Access and Review Companion Resources

Prior to starting a PPA process, confirm that:

1. At minimum, a few key team members have resources available at ppa.linksbridge.com, including country PPA case studies, the PPA Wizard, and this How-To Guide
2. The timing is right to conduct such an analysis, i.e., results can be used to inform an upcoming planning, resource allocation, or decision-making process
3. Decision-makers and partners will allow and facilitate access to national and sub-national data for the PPA
4. Human resources are sufficient to dedicate to the analytical process
5. Resources are available to involve stakeholders in the interpretation and dissemination of results, and for their translation into programmatic planning

Assemble PPA Team

The process for completing a PPA is likely to require between .5 and .75 FTE staff between three to five weeks, depending on data availability. An individual with skills in data management, data cleaning and analysis, and interpretation should be identified to lead the exercise. This person will be responsible for ensuring that the data are collected, analyzed, and visualized as needed by the broader NTP and technical partners team. There should also be someone on the team who has experience with Excel and is willing to learn new analytical tools as needed (e.g., Tableau and R). Ideally, one person on the PPA team will have relationships with government counterparts to fulfill requests for non-publicly available data and for interpretation of the findings.

Finally, it is beneficial but not essential for some of the PPA team members to also have familiarity with broader health systems data. These might include Demographic and Health Surveys (DHS), Service Provision Assessments (SPA), Health Expenditure Utilization Surveys (HEUS) or National Health Account (NHA) data sources (described in more detail in Step 2). For those who aren’t familiar with other non-TB data sources, this guide will explain how they can be used in support of the PPA.

Define Scope

Depending on the availability of data and the programmatic objectives for completing a PPA, the scope of the analysis will differ. In particular, consideration should be given to whether the analysis will be done at the national or sub-national level, and if it will cover all forms of TB or a subset of drug-sensitive or drug-resistant patients. Defining this scope early in the process will influence the types of data points that the PPA team will need to collect later in the process (Table 2).

It is important to consider the population that is most important for the TB program context. Many TB programs have become increasingly decentralized, in which case a sub-national level PPA could be most useful to guide differentiated planning.

In other situations, there are important urban and rural differences in health care access, thus this level of detail in the PPA could be more useful. Finding the necessary data for the PPA is often more difficult for sub-national analyses.