medical education for health development fortunato l. cristobal, md, mph, mphed, fpps, fspganh dean,...

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MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University Zamboanga City, PHILIPPINES th Social Accountabili

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Page 1: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

MEDICAL EDUCATIONFOR HEALTH DEVELOPMENT

Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH

DEAN, School of MedicineAteneo de Zamboanga UniversityZamboanga City, PHILIPPINES

With Social AccountabilityWith Social Accountability

Page 2: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

SETTING

Page 3: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

DISCIPLINEBASED

38MEDICAL SCHOOLS

ZAMBOANGAZAMBOANGABiological OrientedIndividual Health Care Focused

Biological OrientedIndividual Health Care Focused

Page 4: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

4,000 MD – taking Nursing4,000 MD – taking Nursing

Galvez, 2004

Medical DiasporaCareer Shift

Medical DiasporaCareer Shift

3,500 MD left for USA as Nurses

3,500 MD left for USA as Nurses

MD - NurseMD - Nurse

Page 5: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

REDESIGNING OF THE DOCTORS

REDESIGNING OF THE DOCTORS

Page 6: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

MOST UNDERSERVED AREAS

200340 Top Poorest Municipalities

28 - Mindanao14 - Zamb. Peninsula

Siay- ZDN – Phil Poorest

200610 Poorest Provinces

7 – In Mindanao1st – Tawi-Tawi2nd- ZDN

2007Hunger Incidence - Region

2nd ARMM3rd Zamb. Peninsula

Page 7: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

8

Page 8: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University
Page 9: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

ZAMBOANGAMEDICALSCHOOLFOUNDATION

19941994ADZU-SOM 2004ADZU-SOM 2004

Page 10: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

COMMUNITY IMMERSION

4th Year

1st Year

2nd Year

3rd Year

SameCommunity

Page 11: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

House to House surveys

House to House surveys

Page 12: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

Baseline Data

NEEDSASSESSMENTS

COMPREHENSIVEHEALTH PLAN

COMMUNITYLEADERSHIP

Page 13: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

Student Transforming CommunitiesStudent Transforming Communities

Page 14: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

17 YEARS

RESOURCE CONSTRAINTS

OPPOSITION

Page 15: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University
Page 16: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University
Page 17: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

Solar Disinfection (SODIS)

Page 18: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

Strategies Time Frame

Outcome Indicator

MothersCooking Contest

“Vegetable Queen”

Oct. 2010Affordable menuNutritious menuReduce Malnutrition

“Kitchen Queen”

80% attendance

Page 19: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

Strategies Time Frame Outcome

“Play Time” under 5 children on nutritious foods

August 2011 80% attendance of children

75% identified healthy foods

Page 20: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

Strategies Time Frame Outcome Indicator

“Communal Garden Contest”

August 2011 Communal Garden

EstablishedShared

Page 21: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

INFANT WEIGHT MONITORING

NORMAL UNDERWEIGHT

2009

2010

2011

379

498

472

70%

88%

93% 40

66

159 30%

12%

7%

N= 538 N (%) N (%)

Page 22: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

Infant Mortality Rate(Infant deaths per 1000 live births)

Infant Mortality Rate(Infant deaths per 1000 live births)

Area 1995 2003 2008

Zamboanga Del Norte

Zamboanga Del Sur

Zamboanga Sibugay

Region 9

National Capital Region

83.10

55.99

55.99

55.55

46.93

9.21

9.55

7.59

14.58

26.81

3.7

3.98

8.23

24

8.2

Page 23: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

Infant Mortality Rate

1995: 50 -802003: 5-172008: 3-8

Page 24: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University
Page 25: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

Admission Graduate Took-Board P-Board

1

2

3

4

5

6

7

8

170 165 146

9

26

13

16

6

11

11

18

25

19

19

26

12

15

3

10

11

18

24

18

19

22

12

13

3

9

11

16

23

18

19

27

22

26

7

16

17

35

36

2010

Performance Rate : 90.90% Performance Rate : 90.90%

Page 26: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

95.4%Philippines 95.4%Philippines

Page 27: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

90 % Region 9

90 % Region 9

Page 28: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

50 % Rural DoctorlessAreas

50 % Rural DoctorlessAreas

Page 29: MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University

4.6%4.6% Abroad Abroad

Served 6-8 yrsbefore they leftServed 6-8 yrsbefore they left