I. INTRODUCTION

Tuberculosis remains to be a significant health problem in the country.  A Philippine prevalence survey in 1997 showed that a significant proportion of TB patients seek medical care from the private sector regardless of socio-economic status.  Poor people use the private sector services almost as much as those who are better off.

The National TB Program (NTP) has adopted Directly-observed treatment, short-course, or DOTS, as its strategy to control TB.  DOTS aims to decrease TB-related morbidity, prevent TB deaths, and decrease TB transmission.  Today, DOTS is the most effective strategy available globally.  The Public-Private Mix DOTS (PPMD) has been integrated to NTP to reach to a large number of TB patients through private practitioners and was seen as a good strategy for increasing case detection rate, consequently improving cure rate in the country.

The Global Fund to Fight AIDS, TB and Malaria has supported a project to accelerate response to TB including a massive scale up of PPMD initiative.  Seventy (70) PPMD facilities have been installed under Round 2 Global Fund grant while one hundred (100) PPMD facilities will be established under Round 5.  The 70 PPMD units will be exiting from the Global Fund support by July 2008.  There is a greater challenge more than ever to identify ways on how to sustain financial and other resources to provide sustainability of PPM DOTS services.

PPMD sustainability is viewed as the capacity of facilities to continuously provide accessible and acceptable quality DOTS services even beyond Global Fund support.   To achieve sustainability, PPMD facilities are encouraged to institutionalize elements of technological, political, socio-cultural and financial viability in its system.

Financial viability reflects whether a PPMD facility has the capacity to maintain its resources for provision of quality TB-DOTS services by being able to recover its operational expenses.  Ensuring access to sufficient and stable sources of funds can be done through various strategies such as availing the PhilHealth DOTS package, implementation of cost recovery schemes and resource mobilization.

The study on financial viability and sustainability will aid existing PPMD facilities in making decisions toward which directions to take in maintaining their financial health.  PPMD units must strive to continuously provide quality TB-DOTS services until such time when TB is no longer a threat to public health.  Effective strategies and financial management tools must be identified and institutionalized through the aid of this study.  
      
 
II. OBJECTIVES

This study aims to assess the financial viability of PPMD facilities so as to ensure sustainability of their operations even after the termination of the grant from the Global Fund to Fight AIDS, TB and Malaria, and assist them by providing ideas and ways to sustain their operation as a result of the undertaking.

Specifically, this study aims to:

 A. Assess the current financial performance of the PPMD unit using financial and other relevant performance indicators;
 B. Assess the actual practices and programs to maintain financial soundness;
 C. Analyze cost drivers in operation and maintenance of the PPMD unit;
 D. Establish standard and socialized service pricing scheme based on the application and result of break-even analysis, activity-based costing technique and other relevant tools;
 E. Formulate recommended programs through benchmark and system improvement concepts to improve financial soundness

III. METHODOLOGY

A. Coverage

There are two models of facilities currently under the PPMD initiative.  Two separate studies should be designed for each of the following model: 

 1. Public-initiated PPM DOTS facility  
 2. Private-initiated PPM DOTS facility

The study shall cover, but will not be limited to, the following performance indicators:

 1. Revenue performance
 2. Cost performance
 3. Financial Ratios
 4. Investment/Fund-raising effort
 5. Others

B. Professional Services
The project shall engage the services of a research outfit with proven track record in financial viability research.  The service provider shall be tasked with the following:

 1. Formulation of a research design
 2. Implementation of the research design
 3. Analysis of the results and formulation of recommendations
 4. Presentation of the results to PhilCAT and its partner agencies and health service deliverers

Given these tasks, the expected deliverables by the research service providers are the following:

 1. Research design
 2. Research output report to include analysis and recommendations
 3. Four (4) presentation sessions with several PhilCAT partners

Bid documents including Letter Of Intent, Company Information Sheet and Technical and Financial Proposal shall be submitted in one sealed small brown envelope.  Said envelope shall be submitted to PhilCAT at the G/F Research and Training Center Bldg., Quezon Institute Compound, E. Rodriguez Sr., Quezon City.  The documents must be received not later than 12:00 noon of April 24, 2008.  Opening of bids will be conducted at exactly 1:00 PM of the same day.

PhilCAT reserves the right to accept or reject any or all bids, waive any formalities or defects found therein, and accept only such bids which to its judgment are reasonable and most advantageous to PhilCAT.

For further inquiries/details, interested parties may call Tito F. Rodrigo at telephone numbers 749-8990; 781-9535 to 36.

PhilCAT-Global Fund PPMD Initiative
Operations Department, Project Management Office
tfrodrigo@philcat.org www.philcat.org