To: Bureau Directors
Regional Directors
Schools Division/City Superintendents

1. In compliance with Executive Order No. 187, s. 2003, the Department of Education through the Health and Nutrition Center, shall strengthen the implementation of its TB Prevention and Control Program. It will adopt the Comprehensive and Unified Policy on TB Control in the Philippines (CUPTBCP) utilizing the Directly Observed Treatment Short Course (DOTS) Strategy.
2. The salient features of the MOA are the roles and responsibilities of each agency. The DOH shall assist DepED on program needs – provision of medicines, microscopes and other supplies and materials, capability building activities, monitoring and evaluation; and shall serve as referral center for pulmonary cases in the field. The DepED shall integrate TB prevention messages in the school curricula and shall collaborate with DOH on the provision of health services, conduct of surveys, training of health personnel and on the planning, monitoring and evaluation of the DepED TB Prevention and Control Program. Coordination shall likewise be conducted with the local government units (LGUs), NGOs and PTCAs to create awareness on TB.
3. Regional Directors and Schools Division Superintendents shall oversee the implementation of the following:
   1. Health Information Dissemination and Education
      • School health and nutrition personnel shall disseminate information on TB prevention and control to the pupils/students, teachers and non-teaching personnel.
      • Student government organizations, scouts and youth leaders shall create awareness on TB prevention and control.
      • School heads shall be oriented/re-oriented on the DepED TB Prevention and Control Program and CUPTBCP utilizing the DOTS strategy.
      • Meetings shall be held with the Parent-Teacher- Community Associations (PTCAs) giving emphasis on TB prevention and control.
      • Updates on TB control shall be published in school papers/organs/newsletters to lessen the stigma on TB.
      • Health instruction in the classroom giving emphasis on prevention, early diagnosis and proper treatment of TB shall be intensified.
      • TB modules developed for the DepED-GSK “Healthy Lungs” Project shall be utilized to supplement health teaching in Grades V and VI.
   2. Health Service Delivery
      • Direct sputum smear examination shall be the initial diagnostic tool in case finding.
      • As part of the Teachers Health Welfare Enhancement Program, all teaching and non-teaching staff will undergo health profiling and annual physical examination including chest x-ray in compliance with Civil Service Commission Memorandum Circular#17, s. 1989. The conduct of chest x-ray is not to screen TB but as part of the annual physical examination. All chest x-ray results suggestive of TB shall be subjected to sputum microscopy to establish the diagnosis of TB.
      • School nurses trained on sputum microscopy shall assist in the conduct of direct sputum smear examination to facilitate diagnosis of PTB. They shall coordinate with established DOH validation centers to validate result and to ensure a systematic referral system.
      • Division offices with trained nurse-microscopist shall provide a safe, spacious and enabling work environment for the microscopic examination of sputum specimens.
      • Standardized chemotherapy in accordance with the DOTS strategy should be strictly implemented. A treatment partner shall be identified to ensure compliance to medication by the patient. The partner may be the clinic teacher or principal in the same school where the patient is a member of the staff, or the school nurse stationed in the school district.
      • Recording and reporting of cases shall be done on the standardized National TB Program (NTP) forms.
   3. Monitoring
      • Monitoring shall be done regularly at the regional/division levels utilizing the prescribed forms. Monitoring reports shall be incorporated in the quarterly accomplishment report of the Regional/Division Health and Nutrition Units/Section (RHNU/DHNS). The DOH TB coordinators, in coordination with the school health personnel, shall monitor regularly the implementation of TB prevention and control program in the schools.
   4. Collaboration with the stakeholders
      • Close collaboration shall be established with Parent- Teacher-Community Associations, Local Government Units, Municipal Health Officers (MHO), DOH TB Coordinators, and established local TB validation committees for sputum microscopy.
   5. Administrative Support
      • School heads shall provide administrative support including appropriate funding for the effective operations of the DepED TB Prevention and Control Program in their areas of responsibility.
      • Principals shall be held accountable for the complete treatment/cure of the members of his/her teaching/non¬teaching staff found positive for TB.
4. All schools medical officers and nurses-in-charge shall be trained by DOH on the CUPTBCP utilizing the DOTS strategy. The members of the regional HNU staff who had already undergone training by the DOH at the Splash Mountain Resort, Laguna, on September 2-5, 2003 are expected to coordinate the training at the regional and division levels. Such series of trainings shall be managed by the Health and Nutrition Center, in close coordination with the Infectious Disease Control Division of DOH. Training of selected school nurses on sputum microscopy shall likewise be conducted, in coordination with DOH and the Research Institute for Tropical Medicine (RITM) to complement the services provided for TB diagnosis. The Region/Division Action Plans shall be formulated during the training, and the trained staff shall immediately operationalize such plans in their areas.
5. A quarterly accomplishment report shall be prepared and submitted to the Office of the Secretary, Attention: Health and Nutrition Center, DepED Complex, Meralco Avenue, Pasig City.
6. Immediate dissemination of and compliance with this Order is directed.

Encls.:
As stated
Reference:
Allotment: 1—(D.O. 50-97)

To be indicated in the Perpetual Index under the following subjects:
HEALTH EDUCATION
PROGRAMS
TEACHERS
EMPLOYEES