chapter iii my work

8/12/2019 Chapter III My Work

1/50

1

Chapter III

Health Situationer

This chapter presents the health situation of the province of Northern Samar. It

articulates data on natality, mortality and morbidity, family planning, malnutrition, health

practices and best practices, diseases and causes, dental health program, health facilities,

services and personnel, financing and expenditures as well as gaps and deficiencies in

services/programs delivery.

Health Status

Natality

Figure 1below presents the Crude Birth Rate (CBR) per 100,000 population data of

the twenty four (24) municipalities of Northern Samar. The entries are sex disaggregated

and geographically presented.

The 1st District is composed of thirteen (13) municipalities where the highest

recorded CBR is at 2,872 in the Municipality of Allen; and the lowest CBR is at 1,537 in the

island town of San Antonio. On cumulative average, the districts CBR is recorded at 1,797

or 17.99% per 100,000 population. This CBR is estimated to be at 1.12% of 100,000

population per municipality and 7.29% of the districts total population.

On the other hand, the data for the eleven (11) municipalities comprising the 2nd

District is as follows: 1,294 is the cumulative average CBR per 100,000 population. The

highest rate is at 2,123 in the Municipality of Pambujan; and the lowest is at 1,150 in


2/50

2

Lapinig. The districts cumulative average CBR is at 14.32% per 100,000 Population or 1.5%

per municipality.

On the whole, the grand average CBR or the 1st

District is at 13.80 per 100,000

population and that of the 2nd

District is at 1.69 per 100,000 population. Roughly, it is 15.49

per 100,000 population CBR for the Province of Northern Samar.

Municipality Total Popu-

lation

Crude Birth Rate Rate/ 100,000

PopulationMale Female

1st DistrictAllen 27,187 378 403 2.87

Biri 10,759 135 135 2.51

Bobon 22,168 280 306 2.6

Capul 13,961 141 130 1.94

Catarman 90,641 898 882 1.95

Lavezares 33,505 269 229 1.49

Lope de Vega 14,680 117 110 1.54

Rosario 10,930 75 102 1.61

San Antonio 9,952 83 70 154

San Jose 17,992 249 245 2.74San Isidro 28,726 283 305 2.05

San Vicente 7,249 91 85 2.42

Victoria 14,966 153 108 1.74

DistrictsAverage 13.80

2nd District

Catubig 35,452 330 325 1.85

Gamay 28,523 230 240 1.64

Laoang 75,265 648 534 1.57

Lapinig 14,493 114 99 1.50

Las Navas 41,031 214 258 1.15Mapanas 15,732 113 115 1.45

Mondragon 37,747 469 432 2.39

Palapag 43,847 389 366 1.72

Pambujan 34,993 378 365 2.12

San Roque 26,581 286 255 2.0

Silvino Lobos 17,425 119 97 1.26

DistrictsAverage 1.69

Provincial Average 15.49

Fig. 1 Crude Birth Rate/ 100,000 Population Northern Samar

(Source: PHO Accomplishment Report 2012)


3/50

3

Data on deliveries by birth attendance is presented in Figure 2. Deliveries attended

by professional health workers doctors, nurses and midwives totaled to 7,665 or 61.6% of

the deliveries in 2012.

The traditional birth attendants and untrained hilots deliveries were 4,984 or

39.4%. The data apparently indicate that there was decline of deliveries by traditional birth

attendants as compared with those of some years back due to upgraded Rural Health Units

as BeMoNC activity. Services of the TBAs are secured due to distant and hard to reach

locations.

Figure 2. Deliveries by Birth Attendance

Accomplishment Report 2012

Figure 3 shows a record of 7,301 or 58% live births which were home deliveries;

2710 or 21% hospital deliveries and 2650 or 20% were delivered at the Rural Health Unit

with Basic Emergency Manage Obstetric Neonatal Care Facilities (BeMonC) and 1.3 others.

While most are home deliveries, it is to be noted that deliveries at both hospital and RHUs


4/50

4

are increasing. There remains however, to be a need to further undertake massive

campaigns about maternal deliveries. This is geared towards changing a particular health

seeking behavior especially for expectant mothers.

In addition, the data explicitly tells the need or local government units (LGUs) and

the health sector to converge and collaborate for the enrolment of the two poorest quintiles

to the PhilHealth Program at No Billing level.

Figure 3. Maternal Deliveries by Place

Source: PHO- Accomplishment Report 2012

Infant Mortality

Figure 4, articulates the data on infant mortality. Highlights include deaths at 74 for the 1st

District over the 5-year average and 43 for CY 2012. This implies a rather high infant mortality data.

Data for the 2nd

District reveal that there are 53 infant mortality on a 5-year average data

and 74 for the CY 2012; and total deaths is at 108 for the 5-year average and 117 for CY 2012; and

highest deaths has been recorded to be those from Catubig at 15 and 40, respectively.


5/50

5

At a rate of 1,000 live births, the data reveals that for the 1st

Districtthe rate is 11.16 and

7.56 for the 5-year average and CY 2012 respectively.

The infant mortality picture at the 2nd

District includes a recorded death of 13 in Palapag. Its

5-year average rate is 10.09 and 14.31 at CY 2012.

The provinces infant mortality rate is at 10.62 on a 5-year average and 10.93 for CY 2012.

These data necessarily suggest for the need to intensify child health programs

implementation. At the grassroots level, breast feeding, nutrition services and the like

services may be given immediate focus. The 4Ps families and their children14 years old

and below provide a potent avenue for health workers to converge with the DSWD. The

Family Development Sessions (FDS) can be best utilized to re-educate the mothers at the

grassroots level.

Most importantly however, attention should be given to the infant mortality rate at

the provincial level; taking particular notice over the wide disparity between the 5-year

average and the CY 2012. The figure rings the alarm

. This may not only suggest an adequate health seeking behavior but may also strongly

forward an institutional evaluation of how programs intended for such clientele are taking

ground. An intelligent looking back may well address the situation.


6/50

6

Infant Mortality 2012

Per 1000 Live births

5- Year Average

Municipalities 5-Year Average CY 2012

1st

District Number Rate Number Rate

Allen 5 6 4 5.10

Biri 0 0 0 0.00

Bobon 7 12 10 17.6

Capul 9 33 11 40.5

Catarman 9 5 6 3.37

Lavezares 7 14 6 12Lope de Vega 5 22 0 0

Rosario 1 6 0 0

San Antonio 2 13 0 0

San Jose 5 10 6 12.15

San Isidro 4 7 0 0

San Vicente 1 6 0 0

Victoria 0 0 0 0

Total 74 43

Average 11.16 7.56

2ndDistrict

Gamay 4 9 2 4.26Laoang 6 5 0 0

Lapinig 4 19 4 18.7

Las Navas 0 0 0 0

Catubig 15 23 40 61

Mapanas 3 13 2 13.16

Mondragon 3 3 3 3.33

Palapag 7 9 13 17.22

Pambujan 4 5 3 4.04

San Roque 3 6 1 7.94

Silvino Lobos 4 19 6 27.78

Total 53 74

Grand Total 108 117

Average 10.09 14.31

Grand Average 10.62 10.93


7/50

7

Maternal Mortality

Figure 5shows the trend of Maternal Mortality Rate (MMR ) in Northern Samar from

2008 to 2012. Over the five year spread MMR increased doubling its record from 150 to

300. This may be attributed to active maternal birth reporting and tracking; which suffices

to say that with up to date MMR reporting and tracking better interventions may be

resorted to and therefoer attend to the maternal mortality situation of the province.

The data suggest of a service delivery at the grassroots level. This would entail more

health workers at the front line doing what they do best community organizing,

mobilization and social marketing. Tracking and reporting should include 4Ps partners since

health services form part of the condition for compliance. While, it may be true that there

are mothers with poor health seeking behavior which in effect causes delay in decision

making this remains to be a real and material point for consideration. Meanwhile,

BeMonc trainees and trainings should continue.

Maternal Mortality Rate/ 100,000 Live Births.


8/50

8

Figure 5. Maternal Mortality Rate

Source : PHO- Accomplishment Report 2012

0

50

100

150

200

250

300

350

2008 2009 2010 2011 2012


9/50

9

Maternal Mortality Rate by Municipality

Figure 6details the information on maternal mortality on a per municipality basis for

CY 2012.

For the 1st

District of Samar, the highest total live births recorded are from

Catarman. The highest live birth recorded was 1,780 in Catarman at a rate of

1.69/1.69MMR/100,000 live births; meanwhile the data for the 2nd

District is topped by

Laoang with a total live birth of 1,182 at 0 MMR. At the provincial level, total live births

recorded were at 12,724 at 30.8 MMR/100,000.

Maternal Mortality Rate /100,000

Total Live

birth

FHSIS Hospital Total Rate

1st

District

1. Allen 781 0 0 0 0

2. Biri 280 1 1 2 714

3. Bobon 586 1 1 2 341

4. Capul 271 0 0 0 0

5. Catarman 1,780 1 2 3 169

6.Lavezares 498 0 0 0 0

7. Lope De Vega 227 2 1 3 1321

8.Rosario 177 0 1 1 564

9. San Antonio 153 0 0 0 0

10. San Jose 494 2 1 3 607

11. San Isidro 588 0 0 0 0

12. San Vicente 174 0 0 0 0

13. Victoria 261 0 2 2 766

Total 6270 7 9 16 344.96

2nd

District

14. Gamay 470 0 0 0 0

15. Laoang 1182 0 0 0 0

16. Mapanas 228 0 1 1 438

17. Catubig 655 2 4 6 916

18. Mondragon 901 1 1 2 222

19. Palapag 833 0 1 1 120

20. Pambujan 743 2 2 4 538

21. Lapinig 213 0 0 0 0


10/50


11/50

11

9. Dermatitis 787 123 1059 165

10.Abscess 675 105 675 105

Figure 7. Leading Causes of Morbidity per 100,000 Population

Source: PHO Accomplishment Report 2012

Causes of Mortality As shown below Heart disease and Diabetes Mellitus lead the top ten

causes of mortality. This means that Healthy Lifestyle diseases are emergency and

surpassing the communicable disease which is prevalent over the years. Included in this plan

is the intensive intensification of the prevention and control of such disease.

Ten Leading Causes of Mortality per 100,000 Population

Cause o Mortality 5-Year Average CY 2012

Number Rate Number Rate

1. Heart Disease 187 29 177 27

2. Diabetes Mellitus 184 29 119 19

3. Hypertension 137 22 316 49

4. Pneumonia 134 21 372 58

5. Acute Renal Failure 127 20 - -

6. Drowning 124 19 - -

7. CVA 115 18 97 15

8. PTB 110 17 77 12

9. Septecemia 107 17 70 11


12/50

12

10.Diarrhea (AGE) 106 17 95 15

Prevalence of Malnutrition

Figure. Below shows that prevalence of Malnutrition are diminishing from year 2008

up to 2012. From 28.00 prevalence it decline to 16.1 on 2012.

Prevalence Rate

0

5

10

15

20

25

30

2008 2009 2010 2011 2012


13/50

13

Municipalities of 1st district and then prevalence Rate of 2011 & 2012

Municipalities of 2nd District and then prevalence Rate of 2011 & 2012

9.4

17.8

10.6 11

20.2 21 21.4

23

18.7

11.9

1918

1210.4

0

5

10

15

20

25

30


14/50

14

Family Planning

The figure below shows the utilization of the family planning methods commonly practiced

in the province of Northern Samar. The figure reveals that out of 7,632 current users of

family planning 3,808 or 42% use natural method. The permanent method is only 7%. Very

few are using permanent method of family planning for the fact that the province is a pro-

life advocate especially our former Governor.

Fig. Utilization of family planning methods

0

5

10

15

20

25

30

19.5

15 15.314.1

27

17.516 15.1

18.6

30


15/50

15

Source: PHO Accomplishment Report 2012

National Tuberculosis Program

For decades already, Tuberculosis is still a burden disease in Northern Samar. Province-wide

there were enornous private individuals that can identify significant number of patients with

symptoms of Tuberculosis but has no capacity to manage them through Directly Observed

Treatment Short-Course ( DOTS) therapy.

The Department of Health (DOH) implemented the program in the province

with National targets of 85% Case Detection Rate and 90% Cure Rate the Accomplishment of

the Province for CDR is 68% and CR is 72%. As the CY 2012 TB ranked 8 to 10 leading causes

of Mortality. There are 1.001 all forms of Tb cases and 496 New smear positive Tb cases.

49, 50%

42, 43%

7, 7%

Family planning Methods

Artificial

Nutural

Permanent


16/50

16

This means that the Sizeable numbers of new smear positive cases are potential sources of

infection from Tb considering that if left untreated each case can reflect 10 more persons in

a year time.

Endemic Diseases

A. An additional share of disease burden from endemic diseases such as

Schistosomiasis, Dengue and Malaria by 2012 Northern Samar is declared

Filaria free province. Schistosomiasis is considered endemic to the province

and the highest schisto prevalence at 68%. Both parasitic diseases employ

mass treatment strategy providing force medicines. However the side effect to

mass treatment being experienced by individuals taking the medicines

contributed to low compliance to the program.


17/50

17

Leprosy has ceased to be a major health public problem. Its prevalence has gone

down to less than 12 per 100,000 populations, Northern Samar has 14 municipalities

endemic for malaria but was declared malaria free since 1997.

B. Implementation of the filaria program is being undertaken by the Province

with assistance of DOH CHD region VIII which started two years ago. 58% of

the population were covered by mass treatment for filariasis.

On Rabis prevention from jan to december 2012 a total of 1,783 dogs and cat bites patients

were evaluated. The animal bite victimfor thus year declined by 16%. It is maybe due to

massive campaign on the Animal Bite Treatment and management and rabies awareness

that it kills 100% if not treated but 100% preventive if seek early consultation and given post

exposure prophylaxis.

Best Practices PHO ( Provincial Health Office )

Conduct Health Education and Animal Bite Management during vaccination schedule

to the victim and guardian at ABC

Encourage patients to complete post exposure prophylaxis and report if

the biting animal died during treatment.

84, 84%

16, 16%

Percentage of Biting Animal

Dog

Cat


18/50

18

Life Style Related Diseases

Although there are many programs on the prevention of LifeStyle Related Diseases, many of

these are losing steam in terms of sustained advocacy promotion both from the National

and Local Goverments. A classic example is Anti-smoking program supported by the passage

of anti-smoking law, reinforced by corresponding ordinance at the local level. And yet

enforcement remains dismally weak. The phenomenal predominance of lifestyle diseases in

the morbidity and mortalitystatistics is indicative of the need for more vigorous

information,education campaign agaisnt lifetyle diseases, through healty life style practices.

Household Access to Safe Drinking Water

The provinced has 100,799 households out of this only 68% had access to

safe dringking water while the 32% do not have access to safe dringking water.

Consequently diarrhea diseases have prevalent occurences in the provinceespecially at the Flung Barangays with level 1 water source.


19/50

19

Household with Sanitary Toilet Facilities

Figure below shows the provinces number of households with and without sanitary toilets

of the 100,799 total HHs of the provinc 65,364 or 65% have sanitary toilet and 35,435 or

35% have no sanitary toilets. Majority of the HHs residing in the rural areas have no sanitary

toilets. Silvino lobos being the rural & hard to reach municipality has the greatest number

74% of the HHs that has no toilet. This situation aggravates the provincesever present

problem or poor environmental sanitation

Fig: Household with and without Sanitary Toilet

68, 68%

32, 32%

Safe Drinking Water

with access68

without access


20/50

20

Dental Health Programs

There is need to support Dental Health Program. There is a need to augment the 6 Public

health Dentist of the province. Of the 24 municipalities oly 5 have plantella positions for

municipal dentist Support to Dental Health Program is extremely wanting.

A sizeable proportion of the population specially school children have been served

through DOH and Provinces dental program, In 2012 97% pregnant womens provided with

Basic Oral Health care which was given priority the school children with 37% given BOHC

and only 10% are orally fit children 12-71 months

Health Delivery System

65, 65%

35, 35%

Household with and without Sanitary Toilet

With sanitary toilet

Without Sanitary Toilet


21/50

21

The Province of Northern Samar adopts the dual health system consisting of a public

sector and a private sector. The former is basically under the supervision of the Provincial

Health Office headed by a Provincial Health Officer who supervices all Health Units (RHU) in

every municipalities. Municipal Health Officer man and operates the RHU with the

assistance of nurses and midwives, They are also assisted by the Barangays Health Workers

(BHW).

Health Facilities

There ar 12 Public and Private Hospitals operating in the province providing for a total of

400 beds, 9 of which are being operated, managed and maintained by the Provincial

Goverment of Northern Samar (PGNS) providing 350 beds while the remaining 3 are private

hospitals operating as infirmaries and one New Hospital the Catarman Doctors Hospital

operating a Secondary Hospital? With a combined total bed capacity of 45 beds of these

Hospitals operated by PgnS only Northern Samar Provincial Hospital and Allen District

Hospital are able to maintain theirprevious Secondary Standards. The remaining seven

District Hospitals of San Vicente, San Antonio, Gamay, Capul, Catubig, Biri, and G.B Tan are

operating as primary. San Antonio, Capul, Biri and San Vicente can be labeled as infirmary

similar to that of a municipal hospital as these hospital are situated in an island.

Deficiencies of the Hospitals are mainly referable to man power, Infrastrusture and

equipments. Full time physicians with permanent status mans the (19) of the 24 rural Health

Units (RHUs) of the province. However of these 24 RHU 5 (RHUs) of San Roque, Mapanas,


22/50

22

Biri, Laoang, and Silvino are manned withDoctors to the Barrio physicians (DTTBs) although

all of these have plantilla positions for MHO

Almost all 24 RHUs are 100% upgraded as birthing facilities to develop lying in capabalities

to become Become Basic Emergency Obstetric Neonetal Care (BEmONC) health facilties. Out

of 24 only San Vicente RHU and RHU Silvino are not yet 100% complted, In Catarman the

capital town a new Rural Health Unit way able to cope-up the ever increasing population of

90,549.

Health Personnel

Goverment health personnel both the Provincial and Municipal Govt totaled to 534. All the

24 municipalities have physicians. The municipalities of Laoang with 2 rural health

physicians one is DTTB (doctors to the barrios) and the other is hired by the Local

Goverment. The 24 municipalities had 34 physicians, 150 RHU, 18 midtechnologist,24

medical doctors,.

The Provincial Goverment hired 37 midical doctors, are assigned in the provincial Health

office while the remaining 34 are working in the provincial Hospitals as residents,

consultants and contractual, The others mans the 8 district Hospital. There are 15 dentist 12

Midtechnologist, 11 pharmacist, 178 nurses and 21 Provincial Sanitary Inspectors.


23/50

23

UTILIZATION OF HOSPITAL SERVICES

Facility

%

Occupancy

Bed Days

Utilized Expenditure

Ave. Cost

perpatient/Day

1. Northern

Samar

Provincial

Hospital

126.63% 126.63 11,987,876.00 P772.11

2. Allen

District

Hospital

49.35% 24,67 3,374,370.00 P46.33

3. BIRI

District

Hospital

27.94% 6.98 1,333,845.00 P86.97

4. San

Antonio

District 1

Hospital

10.91% 2.72 1,034,200.00 P75.00

5. Capul

DistrictHospital

9.11% 2.27 864,400.00 P79.99

6. San

Vicente

District

Hospital

- - - -

7. GB- TAN

Memorial

District

Hospital

41.98% 20.49 2,626,051.00

I88. Catubig

District

Hospital

44.27% 11.06 P8,232,295.03 P115.38

9. Gamay

District y

Hospital

27.17% 6.79 8,279,681.73 P312.57


24/50

24

Profile of Northern Samar Goverment & Private Hospitals

Hospital Types No. of Beds Category Operating as

1.Northern Samar

Provincial Hospital

(NSPH)

G 100 Secondary Secondary

2. Our Lady of Peace

HospitalP 15 Infirmary Infirmary

3. Leoncio Uy Hospital P 10 Infirmary Infirmary

4. Catarman Doctors

Hospital

P 25 Secondary secondary

5. BIRI District Hospital G 25 Primary Primary

6. Allen District

HospitalG 50 Primary Secondary

7. San Antonio District

HospitalG 25 Primary Primary

8. Capul District


9. San Vicente District

Hospital G 25 Primary Primary

10. GB-TAN Memorial


11. Catubig District


12. Gamay District



25/50


26/50

26

TOTAL PS and MOOE 158,218,087.55 339,111,902.55

GAPS AND DEFICIENCIES

Deficiencies in terms of physical structure manpower and equipment have decreased due to

Department of Health augmentation in relation to its KP ( Universal Health Care Program ).

The ( HFEP ) Health Facility Enhancement Program for the 24 Rural Health Unit as BemonC

and 9 disctrict hospitals was upgraded in physical structure and equipment still the high cost

ofmaintaining so many Hospitals is stretching resources of the province to the limit and

spreading thinly whatever fund is available.

The presence of local and foreign donors like UNICEF, PLAN philippines and DOH

hasa ensured the implementation of public health program especially maternal and Child

Health Programs. HIV-AIDS and TB However thre is still the used to strengthen and intensify

program operations and management institute strategies to further enhance their

implementation and disease elimination efforts.

Problem are noted i programs not covered by donors or partners particularly

environmental sanitation and Dental Health Program. The Reproductive Health Responsible

Parenthood Program was influenced by our former Governor for his prolife stances at the

provinced level only 61% of households have access to saitary toilets which is much lower in

somemunicipalities. While access to safe drinking water is 68% those are level 1 and level 2

water facilities. Some water facilities are built near toilets and care less than 65m deep.

More efficient monitoring by sanitary inspectors and enforcement of sanitation could have


27/50

27

made difference. There is no wonder that outbreaks of diarrhea and typhoid fever occurs

more often in the province.

1. HEALTH FINANCING

A.Financial risk protection

I. Philhealth enrolment and utilization

1. Low PHIC utilization

2. Non sponsorship of 2nd poorest quintile

II.LGU Investment for Health

1.Low revenue-enhancement and resource mobilization schemes to all devolved

Health facilities and Inter-local Health Zones .

2. Low percent of budget allocated to health

3. Low percent of MOOE allocated to health.

2. SERVICE DELIVERY

2.1 DISEASE FREE ZONE INITIATIVE

I. filariasis Elimination

Low percentage of mass treatment coverage of target population in endemic areas.

Non compliance of target recipients to mass treatment.

II.Schistosomiasis Elimination

Low percentage of mass treatment coverage of target population in endemic areas

Poor environmental sanitation.

III. Rabies Elimination Program

Inadequate human anti- rabies vaccine

Poor Implementation on ordinance on responsible pet ownership.

No LGU counterpart in human anti-rabies vaccine.

IV. Leprosy Program

Low detection of leprosy cases.


28/50

28

2.2 INTENSIFIED DISEASE PREVENTION AND CONTROL

I. TB Prevention and Control

Low detection rate

Low cure rate

II. HIV /AIDS and STI Prevention and control

Inactive provincial and municipal HIV-AIDS council

Lack of program directed towards education and counseling conducted among

Commercial sex workers (csw)

III. Emerging/Reemerging Infection Control Services

(SARS, MENINGOCOCCEMIA,AVIAN FLU)

Lack of capability to diagnose emerging case.

Inadequate information campaign

No preparedness plan for emerging and reemerging cases.

IV. Dengue Prevention and Control

Poor Environmental sanitation(behavioral practices)

Poor monitoring house index and breautex index

2.3 IMPROVEMENT OF MNCHN OUTCOME

C. Attainment of MDG # 4

I.Child Health Program

1.Low FIC coverage

2.Inadequate vaccines

3. High prevalence of malnutrition

4.Lack of essential IMCI drugs in health facilities

5. Inadequate newborn screening filter cards

6. Low percentage of orally fit children

7.Poor behavioral practices of complimentary feeding program


29/50

29

C. attainment of MDG # 5

II.Maternal Health Program

1. low percentage of facility based deliveries

2. Low contraceptive prevalence rate

3. Low percentage of tetanus toxoid immunization coverage and provision of

Iron to mothers.

4. Low deliveries attended by skilled birth attendant

5. Inadequate EmONC, BEmONC, CEmONC drugs and medicines.

2.4 Healthy Lifestyle and Management of Health Risks

I. Control of Degenerative Disease

1.Poor hospital and public health integration in promoting healthy lifestyle.

2. Non functional Health and wellness Clinic and Smoking Cessation Clinic

3. Lack of trained personnel in promoting healthy lifestyle.

II. Oral Health Care

1. Poor advocacy and Health promotion

2. Lack of Dental Equipment

3. Lack of Dentist at RHU

III. Water and Sanitation Program

1.Low access to safe drinking water.

2. Low access to sanitary toilet facilities

3. Poor behavioral practices on environmental sanitation.

4. Weak political will to enforce follow ordinances on solid waste

management.


30/50


31/50

31

13. No NSPH Bloodbank

REGULATION

1. Poor hospital drug management

2. Low Philhealth accreditation TB-DOTS ( 10 out 24)

3. Some health ordinances are not implemented.

GOVERNANCE

1. Nonfunctional Inter Local Health Zones (ILHZs)

2. Non- fully functional hospital therapeutic committe

3. Not- fully functional Referral system

4. No Inter Zonal Blood Council

5. Non functional Local Health Board

HEALTH HUMAN RESOURCE

1. Lack of physician for RHUs with high population

2. Lack of PHN for RHUs with high population

3. Lack of medical technologist in RHU for TB DOTS

4. Lack of dentist in RHUs

5. No plantilla position for data encoder in RHUs

6. No health statistician in provincial level

7. Lack of physician in district hospitals.

Health Information System

1. Few RHUs with intrnet connection to support EFHSIS report.

2. No IT equipment in BHS

3. No IT training for BHS personnel 4. Late FHSIS reporting


32/50

32

VISION:

A Healthy Norte Samarenos by the year 2016 and beyond

MISSION:

To provide guaranteed, accesible, sustainable and quality health services, for all,

especially the indigents, with fully supportive LCEs in partnership with othr agencies, run by

competent and compassionate health workers through acquired technologies to an empoweredcommunity.

GOAL:

To provide access to sustainable, quality and affordable health care services

giving priority to the marginalized and vulnerable sectors of society.

Stratgic Thrusts/ Instruments

1.Health financing

A. Increase in PhilHealth Enrolment and utilization

I. Increase in PhilHealth Enrolment and Utilization

1. Maintain 100% Universal Philhealth coverage

2. Intensify health promotion on PHIC benefits and processes to increase utilization

3. Facilitate annual renewal of enrollees

II. Increase in LGU Investment for Health

1. Increase percent of budget allocated to health


33/50

33

2. Increase percent of MOOE to total health budget.

3. Strengthen hospital drug management .

4. Enhanace water analysis laboratory from bactriological to physical and chemical analysis for

revenue generation.

5. Strengthen of Revolving Fund Management.

Service Delivery


I. Filariasis Elimination

Objective:

1. Increase Mass Drug Administration (MDA) coverage from 58% to 85% by the end of 2016

2. Reduce micro filarial rate from 3.2 % to less than 1% by 2016

Key Interventions:

1. Conduct mass treatment

2. Provision of DEC tablets

3. Provision of adverse reaction drugs

4. Provision of disability kits

5. Boarder Operations

Support Interventions:

1. Disability management training

2. Training on NBE and ICT


II. Schistosomiasis Elimination

Objective: Increase mass treatment coverage from 49% to 85% by the end of 2016

Key Interventions:


34/50

34

1. Conduct mass treatment to endemic municipalities

2. Provision of PRAZIQUANTEL tablets

3. Provision of side reaction drugs

4. Provision of Schisto kits


1. Production of IEF materials

2. Establishment referral system/ linkages to private health facilities

3. Networking with partner agencies and NGOs

4. Training on Shisto case management

5. Training on malacological survey

6. Refresher course on quality control for micropist


III. Rabies Elimination Program

Objectives:

1 .zero human rabies case to all animal bite victims

2. Post- exposure Prophylaxis to all animal bite victims

Key Interventions:

1. Provision of post-exposure prophylaxis

2. Provision of rabies vaccines

3. Advocacy for responsible pet ownership.


1. training on animal bite management

2. Conduct program implementation review

3. Rabies awareness month and worl rabies day celeration


35/50

35

DISEASE FREE ZONE INITIATIVE

IV. Leprosy program

Objective:Decrease prevalence rate to less than 2% per 20,000 population by 2016

Key Interventions:

1. Leprosy case finding

2. Leprosy case management

3. Provision of drugs and medicines

Support Intervention:

1. Monitoring

2. Recording and reporting

3. Leprosy awareness activity

4. Capability building on leprosy case


I. TB Prevention and Control

Objectives: 1. Increase detection rate from 65% to 85% by the end of 2016

2. Increase cure rate from 59% to 90% by the end of 2016

Key Intervention:

1. Case detection

2. Case holding

3. Provision of anti- TB drugs

4. Oranize Kusgod baga/ treatment partner task force at Barangay level


1. Monitoring, supervision and evaluation

2. Lung month and world TB day celebration

3. Training on programmatic management of drugs resistance Tuberculosis


36/50

36

4. RSS training for midwives and BHW


C. Attainment of MDG#6

II. HIV/AIDS Prevention and Control

Objectives: To reduce HIV/ AIDS by 5% from 6,198/ 100,000 pop. to 5,888/100,000 by the end of

2016

Key Interventions:

1. Strengtheningof HIV/AIDS council

2. Orientation and Advacacy on HIV/ AIDS

3. Case management

4. Conduct social hygience clinic


1. Capability building

2. Provision of Drugs

III. Emerging/Reemerging Infection Control Services

(SARS, MENINGOCOCCEMIA,AVIAN FLU)

Objectives: Increase case detection, improve contact tracing,implement quarantine policies for all

cases of emerging an reemerging infections.

Key Interventions:

1. Formulation of emerging and reemerging disease preparedness plan.

2. Identification of isolation ward in the hospital

3. Contact tracing of suspected cases

4.Treatment service


1. Conduct information dissemination and distribution of IEC materials for immediate public

information


37/50

37

IV. Dengue Prevention and Control

Objective: Reduce Dengue case fatality from .08% to .05% by 2016

Key Intervention:

1. Environmental sanitation and vector control

2. Triaging of cases

3. Reactivation of BHERT (Barangay Health Emergency and Response Team)

4. Advocacy


1. Procurement of laboratory supplies and reagents

2. Dengue awareness month and dengue ASEAN day celebration

3. Strengthen referral system to other health facilities for further treatment if necessary and

adequate supply of blood platelets.

4. Training on Integrated vector borne disease management

5. Capability building on epidemiology surveillance

6. Provision of surveilance communication equipment



A. Child Health Program

Objectives:

1. Increase FIC coverage from 47% to 95% by 2016

2. Reduce under-five mortality from 9.5/1,000 lb to 5/1,000 lb by 2016

3. Reduce infant mortality rate from 9.3/1,000 lb to 7/1,000 lb by 2016

4. Reduce prevalence rate of malnutrition from 16% to 10% by 2016

5. Reduce Neonatal mortality rate from 9.4% to 6% by 2016

Key Interventions:

1. Expanded program on immunization


38/50

38

2. Establishment of breastfeeding room

3. Setting-up of breastfeeding support group

4. IMCI

5. IYCF

6. Essential Intrapartum and newborn Care

7. Complimentary feeding


C. Attainment of MDG #4

A. Child Health Program


1. Vitamin A and Iron supplementation

2. Operation Timbang and follow-up weighing

3. Conduct deworming activities

4. Procurement of Newborn screening kits

5. Procurement of EINC drugs

6. Procurement of Under-five drugs.



A. 1. Nutrition Services

Objective: Reduce prevalence rate of malnutrition from 16% to 10% by the end of 2016

Key Interventions:

1. Supplementary feeding

2. Garantisadong Pambata

3. Micronutrient supplementation

4. Operation Timbang


39/50

39

5. Pabasa ng Barangay

6. Follow-up OPT for malnourished children

7. Linkages to other agencies


1. Provision of supplies for health Nutrition Posts

2. Construction of malnutrition ward

3. Creation/Establishment of Health Nutrition Posts



A.2. Expanded Program on Immunization.

Objective: To increase percentage of fully immunized children from 47% to 95% by the end of

2016

Key Interventions:

1. Outreach activities

2. Continued EPI/Reb activities activities

3. EPI/REB monitoring child survival program

5. Organization of community health teams


1. Rehabilization and maintenance of cold chain facilities

2. Provision of generators




A.3. Integrated Management of Childhood Illnessess

Objective: To reduce under-five mortality from 9.5/1,000 LB to 5/1,000 LB by the end of 2016


40/50

40

Key Interventions:

1. Under-five Death Review

2. Newborn Screening

3. Immunization

4. Breastfeeding and complimentary feeding

5. Micronutrient supplementation and deworming



2. Provision of Essetial Newborn care package

3. Support drugs and medicines



A.4. Breatfeeding Program

Objective: to sustain/increase the 90% rate of infats exclusively breastfeed up to 6 onths to 95% by2016

Key Interventions:

1. Quarterly monitoring of MBFHI sustainability

2. Advocacy and promotion

3. Lactation management training BEmONC and CEmONC level



B. Maternal Health Program

Objectives:

1. Reduce maternal mortality ratio from 304/100,000 to 52/100,000 by 2016

2. Increase facility based delivery from 41% to 90% by 2016


41/50

41

3. Increase skilled health professional from 62% to 90% by 2016

4. Increase antenatal care from 69% to 80% by 2016

5. Increase contraceptive prevalence rate from 11.36% to 60% by 2016




Key Intervention

1. Creation/Integration of mnchn/fp/ahp in hospitals and RHUS

2. Strengthening of Mother baby friendly hospital initiative

3. Institutionalization of MNDR

4. Program Implementation Review

5. Establishment of AYHR friendly clinic in hospitals and RHUs

6. Strengthening IECM

7. Retooling of CHT-KP

8. Strengthening of referral system

9. Continueing quality improvement system

10. Establishment of halfway house


C.Attainment of MDG#5



1.Capability building

2. Procurement of Mother and Child book

3. Advocacy meeting among identified Service Delivery Network (SDN) private and public


42/50


43/50

43

2.4 HEALTHY LIFESTYLE AND MANAGEMENT OF HEALTH RISK

1. Control of Degenerative Disease

Objective : To intensify advocacy campaign for healthy lifestyle

Key Interventions:

1. Integration of hospitals and public health in promoting healthy lifestyle

2. Activate Health and Wellness Clinic in all hospitals and RHUs.

3. Avtivate Smoking Cessation Clinic in District hospitals and RHUs

4. Ogranization of HL coordinators at the hospital and RHU level

5. Provision of physical fitness equipment in recreation area/park

6. Provision of supplies and equipment

7. Advocacy and health promotion on health lifestyle

8. Drugs for control of degenerative diseases


II. Oral Health Care

Objective:

1. Reduction of dental caries from 56% to 85% by 2016

2. Reduction of periodontal disease from 40% to 60% by 2016

Key Intervention:

1. Institutionalization of Orally fit children campaign

2. Health promotion and advocacy


1. Provision of dental equipment and supplies



44/50


45/50

45

1. To increase number of Household with sanitary toilet facilities from 61% to 95% by 2016

Key Interventions:

1. Inspection public toilet facilities

2. Campaign and provision of technical assistance proper construction of toilet


1. refresher course for sanitation inspectors in sanitary toilet construction

2. Strengthen Zero Open Defecation campaign

3. Search for Barangay with best sanitation practices

4. Enforcement of Sanitation Code of the phils.


IV. National Voluntary Blood Services Program

Objective:

1. To increase voluntary blood donors from 45% to 85% by 2016

2. To prevent the transmission of blood transmissible diseases (HIV, Hepa B, Hepa C,Syphillis and

Malaria)

Key Interventions:

1. Mass blood donation activity

2. Ogranization of Inter- local council

3. Advocacy and health promotion on blood donation

4. Establishment of Licensed Blood bank


1. Provision of blood screening kits and laboratory supplies and equipment

2. Provision of donors incentives and awards.

3. Construction of blood bank building.


46/50

46

2.5 SURVEILLANCE AND EPIDEMIC MANAGEMENT SYSTEM

I. Disease Surveillance

Object: Reduce morbidity and mortality through an institutionalized functional integrated disease

surveillance system

Key Interventions:

1. Improved communicating facilities in all RHUs and hospitals

2. Updated reporting of notifiable disease in all health facilities

3. Improve referral system in all health facilities

4. Establishment of PESU and MESU.


1. Training on basic Epidemiology

2. Management training on prevention and control of emerging and reemerging diseases

3. Outbreak management

4. Purchase of laboratory reagents

2.6 DISASTER PREPAREDNESS AND RESPONSE SYSTEM

1. Health Emergency Management System

Objective: Reduce morbidity and mortality during emergency and disaster

Key Interventions:

1. Reactivation of HEMS Cluster

2. Institutionalization of HEMS

3. Provision of supplies and equip ment to respond emergency situation.

4. Capability building to health personnel to respond emergency situation.

5. Establishment of OPCEN


47/50

47

2.7 HEALTH FACILItiES AND DEVELOPMENT PROGRAM

B. Improved acces to quality hospitals and health care facilities

I. Rationalization of Local Health Facilities

1. Upgrading of District hospitals from infirmary to level 1

2. Construction of new NSPH with blood bank building

3. Upgrading of 3 remaining RHUs to Bemonc facility (allen, Silvino Lobos and Mapanas)

4. Construction and equipping BHS

5. Upgrading of hospital medical and dental equipment

6. Construction of PHO/PHTO building and training center with HEMS OPCEN

7 Construction of NTP warehouse

8. Provision of malnutrition ward in all hospitals

HEALTH REGULATION

KEY INTERVENTIONS:

1. Sustain Philhealth in PCB, MCP and increase TB-DOTS accreditation.

2. Institutionalize revenue-enhancement and resource mobilization schemes to all devolved health

facilities and Inter-Local Health Zones

3. Implementation/Enforceent of national health laws and health regulatory policies and compliance

4. Implementation of facility based standards as required by DOH and philhealth.

5. Enforcement of national laws to provencial and municipal level

6. Enforcement of national laws to provincial and municipal level

7. Creation of local health regulatory policy for implementtion at the ILHZs Bids and Awards

Committee (BAC) and referral system


48/50

48

GOVERNANCE

OBJECTIVE:

1. Improve health system at ptovincial Inter-local Health Zones,municipal and GIDA sites.

Key Interventions:

1. Revitalization of governance structures for local health board at provincial and local level

2. Enhance inter LGU cooperation through ILHZ.

3. Strengthen referral system to include private sectors

4. Institutionalize integrated planning (PIPH, AOPs/ AIPs) health information system,monitoring and

evaluation.

5. Enhancement health financing in the province

6. Enhance Public-Private Partnership (PPP)


1. Ensure allocation of LGUs for ILHZ CHTF

2. Strengthen reporting system

3. Health facility enhancement to facilities referral system

4. Policy formulation for income retention for health facilities

5. Development of Provincial and Municipal Inter Local Drug procurement and management system.

HEALTH INFORMATION SYSTEM

OBJECTIVES: Ensure, Accurate,reliable and timely information for both public health programs and

clinical services are availanbe to constituents and decision makers

Key Interventions:

1. Hospital information system

2. Electronic Field Health Service Information System Training to RHUs Data Encoder

3. Clinic Information system training to RHU and BHS Data Encoder

4. Procurement of computer/Laptop for provincial Health Program Coordinators for database

5. Computer set to all BHS


49/50

49

6. Internet connection in RHUs/BHS

HEALTH HUMAN RESOURCE

OBJECTIVE: Strengthening the local health human resource management system in the

provinceq\

Key Interventions:

1. Additional physician for RHUs with high population

2. Additional PHN for RHUs with high population

3. Hiring of Medical technologist in RHU for TB Dots accreditation

4. Hiring of Dentist in RHU

5. Designate surveillance nursees in district hospitals

6. Plantilla position for data encoder in RHUs

7. Plantilla position for health statistician in provincial level

8. Additional Medical technologist in blood bank

9. Additional physician in district hospitals


50/50

chapter iii my work

Documents