09 – Strengthening Information Systems and Linkages to Care

Funding is obviously critical for the purchase or development of software systems and required hardware and equipment. However, there must be funding available for ongoing maintenance and changes to the system. While everyone strives towards developing an optimal system, no system deployed in the field will be perfect on day one. Field experience can instigate changes. Changes might also be needed after additional programmes or sub-programmes/studies have been initiated, there is a desire to integrate with other systems in use or there are advances in TB control (e.g. existing information systems had to be updated to incorporate GeneXpert when it began to be deployed; now systems need to be updated to use the Ultra cartridge). Consequently, it is critical for programmes to understand that funding for information systems is not a one-time need. A significant amount of funding is needed up-front for active development and then roll-out. However, it is equally critical for some level of funding to be available long-term for maintenance and enhancement of the system, to repair/replace/upgrade hardware, and to provide connectivity for data entry devices and servers. Whether NTPs use this funding to build internal capacity for these tasks or commission a software vendor or IT firm to do them is implementation-specific and will vary from country to country, depending on national strategy and priorities.

Donors have increasingly encouraged the use of information systems, and system development is often seen as a milestone for TB programmes. However, it is important that NTPs truly buy in to these systems, meaning that governments need to find ways to fund these systems beyond grant timelines and make data use and analysis a major part of their TB control efforts.