ETHELYN P. NIETO, MD, MPH, MHA, CESO III ETHELYN P. NIETO, MD, MPH, MHA, CESO III Undersecretary of Health Undersecretary of Health Health Program Development Cluster Health Program Development Cluster DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH PRESENTED AT THE 1 ST NATIONAL STAFF MEETING 2007 FOUR FOUR MULA MULA ONE FOR HEALTH ONE FOR HEALTH Updates on the Implementation Updates on the Implementation
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ETHELYN P. NIETO, MD, MPH, MHA, CESO III Undersecretary of Health Health Program Development Cluster DEPARTMENT OF HEALTH PRESENTED AT THE 1 ST NATIONAL.
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ETHELYN P. NIETO, MD, MPH, MHA, CESO IIIETHELYN P. NIETO, MD, MPH, MHA, CESO IIIUndersecretary of HealthUndersecretary of Health
Health Program Development ClusterHealth Program Development ClusterDEPARTMENT OF HEALTHDEPARTMENT OF HEALTH
PRESENTED AT THE 1ST NATIONAL STAFF MEETING2007
FOURFOURMULA MULA ONE FOR HEALTHONE FOR HEALTHUpdates on the ImplementationUpdates on the Implementation
Service Delivery – Service Delivery – Public Health Program DevelopmentPublic Health Program Development
1. Disease – Free Zone Initiatives
a. Malaria
b. Filariasis
c. Schistosomiasis
d. Rabies
e. Leprosy
2. Intensified Disease Prevention & Control
a. TB
b. VPI
c. HIV/AIDS
d. Emerging & RE-Emerging Infectious Diseases
e. Dengue
Service Delivery – Service Delivery – Public Health Program Public Health Program
DevelopmentDevelopment
3. Maternal & Child Health
4. Healthy Lifestyle & Risk Management
Service Delivery – Service Delivery – Health Facilities Development Health Facilities Development
ProgramProgram
1. Rationalization of Local Health Facilities
2. Upgrading of Local Health Facilities
3. Health Human Resource Capacity Building
4. Rationalizing Services & Strengthening Management Systems in Health Facilities
5. Integrating wellness services in hospitals
Service Delivery – Service Delivery – Strengthening Surveillance & Strengthening Surveillance & Epidemic Management SystemEpidemic Management System
1. Creation & Strengthening of Epidemic and Surveillance Units
2. Setting up of Surveillance Systems
3. Linkage with private sector
Service Delivery – Service Delivery – Strengthening of Disaster Strengthening of Disaster Preparedness & Response Preparedness & Response
SystemSystem
1. Advocacy/BCC
2. Localization of IEC messages
3. Reproduction of localized IEC messages
Service Delivery – Service Delivery – Health PromotionHealth Promotion
UPDATESUPDATES
NSM ResolutionNSM Resolution Actions TakenActions Taken Resp. Resp. OfficeOffice
Operationalization Operationalization of Priority of Priority ProgramsPrograms
Disease-Free Zones Disease-Free Zones InitiativesInitiatives
Filariasis (Cont.)Filariasis (Cont.) -Mass Treatment in 35 Mass Treatment in 35 provinces; Conduct of provinces; Conduct of Mid-MDA Survey to det. Mid-MDA Survey to det. MFR as a result of mass MFR as a result of mass treatmenttreatment
Results:Results:
a. 42/43 sentinel sites a. 42/43 sentinel sites with reduced MFRwith reduced MFR
b. 8 endemic provinces b. 8 endemic provinces w/ reduced MFRsw/ reduced MFRs
NCDPCNCDPC ensure high MDA ensure high MDA coveragecoverage
- Need to - Need to strengthen strengthen Disability Disability Prevention aspect Prevention aspect of elimination of elimination programprogram
NSM ResolutionNSM Resolution Actions TakenActions Taken Resp. Resp. OfficeOffice
Operationalization Operationalization of Priority of Priority ProgramsPrograms
Intensified Disease Intensified Disease Prevention and Control Prevention and Control InitiativesInitiatives
TuberculosisTuberculosis - Nationwide - Nationwide implementation of DOTSimplementation of DOTS
- TB in Children - TB in Children expanded to 1 city/ expanded to 1 city/ regionregion-100 PPMD Units 100 PPMD Units installedinstalled- 470 DOTS facilities 470 DOTS facilities certified, 370 accreditedcertified, 370 accredited-Programmatic MDR-TB Programmatic MDR-TB ManagementManagement-Training on Hospital-Training on Hospital-based NTP DOTSbased NTP DOTS
NCDPCNCDPC Funding for Funding for expansion of expansion of Childhood TB & Childhood TB & MDR - TBMDR - TB
NSM ResolutionNSM Resolution Actions TakenActions Taken Resp. Resp. OfficeOffice
Operationalization Operationalization of Priority of Priority ProgramsPrograms
Intensified Disease Intensified Disease Prevention and Control Prevention and Control InitiativesInitiatives
HIV-AIDSHIV-AIDS - Establishment of - Establishment of Social Hygiene Clinics & Social Hygiene Clinics & Local AIDS CouncilsLocal AIDS Councils- Community-based Community-based programsprograms- Home-based careHome-based care-Preliminary activities for Preliminary activities for the integration with MCH the integration with MCH ProgramProgram
NCDPCNCDPC Drafting of HIV Drafting of HIV Benefit Package Benefit Package GuidelinesGuidelines
NSM ResolutionNSM Resolution Action TakenAction Taken Resp. Resp. OfficeOffice
-Adoption of Reaching Adoption of Reaching Every Barangay strategy Every Barangay strategy (60% of health facilities)(60% of health facilities)-Memo to CHDs to Memo to CHDs to prioritize top 31 prioritize top 31 provinces/cities w/ high provinces/cities w/ high unimmunized childrenunimmunized children-100% fund availability 100% fund availability for EPIfor EPI-Integration through 4Bs Integration through 4Bs (Bakuna, Bitamina A, (Bakuna, Bitamina A, Breastfeeding, purga sa Breastfeeding, purga sa Bulate)Bulate)
NCDPCNCDPC -Pockets of low -Pockets of low immunization immunization coveragecoverage
-Reported data in -Reported data in cities disparate cities disparate from validated datafrom validated data-Inventory Inventory managementmanagement-Increasing routine Increasing routine OPV3/DPT3/AMV OPV3/DPT3/AMV from current 80% to from current 80% to 95% to achieve 95% to achieve eliminationelimination
NSM ResolutionNSM Resolution Action TakenAction Taken Resp. Resp. OfficeOffice
Operationalization Operationalization of Priority of Priority ProgramsPrograms
Intensified Disease Intensified Disease Prevention and Control Prevention and Control InitiativesInitiatives
EREIDs (Avian EREIDs (Avian Influenza)Influenza)
- Establishment of AI - Establishment of AI Task Forces (Nat’l, Task Forces (Nat’l, Reg’l, Prov’l, Mun’l)Reg’l, Prov’l, Mun’l)-Development of Development of Preparedness & Preparedness & Response Plans (up to Response Plans (up to Mun’l level)Mun’l level)-Capability-building Capability-building activities up to the activities up to the Barangay levelBarangay level-Procurement of Procurement of antivirals, PPEsantivirals, PPEs-IEC materials IEC materials developeddeveloped
NCDPCNCDPC - Advocacy to LCEs - Advocacy to LCEs to allocate funds for to allocate funds for Preparedness & Preparedness & Response act.Response act.
- Adequacy of - Adequacy of supplies (antivirals, supplies (antivirals, vaccines, PPEs)vaccines, PPEs)
- Readiness of - Readiness of referral facilitiesreferral facilities
- M & E of initiatives - M & E of initiatives by various sectorsby various sectors
NSM ResolutionNSM Resolution Action TakenAction Taken Resp. Resp. OfficeOffice
-Capability-building act -Capability-building act on Promotion & on Promotion & Advocacy of HLAdvocacy of HL
-Development of -Development of National Tobacco National Tobacco Control Prog. – Smoking Control Prog. – Smoking Cessation Clinics; Cessation Clinics; Integrated NCD Integrated NCD Prevention & Control Prevention & Control ProgramProgram
-Development of the -Development of the National Environmental National Environmental Health Action PlanHealth Action Plan
-Technical Assistance in -Technical Assistance in the Guimaras Oil spillthe Guimaras Oil spill
NCDPCNCDPC -Strong influence of -Strong influence of MNCsMNCs
-Availability of low--Availability of low-priced anti-HPN priced anti-HPN drugsdrugs
-Lack of -Lack of organizational/ organizational/ financial/facility financial/facility preparedness to preparedness to address chemical address chemical accidentsaccidents
NSM ResolutionNSM Resolution Action TakenAction Taken Resp. Resp. OfficeOffice
Operationalization Operationalization of Priority of Priority ProgramsPrograms
Maternal & Child Maternal & Child HealthHealth
- Modeling of Mother-- Modeling of Mother-Baby Friendly Baby Friendly Community & Community & WorkplaceWorkplace-Institutionalization of Institutionalization of IMCI training modules in IMCI training modules in training institutionstraining institutions-Manual & Trng. on Salt Manual & Trng. on Salt Iodization Tech. & QAIodization Tech. & QA-Strategic Plan for Strategic Plan for Integrated Helminth Integrated Helminth Control ProgramControl Program-Policy & Plan on Child Policy & Plan on Child Injury PreventionInjury Prevention
NCDPCNCDPC -TRO on IRR of EO -TRO on IRR of EO 5151-Low immunization Low immunization coverage for TT coverage for TT (37%)(37%)-Exclusive BF (’03): Exclusive BF (’03): 33.5%33.5%-Ave. Length of Ave. Length of Exclusive BF (‘03): Exclusive BF (‘03): 0.8 mos.0.8 mos.-Difficulty of getting Difficulty of getting Garantisadong Garantisadong Pambata & Patak Pambata & Patak sa Asin Reportssa Asin Reports
NSM ResolutionNSM Resolution Action TakenAction Taken Resp. Resp. OfficeOffice
- Establishment of - Establishment of BEmOC Training BEmOC Training CentersCenters
NCDPCNCDPC -Need to replicate Need to replicate trainings on trainings on BEmOC & Revised BEmOC & Revised FP Manual FP Manual nationwidenationwide-Not all LGUs are Not all LGUs are providing full providing full support for their support for their contraceptive contraceptive suppliessupplies- Need for active Need for active participation of participation of private sector in private sector in NFP (e.g. church)NFP (e.g. church)
Development of Central Development of Central Office *PIF indicators to Office *PIF indicators to for Performance-Based for Performance-Based Budgeting SystemBudgeting System
Strengthening of Strengthening of Disaster Disaster Preparedness & Preparedness & Response SystemResponse System
-Development of the ff.:-Development of the ff.:
a.Weapons for Mass a.Weapons for Mass Destruction Hospital- Destruction Hospital- Based ManualBased Manual
b.Guidelines on b.Guidelines on Expanded Utilization of Expanded Utilization of BP 5 Compact FoodBP 5 Compact Food
c.Guidelines for c.Guidelines for Performance Evaluation Performance Evaluation of CHDs on HEMof CHDs on HEM
d.Standards for d.Standards for developing Emergency developing Emergency Preparedness & Preparedness & Response Plans as Response Plans as requirement for hospital requirement for hospital licensinglicensing
HEMSHEMS
NSM ResolutionNSM Resolution Action TakenAction Taken Resp. Resp. OfficeOffice
Strengthening of Strengthening of Disaster Disaster Preparedness & Preparedness & Response SystemResponse System
-Strengthening of CHD 3 -Strengthening of CHD 3 OPCENOPCEN
-Review & Publication of -Review & Publication of “Pocket Emergency “Pocket Emergency Tool” – 2Tool” – 2ndnd ed. ed.
-Logistic Support -Logistic Support (Mayon, Nitrate (Mayon, Nitrate poisoning, etc.)poisoning, etc.)
HEMSHEMS
NSM ResolutionNSM Resolution Action TakenAction Taken Resp. Resp. OfficeOffice
Issues/Issues/Difficulties Difficulties
EncounteredEncountered
Strengthening Strengthening of Health of Health Promotion to Promotion to effect behavior effect behavior changechange
-.) developed a -.) developed a health promotion plan health promotion plan for the promotion of for the promotion of F1 packageF1 package-Prepared script and Prepared script and produced AVP for F1produced AVP for F1-Composed the F1 Composed the F1 jinglejingle
NCHPNCHP
NSM ResolutionNSM Resolution Action TakenAction Taken Resp. Resp. OfficeOffice
Issues/Issues/Difficulties Difficulties
EncounteredEncountered
Strengthening Strengthening of Health of Health Promotion to Promotion to effect behavior effect behavior changechange
-.) developed health -.) developed health promotion and promotion and communication plans communication plans for the major health for the major health events especially events especially those geared those geared towards:towards:-disease-free zone disease-free zone initiativesinitiatives-- promotion of - promotion of Healthy Lifestyle Healthy Lifestyle
NCHPNCHP - Lack of budget - Lack of budget to sustain tri-to sustain tri-media campaignmedia campaign-Lack of CHD Lack of CHD budget to trickle budget to trickle down national down national campaigns to campaigns to LGU levelsLGU levels-Lack of LGU Lack of LGU activities on face-activities on face-to-face to-face communication to communication to change behaviorchange behavior
NSM ResolutionNSM Resolution Action TakenAction Taken Resp. Resp. OfficeOffice
Issues/Issues/Difficulties Difficulties
EncounteredEncountered
Strengthening Strengthening of Health of Health Promotion to Promotion to effect behavior effect behavior changechange
-.) Conducted -.) Conducted meetings and meetings and workshops to pave workshops to pave the way for the the way for the creation of a Health creation of a Health Promotion Promotion FoundationFoundation
NCHPNCHP - Lack of top - Lack of top management management supportsupport
- Lack of budget - Lack of budget to initiate to initiate preparatory preparatory activitiesactivities
NSM ResolutionNSM Resolution Actions TakenActions Taken Resp. Resp. OfficeOffice
Rationalization of Rationalization of Local Health Local Health Facilities to Facilities to include facility include facility mapping for mapping for BEMOCs & BEMOCs & CEMOCsCEMOCs
A.O. #2006-0029 dated A.O. #2006-0029 dated June 15,2006 issued: June 15,2006 issued: Guidelines on Guidelines on Rationalization of Health Rationalization of Health Care Delivery System Care Delivery System Based on Health NeedsBased on Health Needs
*On-going development *On-going development of Implementation of Implementation Manual (Manual of Manual (Manual of Procedures).Procedures).
*Coordination with *Coordination with Regulatory Bureau Regulatory Bureau (BHFS) requirement for (BHFS) requirement for Certification of Needs Certification of Needs (CON)(CON)
*Used in evaluation of *Used in evaluation of House & Senate Bills on House & Senate Bills on Hosp establishment, Hosp establishment, upgrading, upgrading, renationalization.renationalization.
NCHFDNCHFD Different application Different application due to geographical due to geographical differences.differences.
NSM ResolutionNSM Resolution Actions TakenActions Taken Resp. Resp. OfficeOffice
Upgrading of Upgrading of Local Health Local Health Facilities – Facilities – Infrastructure, Infrastructure, EquipmentEquipment
Under the PGMA Under the PGMA Priority Hospital Priority Hospital Upgrading Project: 22 Upgrading Project: 22 LGU Hospitals for LGU Hospitals for upgrading, amounting to upgrading, amounting to P371.797M; funds sub-P371.797M; funds sub-allotted to CHDs as of allotted to CHDs as of Jan 22, 2007.Jan 22, 2007.
NCHFDNCHFD
Health Human Health Human Resource Capacity Resource Capacity Building for LGU & Building for LGU & National Govt National Govt HospitalsHospitals
-Conducted Training Conducted Training Courses:Courses:
Health Human Health Human Resource Resource Capacity Building Capacity Building for LGU & for LGU & National Govt National Govt HospitalsHospitals
Conducted Training Conducted Training Courses:Courses:
5. Qualitative & 5. Qualitative & Quantitative Analysis of Quantitative Analysis of In-patient Medical In-patient Medical Records; Analysis of Records; Analysis of Hospital Statistical Hospital Statistical ReportReport
6. Clinical Toxicology for 6. Clinical Toxicology for Doctors & Nurses (DOH Doctors & Nurses (DOH Hospitals)Hospitals)
7. Occupational Health 7. Occupational Health & Safety for Hospital-& Safety for Hospital-based Workforce in MM based Workforce in MM Hospitals.Hospitals.
8. Preparedness for 8. Preparedness for Avian/Pandemic Avian/Pandemic Influenza for DOH HospInfluenza for DOH Hosp
NCHFDNCHFD
NSM ResolutionNSM Resolution Actions TakenActions Taken Resp. Resp. OfficeOffice
Health Human Health Human Resource Resource Provision/Capacity Provision/Capacity Building for LGU & Building for LGU & National Govt National Govt HospitalsHospitals
-Conducted Training Conducted Training Courses:Courses:
Health Human Health Human Resource Resource Provision/Capacity Provision/Capacity Building for LGU & Building for LGU & National Govt National Govt HospitalsHospitals
-Conducted Training Conducted Training Courses:Courses:
14. Implementation of 14. Implementation of Integrated Hospital Integrated Hospital Operations & Operations & Management Program Management Program (IHOMP) & Hospital (IHOMP) & Hospital Operations & Mx Operations & Mx Information System Information System (HOMIS) software(HOMIS) software
NCHFDNCHFD
Rationalizing Rationalizing Services & Services & Strengthening Strengthening Management Management Systems in Health Systems in Health FacilitiesFacilities
Updating of Manuals of Updating of Manuals of Operations: Nursing Operations: Nursing Service, Pharmacy, Service, Pharmacy, Dietary Service, Medical Dietary Service, Medical Records, Medical Social Records, Medical Social Service, Administrative Service, Administrative Procedures. Procedures.
Manual of Standards for Manual of Standards for Infection Control issued.Infection Control issued.
NCHFDNCHFD
NSM ResolutionNSM Resolution Actions TakenActions Taken Resp. Resp. OfficeOffice
Rationalizing Rationalizing Services & Services & Strengthening Strengthening Management Management Systems in Health Systems in Health FacilitiesFacilities
-Strategies for reducing -Strategies for reducing high % of primary & high % of primary & secondary services in secondary services in DOH tertiary care DOH tertiary care facilities (“devolution of facilities (“devolution of primary & secondary primary & secondary services”).services”).
-Devolution of primary -Devolution of primary licensed hospital.licensed hospital.
-Continued -Continued implementation of implementation of hospital upgrading hospital upgrading projects to establish projects to establish tertiary care & specialty tertiary care & specialty services in DOH services in DOH Hospitals (Phil. Hospital Hospitals (Phil. Hospital Development Program)Development Program)
Resistance from Resistance from hospital staff; Need hospital staff; Need for longer social for longer social preparation to preparation to influence patient influence patient health seeking health seeking behavior.behavior.
NSM ResolutionNSM Resolution Actions TakenActions Taken Resp. Resp. OfficeOffice
Rationalizing Rationalizing Services & Services & Strengthening Strengthening Management Management Systems in Health Systems in Health FacilitiesFacilities
-Financial Management -Financial Management Systems in Hospitals: Systems in Hospitals: Cost-finding, Rate-Cost-finding, Rate-settingsetting
_ Coordination with _ Coordination with PHIC for new benefit PHIC for new benefit Packages & Financing Packages & Financing opportunities for opportunities for Hospitals:Hospitals:
Integrated Integrated Wellness services Wellness services in Hospitalsin Hospitals
Drafting of AO to Drafting of AO to strengthen MBFHI strengthen MBFHI (inclusion of (inclusion of “mother-friendly” “mother-friendly” strategies.strategies.
TB DOTS Referral TB DOTS Referral System established System established in Hospitals.in Hospitals.