Challenges in the Implementation of Tuberculosis Prevention and Control in Iligan City

Tuberculosis (TB) remains a major public health concern in Iligan City, where challenges such as limited health-seeking behaviors, persistent stigma, patient non-compliance, and resource-strained frontline workers hinder effective implementation of the National Tuberculosis Program (NTP). Despite comprehensive national guidelines, program delivery at the community level is affected by complex social, operational, and institutional barriers. A descriptive-comparative research design was employed to examine the difficulties encountered by nurses and barangay midwives in carrying out TB prevention and control activities. The study involved 84 respondents—47 nurses and 37 midwives—from 44 barangays and 50 rural health centers in Iligan City. A modified questionnaire based on the DOH Manual on Tuberculosis Control and Prevention (6th Edition, 2020) was used to assess challenges across four implementation dimensions: patient-centered TB care, screening and diagnosis, treatment, and recording and reporting. Data were analyzed to determine differences in implementation challenges based on respondents’ profiles and years of service. Findings revealed that most respondents were nurses (56%), and nearly half had more than three years of program experience. Implementers reported the least difficulty in patient-centered care (M=2.06) and treatment delivery (M=1.59). Moderate difficulty was noted in screening and diagnosis (M=1.89), while preventive treatment posed the greatest challenge (M=2.53). No significant difference was observed in challenges when grouped by position (p=.142), but difficulty levels varied significantly according to years of service (p=.044). Years of experience substantially influence implementers’ ease in delivering TB services, highlighting the need for strengthened capacity-building. Enhancing training, addressing stigma, and improving systematic screening may improve NTP implementation. Further studies with larger samples and qualitative approaches are recommended to deepen insights into persistent implementation challenges.