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Health Care Group 1, BSMT II-‐A, Velez College, Cebu City
A written output about Day-‐as Health Center, Barangay Day-‐as, Cebu City in their implementation of the program and services as a Primary Health Care provider in Cebu City. Submitted to: Jogi Rivamonte, RN MN Health Care Instructor
Dec 2010
Primary Health Care Delivery System
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Table of Contents
Cover Page..............................................................................................................................................1
Table of Contents…………………………………………………………………………………………….2
Primary Health Care Delivery System………………………………………………………………3
Spot Map of Day-‐as Health Center……………………………………………………………………4
Barangay Day-‐as History and Profile………………………………………………………………..5
Barangay Day-‐as Health Center Vision and Mission…………………………………………..7
Barangay Day-‐as Health Center Services Offered………………………………………………8
Barangay Day-‐as Health Council Structure……………………………………………………….9
Barangay Day-‐as Health Statistics………………………………………………………………….10
Interview Verbatim……………………………………………………………………………………….13
Bibliography and Group Members…………………………………………………………………16
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PRIMARY HEALTH CARE DELIVERY SYSTEM
An Introduction Primary health care delivery system is an approach for building interventions that lead to improved health outcomes for an entire population. Primary health care model focuses on collaboration of health professionals, community members and others working in multiple sectors, emphasizing health promotion, development of health policies, and prevention of diseases for all individuals. A closer look at each sector finds that they are all linked and that events within each sector have an impact, either positive or negative, on each other and on the outcome of the population’s health.
A primary health care approach requires a multi-‐sectoral approach by addressing many of the determinants of health. Primary care, which focuses on personal health services, is a key concept in primary health care model. However, primary health care looks beyond primary care, with essential elements that include health education, proper nutrition, maternal/child health care, family planning, immunizations, and control of locally endemic diseases.
In the Philippines, it roots back in the year 1979 when the Primary Health Care model was adopted. This was also supported by the ratification of the Local Government Code of 1991 where it provides the decentralization of health care systems and mandates the local governments to manage their own health care system.
The Philippines primary health care delivery system is at par with the PHCDC in the rest of the world. The Philippine primary health care delivery system is composed of barangay, the smallest administrative division of the Philippines, municipal, and Medicare health care institutions with facilities and capabilities for first contact emergency care. It can usually be found in rural health units that are found in areas which are not industrialized, chest clinics, malaria eradication units, schistosomiasis control units, puericulture clinics for maternal and child cases, private clinics and company clinics.
In connection with the primary health care delivery system, the group conducted an interview in a selected implementer of the primary health care delivery system, which is the Barangay Day-‐as Health Center to be able to understand the situation, and how the system works to gain knowledge of it. The report aims to give a bird’s eye view on the situation of Barangay Day-‐as Health Center with reference to the submitted reports and through the conducted interview.
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Spot Map of Day-as Health Center
The light green figure encompasses the total area of jurisdiction of Barangay Day-‐as and the yellow line points at the location of the Barangay Health Center of Barangay Day-‐as which is strategically located at corner Imus, and Sikatuna Streets, Cebu City.
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Barangay Day-as History
In the primitive times, Cebuanos got their sources of living from the abundance of natural resources of their native land.
One of this was fishing. Because of the wide seas that surround Cebu, fishing became one of the most well known livelihoods. It was during the Spanish regime when there began a tight competition among fisher folks who were from a barrio named Day-‐as, in the town of Cordova in Opon, Lapu-‐lapu city, supplied the fishes along the interior part of Imus street. As they visited the place, they frequently did their daily business, and that part of Imus formally adopted the name “DAY-‐AS”. It was in 1910 that barangay Day-‐as was formally established, alongside the merry-‐making activities that old folks were celebrating that day.
Barangay Profile Official Name Barangay Day-as
Sitios 11 which includes:
1. Sitio Ulidamin
2. Sitio Moonpeace
3. Sitio Beavers
4. Sitio Upper Day-as
5. Sitio Lower Day-as
6. Sitio Peralta Compound
7. SItio Jester
8. Sitio JYC
9. Sitio Feathers Gala
10. Sitio Saba
11. Sitio Tender Hearts
Punong Barangay Hon. Rey Ellery E. Canada
Barangay Councilors Hon. Nikki Dingal
Hon. Jerome Puerto
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Hon. Jovie Francisco
Hon. Mariter del Rosario
Hon. Jherell Lui
Hon. Anthony Daanton
Hon. Edgar Esmas
Population as of Year 2009 5250 constituents
Registered Voters Approximately 3000
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Barangay Day-as Health Center
Vision A responsive department guided by highly principled leadership, with
professional human resources adapting different health strategies, supported by strong inter/intrasectoral partnership, focusing on the underprivileged residents
leading to a healthy and empowered populace. Paglantaw
Usa ka maabtik nga departamento nga giniyahan sa usa ka tawong halangdon ug may prinsipyong pinasubay sa professional nga mga tawhanon ug modernong teknolohiya, pinaagi sa lain-‐laing kusganong panaghugpong sa gawas ug sulud sa komunidad nga ang tuyo mao ang pag-‐abot sa maayong serbisyong panglawas hangtud sa kinapobrehang tawo o molupyo sa komunidad nga ang tumong mao
ang pagmugna ug usa ka mahimsog nga katilingban.
Mission 1. To provide the highest standard of quality health care services to all
especially the underserved through the Primary Health Care approach.
2. Meet the spiritual, moral, social and economic needs of health.
3. Deliver health care services in an integrated convergent manner.
4. Continuous professional education and development of health workers.
Buluhaton 1. Paghatag ug dekalidad nga serbisyo sa maayong panglawas sa tanan
hangtud sa kinatumyang dapit sa komunidad pinaagi sa Primary Health Care approach.
2. Atong tumong nga mahatag ngadto sa katawhan dili lang ang aspetong Pisikal kon dili hasta na ang Moral, Spiritual nga katilingbanong kalihukan ingon man ang ekonomikanhong pagpanginahanglan sa
katawhan.
3. Paghatod sa maayong serbisyong panglawas pinaagi sa usa ka kinatibuk-‐ang katilingbanon nga mga kalihukan.
4. Pagbansay sa health workers, paghatag ug dugang nga bag-‐ong pamaagi aron sila maumol ug mabansay sa usa ka epektibong solusyon.
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Barangay Day-as Health Center Services Offered
SAFE MOTHERHOOD:
• Prenatal Check-‐ups
• Post Natal Check-‐ups
• Health Education
CHILD CARE:
• Immunizations
• Deworming
• Monthly Weighing
• Feeding Program
• Health Education
PREVENTION AND CONTROL OF INFECTIOUS DISEASES/NON-COMMUNICABLE DISEASE CONTROL:
• Lab Exams
• Sputum Exams
• Health Education on Self Examinations
• Health Education on Infectious Diseases
HEALTHY LIFESTYLE TEACHING:
• Health Education
• Clean-‐up Drives
• Lecture on Proper Diet
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Barangay Day-as Health Council Structure
The Day-‐as Health Center is under the jurisdiction of Cebu City Health Office that is under the City Mayors Office. Mayor Michael Rama, being the head of Cebu City and the different departments of the Cebu City government is placed at the topmost portion of the organization structure. The Cebu City Health Officer, Dr. Stella Ygonia, then follows him in the structure. The health centers are under the field program of the Cebu City health that is headed by Dr. Evelyn Villamor. Under the field program, two area medical officer are assigned to Barangay Day-‐as and they are Dr. Gloria Paz and Dr. Flordeliza Yazar. In the health center setting, the area medical officer is the head of the health center, there are different supervisors, in the Dental Services it is Dr. Cristy Lodovice and in the Nursing Services it is Grace Borromeo. Under the Dental services, one dentist is serving Barangay Day-‐as, she is Dr. Chona Calinawan. There is also 1 midwife serving Barangay Day-‐as, Melinda Tigley and assisting her are two Barangay Health Workers namely Anna Opada and Rachel Daclar.
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Barangay Day-as Health Statistics
Morbidity Top 5 Cases of Morbidity as of September 2010
Case Number of Cases Upper Respiratory Tract
Infection (URTI) 26 Cases
Hypertension (HPN) 22 Cases
Lock-‐up 20 Cases
Urinary Tract Infection (UTI) 9 Cases
Diabetes Mellitus 8 Cases Source: Day-‐as Health Center
Mortality There are no reported mortality cases due to morbidity or health related reasons in Day-‐as Health Center for the year 2010 but on the month of October 2009, there was 1 case of Mortality due to Dengue Fever. Most of the mortality cases are due to age-‐related causes.
Ratio of Health Care Personnel to recipients Ratio of Health Care Personnel to Recipients
Health Care Personnel Ratio Doctors 1:2625
Nurse 1:5250
Dentist 1:5250
Midwife 1:5250
BHW 1:2625
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Ratio of Health Care facilities to recipients
Ratio of Health Care Facilities to recipients Health Care Facility Ratio Sphygmomanometer 1:1750
Weighing Scale 1:2625
Delivery Table 1:2625
Dental Chair 1:5250
DOS kit 1:5250 Source: Day-‐as Health Center
Problem on lack of health personnel and health facilities:
It is already a reality in the Philippine setting that there is a lack of health personnel and health facilities, however, Barangay Day-‐as tried to cope with it through the following measures to ensure that if not all, majority of their constituents will receive health care:
1. Scheduling of Activities-‐ this is to prevent swarming inside the health center and it gives venue for particular cases to be focused on.
PHM Clinical Activities Day Activity
Monday Family Planning
Tuesday Morbidity
Wednesday Immunizations at Pari-‐an
Thursday Prenatal at Day-‐as
Friday Dispensory, Recording
Saturday Home Visits
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2. Aside from scheduling the Day-‐as health center said that its health workers are enough especially the Barangay health workers because they are following what the city health office has mandated, to have atleast 1 BHW for every 2000 citizens.
3. For the health care facilities, the Day-‐as health center said that their health care facility is not lacking and it can accommodate every patient that goes to the health care facility for the reason that it is not from time to time that a facility is used and it is not from time to time that a certain case occur.
4. For the medicines, Day-‐as health center employs a first come-‐first served basis because there is a lack of medicine. However, the medicines are given for free.
Role of the community: The Day-‐as Health Center has emphasized that the only role of the community in the different activities and services they are extending to them is their cooperation. They have stressed that if there is no cooperation in the community, the programs, or activities will defeat its purpose. 70% cooperation is seen in every activity that they are undertaking, the remaining 30% necessitates the health care personnel to give follow-‐ups and let they comply be it with their schedules, medications or immunizations.
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Interview Verbatim
Interview with a Barangay Health Worker that took place at the Health Center of Day-‐as last December 11, 2010.
Group 1 Rep: Maam good morning. Daghan kaayong salamat sa inyong pag-‐accommodate sa amo bisan pa nga daghan mog activities karon adlawa kay pista man diay ninyo.
BHW: Ok ra man, wala nay problema pasensya kay wala ang midwife maong ako ray gibinlan diri, ug ako lang sad tubagon sa asa nako kutob matubag ang inyo mga pangutana.
Group 1 Rep: Maam, dinhi man jud ka gatrabaho sa health center noh? Kanang, unsa man jud ang inyo ginapaningkamutan maabot or mapaninguhaan or inyong objectives ba ngano naa ning health center?
BHW: Makita man na sa atong mission ug vision noh nga atong gisunod gikan sa Cebu City Health, pero personally, kung ako imo pangutan-on, ang amoa jud gipaninguhaan kay ang kaayuhan sa amo constituents. Mao siguro na.
Group 1 Rep: So mao jud na ang goal maam?
BHW: Yes, mao na ang goal namo, nga mapaninguhaan ang kaayuhan sa mga taga dinhi sa Day-as.
Group 1 Rep: Diba maam nakahisgut ka nga kaayuhan sa constituents, unsa unsa man sad ang mga strategies or policies nga inyong ginabuhat para makuha na?
BHW: Kanang kung unsay giingon sa amo sa City Health Office, mao na among mga polisiya sad. Sama anang mga vaccination, immunization, or weighing in sa mga bata. Mao sad na amo ginabuhat.
Group 1 Rep: Maam, sa mga milabay nga mga bulan, unsa may pinakataas nga kaso sa kasakitan sa inyo constituents?
BHW: Sa amo report, kanang mga kasong mga ubo ubo, pneumonia ug mga high blood ang taas.
Group 1 Rep: Wala bay lain sama sa Dengue?
BHW: Wala, naay uban kaso pero gagmay raman sad.
Group 1 Rep: Niya maam, sa kana nga mga kasakitan, aduna sad bat ay mga taas nga kaso sa kamatayon dinhi or kanang gitawag nga mortality rate?
BHW: Mao nay wala diri, so far karong tuiga, wala pa miy kaso sa patay tungod sa sakit ka yang mga tawo muduol man daun diri kung magkasakit, ang mga namatay kay tungod sa katiguwangon.
Group 1 Rep: Tinuod ka maam? Kanus-‐a lang inyo last naay namatay?
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BHW: Tinuod, aduna diay miy usa ka kaso last October 2009, dengue iya gikamatyan, bata siya, 9 years old.
Group 1 Rep: Unsa may mga health services nga ginahatag diri maam?
BHW: Daghan man, aduna tay immunizations, mag-apud apud sad ta ug mga tambal kaso first come first serve lang kay kulang kaayo ta sa tambal. Magbuhat sad mi ug pagpanudlo sa mga ginikanan, sa anak para healthy sila.
Group 1 Rep: Maam, ikaw ra ba usa nga BHW?
BHW: Dili aduna koy kauban usa pero wala siya karon diri kay nagclean-up drive.
Group 1 Rep: Niya maam, aside sa inyo nga mga BHW, kinsa pa man ang lain personnel dinhi sa health center?
BHW: Aduna tay duha ka doctor nga magpuli-puli diri, tungod kay dako kaayo ila scope, sugod pa sa Kamagayan kutob diri, dili jud na sila permanente makit-an diri. Aduna sad tay usa ka nurse, usa ka midwife, ug usa ka dentist.
Group 1 Rep: So kompleto jud diay mo maam sah?
BHW: Kompleto jud.
Group 1 Rep: Niya maam inyong mga health care facilities, sa imo panan-‐aw dili raba kulang para sa mga pasyente?
BHW: Kung maghisgot ta ana, sa ako panan-aw, dili raman, kay dili man na kada minuto naay manganak, dili man na kada minuto naay magpaibot ug ngipon, mahatagan ra pud ug oras ang mga muari diri.
Group 1 Rep: Tinuod maam? As in wala jud kuwang?
BHW: Wala jud, naa nuon sa mga tambal. Usahay 100 ra kabuok muabot, naa gani to panahon nga 6 lang ka paracetamol kay ako man ni-assist atong pagkuha sa tambal.
Group 1 Rep: Unsaon sad na ninyo pag-‐hatag maam nga kuwang man jud na, di man na kaabot ug 5 mil?
BHW: Mao nang first come first served basis jud basta tambal, pero sa uban, dili na.
Group 1 Rep: Mao ba maam, maam, last pangutana, diba kamo nagahatag man mo ug serbisyo sa katawhan, unsa man inyo gina-‐expect in return or unsa ang role sa mga katawhan ani?
BHW: Usa lang jud amo gihangyo nila. Ila cooperation. Kay dili man gud ni mamahimong successful kung dili sila mutabang sa amo. Aduna tay 70% nga katawhan nga mu-cooperate pero ang 30% kinahanglanon pa jud nimo ifollow-up kay aron mutunga lang jud sa ila schedule, mga tambalanay, ug uban pa. Mao nang usahay magvisitation sad mi aron maadtuan na namo sila kay sugo raman sad na sa City Health kung makadawat mi ug mag-pasurveillance sila, mao nang magvisitation mi.
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Group 1: Salamat kaayo maam, pasensya sa disturbo.
BHW: Way problema.
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Bibliography Kozier, Barbara et al. Fundamentals of Nursing: Concepts, Process and Practice 7th Edition. Philippines: Prentice Hall 2004
Potter, Patricia and Anne Griffin Perry. Fundamentals of Nursing 6th Edition. Philippines: Elsevier PTE LTD 2005
Borromeo, Ignatius C. Velez College Health Care Manual. N.p. 2009
Group Members Atheus Zacharry Siacor James Annjo Salomon Krissa Flores Jeena Megan Tanco Kimberly Cabonita Dennis Baritua Rey Perez-‐ Group Leader BSMT 2A Health Care Second Semester 2010-‐2011
