Facilitators and Barriers to the Implementation of Selected Local Tuberculosis Control Programs in the Province of Laguna, Philippines

This paper aimed to determine the facilitating and hindering factors in the implementation of local tuberculosis (TB) control programs in two purposively selected localities in the Province of Laguna, Philippines. Transcripts of semi-structured interviews with six policymakers and program implementers at the regional, provincial, and city/municipal levels were qualitatively analyzed in accordance with the method of Miles and co-authors and validated through triangulation and informant/stakeholder feedback. Identified facilitating factors include 1) allocation and mobilization of human, material, and financial resources to support the implementation of program activities; 2) supervision and monitoring of program implementation; 3) formation and mobilization of partnerships with the other government agencies and the private sector; and 4) streamlining and improvement of existing processes and technologies. Hindering factors were: 1) mismatch in demand and supply for program-related resources; 2) variation in the diagnostic and treatment strategies employed by providers; 3) focus on service provision and reduced attention to activities focused on more upstream factors; and 4) external program drivers. In a decentralized healthcare setting such as the Philippines, local governments play an important role in implementing health programs designed to achieve national and even global health goals. Program managers and implementers will need to design strategies to leverage the identified facilitating factors and mitigate the effects, if not totally prevent the emergence, of hindering factors to implementation of the local TB prevention and control program.