Caampued, M. S. (2012). Developing effective participatory processes of barangay health and nutrition in policy formulation and program implementation to increase tuberculosis case notification rates and initiation to treatment in the Municipality of Polillo, Quezon (Unpublished master's thesis). Graduate School of Public and Development Management, Development Academy of the Philippines.

Graduate School of Public and Development Management Health Systems and Development Batch 2 Thesis (MPM-HSD)--Development Academy of the Philippines.

In 2010, tuberculosis (TB) does not rank among the top morbidities and mortalities of Polillo and TB diagnosis was low. This is incongruous with the growing attention that the province of Quezon is placing on the implementation of the National Tuberculosis Program (NTP) after it has ranked as their 6th highest mortality cause in 2008. The author surmised a probable masked TB burden in the municipality. This led to the review of health records and the conduct of exploratory discussions with the rural health unit (RHU), the local health board and barangay health workers to diagnose Polillo's health situation. Part of the conclusions was a poor local implementation of the National Tuberculosis Program (NTP). Participatory analysis and planning was later done to form the strategic plan for improving the NTP implementation. Top strategic issues were the poor barangay-level participation, poor diagnostic function of the RHU, logistic difficulties and the lack of enabling policies. The strategic plan is to increase effective participatory policy and planning processes of Barangay Health and Nutrition Councils to improve NTP implementation. Increase in short term indicators, specifically case notification rates and case enrolment (or initiation to treatment), were also set as targets to generate early wins. After a tear of interventions, there was still a failure in engaging the barangay leaders to community-level policy formulation. However, case notification and enrolment and even other longer-term targets such as case detection rates and cure rates still significantly improved. Other system aspects like TB program allocation increased, laboratory function was restored, municipal legislations were passed, and additional human resource was hired. The action steps were analysed in a three step process: (1) analysis of strategic issues and concerns, (2) review and validation of action taken, and (3) thematic analysis to model the approach. In the end, a transaction model was made as a visual representation of the successful program implementation despite failure in the originally planned intervention. In conclusion, the action plan and project demonstrated that participatory analysis and planning provides an enabling environment for health service provision. Context-based models of program implementation facilitate ownership; and collectively aligned stakeholder efforts towards a clear strategic goal lead to longer-term, more acceptable, and more significant outcomes.