Paombong Municipality in Bulacan Province has a population of over 57,600 among 14 barangays (villages). In 2007, tuberculosis ranked seventh among the top ten causes of illness and sixth as a cause of death.
 
The local TB program has been classified as low performing in past years. Among its 14 barangays, only two were able to reach the national targets for number of TB cases detected (70%) and number of patients cured (85%) per 100,000 population. The low performance can be explained by irregular TB drug supply, people exhibiting TB symptoms not consulting health personnel, lack of community involvement in identifying persons with TB symptoms and ensuring that patients complete their treatment, and inadequate number of health personnel.
 
With USG assistance, the municipality engaged its barangays and various sectors in the community to form the Barangay TB Patrol. The TB Patrol is composed of local officials (barangay captains and councilors); health personnel (rural health midwives and barangay health workers); and other representatives (cured TB patients, school principals, police officers and members of civil organizations). The TB Patrol functions include: formulating a TB health plan with the Municipal Health Office; educating community residents on basic TB, its treatment and management; identifying and referring TB symptomatics to health centers; serving as treatment partners; and acting as an advisory group to the Barangay Council on TB-related matters.
 

Initially, 18 health educators and 98 TB Patrol members were trained with USG assistance on TB education, counseling, effective presentation, and community organizing. As part of their tasks, they assisted in crafting village ordinances to fund TB control and in the conduct of participatory assessments to determine the TB situation in the barangays.
 
Community assemblies with over 1,000 people and house-to-house education sessions were also held in all 14 barangays, reaching about 7,200 households or about 42,000 people.
 
Consequently, 686 people exhibiting TB symptoms were motivated to consult with the local health center. Of these, 571 were referred to the local laboratory for diagnosis, and 33 are now undergoing treatment. Before the TB Patrol initiative, there were no diagnosed TB patients. The 33 new smear-positive individuals identified since the TB Patrol became active represent more than half of the municipality’s annual TB case detection target.
 
The TB Patrol exemplifies a true partnership even in the sharing of resources. Of the total amount of US$27,000 spent on the program, 54 percent came from the Department of Health (US$14,600 worth of medicines); 20 percent came from the Bulacan provincial government (US$5,500); 12 percent from the 14 barangays of Paombong (US$3,000); 10 percent from USAID – mostly for training and materials (US$2,800); and, three percent from the Paombong municipal government (US$1,100).
 
The TB Patrol has also been proven to be a good investment. For instance, with a budget of US$5,500 from the Bulacan provincial government and the number of persons reached by its activities at about 42,000 (71% of the total number of households), the cost per person reached amounted to only US$0.13.
 
Paombong’s Barangay TB Patrol is being replicated. The model has been presented in a workshop to the ten municipalities of the province. The provincial health investment plan already includes scaling up of the TB Patrol in all 63 villages of the ten municipalities of Bulacan by 2015.