Reducing the tuberculosis burden in U.S. Bound populations from the philippines - problem statement: the TB incidence rate of 539/100,000 in the philippines remains high (world TB report 2021)

In 2020, over half of the TB cases were not detected or notified by the program. Only 60 percent of cases notified were tested with molecular diagnostic tests and only 43 percent of the cases put on treatment were bacteriologically confirmed. Health systems gaps as well as inadequate health seeking behavior are major factors leading to a significant number of the missing TB cases in the country. Approach: guided by the CDC and DOH philippines, chsi will work with government and non-government partners at all levels to build capacity of program managers to improve diagnostics and drug logistics systems and enhance TB-related competencies and proficiencies of public, private community health workers in the detection, diagnosis, treatment and follow up of TB patients. Focusing on four key strategies, the chsi team will: 1) work to improve/update policies and operational guidelines for quality TB service delivery; 2) increase access to TB and DR TB diagnostics, treatment, and follow-up of TB symptomatic and bacteriologically confirmed TB cases; 3) scale up innovative and cost effective approaches for improving health seeking behaviors, patient education to increase treatment adherence; and 4) enhance surveillance capacity and performance monitoring by building capacity in data collection, analytics and data visualization for decision-making. Chsi will also improve the TB cascade outcomes by ensuring that various personnel understand the patient needs, have capacity to provide timely quality services, and are following up patients to improve treatment outcomes. We will implement continuous quality improvement to enhance various elements of the TB program. We will also use digital platforms for virtual consultations, patient education and follow-up, as well as improve patient record keeping. The chsi team members have been engaged with the TB program in the philippines building surveillance and service delivery capacities at all levels. We plan to continue building on our working relationships at various levels to improve and enhance TB implementation strategies. The team will draw upon subject matter experts from the local universities to provide training and capacity development support in the different regions of the country. Outcomes: the chsi team will ensure work with DOH and other key stakeholders helps improve capacity to detect, diagnose and treat TB patients in various regions with large outbound populations to the U.S. While the program will enhance TB services for all, IT will also help ensure that the outbound populations to the U.S. And other coutnries have easy access to quality TB prevention and treatment services. Staffing: the chsi team will be led by MR. Nilo yacat, who is a recognized leader in the public health including TB in the philippines. He will be supported by DR. Christian villacorte as the TB/DR TB advisor, who is currently working with the USAID-funded TB platforms as its technical lead for clinical programs. MR. Briccio echo, currently with NTP, will be responsible for training and other capacity building activities of program managers and health service providers. MS. REA epistola will lead the evaluation and performance measurement component of the project. She has been engaged with government partners and international agencies on m & e issues in the country. MS. Retchie montallana will lead the finance and administration team. Short-term TA will be provided by DR. Neeraj KAK (aquity) who has worked extensively on TB in the philippines. Caroline van cauwelaert of epcon will provide short-term TA for the surveillance and other hmis database integration and integration of AI for predictive learning. Training and technical support will be sourced from local universities as well as select US universities if REQ