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Mobilizing Single Practice Providers for DOTS Network Service Delivery

Mobilizing Single Practice Providers for DOTS Network Service Delivery. Marilou P. Costello, PhD Elmer S. Soriano, MD Philippine Tuberculosis Initiative for the Private Sector (PhilTIPS). The Need to Mobilize the Private Sector.

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Mobilizing Single Practice Providers for DOTS Network Service Delivery

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  1. Mobilizing Single Practice Providers for DOTS Network Service Delivery Marilou P. Costello, PhD Elmer S. Soriano, MD Philippine Tuberculosis Initiative for the Private Sector (PhilTIPS)

  2. The Need to Mobilize the Private Sector “If the Philippines is to make any headway in the management and control of TB…the private sector needs to be encouraged to play a bigger role in the campaign.” -PhilTIPS 2002 Policy Assessment

  3. The Philippine Tuberculosis Initiative for the Private Sector • A USAID-funded project organized in 2002, managed by a consortium led by Chemonics International • Aims to enhance private sector involvement in TB Control • Developed models for bringing private sector to TB management aligned with the NTP- DOTS guidelines

  4. Single Practice Physicians Who are they? • Physicians with individual, stand-alone private practices • Constitute the largest percentage of private practitioners • Numbering 12,000-15,000 in the country • General practitioners or family physicians • Slow to adopt DOTS; longtime GPs relatively set in their ways --treat suspected TB patients more traditionally, with visual examination and chest x-ray, and limited use of sputum testing. • Linked with organized groups: HMOs, workplace, schools, pharmaceuticals, etc

  5. Single Practice Physicians Why are SPPs slow to adopt DOTS? SPPS are not in a position to provide the full DOTS regimen for their TB patients • Have no sputum testing capacity • No access to free or low-cost drugs nor assured of uninterrupted supply • No experience organizing treatment partners • Have neither time nor inclination to do essential record keeping and case reporting But : There is willingness to participate if some mechanisms could be established to meet the requirements of DOTS in their situation.

  6. PPM DOTS Clinic Model The SPN Model Microscopy Laboratory STAND ALONE Microscopy Laboratory Drugs SPP DOTS Clinic STAND ALONE Pharmacy STAND ALONE SPP Treatment Partner STAND ALONE CASE MANAGER DOTS elements contained in four walls of clinic Vs. Distributed functions of DOTS In a network Unbundling the DOTS Elements: Single Practice Network (SPN) Model

  7. Features of the SPN Approach • Physicians linked with other providers (pharmacy, lab services, health workers) • Networks certified and accredited (DOH-NTP and PHIC) • Each network provides quality DOTS---ensured through effective monitoring • Manual of procedures (suited to different contexts) • Tested in different settings and evaluated

  8. Conclusions • SPPs occupy an important role in TB control • Stand alone SPPs cannot implement a full DOTS regimen • Stand alone SPPs are willing to become DOTS providers if necessary support systems were available

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