Evaluation of Tuberculosis Control Program in Lull County

The evaluation focuses on a TB support program implemented in Lull County to address the spread of tuberculosis, particularly exacerbated by the arrival of newly arrived Salvadoran immigrants. The report assesses various aspects such as the effectiveness of staff performance, patient perception surveys conducted in Spanish due to language barriers, and record reviews. Data collection methodologies employed include interviews with medical staff, observations of clinical operations, patient surveys, and comprehensive review of medical records. Key strategies for disseminating the evaluation findings involve publishing results in medical journals, featuring them on county health department websites, and presenting at medical conferences to ensure broad accessibility and implementation insights. The conclusion underscores the program's success in enhancing TB control measures within the community.

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Introduction
An evaluation plan is an important tool to evaluating the outcome of a health program to
understand its’ effectiveness in meeting predetermined program goals (Chen, 2014). The
following report is a health evaluation plan of Tuberculosis support program of Lull County.
Tuberculosis (TB) is a disease which is infectious and is caused by a bacterium called
Mycobacterium tuberculosis (MTB) (Blasi, 2014). This disease initially affects the respiratory
system damaging the lungs that lead to death.
The program was undertaken in 2002 to 2005. The program was implemented to reduce the
increasing incidence of TB case in Lull County among Salvadoran community. The evaluation
plan will evaluate the implementation process and outcomes of the health program to outline the
effectiveness of the program and what could be done to increase its effectiveness. The report will
also highlight strategies that will be used to disseminate the evaluation plan report findings.
Description of the program
The Tuberculosis support program was undertaken by Lull’s county directory Henry Evans. The
support program aimed at controlling and preventing further transmission of Tuberculosis in the
county. Tuberculosis was not a big issue in Lull County and increased with increasing number of
immigrants from Salvador. The disease was predominately among the immigrant and it was
import to control it because of the nature of the disease. The statistics there were three (3) cases
at average were reported per year that is from the year 1995 – 2001. Then in the following year,
the number increased to six in less than a period of three months (Salomon, 2012). According to
reports, infected were Salvadoran men who were new immigrants in the county. As a result, it
was important to formulate and implement a TB support program to control and prevent further
infections in the county.
The main objective of this program was to enable control and prevent spread of TB between
Salvadoran immigrants and the locals. The program aimed to diagnosis and treat TB cases in the
County. The program also aimed at creating awareness on the preventing methods of TB
especially in public places.
The program was implemented by a team of professionals in the department of health in the Lull
county department led by Henry Evans.

Project and evaluation plan of TB support program of Lull County
Goal: The goal of the program is to reduce TB transmission and enhance healthier Salvadoran
patients through eliminations of TB in the community.
Objective
s
Strategies Process
Indicators
Data
collection
methods
Impact/
Outcome
Indicators
Data
Collecting
Methods
To create
public
awareness
on TB
Creating
awareness
advertisements
on the national
radios and in
print media
Number of
TB adverts
running in
the media
Documentation People
being
awareness
of TB
(informed
patients)
Survey
Undertake
public
education in
the
community
Number of
educational
camps held
in the
community
Records from
health
educators and
survey
TB
knowledge
based
increased
Survey
Undertake
door to door
campaigns
Number of
households
visited
Surveying and
count
Patients
going for
treatment
counting
To
Diagnosis
and treat
TB
patients
Set health
camps in the
community
Number of
TB camps
operational
in the
community
Camp records
and survey
Patients
accepting
treatment.
Reduced
hospital
admissions
Observation
Prescribe TB
medication for
patients
Number of
TB patients
treated
Clinical
records from
professionals
Patients
adhering to
treatments.
Observation
and survey

To ensure
all new
arrival
migrants
are treated
Set a TB
testing camp
on the border,
ports and
railway
stations.
Setting of
camps in all
entry of
migrants in
the county
Observation
and
Documentation
of camps
started
TB
knowledge
among
immigrants
Survey
Include TB
test as
compulsory
for new
arrivals
migrants (TB
clearance
Form)
New
migrants
have TB
clearance
form
Survey Compliance
with the
law.
Healthier
immigrants
Counting,
survey
Rationale of the Evaluation plan
Evaluation Goal
The main objective of this plan is to determine the efficiency of TB Support Program in
controlling and avoiding the spread of this disease between Salvadoran immigrants. The
assessment will examine the effectiveness of the TB support program to enable future
appropriateness of health programs.
Evaluation Team
An evaluation team is a group of people who come together for the purpose of assessing a
particular thing. The team comprised of a clinical nurse and staffs from the program. This came
out of decision as she will have an access to the program data. Public health commissioner was
also in our midst to make sure that all review plans are met. Kelvin, a community leader was also
in the team to make sure the practice is culturally practiced.
SINGLE PERSON FUNCTION TASK
Sheila (nurse) Leads the plan  Making sure evaluation

activities are done as
planned.
 Coordinating all the
meetings held for the team
Joseph (Manager of the
program)
Analyzing data  Evaluate quantitative data
 Organize the investigation
of qualitative data.
 Ensure application of
results.
Erick (County commissioner
of health)
Stakeholder Offer provision and guidance
in giving out of results.
Sharon (Field employee) Data gathering Collect and confirm data
Kelvin (Society leader) Community link Organize data gathering with
the members of community
Table 1: Roles and responsibilities of team members
Stakeholders Assessment Plan
The stakeholders of the program were people having interest in the evaluation process.
The table below reviews the plan for stakeholder engagement.
Stakeholder classes
Standpoints Function in the
assessment
How to
participate
Personnel involved in program processes
 Peter, Miriam, and
Sheila
 Fear program can be
changed negatively
 Defining context and
program
 Meetings
 Direct

 View program
assessment as a
personal decision
 Recognizing data
sources
 Assembling data
 Interpreting
discoveries
 Publishing and
implementing
conclusions
functions in
doing
evaluation
Persons served or affected by the program
 Patients in clinic  May panic or reject
health system
 Need good and
accessible amenities
 Giving customer
perception
 Interpreting outcomes
 Survey
 Foreign-born
community in
general
 Perhaps they are
doubtful of immigrants
to neighborhoods, most
when immigration is
banned
 Providing community
setting
 Inform of
findings
 Other facility
programs in the
region
 May or may not be
duplicating with same
challenges
 Disseminating
conclusions to
community spectators
 Notify of
findings
Proposed users of assessment findings

 Miriam  To show usefulness
 Use results to improve
the program
 Defining information
required from the
estimation
 Emerging and
executing
recommendations
 Direct
functions in
doing
evaluation
 County
Commissioners of
Health
 Know whether program
is operative through
county funds
 Providing funding
context
 Interpreting results
 Erick, direct
participation;
others
meeting
 Clinicalteam  Offer effective and
suitable treatment and
care involvements for
TB
 Interpreting results
 Modifying exercise
when in need
 Meeting
 Board of community
planning
- Kelvin
 Improve public health,
well being
 Disseminating
outcomes
 Giving of
findings
Table 2: Stakeholder Assessment and Engagement Plan
Resources Happenings Productions Results
Initials Subsequent Short-term Mid-term Long-term
LHAs of
Salvadoran
Engaging LHAs LHAs
engaged &
Offer Spanish
communicatio
Increase
application
Eradicate
TB in the

communal LHAs training trained n and
ethnically
skilled services
to Salvadoran
community
of TB
facilities by
Salvadoran
Community
community
TB Staff
Funding
Public
outreach
Education TB door to
door and
education
did
Increase TB
know how in
the community
Community-
based
organization
s serving the
community
Guidance
and
counseling
provided
Trust built
among health
care workers
and the
community
TB
screening
Referrals Screening
made and
referrals
done
Early LTBI
and TB
discovery and
interventions
Lower TB
transmission
Patients
recognize
contacts and
source cases
Treatment
plan
established
Patients admit
treatment for
TB and LTBI
Rise in the
completion
of therapy
degree.

Patient
complete
treatment
DOT calls DOT
overseen
Patients adhere
to treatment
Table 3: Project Description of TB Subscribe Program
The health program is commendable in the society in order to control and prevent the widespread
of this infectious disease (Zumla, 2013). The newly concerned people are the one that is
immigrating in the county, another thing is that people with TB are not reached in time for the
treatment thus these cases are found mostly in hospital after a great health damage has already
occurred (Salomon, 2012). Again, those that get discharged nobody follows them up to know
how they are doing and in case of any help to be ready to help. Unlike in earlier days, treatment
of this disease has become so costly due to the rising illness and suffering of the members of the
community. In the current situation, nothing has been left other than an immediate attention to
the disease if not so there will be no next generation to inherit us (Blasi, 2014).
Before the huge number of immigrants in the area, Lull County has been a low TB incidence
area (Menjivar, 2004). The current number of cases had raised a lot of attention in the county
administration. Although the urge to prevent and finish this disease is enormous, the resources
that are needed to deal with it were limited. There was an outreach programs using Lay Health
Advisors (LHAs) that was tailored for newly immigrants in Lull County. The TB Support
program used Spanish-speaking health officers to do Directly Observed Therapy (DOT). There
was also social support to immigrants communities to increase voluntary testing and treatment
(Stowers, 2012).
Resources/Inputs
LHAs, community-based organizations, TB staff, and community health centers were the
resource input in the TB health program.

Activities
The activities included training, TB screening/testing, DOT visits, community
outreach/education, and prescribing treatment.
Outputs
The output of the support program were LHAs were trained and hired, counseling provided,
referrals made, TB outreach conducted, the test conducted, DOT was administered and treatment
plan developed
Outcome
The outcomes of the evaluation program were; the resources were efficiently allocated, patients
were treated and the community became healthier, and there was a set mechanism to prevent
further infections.
Evaluation Design
The TB support program used multiple data sources. Although the evaluation was serving few
people, there was need to acquire a lot of data in order to recommend on improve health program
(Chen, 2014). The design ensured that the data was detailed. The evaluation plan used
Salvadoran patients’ records in the past and tried to compare them with current program data.
Data Collection
Several methods of data collection were used to collect required data. They include; interviews,
observations, record review, and surveys. Staff interview was done to assess evaluate the
challenges and observations that they made in the health program. Most Salvadoran patients
could not speak English that led to collecting written data in Spanish that was administered to
patients that were in the clinics’ waiting room. This was meant to evaluate patients’ perception
on TB treatment and medication. Observation was to assess staffs performances and techniques
used in Tuberculosis awareness. Finally, there was review of records, charts, and training
materials..
Strategies for Successful Dissemination and Utilization of the Evaluation Report

In order to ensure that the findings of this report are utilized, the report will be disseminated in
the following ways;
First, the findings of the evaluation plan will be published in the medical journals. This will
enable academicians formulating health programs to read on how to make the programs effective
and efficient.
Secondly, the evaluation finding will be published in the county medical department website to
be available to all professional and learners who will be willing to study it.
Lastly, the evaluation will be presented in medial conferences to disseminate finding to
professionals and all stakeholders involved.
Conclusion
Based on our evaluation program, it is clear that TB support program was effective and enabled
the County to control and prevent the infectious disease. According to data collected in Lull
County, the spread of this disease was highly enhanced by the newly arrived Salvadoran
immigrants who entered in the county. Also, it has been noted that people have the fear to go and
be tested or go for a medical checkup once you encounter these signs and symptoms of this
disease. Our evaluation program has been successful as we have met all the objectives that we
had before we could start this process.
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