Bridging Leadership Story in Service Delivery
12, 737 population 11 Barangays and 77 Sitios 303 kms. north of Manila 40 kms. from regional and provincial hospital 1 Rural Unit with 11 Barangay Stations Our Municipal Story
Mountainous Hilly Areas Flat Terrain
Our Municipal Story Goal Indicator Santol (2012) La Union (2010) Philippine MDG Target Rating as compared with MDG 5 4 7 Maternal Mortality Ratio 0 40 52.2 Births Attended by Skilled Professionals 85.16 88.7 100.0 Under 5 Mortality Rate 0.0-26.7 Infant Mortality Rate 31.25* 13.66 19.0 Household with Access to Water 85.41 93.08 86.5 Households with Sanitary Toilet 85.69 91.75 83.8
Our Municipal Story I thought my town is best performing but it made me realize that we are not hitting the MDG indicators for yet Systems thinking taught me a need to evaluate the health system of my municipality
Community Other Financing Team PHILHEALTH Leadership and Governance Activated LHB 1 session/month Expanded LHB LHB resolutions 1 resolution/month 100% Activated Barangay Boards Financing 100% enrolment 4-in-1 accredited 100% utilization of Capitation/ Reimburse ment 15% LGU Budget for Access to Medicines Botika ng Barangay 1:1 Drug Management Policy Information System Human Resources MD 1:20,000 PHN 1:20,000 RHM 1:5000 BHW 1:20 HH Service Delivery Zero Maternal Mortality Ratio at least 80% Facility Based Delivery at least 80% Skilled Birth Attendants 100% Complete Prenatal Check ups RSI: 20,000 100% mothers given TT Personnel Trained in Zero Infant Mortality Ratio EPI 100% Child Protected at Birth Barangay Resolutions in support for health IMCI 100% Newborn Screened 1. Facility-based delivery BEMONC Zero Under-Five Mortality Ratio 2. Expanded Program of Immunization NBS Decresed Malnutrition Rate 3. Infant and Young Child Feeding Program Updated TB DOTS 100% target-age children dewormed 60% of FHSIS 4. TB DOTS IYCF/Nutrition 100% target-age children given Vit. A health 5. y Lifestyle Program budget for Advocacy Zero Deaths due to TB Organized Community Teams 1:1 ratio MOOE Family Planning at least 80% CDR SB Ordinance on Facility-Based Delivery SB Ordinance on TB DOTS Updated Fully Immunized Children 95% CBMIS SB Ordinance on EPI SB Ordinance on Nutrition SB Ordinance related to PHILHEALTH Six Building Blocks of System status of year 2012 Communit y-based Financing Scheme at least 15% of barangay fund for Database Management Magna Carta 100% at least 85% Cure Rate Zero incidence of Measles 100% children with pneumonia treated 100% children with diarrhea treated 100% HH with access to potable water 100% HH with proper garbage disposal 100% patients with DM managed and referred 100% patients with HPN managed and referred
BRIDGING LEADERSHIP application in our municipality Ownership Co-Ownership Co- Creation Results Owning the issue of health Personal response Personal vision and mission Municipality Rural Unit Barangay Mothers/ Infants Departme nt of Dialogue/ Convening Multistakeholder process Shared vision and mission Collaborati ve response Leadership and Governance -creation and expansion of health boards -strengthened implementation and accountability of health policies - Human Resource -improved competency and adequacy of health providers Service Delivery - Improved health services and products suitable and accessible to people Responsive Programs Improve relationship of local health leaders and providers Increase utilization of health facilities Improvement in Indicators Increased Fully Immunized Children Increased Facility Based Deliveries (2013:63.9%) Decreased Infant Mortality Rate (IMR) (2013: 8.20%) Maintained the Zero Maternal Mortality Ratio
HEALTH CHALLENGES Our Municipal Story Ownership Owning the issue of health Personal response Personal vision and mission Wala nang mamamatay na sanggol at nanay sa santol...!
Our Municipal Story Co-Ownership Municipality Departme nt of Rural Unit Barangay Mothers/ Infants Dialogue/ Convening Multistakeholder process Shared vision and mission Collaborati ve response Participatory Planning in different levels & groups Together we say, No More Maternal & Infant Deaths!
Our Municipal Story Co- Creation Addressing the 6 building of health system blocks roadmap 1. Leadership and Governance Strengthening of local health boards Creation of Barangay Boards 2. Human Resource Hiring of additional health personnel (1 daytime and night shift Nurses, 2 Municipal Nutrition Action Officer Assistant) Improved competency through Bemonc training for doctor, nurse and midwife and capability training & teambuilding 3. Access to Medicines 4. Service Delivery Augmentation personnel from MAC 24/7 during emergency situations Additional health and diagnostic equipments (XRAY, ECG, Ultrasound) 5. Information System Creation of community pregnancy tracking system and Infant mortality review board Launch KEDUHEALTH program for school children and parents Built social service center 6. Financing 4 in 1 Philhealth accreditation
Our Municipal Story CO-CREATION KEDUHEALTH Program during the children s congress 24-HOUR Ambulance Service
Our Municipal Story Valuing performance through regular monitoring and evaluation of Barangay health stations (BHS) Submission of updated monthly reports of BHS thru electronic database (E-FHSIS) Monthly Reporting to internal and external partners Series of coaching sessions and teleconferencing with Zuellig Family Foundation senior coaches
Our Municipal Story Results Goal Indicator Santol (2013 1H) La Union (2010) Philippine MDG Target Maternal Mortality Ratio 0 40 52.2 Rating as compar ed with MDG 5 Births Attended by Skilled Professionals 95.08 88.7 100.0 4 Under 5 Mortality Rate 8.20-26.7 Infant Mortality Rate 8.20 13.66 19.0 7 Household with Access to Water Households with Sanitary Toilet 85.41 93.08 86.5 85.69 91.75 83.8
MMR (per 100,000 LB) Rate (per 1,000 Livebirths) Our Municipal Story Percentage 450 400 350 300 250 200 150 100 50 0 Maternal Mortality Ratio 418 410 0 0 0 2009 2010 2011 2012 1st Half 2013 Infant Mortality Rate and under 5 yrs old Mortality Rate 35.00 30.00 25.00 20.00 15.00 10.00 5.00 0.00 16.74 3.51 28.69 16.39 31.25 0.00 0.00 0.00 2009 2010 2011 2012 1st Half 2013 8.20 100.00 90.00 80.00 70.00 60.00 50.00 40.00 30.00 20.00 10.00 0.00 Facility Based Deliveries and Skilled Birth Attendants (%) 60.67 33.47 74.74 43.86 81.56 85.16 95.08 54.10 55.47 66.39 2009 2010 2011 2012 1st Half 2013 FBD BASHP IMR U5MR
Community Other Financing Team PHILHEALTH Leadership and Governance Activated LHB 1 session/month Expanded LHB LHB resolutions 1 resolution/month 100% Activated Barangay Boards Financing 100% enrolment 4-in-1 accredited 100% utilization of Capitation/ Reimburse ment 15% LGU Budget for Access to Medicines Botika ng Barangay 1:1 Drug Management Policy Information System Human Resources MD 1:20,000 PHN 1:20,000 RHM 1:5000 BHW 1:20 HH Service Delivery Zero Maternal Mortality Ratio at least 80% Facility Based Delivery at least 80% Skilled Birth Attendants 100% Complete Prenatal Check ups RSI: 20,000 100% mothers given TT Personnel Trained in Zero Infant Mortality Ratio EPI 100% Child Protected at Birth Barangay Resolutions in support for health IMCI 100% Newborn Screened 1. Facility-based delivery BEMONC Zero Under-Five Mortality Ratio 2. Expanded Program of Immunization NBS Decresed Malnutrition Rate 3. Infant and Young Child Feeding Program Updated TB DOTS 100% target-age children dewormed 60% of FHSIS 4. TB DOTS IYCF/Nutrition 100% target-age children given Vit. A health 5. y Lifestyle Program budget for Advocacy Zero Deaths due to TB Organized Community Teams 1:1 ratio MOOE Family Planning at least 80% CDR SB Ordinance on Facility-Based Delivery SB Ordinance on TB DOTS Updated Fully Immunized Children 95% CBMIS SB Ordinance on EPI SB Ordinance on Nutrition SB Ordinance related to PHILHEALTH Six Building Blocks of System status of year 2012 Communit y-based Financing Scheme at least 15% of barangay fund for Database Management Magna Carta 100% at least 85% Cure Rate Zero incidence of Measles 100% children with pneumonia treated 100% children with diarrhea treated 100% HH with access to potable water 100% HH with proper garbage disposal 100% patients with DM managed and referred 100% patients with HPN managed and referred
Community Other Financing Team PHILHEALTH Leadership and Governance Activated LHB 1 session/month Expanded LHB LHB resolutions 1 resolution/month 100% Activated Barangay Boards Financing 100% enrolment 4-in-1 accredited 100% utilization of Capitation/ Reimburse ment 15% LGU Budget for Access to Medicines Botika ng Barangay 1:1 Drug Management Policy Information System Human Resources MD 1:20,000 PHN 1:20,000 RHM 1:5000 BHW 1:20 HH Service Delivery Zero Maternal Mortality Ratio at least 80% Facility Based Delivery at least 80% Skilled Birth Attendants 100% Complete Prenatal Check ups RSI: 20,000 100% mothers given TT Personnel Trained in Zero Infant Mortality Ratio EPI 100% Child Protected at Birth Barangay Resolutions in support for health IMCI 100% Newborn Screened 1. Facility-based delivery BEMONC Zero Under-Five Mortality Ratio 2. Expanded Program of Immunization NBS Decresed Malnutrition Rate 3. Infant and Young Child Feeding Program Updated TB DOTS 100% target-age children dewormed 60% of FHSIS 4. TB DOTS IYCF/Nutrition 100% target-age children given Vit. A health 5. y Lifestyle Program budget for Advocacy Zero Deaths due to TB Organized Community Teams 1:1 ratio MOOE Family Planning at least 80% CDR SB Ordinance on Facility-Based Delivery SB Ordinance on TB DOTS Updated Fully Immunized Children 95% CBMIS SB Ordinance on EPI SB Ordinance on Nutrition SB Ordinance related to PHILHEALTH Six Building Blocks of System status of year 2013 Communit y-based Financing Scheme at least 15% of barangay fund for Database Management Magna Carta 100% at least 85% Cure Rate Zero incidence of Measles 100% children with pneumonia treated 100% children with diarrhea treated 100% HH with access to potable water 100% HH with proper garbage disposal 100% patients with DM managed and referred 100% patients with HPN managed and referred
Maraming Salamat! Hon. Daisy A. Sayangda (Municipal Mayor) Dr. Rodolfo C. Tongson (Municipal Officer) Rural Unit Barangay Officials/ BHWs Local Board Members People of