09 – Strengthening Information Systems and Linkages to Care

TB control efforts need to be tailored to local conditions, as the disease’s epidemiology depends on geography, age, gender and presence of coinfections or comorbidities, among other factors. To effectively control TB epidemics, it is desirable to shift from a centralized approach in which local data are deposited into national databases for aggregated analyses, to a bidirectional one in which local partners have the capacity to collect and analyse data and then use those data to design locally responsive interventions. (The bidirectionality may need to include some restrictions; e.g. all partners can view the information but not necessarily edit it). This shift requires local TB programmes to make better use of existing data, expand routine data collection, and make informed use of targeted surveys (7). At the most basic level, effective bidirectional use of data not only entails active engagement with programme staff on a more frequent basis than quarterly reporting meetings, but also requires capacity-building so that staff can identify local gaps in the patient care cascade. It also requires a higher degree of autonomy (as local capacities increase) and even additional resources to permit staff to respond to gaps that are detected.