Francis Anthony B.

Losloso, RN
MAN-AHN
March, 2019

Article: Enhancing tuberculosis patient detection and care through community volunteers in
the urban poor, The Philippines

Tuberculosis remains a persistent challenge to global health development. Over 95%

deaths are due to tuberculosis that occur in low to middle-income countries. It is a public
health concern wherein the Philippines ranked sixth and eight in mortality and morbidity
respectively. Among all causes of death and disease in national health statistics (WHO, 2013).
The Philippines is one of the highest tuberculosis burden countries in the world. Because of this,
programs were implemented from national to local government units.

Barangay health workers and community health volunteers plays a major role in
preventing the disease process. They trained by local government units to assist in all health
programs about nutrition and tuberculosis. However, since barangay health workers are unable
to focus on tuberculosis alone due to multiple tasks, NGO DOTS facilities were established in
providing full TB care. Direct Observed Treatment Short course or known as TB DOTS were
implemented in the local government levels so that patients with presumptive TB will be able
to seek consult and early treatment because prevention and proper health education is the
priority.

Despite improvements in detection rate and treatment, TB control program is still facing
challenges. There are different barriers experienced by patients with presumptive TB in seeking
health care to treatment. They have low perception of health benefits of seeking early
consultation. Patient often verbalizes that it is just only a cough without being properly
diagnosed. Also, they prioritize they work or school and have no time for consultation. Some
prefer private consults due to long queues in health centers. Parents refused to have child
treated due to financial constraints. They rather use their money in buying foods than in
personal protective equipment such as mask, and medications not provided by health centers.

Community health volunteers are required to a lot at least 2 house visits days per week
for follow-up visits. However, in relation to this, their communication skills were determined to
be poor. Being able to communicate well with patients effectively highly affects their
cooperation in seeking health care. In order to address this concern, monthly sharing of
experiences and interpersonal communication and counselling training was conducted to
develop skills in understanding client’s behavior and providing targeted health education to
facilitate behavioral changes among clients.

Some challenges are already financially related such as budget for transportation,
volunteers shouldering their own meals and also amotivation. However, this can be addressed
by the government easily by solicitation and proper funding.
 Health care workers and volunteers act as a bridge between unreachable population
and achieving health care. Identification of environmental health risk factors such as proper
house ventilation, smoking, and proper hand washing must be observed. Continuous health
education, provision of flyers and infographics, commercial advertisement and aggressive
health seeking behavior are helpful in preventing communicable disease such as tuberculosis so
that we can achieve health in our hands.

Resources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5753779/