NUHRA Regional CAR Agenda

8/8/2019 NUHRA Regional CAR Agenda

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REGIONAL HEALTH RESEARCH AGENDA FORTHE CORDILLERA ADMINISTRATIVE REGION (CAR)

ELIZABETH FE-DACANAY, M.D., FCAP, FPSPDean, Saint Louis University College of Medicine

Regional Facilitator for CAR


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FOREWORD

The Regional Consultation Workshop for Setting the Regional Health ResearchAgenda was held last October 27, 2005 at the Golden Pine Hotel, Legarda Road, BaguioCity, from 8:00 a.m. to 4:00 p.m. The objective of the workshop was to formulate a healthresearch agenda based on priority areas, which would involve the participation of concernedstakeholders at the provincial and regional levels.

The workshop was sponsored by the Department of Science and Technology(DOST) -- Philippine Council for Health Research and Development (PCHRD), and theSaint Louis University (SLU) College of Medicine. Dr. Elizabeth Fe-Dacanay, Dean of theSLU College of Medicine was designated by the PCHRD as Regional Facilitator for thisproject, as an offshoot of the colleges active involvement in the Research Twinning Projectfor the past five years.

The participants in the workshop comprised a multi-sectoral group representingvarious government and non-government agencies in the region i.e. Department of Health CAR, Baguio Health Department, Provincial Health Offices, DOST, CHED, PhilHealth,Department of Agriculture, DILG, Population Commission, NEDA, DSWD, DOLE, CordilleraCoalition Against TB (CORCAT), Community Health Education Services Training in the

Cordillera Region (CHESTCORE), and the Cordillera Womens Education and ResourceCenter.

The program of the said activity is shown on the next two pages, followed by a list ofthe participants in the workshop.


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ACKNOWLEDGMENT

The Regional Facilitator would like to express her gratitude to the following:

The Department of Science and Technology (DOST) -- Philippine Council for HealthResearch And Development (PCHRD) through:

Dr. Jaime C. Montoya, Executive Director; Dr. Allan Fernail, Chief, Research Management Development Program; Ms. Teresita O. Laguimun, Officer-in-Charge, Human Resources and Institution

Development Division; Mrs. Angelina M. Aquino, Administrative Assistant, Office of the Executive Director; Director Leonardo N. Quitos, Jr., Zonal Convenor; Faculty and Staff of the Saint

Louis University College of Medicine, Baguio City; Workshop participants from the various government and private sectors;

And to all those who, in one way or another, contributed to the formulation of ourregional research agenda.


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Table of Contents

I. Overview of the Health Situation / Current 5

Health Problems

II. Methodology / Process for Arriving at 16Priorities and Criteria Used

III. Health Research Priorities Following the 17Standard Matrix

IV. Report on the Focus Group Discussion 19

V. Annexes 23


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OVERVIEW OF THE HEALTH SITUATION / CURRENT HEALTH PROBLEMS

At the start of the workshop, Dr. Julius Alcala (Medial Specialist II) and Dr. ElviraBelingon (Medical Specialist II) of the Department of Health Cordillera AdministrativeRegion (DOH-CAR) presented an overview of the Regional Health Situation in terms of thefollowing:

- Vital Health Indices (based on the FHSIS)

- National Demographic Health Survey Results for 2003 Maternal Health Child Health

- Health Expenditures and PhilHealth Coverage-According to Drs. Alcala and Belingon, the health status of the region is improving,

but at a slower rate than desired. They pointed out the following factors contributing to thestate of the regions health: double burden of disease, threat from emerging and resurgentdiseases, large variation in health status across population groups, income classes, andgeographic areas, and the decentralized health delivery system. An open forum followedtheir presentation where the participants clarified several issues on health such asimmunization of children and antenatal care for women.

The details of the presentation are depicted in the attached PowerPoint slides.(Please see attachment: health situation CAR)

To set the stage for the workshop, Ms. Teresita O. Laguimun, Officer-in-Charge ofthe Human Resources and Institution Development Division of the PCHRD, spoke on ThePhilippine National Health System: Creating Synergies. In her talk, she focused on the taskat hand which was to set regional research priorities with the goal of developing andstrengthening regional research and development capacities.

The details of Ms. Laguimuns presentation are also attached. (Please seeattachment: overview of agenda setting)

Outline of Presentation

Vital Health Indices- Based on the FHSIS

National Demographic Health Survey Results (CY 2003)- Maternal Health

- Child Health

Health Expenditures & PhilHealth

State of the Regions Health

Health status is improving but at a slower rate than desired Double burden of disease Threat from emerging and resurgent diseases Large variation in health status across population groups, income classes and

geographic areas

Decentralized health care delivery system


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Population Distribution

Cordillera Administrative Region 2004

Annual Growth Rate

VITAL HEALTH INDICES, CAR, 2000-2004

10.3151,301Mt. Province

100.01,467,280CAR

19.6286,942Baguio City

13.0191,416Kalinga

11.4167,719Ifugao

23.3341,768Benguet

7.4107,883Apayao

15.0220,251Abra

PERCENTAGE

DISTRIBUTION

NUMBERPROVINCE/

CITY

10.3151,301Mt. Province

100.01,467,280CAR

19.6286,942Baguio City

13.0191,416Kalinga

11.4167,719Ifugao

23.3341,768Benguet

7.4107,883Apayao

15.0220,251Abra

PERCENTAGE

DISTRIBUTION

NUMBERPROVINCE/

CITY

1.821.76CAR

2.313.26Baguio City

1.541.88Mountain

2.632.41Kalinga

1.67.93Ifugao

1.09.87Benguet

3.252.66Apayao

1.441.26Abra

1995-20001990-2000Province/City

1.821.76CAR

2.313.26Baguio City

1.541.88Mountain

2.632.41Kalinga

1.67.93Ifugao

1.09.87Benguet

3.252.66Apayao

1.441.26Abra

1995-20001990-2000Province/City

Indices 2000 2001 2002 2003 2004

CBR* 22.78 21.88 22.80 22.46 22.15

CDR* 3.76 3.91 4.13 4.11 4.11

IMR*** 12.25 11.11 10.25 9.48 10.74

MMR*** 1.09 0.89 0.68 0.68 0.80** Per 1,000 population ***Per 1,000 livebirths


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LEADING CAUSES OF MORTALITY, 2002 TO 2004

LEADING CAUSES OF MORBIDITY, 2002 TO 2004

5. TB, all forms5. TB, all forms5. Peptic Ulcer Disease

4. Accidents4. Accidents4. Accidents

3. Cancer, all forms3. Cancer, all forms3. Cancer, all forms

2.Pneumonias2.Pneumonias2.Pneumonias

1.Cardiovascular Diseases1.Cardiovascular Diseases1.Cardiovascular Diseases

200420032002

5. TB, all forms5. TB, all forms5. Peptic Ulcer Disease

4. Accidents4. Accidents4. Accidents

3. Cancer, all forms3. Cancer, all forms3. Cancer, all forms

2.Pneumonias2.Pneumonias2.Pneumonias

1.Cardiovascular Diseases1.Cardiovascular Diseases1.Cardiovascular Diseases

200420032002

5. Diarrheas5. Diarrheas5. Diarrheas

4. Influenza4. Influenza4. Other Respiratory

Infections

3. Pneumonias3. Pneumonia3. Bronchitis

2. Bronchitis2. Acute Respiratory

Infection

2. Influenza

1. Acute Respiratory

Infection

1. Bronchitis1. Pneumonias

200420032002

5. Diarrheas5. Diarrheas5. Diarrheas

4. Influenza4. Influenza4. Other Respiratory

Infections

3. Pneumonias3. Pneumonia3. Bronchitis

2. Bronchitis2. Acute Respiratory

Infection

2. Influenza

1. Acute Respiratory

Infection

1. Bronchitis1. Pneumonias

200420032002


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LEADING CAUSES OF MORBIDITYNumber and Rate per 100,000 PopulationCAR, 2004

LEADING CAUSES OF MORTALITYNumber and Rate per 100,000 PopulationCAR, 5-Year Average (1999-2003) and 2004

404.295,932188.892,639WOUNDS

457.856,718227.553,179ASTHMA

494.597,257210.442,940PARASITISM

549.048,056308.794,314ACUTE TONSILLOPHARYNGITIS

1,053.0415,4511,022.4214,284HYPERTENSION

1,198.9517,5921,801.7725,172DIARRHEAS

1,512.1922,1881,378.2419,255INFLUENZA

2,089.7930,6631,854.5225,909PNEUMONIA

2,374.8034,8452,272.7531,752BRONCHITIS

4,167.7161,1521,671.0623,346ACUTE RESPIRATORY INFECTION

RATE#RATE#

20045YR AVE.CAUSES

404.295,932188.892,639WOUNDS

457.856,718227.553,179ASTHMA

494.597,257210.442,940PARASITISM

549.048,056308.794,314ACUTE TONSILLOPHARYNGITIS

1,053.0415,4511,022.4214,284HYPERTENSION

1,198.9517,5921,801.7725,172DIARRHEAS

1,512.1922,1881,378.2419,255INFLUENZA

2,089.7930,6631,854.5225,909PNEUMONIA

2,374.8034,8452,272.7531,752BRONCHITIS

4,167.7161,1521,671.0623,346ACUTE RESPIRATORY INFECTION

RATE#RATE#

20045YR AVE.CAUSES

Source: FHSIS *4-Year Average

# rate # rate

CARDIOVASCULAR DISEASES 1,372 99.91 1,562 108.35

PNEUMONIA 896 65.25 896 62.15

CANCER (ALL FORMS) 544 39.60 571 39.61

ACCIDENTS 328 23.86 264 18.31

TB, ALL FORMS 220 16.03 162 11.24

HOMICIDE* 106 7.73 158 10.96

PEPTIC ULCER DISEASE 181 13.17 152 10.54

DIABETES MELLITUS 69 5.00 131 9.09

KIDNEY DISEASE 112 8.17 93 6.45

SENILITY 103 7.49 93 6.45

CAUSES5-Year Average 2004


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LEADING CAUSES OF INFANT MORTALITY

Number and Rate per 1,000 Livebirths

CAR, 5-Year Average (1999-2003) and 2004

Source: FHSIS

.155Congenital Anomalies

.186Hydrocephalus

.258Unknown

.258Diarrheas

.4314Sudden Infant Death Syndrome

.5217Diseases of the Heart

.6521Asphyxia

.8327Sepsis

1.9463Prematurity

2.5583Pneumonias

RATENUMBERCAUSES

.155Congenital Anomalies

.186Hydrocephalus

.258Unknown

.258Diarrheas

.4314Sudden Infant Death Syndrome

.5217Diseases of the Heart

.6521Asphyxia

.8327Sepsis

1.9463Prematurity

2.5583Pneumonias

RATENUMBERCAUSES

CAUSES OF MATERNAL MORTALITY

Number and Rate per 1,000 Livebirths

CAR, 5-Year Average (1999-2003) and 2004

Source: FHSIS

.062Dystocia

.062Uterine Atony

.062Sepsis secondary to postpartum trauma

.062Retained placenta

.093Unknown

.093Abruptio placenta

.124Postpartum Hemorrhage

RATENUMBERCAUSES

.062Dystocia

.062Uterine Atony

.062Sepsis secondary to postpartum trauma

.062Retained placenta

.093Unknown

.093Abruptio placenta

.124Postpartum Hemorrhage

RATENUMBERCAUSES


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MATERNAL MORTALITY BY PROVINCE/ CITY/,

CAR, 2004

2Tublay

3La Trinidad

1Kibungan

1Bakun

1.017BENGUET

1Luna

1Kabugao

1Flora

1.443APAYAO

1Manabo

1Luba

0.542ABRA

Rate per

1,000

livebirths

Number

Province/

City/

Municipality

2Tublay

3La Trinidad

1Kibungan

1Bakun

1.017BENGUET

1Luna

1Kabugao

1Flora

1.443APAYAO

1Manabo

1Luba

0.542ABRA

Rate per

1,000

livebirths

Number

Province/

City/

Municipality

1Transient

1Baguio City

0.212BAGUIO

CITY

1Natonin

0.331MT.

PROVINCE

1Tanudan

4Tabuk

1Pinukpuk

1.586KALINGA

1Asipulo

0.261IFUGAO

Rate per

1,000

livebirths

Number

Province/

City/

Municipality

1Transient

1Baguio City

0.212BAGUIO

CITY

1Natonin

0.331MT.

PROVINCE

1Tanudan

4Tabuk

1Pinukpuk

1.586KALINGA

1Asipulo

0.261IFUGAO

Rate per

1,000

livebirths

Number

Province/

City/

Municipality

FULLY IMMUNIZED CHILDREN, CAR, 2004

7934,92944,018CAR

457,5308,608Baguio City

653,0674,539Mt. Province

664,3125,742Kalinga

844,2405,032Ifugao788,02410,253Benguet

752,4233,236Apayao

815,3336,608Abra

Percent

FIC

No. of Fully

Immunized

Children

Elig. Pop.

TP x 3%Province/City

7934,92944,018CAR

457,5308,608Baguio City

653,0674,539Mt. Province

664,3125,742Kalinga

844,2405,032Ifugao788,02410,253Benguet

752,4233,236Apayao

815,3336,608Abra

Percent

FIC

No. of Fully

Immunized

Children

Elig. Pop.

TP x 3%Province/City


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Three Most Nutritionally Depressed Municipalities in CAR(Based on combined Severe and Moderate Underweight

Children 0-5 years old)

ABRA (8.5%)

Malibcong 24.7%

San Juan 18.4%

Bucloc 16.1%

APAYAO (7.2%)

Calanasan 16.4%

Flora 13.5%

Santa Marcela 7.16%

BENGUET (1.5%)

Atok 3.2%

Itogon 3.1%

Bakun 2.8%

IFUGAO (2.3%)

Asipulo 4.4%

Hungduan 3.9%

Aguinaldo 2.8%

KALINGA (4.6%)

Tabuk 8.8%

Tanudan 6.6%

Pasil 6.4%

MT. PROVINCE (2.3%)

Paracelis 5.8%

Natonin 3.4%

Barlig 3.2%

BAGUIO CITY (0.4%) Pacdal 0.9% Loakan 0.8% Lucban 0.4%

Source: Operation Timbang Results 2002, National Nutrition Council-CAR

ENVIRONMENTAL HEALTH REPORT, CAR, 2004

57.060.975.293.2CAR

97.597.598.398.9Baguio City

36.639.470.598.0Mt. Province

29.545.351.288.9Kalinga

40.846.561.086.3Ifugao

48.953.172.895.0Benguet

63.267.480.276.2Apayao

60.659.978.396.0Abra

% of HHs with

Complete Basic

Sanitation

Facilities

% of HHs with

Satisfactory

Garbage

Disposal

% of

HHs with

Sanitary Toilets

% of HHs with

Access to Safe

Water

Province/City

57.060.975.293.2CAR

97.597.598.398.9Baguio City

36.639.470.598.0Mt. Province

29.545.351.288.9Kalinga

40.846.561.086.3Ifugao

48.953.172.895.0Benguet

63.267.480.276.2Apayao

60.659.978.396.0Abra

% of HHs with

Complete Basic

Sanitation

Facilities

% of HHs with

Satisfactory

Garbage

Disposal

% of

HHs with

Sanitary Toilets

% of HHs with

Access to Safe

Water

Province/City


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Phil

NCR

CARR1 R2R3R4

AR4

B R5R6 R7 R8R9R10R1

1R1

2

Caraga

ARMM

CAR has the lowest infant mortality among regions

38.4

23.0

36.0

30.0

14.0

42.7

Philippines CAR

1993* NDS 1998* NDHS 2003 NDHS

71.5

85.5

72.875.9

69.8 67.4

Philippines CAR

1993* NDS 1998* NDHS 2003 NDHS

Fully Immunized Children, Philippines vs. CAR 1993-2003

Percent of Children

12-23 months old

Fully Immunized Children in CAR declinedconsistently.

1993, 1 998, 2003 P hilippine Na tional Demog rap hic and Hea lth S urvey (NSO, ORCMacro)


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42.2

25.323.5 26.4

2.3 1.8

Philippines CAR

ORS Packets RHF Increased Fluids

Among children who had diarrhea in 2 weeks prior to survey, percentage whoreceived oral rehydration therapy (ORT), Philippines vs. CAR: 2003

Percent

Children in CAR were treated more with recommended homefluids (RHF). Oral Rehydration Salts (ORS) packets were given tochildren in the national level.

2003 P hilippine National Demographic a nd Health S urvey (NS O, ORC Ma cro)

70.6

74.0

76.0 74.9

Philippines CAR

1998 NDHS 2003 NDHS

Percentage of children under 3 who received Vitamin Asupplements prior to survey,

Philippines vs. CAR: 1998-2003

Less than a percent increase is seen in CAR for childrenwho received Vitamin A supplements while the national

level increased by five percent.

1998, 2003 P hilippine Nationa l Demograp hic and Hea lth S urvey (NS O, ORC Mac ro)


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Percent of women with Antenatal Care(ANC) from a Health Professional,

Philippines vs. CAR: 1993-2003

Percent

A decrease is seen for women in CAR who consulted a

health professional for antenatal care from 1993 to1998but increased in 2003.

83.1

87.7

85.7

84.6

87.6

86.0

Philippines CAR

1993* NDS 1998* NDHS 2003 NDHS

1998 , 2003 P hilippine Na tiona l Demogra phic a nd Health S urvey (NS O, ORC Mac ro)

Phil

NCRCA

R R1 R2 R3R4AR4

B R5 R6 R7 R8 R9R10R1

1R1

2

Caraga

ARMM

87.692.4

85.6

93.490.592.1

86.0

91.390.1 91.0

82.079.1

91.4

77.1

91.1 90.2

82.1

49.8

Antenatal Care (ANC)* by Region: 2003Percent

Over four-fifths of women in CAR consulted a healthprofessional for antenatal care.

*Health Professionals (Doctors and Nurses)

2003 Ph ilippine National Demog raphic and Health Surv ey (NS O, ORC Macro)


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Phil

NCR

CAR R1 R2 R3R4

AR4

B R5 R6 R7 R8 R9 R10

R11

R12

Caraga

ARMM

37.9

69.6

49.4

39.8 41.0

23.1

26.1

10.7

44.8

29.125.7

45.8

15.7

21.920.7

33.4

15.6

28.9

Birth delivered in Health Facility* by Region: 2003

Percent

CAR is among the regions withwomen who gave birth in a health

facility higher than the national level.

*Health Facility (Govthospital, Govt health

center and Private Sector)

2003 Philippine National Demograph ic and Health Survey (NSO, ORC Macro)

52.3 48.159.652.8 56.4 59.8

14.116.3

45.3 41.3 37.1

21.8

1993 1998 2003 1993 1998 2003

Health Professional Hilot

Philippines CAR

Percent of births with delivery assistance fromhealth professionals and hilots,Philippines vs. CAR: 1993-2003Percent

Delivery assistance from a health professional is more

common in the Cordilleras. Assistance from hilotsdecreased in CAR and the national level.

1993, 1998, 2003 Philippine National Demographic and Health Survey (NSO, ORC Macro)


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Sources of Funds for Health 2003

PPhhiillHHeeaalltthh CCoovveerraaggee

179,749 individuals are currently enrolled with PHIC (translates to 65% coverage if eachindividual has an average of 4 dependents)

Increased enrollees in the individual paying sector and LGU sponsorship of indigents

METHODOLOGY / PROCESS FOR ARRIVING AT PRIORITIES AND CRITERIA USEDThe following steps were undertaken during the workshop to arrive at the health

research priorities of the region:

1. The participants were distributed into three groups, as follows:

Group I: Representatives from DOH-CAR, City Health Department,Provincial Health Offices

Group II: Representatives from PhilHealth, CHED, CORCAT, DOST,Department of Agriculture, Cordillera Womens Education andResource Center, PopCom

Group III: Representatives from DILG, NEDA, DOLE, DSWD, CHESTCORE

2. Each group elected a group leader and a group secretary.3. The groups were asked to discuss the regions priorities for health research based

on two matrices / tables which were recommended by the PCHRD.

Table 1: Matrix for Arriving at Regional Priorities for Health Research andDevelopment

Column 1: The participants were asked to list down the five issues of concernwhich they perceived to be most important in the region. As a guide, achecklist of Health Concerns and Issues to be Considered, alsorecommended by the PCHRD, was distributed.

Social HealthSocial HealthSocial HealthSocial Health

InsuranceInsuranceInsuranceInsurance

10%10%10%10%

Out-of-Out-of-Out-of-Out-of-

pocketpocketpocketpocket

44%44%44%44%

OthersOthersOthersOthers

13%13%13%13%

NationalNationalNationalNational

15%15%15%15%

LocalLocalLocalLocal

18%18%18%18%


Social HealthSocial HealthSocial HealthSocial Health

InsuranceInsuranceInsuranceInsurance

10%10%10%10%

Out-of-Out-of-Out-of-Out-of-

pocketpocketpocketpocket

44%44%44%44%

OthersOthersOthersOthers

13%13%13%13%

NationalNationalNationalNational

15%15%15%15%

LocalLocalLocalLocal

18%18%18%18%



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Column 2: The participants were given the criteria for ranking of the areas i.e.extent, prevalence, urgency, and burden to the community.

Column 3: The participants were asked to state the reasons for persistence of theissue or problem e.g. lack of funds, poor utilization, poor knowledge,etc.

Column 4: The participants were asked to indicate the type of research that can beconducted to address the issue i.e. biomedical, product development,operations, communications, etc.

Columns 5 through 8: The participants were asked to evaluate the identifiedresearch areas in terms of the following parameters:- Feasibility of research based on existing resources in the region- Impact of research and development on the issue addressed

i.e.impact on the greater number or population, on the cost ofhealth care

- Lack of funds for the research area- Priority status (high, medium, or low)

Table 2: Matrix for Priority Research Topics

For Table 2, the participants were asked to cite specific research topics on theissues that were identified in Table 1.

Copies of the matrices and instructions for accomplishing them were sent to theparticipants beforehand, together with the letters of invitation. This was done to facilitate theconduct of the workshop and to ensure a relevant and fruitful discussion.

The outputs of the groups were presented in a forum during the afternoon session.The matrices of the groups are shown in the tables that follow. (Please see attachments.)

HEALTH RESEARCH PRIORITIES FOLLOWING THE STANDARD MATRIXTo consolidate the outputs to arrive at a Regional Health Research Agenda, a

ranking system was used. The ranks assigned to the research areas identified by thegroups e.g. 1, 2, 3, etc. were added. If an area was not included in a groups list, but wasincluded by another group, this area was assigned an arbitrary low rank. After adding theranks, the area with the lowest sum was designated as having the highest priority i.e. thehigher the sum of ranks, the lower the priority.

Thus, using this ranking system, the following are the Regional Health ResearchPriority Areas for CAR:

1. LOCAL HEALTH SYSTEM2. LIFESTYLE-RELATED DISEASES3. WOMEN, CHILDREN, AND ADOLESCENTS IN DIFFICULT

CIRCUMSTANCES (e.g. STI)4. HEALTH INFORMATION SYSTEMS

2. HEALTH POLICY3. ENVIRONMENTAL HEALTH4. HEALTH PROMOTION5. INFECTIOUS DISEASES6. TRADITIONAL MEDICINE7. OVERSEAS FILIPINO WORKERS (OFW)


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Examples of specific research topics identified by the groups are cited below:

Local Health System (Ranked No. 1)

- To determine the factors that affect the functionality of the Inter-Local HealthZone

- To determine the impact of devolution on the effectiveness and efficiency ofthe health care delivery system

- To determine the impact of health programs on intended beneficiaries as abasis for future health policy implementation

Lifestyle Related Diseases (Ranked No. 2)

- To compare locally grown fruits and vegetables with genetically modifiedfruits and vegetables

- To determine the prevalence of cases of lifestyle related diseases

Women, Children, and Adolescents in Difficult Circumstances (Ranked No. 3)

- To determine the factors that subject women and children to difficultcircumstances / situations

- To determine the profile of women in relation to violence against women andreproductive health

Health Information Systems (Ranked No. 4)

- To develop and establish a system of reporting, referring, and networking- To generate a unified health database

Health Policy (Ranked No. 4)

- To determine the impact of migration on health care delivery- To assess and evaluate existing health and education policies

Environmental Health (Ranked No. 4)

- To determine the effects, causes, and levels and extent of pollution

Health Promotion (Ranked No. 5)

- To determine more effective and relevant strategies of health promotion

Infectious Diseases (Ranked No. 5)

- To determine the knowledge, attitudes, and practices of the population in

relation to the prevention and treatment of infectious diseases

Traditional Medicine (Ranked No. 6)

- To identify indigenous flora present in the region that can be used asalternative measures

Overseas Filipino Workers (Ranked No. 7)

- To determine the health benefits of overseas Filipino workers after thecontract is over


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REPORT ON THE FOCUS GROUP DISCUSSION (FGD)

Some of the priority areas for research identified by the participants were stated invery broad terms i.e. lifestyle related diseases, infectious diseases. Thus, the PCHRD,through Ms. Laguimun, recommended that the Regional Facilitator conduct an additionalsmall focus group discussion (FGD) to further refine the outputs of the workshop and tomake the health research prioritization more specific.

The FGD was scheduled on Wednesday, November 16, 2005 at 2:00 p.m. at theSLU College of Medicine. However, the supposed participants were unavailable due to fieldwork and previous out-of-town commitments. Thus, the FGD was postponed and reset toanother date.

We conducted the focused group discussion last January 13, 2005 at the SLUCollege of Medicine, to refine the outputs of the regional consultation workshop and to makethe health research prioritization more specific.

The following were the participants in the focused group discussion:

1. Dr. Elizabeth Fe-Dacanay Regional Facilitator and

Dean, SLU College of Medicine

2. Dr. John Anthony A. Domantay Chairman, Department of PathologySLU College of Medicine

3. Dr. Robert E. Tolentino Executive Director, MOMFISaint Louis University

4. Dr. Nelson Hora Faculty, Department of Communityand Preventive MedicineSLU College of Medicine

5. Dr. Catherine T. Gomez Chairman, Department of PediatricsSLU College of Medicine

6. Dr. Julius Alcala Medical Specialist IIDepartment of Health-CAR

7. Dr. Cybelle Luz Abalos Medical Services CoordinatorCHESTCORE

8. Dr. Wener Paul Irmscher Faculty, Department of MedicineSLU College of Medicine

9. Dr. Christine Ayochok Faculty, Department of PathologySLU College of Medicine

10. Dr. Catalina Toquillo Resident, Department of PathologySLU Hospital of the Sacred Heart


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We also invited the following to the focused group discussion but they could notattend due to previous and simultaneous commitments:1. Dr. Antonio Bautista Infectious Disease Control Cluster

DOH-CAR

2. Dr. Florence Reyes City Health OfficerBaguio Health Department

3. Dr. Celia Brillantes Medical Officer VBaguio Health Department

4. Dr. Elvira Belingon Medical Specialist IIDOH-CAR

5. Dr. Evelyn Dayot ChairmanCordillera Coalition Against TB

6. Mr. Joey Lubrica Project Evaluation OfficerPHILHEALTH-CAR

7. Dr. Ana Marie Leung Chairman, Department of

Community and PreventiveMedicine

SLU College of Medicine

8. Dr. Myrna M. Espiritu Chairman, Department ofMicrobiology and Parasitology


9. Dr. Elizabeth E. Gallardo Faculty, Department of PediatricsSLU College of Medicine

10. Dr. Roma Anna G. Dumaup Chairman, Department ofObstetrics and Gynecology


The group discussed the regional health research priority areas in terms of specificresearch projects that could be undertaken. The research projects were conceptualizedand prioritized based on the following criteria:

1. Magnitude of the issue or problem to the community2. Feasibility of the research based on existing capabilities3. Impact on research and development on the population in terms of mortality

and morbidity, quality of life, social desirability, cost of health care, and inanticipating future health problems or issues.

4. Impact of research on the health issues being addressed

5. Neglect of the area of concern by other government agencies

After discussion and deliberation, the group agreed upon five priority research areasand six specific priority research topics. These are presented in the succeeding tablefollowing the standard matrix.


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MATRIX FOR PRIORITY RESEARCH TOPICSOUTPUT OF FOCUS GROUP DISCUSSION HELD AT THE SLU COLLEGE OF

MEDICINE ON JANUARY 13, 2006Colum

n 1Column 2 Column 3 Column 4 Column 5

IssueofConcer

n

SpecificResearch Topic

Rationale for theResearch

General Objective ofthe Research Study

AgencyResponsible for

Implementation

RankedNo. 1:LocalHealthSystem

Devolution:Attitudes ofImplementorsand End-Users ofthe Local HealthCare System inSelectedMunicipalities ofthe Baguio-Benguet Area

Despite devolution offunds for health care, ithas been observedthat basic health careservices remainunavailable to manypeople in theCordilleras.

To determine theattitudes towardsdevolution ofimplementors andend-users of the localhealth care system inselectedmunicipalities of theBaguio-Benguet area.

To bedeterminedby PCHRD

RankedNo. 2:LifestyleRelatedDiseases

Prevalence andRisk Factors forHypertensionAmong Residentsof SelectedMunicipalities inthe Cordillera

Hypertension and itsassociated diseaseshave overtakeninfectious diseases asleading causes ofmorbidity and mortalityin the Cordillera region.

To determine theprevalence and riskfactors forhypertension amongresidents of selectedmunicipalities in theCordillera


RankedNo. 3:Women,Children, and

Adolescents inDifficultCircumstances

Knowledge,Attitudes, andPractices ofCordilleraWomenRegarding

ReproductiveHealth

There are beliefs andpractices concerningreproductive healthwhich are unique to theculture of theCordilleras.

To determine theknowledge, attitudes,and practices ofCordillera womenregardingreproductive health


RankedNo. 4:EnvironmentalHealth

Levels of AirPollution inVarious Areas ofBaguio City fromJanuary toDecember 200_

Baguio City is said tohave the highest levelof air pollution in thecountry, but there hasbeen no study thatmeasures air pollutionin different areas of thecity in all months of the

year.

To determine thelevels of air pollutionin various areas ofBaguio City duringdifferent times of theyear



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RankedNo. 5:InfectiousDiseases (1)

AntibioticSensitivityPatterns ofMycobacteriumtuberculosisIsolates in BaguioCity

Tuberculosis remainsan important cause ofmorbidity and mortalityand is curable, butthere has been nostudy of the antibioticsensitivity patterns ofMycobacterium

tuberculosis isolates inthe Cordillera region.

To determine theantibiotic sensitivitypatterns of isolates ofMycobacteriumtuberculosis inBaguio City


InfectiousDiseases (2)

Knowledge,Attitudes, andPracticesRegardingTuberculosisAmong Residentsof SelectedMunicipalities inthe Cordillera

There are beliefs andpractices concerningTuberculosis as adisease which areunique to the culture ofthe Cordilleras.

To determine theknowledge, attitudes,and practices ofresidents of selectedmunicipalities in theCordillera regardingTuberculosis



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ANNEXES

ANNEX A

HEALTH RESEARCH AGENDA SETTINGREGIONAL CONSULTATION WORKSHOP

sponsored by:

Department of Science and Technology (DOST)Philippine Council for Health Research and Development (PCHRD)

and theSaint Louis University (SLU) College of Medicine

Thursday, October 27, 2005, 8:00 a.m. 4:00 p.m.Golden Pine Hotel

Legarda Road, Baguio City

P R O G R A M

8:00 9:00 a.m. REGISTRATION

9:00 10:00 a.m. OPENING CEREMONIES

I. Invocation Dr. Ana Marie R. LeungChairman, Department of Preventive

and Community MedicineSLU College of Medicine

II. The Philippine National Anthem

III. Welcome Address andIntroduction of Participants Dr. Elizabeth Fe-Dacanay

Dean, SLU College of MedicineRegional Facilitator for CAR

IV. Overview of the RegionalHealth Situation Dr. Julius Alcala and

Dr. Elvira BelingonMedical Specialists IIDepartment of Health CAR

V. Setting the Regional and ZonalHealth Research Agenda Ms. Teresita O. Laguimun

OIC, Human Resources andInstitution DevelopmentDivision

PCHRD

10:00 10:30 a.m. BREAK

10:30 12:00 noon WORKSHOP

12:00 1:00 p.m. LUNCH


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1:00 2:00 p.m. Continuation of Workshop

2:00 3:00 p.m. Presentation of Workshop Outputs

3:00 3:30 p.m. BREAK

3:30 4:00 p.m. Synthesis and Recapitulation

4:00 p.m. Closing RemarksDr. Allan FeranilChief, Research Management Development

ProgramPCHRD

Master of Ceremonies:Dr. John Anthony A. Domantay



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ANNEX B

LIST OF PARTICIPANTSRegional Consultation Workshop

On the Unified Health Research AgendaOctober 27, 2005

Golden Pine Hotel, Baguio City

1. Dept. of Interior and Local Government-CAR Ms. Florinda M. GarciaLocal Govt Operations

Officer II

2. Population Commission Ms. Annie D. CalimquimInformation Officer II

3. National Economic Devt. Authority-CAR Ms. Florida FaculoChief, Social DevelopmentDivision

4. Dept. of Social Welfare and Development-CAR Ms. Marcia B. Espinueva

Nutritionist III

5. Dept. of Labor and Employment-CAR Ms. Ma Lourdes RosalAurelio-Bala

Labor Employment Officer III

6. Dept. of Science and Technology-CAR Mr. Menandro B. BuenafeSr. Science ResearchSpecialist

7. CHED-CAR Dr. Ramon SantiagoSupervising EducationProgram Specialist

8. Dept. of Health-CAR Dr. Julius AlcalaMedical Specialist II

Dr. Elvira BelingonMedical Specialist II

9. PHILHEALTH-CAR Mr. Joey V. Lubrica, R.N.Project Evaluation Officer II

10. Department of Agriculture Ms. Leonora K. VerzolaSr. Agriculturist

OIC-Cordillera IntegrationAgricultural ResearchCenter


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11. Baguio Health Department Dr. Florence G. ReyesCity Health officer

Dr. Celia Flor BrillantesMedical Officer V

12. Provincial Health Office-Benguet Dr. Esteban Piok

Provincial Health Officer-Benguet

13. Provincial Health Office-Ifugao Dr. Mary Jo DulnuanProvincial Health Officer-Ifugao

14. Cordillera Coalition Against TB Dr. Evelyn DayotChairman-CORCAT

15. Community Health Education Services Trainingin the Cordillera Region (CHESTCORE) Dr. Cybelle Luz A. Abalos

Medical Services Coordinator

16. Cordillera Womens Education and Resource Center Ms. Lucille Lumas-i

Officials from the Philippine Council for Health Research and Development (PCHRD)

DR. ALLAN FERANILChief, Research Management Development Program

PCHRD

MS. TERESITA O. LAGUIMUNOfficer-in-Charge, Human Resources and Institurion Development Division

PCHRD

MRS. ANGELINA M. AQUINOAdministrative Assistant, Office of the Executive Director

PCHRD

Workshop Facilitators

DR. JOHN ANTHONY A. DOMANTAYChairman, Department of Pathology and Laboratory Medicine


DR. MYRNA M. ESPIRITUChairman, Department of Microbiology and Parasitology


DR. ANA MARIE R. LEUNGChairman, Department of Preventive and Community Medicine



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Secretariat

MRS. MARIETTA E. CASTROSecretary, Office of the Dean


MR. RUBEN SIA(Documentation)

Laboratory CustodianSLU College of Medicine

MR. LEYNARD R. MARRERO(Student Assistant)Second Year Mayor


REGIONAL FACILITATOR FOR CAR

DR. ELIZABETH FE-DACANAY

Dean, SLU College of Medicine

Documents

NUHRA Regional CAR Agenda