Health for all citizenry of Caloocan City by the year 2001 and Health in the hands of the people by year 2020
To provide accessible, available, affordable and acceptable quality basic health care delivery system at all times through advance technology and fully equipped health facilities manned by dedicated, competent and well-compensated manpower
Harmonious partnership with LGU, NGOs, PO’s and GO’s towards a common goal of achieving a productive self-reliant and healthy citizenry
Advocate for political commitment at all levels of the health system including the private sector by:
Provide access to quality-assured TB sputum microscopy by:
Improve the program management capability of health workers by:
Improve the data/information system by:
Case detection by:
Provide standardized chemotherapy to all confirmed cases of TB under Directly Observe Treatment (DOT)/supervised treatment by:
Ensure uninterrupted supply of quality-assured anti-TB drugs through reliable procedure and distribution system by:
The general objective of case finding is the early identification and diagnosis of TB cases.
a) Direct sputum smear examination (primary diagnosis tool in NTP case finding):
1. Sputum smear examination is the preferred method for the diagnosis of TB. All TB symptomatics identified shall be made to undergo smear examination for diagnosis prior to initiation of treatment, regardless of whether or not they are suspected of having extra-pulmonary TB. The only contraindication to sputum collection is massive hemoptysis.
It is only after a pulmonary TB symptomatic has undergone sputum examination for diagnosis with three sputum specimens and subsequently yielded negative results that he shall be made to undergo other diagnostic tests such as X-ray, culture and others, if necessary.
2. All health facilities shall be encouraged to establish and maintain a microscopy unit in their areas of jurisdiction. In areas where this is not possible, referral to an NTP microscopy service provider shall be encouraged.
3. Quality of sputum microscopy shall be maintained and sustained through the regular quality assurance system at the provincial/city level.
b) Chest X-ray:
1. Chest x-ray examination shall be the secondary diagnostic tool for TB case finding. However, no diagnosis of pulmonary tuberculosis shall be made based on the result of X-ray examination alone.
2. Smear negative cases whose chest x-ray examination result is suspected to be positive for TB lesions shall be referred to the TB Diagnostic Committee that shall decide on the appropriate action to take. Comparative reading of previous and current X-rays is highly recommended for confirming diagnosis of TB in such situations.
3. In each province/city, the creation of a TB Diagnostic Committee (TBDC) is recommended. The TBDC shall provide diagnostic services to TB smear negative cases whose chest x-ray results are consistent with active TB.
c) Skin test for TB infection (PPD skin tests) should NOT be used as a basis for the diagnosis of TB in adults.
d) Passive case finding shall be implemented in all health facilities.
e) Sputum smear examination (smearing, fixing and staining of sputum specimens, reading the smear) shall be performed only by adequately trained medical technologist or NTP microscopist.
Objective The general objective of chemotherapy is to treat TB cases effectively and completely, especially pulmonary sputum smear positive cases.
a) Treatment of all TB cases shall be primarily based on reliable diagnostic technique, namely, sputum smear examination aside from clinical findings. Chest x-ray examination is used only as a secondary diagnostic tool. Treatment of all sputum smear negative CXR positive cases shall be based upon the decision of the TB Diagnostic Committee.
b) Domiciliary treatment shall be the preferred mode of care.
c) Patients recommended for hospitalization are those with the following conditions:
d) No patient shall initiate treatment unless the patient and health workers have agreed upon a case holding mechanism for treatment compliance.
e) For all patients to be started on treatment, provision of the complete drug requirement should be ensured. The complete drug allocation of each patient shall be secured before treatment is started.
f) The DOH shall ensure the provision of FDC drugs to the health Centers, including PPMD units and other health facilities giving priority to sputum smear positive cases. However, the health facilities (including LGUs) shall be encouraged to procure SDF preparations (at least 5% of the expected cases), intended for those who may develop adverse reaction to FDCs.
g.) Quality of FDCs shall be ensured by ordering them from a source with track record of producing FDCs according to World Health Organization (WHO) prescribed standards.
RECORDING AND REPORTING
a) To provide program implementers with information to serve as basis for planning on how best to assist their clients and patients.
b) To provide program supervisors with information to serve as basis for planning on how best to assist TB control program implementers.
a) Recording and reporting for NTP shall be implemented at all health facilities, including PPMD units, government and private hospitals.
b) Reporting TB cases should be made mandatory to private physicians and private clinics after agreement with parties concerned shall have been made.
c) Recording and reporting shall include all cases of TB, classified according to internationally accepted case definitions.
d) Recording and reporting for NTP shall use, as much as possible, the Field Health Services Information System (FHSIS) network for routine reporting and feedback.
e) Records and reports should allow for the calculation of the main indicators for program evaluation.
f) All four quarterly reports should be sent to DOH through the CHD. PPMD reports should be disaggregated to reflect additions to total cases reported in the province/city/municipality where PPMD's are installed.
g) The DOH shall make an annual consolidation, analysis, interpretation and dissemination of information to all partners, stakeholders and general public as necessary.
Health Officer/Medical Officer/Physician (Public and Private)
a) Supervise respective health workers when applicable to ensure the proper and quality implementation of NTP core policies such as:
b) Participating in Continuing Medical Education (CME) related to TB-DOTS
c) Provide continuous health education to all TB patients, their families and to the community to strengthen their participation in TB control activities
d) Coordinate with the local chief executives (LCEs), other government agencies, locally existing TB organizations, private sector and NGOs in the area to ensure support for the TB program
a) On case finding:
b) On case Holding:
BHWs are key-role players in the NTP especially since they contribute voluntary health services to the community.
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