The DTTB Experience Sharing Experiences that Worked By Bien Eli Nillos, MD DTTB Batch 23
Background <ul><li>Candoni, Negros Occidental </li></ul><ul><li>4 th class municipality, one of the poorest towns in Negros Occidental </li></ul><ul><li>Infamous for its history of insurgency – CHICKS area </li></ul><ul><li>Mountainous, no costal areas, largely agricultural </li></ul><ul><li>No health system in place </li></ul>
Top Concerns <ul><li>Maternal and Child Care – high maternal mortality ratio, high infant mortality ratio, low facility-based delivery, low rate of delivery attended by Skill birth attendants, high incidence of malnutrition </li></ul><ul><li>TB Deaths still in top five causes of mortality – low TB case detection rate </li></ul><ul><li>No licensed pharmacies – lack of access to cheaper drugs </li></ul>
Maternal Mortality per 1,000 LBs Facility based deliveries – 24% in 2007 Skilled birth attendant deliveries – 74% in 2007 Top Causes of MM – post-partum bleeding, Pregnancy Induced Hypertension
Infectious (Pulmonary Tuberculosis) Cure Rate – 93% in 2007 No med. Tech. – only 1 midwife microscopist Practicing TB DOTS but not Philhealth accredited
<ul><li>“Primary health care starts with people. Our common humanity compels us to respect people’s universal aspiration for a better life. It compels us to respect the resilience and ingenuity of the human spirit, and the great capacity of individuals and communities to solve their own problems.” (Margaret Chan, WHO Director-General) </li></ul>
<ul><li>“ We will lead and the rest of the world will follow. That’s what they want, to be like us.” – George Bush </li></ul>
<ul><li>“ Change will come when those who have the resources learn that they do not have all the answers…they need to learn how to listen.” – Desmund Tutu </li></ul>
CHART (Community Health Allies and Reform Team)
COMMUNITY HEALTH INITIATIVES PARTNERS (CHIP) Members: Barangay Captains, Brgy. Kagawads for Health, SK, BHW Federation Role: Coordinate all health program implementation at the barangay level, initiate community-based health programs through original approaches.
Relations and Advocacy Managers (RAM) Members: Teachers, Faculty-in-charge, church-based organizations, PNP and other NGO’s Role: help in the promotion of health advocacies in schools and communities through integration.
Legislative Action Network (LAN) Members: Political leaders, councilors, department heads, NGO’s Role: provide strong legislative support for health programs, influence policy in favor of health initiatives
MONITORING team (MONITOR) Members: Program coordinators, DOH representative, PHO/CHD/Philhealth, Public health managers, MPDO, Budget Officer Role: Monitor progress of initiatives, plot outcomes and results and provide feedback to community at large.
Engaging the Community <ul><li>Assembly of hilots and revival of Women’s Health Team </li></ul><ul><li>Legislative support – barangay ordinances </li></ul><ul><li>Increased advocacy and social awareness </li></ul><ul><li>Training of midwives and nurses (refresher’s course) </li></ul>
<ul><li>Upgrading of facilities </li></ul><ul><li>Assignment of Midwife-in-charge of DR </li></ul><ul><li>Alkansiyang Pampamilya </li></ul><ul><li>Buntis Baby Bag </li></ul><ul><li>Barangay Surveillance of “Hilot Activities” </li></ul>
FBD = Facility Based Delivery SBA = Skilled Birth Attendant MMR = Maternal Mortality Ratio
Infant and Child Health Care <ul><li>Under-five Clinic Thursdays – follow up immunizations, feeding activities, consultations, etc. </li></ul><ul><li>Newborn Screening Facility accreditation </li></ul><ul><li>Intensified EPI – BHW surveillance </li></ul>
<ul><li>Establishment of Botika ng Barangays 9/9 </li></ul><ul><li>Establishment of Botika ng Barangay Monitoring Team: DOH representative, Municipal Accountant, BnB Operator, Nurse Coordinator, Brgy. Captain </li></ul><ul><li>Under the LHB </li></ul>
Struggl es of a DTTB “ Between the great things that we cannot do and the small things we will not do, the danger is that we shall do nothing.” -Adolph Monod
“Anything worth doing is difficult” -Patch Adams
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