Walking through the wards of a crowded public hospital and seeing suffering and tragedy from easily preventable conditionsmakes one wonder what it takes for a facility to change the outcomes. The evidence is there, and guidelines have beendeveloped from it; yet practices remain difficult to change—whether in screening, prevention, treatment, or rehabilitation.

Recently, the Department of Health has put up a compendium of clinical practice guidelines (CPG) crafted accordingto the standards set by the Manual for Clinical Practice Guideline Development of DOH-Philhealth.Guidelines stipulatethat dissemination and implementation be considered, and applicability issues are discussed. The uptake of the guidelinesshould be evaluated, and facilitators and barriers should be identified. Thus, there is a need for implementation andapplicability studies to assess how effective guidelines are. For breast cancer, the Philippine Guidelines were published in 2022and updated in 2026.Identified as barriers against implementation are financial constraints and out-of-pocket costs. Actahas since responded to these concerns by publishing articles on financing cost assessment, and in this issue, by Mondragonand co-authors, an “Assessment of Out-of-Pocket Expenditure of HER2-Positive Breast Cancer Patients in a Tertiary CancerCenter and Private Clinics in the Philippines.”

These types of studies are necessary in the translation of evidence to practice, allowing organizations to adopt, scale,and sustain recommendations to real-world settings.

Where CPGs on malnutrition cite resource constraints as the only significant barrier for implementation, the article byde Luna and co-authors on the “A Qualitative Program Evaluation Study on the Perceived Impact of Health and NutritionPrograms among Beneficiaries of a Civil Society Organization in the Philippines” in this issue of the Acta add fear ofsustainability by families and competition from readily accessible instant food of poor nutritional value as barriers in implementingsuch programs.

These studies help us go beyond information dissemination of evidence-based practice to create pathways for impactfulintegration of recommended interventions. Implementation studies sharpen our analysis and focus our efforts on strategies thatcan help pilot, roll out, and scale up guidelines.

New modalities to carry out recommendations can also be part of how guidelines are implemented in the communitysetting. Where the Philippine Academy of Rehabilitation Medicine (PARM) recommends early home-based rehabilitation,the Stroke Society of the Philippines recommends telerehabilitation to augment the efforts of care providers.The articleby Laxamana and co-authors in this issue on “The Acceptance of Stroke Telerehabilitation among Rehabilitation Providersand Consumers in Two Tertiary Hospitals in the Philippines” not only identifies but also provides suggestions to addressimplementation barriers.

We support and encourage articles on implementation science. These works provide tools to convert evidence into outcomes.These transform organizations and help us accomplish meaningful, lasting structural change that should come withoutany delay to provide relief to our patients in our crowded public wards.

BACKGROUND

Undernutrition remains a public health concern in the Philippines despite multitude of government efforts using different nutrition specific and sensitive interventions. Hence, the role civil society organizations play is important in augmenting the health and nutrition programs in the country. Community feedback is important as they are the receiving end of these programs.

The study aimed to know the perceived impact and community insights on the implemented health and nutrition programs in the four selected sites in the Philippines.

Qualitative program evaluation was used, and 50 discussants were recruited through purposive sampling. Semi-structured interview guide for focus group discussion was utilized to determine the perceived impact of the programs among the discussants, and thematic analysis was used to generate codes and themes.

The implemented health and nutrition programs were found to be a source of hope for the family and community and beyond basic necessities. However, there remain barriers in successful acquisition of new information such as a lack of resources and environmental influences. There are also learned opportunities such as continued support from the Civil Society Organization (CSO), and impact capacity building that are not sponsor-driven.

Overall, the participants see the health and nutrition programs as helpful for their children as these programs foster proper child rearing. The programs also empower the parents and the community through capacity building. However, there is a need to revisit implementing rules and guidelines to further maximize the benefits and resources of the programs.

Walking through the wards of a crowded public hospital and seeing suffering and tragedy from easily preventable conditionsmakes one wonder what it takes for a facility to change the outcomes. The evidence is there, and guidelines have beendeveloped from it; yet practices remain difficult to change—whether in screening, prevention, treatment, or rehabilitation.

Recently, the Department of Health has put up a compendium of clinical practice guidelines (CPG) crafted accordingto the standards set by the Manual for Clinical Practice Guideline Development of DOH-Philhealth.Guidelines stipulatethat dissemination and implementation be considered, and applicability issues are discussed. The uptake of the guidelinesshould be evaluated, and facilitators and barriers should be identified. Thus, there is a need for implementation andapplicability studies to assess how effective guidelines are. For breast cancer, the Philippine Guidelines were published in 2022and updated in 2026.Identified as barriers against implementation are financial constraints and out-of-pocket costs. Actahas since responded to these concerns by publishing articles on financing cost assessment, and in this issue, by Mondragonand co-authors, an “Assessment of Out-of-Pocket Expenditure of HER2-Positive Breast Cancer Patients in a Tertiary CancerCenter and Private Clinics in the Philippines.”

These types of studies are necessary in the translation of evidence to practice, allowing organizations to adopt, scale,and sustain recommendations to real-world settings.

Where CPGs on malnutrition cite resource constraints as the only significant barrier for implementation, the article byde Luna and co-authors on the “A Qualitative Program Evaluation Study on the Perceived Impact of Health and NutritionPrograms among Beneficiaries of a Civil Society Organization in the Philippines” in this issue of the Acta add fear ofsustainability by families and competition from readily accessible instant food of poor nutritional value as barriers in implementingsuch programs.

These studies help us go beyond information dissemination of evidence-based practice to create pathways for impactfulintegration of recommended interventions. Implementation studies sharpen our analysis and focus our efforts on strategies thatcan help pilot, roll out, and scale up guidelines.

New modalities to carry out recommendations can also be part of how guidelines are implemented in the communitysetting. Where the Philippine Academy of Rehabilitation Medicine (PARM) recommends early home-based rehabilitation,the Stroke Society of the Philippines recommends telerehabilitation to augment the efforts of care providers.The articleby Laxamana and co-authors in this issue on “The Acceptance of Stroke Telerehabilitation among Rehabilitation Providersand Consumers in Two Tertiary Hospitals in the Philippines” not only identifies but also provides suggestions to addressimplementation barriers.

We support and encourage articles on implementation science. These works provide tools to convert evidence into outcomes.These transform organizations and help us accomplish meaningful, lasting structural change that should come withoutany delay to provide relief to our patients in our crowded public wards.

BACKGROUND

Undernutrition remains a public health concern in the Philippines despite multitude of government efforts using different nutrition specific and sensitive interventions. Hence, the role civil society organizations play is important in augmenting the health and nutrition programs in the country. Community feedback is important as they are the receiving end of these programs.

The study aimed to know the perceived impact and community insights on the implemented health and nutrition programs in the four selected sites in the Philippines.

Qualitative program evaluation was used, and 50 discussants were recruited through purposive sampling. Semi-structured interview guide for focus group discussion was utilized to determine the perceived impact of the programs among the discussants, and thematic analysis was used to generate codes and themes.

The implemented health and nutrition programs were found to be a source of hope for the family and community and beyond basic necessities. However, there remain barriers in successful acquisition of new information such as a lack of resources and environmental influences. There are also learned opportunities such as continued support from the Civil Society Organization (CSO), and impact capacity building that are not sponsor-driven.

Overall, the participants see the health and nutrition programs as helpful for their children as these programs foster proper child rearing. The programs also empower the parents and the community through capacity building. However, there is a need to revisit implementing rules and guidelines to further maximize the benefits and resources of the programs.

INTRODUCTION

Rabies is a public health concern in the Philippines, where gaps in animal bite prevention and control persist despite national mandates. The One Health approach is a framework which recognizes the interconnectedness of human, animal, and environmental health. Although the Anti-Rabies Act of 2007 aligns with the One Health strategies, its implementation at the local level faced many challenges in coordination, delivery of service, and program sustainability.

This study aimed to determine the factors influencing the acceptability of One Health approach among key stakeholders as a strategy in the prevention and control of animal bites and rabies in the municipality of Alaminos, Laguna.

A qualitative Grounded Theory design was used in the study. Eleven key informants from the provincial, municipal, and barangay levels were interviewed.

Thematic analysis of key informants’ responses revealed that, despite limited awareness of the One Health approach, multi-sectoral coordination aids program implementation, although operational gaps remain. Fragmented program delivery, lack of formal training and certification, unclear roles, poor communication, inactive task forces, outdated ordinances, weak enforcement, limited community engagement, and low prioritization of rabies prevention collectively hinder effective implementation.

The study highlights the complex challenges of implementing the One Health approach for animal bites and rabies control in rural communities. Effective implementation requires strengthened stakeholder capacity-building and training, enhanced community engagement, improved access to veterinary services, reinforced intersectoral coordination and policy enforcement through revitalized task forces, and ongoing monitoring of progress through vaccination coverage and incidence data.

INTRODUCTION: Adverse childhood experiences (ACEs) are associated with significant long-term impacts, yet few interventions specifically target ACE exposure, especially in Asian populations. Anchor, Singapore's first home visitation programme, addresses maltreat-ment among preschool children. This study evaluated Anchor's impact on children's developmental and behavioural outcomes. METHOD: We conducted a prospective evaluation of children under 4 years assessed for maltreatment from November 2019 to July 2023. Developmental and behavioural progress was measured every 6 months using the Ages and Stages Questionnaires (ASQ-3) and ASQ:Social-Emotional (ASQ:SE-2), and annually using the Child Behaviour Checklist (CBCL). RESULTS: The results of 125 children (mean age 20.0 months, 48% female) were analysed. The mean length of stay in programme was 21.2 (7.3) months. At baseline, 92 (73.6%) children were at risk of develop-mental delay and 25 (31.7%) children aged ≥18 months had behavioural concerns. The programme was associated with significant improvements in gross motor (P=0.002) and fine motor (P=0.001) domains of the ASQ-3 and internalising problem scale (P=0.001) of the CBCL. CONCLUSION Anchor effectively enhances develop-mental and behavioural outcomes for children exposed to maltreatment. Targeted early intervention through such programmes can mitigate adverse impacts, optimising developmental trajectories and potentially reducing the long-term clinical and economic burdens associated with ACEs.
Humans ; Female ; Male ; Child Abuse/therapy* ; Child, Preschool ; Singapore ; House Calls ; Infant ; Prospective Studies ; Child Development ; Developmental Disabilities/epidemiology* ; Program Evaluation ; Child Behavior Disorders ; Child Behavior

Background and Objective: The pandemic acted as an accelerator for the development of online teaching formats in anatomy and histology worldwide. The authors introduce a bridging program that reinforces the knowledge and understanding of gross and correlative anatomy and histology acquired in a virtual environment in preparation for its future clinical application. The study aims to evaluate the Learning Enhancement in Anatomy Program (LEAP) conducted among first-year medical students at the College of Medicine, University of the Philippines Manila. Methods: This descriptive cross-sectional study aims to determine the initial experience of implementing a learning enhancement program and assess areas for its improvement. An internally validated questionnaire was given to students after the program to gauge students’ reactions (Kirkpatrick Level 1 evaluation). Pre- and post-tests were administered to evaluate knowledge acquisition (Kirkpatrick Level 2 evaluation). Short-term behavioral peer evaluation (Kirkpatrick Level 3 evaluation) was also instituted. Results: One hundred fifty-two (152) students participated in the study. General reactions from students to the LEAP were consistently positive, with a steady majority of the students rating ‘5’ or a ‘Strongly Agree’ to positive statements regarding the program. Higher ratings for more traditional teaching methods, such as cadavers, formalinized specimens, and bones, compared to virtual systems were apparent. However, inter-student variation in preference for teaching modalities was observed. All stations of the LEAP were evaluated satisfactorily, with most gross anatomy stations rated higher than histology stations. A significant increase was noted in the total post-test scores compared to pre-test scores. This improvement in test scores was observed in the anatomy and histology subcategories and in six of the seven organ system modules. Perceived behavioral outcomes were also generally positive. Conclusion The LEAP is a worthwhile endeavor, garnering overwhelmingly positive reactions and a significant improvement in test scores. Future studies are necessary to fine-tune teaching and training in a blended learning environment.
Anatomy ; COVID-19 ; Education, Medical ; Program Evaluation

Objective: To analyze the work indicators of China Comprehensive AIDS Response Program (China CARES) and provide reference for future work of the program. Methods: The scores of each indicator were calculated, and different scores among different types of program areas were compared. The M(Q₁,Q₃) was used to describe the score of each indicator. The entropy weight method was used to calculate the composite score of each indicator and the composite score was translated into a 100-point system and compared among indicators. Results: In terms of the first-level indicators, organizational leadership and management (96.0 points), publicity and education (94.0 points), and innovative strategies and measures (98.0 points) got relatively high scores; while comprehensive social governance of AIDS prevention (72.0 points) was with the lowest score. The scores of publicity and education and comprehensive intervention in county-level program areas were significantly lower than those in urban areas. For secondary indicators, the indicator with relatively lower scores included "condom use among female sex workers last time" (70.0 points)", "at least one local key population has an increase in the number of people receiving HIV testing compared with the previous year" (70.0 points)", "colleges and occupational schools set up AIDS-related self-service facilities" (65.0 points), "HIV testing among the arrested people suspected of prostitution, adultery, drug users and traffickers" (55.0 points) and "condom use among men who have sex with men during last episode" (50.0 points). The "indicator 3 comprehensive intervention" contributed most to the evaluation, while "indicator 7 innovation strategies and measures" played a minor role in the evaluation results. Conclusions: The overall situation of AIDS Response Program in 2020 was good, but the progress in different word areas was not yet balanced. The two areas of comprehensive intervention and comprehensive social governance of AIDS prevention should be strengthened. It is also suggested that relevant indicators be adjusted appropriately to improve evaluation indicators system and comprehensively promote the program.
Acquired Immunodeficiency Syndrome/prevention & control* ; China/epidemiology* ; Female ; HIV Infections/epidemiology* ; Homosexuality, Male ; Humans ; Male ; Program Evaluation ; Sex Workers ; Sexual and Gender Minorities

Objectives: The Pharmacy DOTS Initiative (PDI) was relaunched on a larger scale in 2014 through the Innovations and Multi-Sectoral Partnerships to Achieve Control of Tuberculosis (IMPACT) project. This paper aimed to assess the PDI program through IMPACT by identifying the facilitating and hindering factors in its implementation. The identified factors are classified as to the affected stakeholders or processes.

Methods: Semi-structured interviews were conducted with the PDI Program Manager and four NTP coordinators from selected project sites. Thematic analysis was done to determine the recurring facilitating and hindering factors as identified by the key informants.

Results: Facilitating factors identified include cooperation of the stakeholders, capability-building and a good referral system. The barriers to the implementation were grouped into patient-related, pharmacy-related, health center-related, program-related as well as external factors.

Conclusion: The referral system created through PDI facilitated the flow of referrals starting from the pharmacy. This enabled presumptive patients to have access to health facilities for TB. Hindering factors contributed to the inability of the engaged pharmacies to sustain their consistency and commitment in conducting the PDI interventions.

Key Words: barriers, facilitators, tuberculosis, directly observed therapy, program evaluation, pharmacy

The Community Mental Health Program (CMHP) of the Center for Health Development Calabarzon is an initiative that aims to integrate mental health into primary care to facilitate person-centered and holistic services. At the core of CMHP is a referral pathway between health centers and tertiary-level mental health services for the diagnosis and continuing management of persons with mental health conditions, as well as the use of an innovative medication (specifically for schizophrenia). This commentary presents lessons learned from a one-year implementation of CMHP in four pilot sites in the provinces of Rizal and Laguna, which stakeholders in mental health may consider in the design of community-based mental health programs to further the mandate of the Mental Health Act.
Schizophrenia ; Mental Health Services ; Program Evaluation ; Paliperidone Palmitate