A Multi-Sectoral Alliance Building for TB Control

A Experience

VERDADES P. LINGA, MD, MPH City Health Officer II Quezon City Health Department

QUEZON CITY

3,085,789 • Total Population (2014)

6 • No. of Districts

142 • No. of Barangays

64 • No. of Health Centers

1 QUEZON CITY

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

• No. of Quality Assurance 1 Laboratory

• No. of Satellite Treatment 5 Center/Treatment Center

6 • No. of TBDC Team

1 • No. of TB Free Council

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)

2 QUEZON CITY, 2004

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8 TB ranks 7 QC, 2004 6 th  4 in morbidity 5 th Morbidity 4  5 in mortality Mortality 3

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0 2004 2005 2006 2007 2008 2009 2010

QC Accomplishment, 2004

CDR of 55% Cure rate of 77.3%

100 90 Cured Completed 80 70 12 9.2 4.1 3.2 2.1 60 10.7 10.7

50 CNR 40 CDR 80.4 81.2 81.5 84.1 30 77.3 70 74 20 10 0 2004 2005 2006 2007 2008 2009 2010 2004 2005 2006 2007 2008 2009 2010

3 Three-Pronged strategy for SB-QC:

2005  Target clients Conducted Multi-sectoral  Designate providers alliance meeting, presented  Create enabling the Sagip-Baga QC Model environment

2006 Launched Sagip 2005 Baga QC Conducted Multi- BTBMC organized sectoral alliance meeting, presented the Sagip-Baga QC Model

4 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

5 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

6 • 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 Program providing its implementing mechanisms, appropriating funds therefor, and for other purposes

7 Sagip Baga QC

• Advocating political commitment - Barangay TB Management Council (BTBMC) was established in Payatas, headed by the Barangay Captain & Health center Physicians

BTBMC PAYATAS Functional ORGANIZATION

Technical Advisers Punong Barangay QCHD

City Health Officer

District 2 Health Officer

BTBMC-Payatas Adviser Secretariat

MOIII Appointee, HC Nurses, DOTS facility and Referring Facility Nurses, Bgy Secretary

Core Team Members

Kagawad on health, MO III Appointee, Private Clinic MD, NGO representative, JCMPHS Principal /Teacher in Charge,BTBMC-P Treatment Partner Leader

Treatment Partners NGOs/Private Providers Health Centers Technical Assistance Providers PAOFI Area A GOs JATA St. Luigi PAHC Area B Justice Palma High School German Doctors PBHC LupangPangako UNILAB Payatas Med Clinic Tahanan LPHC CCT MSH GK Clinics of ASMPH NGO Providers

8 Most TB symptomatics consulted hospitals

Health Care Worker/ 2007 National TB Facility consulted Prev Survey (%)

Public Health Center 26.7 (DOTS) Hospitals (Public and Private) 43.0

Private physician 21.7 Others 2.6

2007 2006 Hospitals engaged as Launched PPM Sagip Baga QC 2005 BTBMC organized Conducted Multi- sectoral alliance meeting, presented the Sagip-Baga QC Model

9 Hospitals Engagement

▪ Public-Private Mixed - UERM, Novaliches General Hospital & St. Agnes General Hospital, Lung Center of the , 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 Orione German Doctors Maria De Matias Mission Clinic ICAN Foundation Guanela Center Unang Lingap Community Christian Transformation Abot Kamay Children International

10 QC Accomplishment, 2007-2008

CDR of 55% Cure rate of 77.3%

100 90 Cured Completed 80 70 12 9.2 4.1 3.2 2.1 60 10.7 10.7

50 CNR 40 CDR 80.4 81.2 81.5 84.1 30 77.3 70 74 20 10 0 2004 2005 2006 2007 2008 2009 2010 2004 2005 2006 2007 2008 2009 2010

Functional TBDC established

▪ Veterans Memorial Medical Center ▪ Quirino Memorial Medical Center ▪ East Avenue Medical Center ▪ Quezon City General Hospital ▪ PTSI QC

11 2008 2007 Hospitals CUP in TB 2006 engaged PPM Control in QC Drafting of IRR Launched started 2005 Sagip Baga QC

Conducted Multi- sectoral alliance meeting, presented the Sagip-Baga QC Model

• QC Ordinance 1845, s.2008

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

12 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

2010 Conducted 2nd 2008 Multi-sectoral Alliance for TB CUP in TB Free QC Control in QC Drafting of IRR 2007 started Hospitals engaged PPM

13 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

2011 2010 TB Free QC established IRR finalized Conducted Multi- & approved by sectoral Alliance for Council TB Free QC

14 QC TB Free Council

▪ Council Members: CHD-NCR, DOLE, PhilHealth, CODE NGO, SSDD, PAISO, CATIMM, DSAP, PAMET, QCHD

DOTS Referral Network was organized

15 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

16 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

17 THANK YOU

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