Objectives: This study aimed to describe the clinical outcomes related to theintroduction of Paliperidone Palmitate in a specialty hospital in the Philippines. Methodology: Cross-sectional study among patients with Schizophrenia seen at thepsychiatry service of a specialty hospital catering to war veterans who were initiated onPaliperidone Palmitate. We reviewed and abstracted baseline patient data from themedical record of eligible patients. Outcome of treatment was collected through a one-time objective assessment of the patient by a third-party psychiatrist using theStructured Clinical Interview for Symptoms of Remission (SCI-SR) tool. Results: A total of 30 patients were recruited for the study from August 2020 and June2021, the majority of whom were males (80%), residents of the National Capital Region(50%) and single (20%). The median duration from schizophrenia diagnosis to initiation of Paliperidone treatment was 19.50 years (IQR: 16.60 – 33.50). In eight patients (22.67%),other antipsychotic drugs were discontinued following initiation of Paliperidonetreatment; in the remaining 22 participants (73.33%), Paliperidone was taken concurrentlywith other antipsychotic drugs. The median duration from the initiation of Paliperidonetreatment to follow-up assessment was 27.20 months (IQR: 24.73 – 30.50), with allparticipants having at least 6 months of treatment. At follow-up assessment, allparticipants were classified to be in remission. Conclusion In this study among patients with schizophrenia seen in a specialtyhospital in the Philippines, we found evidence that clinical outcomes with PaliperidonePalmitate were comparable to those given a combination of oral and long- actingantipsychotics.
Paliperidone Palmitate ; Schizophrenia

Sample size computations, which should be done at the planning stage of the study, are necessary for research to estimate a population parameter or test a hypothesis. For causal analysis of observational databases, sample size computations are generally not needed. Post-hoc power analyses, which are typically done with non-significant findings, should not be performed since reporting post-hoc power is nothing more than reporting p values differently. While sample size calculations are typically based on the tradition of significance testing, sample size calculations based on precision are feasible – if not preferred – alternatives. Sample size calculations depend on several factors such as the study objective, scale of measurement of the outcome variable, study design, and sampling design. Computing for sample size is not as straightforward as presented in textbooks but specific strategies may be resorted to in the face of challenges and constraints.
Sample Size ; Power, Psychological

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

Objective: This paper aims to characterize existing financial assistance available to patients with schizophrenia. Specifically, we described (1) the funding mechanisms for the treatment of patients with schizophrenia; (2) the process for accessing financial assistance; and (3) the experiences of consumers of services of these support mechanisms.

Methods: We employed qualitative techniques using key informant interviews (KII) and focus group discussion (FGD). Key informants were officials from institutions providing or offering financial assistance for patients with any health-related concerns, including schizophrenia. Focus group participants were support group members or caregivers of patients with schizophrenia. Purposive sampling was used to select participants for both providers and consumers of financial assistance or scheme. Topic guides for KII and FGD were used for data collection. Thematic analysis was performed on the qualitative data gathered from the informants and focus group participants.

Results: Securing financial assistance for schizophrenia followed a generally similar process, whether the source is from government offices or civil society organizations, and can be grouped into three main stages: (a) pre-application, (b) application, and (c) post-application. While the process of seeking financial assistance appears to be straightforward, issues were encountered in all of the stages by both providers and recipients alike, namely: (a) Financial assistance as an augmentation to patient resources; (b) Mismatch between demand and service capability; (c) Measures of organizational effectiveness; (d) Health professionals and support groups as "bridges" / "facilitators" to financial assistance providers; (e) Financial and non-financial costs incurred by caregivers in applying for financial assistance; and (f) Recipient-provider relationship as a barrier to the feedback process.

Conclusion: This study provides a glimpse of available financial and other relevant assistance to clients, including clients suffering from schizophrenia. More extensive research covering more organizations, support groups, and caregivers from different parts of the country is recommended.

Objective: We aimed to provide practical guidance on the scoping review process, building on the methodologies and general steps outlined by Arksey and O’Malley, Levac et al. and The Joanna Briggs Institute. Methods: We reviewed the methodologies of three scoping studies conducted by the authors in the College of Public Health, University of the Philippines Manila between 2016 and 2017. For each project, we outlined the steps, tools utilized, good practices performed, challenges encountered, and recommendations for improving the scoping review process in relation to existing guidelines. We compared the similarities and differences across the three reviews and guidelines to come up with a list of good practices and recommendations. Results: We propose an expanded 10-step and iterative framework based on our analysis of three scoping studies: Define your research question; 2. Specify your research statement according to population, concept, and context; Prepare the necessary tools, forms, and software packages; 4. Assemble your expert panel and/or consultants; Develop your search strategy; 6. Implement the search strategy and retrieve identified studies; 7. Screen and assess studies for inclusion in the scoping review; 8. Chart the data; 9. Synthesize your results; and 10. Prepare your final report. Conclusion Scoping reviews as a method of evidence synthesis are increasingly gaining popularity among researchers due to the scope of what can be reviewed in a relatively short amount of time. With only three scoping studies informing our proposed methodology, other issues and challenges in the conduct of a scoping review may have been missed in the expanded framework presented in this paper. We suggest future studies to apply existing scoping review methodologies, to further enhance this rapidly evolving framework in research, policy, and practice.
Review ; Methods

OBJECTIVE: This paper describes the process utilized in developing a training program on data use for decision- making tailored for real-time monitoring of maternal and child health indicators through Community Health Information Tracking System (rCHITS) end-users in selected areas in the Philippines. METHODS: Guided by the ADDIE (Analysis, Design, Development, Implementation and Evaluation) model and the training cycle, existing records and reports lodged with the National Telehealth Center (NTHC) pertaining to rCHITS were reviewed, supplemented by interviews with the technical staff of the NTHC and discussion with healthcare workers. Training design was developed, training modules and materials were prepared, critiqued, revised and finalized. The training was implemented and evaluated using an evaluation tool designed for this specific capability-building endeavors. RESULTS: A tailored training program on data use for decision-making was designed for rCHITS end-users in select areas in the Philippines. The process of developing the training program was guided by the ADDIE Model and the Training Cycle. Training was delivered to a total of 128 public health workers. Majority of the participants gave high evaluation on the clarity and relevance of objectives, discussion of topics, methods of delivery, and time devoted in addressing issues (range 3.5-3.8 out of highest possible score of 4) CONCLUSION This paper demonstrates the utility of the ADDIE Model and the Training Cycle in developing a training program aimed at enhancing the capability of the field personnel in utilizing the data generated from rCHITS in decision-making. Training participants must also be monitored and evaluated in their workplace setting in order to determine if the concepts and principles covered during the training program are put into practice.
Philippines

Background: Tuberculosis (TB) is a disease that has continuously burdened Filipinos. Various programs have been launched by public and private sectors to decrease the incidence of TB and to scale up TB prevention and control in the country. In line with this, pharmacists have been contributing in the campaign against TB since 2004 through the implementation of the Pharmacy DOTS Initiative (PDI). Through the project Innovations and Multi-Sectorial Partnerships to Achieve Control of TB (IMPACT), PDI was relaunched in the country in 2014. Objectives: This case study aims to evaluate the impact of PDI on TB prevention and control by assessing the effectiveness of the technical assistance package rolled out during program implementation. Methods: A review of documents was done to evaluate the achievement of the specific targets of PDI. Results: Among the targets, the percentage of actively referring pharmacies and the number of referrals made throughout the program failed to meet the target. The remaining program targets such as the establishment of a referral system, training of pharmacy personnel, adoption of a TB DOTS curriculum in pharmacy schools, and presence of national legislation, policies, and guidelines relevant to PDI were satisfactorily met. Conclusion PDI had a good response at the start of its implementation, but several issues resulted in the inability to sustain the interventions and achieve set targets.
Tuberculosis ; Program Evaluation ; Case Reports

Background: In the Philippines, 25% of ever-married women reported experiencing some form of violence from their partners but only 10% of them actually sought medical or legal help (NDHS, 2013). The objective of this study was to describe the type and severity of intimate partner violence experienced, and its association with formal help-seeking,among women aged 15-49 years in the Philippines. Methodology: The cross-sectional data used for this study came from the National Demographic and Health Survey of women aged 15-49 years old conducted in 2013. To estimate the association of interest, confounders were identified using the change-in-estimate criterion and were controlled by multiple logistic regression modelling. Results: Among women aged 15-49 years who experienced intimate partner violence, those who experienced all types of abuse had the highest proportion of formal help-seeking (7.3%), while women who experienced only sexual abuse had the lowest (0 out of 67). Controlling for the effect of other variables, women who experienced severe physical abuse were more likely to seek medical or legal assistance compared to those who experienced moderate physical abuse (OR=4.77; 95% Confidence Interval: 1.96 – 11.62). Conclusion Formal help-seeking rates were low among victims of intimate partner violence in the Philippines. The severity of the abuse experienced is likely an important factor in seeking medical and legal help. These systems should thus be capable of handling severe cases of abuse in order to address the needs of women who seek help. Efforts should be made to increase formal help-seeking among all victims of domestic violence.
Intimate Partner Violence ; Domestic Violence ; Physical Abuse

Objectives: This scoping review aimed to support a landscape analysis to identify lessons learned about intersectoral collaborations (ISCs) by describing their existing models in the context of dengue, malaria and yellow fever. Methods: A scoping review following the methodology of Joanna Briggs Institute was performed using the following inclusion criteria: studies involving humans; studies discussing intersectoral collaborations, malaria/dengue/yellow fever, and prevention or control at any level; and studies in countries endemic for the aforementioned diseases. Studies were screened using Covidence, while data were extracted using NVivo. Results: Of the 7,535 records retrieved, 69 were included in the qualitative analysis. Most ISCs were initiated by multilateral organizations and ministries of health, and none by communities. Strategies included advocacy, health education, research, public health measures, resource mobilization, service delivery and training; mostly employed on a community level. Monitoring and evaluation were mostly formative, ongoing, and participatory. Gaps included administrative and policy barriers, resource shortages, and inadequate research and training. Conclusions Multiple models of ISC exist in the literature. There is a need to develop a comprehensive framework for an effective and sustainable multisectoral approach for the prevention and control of VBDs ensuring adequate resources, active stakeholders, and strategies that span the entire socio-ecological spectrum.
Dengue ; Disease Vectors ; Intersectoral Collaboration ; Malaria ; Vector Borne Diseases

OBJECTIVE: This was an evaluation of the effectiveness of the technical assistance package for the Pharmacy DOTS Initiative (PDI) in the Philippines.

METHODOLOGY: Five pre-identified implementation sites were included in the evaluation. A survey was conducted to ascertain pharmacies currently implementing PDI and the number of TB presumptive cases referred by these pharmacies. Data abstraction was performed to determine the change in the number of TB cases seen by local TB programs after its implementation.

RESULTS: Findings revealed that the proportion of pharmacies actively referring presumptive TB patients is not significantly lower than 60% (p=0.1892). Furthermore, results showed that the average monthly referrals were not statistically lower than 20 clients per month (p=0.9159). Nevertheless, interrupted time series analysis found no statistically significant immediate effects (p=0.516) and long-term effects (p=0.3673) on the total number of new TB cases identified after the PDI was implemented in the year 2014.

CONCLUSION: The PDI was able to achieve outputs related to pharmacy engagement and referral of TB presumptive clients. However, the PDI was unsuccessful in increasing the actual number of TB presumptive cases seen by local TB programs in its implementation sites.