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1
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
2
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)
3
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%
4
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
5
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
6
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
7
• 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
8
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
9
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
10
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
11
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
12
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
13
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
14
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
15
QC TB Free Council
▪ Council Members:
CHD-NCR, DOLE, PhilHealth, CODE NGO, SSDD, PAISO,
CATIMM, DSAP, PAMET, QCHD
DOTS Referral Network was organized
16
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
17
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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