Salongcay, R. P. (2012). The Nueva Ecija public-private mix directly observed treatment short course (PPMD) for tuberculosis: A case study in healthcare management (Unpublished master's thesis).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.

Recognizing the DOTS implementation by the National TB Control Program (NTP) is essential but not enough to meet the TB control targets in Nueva Ecija, the researcher looked into the systemic engagement of all care providers in TB care and control through the Public-Private Mix DOTS (PPMD) program. The use of PPMD implies the engagement of a diverse group of care providers in congruence with the NTP guidelines. But because of the diversity of private care providers, and their varying interests and degrees of involvement in the PPMD, there is a felt need and demand for more specific Nueva Ecija PPMD protocols. This study attempts to address this need. Focus group discussions, key informant interview and document analysis were employed to fulfill the study's objectives. The current PPMD project of Nueva Ecija was analyzed and recommends to improve its current processes were drawn. The Nueva Ecija PPMD Unit is an example that even with adequate support and initial planning PPMD cannot always be completely successful. Good monitoring, management, engagement and commitment of both public and private sectors are essential. While the TB commodities and technical support are provided by external sources, there is insufficient counterpart funding for PPMD human resources by the provincial government. Because of lack of manpower, follow-up of the program after its official launch was done on a regular basis. The program was also not rolled-out properly to the municipalities and as such, there was no ownership of the program at the grassroots level. Program management of PPMD is also problematic as there is no designated TB Coordinator at the municipal level who will focus on the implementation of the TB-DOTS Program. It is usually the Public Health Nurse who is in-charge of managing the TB-DOTS Program alongside all the other programs. Private practitioners find it hard to comply with the strict PPMD standards, and many are not aware if the proper referral system and protocols due to lack of proper training and information dissemination. To address these gaps, different linkages must be harnessed and certain areas of the current Nueva Ecija PPMD st-up must be tailored-fit to the local experience. There must be an enabling environment (policies) for PPMD to be a success. Right mechanisms (guidelines and processes) should also be in place for its implementation. A sustainable NE-PPMD should be suited not only to the public but also to the private setting. A collaborative rather than authoritative approach should be employed. This study hopes to help NTP program supervisors in engaging more practitioners in the fight against TB through partnerships and PPMD in order to deliver quality TB services in line with the guidelines set by the International Standards for Tuberculosis Care (ISTC). This can also help PPMD project staff better manage the public-private mix DOTS program and customize its procedures to become more responsive to the needs of its clients.