TB REACH grants independent evaluation

With the right treatment and care tuberculosis is curable for the majority of people. But 1.4 million people still die from the disease every year. In January 2010, TB REACH was launched to provide grants to projects that find and treat people with TB using innovative approaches in hard-to-reach populations.

Grantees included NGOs, governments, private organisations and community groups and beneficiaries ranges from those attending health posts to prisoners and nomadic communities.

143TB diagnosis and prevention projects monitored in 46 countries.

33%average increase in case detection due to innovations used by TB REACH partners.

Our health experts designed and implemented the monitoring and evaluation framework for Stop TB Partnership's TB REACH initiative. From 2010 to 2016 we were commissioned to assess whether the programme was achieving its intended outcomes and that this investment represented real value for money.

Key facts

We monitored 143 TB REACH projects across 46 countries to improve the effectiveness, efficiency and impact of grantees' work.
With each wave of funding, Mott MacDonald and partner the Dutch Royal Tropical Institute (KIT), adapted the monitoring framework to meet the client’s needs.
Two million people with TB have been treated in project areas, many of whom would have been missed without the varied interventions. Average increase in case detection was 33%.

Solution

We designed the whole monitoring and evaluation process and continued to adapt it through the four waves of funding, responding to feedback from the clients and grantees.

The dialogue between grantees and evaluators on matters of analysis and interpretation was key to building capacity, common understanding and consensus around results.

The third wave was launched with a greater focus on early case detection and the use of GeneXpert technology. GeneXpert technology offers more accurate diagnosis and can reduce time to appropriate treatment, but is not without pitfalls. We enhanced both our monitoring and analyses accordingly to ensure best use was made of this unique opportunity.

We also collected and analysed qualitative data to improve the sustainability of TB detection, as part of the evolving monitoring and evaluation framework.

Value and benefits

The results showed that the range of innovations used by TB REACH partners increased case detection by an average of 33%, compared to historical trends.
The careful monitoring of TB REACH projects created a clear evidence base of what technologies and approaches can help detect and prevent TB, and at what cost.
Working in open partnership with the grantees enabled seamless checking and verifying data to measure results. This allowed for advice on mid-course corrections and recommendations to improve performance and progress towards the individual targets.
We ultimately provided the evidence to the TB REACH Secretariat on what worked and what did not, whether access to TB services was increasing in the targeted groups of people and to what extent the different innovations used were efficient, effective and sustainable.