Bonagua, A. B. (2014). Strengthening advocacy, communication and social mobilization mechanism to increase TB case detection in the municipality of Rapu-Rapu, Albay: A geographically isolated and disadvantaged area (Unpublished master's thesis).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 Philippines initiative to reduce the TB burden has been consistent with the attainment of Millennium Development Goals. In the Bicol Region, performance on TB elimination program showed that it was able to reach the national target of case detection rate reaching as high as 100%. Despite the positive regional and provincial performances on TB elimination, the municipality of Rapu-Rapu continues to be preforming poorly. Tuberculosis still remains a pressing public health issue in the municipality of Rapu-Rapu in the province of Albay. This paper aims to achieve a nationally acceptable Case Detection Rate through quality Directly Observed Treatment Short Course (DOTS) in the municipality of Rapu-Rapu, Albay, a Geographically Isolated and Disadvantaged Area. Specifically, this paper aim to (1) determine knowledge, attitudes and practices that contribute to low case detection rate in the municipality of Rapu-Rapu, Albay; (2) increae capacity of Barangay Health Workers in advocacy, communication and social mobilization in improving case detection; and (3) engage all health care providers and NGOs in the municipality of Rapu-Rapu, Albay in increasing TB case detection. A Knowledge, Attitudes and Practice (KAP) Survey, Key Informant Interview and Focused Group Discussions were employed to identify the gaps and barriers for low case detection in the municipality. Data were analyzed using descriptive and univariate statistics using SPSS v20. Review of data in the TB registry and consultation logbook was used to analyzed the effects of the advocacy., communication and social mobilization mechanism as the intervention for increasing low case detection rates. The study found that the barriers for low case detection rate in the municipality on the part of the patients were lack of awareness on TB diagnosis and treatment; patients are more on the elderly group, less educated and unemployed. On the part of the health care providers, gaps and barriers identified were patients unable to comply diagnotic procedure; hospital workers do not implement NTP policies and guidelines; hospital workers not trained on manual of operations of NTP, insufficient staffs, poor case holding (patients not followed-up) and referral system are not in place. The impact of the advocacy, communication and social mobilization activities revealed that case detection rate is 8% higher for year 2014 compared to same period last 2013 (January to September). There were a total of 41(46%) patients enrolled for TB treatment from January to September of 2013 while there is a total of 50 (54%) patients enrolled for treatment on the same period (January to September 2014). In this study it was revealed that knowledge and attitudes and practices of the community on TB control play an influential role in eliminating delays in the diagnosis. The activities rolled-out for advocacy, communication and social mobilization as a part of community engagement did really showed a significant change in increasing the case detection.