July 01, 2010

REGIONAL ORDER NO. 2010-____ SUBJECT POLICIES/GUIDELINES FOR THE EFFECTIVE AND EFFICIENT IMPLEMENTATION OF THE TUBERCULOSIS PREVENTION AND CONTROL PROGRAM IN THE WORKPLACE, DILG XI, CY 2010-2011 =========================================================== Rationale and Purpose: Tuberculosis remains a major public health problem in the country. Despite availability of drugs, TB continues to kill 75 Filipinos daily. TB incidence is highest among the productive age group(20-59 y.o.), if no measure to reduce the spread of TB were done, it would only be a matter of time before it impacts productivity of the employees in the bureaucracy. Under the Comprehensive and Unified Policy for Tuberculosis Control (CUP-EO. 187), TB control must be standardized in public sectors directly through its implementing guidelines and in compliance with GSIS, ECC and Phil. Health Care and CSC Policies on employees welfare. As part of the social responsibility of the office to maintain healthy and TB-free workplace in Region XI, the DILG Regional Office/Provincial/Municipal/Highly Urbanized City/Component Cities suboffices are enjoined to support the reduction of the TB incidents in Region XI. By initiating efforts within respective workplace and to prevent and control of TB. The purpose of this workplace policy is to strengthen the diagnosis, treatment, and prevention of tuberculosis in the workplace through DOTS strategy. General Policy Statement: DILG XI recognizes the need to maintain a healthy and productive workforce. Realizing that TB can affect the workforce, the office shall devise systems and procedures in TB management and control in the workplace consistent with the provisions of the CUP, National TB Control Program(NTP), adopting DOTS as the strategy of choice. This agency shall initiate efforts to decrease the risk of spreading TB through effective TB control measures; increase awareness and understanding through sustained TB education program for, employees, and their household members. :

Pursuant to Executive Order No. 187, Instituting a Comprehensive and Unified Policy for Tuberculosis Control in the Philippines (CUP), the following guidelines for the implementation of the policy and program on the prevention and control of tuberculosis in the workplace are hereby adopted and promulgated: 1. Coverage: These guidelines shall apply to the Regional and sub-offices/workplaces in the Department of the Interior and Local Government (DILG), Region XI, CY 2010-2011. 2. Implementing Structure: The TB-DOTS in the workplace program shall be lodged in the Administrative Division under the Personnel Section. The DILG RO-XI TB Alert Committee was organized/reorganized to handle all TB related concerns for the benefit of the employees and their dependents. Per Regional Order No. 2010-22 and 2010-41 dated February 12, 2010 and May 11, 2010 respectively, the composition of the committee are as follows: Chairperson : Director Quirino M. Libunao Vice-Chairperson : LGDD Chief, Gaudioso O. Catubig, Jr. Members : LGSD Asst. Cristina D. Amoy LGOO V Ursula A. Pague LGOO V Edna G. Yap LGOO IV Bienvenida C. Roble LGOO IV Ma. Nilda B. Piedraverde Admin. Asst II Evangeline G. Bernales Admin. Aide III Joy A. Bontuyan Guidelines 3.1 Prevention/Control Strategies 3.1.1 TB awareness program shall be undertaken through TB orientation/briefing/for a. 3.1.2 Such awareness program shall be deal with the nature, frequency and transmission, treatment with Directly Observed Treatment Short Course (DOTS), control and management of TB in the workplace. 3.1.3 It shall be conducted twice a year during Monday Convocation: World TB Day Celebration (every March 24) Lung Month celebration (August) 3.1.4 It shall be spearheaded by the Administrative Division/DILG RO.XI TB Alert Committee and Management Support Team (MST) in close coordination with the Center for Health Development-DOH, Davao Region. 3.1.5 To ensure that contamination from TB airborne particles is controlled, workplaces must provide adequate and appropriate ventilation and there shall be adequate sanitary facilities for employees.

3.

3.2 Case Finding 3.2.1 All personnel of the DILG XI shall undergo an Annual Physical Examination (APE): chest x-ray and direct sputum to be chargeable against 5% GAD budget allocation of the agency. 3.2.2 The DILG XI Regional/Provincial/Municipal/City Offices shall refer a TB symptomatic employee for sputum examination to the nearest DOTS facility/center in their locality. The following are the twenty-seven (27) accredited DOTS Facility of Region XI: Compostela Valley Province 1. Compostela Rural Health Unit (RHU) 2. Laak RHU 3. Mabini RHU 4. Maco RHU 5. Maragusan RHU 6. Mawab RHU 7. Monkayo RHU 8. Montevista RHU 9. Nabunturan RHU-TB DOTS Center 10. New Bataan 11. Pantukan DOTS Clinic Davao del Norte 1. Braulio E. Dujali RHU-TB-DOTS Center 2. Davao Regional Hospital-TB DOTS 3. New Corella RHU-TB DOTS Center 4. Panabo City Public-Private Mix DOTS Center 5. PTS, Inc. 6. Rivera Medical Center, Inc.-DOTS Center 7. Tagum Public-Private Mix DOTS Davao Oriental 1. Banaybanay RHU-TB DOTS Clinic 2. Lupon RHU- TB DOTS Center 3. Mati RHU-TB DOTS Center Davao del Sur 1. Digos City Health Office-TB DOTS Center Davao City 1. Davao Chest Center Public-Private Mix DOTS 2. Davao Doctors Hospital TB-DOTS Center 3. Davao Medical Center TB-DOTS Clinic 4. HMRG DOTS Center 5. PATHS DOTS Center

3.2.3

Employees with Smear (+) result will undergo treatment under Directly Observed Treatment Short-Course (DOTS) chemotherapy strategy for six(6) months. While undergoing treatment, he/she will be assigned with a treatment partner at home, clinic and at the nearest DOTS Center, who will b e doing the daily supervision of treatment. A symptomatic PTB diagnosed household members of the employee shall be required to undergo Chest X-RAY (CXR) and Direct Sputum Examination (DSSE). Confirmed PTB cases will be referred to appropriate DOTS Centers for treatment.

3.2.4

3.3 Social Policy: 3.3.1 Roles/Responsibilities of Employer/Agency In the context of the social responsibility, the employer/agency shall encouraged to extend the TB program to their employees families and their respective communities. Non-Discrimination Employees who have TB shall not be discriminated. Instead, he/she shall be supported with adequate diagnosis and treatment and shall be entitled to work for as long as they are certified by the doctor/accredited health provider as medically fit and shall be restored to work as soon as their illness is controlled. Work Accommodation Through agreements made between the management and the employee, work accommodation measures to accommodate and support workers with TB is encouraged through flexible leave arrangement, rescheduling of working times, and arrangement for return to work. Issuance of Fit to Work Order/Restoration to Work An employee diagnosed with Pulmonary Tuberculosis (PTB) is advised to go on leave for two (2) weeks. The employee may be allowed to return to work until such time the follow-up sputum examination shall yield a negative result with reasonable working arrangements as determined by the office/or the DOTS provider.

3.3.2

3.3.3

3.3.4

3.4 Financing Options: 3.4.1 The cost of expenses for the employees treatment regimens is DOTS free at the Barangay Health Center/RHU/PHO. In case there is a shortage of drugs, the employee shall choose from the financing options desired. The agency may provide financial assistance to the employee adopting the financial option of 50-50 cost sharing.

3.4.1 Employees with Smear (-), CXR (+) will be referred to the nearest clinic/hospital for treatment. The expenses shall be shouldered under Coops scheme

3.5 Recording, Reporting and Setting-Up A Database 3.5.1 Maintain a recording and reporting system of TB cases referred to the DOTS facility/center using an appropriate form. This information shall be a part of the TB registry of the DOH. Semestral minutes shall be conducted to discuss issues relative to tuberculosis.

3.5.2 3.6

Effectivity All concerned shall comply with all the provisions of this Regional Order immediately.

QUIRINO M. LIBUNAO, CESO III Regional Director

ADM:LBD:ROM /jab