TB Innovations and Health Systems Strengthening | Quarterly Report October to December 2018

The project, which began on February 21, 2018, and is set to conclude on February 20, 2023, is implemented by FHI 360 in partnership with Interactive Research and Development (IRD), Meridian, and Philippine Business for Social Progress (PBSP). The project's geographic focus is on the National Capital Region, Region III, and Region IVA. The project's primary objective is to assist the Department of Health (DOH) and other national partners in identifying, developing, testing, and scaling up innovative technologies and approaches to meet TB program objectives and targets. The project is working to fulfill three main objectives: rapidly identifying and expanding state-of-the-art approaches to maximize TB case detection and health seeking behavior, integrating and institutionalizing high-impact practices to improve TB and drug-resistant TB (DR-TB) adherence and quality of care, and creating a supportive environment encompassing the continuum of TB prevention to care. During the reporting period of October to December 2018, the project made significant progress in achieving its objectives. Key achievements include the development of a cohesive National TB Promotion Strategy outline through a workshop attended by 13 Centers for Health Development (CHDs) and other implementing partners. The project also developed a Laboratory Network Strategic Plan 2018-2022 and a Laboratory Network Operational Plan 2019, as well as a rapid assessment tool for mapping the specimen referral transport and logistics system in three project demonstration sites. The project also made progress in integrating and institutionalizing high-impact practices to improve TB and DR-TB adherence and quality of care. Key achievements include the development of a concept note and country transition plan for injectable-free DR-TB treatment regimen, the revision of MDR-TB treatment guidelines based on comments from DOH NTP, WHO, and USAID Headquarters, and the signing of a pledge of commitment by professional societies. In addition, the project made progress in creating a supportive environment encompassing the continuum of TB prevention to care. Key achievements include discussions with the National Economic Development Authority (NEDA) Social Development Committee (SDC), together with DOH NTP, facilitated to recommend the appropriate TB Governance Model. The project also identified Facebook Messenger or Viber as the most appropriate media platform for the online patient support group. The project's team, consisting of Dr. Sein Sein Thi, Dr. Grace Kahenya, and Mr. Deepak Mehra, spent one to two days working closely with their local counterparts in DOH-NTP, National TB Reference Laboratory (NTRL), and Health Promotion Communication Services (HPCS), respectively. Dr. Mary Rose Santiago was also seconded four days per week in DOH-NTP. The project's key challenges include finding missing TB patients, which remains a big challenge faced by the DOH NTP. As of 2016, a significant number of estimated TB patients remain undetected, untreated, and unreported, with 43 percent of drug-susceptible (DS) TB patients and 75 percent of MDR-TB patients still missing. The project is responding to these challenges by supporting the NTP, HPCS, and Centers for Health Development (CHDs) to identify and introduce innovative approaches to optimize service capacity for case detection and encourage positive health seeking behavior. The project's team facilitated several participatory strategic planning events and activities with the NTP, HPCS, and CHDs to create a sustainable platform that addresses TB demand generation issues on strategic, policy formulation, and operational levels. The team also developed an integrated National TB Health Promotion strategy for demand generation and its operationalization, which was piloted in the TB Elimination Integrated Demonstration model.