Health System Realignment and Policy Recommendations for Tuberculosis Control
The rollout of universal health care mandates a strategic shift toward integrated primary care networks capable of sustaining comprehensive disease interventions, including national tuberculosis control programs. While statutory decentralization aims to broaden patient access across local government units, persistent systemic disparities in local health financing continually undermine service delivery at the municipal level (Padilla, 2023). Establishing evidence-based human resource allocations remains pivotal to resolving these delivery gaps, as primary health facilities frequently operate under acute operational burdens that constrain routine case detection, diagnostic follow-up, and direct clinical supervision (Department of Health, 2022). Within this constrained environment, community health workers serve as an indispensable bridge between decentralized primary care facilities and vulnerable patient populations, performing essential outreach, symptom screening, and daily treatment adherence monitoring (Crisostomo et al., 2020). However, delegating continuous frontline responsibilities without formalizing supportive supervisory networks and reliable institutional protections risks compounding local delivery bottlenecks (Crisostomo et al., 2020). Sustainable tuberculosis governance under universal health coverage therefore requires synchronizing baseline municipal staffing formulas with dedicated community-level investments, ensuring that broader equity mandates translate into resilient primary care workflows (Department of Health, 2022; Padilla, 2023).