plans but may be used to cost TB Needs are calculated for TB (and other) Domestic funding can only be calculated if a complete health plan is done Inpatient and outpatient care costs not calculated by disease, only for the health plan Counterpart financing cannot be calculated for TB A budget mapping function allows associating costed interventions to Objectives of your TB NSP WHO data collection items Concept note categories Budget by intervention (not by source)

10 1. Overview of available tools to budget for a TB National Strategic Plan What is different? The structure GLOBAL TB

11 1. Overview of available tools to budget for a TB National Strategic Plan What is different? Summary (1) Detailed feature Designed to cost TB budget Designed to cost Health budget but can be used for TB costing specifically Designed to project patients to treat Designed to be linked to impact tool which will estimate the impact of scaling up interventions Designed to estimate lives saved WHO TB planning and budgeting tool OneHealth 2014 OneHealth 2015 The Design Tool feature Costing method: ingredients approach (Price X Quantity) Baseline epidemiology data updated annually appears by default For each intervention, population in need and coverage appear by default and the user can override Unit cost data updated yearly US$ costing Euro costing Local currency costing Inflation Default ingredients entered in a single entry point and source documented Situation analysis (option) By intervention recommended by WHO TB strategy By standard non-disease specific cost category (patient-centered, program costing, health system) Detailed costing possible (up to 4 levels of detail) Cost of use of health services by TB patients calculated Human resources for TB (e.g. NTP manager and team, Lab technician working in TB) costed Human resources shared with the health sector (e.g. health worker) costed out for TB specifically Health system strengthening (HR, Supply chain, Information systems) GLOBAL TB The Costing method Default ingredient -Patients Default ingredient-unit costs The structure of the tool

12 1. Overview of available tools to budget for a TB National Strategic Plan What is different? Summary (2) Reports automatically generated Manual mapping for personalised presentation available Reports by interventions Reports by source of funding Reports by NSP category Report by Global Fund category Report by National Health Sub-account category Report on Health System costs Fiscal space calculation Bottleneck analysis (option) Ready by May Probable Budget reports Single-user desk top Single user Excel 2010 Flexible, allows adding additional interventions and activities Default data (epidemiology and financial) may be entered in a single entry point and automatically feeds the model English French March Ready in Q2 Spanish Ready in Q2 Ready in Q2 Russian Ready in Q2 Ready in Q2 Portuguese Ready in Q2 Manual Pop-up instructions in the tool itself Video Power-point presentations available Dissemination and use routinely monitored (through WHO TB data Jan-14 GLOBAL TB Software type Software language Training material Dissemination Last updated

13 1. Overview of available tools to budget for a TB National Strategic Plan Do NTPs use it? GLOBAL TB Global TB Programme could check in 2015 Source: The WHO global TB data collection system, Global TB Programme checks every year!

14 1. Overview of available tools to budget for a TB National Strategic Plan Do NTPs use it? GLOBAL TB Used WHO budgeting tool last Bangladesh 2010 Botswana 2009 Eritrea 2009 Gambia 2012 Kenya 2012 Lesotho 2012 Nepal 2012 Sudan 2012 Timor-Leste /12 participant countries in this workshop have used the tool Over 60 low and middle income countries have also used it. No NTP manager has used it yet (Sudan?) Health planning departments have List of users in your country available The added value of OneHealth is when you use it beyond one disease e.g. TB/HIV TB and Maternal Health TB and health sytem strengthening

15 1. Overview of available tools to budget for a TB National Strategic Plan Do NTPs use it? Not yet GLOBAL TB OneHealth trained users in your country Botswana (sector wide) piyer@futuresgroup.com, vmenon@futuresgroup.com Sudan (sector wide) Fatima Elhassan fatima.elhassan@yahoo.com (health economics Unit, MoH Ssudan and facilitator Chris James of OPML Kenya (sector wide) Arin Dutta adutta@futuresgroup.com Lesotho Emeka Nsofor - emekansofor@gmail.com Rwanda (HIV/AIDS) with support from Clinton Access Foundation Sri Lanka (RMNCH) Neil Thalaga - neil6338@yahoo.com

16 1. Overview of available tools to budget for a TB National Strategic Plan Benefit of using either tool GLOBAL TB TB All sectors cost including TB Budget is built in a standardized format It links costs to epidemiological burden and global targets It offers a ready-made list ("checklist") of inputs/activities to consider for each TB control intervention It provides a solid foundation for: resource mobilization from national/local governments, Global Fund and other donors resource tracking

17 1. Overview of available tools to budget for a TB National Strategic Plan Benefit of using either tool Easy to revise, tailor to your needs and update budgets Provides a framework for M&E and for an operational plan Automatically produces summary reports For National Strategic Plans For full expression of demand for TB funding and counterpart financing requirements /Global Fund concept For financing data on annual WHO TB data collection form Mapping function allows you to tailor your reports easily Reports by sources of funding will be available in May 2014 GLOBAL TB

18 1. Using the tool(s) cleverly to cost for a TB National Strategic Plan

19 2. Using the tools cleverly to cost TB National Strategic Plansa) Data collected vs default data (1) What are your NSP objectives and interventions from Core Plan? the number of patients with DS-TB and or MDR-TB that need to be diagnosed and treated (incl. rate of scale up for detection (incl. Xpert) and treatment) Notifications appear by default Projections are user entered in WHO TB planning and budgeting tool and modeled in OneHealth. The use may override projections at any time. (Remember projections should be done after an Epidemiology review. Follow Philippe Glaziou s advice from Day 1.) model of care for DS-TB and MDR-TB patients Data you reported to WHO on inpatient and outpatient care appears by default (new 2013) in WHO TB planning and budgeting tool. GLOBAL TB

20 2. Using the tools cleverly to cost TB National Strategic Plansa) Data collected vs default data (2) unit costs TB specific (default values are proposed in both tools) General unit costs (e.g cost of room rental) to document in the tools TIP: WHO TB planning and budgeting tool/ Unit costs worksheet (you completed) resource use for all activities (frequency of use and amount) Current information on present and future domestic and donor funding (Global Fund, USAID) to be used in WHO TB planning and budgeting tool only. By intervention? Predictability/uncertainty? GLOBAL TB

21 2. Using the tools cleverly to cost TB National Strategic Plansb) Assumptions revised c) Single user tools but many actors b) Assumptions revised Any default data appearing in either tools should be revised especially if key budget driver. If unchanged useful to produce a first budget draft. Treatment and diagnosis assumptions ought to be discussed internally with the relevant experts Always question the information you are presented c) Single user tools but many actors involved As in the rest of the NSP development It is not the affair of a finance whiz kid! It is an iterative process: plan-budget-re-plan-re-budget

22 3. a. Using OneHealth tool to cost a National Strategic plan for TB

23 15.30 Coffee break and webinar session with Rachel Sanders at Futures Institute GLOBAL TB

24 OneHealth tool: location for interventions WHO Planning and budgeting tool interventions OneHealth tool location Improving diagnosis Microscopy laboratories Culture laboratories DST laboratory Molecular tests: LPA and Xpert Other equipment, X-ray Quality assurance programme and transportation of specimens/panels Retooling process GLOBAL TB Lab construction and equipment in Programme costs 5.2 (New labs) and 5.3 (Upgrade/rehabilitation/maintenance) Chemicals and consumables in Intervention costing Lab construction and equipment in Programme costs 5.2 (New labs) and 5.3 (Upgrade/rehabilitation/maintenance) Chemicals and consumables in Intervention costing Lab construction and equipment in Programme costs 5.2 (New labs) and 5.3 (Upgrade/rehabilitation/maintenance) Chemicals and consumables in Intervention costing Lab construction and equipment in Programme costs 5.2 (New labs) and 5.3 (Upgrade/rehabilitation/maintenance) Chemicals and consumables in Intervention costing Lab construction and equipment in Programme costs 5.2 (New labs) and 5.3 (Upgrade/rehabilitation/maintenance) Chemicals and consumables in Intervention costing TB Programme Costs Section 5.4 TB Programme Costs: Section 5.1 Situation Assessment and Retooling Process PAL Activities and costs at national level Programme Costs section 10.5 Activities and costs at sub-national level Programme Costs section 10.5 Involving all care providers: PPM/ISTC Activities and costs at national level Programme costs section 10.6 Activities and costs at sub-national level Programme costs section 10.6 First-line drugs procurement and management First-line drugs for Category I & III patients Intervention First-line drugs for Category II patients Intervention First-line drugs for children Intervention Buffer stock for first-line drugs Health Systems Logistics module Drug management: procurement, storage, distribution Health Systems Logistics module Programme management and supervision Recruitment processes Health System HR module National staff meetings TB Programme costs section 9.4 Staff meetings at intermediate and peripheral level TB Programme costs section 9.4 Development, production and distribution of guidelines (including retooling for new case definition) Supervision from national level TB Programme Costs: Section 3: Supervision Supervision from intermediate level TB Programme Costs: Section 3: Supervision Supervision from peripheral level TB Programme Costs: Section 3: Supervision Strengthening supervision Can add under Other if needed Transportation TB Programme Costs Section 6 Office space, supplies and equipment at national level TB Programme Costs: Section 1.1 Office space, supplies and equipment at sub-national level TB Programme Costs: Section 1.2 Infrastructure, new and renovations Health systems Infrastructure Module Advocacy activities Program Costs Section 8 Communication activities Program Costs Section 7 HRD: Staff National level Program Costs Section 1 Intermediate level Program Costs Section 1 Peripheral level Program Costs Section 1 WHO Planning and budgeting tool interventions OneHealth tool location HRD: Training Training on patient care and programme management TB programme Costs: Section 2.1: In service or Refresher Training Training on diagnosis TB programme Costs: Section 2.1: In service or Refresher Training Training on TB/HIV TB programme Costs: Section 2.1: In service or Refresher Training Training on MDR-TB TB programme Costs: Section 2.1: In service or Refresher Training Training on PAL TB programme Costs: Section 2.1: In service or Refresher Training Training on PPM/ISTC TB programme Costs: Section 2.1: In service or Refresher Training Training on community involvement TB programme Costs: Section 2.1: In service or Refresher Training Training on advocacy and communication TB programme Costs: Section 2.1: In service or Refresher Training Training on infection control TB programme Costs: Section 2.1: In service or Refresher Training International training TB programme Costs: Section 2.1: In service or Refresher Training Other training can be added to Other as needed Coordination with other programmes and departments Part of HR costs (Programme Costs Section 1) Other aspects of HRD Situation analysis in HR(Programme Costs Section 1) Community involvement Policy and piloting TB programme Costs: Section 10.7 Advocacy and communication TB programme Costs: Section 10.7 Development of training materials TB programme Costs: Section 10.7 Incentives to community health workers TB programme Costs: Section 10.7 Patient support Situation analysis Section 9.6: overall situation analysis Incentives Intervention MDR TB Assessment of situation Should be part of overall situation analysis Second-line drugs Intervention Drugs for adverse events Intervention Default and contact tracing TB Programme Costs: Other Support to GLC initiative TB Programme Costs: Other Infrastructure Infrastructure and equipment Collaborative TB/HIV activities Establish mechanisms for collaboration TB Programme costs Section 10.1: Collaborative TB/HIV activities Conduct surveillance of HIV prevalence among TB patients TB Programme costs Section 4.4: Data Collection and Analysis Decrease the burden of TB in people living with HIV/AIDS Intervention: HIV testing and counseling: Isoniazid Decrease the burden of HIV/AIDS in TB patients Intervention: HIV testing and counseling High risk groups Situation analysis TB programme Costs: Section 10.2 Coordination with partners ad NGOs TB programme Costs: Section 10.2 Transportation TB programme Costs: Section 10.2 Develop strategy TB programme Costs: Section 10.2 Develop training material TB programme Costs: Section 10.2 Childhood TB Preparation phase TB programme Costs: Section 10.4 M and E Periodic surveys TB Programme costs Section 4.4: Data Collection and Analysis Routine surveillance TB Programme costs Section 4.4: Data Collection and Analysis Strengthening surveillance system TB Programme costs Section 4.4: Data Collection and Analysis Operational research Type and costs of studies TB Programme costs Section 4.4: Data Collection and Analysis HRD: International technical assistance International assessment missions Program Costs Section 1 Country-based staff Program Costs Section 1 Infection control Programmatic measures TB Programme Costs: Section 10.3 Administrative measures TB Programme Costs: Section 10.3 Environmental measures TB Programme Costs: Section 10.3 Personal protection TB Programme Costs: Section 10.3 Partnering Initiatives Partnership exploration TB Programme Costs Section 10.8 Partnership building TB Programme Costs Section 10.8 Partnership maintenance TB Programme Costs Section 10.8

25 3.b. Using WHO TB planning and budgeting tool to cost a National Strategic plan for TB

26 Menu driven system 3. Using the tool in practice The wording of the Core plan may be used to define the objectives/interventions Ready-made framework for planning/budgeting for each component of TB control Application options to enhance user-friendliness Choosing country via menu system selects correct set of epidemiology/ demographic/financial historical data, projections and default values Summary tables and figures automatically produced Guidance available within tool

27 IN 3. Using the tool in practice Main features The index (Welcome page) guides you through 5 steps 1. Select your country/save copy in your computer 2. Define objectives/interventions 3. Define treatment targets and validate unit costs 4. Budget for interventions 5. View summary reports

28 IN 3. Using the tool in practice GLOBAL TB

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30 IN 3. Using the tool in practice project patients on treatment GLOBAL TB

31 IN 3. Using the tool in practice and validate unit costs GLOBAL TB

32 3. Using the tool in practice validating unit costs (detail) «General» unit costs «TB» specific resources

33 3. Using the tool in practice Summary reports automatically produced OUT

34 OUT 3. Using the tool in practice Summary reports automatically produced Sources of funding: figure Funding gap Other grants Global Fund Loans Governments

35 OUT 3. Using the tool in practice Summary reports automatically produced Summary by NSP Objective

36 OUT 3. Using the tool in practice Summary reports automatically produced Table costs by intervention and sources of funding Counterpart financing? Government Total costs for TB control

37 OUT 3. Using the tool in practice Summary reports automatically produced Total costs - figure

38 3. Using the tool in practice Recent innovations Users survey, 2011 Key resulting changes in the Excel 2010 based tool, version 6, 2013: enhanced features Flexible definition of objectives and mapping of interventions Prioritization of activities: High, Medium and Low (X 20) Facilitate user to enable macros and automatized backup Results feed into United Nations OneHealth Areas that are now accomodated in the tool (Nov. 2013) Pharmacovigilance Technical assistance for laboratory strengthening Childhood TB care (2013 guidelines) Palliative care (additional infection control for hospital based XDR) Improving adherence through economic support GLOBAL TB

39 Next presentation Please open the tool on the web or available in the USB* and follow the next practical introduction

40 WEBSITES For more information Inés Garcia Baena, Technical Officer, WHO Global TB and