Community PediatricsAugust 2013

Maria Celeste Gomez, MDMarco Romulo R. Manzano, MD

CALENDAR OF ACTIVITIESCOMMUNITY PEDIATRICS-AUGUST 2013

SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY

1-Introduction to Community- Area/ Site Awareness- Pabasa sa Nutrisyon (Ms Connie Valenzuela)-FEEDING PROGRAM

2-Sensitivity Training seminar-Friday Conference

3

4 5-FEEDING-ORIENTATION OF CLERKS-FOCUS GROUP DISCUSSION with CHVs re plans/ livelihood/ and other projects - list kids who are not yet dewormed- compute other expenses and funds needed

6-Inventory of Medications- Re stocking pharmacy - re stocking of papers/ prescription pad, opd materialsFIRST ACTIVITY

7-OPD CLINICS

8-FEEDING-Deworming Day Attendance for deworming- Star Sangkap(sopas: carrots) (Clerks)

9HOLIDAY

10

2nd WEEK

11 12Typhoon day (kids not being able to attend feeding)Inventory of Materials/ supplies at Community CenterCOOP: calls/emails on how to form a coop; invite lecturer

13VERTICAL FORUM (Intern’s)FEEDING- Star SangkapLecture to parents (Clerks) - FIRST ACTIVITY

14-OPD CLINICS

15-FEEDING-Flu Vaccination Day-Star Sangkap (Clerks)

16Intern’s (LEC 4) ReportInventory StickerCoop ResearchAnd Kuto Stability Studies ResearchFRIDAY CONFERENCE (M&M)

17

3rd – 4th WEEK18 19

-FEEDING-Star Sangkap(Residents)

20TYPHOON MARINGNO COMMUNITYFIRST ACTIVITY

21HOLIDAY

22-FEEDING-Star Sangkap report (Residents)-Rotary Meeting for KUTO project fundingEXAM

23FGD on COOP

FRIDAY CONFERENCE

24

25 26HOLIDAY

27FEEDING (rescheduled)

FIRST ACTIVITY

28-OPD- Home visit on important cases

29-FEEDING activity- Lectiure on Oral Hygeine-Evaluation of Feeding enrollees (for next month’s graduation)

30- Month

end Report

FRIDAY CONFERENCE

31

COMMITTEE REPORTS

OPDCHV

Feeding ProgramLivelihood Program

Finance

OUTPATIENT

• 3 Wednesdays (August 7, 14, and 28)– Holiday- August 21

• Total No of Patients Seen: 97

Total Number of Patients (Jan-Aug)

Jan Feb March April May June July August0

20

40

60

80

100

120

140125

118

8290 90

55

8997

No. of Patient

Monthly Census (2012)Infectious NonInfectious Total

January 121 11 132

February 137 14 154

March 77 13 90

April 52 20 72

May 131 13 144

June 130 22 117

July 121 22 143

August 135 11 146

September 127 15 142

October 135 9 144

November 129 13 142

December 95 11 106

Monthly Census (2011 vs 2012)

January

February

March

AprilMay

JuneJuly

August

September

October

November

December

0

50

100

150

200

250

20112012

Old and New Patients

98%

2%

No. Of Patients

OldNew

Old and New Patients (Jan-Aug)

Jan Feb Mar April May Jun July August0

20

40

60

80

100

120

70 67

8896

87

51

77

95

17 17

2 310

412

2

OldNew

Infectious vs Non-Infectious

90%

10%

Classification

InfectiousNon-infectious

Infectious vs Non-Infectious (Jan-Aug)

Jan Feb Mar Apr May Jun July August0

10

20

30

40

50

60

70

80

90

10090 88

92 89 87

55

86 87

8 105

11

0 0 310

InfectiousNon infectious

Infectious vs Non-Infectious (2012)

January

February

March

AprilMay

JuneJuly

August

September

October

November

December

020406080

100120140160

InfectiousNonInfectious

Top Diseases

47%

16%

9%

6%

21%

Diseases

URTIPneumoniaSkin InfectionAGEOthers

Top 5 Cases (2012)

CASES NUMBER OF PATIENTS

1. Upper Respiratory Tract Infection 7202. Pneumonia 2423. Acute Gastroenteritis 594. Furunculosis 555. Bronchial Asthma in Acute Exacerbation 33

Distribution of Patients

27%

27%

46%

Residence

RiversidePhase 1Phase 2

Distribution of Patients (July)

Phase 138%

Phase 242%

Riverside20%

Phase 1Phase 2Riverside

Inventory of Medications

Medications• Usual medications used/

Fast-Moving Meds– Mucolytics (carbocisteine /

mucosolvan)– Medications for skin and

soft tissue infections– Amoxicillin– Salbutamol nebule– Phenylephrine– Paracetamol– Multivitamins

• Medications needed to be purchased– Cloxacillin– Mupirocin ointment– PND otic drops– Cefalexin– Paracetamol

• Slow-Moving Medications– Clarithromycin– Cefixime– Phelylephrine– Phenylephrine+Chlorphe

namine Maleate+ Bromhexine

• Expiring Medications– Amoxicillin 125/5ml

Reportable Case

• JC, 1 year and 10 months/male, Riverside• 2 weeks loose watery stools with no vomiting and

fever with associated weakness, given ORS. Resolution of diarrhea after 1 week. 1 week PTC had productive cough and colds with recurrence of vomiting

• Born full term to a 26 y/o G5P5 (5005) BW 3.3 kg at home by a midwife, no complications

• No previous admissions, but prev had URTI and Furunculosis

• Weight 5.5 kg (Z<-3), Height 65.7 cm (Z<-3)• HR 110, RR 40, Temp 36• Weak looking, sunken eyes, with intercostal

retractions, rhonchi, rales, hyperactive bowel sounds

• A > PCAP C, AGE, Malnutrition (Severely underweight, severely stunted), Developmental Delay

• Advised admission but opted to stay home• Inserted with NGT for trial feeding• Started on oral antibiotics and zinc• Advised follow-up

Flu Vaccination• Objectives– To promote disease prevention especially to the children at risk

(enrollees of feeding program)– To enhance the skills of doctors and medical students in

immunization techniques• Mechanics– Total of 11 children were vaccinated, and only 8 vaccines were

used.– The flu vaccines donated by the Rotary Club of Pasig were

utilized.– The ASMPH Clerks assisted by Pediatric Residents and

Consultants administered the vaccines

RecipientsName Age/Sex

1. Felias, Josted 1/M

2. Colcol, Carshalie 3/F

3. Niedo, Princess 1y5m/F

4. Dula, Alexy 1/F

5. Timbol, John 3/M

6. Alcera, Andrea 3/F

7. Santelices, Dharlyn 11mos/F

8. Tupaz, Angelica 4/F

9. Ingote, John 1/M

10. Jasceno, Lora 8/F

11. Dela Cruz, Alia 1y5m/F

• Recommendation– A yearly vaccination for feeding program enrollees– Involvement of medical clerks were helpful to

both the student and the patient

Deworming

• Objectives– To reduce the prevalence of parasitic infections

especially for those that are at high-risk (underweight, low-SES, crowded living conditions)

• Mechanics– To provide 1 dose of Mebendazole for children

enrolled in our Feeding Program who have not yet been dewormed this year

RecipientsName Age/Sex

1. Drio, Stephanie Mae 2/F

2. Dela Cruz, April 4/F

3. Mendoza, Jhane Josephine 5/F

4. Pamplona, Antonio 3/M

5. San Jose, Kheana 3/F

6. Espiritu, Sigfred Anthony 2/M

7. Felias, Joshten 2/M

8. Dula, Alexy 2/F

9. Galora, Kian 2/M

10. Colcol, Carisha Lai 3/F

11. Niedo, Princess 1y7m/F

• Recommendation– Have a MASS

DEWORMING project for SEPTEMBER

– Still with approximately >50pcs of Mebendazole tablets

– Expiration is October 2013

COMMUNITY HEALTH VOLUNTEERS

• Recruitment– Objective: to increase OPD census and for wider

area coverage– Plans of recruiting Nagpayong CHVs– 1 area only (Montevilla Homeowners)– Representatives already met with Dr. Acantilado

• Attendance of CHVs– Mostly 100% Attendance for July and August

• Active CHVs– Fely Padilla– Vergie Pacuan– Carla Benbinito

• Active Mother Mentors– Rea Llarinas– Lolly Tasareno– Luz Cambe– Carina Espiritu– Gertudes Bartolata

• “OPEN SESSION”– Objective

• To empower the people of the community by involving the CHVs and Mother Mentors in the planning session of which activities to continue and focus on for the month assigned (August)

• To hear out comments, evaluation, and suggestions from the CHVs and Mother Mentors on the past activities and for the suggested activities by the past group

– Target Population• CHVs and Mother Mentors

• “OPEN SESSION”– Mechanics• To have a small “merienda” with the CHVs and Mother

Mentors while informally talking about the activities done in the past month and the plans for the current month.• The residents will be facilitators in asking the opinions of

the Ilugin volunteers which activities they like and which activities they find hard or not too helpful for them.• Any suggestions for all committees are welcome:

– OPD, Livelihood, and Feeding

• “OPEN SESSION”– Results and Evaluation• Would like to continue Exercise and Health Awareness

for CHVs and Mother Mentors– Continue weekly exercise / Zumba sessions– Voltaire or Rachelle Vicencio as Dance Instructors

• Happy Community with Happy CHVs– Have a wellness day where we will invite an IM resident to

help our CHVs and Mother Mentors on their sickness and other ailments.

• Would rather learn new skills for livelihood• Focus more on livelihood

– KUTO PROJECT» willing to manufacture and sell CVCs» Will not be willing to do another round of treatment of

schoolchildren due to health risk exposure and the method being very tedious

– CANDLE MAKING» They enjoy and feel very confident in making and selling

candles. » Candle making for August might not get in more returns

because its demand is seasonal.

• “OPEN SESSION”– Results and Evaluation• Focus more on livelihood

– DISHWASHING LIQUID » This was another project also suggested by CHVs and was

known to them several months or years back.» The idea of making and selling Dishwashing liquid from their

home (either wholesale or retail “tingi-tingi”)made the CHVs excited because it is a product all are using everyday.

» Need to get more information from TESDA on how to make this product and CHVs and Mother Mentors are willing and eager to learn it.

• “OPEN SESSION”– Results and Evaluation• Focus more on livelihood

– UKAY-UKAY» This idea was brought up due to lack of funds to start a

livelihood project.» Pedia Residents and Clerks have come up with a joint plan

to get donations (old clothes, bags and shoes) from TMC and ASMPH Family and these will be sold in verious areas to raise funds for the community.

» Venues? Ilugin? Pasig Barangay hall?

• Stipend/ CompensationJuly August

Fely 800 800

Vergie 800 800

Carla 800 800

Lolly 331 320

Rhea 347 320

Luz 325 320

Bartu 347 320

Carina 250 320

• Challenges Encountered– Desired Projects were put on hold• Dishwashing liquid: too short term focus on COOP

and KUTO PROJECT• UKAY-UKAY no need because Rotary will fund a good

and stable livelihood program like KUTO PROJECT or WATER HYACINTH HARVESTER

– CHVs are not yet too keen on other people becoming mother mentors from Nagpayong (TRUST issue)

FEEDING

EnrolleesCURRENT ENROLLEES (Jan-July)

<2013 8Jan-July 2013 23August 5

GRADUATED (Jan-July) 7

DROPOUT (Jan-July) 20

ONGOING FEEDING ENROLLEES 36

Current EnrolleesNAME AGE DATE

OF ENTRY

WEIGT AT ENTRY

INTERPRET

WEIGHT IN AUG

INTERPRET

HEIGHT AT ENTRY

INTERPRET

HEIGHT IN AUG

INTERPRET

Alcera, Andrea 3

July 18, 2013

13.9 <0 13.0 <0 93.5 -2 93.8 <0

Drio, Stephanie 2

July 4, 2013

10.9 <0 10.9 <0 83.2 <0 82.7 <0

Espiritu, Sigfred 2

July 4, 2013

12.1 <0 12.4 <0 86 <0 87.4 <0

Drio, Bianca 1

July 4, 2013

7.4 -3 7.5 -2 79 <0 75.8 -3

Dula, Alexy 1

July 18, 2013

7.8 -2 7.5 -2 74 <0 69.8 <0

NAME AGE DATE OF ENTRY

WEIGT AT ENTRY

INTERPRET

WEIGHT IN AUG

INTERPRET

HEIGHT AT ENTRY

INTERPRET

HEIGHT IN AUG

INTERPRET

Tupaz, Arturo 2

July 4, 2013

9 -2 9.1 -2 78 -2 78.2 -2Bolado, Richard 2 

July 4, 2013

8.8 -2 8.9 -2 79 -2 79 -2Tabada, Arvin Jay 2

July 18, 2013

11.2 <0 11.3 <0 82.9 -2 82.9 -2Timbol, Jan Andrei 3

July 4, 2013

12.9 <0 10.5 -2 79 -2 92.6 <0Felias, Josted 1

July 25, 2013

9.1 <0 9.3 <0 75.4 <0 74.3 <0Sayson, Steffany 1

July 18, 2013

8.3 <0 7.5 <0 77 <0 77.3 <0Ingote, Jhon Carlo 1

July 25, 2013

7.8 -2 7.6 -2 72.3 -3 73 -3Colcol, Clarishalai 2 

July 25, 2013

11.4 <0 11.4 <0 88.2 <0 88.2 <0

Niedo, Princess Jhesca 3 

July 25, 2013

9.8 -3 9.8 -3 78.1 -3 78.1 -3

Tupaz, Angelica 4

July 4, 2013

11.9 -2 12 -2 85 <0 85.3 <0

NAME AGE DATE OF ENTRY

WEIGT AT ENTRY

INTERPRET

WEIGHT IN AUG

INTERPRET

HEIGHT AT ENTRY

INTERPRET

HEIGHT IN AUG

INTERPRET

Pamplona, Antonio 3

September

2012

10.9 -1 11 <0 80.1 -2 87.8 -2

San Jose, Kheana 2

June 2012

9.8 -2 10.5 <0 82 <0 80 -2

Laron, James 1

June 27, 2013

9 -2 9.4 <0 81.3 <0 82.4 <0

Dela Cruz, April 4

June 6, 2013

15.5 <0 14.5 <0 101 <0 101 <0

Galora, Jhian 1

June 27, 2013

9.6 <0 10 <0 78.5 <0 78.9 <0

Tantiangco, Prince 1

June 27, 2013

9.9 <0 10.5 <0 79.1 <0 80 <0

NAME AGE DATE OF ENTRY

WEIGT AT ENTRY

INTERPRET

WEIGHT IN AUG

INTERPRET

HEIGHT AT ENTRY

INTERPRET

HEIGHT IN AUG

INTERPRET

Llarinas, Frellex 2

June 2012

7 -3 9.5 -2 66 -3 75.9 -3

Ramos, Jovanni 4

June 2011

10.6 -4 12.5 -3 91.5 -2 101 -3

Mendoza, Josephine 5

June 2012

13.5 -2 15.2 -1 94.5 -2 100.2 -2

Tigue, Clarence 1

May 2013

11.3 -2 9.5 -2 79 -3 71.2 -3

NAME AGE DATE OF ENTRY

WEIGT AT ENTRY

INTERPRET

WEIGHT IN AUG

INTERPRET

HEIGHT AT ENTRY

INTERPRET

HEIGHT IN AUG

INTERPRET

Galora, Jiro 4June 27,

2013 14.3 <0 13.5 <0 95.5 -2 96.2 -2Francisco, Chrystelle 4

June 6, 2013 14.7 <0 15 <0 96.2 -2 98 -2

Perras, Jaimie Lee 6

June 2012 13 -2 17 -2 96 -2 105 -2

Perras, James 3

June 2012 11 -2 11.5 -3 89 -2 95.9 -2

Santos, Rose Mary 3

June 6, 2013 10 -2 10.5 -2 86.1 -2 86.7 -2

Irondo, Geneva 6

December 2012 15.8 -1 15.5 -2 102 -2 106.4 -2

Caceres, Jay-M 1

Aug 29, 2013 5.2 -3 15.2 -3

Caceres, Jasmine 2

Aug 29, 2013 10.5 -2 90.1 -2

Delllera, Mariane 2

Aug 29, 2013 14 -2 100.5 -2

Balaguat, Anna Marie 2

Aug 29, 2013 13.5 -2 103.2 -2

Santelices, Dharlyn 11mos

Aug 29, 2013 6.9 -2 67.9 -2

WEIGHT

<044%

-13%

-247%

-36%

Zscore

<0-1-2-3

HEIGHT

<037%

-246%

-317%

Zscore

<0-2-3

Star Sangkap

• Feature an ingredient• Highlight its nutrient content and health

benefits• Use of chosen Star Sangkap for feeding

• Criteria for choosing a STAR SANGKAP1. Nutrient rich2. Locally available3. Affordable

Cookbook

Feeding: Aug 1Calories

2 kg rice 6400

¼ kg ground pork 342

1 squash 64

1 string beans 32

niyog 720

2 knorr cubes 30

oil 450

sugar 120

1 ¾ kg galunggong 2392

2 ½ avocado with milk (Pediasure)

225

Ginisa, Galunggong, Avocado with milk

600 Calories/Serving

Feeding: Aug 5Calories

2 kg rice 6400

1 ½ kg ground pork 2050

2 kangkong 32

2 radish 16

2 sitaw 32

3 okra 16

3 gabi 450

sugar 120

2 ½ banana 1200

Sinigang, BananaStar Sangkap: Gabi

567 Calories/Serving

Feeding: Aug 8Calories

1 ½ kg sopas 2000

1 kg corn 1538

½ kg carrot 178

½ kg ground pork 683

2 knorr cubes 30

1 can alaska milk 340

Pandesal (1/kid) 990

milk 7200

2 ½ banana 1200

Sopas, BananaStar Sangkap: Carrot472 Calories/Serving

Feeding: Aug 12Calories

2 kg chicken 2733

1 kg rice 6400

1 kg sayote 356

1 malunggay 16

1 knorr cube 15

2 kg mango 1333

Tinola, ManggoStar Sangkap:

Malunggay602Calories/Serving

Feeding: Aug 15Calories

1 ½ kg rice 4800

1 kg fish 1367

2 egg 172

2 whole squash 356

5 carrots 178

1 whole chicken 1640

2 knorr cubes 30

oil 450

butter 450

All purpose cream 100

Squasharaap, Lumpia

Star Sangkap: Squash

558 Calories/Serving

Feeding: Aug 19Calories

1 ½ kg rice 4800

1 kg ground pork 1367

5-10 talbos 16

3 potato 200

Oyster sauce 90

1 whole chicken 1640

450 30

2 ½ kg banana 1200

Giniling, Banana646 Calories/Serving

Feeding: Aug 22Calories

2 kg chicken 2734

2 kg rice 6400

2 sayote 80

malunggay 16

2 knorr cubes 30

1 cabbage 356

carrots 32

2 ½ kg banaba 1200

Tinola, Banana609 Calories/Serving

Star Sangkap: Cabbage

Feeding: Aug 27Calories

10 eggs 860

2 kg rice 6400

miswa 100

ketchup 60

oil 450

malunggay 16

potato 50

carrot 356

kamote 3750

sago 100

Torta, Misua, Sago Kamote

645 Calories/Serving

Weighing of Patients

AttendanceDate Number of Attendees

8/1 20

8/5 21

8/8 21

8/13 21

8/15 23

8/19 16

8/22 14

8/27 19

8/29 28

Problems

• Absences • Most mothers/kids don’t participate in the

activities

LIVELIHOOD

• KUTO PROJECT (CVC) Stability Testing• Objectives– To determine shelf life of the current concoction

when subjected under different temperatures– To determine what preservative is necessary to

prolong shelf life without affecting efficacy of the concoction.

• Mechanics– Coordination with Rotary of Pasig (Mr. Ducky

Paredes, Dr. Tangonan– Coordination with Dr. Valera (Ateneo Dept of

Chemistry, PIPAC (Philippine Institute of Pure and Applied Chemistry), and ADMU ITSO (Innovation and Technology Support Office)

– Contact: 426 6001 loc 5670, email: nsvalera@gmail.com

Kuto Project (CVC)

Meeting with Rotary Dr. Ruth Matos and Dr. Kaye Morales

Meeting with Rotary Meeting with Rotary

Ateneo De Manila Department of Chemistry Visit PIPAC

Cooperative

ASMPH LEC 4

Ilugin Cooperative• Objectives

a) Provide goods and services to its members to enable them to attain increased income, savings, investments, productivity, and purchasing power, and promote among themselves equitable distribution of net surplus through maximum utilization of economies of scale, cost-sharing and risk-sharing;

(b) Provide optimum social and economic benefits to its members;

(c) Teach them efficient ways of doing things in a cooperative manner;

(e) Allow the lower income and less privileged groups to increase their ownership in the wealth of the nation; and

(f) Cooperate with the government, other cooperatives and people-oriented organizations to further the attainment of any of the foregoing objectives.

• Target Population– Ilugin Community especially CHVs, Mother

Mentors and Ilugin Residents– With assistance from Consultants and Residents

from Department of Pediatrics

• Mechanics– 1. Organization• At LEAST 15 members• Determine common problems that need to be solved

– Credit assistance

– 2. Reserve COOP name (with fee)– 3. Economic Survey • Structure and purposes of the cooperative

– 4. By-Laws• Rules and regulations

• Mechanics– 5. Articles of Cooperation

• (a) the name of the cooperative, which must include the word "cooperative";

(b) the purpose or purposes and scope of business for which the cooperative is to be registered;

(c) the term of existence of cooperative;

(d) the area of operation and the postal address of its principal office;

(e) the names, nationality and the postal addresses of the registrants;

(f) the common bond of membership;

(g) The list of names of the directors who shall manage the cooperative; and

(h) The amount of its share capital, the names and residences of its contributors, and a statement of whether the cooperative is primary, secondary or tertiary. The articles of cooperation shall be signed by each of the organizers and acknowledged by them if natural persons, and by the chairpersons or secretaries, if juridical persons, before a notary public. .

• Mechanics– 6.Bond of accountable officers (from insurance or

bonding company)– 7.Execute Treasurer’s Affidavit (sworn statement)• At least 25% or the share has been subscribed and at

least 25% has been paid (not less than Php 15,000)– 8. PMES (Pre-Membership Education Seminar)– 9. Registration of Cooperative at CDA

The Future of Ilugin Cooperative

Phase 1: Baseline Knowledge

(Ilugin Residents)

Phase 1: Baseline Knowledge

(CHVs & MM)

Phase 2: Consolidation of

Data

Organization Phase

Phase 3: GENERAL ASSEMBLY

ELECTION OF LEADERS

Phase 4:ECONOMIC SURVEYBY-LAWS/ ARTICLES

RESERVE NAME

Phase 5: BOND of Accountable OfficersTreasurer’s Affidavit

Committment

Rules/ Laws/ Money

Phase 6: Pre-Membership

Training Seminar (PMES)

Phase 7: Registration SUCCESS !!

Training

Growth

Phase 1: Baseline Knowledge

• Ilugin Community– 100% have the need for credit assistance– 68% use for daily resources of living (food, shelter,

clothing, education)

• Focus Group Discussion • Objectives:– Baseline knowledge about credit services, needs

of the people, and an idea on their commitment on the project

• Target group:– CHVs and Mother Mentors

Cooperative

• Results – Known to the group:

• City Hall coop• CARD (savings)• Bumbai• Impukan/Savings

– Credit Assistance Coop– 50-100 php per week– Ayaw ng “taga labas”, or Membership by Guarantor– CHV to screen members

• Recommendations– Conduct an initial General Assembly for those who

are interested (Ilugin Homeowners)• Decide on how much to contribute per week• Decide on the interest• Promote Cooperative

– Get a core group to start the Paper work and meetings

FINANCE

• Total Budget for August 2013= Php 10,000.00– Endorsed from July 2013= Php 0

• Total Expenses= Php 9230.75• Remaining Balance= Php 769.25

Statement of ExpensesExpenses Period Covered Amount

Feeding 8/1 Php 584.00Cabinet 8/2 1400.00Feeding 8/5 597.00Cleaning Materials 8/5 124.50Feeding 8/8 600.00Feeding 8/12 600.00X-ray (Patient Caceres)+ Fare 8/13 500.00Gas 8/15 700.00Feeding 8/15 600.00Feeding 8/19 600.00Feeding 8/22 500.00Feeding 8/27 600.00Sticker Paper 8/27 86.25

Expenses Date AmountFeeding 8/29 580.00Alcohol 8/29 59.00Nutritionist Payment 8/29 500.00Feeding 9/2 600.00

Equipment Inventory at IHC

• Recommendation– Print stickers and label

the furniture and equipment

– Endorse every month photos of the IHC and the equipment

Other Activities

• Lecture on Dental Care done by Dentists

• Pabasa sa Nutrisyon done by DOH representative Ms Connie

Distribution of Doxycycline (Prophylaxis for Leptospirosis)

• Survey of Pregnant Women in Ilugin

THANKYOU