USAID eliminating tuberculosis in Central Asia final performance evaluation

The evaluation employed desk review, key informant interviews with 68 stakeholders across all five countries, and 91 semi-structured surveys with TB patients across Tajikistan, Uzbekistan, and Kazakhstan. Key findings include that ETICA played a pivotal role in advancing TB laboratory diagnostics in Tajikistan, Uzbekistan, and Kazakhstan, aligning with the latest WHO standards, but some barriers persist, including challenges rolling out information management systems and high lab staff turnover. ETICA enhanced patient-centered care, and medical and non-medical professionals were broadly positive about ETICA’s ability to meet their needs. Overall, civil society organizations were capable and willing to embrace all roles assigned to them. Patients largely reported access to treatment without major barriers, though gender differences were noted, and they had high satisfaction with hospital care and other support services. Patient views on stigma were highly varied, with some saying it had improved, worsened, or not changed. Continued heavy reliance on hospitalization and use of outdated clinical protocols remain challenges to be addressed. In Turkmenistan and Kyrgyzstan ETICA activities included capacity building and knowledge sharing, which was praised by KIIs. Recommendations following from the findings include for USAID to plan how to retain trained and experienced lab staff; prioritize the implementation of digital health systems and tools; and strengthen capacity within National TB Programs while avoiding adoption of their functions.