Upload
lamthien
View
214
Download
2
Embed Size (px)
Citation preview
1
ALBAY HEALTH ALBAY HEALTH STRATEGY STRATEGY
towardstowardsSAFE AND SHAREDSAFE AND SHARED
DEVELOPMENTDEVELOPMENT
Governor Joey Sarte SalcedaProvince of Albay
MDG is all about dignity.
Engaging dignity, Empowering dignity
Ennobling dignity
Albay MDG Achievements
Albay Health Strategies
Story LineStory Line
Albay Health Strategies MDG – make it a goal, the rest follows
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
MDGs are achieved ahead of 2015 exc. MDG 2 and 7
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
M medium probability no data
24%
22
1615
20
25
Proportion of 0 - 5 years old who are malnourished
Achievements on MDG, 2009
0
5
10
15
1992 2009
Achievements on MDG, 2009
133
100
120
140
Maternal Mortality Ratio
59
0
20
40
60
80
1998 2009
90/ 100,000 LB
33
25
30
35
Infant Mortality Rate
Achievements on MDG, 2009
12
0
5
10
15
20
1998 2009
17/1,000 LB
2
80%
Proportion of facility-based deliveries
88
70
80
90
100
Achievements on MDG, 2009
11
0
10
20
30
40
50
60
1998 2009
80%
Proportion of births attended by skilled health personnel
90
60
70
80
90
100
Achievements on MDG, 2009
29
0
10
20
30
40
50
60
1998 2009
65%
29
25
30
35
Contraceptive Prevalence Rate
Achievements on MDG, 2009
8
0
5
10
15
20
1990 2009
28
20
25
30
Child Mortality Rate
27/1,000 LB
Achievements on MDG, 2009
18
0
5
10
15
1998 2009
95%
96
92
94
96
98Fully-Immunized Children
Achievements on MDG, 2009
86
80
82
84
86
88
90
1990 2009
Achievements on MDGAchievements on MDG
40
50
60
TB Mortality RateTB Mortality Rate
•44/100,000 pop
0
10
20
30
1997 2009
3
80
100
120
Case Detection Rate for TBCase Detection Rate for TB
••Achievements on MDGAchievements on MDG
0
20
40
60
1999 2009
•70%
60
70
80
90
Cure Rate for TB
••Achievements on MDGAchievements on MDG
•85%
0
10
20
30
40
50
1999 2009
IndicatorsNational
Average (2006)National
Target (2010)Performance ALBAY (2009)
Gaps/ Gains
Intensified Disease Prevention and Control: TB
Mortality (per 100,000 pop)
28,000 44 26 (18)
••Health OutcomesHealth Outcomes
TB Case Detection Rate, % (NTP Register)
72 70 100 30
TB Cure Rate, % 81 85 81 (4)
Make MDG a goal
Ordain policies and Give it a Budget
Execute programs and projects
Build institutions
AlbayAlbay MDG StrategyMDG Strategy
Nurture partnerships
VisionVision 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 Vision for Health: longer life expectancy, wellbeing in itself, wellbeing for laborproductivity
Albayanos as healthy and happy, well-educated, well-trained
Low-rise, low-carbon, low-energy intensity = green development model
Albay Development Goal 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 li i b il i l f h l
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 li i b il i l f h lclimate action are built-in 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.
climate action are built-in 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.
4
2000 2003 2006 2000 2003 2006 2000 2003 2006 2000 2003 2006 2000 2003 2006
PHILIPPINES 11,458 12,309 15,057 27.5 24.4 26.9 1.6 1.3 1.3 4,146,663 4,022,695 4,677,305 1.6 1.4 1.3
Region V 11,375 12,379 15,015 45.3 40.6 41.8 4.2 3.6 3.5 407,176 383,625 422,278 4.7 4.3 4.3
Albay 12,144 12,915 16,128 40.3 34.4 37.8 11.5 8.1 8.4 83,398 76,200 88,676 11.2 8.5 10.1
Region/Province
pPoverty Threshold (in
Pesos)Poverty Incidence Am ong Fam i l ies (%) Magni tude of Poor Fam il ies
Estim ates (%) Coeffic ient o f Varia tion Estim ates Coefficient o f Varia tion
POVERTY AS AN INITIAL CONDITION IS A MAJOR POVERTY AS AN INITIAL CONDITION IS A MAJOR OBSTACLE TO HEALTH OUTCOMESOBSTACLE TO HEALTH OUTCOMES
yCamarines Norte 11,505 12,727 14,854 52.7 46.1 38.4 10.9 14.4 18.8 50,670 44,874 39,421 11.8 14 22.6Camarines Sur 11,054 11,873 14,634 40.8 40.1 41.2 9.3 7.0 5.6 120,762 121,936 134,599 11.8 7.7 6.6Catanduanes* 11,587 11,815 13,654 43.9 31.8 37.3 10.9 10.3 22.1 18,541 13,604 16,999 10.4 29.3 33.3Masbate 11,019 12,504 14,248 61.3 55.9 51.0 5.8 5.7 6.5 83,660 81,804 80,512 5.9 7.4 8.0Sorsogon 11,146 12,452 15,687 41.4 33.7 43.5 7.3 10.3 5.4 50,146 45,207 62,071 7.6 14.5 5.6* Coefficient of Variation (CV) of 2006 poverty incidence is greater than 20%
•19
•Albay poverty incidence at 37.8%, while lowest in region, remains high
Average annual losses to infrastructure and agriculture in 10 most vulnerable provinces vs. their 2006 local calamity funds
•Source: World Bank
Net resource outflow to cities
•21
Objectives for Health, 2011
1. To decrease maternal mortality ratio from 59/100,000 to 50/100,000.
2. To decrease infant mortality rate from 10/1,000 to 8/1,000.
3. To decrease child mortality rate from 18/1,000 to 15/1,000.
4. Increase FIC coverage from 84% to 88%.
5. To increase CPR from 33% to 40%.
6. To increase voluntary blood donation to 1% of the provincial population.
7. To reduce soil-transmitted helminthiasis to below 50% among children.
Objectives for Health, 2011
8. To reduce prevalence of malnutrition from 19% to 17%.
9. To reduce TB mortality rate by 3%.
10. To sustain TB case detection at 90%.
11. To sustain TB cure rate at 85%.
12. To reduce the incidence of STI/HIV by 2% points annually.
13. To eliminate incidence of filaria to zero.
Objectives for Health, 2011
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.
5
16. To sustain leprosy prevalence at less than 1/10,000 population.
17. To increase leprosy cure rate by 2%.
18. To reduce the mortality and morbidity of
Objectives for Health, 2011
y ylifestyle-related diseases by 2% annually.
19. To increase proportion of HH with access to safe drinking water from 94% to 95%.
20. To increase proportion of HH with sanitary toilets from 69% to 89%.
Total Health BudgetTotal Health Budget2007 2007 -- 20102010
120 000 000
140,000,000
160,000,000
180,000,000
135,673,326 134,566,903
161,373,128
24% of provincial budget
0
20,000,000
40,000,000
60,000,000
80,000,000
100,000,000
120,000,000
2007 2008 2009 2010
101,669,158
Source: PBO, Albay
Resources for Institutionalized MDG Resources for Institutionalized MDG OfficeOffice
• Program office: AMDGO– created by ordinance in 2009 with regular provincial budget
– Oversight to MDG performance and secretariat to MDG Supercom
– Management MDG projects
• Manages relocation programg p g
• 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
•2
Albay MDG Albay MDG SupercomSupercom
•2
Provincial Initiatives• 2011- P178m (exc PHIC) for health PS and
MOOE essentially for hospital care and public health
• Universal health coverage at P59m pa
• Acquisition of 57 ambulancesq
• 19 BeMoNCs
• Modernization of provincial hospitals: Ziga (80-bed) and Duran (60-bed)
• Modernization of BRTTH (300-bed)
• Merger of BRTTH, Ziga and Duran into a 500-bed capacity
InitiativesInitiativesUniversal Phil Health Coverage: 2007-2010
Number of Families Enrolled
180,000 158,000173,262
0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
2007 2008 2009 2010
18,510
122,600
Source: PSWDO, Albay
6
33%
54%
•BRTTH: PHIC REIMBURSEMENT FOR 2010
13% HOSPITAL INCOME
MEDICINES
PROFESSIONAL FEEPHIC REIMBURSEMENTS
HOSPITAL INCOME 67,403,506.73
DRUGS AND MEDICINES 16,929,387.25
PROFESSIONAL FEES 42,339,658.00
TOTAL 126,672,551.98
BRTTH earns P127m from PHIC vs P59m by province
Ambulance DeploymentAmbulance Deployment
•2
•2
2
•6
•6 •2
•RHUs & BEmONC
•Hospitals
•Source: PHO, Albay
•2•1
•4
•3
•2
•1
•2
•4
•2
•3
•2
•1
•2•1
•2
•2
•1
•4
Medical Mobile AssetsHealth Facilities: 15 Health Facilities: 15 BEmONCSBEmONCS
•Hospitals
•BEmONC
•RHUs/CHOs
•Source: PHO, Albay
JBDMHJBDMH JBDMHJBDMH
7
JBDMHJBDMH JBDMHJBDMH
ZIGA Memorial District HospitalZIGA Memorial District Hospital ZDMHZDMH
ZDMHZDMH ZDMHZDMH
8
ZDMHZDMH ZDMHZDMH
ZDMHZDMH •2007 - Renovated under the B-CARE project
•BRTTH Main Building
•Salceda Wing / Philhealth/Surgery Ward •Out-Patient Department
•Emergency Room
9
•Maintenance Building •Laundry
•Dorm •Isolation Ward
•Emergency Room •Trauma Unit
•Services Offered
•Philhealth Ward •Surgery Ward
•OB-Gyne Ward •Private Ward
•Pedia Ward •Medical Ward
•CT Scan•Delivery Room
•Dialysis •ECG/EEG
•Cath Lab •2D Echo
•Ultrasoud •X-Ray
•ICU•CCU
•NICU •PICU
10
•Operating Room – Room 1 - 4 •Laboratory
•Electric Power Substation
Prov’l Gov’t ofAlbay, project ofGov. Joey Salceda
•Pharmacy
•Dietary •Pastoral
•Rehab CenterEstablishment of Regional Oncology Center (P400m)
•BRTTH and Beyond
11
•3. Extension of PHIC ward
•4. Diagnostic Center
•5. ER and Trauma Unit
•6. Bicol Cancer Center•2. Communicable Disease Building
•1 . Waste and Infectious Treatment Plant
•8. Commercial Building
•7. Bicol Regional Blood Center
•Proposed Facilities
•1•23
•7•2•3
•4
•5•6
•8
Health Capital ExpendituresHealth Capital ExpendituresSource
Committed by Source (from
AOP)
Amount Received by the province
Received by the province (in kind)
Amount UtilizedNumber of Recipient
MunicipalitiesPLGU 134,566,903.00 134,566,903.00 134,566,903.00 18 M/C LGUs
M/C LGUs (15 MLGUs/ 3 CLGUs)
188,470,320.51 170,905,125.99 18 M/C LGUs
DOH-regular fund 24,372,850.33 24,372,850.33EPI vaccines, Vit. A, antihelminthics,
TB drugs, Iron24,372,850.33 18 M/C LGUs
DOH- special fund
>MNCHN 2,419,320.00 2,419,320.00 18 M/C LGUs> start-up 2,000,000.00 2,000,000.00 18 M/C LGUs> HEMS 9,100,000.00 9,100,000.00 18 M/C LGUs
> Health Facilities Dev't/RAT Plan
97,608,000.00 71,191,000.00 71,191,000.00 6 District Hospitals
> Health Systems Dev't
2,000,000.00 2,000,000.00 18 M/C LGUs
> RHU/BHS Facility Devt/Eqpt
7,350,000.00 5,900,000.00 8 M/C LGUs
Others:
> USAID 134,823,414.00Technical assistance
18,600,000.00 18 M/C LGUs
> AECID 43,000,000.00 24,000,000.00 24,000,000.00 9 M/C LGUs> capitation (for CSR + drugs)
18,473,296.71 5,000,000.00 18 M/C LGUs
> PCSO 7,984,000.00 drugs, medicines &
ambulances7,984,000.00 18 M/C LGUs
TOTAL 630,191,487.84 296,107,370.04 460,439,199.32
AMDGOAMDGO• Program office started as Ayuda Albay in 2007,
renamed as Albay Mabuhay Task Force to manage the cluster approach to Reming rehabilitation
• Reorganized in June 2009 as Albay Millenium Development Office or AMDGO to (a) monitor and oversight MDG progress (b) coordinate MDG g p g ( )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)
• 2010 organic budget of P2m. for Listeningfor 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 WorkerHealth 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 andgovernment institutions including evacuation centers
3. Maternal Deaths Review• Reviews maternal deaths• Give recommendation and feedback to LGUs withmaternal deaths
• Maternal death reporting
Strategies on Maternal Health Care
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)
12
6. Rationalization planning and health facility
mapping• Upgrading of CEMONC facilities. (ComprehensiveEmergency Obstetric and Newborn Care)
• Construction of BEMONC facilities. (Basic EmergencyObstetric and Newborn Care)
Strategies on Maternal Health Care
)• Hiring of Staff Complement to fill up vacancies and/or augment personnel
7. Organization of Women’s Health Teams in everybarangay:
• 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
8. Capacity building• NBS training (Newborn Screening)• ENC training (Essential Newborn Care)• LSS training (Life-Saving Skills)• BEMONC training (Basic Emergency Obstetric and
N b C )
Strategies on Maternal Health Care
Newborn Care)• WHT training (Women’s Health Team)• CMMNC training (Community-Managed Maternal and
Newborn Care)
9. Sustain Universal Phil HealthEnrollment/Coverage
10. MCP Accreditation of LGU’s birthing facilities
(Maternity Care Package)
11. Enact ordinances on FBD and User’s Fee
Strategies on Maternal Health Care
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 stakeholdersin the municipality/ city
• conduct one day orientation to identified FP privateproviders & other stakeholdersp
2. Validation of current FP users (data cleaning)
3. Review/assess CDLMIS of LGUs (ContraceptiveDistribution, Logistics, Management InformationSystem)
Strategies on Family Planning
4. Planning workshop to draft plan to
operationalize modified CDLMIS
5. Capacity BuildingFP Competency based training• 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 50% of FP commodities
requirements (Pills, DMPA, Condom, NFP to LGUs• Provision of medicines and supplies for BTL & NSV toProvision of medicines and supplies for BTL & NSV to
District Hospitals providing surgical sterilization
13
Strategies on Family Planning
7. Intensify and Improve FP Promotion andEducation Integration of FP in EPI (ExpandedProgram on Immunization)
• Conduct regular RPM ( Responsible ParentingMovement)C d t l AHYD (Ad l t H lth d Y th)• 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 follow-up 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 ofCSR+ ordinanceCSR+ ordinance
• Training of SB/SP Committee on Health on Evidence-based legislation
• Present proposal to the PHB and seek SP Committeeon 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 InformationSystem)System)
Strategies on Nutrition Program
1. Operation Timbang (OPT)• Identification of malnourished children thru massweighing of 0-71 mos. old children
2. Micronutrient supplementation• Provision of Vitamin A capsules & iron• Provision of Vitamin A capsules & iron supplementation to:
a. infantsb. preschool childrenc. pregnant womend. lactating womene. 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 Implementation4. 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)
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
Strategies on Nutrition Program
Promotion of child rearing practices during GP• Distribution of IEC materials• Feeding during disasters• Breastfeeding initiatives
7. Monitoring and supervision
14
Strategic Imperatives
Policies
Institutions
Public-Private Partnerships
Resources
Champion
Other Provincial Initiatives
InitiativesA. Beneficiary-led Procurement :
Universal Phil Health Coverage: 2007-2010
Universal Anti-Rabies Immunization
InitiativesB. Safe Hospitals:
Upgrading of structures and equipment of Provincial Hospital System
Modernization of the Bicol Regional Teaching 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
InitiativesC. Partnership with NGOs:
Health Program Management (USAID,
PTSI, Intervida, MIDAS, WHSMP2, CSCDI)
Health Promotion (PRRM, PBSP)
Discounted Medicines (Pfizer, RNMD)
Health Infrastructure (AECID, PODER, WHSMP2)
InitiativesD. Partnerships with LGUs:
Inter-local Health Zones [ILHZ]
Commodity Self-Reliance Strategy [CSR]
Botika ng Barangays [BnBs]
15
InitiativesE. Disaster Risk Management - Health:
Preemptive Health Care – Medical Missions
targeted at APSEMO identified vulnerable areas
Albay Health Emergency Management [AHEM]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
InitiativesAmbulance Project: Provision of
ambulances (57) to:
Provincial Hospital System
& C Off Rural Health Units & City Health Offices
Basic Emergency Obstetrical and Newborn Care Facilities
Operation Centers
Geographically-Isolated and
Disadvantaged Areas [GIDA]
Strategic Priorities: Public Health
Strategic Priorities Funding Gaps
Health Care Waste Management under BOT
40 M
Establishment of another 9 BEMONC facilities
45 M
Renovation of 30 BHS 15 M
Establishment of PhilHealth Desks 2 M
Capacity Building 10 M
Provision of Sanitary Toilet 40 M
Strengthening of Public Health Program Management
30 M
TOTAL 182 M
Strategic Priorities: Hospital
Strategic Priorities Funding Gaps
Merging of ZMDH and JBDMDH to BRTTH
200 M
Upgrading of PDMDH and PDH into a secondary (inc. safe
50 M
hospitals)
Conversion of VMH into a Birthing Home
5 M
Modernization of BRTTH: Oncology Center under BOT
240 M
TOTAL 495 M
GRAND TOTAL 677 M
MEET Albay Medical
BRTTH modernization
Educational
Bicol University modernization Bicol University modernization
Eco-cultural Tourism
Magayon Festival
Infrastructure Development
Transportation facilities by National Government
Tourism facilities by private sector
MEET AlbayEDUCATIONAL MEDICAL ECO-CULTURAL TOURISM
VISION Bicol University as first class higher education institution
Bicol Regional Training and Teaching Hospital as wellness Center
Albay as prime destination for culture and nature
Albay as hub to tourist destinations of Bicol
SUPPLY SIDE
Bicol University modernization
Bicol University School of M di i
Province to gatekeep thru facilities upgrading
Bi l U i it
Magayon Festival
Albay History Project
Mayon Resort House
Southern Luzon International Airport
Pantao PortMedicine Bicol University
Medical CenterLigñon Hills
Mayon Trek
Wildlife Park
Albay Donsol Access Roads
Andaya Highway
DEMAND SIDE
AHECS
Seek more scholarship funds for Albay studies
Universal PhilHealth
Responsible Agencies
Bicol University
EQUAL
DOH/BRTTH
PHO
DOT/NCCA
PTCAO/ACAC
DOTC, PPA
PPDO, PEO
AHECS – Albay Higher Education Contribution Scheme EQUAL – Education Quality for Albayanos
16
Health Sector Reform Framework
Service Delivery
Governance
Regulation
Health Care Financing
Health for AllHealth for All
Goal for Health Sector
Capacity Building for:B tt h lth t Better health outcomes More responsive health system Equitable health care financing
Opportunity-seeking for: Medical tourism
for Listeningfor Listening