TB Platforms for Sustainable Detection, Care, and Treatment in the Philippines

Overview

The TB Platforms Project aims to strengthen TB interventions at the regional, local government, and community levels to increase TB case detection and treatment success rates.

 

The Challenge

According to the National TB Prevalence Survey, the TB prevalence rate in the Philippines is 1,159/100,000 people, two and a half times higher than previously estimated. While the estimated incidence is 554/100,000 people, the treatment coverage is just over half (58%) of all cases. In order to improve TB detection, notification rates ,and treatment outcomes, national support must be coupled with local capacity building, system strengthening, and community engagement, including that of the private sector.

 

Objectives

Advance adoption and improvement of healthy behaviors of individuals and the community to prevent, detect, and treat TB by:

  • Utilizing novel approaches in social behavioral change to improve communication with communities and individuals and encourage positive health-seeking and preventative behaviors.
  • Engaging NGOs and public and private providers to increase data reporting, train regional and provincial health teams to apply local TB data in strategic planning and prioritization and promote the use of evidence-based decision making to ensure that activities are effective and cost-efficient.

Bolster high-quality patient-centered TB and drug-resistant TB treatment for adults, children, and vulnerable populations by:

  • Applying URC’s patient-centered care framework through quality improvement (QI) teams, focusing QI strategies on comprehensively addressing patient needs, reorganizing procedures for more coordinated and efficient patient care, creating systems for client feedback, emphasizing gender-sensitive services, and boosting health worker motivation.
  • Engaging facility, diagnostic, and community providers in strong service delivery networks to improve management of TB care, establishing functional linkages among providers, and ensuring access to TB services throughout the continuum of care, thereby increasing treatment completion rates and decreasing the spread of TB.

Expand local health system capacity to delivery TB and drug-resistant TB services to targeted populations by:

  • Supporting, strengthening, and empowering local government units to plan, manage, finance, oversee, and lead TB control efforts.
  • Establishing linkages between formal health institutions and non-traditional actors including private providers, civil society organizations/community-based organizations, patients, and other advocacy groups, engaging and mobilizing local stakeholders to ensure a strong network of community and facility-based services.

 

Achievements

  • One key project tactic is the Finding TB Actively, Separating safely, and Treating effectively (FAST) approach, which includes actively seeking and identifying hospital visitors, patients, and health care workers with TB symptoms, testing them, and educating them about TB. TB Platforms developed a FAST standard operating procedure that was approved by the Department of Health. In two years, the project introduced and scaled up FAST to 63 hospitals and 81 rural health units in the Big 3 Regions and Marawi City as an infection prevention approach to reduce TB transmission in health care facilities, screening 495,504 individuals and diagnosing 2,376 people with TB.
  • TB Platforms supported the adoption by local government units of TB ordinances that allocate resources and funding for local TB responses. Metro Manila, Pasig, Paranaque, Manila, and Navotas are the first cities to develop and pass TB ordinances. In Pasig, the TB ordinance supports the allocation of an annual budget of Php 2M, the creation of a local TB council, and implementation of the FAST strategy in hospitals.
  • TB Platforms designed and pretested a social behavior change strategy, called Tibay ng Dibdib – literally, “chest strong,” which aims to improve knowledge and risk perception of TB among Filipinos. In Marawi, this concept was tested and later scaled up with buy-in from the regional centers for health development. The project then developed a mentoring program called COME ALIVE (Communicate and Mentor Effectively through Ask-Listen-Inform-Verify-Encourage) framework that engages community and Barangay health workers (BHWs) to improve TB awareness in communities. To quantify their efforts, the project provided BHWs and community health volunteers (CHVs) with community TB screening and contact investigation forms.
  • TB Platforms has reached more than 775,000 individuals with TB educational and informational materials and more than 100,000 individuals with news releases and social media postings. A total of 1,674 BHWs have been mentored using the COME ALIVE approach to empower their communities to improve their health-seeking behavior. With these mentored BHWs and other CHVs, 523,058 high-risk individuals were screened, 13,000 household contacts were investigated, and 27,554 individuals were screened by X-ray with 735 TB cases diagnosed.

 

TB Platforms on CNN Philippines

Dr. Marianne Calnan, Chief of Party for the USAID TB Platforms Project, explains how the project is successfully addressing tuberculosis cases and response amid the COVID-19 crisis. This interview was shown on CNN Philippines on June 25, 2020 (9 minutes).

 

Senior citizens and other groups at risk for TB (household contacts of TB patients, persons with diabetes, smokers. etc.) register for TB screening. Photo Credit: APascua/URC
Senior citizens and other groups at risk for TB (household contacts of TB patients, persons with diabetes, smokers. etc.) register for TB screening. Photo Credit: APascua/URC
Duration
2018 to 2023
Funders 
US Agency for International Development (USAID)
Partners 
Center for Health Solutions & Innovations Philippines (CHSI)
Gerry Roxas Foundation (GRF)
Philippine Tuberculosis Society Inc. (PTSI)
Pilipinas Shell Foundation, Inc. (PSFI)
Regions/ Countries