Table 2 Governance of national tuberculosis control programme (NTP) in Nigeria

Strategic vision

Insufficient or delayed government funding

Existence of strategic plans for Tuberculosis (TB)

Robust policy coordination framework

Participation and consensus orientation

Weak public-private mix for TB service delivery

Strong stakeholder involvement in policy development and service delivery

Rule of law

Weak legal regimen for isolation of TB patients

Assessment of legal environment for TB control completed.

Absence of TB legislation and law regulating sale of anti-TB drugs

Transparency

Absence of clear staff needs.

Frequent changes in leadership of NTP

Responsiveness

Stigma by health workers and the public

Need-based drug distribution system

Poor infrastructure

Policies support integration of TB into general health services and community.

Weak linkage between TB and Maternal and child health services

Weak collaboration between NTP and National Primary Health Care Development Agency.

Lack of incentives for community volunteers

Use of community volunteers

Equity and inclusiveness

High transaction cost.

Free TB sputum microscopy and treatment policy

Women, children and rural dwellers have poor access to TB care.

Exclusion of TB from national health insurance guidelines.

Effectiveness and efficiency

Poor attraction of health workers to TB care

Existence of a national TB training school

NTP lack authority to influence staff recruitment and distribution.

Well-structured laboratory network system.

Introduction of new diagnostics

Poorly motivated TB service providers

Poor service delivery infrastructure

Inadequate drug distribution from state store to health facilities.

Accountability

Absence of formal social accountability initiatives

Strong civil society involvement

Intelligence and information

Incomplete and delayed quarterly reporting.

Adherence to World Health Organisation’s recording and reporting standard

Poor storage of surveillance data

Regular and effective data review meetings

Weak human resources capacity in data management

Frequent revision of reporting formats

Transition from paper to an electronic data management system

Inadequate coverage for childhood TB

Existence of national prevalence data

Ethics

Delays in TB diagnosis and initiation of care

Standards for TB care exist.

Poor staff attitude

Long waiting time

Absence of TB infection control measures

Prevalent informal payments

Existence of infection control guidelines