MEMORANDUM OF AGREEMENT

I.PARTIES

The Department of Health Center for Health Development CARAGA, Bureau of Jail
Management and Penology Regional Office XIII, Butuan City Jail, Butuan Medical Center and
City Health Office of Brgy. Libertad, Butuan City mutually agree to cooperate and provide
assistance for the establishment of BJMP CLUSTER 1 BCJ TB DOTS CENTER serving as a
diagnostic and treatment center for TB.

WITNESSETH

WHEREAS, the National Tuberculosis Control Program (NTP) Manual of Procedures (MOP) of
the revised version (5th edition) that embodies new strategies and initiatives designed to
national targets of 70% case detection and 85% cure rate, among those initiatives are
expansion of TB DOTS services to cover health related sectors like teachers and school
personnel, the military, and those in prisons;

WHEREAS, Tuberculosis is a major public health problem, as it remains to be the 6 th leading

cause of death in the country. Worldwide, the Philippines is ranked 9 th among the 22 high-
burdened countries and 2nd in the Western Pacific region with the highest burden of the
disease.

WHEREAS, Tuberculosis is a substantial concern in prison facilities; inmates and employees are
at risk, and TB outbreaks can lead to transmission in surrounding communities; The Philippine
TB Society publishes a study on TB prevalence in prisons in 2009 stating that crowded settings
like prisons, is estimated that TB is 30 to 100 times more prevalent than in the general
population; Two out of every 1,000 Filipinos have TB and 14 out of 1,000 inmates have TB; The
risk of acquiring TB in detention places is seven times higher than in the free community; and
TB is also the second leading cause of death among inmates in Philippine jails and prisons.

WHEREAS, the Bureau of Jail Management and Penology adheres to United Nation Standard
Minimum Rules for the Treatment of prisoners which includes separation of inmates according
to categories, accommodations and medical services, however, the rise in the criminality in
recent years, coupled with the passage of more stringent laws and the adoption of better crime
solution methods, resulted to mark increase in inmate population in BJMP detention centers.
The lack of funds to expand existing jail aggravates the situation, a condition that may
aggravate the incidence of Tuberculosis Transmission in Multiple Jail/Correctional Facilities.
Health Department should provide assistance to jail facilities in creating a TB DOTS Center,
thereby controlling transmission within facilities and the surrounding communities.

WHEREAS, the facility will be the prime mover of the public-private collaborations in the city, to
ensure that all people especially the vulnerable sectors (e.g. Children, indigenous people, or
those in prison) can avail of proper TB treatment and management.

WHEREAS, the TB DOTS Center will be situated inside the Butuan City Jail premises and will be
comprised of three sputum collection areas to wit:

(1) Butuan City Jail;

(2) Bayugan City Jail; and
(3) Cabadbaran City District Jail
NOW, THEREFORE, FOR AND IN CONSIDERATION OF THE FOREGOING PREMISES AND THE
COVENANTS AND UNDERTAKING HEREINAFTER SET FORTH, all the parties above hereby bind
themselves and mutually agree as follows:

Terms and conditions

1. The Department of Health Center for Health Development CARAGA shall:

a) Implement NTP program in accordance to policies and guidelines;

b) Act as an overseer in program implementation in coordination with LGUs
(provincial/city) and BJMP Jails that has TB DOTS Program;
c) Assess TB DOTS program of Butuan City Jail, and provide assistance based on gaps
identified trainings, seminars among health practitioner, inmate contacts, etc.
d) Provide the following logistics:
Uninterrupted supply of TB Drugs
Laboratory Supplies, Microscope
IEC Materials
Recording and Reporting Forms
e) Monitor and Evaluate regularly NTP activities including Quality Assurance System and
TBDC implementation/operation
f) Provide free X-ray to TB suspected inmates with negative sputum smear
g) Collate and Analyze data from all reports and feedback findings and recommendation
to all stakeholders
h) Encourage establishment of TB DOTS Facility

2. The Butuan Medical Center/PMDT shall:

a) Provide free X-ray to TB suspected inmates with negative sputum smear

b) Provide free GenXpert examination to x-ray positive or MDR TB suspected inmates
c) Accommodate treatment of inmates with MDR TB
d) Support Butuan City Jail TB DOTS Center as its referring physician

3. The Butuan City Health Office shall:

a) Support Butuan City Jail TB DOTS Center as its referring physician

b) Be willing to support BCJ TB DOTS Center in the implementation of its health
programs
c) Provide additional manpower during mass sputum collection and examination
d) Designate a Nurse NTP Coordinator to assist the BCJ TB DOTS Center

4. The Bureau of Jail Management and Penology through the Butuan City Jail TB DOTS
Center (BJMP Cluster 1) shall:

a) Do Direct Sputum Smear Microscopy (DSSM) for diagnosis and treatment of inmates
by designating a Medical Technologist or a trained sputum microscopist, an NTP
nurse and other BJMP Personnel trained for its operation;
b) Follow proper procedures in Case Finding of TB symptomatic patients and maintain
the proper procedures in Case holding or treating TB patients;
 c) Ensure the requisition and distribution of drugs among TB patients
d) Adhere to NTP Strategies and Guidelines by recording and submitting quarterly
reports to the City NTP Coordinators, as well as subjecting TB DOTS facility to an
independent External Quality Assessment at any given time.
e) Refer to the TBDC all smear negative / x-ray positive TB suspects using a TBDC
Referral form
f) Train, assign and supervise a treatment partner for those patients who will undergo
DOTS treatment
g) Provide continuous Health Education and Health Promotion to all inmates, specially
the TB patients and encourage their family to participate in TB infection control
h) Attend/participate in seminars, trainings, conferences, advocacy and other activities
in collaboration with the DOH and other partners or stakeholders
i) Assist the CHO, DOH and other partner agencies in logistics, manpower, security and
any relevant activities as the need arises
j) Whereas the following BJMP manned jail throughout Province of Agusan del Norte
shall be considered as referring units to Butuan City Jail TB DOTS Center, to wit:
Bayugan City Jail; and
Cabadbaran City District Jail

5. The Bureau of Jail Management and Penology through the Regional Health Service
Unit shall:

a) Supervise and monitor implementation of TB DOTS in all three clusters throughout

CARAGA consisting of:
Cluster 1 = Butuan City Jail
Cluster 2 = Surigao City Jail
Cluster 3 = Surigao del Sur District Jail (Tandag City)

b) Conduct quarterly visitation to all jails throughout CARAGA

c) Conduct quarterly collection and validation of Sputum Slides (EQA)
d) Collect, consolidate and submit monthly and quarterly reports to NHQ and DOH
e) Conduct Provider-initiated counseling and testing to TB-Positive Inmates.
DURATION AND RENEWAL

This Memorandum of Agreement shall be valid from the date of signing of all parties
and will be continuous, unless terminated sooner by either of the parties hereto.

Signed:

J/SSUPT ESTER G PEPITO, PhD DR. JOSE R LLACUNA JR., MD, MPH, CESO III
Regional Director Director IV
RBJMP XIII CARAGA Center for Health Development CARAGA

J/CINSP MARGIE D CANANGCA-AN, DMD DR. GLEE D. VALENZONA

CHIEF, Health Service Section Medical NTP Coordinator
RBJMP XIII CARAGA Center for Health Development CARAGA

DR. JOYCE T HIDALGO, MD DR. SHERYL S. TAPERLA, MD

City Health Officer/Hospital Director BMC- STC / PMDT Physician
Butuan Medical Center Butuan Medical Center

J/SINSP MARLON B CASTELO DR. TERESITA HELEN V. MAKILING

Jail Warden Medical Officer III
Butuan City Jail Libertad Health Center
WITNESS

SJO4 RICHARD C RECOSOSA, RN ARLENE M SERRANO, RN

Regional TB DOTS Anchorperson NTP Nurse Coordinator
RBJMP XIII CARAGA Center for Health Development CARAGA

JO1 JESSIE Z DOYSABAS, RMT ERNA T CRAVAJAL, RMT

Regional Medical Technologist/ NTP Laboratory Coordinator
Microscopist/NTP Validator Center for Health Development CARAGA
RBJMP XIII CARAGA

SJO2 FLOREFE M BADILLO, RN

NTP Nurse Coordinator
Butuan City Jail