Variations in the Clinical Management of Multibacillary Leprosy Patients in Selected Hospitals in Metro Manila
Introduction.
This paper documents the variations in the diagnosis and management of multibacillary leprosy
patients in three of the biggest case-holding hospitals in Metro Manila. Furthermore, we aimed to discuss the
implications of these variations on the country’s leprosy control and elimination program.
Methods.
Focus group discussions (FGD) were conducted with 23 health professionals composed of doctors and
nurses with at least a year of experience in managing leprosy patients. The topics included procedures on patient
diagnosis and management such as treatment duration, patient follow-up and definitions of treatment completion
and default. The FGD participants provided suggestions to improve treatment compliance of patients. Their
responses were compared with World Health Organization (WHO) standards and/or the 2002 DOH Manual of
Operating Procedures (MOP) for leprosy. Transcripts of the recordings of the FGDs were prepared and thematic
analysis was then performed.
Results.
There were variations in the hospitals’ procedures to diagnose leprosy, in treatment duration, and in patient
follow-up. Definitions for treatment completion and default differed not just between hospitals but also with the
WHO guidelines and the 2002 MOP. Hospitals extended treatment up to 24 or even 36 months, despite the 12
months stipulated in the MOP. Two hospitals required slit skin smear and skin biopsy in diagnosis, despite the MOP
and WHO provisions that these were not mandatory. One hospital defined default as three consecutive months
without treatment, which was different from the MOP and WHO standards and from the other hospitals.
Conclusion.
Given the variations in patient management, we recommended that effectiveness of the standard
treatment relative to other regimens being practiced by specialists be evaluated.
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Health workforce issues and recommended practices in the implementation of Universal Health Coverage in the Philippines: a qualitative study.
The Philippines' Universal Health Coverage program faces a critical workforce crisis that threatens its very foundation. A new Ateneo de Manila University study reveals that while the country exports healthcare workers globally, it struggles to retain the professionals needed for its own ambitious health reforms. With only 7.92 physicians per 10,000 population and a shortage of 127,000 nurses, systemic barriers—from restrictive hiring policies to uncompetitive salaries—are driving away the very people meant to deliver healthcare for all Filipinos. The research identifies promising solutions, including scholarship programs and comprehensive benefits, but warns that without addressing these fundamental workforce issues, universal healthcare remains at risk.
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Measuring and Understanding Geographic Inequities in Physician Distribution in the Philippines
Access to quality health care in the Philippines is shaped not only by the availability of physicians, but also by how equitably they are distributed across regions. Many communities, particularly in rural and geographically isolated areas, continue to face limited access to medical professionals, while urban centers often see a concentration of physicians and specialists. The project Measuring and Understanding Geographic Inequities in Physician Distribution in the Philippines seeks to address this challenge by providing a clear, evidence-based picture of physician maldistribution nationwide.