Data-to-Action Continuum Scale

1. Non-standardized paper-based tools are the primary tools for data collection at all levels.
2. There is an ad hoc list of TB data collection systems.
3. Data collection is ad hoc or mainly driven by donor or external stakeholder mandate for data collection.
4. Unique identification is absent or rarely used to identify TB cases.
5. The NTP site list is absent or only includes site names.
6. Data are rarely or inadequately disaggregated in the site-level data collection.

1. Standardized paper-based data collection tools are the primary tools for data collection at all levels.
2. A list of all TB data collection systems exists but information about its data and users is limited to the national level.
3. Some data collection processes align with service delivery guidance.
4. Some TB program sites use their own unique identifiers to identify TB cases.
5. The NTP has an electronic site list but it is incomplete.
6. Data collection tools (paper or digital) and processes allow disaggregation of data but disaggregate data are not collected.

1. Standalone standardized electronic data collection tools are often used, including for retrospective data entry, at higher levels.
2. A complete inventory of all the TB data collection systems, its data, and target users is available with the NTP.
3. Data collection processes are aligned with the TB service delivery guidance.
4. The NTP uses unique identifiers for TB cases across program sites.
5. The NTP has a web-based site list (similar to a master facility list) that is complete.
6. NTP guidance requires collection of disaggregate data.

1. Standardized electronic data collection tools are used at all levels and integrated with the national health management information system (HMIS) data collection system.
2. The inventory information is used to inform the need for a new TB data collection system.
3. Data collection processes are monitored and assessed to check alignment with the service delivery guidance.
4. Unique identifiers for TB cases are aligned with the national unique (person or patient) identifiers.
5. The NTP web-based site list is integrated into the master facility list.
6. NTP monitoring and review assesses quality of disaggregated data collection.

1. National HMIS data collection system is used for real-time data entry.
2. TB data collection system inventory is routinely updated to add information about a new TB data collection system.
3. Data collection process monitoring and assessment findings guide revisions and updates.
4. The NTP ensures use of unique identifiers to track and treat TB cases across all TB sites (program, testing, and pharmacy).
5. The NTP web-based site list is routinely reviewed and updated together with the national master facility list.
6. The NTP routinely reviews and updates disaggregate data collection requirement in the monitoring and evaluation (M&E) plan.

1. Non-standardized paper-based tools are the primary tools for reporting at all levels.
2. Data are rarely or inadequately disaggregated in the site-level reporting.
3. Data reporting is ad hoc or mainly driven by donor or external stakeholder mandate for reporting.

1. Standardized paper-based reporting tools are used at all levels.
2. Data reporting tools (paper or digital) and processes allow disaggregation of data but data are incomplete or rarely collected.
3. Some data reporting processes align with TB service delivery guidance.

1. Standalone standardized electronic data reporting tools are used at national and district levels for aggregate data reporting, at higher levels.
2. NTP guidance requires reporting of disaggregate data.
3. Data reporting processes are aligned with the TB service delivery guidance.

1. Standardized electronic data reporting tools are used at all levels and integrated into the national HMIS.
2. NTP monitoring and review assesses quality of disaggregated data reporting.
3. Data reporting processes are monitored and assessed to check alignment with TB service delivery guidance.

1. Standardized real time case-based electronic data reporting tools are used.
2. The NTP routinely reviews and updates disaggregate data reporting requirement in the M&E plan.
3. Routine NTP guidance revision/update guides revision of data reporting processes.

1. Data quality is defined and measured in an ad hoc manner.
2. Data quality is not checked or ad hoc and non-standardized data quality assessments are conducted.

1. Data quality parameters are clearly defined and documented by NTP.
2. Application of standard data quality tool is limited to donor-funded programs.

1. Data are generally complete, consistent, and accurate for priority data elements for at least the last 12 months.
2. The NTP conducts routine data quality reviews both in source documents at the facility and for the reported data.

1. Data quality problems are documented and factored in data analysis to be comparable across sources and time.
2. Data quality parameters are integrated into program review and management.

1. High quality data is available for at least the priority data elements for at least the last 5 years.
2. The NTP uses data quality assessment findings to improve the data and capacity to collect and report good quality data.

1. The NTP lacks central data repository(ies) (e.g., a national reporting system, a TB case report repository) where TB case report data are analyzed/reported to (at case or aggregate level).
2. Data exchange processes between systems at points of service for TB cases and reporting and/or central repositories are missing or are limited and require manual intervention.
3. Data exchange processes between systems at points of service for laboratory testing and reporting and/or central repositories are missing or are limited and require manual intervention.
4. No defined technical standards exist for use in the TB data management and exchange but may exist for other diseases or HIS activities.

1. The system requirements for a central data repository are documented but not implemented.
2. There is some data exchange between systems at points of service for TB cases and reporting and/or central repositories at the national level but limited automated exchange.
3. There is some data exchange at the national level but limited automated exchange.
4. The country has adopted and/or developed standards for TB data management and exchange, but standards may be localized to specific projects.

1. An electronic central data repository collates aggregate program data only at national level.
2. Data exchange between systems at points of service for TB cases and reporting and/or central repositories occurs extensively on a national level and is mostly automated.
3. Data exchange between systems at points of service for laboratory testing and reporting and/or central repositories occurs extensively on a national level and is mostly automated.
4. Standards for TB data management and exchange are approved and require certification of new exchange partners for compliance.

1. A standard-based central data repository collates data from all the TB data collection systems.
2. All data exchange between systems at points of service for TB cases and reporting and/or central repositories is automated with adequate budgetary resources in the program to meet custom requirements.
3. All data exchange between systems at points of service for laboratory testing and reporting and/or central repositories is automated and integrated with the national health data exchange (if it exists).
4. The national TB data management and exchange standards are integrated in the national HIS and/or health plan.

1. The central data repository is routinely used by NTP stakeholders to address program data analytics and visualization needs.
2. All data exchanges between systems at points of service for TB cases and reporting and/or central repositories are automated, resourced, and no specialized engineering efforts or expertise is needed to meet new requirements.
3. All data exchanges between systems at points of service for laboratory testing and reporting and/or central repositories are automated, integrated, and no specialized engineering efforts or expertise are needed to meet new requirements.
4. TB data management and exchange standards are tracked, monitored, and reviewed through a standardized process.

1. Basic or no knowledge/skill exists to conduct analysis and develop visualization.
2. Data analysis and visualization requirements/needs are missing or ad hoc.
3. Decision making is informal or only one data source is used for decision making.
4. The need for decision support tools has yet to be identified.

1. NTP staff can conduct descriptive analysis and generate some visualization (tables, graphs, charts, etc.) to make comparisons and evaluate trends.
2. Data analysis and visualization requirements/needs are documented to support NTP decision making.
3. Some guidance is available that explains how multiple data sources support decision making.
4. Need for decision-support tools is documented and exists locally or for specific implementations.

1. NTP staff are able to conduct advanced analysis (e.g., cascade analysis) and develop visualization in real-time mostly at the national level.
2. The NTP has identified and documented a minimum set of standard data analyses and visualizations requirements/needs at all levels.
3. Decision making is focused only on program resources and/or patient data reports and summaries. Some decision support tools exist locally or for specific implementations.
4. Decision-support tools are automated to use the knowledge base for contextually-relevant reference information.

1. NTP staff at national, sub-national, and facility levels are able to conduct advanced analysis (e.g., cascade analysis) and develop visualization in real-time (e.g., for identifying causes of poor performance, implementation problems, and monitor and forecast services/commodities demand) as part of the M&E activities.
2. The NTP's analytics and visualization requirements are monitored and budgeted in the NTP plan.
3. Program staff routinely make decisions with data incorporated from multiple sources (e.g., to provide scenario-based, health-system level specific decision making support, and predict the impact of decisions and policy).
4. Assessments to ensure the knowledge relevance, value, and accuracy of decision support algorithms are conducted on a regular schedule.

1. NTP staff can develop customized analytics and visualization using the central data repository (e.g., to monitor stock availability and forecast demand at all levels).
2. The NTP routinely updates analytic and visualization needs using monitoring data.
3. Advanced models, used for decision making, incorporate multiple data sources (including the central data repository) to optimize and influence TB health outcomes.
4. Assessment findings are used for continuous improvement of decision support algorithms (in terms of relevance of information and accuracy).

1. Communication is informal and lacks documented communication strategy.
2. Development and sharing of information products are ad hoc or driven by specific program needs.

1. A documented national communications strategy is in place but not operationalized.
2. Dissemination of information products is typically limited to senior-level decision makers.

1. An approved communication strategy is being implemented but confined to the national level.
2. Targeted information products are disseminated in multiple formats (print, digital) using electronic and web-based platforms at higher levels.

1. Implementation monitoring and assessment are routinely conducted to gauge the effectiveness of the communication strategy as part of the NTP review.
2. Information products are routinely produced and distributed to stakeholders at all levels of the health system is monitored and evaluated.

1. A communication strategy and its implementation are adjusted based on the assessment findings.
2. Information product dissemination is improved using monitoring and evaluation data.

1. The need for policies that govern data use at health system levels has been identified but no such guidance exist.

1. The NTP uses data use guidance to manage its data use activities at various levels.

1. The NTP has an approved and comprehensive data use guidance implemented at all health system levels to support data use for decision making.

1. Implementation of data use guidance is monitored and assessed by the national governing/leadership body.

1. The NTP's data use guidance is annually reviewed and updated using the monitoring data.

1. The NTP lacks a data sharing mechanism.

1. Data access and sharing processes and methods are mostly documented but data are shared mainly through email.

1. Access-based control and data sharing agreements are established to allow access to and sharing of NTP data within and outside the NTP.

1. Access-based control and data sharing agreement implementation is monitored to ensure compliance with data use guidance/policy.

1. The NTP uses monitoring data to support access to and sharing of data with all relevant stakeholders (e.g., NTP, external stakeholders).

1. Job descriptions are absent or lack data use roles and responsibilities.

1. Job descriptions clearly document data use roles and responsibilities but only at the national level.

1. NTP staff at all levels have access to their written role and responsibilities related to data use.

1. Supervisor(s) regularly review staff data use roles using the job description to offer constructive feedback.

1. Supervisor(s) follow NTP guidelines to review and update data use roles and responsibilities of staff.

1. The leadership and coordination team structure is informal or ad hoc.
2. An informal leadership and coordination team meets at the national level.

1. Some formal leadership and coordination team structure with a clearly-defined scope of work exists.
2. Meetings are held periodically among individual health system levels, but there is no standard operating procedure (SOP) related to meeting management.

1. A formal leadership and coordination team is managing implementation of the data use policy and data access and sharing guidance with attention to gender and equity.
2. Leadership and coordination team meetings occur on a periodic, regular schedule across the health system levels with SOPs to follow related to meeting management.

1. A formal leadership and coordination team is an integral part of the NTP review and assessment process.
2. The monitoring, evaluation, and learning (MEL) team monitors and assesses ability of leadership and coordination team to lead and coordinate regularly scheduled meetings.

1. The formal leadership and coordination team facilitates an annual review of TB data use activities at all levels of the health system and decisions are evident in the updated program/guidance documents.
2. Assessment findings are used to improve leadership and coordination team meeting outcomes.

1. MEL activities are informal or ad hoc.
2. Health outcomes are yet to be defined or lack standardized outcome parameters.
3. MEL processes are ad hoc.
4. MEL is informal and relies on individual experiences.

1. An MEL guidance document exists but is only accessible at the national level.
2. Some health outcomes are defined and monitored at the national level.
3. MEL processes are documented but project- or intervention-focused.
4. MEL data are sometimes used to monitor implementation and program performance.

1. An approved MEL plan with adequate budget allocation is being implemented at the national level.
2. Health outcome parameters are documented and monitored at all the levels.
3. MEL processes are documented and aligned with the data collection and reporting at all levels.
4. Leadership and coordination team(s) uses MEL data at the national level for program review and course correction.

1. The MEL plan implementation is monitored and reviewed as part of the program/strategy review.
2. Routine health outcome assessment and evaluation is conducted to measure improvement in individual and population level health outcomes.
3. MEL processes are routinely reviewed as part of the NTP performance review.
4. The MEL data are used to monitor, measure, and improve program data use at all levels.

1. Monitoring data are used to inform the annual review/update of the MEL plan.
2. Health outcome measurement data are used to revise and prioritize program interventions.
3. Program performance review findings are used to routinely revise/update MEL processes.
4. The MEL data are used to continuously improve the MEL plan for achieving better program goals.

1. Budget for data use activities are absent or ad hoc.
2. Availability of financial resources is ad hoc or specific to interventions.

1. Budget for data use activities is allocated but tied with specific interventions/projects.
2. Financial resource needs are documented for national level data use activities.

1. Operations of data use activities have been secured with annual budgets.
2. The NTP has a comprehensive financial plan that diversifies funding (resources from NTP, donors, and private sector) in place.

1. Budget for data use activities is monitored and reviewed during the program review process.
2. Availability and utilization of financial resources is monitored and measured by the MEL team.

1. Monitoring and review findings are used to revise/update the budget allocated to data use activities.
2. The leadership and coordination team revises financial plan using the monitoring data to align with the national TB goals.

1. Data use forums are missing or ad hoc.
2. Data review by program staff are rare or ad hoc.
3. NTP staff receive ad hoc supervision support for data use.

1. Data use forums with terms of reference are convened, but only at the national level.
2. Program staff review data at the national level for specific program implementation.
3. NTP staff receive program specific supervision and mentoring to take action on reported findings from indicators.

1. Data use forums with approved terms of reference are operational at all levels.
2. Program staff routinely conduct data review at all levels using the data use forums to identify corrective action.
3. NTP staff receive supportive supervision for data use at the national level.

1. Performance of data use forums is monitored and assessed as part of the program performance review.
2. MEL staff routinely monitor and assess implementation of actions identified in the data review.
3. Supportive supervision is monitored to help identify technical resources NTP staff can access to meet supportive supervision needs.

1. Monitoring and assessment findings are used to improve performance of data use forums.
2. Monitoring and assessment data are used to continuously improve implementation of actions identified in the data review.
3. NTP staff can mentor/coach peers on data use.

1. A national pre-service training program to impart knowledge and skills is absent or ad hoc.
2. Institutions offering pre-service training are identified in an ad hoc manner.
3. A national in-service training program to impart knowledge and skills is absent or ad hoc.
4. Institutions offering in-service training are identified in an ad hoc manner.
5. In-service training offerings are limited or ad hoc.

1. A national pre-service training program for imparting knowledge and skills exists but only for clinical staff.
2. Pre-service training is conducted by government and/or private training institutions.
3. A national in-service training program for imparting knowledge and skills exists but only for clinical staff.
4. In-service training is conducted by government and/or private training institutions.
5. In-service training offerings are aligned with training needs but only at the national level.

1. A national pre-service training program for all cadres of the NTP is being implemented.
2. A designated NTP authority oversees pre-service training programs.
3. A national in-service training program for all cadres of the NTP is being implemented.
4. A designated NTP authority oversees in-service training programs.
5. Training needs assessment data are used for identification and recommending appropriate trainings.

1. Pre-service training programs are monitored and assessed for their effectiveness and relevance.
2. The NTP offers opportunities and incentives to promote pre-service training of potential staff.
3. In-service training programs are monitored and assessed for their effectiveness and relevance.
4. Training institutions offer opportunities and incentives to promote continuous education of staff at all levels.
5. Assessment of training programs is routinely conducted as part of the MEL activities to gauge skill and knowledge of trainees.

1. The pre-service training program is routinely updated using the monitoring and assessment data.
2. Institutions and their pre-service training offerings are identified based on the NTP strategic goals.
3. The in-service training program is routinely updated using the monitoring and assessment data.
4. Institutions and their offerings are identified based on the program review findings.
5. Training assessment data are used to improve design and delivery of targeted in-service training programs.

1. My responsibilities do not include using data for decision making.
2. I feel discouraged because my job often does not seem to matter.
3. I have never received training specific to data use.
4. I do not have a colleague (e.g., knowledgeable peer or mentor) to whom I can go to for support for data use.

1. My responsibilities include using data for decision making, however I do not have access to data.
2. I feel my job is important but the work environment is unsatisfactory.
3. I have only received informal training on data use (e.g., on-the-job training from a colleague).
4. I have identified a colleague whom I would like to work with more closely for data use support, but I have not reached out for support yet.

1. I have access to data but I do not feel empowered or encouraged to use the data for decision making.
2. I enjoy and find interest in my work and I feel valued in my team but I do not feel I have many opportunities for growth.
3. I have received formal training on data use but it was neither pertinent nor recent.
4. I have a colleague knowledgeable about my responsibilities and skills but I cannot regularly turn to them for support for questions related to data use (e.g., due to their unavailability).

1. I feel like my input to my colleagues around decision making is often taken into consideration and valued, but I am not often encouraged to make decisions myself.
2. I feel that I work in an encouraging environment that promotes growth and the development of skills I need to perform well.
3. I have received formal training that was pertinent to data use at my level, but over two years ago.
4. I have a colleague knowledgeable about my responsibilities and skills with whom I am increasingly collaborating and sharing knowledge about data use.

1. I feel like my input is often taken into consideration and valued, and that I am almost always able and encouraged to make decisions based on the available data.
2. I feel that I work in an encouraging environment that promotes growth and learning, and I am rewarded for strong performance (e.g. incentives).
3. I have received formal training that was pertinent to data use at my level, and within the last two years.
4. I have a colleague knowledgeable about my responsibilities and skills whom I can regularly turn to for support and who provides feedback based on best practices in data use.

1. The NTP has few computers to support it or hardware is dedicated to specific TB HIS activities.
2. No guidance exists on the minimum hardware specifications for TB data system.

1. Less than half of the NTP's central and subnational offices have adequate hardware.
2. Hardware specifications are documented at the national and sub-national levels.

1. Hardware needs are documented, and national offices have adequate hardware, including backup services.
2. Hardware specifications are documented and followed in procurement at all levels.

1. Hardware needs are monitored and assessed at all levels. Assessment is conducted annually as part of the program performance review.
2. Hardware specifications are supported by adequate budget in the program plan.

1. Hardware needs for the program are updated and addressed routinely through annual program planning.
2. Hardware specifications are routinely updated based on the program data analytics, visualization, and data exchange needs.

No network and Internet connectivity exists or is limited to the national level.

Network and Internet connection exist at the national level and about half of subnational offices have a reliable network and Internet connection.

Adequate dedicated network and Internet connectivity exist at the national and sub-national level sites.

Network and Internet connectivity needs are routinely monitored and assessed to identify and address gaps to support programmatic data collection, reporting, and analysis.

All or almost all of the NTP national and subnational sites have reliable network and Internet connections supported by a dedicated technology support team.

There is basic or no support for ICT or electronic systems equipment installation and maintenance related to the TB HIS.

There is a recognized need to standardize processes to oversee and support ICT infrastructure, but no established or harmonized process exists specific to HIS needs.

An ICT operations and maintenance plan is being implemented at the national level.

Data are collected and regularly reviewed on the ICT infrastructure operations and maintenance plan as mandated by the NTP strategic plan.

The ICT operations and maintenance plan is continuously reviewed and adapted based on the review data.