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Table 3 Conceptual framework for indicators for TB health promotion among Health policymakers and TB HCWs

From: Framework of behavioral indicators evaluating TB health promotion outcomes: a modified Delphi study of TB policymakers and health workers

Domain Subdomain Indicator Measure Data collection
Policymakers  
Resource inputs Human resources (Full time/part time) Human resources per 100,000 people Number of full-time/part-time personnel (physicians, nurses) for TB control per 100 000 people (physicians/nurses/technicians per 100,000 people) and the quality of human resources Review of documents and records in the department of human resources in the TB unit
Financial resources Special funds for TB control/person Input of funds for TB control per person (RMB Yuan per person) Review of documents in the financial department of the TB unit
Funds for infrastructural construction in the past 5 years Funds for infrastructural construction in the past 5 years (RMB Yuan) Document and record review in TB-control health facilities
Funds for infrastructural construction during the evaluation Funds for infrastructural construction during the evaluation (RMB Yuan) Document and record review in TB-control health facilities
Policymaking and monitoring behaviors Policymaking Percentage of meetings assigned to TB control in the workplace Percentage of meetings assigned to TB control overall in work meetings, which evaluated attention of policymakers to TB control Document and record review
Percentage of policies made for TB control Percentage of policies made for TB control (including policies for health insurance, free treatment, poverty alleviation, HCW incentives, activation of multi-sector participation in TB control, strategy, and guidelines) Document review
Rate of satisfaction with policy (in terms of funding, making, implementing, monitoring) Rate of satisfaction with policy funding, policymaking, policy implementation, and policy monitoring Policy implementation and beneficiary survey
Percentage of policies made on the basis of evidence Percentage of policies made based on evidence Document and record review
Percentage of policies made through a bottom-up approach Percentage of policies made through a bottom-up approach Document and record review
Percentage of policies with measures to assess input, output, outcome, and impact Percentage of policies that included measures to assess input, output, outcomes, and impact Document and record review
Percentage of policies with measures to promote cooperation of relevant sectors for policy implementation Percentage of policies that included measures to promote cooperation of relevant sectors for policy implementation Document and record review
Surveillance of policy implementation Percentage and number of policies monitored Percentage and number of policies that were monitored and evaluated when implemented Document and record review
Number of documents/policies on Surveillance Number of policy and strategy related to surveillance of related policy implementation Document and record review
TB HCWs  
Self-protective behavior Breaking the chains of transmission (Preventing infection) Average hours spent daily on workplace disinfection by ultraviolet radiation everyday Average hours spent on disinfecting the workplace by ultraviolet radiation each day in TB-control health facilities HCW survey and observation study on HCWs
Percentage of doctors who ventilate the workplace Percentage of clinic doctors who ventilated the workplace every day in TB-control health facilities HCW survey and observation study on HCWs
Percentage of doctors who consistently wear N-95 respirators Percentage of clinic doctors who wore N-95 respirators daily when working in TB-control health facilities HCW survey and observation study on HCWs
Behaviors related to TB patient diagnosis Implementing clinic guidelines in TB patient diagnosis Percentage of patients diagnosed by implementing clinic guidelines Percentage of patients diagnosed by implementing clinic guidelines in TB-control health facilities TB patient survey and clinic records review
Behaviors related to tracing TB suspects Tracing TB suspects referred by non-TB control health facilities Percentage of TB suspects successfully traced Percentage of TB suspects successfully referred to TB-control health facilities. Clinic record review
Behaviors related to TB patient treatment Implementing Standardized chemotherapy Percentage of patients treated with standard treatment regimens Percentage of patients who received standard treatment regimens recommended by WHO TB patient survey and clinic record review
Monitoring treatment Percentage of patients covered by DOT DOT refers to a standardized treatment regimen directly observed by an HCW or a community health worker for at least the first two months. TB patient survey and clinic record review
Behaviors related to TB health education Content of health education Percentage of patients who received information on free treatment policy Percentage of patients who received information about the TB free-treatment policy and who accurately understood this policy. TB patient survey
Percentage of patients who received information on importance of adhering to treatment Percentage of patients receiving information on adherence to TB treatment and who accurately understood the importance of adhering to TB treatment. TB patient survey
Percentage of patients who received information on regular follow-up sputum microscopy Percentage of patients receiving information about regular follow-up sputum microscopy and who accurately understood the importance of regular follow-up sputum microscopies. TB patient survey
Percentage of patients who received information on managing side-effects of anti-TB drugs Percentage of patients who received information about managing side-effects of anti-TB drugs and who accurately understood the management of these side-effects. TB patient survey
Percentage of patients who received information on a healthy lifestyle Percentage of patients who received information about a healthy lifestyle to complement TB treatment and who accurately understood how to maintain this healthy lifestyle TB patient survey
Percentage of patients who received information on preventing TB transmission Percentage of patients who received information about preventing TB transmission and who accurately understood how to prevent TB transmission TB patient survey
Time on health education Length of time spent on health education with each patient Length of time spent on health education with each TB patient TB patient survey, HCW observation study