Famor, H. S. (2014). Tuberculosis program reform implementation to increase case detection rate in the municipality of Argao, Cebu (Unpublished master's thesis).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 4 Thesis (MPM-HSD)--Development Academy of the Philippines.

The municipality of Argao is located southeast of Cebu Province, 66.90 kilometers from Cebu City. It is a first class municipality with population of 72 274 (year 2013). Respiratory Infectious diseases in the municipality for the past 7 years. Specifically, the municipality has low Case Detection Rate (CDR) for Tuberculosis for the past 7 years indicating with the remaining undetected cases not receiving the correct treatment resulting to the spread of infection or even Multi-Drug Resistance (MDR). Patiently, there is emerging number of MDR cases, which are all congregated in the coastal area. The paper identified Gaps in the local TB Control Plan using the 6 strategic thrusts of Universal Health Care: accessibility and service delivery, financing, governance, human resource, health information, medicine and supplies. Interventions were implemented in order to meet the gaps. The Increase TB Case Detection Rate was the only indicator to evaluate the TB Program reforms. The gaps which were identified include: Difficult access of health facilities which were clustered in the town proper; Household contacts of TB patients were not automatically seen by the physician for further evaluation; MDR patients were not formally given financial support; Lack of local barangay support to incentivize TB DOTS partnership of BHWs; Financial difficulty of patients in complying with laboratory work-up such as chest x-ray; Private health care providers are not integrated in the referral system. The following strategies were implemented in order to meet these gaps: Strategy 1. Access and Service Delivery. Remote Smearing Stations were established in 5 mountainous barangays. Targeted TB screening for household contacts of TB patients in 2 coastal barangays with most number of TB patients. RSS for hard-to-reach upland barangays and enhance intensified case finding. Strategy 2. Health Financing. Adequate funding for the program by allocating annual budget of 200 000.00Php from the general fund and systematized the disbursement of TB DOTS package. Startegy 3. Human Resource.The 184 BHWs who are mostly Community Health Team partners were mobilized by doing bench discussions and lectures during their monthly meeting at the RHU. All the RHU personnel were trained for the New 2013 TB Manual of Procedure. Strategy 4. Medicine, Supplies. Contingency plan for medicines and laboratory reagents was made by allocation a budget. Strategy 5. Health Information. TB registry was converted to electronic databy using PC software. The Public Health Nurse was assigned to update the e-TB registry monthly. Strategy 6. Governance. To make the TB control plan sustainable, a TB ordinance both for barangay and municipal were drafted and lobbied. Presently, there is an increasing number of cases of TB identified. The TB program only started last April and it already reached a 51% target of CDR compared to the National Target which is 90% CDR. The program is still in its implementation phase and closely being monitored by the RHU.