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To understand which partnership options are applicable in a certain geography, it is recommended that programme manager undertake a detailed 'needs assessment' exercise This is crucial to identify specific gaps and challenges that could be addressed either through various health systems strengthening exercises or partnering with appropriate service providers. It is recommended that this exercise is repeated on an annual basis to incorporate the changing needs of the programme.

To identify the gaps programme manager may use the recommended cascade of services provided to TB patients (Figure 1) as a guidance and starting point. The thematic areas in the cascade of care are indicative of critical gaps as we see today in the TB care and these are subject to evolve overtime.

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Themes in cascade of care services

Steps to follow while undertaking a needs assessment 

Programme managers should undertake the needs assessment exercise in consultation of all stakeholders such as state level authorities, development partners, patient's groups community based organizations, professional associations and academic experts. They may also include third party measurements as a 'checks and balances' mechanism for the assessment of these services. While conducting the needs assessment all programme managers need to consider how this process will be used to strengthen the existing health systems. Due consideration needs to be given to understand how to increase and expand the capacity of health system in terms of capacity, skills or by investment in human resources. These states and districts as a starting point for their needs assessment may use the format prescribed in Annexure 1 of the guidance document on partnerships RNTCP 2019. The updated and latest version may be available on the NTEP website.

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Steps in undertaking needs assessment

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Assessment

Question​  Answer 1​  Answer 2​  Answer 3​  Answer 4​  Correct answer​  Correct explanation​  Page id​  Part of Pre-test​  Part of Post-test​ 
To identify the gaps programme manager may use the recommended cascade of services provided to TB patients, as a guidance and starting point True False     1 the cascade of Care Services thematic chart can be used as a guidance and starting point to identify the needs of the program. They are indicative of critical gaps as as we see in today's TB care.      
Which of these are one of the first three steps for the needs assessment? Identify gaps from key output and key performance indicators. Identify gaps from activities and processes. Identify systemic gaps of Inputs All of the above 4 Broadly speaking, gaps are either present in outputs, processes or inputs.      

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