4A-5P Analysis
Active Model
Tuberculosis Philippines
Data Source
Updated 2026-02-04
Source NTP-DOH, WHO TB Reports 2024-2025, RITM, PhilHealth
Year
Region
Case
Executive SummaryAvailablenessAdoptionAwarenessAffordabilityConceptualBottleneck MatrixStrategic RecommendationsLeaky BucketConceptualEvidence AuditFact Sheet
AVAIL 40%
ADOPT 37%
AWARE 75%
AFFORD 58%
MIN 37%

Bottleneck Matrix

Integrated 4A bottleneck prioritization and cross-dimensional analysis

National-Level Bottleneck Analysis

2024 (with latest available capacity/workforce baselines)

Comparing all 4 dimensions to identify the PRIMARY constraint

DimensionTheoreticalActualUtilizationGapData TraceSeverity
▼ AWARENESS (Cases detected)724,000544,94875%179,052A CRITICAL
└Never seek care22% of symptomaticCRITICAL
└Wrong first contact point30% attritionHIGH
└Specimen drop-out before testing30% lossHIGH
▼ ADOPTION (Workforce capacity)259,27795,04037%164,237B HIGH
└TB-trained medical technologists1,500 vs 4,000 neededCRITICAL
└Primary care facility accreditation42% of RHUsHIGH
└Physician density gap0.40 vs 2.3 WHO targetHIGH
▼ AFFORDABILITY (Can afford care)724,000417,02458%306,976U HIGH
└Catastrophic cost incidence42.4% of TB householdsCRITICAL
└PhilHealth OOP coverageOnly 14% of costsHIGH
▶ AVAILABLENESS (Tests/year)361,200144,48040%216,720A MODERATE
Primary Bottleneck
AWARENESS (Cases detected) — 75% utilization
Gap of 179,052 units must be addressed first
Never seek care: 22% of symptomaticWrong first contact point: 30% attritionSpecimen drop-out before testing: 30% loss

Regional Bottleneck Matrix

A-dimension factors and derived rates across all 18 regions. Red indicators show weakest performers.

Dimension / FactorBARMMCALABARZONCARMIMAROPANCRNIRRegion 1Region 2Region 3Region 5Region 6Region 7Region 8Region 9Region 10Region 11Region 12Region 13
Availableness40.0% 47.0% 31.0% 28.0% ◀58.0% 40.0% 40.0% 40.0% 44.0% 40.0% 40.0% 40.0% 40.0% 40.0% 40.0% 40.0% 40.0% 40.0%
Population (M)——————————————————
Screened (CXR)5,988226,05512,72924,140166,79313,44666,81722,869221,2117,01185,77547,1554,7364,06134,09827,66519,0888,721
Tested (GeneXpert)7,76847,6746,71110,92481,29813,65112,15615,53133,76524,57614,09622,59011,65910,15610,07412,46611,33112,614
Screen → Test Rate129.7%21.1%52.7%45.3%48.7%101.5%18.2%67.9%15.3%350.5%16.4%47.9%246.2%250.1%29.5%45.1%59.4%144.6%
Adoption34.9% 34.9% 34.9% ◀34.9% 34.9% 34.9% 34.9% 34.9% 34.9% 34.9% 34.9% 34.9% 34.9% 34.9% 34.9% 34.9% 34.9% 34.9%
Population (M)5.7M16.9M1.8M3.2M14.0M4.4M5.3M3.7M13.0M6.1M8.2M8.1M4.6M3.9M6.0M5.5M5.0M3.0M
Screened5,988226,05512,72924,140166,79313,44666,81722,869221,2117,01185,77547,1554,7364,06134,09827,66519,0888,721
Notified3,16021,0571,4164,12526,6566,3785,8124,66315,8657,6356,3117,3074,4723,9724,7225,0025,5583,252
Started Treatment2,80820,0111,3664,08524,9416,2565,6004,64115,1177,3206,0287,2464,2703,8044,3054,6015,2503,240
Tx/Notification Ratio88.9%95.0%96.5%99.0%93.6%98.1%96.4%99.5%95.3%95.9%95.5%99.2%95.5%95.8%91.2%92.0%94.5%99.6%
Awareness75.3% 75.3% ◀75.3% 75.3% 75.3% 75.3% 75.3% 75.3% 75.3% 75.3% 75.3% 75.3% 75.3% 75.3% 75.3% 75.3% 75.3% 75.3%
Population (M)——————————————————
Screened5,988226,05512,72924,140166,79313,44666,81722,869221,2117,01185,77547,1554,7364,06134,09827,66519,0888,721
Tested7,76847,6746,71110,92481,29813,65112,15615,53133,76524,57614,09622,59011,65910,15610,07412,46611,33112,614
Notified68,00068,00068,00068,00068,00068,00068,00068,00068,00068,00068,00068,00068,00068,00068,00068,00068,00068,000
Test → Notification Yield40.7%44.2%21.1%37.8%32.8%46.7%47.8%30.0%47.0%31.1%44.8%32.4%38.4%39.1%46.9%40.1%49.0%25.8%
Affordability57.6% 62.0% 50.0% 44.0% ◀69.0% 57.6% 57.6% 57.6% 59.0% 57.6% 57.6% 57.6% 57.6% 57.6% 57.6% 57.6% 57.6% 57.6%
Affordability Proxy57.6%62.0%50.0%44.0%69.0%57.6%57.6%57.6%59.0%57.6%57.6%57.6%57.6%57.6%57.6%57.6%57.6%57.6%

Dimension Audit Grid

Diagnostic tables showing source data and calculated A-scores for each dimension across all regions.

▶ Availableness Audit
19 regions
▶ Adoption Audit
19 regions
▶ Awareness Audit
19 regions
▶ Affordability Audit
19 regions