Albay MDG Achievements Albay Health Strategies

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1 ALBAY HEALTH STRATEGY towards SAFE AND SHARED DEVELOPMENT MDG is all about dignity. Engaging dignity, Empoweri ng dignity Ennobling dignity Governor Joey Sarte Salceda Province of Albay Story Line Albay MDG Achievements Albay Health Strategies MDG make it a goal, the rest follows MDGs are achieved ahead of 215 exc. MDG 2 and 7 Goal Indicator Bicol Region Albay 1 Poverty Incidence M H Subsistence Incidence H H Underweight (IRS) H H 2 Participation - Elementary L M Cohort survival - elementary M L 3 Gender parity - elementary H H 4 Under-five mortality H H Infant mortality H H Proportion of fully-immunized children M H 5 Maternal mortality rate L H Contraceptive prevalence rate L M Condom use rate L M 6 Deaths due to TB L H Malaria positive cases H H 7 Household with access to sanitary toilets H L Household with access to safe drinking water H H Legend: L low probability H high probability Achievements on MDG, 29 Proportion of - 5 years old who are malnourished 25 24% M medium probability no data Achievements on MDG, 29 Maternal Mortality Ratio Achievements on MDG, 29 Infant Mortality Rate / 1, LB /1, LB

2 Achievements on MDG, 29 Proportion of facility-based deliveries 88 8% Achievements on MDG, 29 Proportion of births attended by skilled health personnel % Achievements on MDG, 29 Contraceptive Prevalence Rate 65% 29 Achievements on MDG, 29 Child Mortality Rate /1, LB Achievements on MDG, 29 Fully-Immunized Children Achievements on MDG 6 TB Mortality Rate % 5 44/1, pop

3 Achievements on MDG Achievements on MDG 12 Case Detection Rate for TB 9 Cure Rate for TB 85% % Indicators Health Outcomes National Average (26) National Performance Target (21) ALBAY (29) Gaps/ Gains Intensified Disease Prevention and Control: TB Mortality (per 1, 28, (18) pop) TB Case Detection Rate, % (NTP Register) TB Cure Rate, % (4) Albay MDG Strategy Make MDG a goal Ordain policies and Give it a Budget Execute programs and projects Build institutions Nurture partnerships Vision Safe and shared development Albay as most liveable province known for good education, good health and good environment to secure safe and shared development Vision for Health: longer life expectancy, wellbeing in itself, wellbeing for labor productivity Albayanos as healthy and happy, well-educated, well-trained Low-rise, low-carbon, low-energy intensity = green development model Albay Development Goal 1. Shared development: operationally defined as: compliance with MDG and improvement in HDI. Climate change and disaster risks are key obstacles to MDG and HDI. 2. Safe development: Disaster risk reduction and climate action are built-in i elements of the central economic strategy, not a contingency plan. a. Disaster risk reduction is guided by Hyogo Framework for Action b. Climate action is guided by UNFCCC. 3. Structural governance x safe development = shared economic growth. 3

POVERTY AS AN INITIAL CONDITION IS A MAJOR OBSTACLE TO HEALTH OUTCOMES Average annual losses to infrastructure and agriculture in 1 most vulnerable provinces vs.

of Variation 2 23 26 2 23 26 23 2 23 26 2 23 26 2 26 PHILIPPINES 11,458 12,39 15,57 27.5 24.4 26.9 1.6 1.3 1.3 4,146,663 4,22,695 4,677,35 1.6 1.4 1.3 Region V 11,375 12,379 15,15 45.3 4.6 41.8 4.2 3.

8 5,67 44,874 39,421 11.8 14 22.6 Camarines Sur 11,54 11,873 14,634 4.8 4.1 41.2 9.3 7. 5.6 12,762 121,936 134,599 11.8 7.7 6.6 Catanduanes* 11,587 11,815 13,654 43.9 31.8 37.3 1.9 1.3 22.

3 45,27 62,71 7.6 14.5 5.6 1.3 5.4 5,146 37.

4 POVERTY AS AN INITIAL CONDITION IS A MAJOR OBSTACLE TO HEALTH OUTCOMES Average annual losses to infrastructure and agriculture in 1 most vulnerable provinces vs. their 26 local calamity funds Region/Province Poverty Threshold (in Poverty Incidence Among Families (%) Magnitude of Poor Families Pesos) Estimates (%) Coefficient of Variation Estimates Coefficient of Variation PHILIPPINES 11,458 12,39 15, ,146,663 4,22,695 4,677, Region V 11,375 12,379 15, , , , Albay 12,144 12,915 16, ,398 76,2 88, Camarines Norte 11,55 12,727 14, ,67 44,874 39, Camarines Sur 11,54 11,873 14, , , , Catanduanes* 11,587 11,815 13, ,541 13,64 16, Albay 6.5 poverty 83,66 Masbate 11,19 12,54 14, ,84 8, incidence at Sorsogon 11,146 12,452 15, ,27 62, , %, while lowest in * Coefficient of Variation (CV) of 26 poverty incidence is greater than 2% region, remains high 19 Source: World Bank Net resource outflow to cities Objectives for Health, To decrease maternal mortality ratio from 59/1, to 5/1,. 2. To decrease infant mortality rate from 1/1, to 8/1,. 3. To decrease child mortality rate from 18/1, to 15/1,. 4. Increase FIC coverage from 84% to 88%. 5. To increase CPR from 33% to 4%. 1 Objectives for Health, To increase voluntary blood donation to 1% of the provincial population. 7. To reduce soil-transmitted helminthiasis to below 5% among children. 8. To reduce prevalence of malnutrition from 19% to 17%. 9. To reduce TB mortality rate by 3%. 1. To sustain TB case detection at 9%. 11. To sustain TB cure rate at 85%. Objectives for Health, To reduce the incidence of STI/HIV by 2% points annually. 13. To eliminate incidence of filaria to zero. 14. To increase multi drug administration for filariasis control by 2%. 15. To reduce rabies incidence from 5/million population to 2.5/million population. 4

To increase leprosy cure rate by 2%. 18.

95%. 2. To increase proportion of HH with sanitary toilets from 69% to 89%.

budget 11,669,158 27-21 135,673,326 134,566,93 27 28 29 21 161,373,128

Supercom Program office: AMDGO created by ordinance in 29 with regular

Supercom Management MDG projects Manages relocation program Social assets

resources management AIDS Council HIV/AIDS advocacy Sources of Funds Regular

flow of technical and logistical assistance from NG agencies, UNDP and other

Initiatives 211- P178m (exc PHIC) for health PS and MOOE essentially for

Acquisition of 57 ambulances 19 BeMoNCs Modernization of provincial

5 Objectives for Health, To sustain leprosy prevalence at less than 1/1, population. 17. To increase leprosy cure rate by 2%. 18. To reduce the mortality and morbidity of lifestyle-related diseases by 2% annually. 19. To increase proportion of HH with access to safe drinking water from 94% to 95%. 2. To increase proportion of HH with sanitary toilets from 69% to 89%. 18,, 16,, 14,, 12,, 1,, 8,, 6,, 4,, 2,, Total Health Budget 24% of provincial budget 11,669, ,673, ,566, ,373,128 Source: PBO, Albay Resources for Institutionalized MDG Office Albay MDG Supercom Program office: AMDGO created by ordinance in 29 with regular provincial budget Oversight to MDG performance and secretariat to MDG Supercom Management MDG projects Manages relocation program Social assets programs esp livelihood like SEA-K, ETODA CRABS or coastal and marine resources management AIDS Council HIV/AIDS advocacy Sources of Funds Regular allocation from the annual provincial budget (IRA) Intermittent but steady flow of technical and logistical assistance from NG agencies, UNDP and other UN offices, INGOs, NGOs for capacity building and skills training Provincial Initiatives 211- P178m (exc PHIC) for health PS and MOOE essentially for hospital care and public health Universal health coverage at P59m pa Acquisition of 57 ambulances 19 BeMoNCs Modernization of provincial hospitals: Ziga (8- bed) and Duran (6-bed) Modernization of BRTTH (3-bed) Merger of BRTTH, Ziga and Duran into a 5- bed capacity Initiatives Universal Phil Health Coverage: Number of Families Enrolled 18, 16, 14, 12, 1, 8, 6, 4, 2, 18,51 122,6 158, Source: PSWDO, Albay 173,262 5

6 BRTTH: PHIC REIMBURSEMENT FOR 21 33% 54% Ambulance Deployment 6 RHUs & BEmONC Hospitals % HOSPITAL INCOME MEDICINES PHIC REIMBURSEMENTS PROFESSIONAL FEE HOSPITAL INCOME 67,43,56.73 DRUGS AND MEDICINES 16,929, PROFESSIONAL FEES 42,339,658. TOTAL 126,672, BRTTH earns P127m from PHIC vs P59m by province 1 1 Source: PHO, Albay Medical Mobile Assets Health Facilities: 15 BEmONCS Hospitals BEmONC RHUs/CHOs Source: PHO, Albay JBDMH JBDMH 6

7 JBDMH JBDMH ZIGA Memorial District Hospital ZDMH ZDMH ZDMH 7

8 ZDMH ZDMH ZDMH 7 - Renovated under the B-CARE project BRTTH Main Building Salceda Wing / Philhealth/Surgery Ward Out-Patient Department Emergency Room 8

9 Maintenance Building Laundry Services Offered Emergency Room Trauma Unit Dorm Isolation Ward Philhealth Ward Surgery Ward OB-Gyne Ward Private Ward Delivery Room CT Scan Pedia Ward Medical Ward Dialysis ECG/EEG Cath Lab D Echo CCU ICU Ultrasoud X-Ray NICU PICU 9

10 Operating Room Room 1-4 Laboratory Electric Power Substation Prov l Gov t of Albay, project of Gov. Joey Salceda Pharmacy Dietary Pastoral Rehab Center BRTTH and Beyond Establishment of Regional Oncology Center (P4m) 1

Proposed Facilities 1. Waste and Infectious Treatment Plant 5. ER and Trauma Unit 6. Bicol Cancer Center. Communicable Disease Building 3. Extension of PHIC ward 4. Diagnostic Center 8 7 7.

11 Proposed Facilities 1. Waste and Infectious Treatment Plant 5. ER and Trauma Unit 6. Bicol Cancer Center. Communicable Disease Building 3. Extension of PHIC ward 4. Diagnostic Center Bicol Regional Blood Center 8. Commercial Building 3 1 Health Capital Expenditures Committed by Number of Amount Received Received by the Source Source (from Amount Utilized Recipient by the province province (in kind) AOP) Municipalities PLGU 134,566, ,566, ,566, M/C LGUs M/C LGUs (15 188,47, ,95, M/C LGUs MLGUs/ 3 CLGUs) DOH-regular fund 24,372, ,372,85.33 EPI vaccines, Vit. A, antihelminthics, TB drugs, Iron 24,372, M/C LGUs DOH- special fund >MNCHN 2,419,32. 2,419, M/C LGUs > start-up 2,,. 2,,. 18 M/C LGUs > HEMS 9,1,. 9,1,. 18 M/C LGUs > Health Facilities 71,191,. 71,191,. District Hospitals 97,68,. 6 Dev't/RAT Plan > Health Systems 2,,. 2,,. 18 M/C LGUs Dev't > RHU/BHS Facility 7,35,. 5,9,. 8 M/C LGUs Devt/Eqpt Others: Technical > USAID 134,823, ,6,. 18 M/C LGUs assistance > AECID 43,,. 24,,. 24,,. 9 M/C LGUs > capitation (for 18,473, ,,. 18 M/C LGUs CSR + drugs) drugs, medicines & > PCSO 7,984,. 7,984,. 18 M/C LGUs ambulances TOTAL 63,191, ,17, ,439, AMDGO Program office started as Ayuda Albay in 27, renamed as Albay Mabuhay Task Force to manage the cluster approach to Reming rehabilitation Reorganized in June 29 as Albay Millenium Development Office or AMDGO to (a) monitor and oversight MDG progress (b) coordinate MDG programs within functional units and program offices of the provincial government and with NGAs, NGOs and INGOs and (c) manage social assets program of the province including SEA-K, E-TODA Staff complement of 15 personnel with a senior staff (rank Assistant Department Head) 21 organic budget of P2m. for Listening Strategies on Maternal Health Care 1. Formulation of the PIPH. (Province-wide Investment Plan for Health) inc MNCHN (Maternal, Newborn and Child Health Care) Program 2. Advocacy Campaign: Birth Plan/FBD by Skilled Health Worker Bench Conferences Buntis Congress Buntis Pageant IPCC (Interpersonal Communication and Counseling) Training of Health Personnel and BHW s on MNCHN Mothers Classes Radio announcement/ plugging Health Education Classes Establishment of breastfeeding stations in private and government institutions including evacuation centers Strategies on Maternal Health Care 3. Maternal Deaths Review Reviews maternal deaths Give recommendation and feedback to LGUs with maternal deaths Maternal death reporting 4. Facility based deliveries (FBD): Barangay Health Stations Lying-In Clinics Birthing homes Rural Health Units Hospitals (public or private) 5. REB (Reaching Every Barangay) 11

12 Strategies on Maternal Health Care 6. Rationalization planning and health facility mapping Upgrading of CEMONC facilities. (Comprehensive Emergency Obstetric and Newborn Care) Construction of BEMONC facilities. (Basic Emergency Obstetric and Newborn Care) Hiring of Staff Complement to fill up vacancies and/or augment personnel 7. Organization of Women s Health Teams in every barangay: Pregnancy tracking & birth planning Reporting of maternal deaths Referral of pregnant women to deliver at health facility Stewardship to the family of the pregnant mother Strategies on Maternal Health Care 8. Capacity building NBS training (Newborn Screening) ENC training (Essential Newborn Care) LSS training (Life-Saving Skills) BEMONC training (Basic Emergency Obstetric and Newborn Care) WHT training (Women s Health Team) CMMNC training (Community-Managed Maternal and Newborn Care) 9. Sustain Universal Phil Health Enrollment/Coverage Strategies on Maternal Health Care 1. MCP Accreditation of LGU s birthing facilities (Maternity Care Package) 11. Enact ordinances on FBD and User s Fee 12. Sustain MBDs (Mass Blood Donation) in all LGUs. Strategies on Family Planning 1. Establish a system of monitoring FP users with private providers and other stakeholders inventory of FP private providers & other stakeholders in the municipality/ city conduct one day orientation to identified FP private providers & other stakeholders 2. Validation of current FP users (data cleaning) 3. Review/assess CDLMIS of LGUs (Contraceptive Distribution, Logistics, Management Information System) Strategies on Family Planning 4. Planning workshop to draft plan to operationalize modified CDLMIS 5. Capacity Building FP-Competency-based training NSV Training ( non scalpel vasectomy ) BTL Training ( bilateral tubal ligation) Training on FP Counseling for health personnel Training of health personnel on IPCC Strategies on Family Planning 6. Provision of FP Commodities Targeting, costing and forecasting FP commodities requirements based on validated current users Procurement and Provision of 5% of FP commodities requirements (Pills, DMPA, Condom, NFP to LGUs Provision of medicines and supplies for BTL & NSV to District Hospitals providing surgical sterilization 12

13 Strategies on Family Planning 7. Intensify and Improve FP Promotion and Education Integration of FP in EPI (Expanded Program on Immunization) Conduct regular RPM ( Responsible Parenting Movement) Conduct regular AHYD (Adolescent Health and Youth) Development) classes in high schools Conduct regular PMC (Pre-Marital Counseling) Conduct FP counseling to new acceptors and followup by BHWs of FP current users & defaulters Conduct ICV (Informed Choice and Volunteerism) Conduct Men s Congress (Usapang Macho) Strategies on Family Planning 8. Enactment of CSR+ Ordinance (Commodities Self Reliance) Advocacy with the LCEs/SBs for CSR+ ordinance One day orientation with LCEs, MHOs, LFC re: formulation, CSR implementation and drafting of CSR+ ordinance Training of SB/SP Committee on Health on Evidencebased legislation Present proposal to the PHB and seek SP Committee on Health Chair s sponsorship Strengthen 2-way referral system for FP (BTL-NSV- IUD) Provision of referral form Strategies on Family Planning 9. Monitoring and Supervision Regular visits to 18 LGUs monthly Revisit CSR Plans Collection, recording and reporting of FP activities through FHSIS (Field Health Services Information System) Strategies on Nutrition Program 1. Operation Timbang (OPT) Identification of malnourished children thru mass weighing of -71 mos. old children 2. Micronutrient supplementation Provision of Vitamin A capsules & iron supplementation to: a. infants b. preschool children c. pregnant women d. lactating women e. sick children Strategies on Nutrition Program 3. Food Fortification Monitoring of fortified food products in the markets, sari-sari stores, groceries & household utilization of iodized salts 4. Local Level Nutrition Program Implementation Local Plan of Action for Nutrition at the municipal and barangay level 5. Capacity building IYCF Infant and Young Child Feeding CGS (Child Growth Standard) Strategies on Nutrition Program 6. Accelerated Hunger Mitigation Program Milk feeding (tie up with NDA) Supplemental feeding Distribution of growth monitoring charts Pabasa sa Nutrisyon Classes Promotion of child rearing practices during GP Distribution of IEC materials Feeding during disasters Breastfeeding initiatives 7. Monitoring and supervision 13

14 Strategic Imperatives Policies Institutions Public-Private Partnerships Resources Champion Other Provincial Initiatives Initiatives A. Beneficiary-led Procurement : Universal Phil Health Coverage: Universal Anti-Rabies Immunization B. Safe Hospitals: Initiatives Upgrading of structures and equipment of Provincial Hospital System Modernization of the Bicol Regional Teaching and Training Hospital [BRTTH] Rationalization Plan & Health Facility Mapping Establishment of BEMONC/CEMONC facilities Merging of district and regional hospitals Initiatives C. Partnership with NGOs: Health Program Management (USAID, PTSI, Intervida, MIDAS, WHSMP2, CSCDI) Health Promotion (PRRM, PBSP) Discounted Medicines (Pfizer, RNMD) Initiatives D. Partnerships with LGUs: Inter-local Health Zones [ILHZ] Commodity Self-Reliance Strategy [CSR] Botika ng Barangays [BnBs] Health Infrastructure (AECID, PODER, WHSMP2) 14

15 Initiatives E. Disaster Risk Management - Health: Preemptive Health Care Medical Missions targeted at APSEMO identified vulnerable areas Albay Health Emergency Management [AHEM] Emergency Paramedic Training Unit [EPTU] in cooperation with the Bicol University [BU], BRTTH &n DOH Operation Centers [OPCEN] in all three districts Evacuation Camp Management Initiatives Ambulance Project: Provision of ambulances (57) to: Provincial Hospital System Rural Health Units &C City Health Offices Basic Emergency Obstetrical and Newborn Care Facilities Operation Centers Geographically-Isolated and Disadvantaged Areas [GIDA] Strategic Priorities: Public Health Strategic Priorities Health Care Waste Management under BOT Establishment of another 9 BEMONC facilities Renovation of 3 BHS Establishment of PhilHealth Desks Capacity Building Provision of Sanitary Toilet Strengthening of Public Health Program Management TOTAL Funding Gaps 4 M 45 M 15 M 2 M 1 M 4 M 3 M 182 M Strategic Priorities: Hospital Strategic Priorities Merging of ZMDH and JBDMDH to BRTTH Upgrading of PDMDH and PDH into a secondary (inc. safe hospitals) Conversion of VMH into a Birthing Home Modernization of BRTTH: Oncology Center under BOT TOTAL GRAND TOTAL Funding Gaps 2 M 5 M 5 M 24 M 495 M 677 M MEET Albay Medical BRTTH modernization Educational Bicol University modernization Eco-cultural Tourism Magayon Festival Infrastructure Development Transportation facilities by National Government Tourism facilities by private sector MEET Albay VISION SUPPLY SIDE DEMAND SIDE EDUCATIONAL MEDICAL ECO-CULTURAL TOURISM Bicol University as first class higher education institution Bicol University modernization Bicol University School of Medicine i AHECS Seek more scholarship funds for Albay studies Bicol Regional Training and Teaching Hospital as wellness Center Province to gatekeep thru facilities upgrading Bicol University it Medical Center Universal PhilHealth Albay as prime destination for culture and nature Albay as hub to tourist destinations of Bicol Magayon Festival Southern Luzon International Albay History Project Mayon Resort House Airport Pantao Port Ligñon Hills Albay Donsol Mayon Trek Access Roads Wildlife Park Andaya Highway Responsible Bicol University Agencies DOH/BRTTH DOT/NCCA DOTC, PPA EQUAL PHO PTCAO/ACAC PPDO, PEO AHECS Albay Higher Education Contribution Scheme EQUAL Education Quality for Albayanos 15

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