End-Term Comprehensive External Review of the Ghana National Tuberculosis Health Sector Strategic Plan 2009–2013

The plan was developed by the Ghana Ministry of Health, in collaboration with various international organizations, including the World Health Organization (WHO) and the US Agency for International Development (USAID). The plan's specific objectives included reducing the incidence of TB, improving treatment outcomes, and enhancing the capacity of the national TB control program. The review of the plan was conducted by a team of experts from various organizations, including the WHO, USAID, and the Royal Dutch Tuberculosis Foundation (KNCV). The review aimed to assess the progress made towards achieving the plan's objectives and to identify areas for improvement. The review methodology involved a comprehensive analysis of data and information from various sources, including the national TB control program, health facilities, and community-based organizations. The review found that the TB burden in Ghana remained significant, with an estimated incidence of 240 cases per 100,000 population in 2012. The prevalence of TB was also high, with an estimated 1.3% of the population infected with TB. The review also found that the national TB control program had made progress in implementing the plan's strategies, including the expansion of directly observed treatment, short course (DOTS) services and the introduction of new TB diagnostic technologies. However, the review also identified several challenges that needed to be addressed, including the high prevalence of drug-resistant TB, the limited capacity of the national TB control program, and the need for improved coordination and collaboration among stakeholders. The review recommended that the national TB control program strengthen its capacity to implement the plan's strategies, improve its coordination and collaboration with stakeholders, and enhance its monitoring and evaluation systems. The review also highlighted the importance of addressing the TB/HIV co-infection, which was a major challenge in Ghana. The review found that the prevalence of TB/HIV co-infection was high, with an estimated 30% of TB patients also infected with HIV. The review recommended that the national TB control program strengthen its collaboration with the HIV/AIDS control program to improve the diagnosis and treatment of TB/HIV co-infection. In terms of implementation, the review found that the national TB control program had made progress in implementing the plan's strategies, including the expansion of DOTS services and the introduction of new TB diagnostic technologies. However, the review also identified several challenges that needed to be addressed, including the limited capacity of the national TB control program and the need for improved coordination and collaboration among stakeholders. The review also highlighted the importance of engaging all care providers in TB control, including private sector providers and community-based organizations. The review found that the national TB control program had made progress in engaging private sector providers and community-based organizations in TB control, but more needed to be done to strengthen their capacity to provide high-quality TB services. In conclusion, the review of the Ghana National Tuberculosis Health Sector Strategic Plan 2009–2013 found that the plan had made progress in reducing the burden of TB in Ghana, but several challenges remained to be addressed. The review recommended that the national TB control program strengthen its capacity to implement the plan's strategies, improve its coordination and collaboration with stakeholders, and enhance its monitoring and evaluation systems.