Enhancing CLA in the Implementation of the City-wide TB Elimination Campaign to Promote Access to TB Services

The burden of tuberculosis (TB) remains high, especially among the poor. There are at least a million TB cases in the Philippines with some 31,000 deaths reported in 2020. TB disproportionately affects poor communities due to their crowded living conditions, malnutrition and poor hygiene and sanitation that facilitate disease transmission. The poor are also more vulnerable owing to poor access to health services. In Cebu City, almost half of the 7,616 bacteriologically-confirmed TB cases in 2020 were missed and add to p a persistent infection pool. As part of the efforts to eliminate TB cases in the Philippines, USAID’s ProtectHealth supported the design and implementation of the City-wide TB Elimination Campaign (CiTEC) in Cebu City. CiTEC requires working with government partners, city and community health workers and barangay leaders. The use of collaborating, learning and adapting (CLA) approaches is imperative to achieve effective outcomes. Among these approaches include (1) setting up internal collaboration mechanisms between USAID’s TBIHSS and ProtectHealth; (2) ensuring external collaboration with theCebu City Government, the Cebu City Health Department (CCHD), the Department of Health’s Central Visayas Center for Health Development (CVCHD), PhilHealth, and local health workers and community volunteers to reduce duplication by coordinating efforts and creating a culture of knowledge sharing as a learning community; (3) employing evidence-based approaches such as using the CiTEC Baseline Assessment to guide the design of interventions in improving the effectiveness of TB program implementation; (4) enabling adaptive management to improve overall effectiveness in implementation; and (5) facilitating country-led development and local government unit. The project has built a strong partnership with the Pasil and Mambaling communities that helped facilitate access to the area, ensured security of staff and allowed the conduct of case finding as a community-wide activity.