Community health workers, as in many other countries, are the front liners in the delivery of primary health care at the grassroots level, both in urban and rural communities in the Philippines. The term CHWs embraces a variety of community health aides who are selected, trained and are working in the communities from which they come. According to the World Health Organization (WHO), CHWs should be: (1) members of the communities where they work, (2) selected by the communities, (3) answerable to the communities for their activities, (4) supported by the health system but not necessarily as part of its organization, and (5) should have shorter training than professional workers. 1In the Philippines, CHWs refer mainly to Barangay Health Workers (BHWs) although CHWs can also include Barangay Nutrition Scholars (BNSs), Rural Health Midwives (RHMs) and Mother Leaders (MLs). In some areas of the country, there are MLs who perform the same roles as BHWs. Mostly females, BHWs are volunteers who are supposed to be accredited by the Local Health Board (LHB) and who have been trained to provide primary health care services in the community in accordance with the guidelines promulgated by the Department of Health (DOH). 2 The number of health workers in the community is set by the DOH. It is determined by the ideal ratio of BHWs relative to the number of households, provided that the total number of BHWs nationwide shall not exceed one percent (1%) of the total population. 2 BHWs, usually of age 20 to 45 years, play significant roles in providing primary health care in the communities they serve. 1 A study conducted in Camarines Sur in the Luzon island in the Philippines reported that majority of BHWs

Setting The 3rd national tuberculosis (TB) survey in the Philippines in 2007 reported a significant decline in the prevalence of TB. Since then, more significant investments for TB control have been made, yet TB burden estimates from routine surveillance data remain relatively stable. Objective To estimate the prevalence of bacteriologically confirmed pulmonary TB in the Philippines amongst individuals aged ≥15 years in 2016. Design In March–December 2016, we conducted a population-based survey with stratified, multi-stage cluster sampling of residents in 106 clusters aged ≥15 years. Survey participants were screened for TB by symptom-based interview and digital chest X-ray. Those with cough ≥2 weeks and/or haemoptysis and/or chest X-ray suggestive of TB were requested to submit 2 sputum specimens for Xpert MTB/RIF, direct sputum smear microscopy using LED fluorescent microscopy, and mycobacterial solid culture (Ogawa method). Bacteriologically confirmed pulmonary TB was defined as MTB culture positive and/or Xpert positive. Results There were 46,689 individuals interviewed, and 41,444 (88.8%) consented to a chest X-ray. There were 18,597 (39.8%) eligible for sputum examination and 16,242 (87.3%) submitted at least one specimen. Out of 16,058 sputum-eligible participants, 183 (1.1%) were smear-positive. There were 466 bacteriologically confirmed TB cases: 238 (51.1%) Xpert positive, 69 (14.8%) culture positive, and 159 (34.1%) positive by both Xpert and culture. The estimated TB prevalence per 100,000 population aged ≥15 years was 434 (95% CI: 350−518) for smear-positive TB, and 1,159 (95% CI: 1,016−1,301) for bacteriologically confirmed TB. Conclusion This nationally representative survey found that the TB burden in the Philippines in 2016 was higher than estimated from routine TB surveillance data. There was no evidence of a decline in smear and culture positive TB from the 2007 survey despite significant investments in TB control. New strategies for case-finding and patient-centered care must be intensified and expanded.

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A225ombitasvir/dasabuvir) +/-ribavirin compared with Harvoni® (sofosbuvir/ledipasvir) in the United States. METHODS: A cost-effectiveness Markov model, based on previous HCV models, had 13 health states: 8 disease progression states (F0-F4, decompensated cirrhosis, hepatocellular carcinoma, and liver transplant), 3 sustained virologic response states, and 2 mortality states (liver-related and nonliver-related death). Transition rates were obtained from previous models. Adverse events, treatment-related disutility, and efficacy rates were based on phase 3 clinical trials. Baseline patient characteristics were derived from AbbVie 3D phase 3 clinical trials. Treatment durations were 24 weeks for GT1a experienced cirrhotic patients with AbbVie 3D and 8 weeks for 26% of GT1 treatment naïve patients with Harvoni. Direct medical costs were based on a systematic literature review and drug costs were based on December 2014 Red Book. The model was run over a lifetime horizon, discounting at 3% annually. Outcomes were measured in quality-adjusted life-years (QALYs). Probabilistic simulation analysis (PSA) was conducted by varying all parameters simultaneously.

Background The COVID-19 pandemic has expanded the use of mobile health (mHealth) technologies in contact tracing, communicating COVID-19–related information, and monitoring the health conditions of the general population in the Philippines. However, the limited end-user engagement in the features and feedback along the development cycle of mHealth technologies results in risks in adoption. The World Health Organization (WHO) recommends user-centric design and development of mHealth technologies to ensure responsiveness to the needs of the end users. Objective The goal of the study is to understand, using end users’ perspectives, the design and quality of mHealth technology implementations in the Philippines during the COVID-19 pandemic, with a focus on the areas identified by stakeholders: (1) utility, (2) technology readiness level, (3) design, (4) information, (5) usability, (6) features, and (7) security and privacy. Methods Using a descriptive qualitative design, we conducted 5 interviews and 3 focus group discussions (FGDs) with a total of 16 participants (6, 37.5%, males and 10, 62.5%, females). Questions were based on the Mobile App Rating Scale (MARS). Using the cyclical coding approach, transcripts were analyzed with NVivo 12. Themes were identified. Results The qualitative analysis identified 18 themes that were organized under the 7 focus areas: (1) utility: use of mHealth technologies and motivations in using mHealth; (2) technology readiness: mobile technology literacy and user segmentation; (3) design: user interface design, language and content accessibility, and technology design; (4) information: accuracy of information and use of information; (5) usability: design factors, dependency on human processes, and technical issues; (6) features: interoperability and data integration, other feature and design recommendations, and technology features and upgrades; and (7) privacy and security: trust that mHealth can secure data, lack of information, and policies. To highlight, accessibility, privacy and security, a simple interface, and integration are some of the design and quality areas that end users find important and consider in using mHealth tools. Conclusions Engaging end users in the development and design of mHealth technologies ensures adoption and accessibility, making it a valuable tool in curbing the pandemic. The 6 principles for developers, researchers, and implementers to consider when scaling up or developing a new mHealth solution in a low-resource setting are that it should (1) be driven by value in its implementation, (2) be inclusive, (3) address users’ physical and cognitive restrictions, (4) ensure privacy and security, (5) be designed in accordance with digital health systems’ standards, and (6) be trusted by end users.