2. Performance Monitoring of Tuberculosis Infection Control in Zimbabwe: introduction of a novel color-coded evaluation tool Tendayi Jubenkanda On behalf of the Zimbabwe Infection Prevention and Control Project (ZIPCOP) & Biomedical Research and Training Institute (BRTI) Shirish Balachandra U.S. Centers for Disease Control (CDC) Zimbabwe Dec 2015

3. Background: Zimbabwe Context HIV prevalence nationwide is ~15%, with over 1.4 million PLHIV Zimbabwe currently ranks 17 th among the world’s 22 high-burden TB countries, with ~ 69% HIV-TB co-infection rate Both patients and healthcare staff are at high risk of TB infection in health facilities, necessitating the strengthening of tuberculosis infection control (TBIC) measures

5. Background: Performance evaluation tool To improve TBIC, a standardized assessment tool was required The initial tool developed by the project required additional measures to thoroughly assess TBIC activities, and was lacking a scoring system A new tool was developed, adapted from the CDC TB dashboard

6. TBIC Colour Coded Tool Appropriate intervention in place Appropriate intervention in progress Appropriate intervention not in place Not applicable LEGEND

7. Methodology Using the evaluation tool, facilities were assessed through: Direct observation Reviewing records Interviews Data was collected by the ZIPCOP staff from July 2014 to March 2015 Evaluation tool took approximately 3-4 hrs. to administer 82 facilities assessed: 60 facilities had been receiving ZIPCOP support for a period of 3 years 22 facilities were new sites, adopted in 2014-2015

8. Overall performance scores for facilities: with and without ZIPCOP

9. Performance on TBIC variables: with and without ZIPCOP intervention

10. Recommendations TBIC should be uniformly implemented in all healthcare facilities Adoption of the evaluation tool for regular monitoring of TBIC Development of a multidisciplinary approach to health facility design Routine screening of all health care workers for TB

11. Acknowledgements The Ministry of Health and Child Care Directorate of Nursing; AIDS and TB unit ZIPCOP consortium (BRTI and ICAZ) The U.S. Centers for Disease Control Health facility administration and staff throughout Zimbabwe “This project has been supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Centers for Disease Control and Prevention (CDC) under the terms of [CDC –RFA –GH11- 1144].”