Book Review
Guidelines for Conducting a Review of a National Dengue Prevention and Control Programme WHO/CDS/CPE/PVC/2005.13
The World Health Organization (WHO), in collaboration with several national governments, has conducted more than a dozen national dengue prevention and control programme reviews in Asia and Latin America in recent years, and has gained much experience from this process. These guidelines summarize the knowledge and experience obtained from such reviews, and are intended to provide comprehensive advice to national programme managers in planning similar reviews of their programmes. The guidelines consist of a description of the different elements of a programme review, and various tools to assist with the process. Some of these tools will not be needed; others may need to be modified before use.
context of the general health-care system, health sector reform and the economic status of the country. (2) An analysis of the current programme services, achievements and problems. (3) An estimate of the disease burden and trends. (4) Specific discussion of the leading issues and constraints facing the programme. (5) Recommended actions for improving the programme.
Benefits of a review: • • improves effectiveness of the national programme raises awareness about the DF/DHF situation, and increases political commitment for prevention and control develops coalitions for DF/DHF prevention and control with nongovernmental organizations (NGOs), the private sector and donors increases problem solving and supervisory skills of national programme staff participating in the review
Why perform a review of the national dengue prevention and control programme? A programme review can be of great benefit to the national programme. It has three main purposes: (i) to estimate the burden of dengue fever (DF) and dengue haemorrhagic fever (DHF), (ii) to evaluate the adequacy of dengue surveillance and prevention and control policies and procedures for reducing mortality and morbidity, and (iii) to promote organizational, technical and administrative measures to improve the programme. The assessment will incude: (1) A description of the programme resources and the programme structure, within the 228
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The decision to undertake a review should be made by the government, usually in coordination with WHO and other external collaborating organizations. Representatives of
Dengue Bulletin – Vol 29, 2005
Guidelines for Conducting a Review of a National Dengue Prevention and Control Programme
First steps: Responsibilities of the Ministry of Health (1) Decides to conduct a programme review (2) Requests cooperation of WHO and/or other agencies (3) Develops terms of reference for the review (4) Approves selection of international reviewers (5) Identifies national participants of the programme review task force these agencies should be involved in the planning of the review from the beginning. The programme review should analyse the structure and functions of the health services, including the national, regional, district and community levels. Normally, a review will cover a representative sample of regions in a country; in some large countries it may be appropriate to look only at selected parts of the country, e.g. a state of province. •
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financial, institutional and human resources advocacy activities case-reporting policies procedures for diagnosis laboratory services case-detection performance clinical management policies and procedures clinical outcomes policies and procedures health education and health promotion activities schools community service groups treatment seeking hospitalization emergency vector control medicines, intravenous fluids and other medical supplies insecticides, application equipment, transportation and maintenance training and supervision recording and reporting
Diagnosis
Clinical management
Vector surveillance and control Social mobilization and communication
Emergency preparedness plans
What does a programme review cover? Certain key elements need to be considered and evaluated during the review process. These include: • • • • Estimated burden of DF and DHF and epidemiological trends Political commitment Programme policies, strategies, targets and objectives Programme organization and health structures involved in programme activities coverage
Logistics
Monitoring, evaluation and supervision -
Other components of programmes that should also be considered for evaluation include the following: • integration within the general health services;
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Guidelines for Conducting a Review of a National Dengue Prevention and Control Programme
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coordination and collaboration with other communicable disease surveillance and reporting systems; coordination and collaboration with other programmes, such as malaria, lymphatic filariasis, environmental health, diarrhoeal diseases; health education and health promotion activities; role of other diagnostic/treatment providers, such as academic institutions, NGOs and the private sector; operational, clinical and other research activities.
(a) information provided to the review team by the national programme manager and other ministry of health officials (b) information provided by other agencies and stakeholders (c) information collected by the review team on field visits. There are three main components of a review: planning and preparation; conducting the review; and follow-up. Each step described below, from the appointment of review coordinators to the completion of the final report, is considered part of the programme review. These guidelines will help undertake these different components effectively. Each will be considered in turn, and the different tasks are described within each component. They are shown in the planning chart and checklist for a programme review (Figure).
An effective programme review means asking good questions about the essential aspects of the programme, collecting good data to answer the questions, and using the findings to plan and build political support for programme improvements. The information used in a review comes from three sources:
Figure. Planning chart and checklist for a programme review
Planning and preparation: tasks 1. Appoint review coordinators 2. Appoint a programme review task force 3. Convene a preparatory meeting of review coordinators 4. Define the purpose and set objectives 5. Set review dates 6. Plan for wide dissemination of the review findings 7. Select members of the review team and define responsibilities 8. Select sites for field visits 9. Plan logistics Conducting the review: tasks 10. Prepare a budget 1. Briefing the review team 11. Prepare data collection tools 2. Field visits 12. Prepare introductory materials 3. Presentation of field visit reports 4. Preparation of the review report Follow-up: tasks 5. Development of summary findings and 1. Finalize the review report recommendations 2. Disseminate the review report 6. Debriefing to disseminate review 3. Implement recommendations findings and recommendations and monitor progress 4. Revise plans
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