McKinsey 7s

Strategy pursuing high-quality DOTS expansion and enhancement address TB-HIV, MDR-TB and the needs of poor and vulnerable populations contribute to health system strengthening based on primary health care engage all health care providers empower TB with and communities through partnership enable and promote research

Strategy STANDARDIZED TREATMENT Flexible and adaptable Yet with an individual touch Flexible and adaptable Patient treatment cards

Structures DOH LGU DOTS Clinic

Structure DOH LGUs Provide standardized training Central control Where everyone reports to LGUs Reports to DOH Inspects DOTS clinics

Structure DOTS Clinic Provides treatment and follow-up TBDC The centralization of the DOTS program is essential to their success Explicit lines of communication

Style Overall leadership: DOH Trains everyone Everyone reports to them Difference in management in individual DOTS clinics Dedication and teamwork

Shared values Dedication Team-work

Systems Main: DOH Supplies drugs and equipment Provides training Implements rules

Skills Technical skills – DOH training Procedural competency

Staff Nurse and med tech Trained by the DOH Dedication Teamwork Underpain

Financial Analysis More cost efficient to treat people early DALYs = lose P 8B per year

Pulmonary TB Treatment Generic Drug Price per tablet Total (8 months) Myrin P forte Dosage: (Ethambutol(275mg), Rifampicin (150mg), Isoniazid (75mg), Pyrazinamide (400mg)) P11.24 P8,304 MyrinP-P15 (Rimstar) Dosage: (Ethambutol 275mg, Rifampicin 150mg, Isoniazid 75mg, Pyrazinamide 400mg) P11.75 P5,640

Gastrointestinal TB Treatment Surgical Open Surgery (Excision) – P120,000-P150,000 Laparoscopic – P220,000 Medical Pre-operation treatment (3 mos) - P2,115 Post-operation treatment (12 mos) - P8,460

Financial Indicators

Internal Business Process

Customer Perspective

Learning