Evaluation of the performance of the ending tuberculosis strategy in Yasothon Province

Abstract

This study aimed to evaluate and synthesize an operational model for implementing the End TB strategy by applying the CIPPIEST model. Data were collected from 17 stakeholders through focus group discussions and in-depth interviews, 274 participants through questionnaire surveys, and document reviews, including databases on screening and treatment of pulmonary tuberculosis patients across all nine districts of Yasothon Province. The findings revealed that most components assessed using the CIPPIEST framework demonstrated a high level of appropriateness, including context (75.6%), input (62.8%), process (69.3%), output (77.0%), impact (63.5%), effectiveness (76.6%), and sustainability (65.7%). Only the transportability component showed a moderate level of appropriateness (48.5%). Most stakeholders showed a clear understanding of the End TB Strategy and translated policies into practice through existing bureaucratic mechanisms. Key interventions included active case finding for new TB patients, TB treatment through the DOTS system, and integration with HIV services. Results showed a significant decrease (p<0.05) in new tuberculosis patient registrations, from 96.4% to 85.0%, while treatment success significantly increased (p<0.05) from 83.1% to 88.1%, although it remained below the target. Participation and satisfaction were at high levels. Critical success factors included strong collaboration among partner networks and cross-sectoral integration. The synthesized operational model consists of the “Six-Dimensional Strategy for Ending Tuberculosis,” comprising: (1) targeted and precise active case finding; (2) diagnosis with standard technologies; (3) comprehensive care; (4) strengthened support systems; (5) utilization of innovation and research; and (6) integration and stakeholder engagement.