Phase 1 – Prepare to Conduct a PPA

Phase 1 – Prepare to Conduct a PPA

Access and Review Companion Resources

Prior to starting a PPA process, confirm that:

  1. At minimum, a few key team members have resources available at www.patientpathway.org, including country PPA case studies, the PPA Wizard, and this How-To Guide
  2. The timing is right to conduct such an analysis, i.e., results can be used to inform an upcoming planning, resource allocation, or decision-making process
  3. Decision-makers and partners will allow and facilitate access to national and sub-national data for the PPA
  4. Human resources are sufficient to dedicate to the analytical process
  5. Resources are available to involve stakeholders in the interpretation and dissemination of results, and for their translation into programmatic planning

Assemble PPA Team

The process for completing a PPA is likely to require between .5 and .75 FTE staff between three to five weeks, depending on data availability. The team should include:

  • PPA Lead: An individual with skills in data management, data cleaning and analysis, and interpretation should be identified to lead the exercise. This person will be responsible for ensuring that the data are collected, analyzed, and visualized as needed by the broader NTP and technical partners team.
  • TB Program Staff: There should be at least one representative of the team that manages day-to-day programming and strategic decisions for the NTP. This person will be essential in interpreting the PPA for use in decision making and informing relevant assumptions about the data related to the TB program.
  • Supporting Analyst: Ideally the PPA Lead would have support from another team member with skills in data analysis. The PPA Team will need to have an understanding of how their datasets are structured and may need to conduct data cleaning prior to using the PPA Wizard.
  • Researcher: Ideally, one person on the PPA team will have relationships with government counterparts to fulfill requests for non-publicly available data and for interpretation of the findings.
    • It is beneficial but not essential for some of the PPA team members to also have familiarity with broader health systems data. These might include Demographic and Health Surveys (DHS), Service Provision Assessments (SPA), Health Expenditure Utilization Surveys (HEUS) or National Health Account (NHA) data sources (described in more detail in Phase 2). For those who aren’t familiar with other non-TB data sources, this guide will explain how they can be used in support of the PPA.

Define Scope

Depending on the availability of data and the programmatic objectives for completing a PPA, the scope of the analysis will differ. In particular, consideration should be given to whether the analysis will be done at the national or sub-national level, and if it will cover all forms of TB or a subset of drug-sensitive or drug-resistant patients. Defining this scope early in the process will influence the types of data points that the PPA team will need to collect later in the process (see PPA Data Cheat Sheet for more information).

It is important to consider the population that is most important for the TB program context. Many TB programs have become increasingly decentralized, in which case a sub-national level PPA could be most useful to guide differentiated planning.

In other situations, there are important urban and rural differences in health care access, thus this level of detail in the PPA could be more useful. Finding the necessary data for the PPA is often more difficult for sub-national analyses.

Establish Timeline

The table below shows an outline of the estimated timeline for completing a PPA. Note that this timeline incorporates the time that may be involved waiting for data requests to be processed. If all data are immediately accessible, the timeline could be shorter.

Timeline Action Items
Week 1: Pre-PPA Work
  • Hold kick-off meeting with team involved in PPA to discuss scope (national or sub-national)
  • Identify key data sources
  • Contact counterparts who might control access to necessary data
  • Schedule a time for interpretation with TB team leadership (two to five weeks later)
Week 2: Collect and Clean Data
  • Consult Phase 2 for guidance on data access and collection, and proceed according to your program needs
  • Consult the PPA Data Cheat Sheet
  • Consult the data cleaning tips in Phase 3 for data cleaning considerations, and proceed with data cleaning if necessary
Week 3: Create and Review Preliminary PPA
  • Create preliminary PPA using the PPA Wizard
  • Review results with the larger team, including program expert(s)
  • Identify any changes desired for the final PPA
Week 4: Create Final PPA and Documentation
  • Create final PPA using the PPA Wizard, incorporating changes identified by the team
  • Review the final PPA with the team to ensure it meets program needs
  • Create documentation including written summary, slides or any media helpful in communicating results with key stakeholders
Week 5: Interpretation and Finalize Recommendations
  • Hold a meeting or workshop with TB team members to interpret the PPA
  • Develop recommendations for strategy and planning
  • Review PPA in conjunction with other TB analysis tools as recommended by WHO

^ TOP

Next: Phase 2 – Collect Data