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A Multi-Sectoral Alliance Building for TB Control

A Quezon City Experience

VERDADES P. LINGA, MD, MPHCity Health Officer II

Quezon City Health Department

QUEZON CITY

• Total Population (2014)3,085,789

• No. of Barangays142

• No. of Health Centers64

6 • No. of Districts

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QUEZON CITY

• No. of Microscopy Centers (LGU, Hosp, Private)39

• No. of Satellite Treatment Center/Treatment Center5

• No. of TBDC Team6

1 • No. of TB Free Council

1 • No. of Quality Assurance Laboratory

TB BURDEN

▪ Quezon City population may have as many as 15,000 active TB cases

▪ 7,100 cases are sputum positive

▪ An estimated 3,000 new sputum positive cases are added every year

▪ Each case infects 5- 10 persons

(Based on the data from 1997 National Prevalence Survey)

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QC, 2004

QUEZON CITY, 2004

TB ranks

4th in morbidity

5th in mortality

0

1

2

3

4

5

6

7

8

9

2004 2005 2006 2007 2008 2009 2010

Morbidity

Mortality

QC Accomplishment, 2004

0

10

20

30

40

50

60

70

80

90

100

2004 2005 2006 2007 2008 2009 2010

CNR

CDR

77.3 70 74 80.4 81.2 81.5 84.1

9.210.7 10.7 4.1

12 3.2 2.1

2004 2005 2006 2007 2008 2009 2010

Cured Completed

CDR of 55% Cure rate of 77.3%

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2005 Conducted Multi-sectoral

alliance meeting, presented the Sagip-Baga QC Model

Three-Pronged strategy

for SB-QC:

Target clients

Designate providers

Create enabling

environment

2005Conducted Multi-sectoral alliance

meeting, presented the Sagip-Baga QC Model

2006Launched Sagip

Baga QC

BTBMC organized

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Sagip Baga QC launched on January 9, 2006

▪ The City Government headed by Hon. Mayor Feliciano Belmonte, in coordination with the Department of Health, USAID and Philippine Tuberculosis Society, launched the Sagip Baga QC , Stop TB in QC

Sagip Baga QC

▪ Advocating political commitment

- Philhealth DOTS accreditation/certification

- 10 Philhealth DOTS certified/accredited facilities

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Sagip Baga QC

▪ Advocating political commitment

- Strengthening & enhancing of 11 Microscopy Centers

- Establishment of 9 Microscopy Centers

- Upgrading External Quality Assurance (EQA)

Laboratory

Sagip Baga QC

▪ Advocating political commitment

- Passage of Ordinances

- QC Ordinance SP 1582, s.2005

- QC Ordinance SP 1683, s.2006

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• QC Ordinance SP 1582, s.2005

An ordinance directing all drugstores and pharmacies including its owners, managers and employees to strictly enforce the ” No Prescription, No Dispensing of Anti-TB Drugs Policy” and providing penalties for violations

• QC Ordinance SP 1683, S. 2006

An ordinance promulgating QC Sagip Baga Programproviding its implementing mechanisms, appropriating funds therefor, and for other purposes

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Sagip Baga QC

• Advocating political commitment

- Barangay TB Management Council (BTBMC)

was established in Payatas, headed by the Barangay

Captain & Health center Physicians

Health Centers

PAHC

PBHC

LPHC

NGOs/Private Providers

PAOFI

St. Luigi

German Doctors

Payatas Med Clinic

GK Clinics of ASMPH

Treatment Partners

Area A

Area B

LupangPangako

CCT

NGO Providers

GOs

Justice Palma High

School

Tahanan

Technical Assistance Providers

JATA

UNILAB

MSH

Core Team Members

Kagawad on health, MO III

Appointee, Private Clinic MD, NGO

representative, JCMPHS Principal

/Teacher in Charge,BTBMC-P

Treatment Partner Leader

Secretariat

MOIII Appointee, HC

Nurses, DOTS facility and

Referring Facility Nurses, Bgy

Secretary

Punong BarangayTechnical Advisers

QCHD

City Health Officer

District 2 Health Officer

BTBMC-Payatas Adviser

BTBMC PAYATAS

Functional ORGANIZATION

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Health Care Worker/ Facility consulted

2007 National TB Prev Survey

(%)

Public Health Center (DOTS)

26.7

Hospitals (Public and Private)

43.0

Private physician 21.7

Others 2.6

Most TB symptomatics consulted hospitals

2005Conducted Multi-sectoral alliance

meeting, presented the Sagip-Baga QC

Model

2006Launched

Sagip Baga QC

BTBMC organized

2007Hospitals

engaged as PPM

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Hospitals Engagement

▪ Public-Private Mixed

- UERM, Novaliches General Hospital & St. Agnes General

Hospital, Lung Center of the Philippines, New Era

Hospital, PTSI- QI, Veterans Memorial Medical Center,

Quirino Memorial Medical Center, East Avenue Medical

Center

Partnership with NGOs

Payatas Orione Foundation (PAOFI)St Luigi OrioneGerman Doctors Maria De Matias Mission Clinic ICAN FoundationGuanela CenterUnang LingapCommunity Christian TransformationAbot KamayChildren International

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QC Accomplishment, 2007-2008

0

10

20

30

40

50

60

70

80

90

100

2004 2005 2006 2007 2008 2009 2010

CNR

CDR

77.3 70 74 80.4 81.2 81.5 84.1

9.210.7 10.7 4.1

12 3.2 2.1

2004 2005 2006 2007 2008 2009 2010

Cured Completed

CDR of 55% Cure rate of 77.3%

Functional TBDC established

▪ Veterans Memorial Medical Center

▪ Quirino Memorial Medical Center

▪ East Avenue Medical Center

▪ Quezon City General Hospital

▪ PTSI QC

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2005Conducted Multi-sectoral alliance

meeting, presented the Sagip-Baga QC Model

2006Launched

Sagip Baga QC

2007Hospitals

engaged PPM

2008CUP in TB

Control in QC

Drafting of IRR

started

• QC Ordinance 1845, s.2008

An ordinance instituting a Comprehensive and Unified Policy for the Tuberculosis Control Implementation in Quezon City

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Five (5) components of DOTS strategy

1. Direct Sputum Smear examination shall be the initial diagnostic

tool in case finding

2. Effective drug supply & management system in accordance with NTP

3. Recording & Reporting of cases shall be on the standardized NTP

implemented in all health centers

4. Direct Observed Treatment (DOT) shall be used as a strategy to

ensure patient compliance

5. Political commitment to ensure sustained, comprehensive

implementation of NTP activities

2007Hospitals engaged PPM

2008CUP in TB Control in QC

Drafting of IRR started

2010Conducted 2nd Multi-sectoralAlliance for TB Free QC

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Multi-Sectoral Alliance for TB Free QC

▪ An assembly representing both the private & public sectors held last November 2010

in Aberdeen Court, QC assisted by PBSP-TB LINC

- Phil Medical Aooc., QC Medical Society, AFP Medical Center, UERM, NCH, New

Era General Hospital, LCP, QMMC, QCGH, Araneta groupMedical/Dental

clinic, BJMP, GSIS, DEPED, DA, DAR, LTO, PNP, Philhealth, NCIP, Media,

Archdioceses of Cubao & Novaliches, Iglesi a ni Kristo, Rotary Club, malls,

pharmacies/drugstores, PAMET, Occupational Health Nurses, NGOs & local

barangay units

Highlights:

- Multi-sectoral involvement in control of TB in Quezon City

- Initiatives of each agencies in their effort to fight against TB

- Redirect policies in accordance to the MDGs

- Sustainability of the program

2010Conducted Multi-

sectoral Alliance for

TB Free QC

2011TB Free QC established

IRR finalized

& approved by

Council

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QC TB Free Council

▪ Council Members:

CHD-NCR, DOLE, PhilHealth, CODE NGO, SSDD, PAISO,

CATIMM, DSAP, PAMET, QCHD

DOTS Referral Network was organized

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Hospitals, pharmacies and laboratories were re-engaged

QUEZON CITY RECOGNITION in 5th MLQ Achiever’s Award Ceremony

2012

▪ Most Outstanding LGU in NTP Implementation – Quezon City

▪ Most Outstanding NTP Nurse Coordinator

▪ Most Outstanding NTP Controller

▪ Most Outstanding Jail DOTS Unit-QC Jail

▪ Most Outstanding TB in Workplace Initiative – SM Fairview

2011

• Most Outstanding Public DOTS Facility -Lupang Pangako Health Center

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QC TB Free Council

The Council was reconvened last November 2013

spearheaded by CHO

Members of the Council:

QC Medical Society, DEPED, QC, PAISO, SSDD,

BOC, Council on Health, Rotary International District

3780, Children International (QC & Manila), QC

Jail, QC TB Task Force Association & QC

Health Department

QC TB Free Council

Conducted Strategic Planning last April 3 & 4, 2014 in

H2O Hotel

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THANK YOU