Community Health Partnership Program –Improving Governance, Health Systemand InstitutionsTowards Improvement ofMaternal and Child Health OutcomesMay 28, 2013Mandaluyong City
Zuellig Family Foundation1901: FromSwitzerland,FrederickZuellig goesto Manila towork in atrading firm1916: Frederickbecomes apartner inanother tradingfirm that he buyssix years later toform the F.E.Zuellig Inc.1943: His Manila-bornsons, Stephen &Gilbert, take over thehelm of the companyafter the death of theirfather and successfullydiversifies and expandsinternationally1997:PharmaceuticalHealth and FamilyFoundation isestablished for thehealth needs ofcommunitiesaround Canlubang,Laguna2001:Foundation is renamedZuellig Foundationwith focus on advocacyfor public health policyreforms and training ofhealth leaders &professionals2008:Following a review of the Foundation’sobjectives, the focus shifts to“improving health outcomesfor the rural poor.” Foundationbecomes a Family Foundation,independent of the Zuellig’svarious business interestsBIRTH OF THE FOUNDATION: The family’s initiative in improving health outcomesGilbertStephen
Health Status in 2008Rich urban Poor ruralLife Expectancy Over 80 years Less than 60 yearsMaternal Mortality Ratio Less than 15 More than 150Infant Mortality Rate Less than 10 Over 90Skilled Birth Attendant 92.4% 25.1%Devolution of the Philippine healthcare system (1991)Fragmentation of health servicesInequities in health outcomesHealth Status in 2008Source: Sec. Alberto Romualdez, MD, State of the Nation’s Health, Centennial Lecture, 2008
ZFF Development Strategy:Health Change Model andBridging Leadership FrameworkLEADERSHIP ANDGOVERNANCEIMPROVED HEALTH SYSTEMTARGETED AND PRO-POORHEALTH PROGRAMSBETTER HEALTH OUTCOMES:LOWER IMR, MMR &MALNUTRITION RATES;LOWER INCIDENCE OFCOMMUNICABLE &NON-COMMUNICABLEDISEASES
Intervention on Health Systems Transformation: Municipal Basic Health System’s Technical RoadmapLeadership &Governance Health Financing Health HumanResourceAccess toMedicine &TechnologyHealthinformationSystemHealth Service DeliveryMunicipalHealthGovernanceMunicipalHealth ActionPlanHealthResourceGenerationandManagementLGU Budget forHealth(15% IRA)RHUandBHSResourcemanagementHealth HumanResource Adequacyat the RHU(MD 1:20,000)(Nurse 1:20,000)DrugManagementSystemPresence ofEssentialMedicineat theRHU(Stock Basis)DataCollection,UtilizationandInformationDisseminationAccomplishedBaseline DataCollectionBarangayHealthInfrastructurePresence of Barangay Health Stations(1 BHS:1 Braangay or 1 BHS perCatchment)Maintenanceand OperationsUtilizationActual budgetUtilization(95% Utilization)RHU HHRCompetencyAvailableTransportation for EmergencyRegular DataGatheringandRecordingMaternalandChildCareSustainable MaternalHealthCareInitiativesPre-NatalServices(at least 80%)Full Implementationof Magna Carta forPublicHealthWorkersExpanded andFunctionalLocal HealthBoardFacility-BasedDevleiries(85%)BLGU HealthBudget(5% of BarangayIRA)Skilled Birth Attendants(85%)InstalledPerformanceManagementSystemSustainableBreastfeedingInitiativesExclusiveBreastfeeding forInfants (70%)RHU MedicineTracking andInventorySystemMaternal/InfantDeath ReviewNewborns InitiatedBreastfeeding(85%)BarangayHealthGovernanceFunctionalBarangayHealthGovernanceBody(withfunctionalCHT)LocalPhilhealthAdministration4-in-1AccreditationSustainable EssentialIntrapartum and NewbornCare InitiativesHealth HumanResource Adequacyin BHS(1 Midwife: 1 Brgy;with consideration toGIDA)(BHW to HH 1:20HH)Sustainable Infantand ChildCareInitiativesFully ImmunizedChild(95%)Regular IEC forEnrolledIndigent(for Q1 and Q2)MonthlyUpdated HealthData BoardUnder-5 MalnutritionPrevalenceRate(Below 17.3%)BHS HHRCompetency(Basic BHW TrainingCourse and CHTTraining)Accomplishment,UtilizationandDisseminationofthe DILG, DOHLGU ScorecardsReproductiveHealthSustainable Adolescent ReproductiveHealth InitiativesReimbursement Filing(PCB, MCP, TB-DOTS) Sustainable FamilyPlanningInitiativesProvisionof FPCommoditiesand Services(RHU)Implementedand IntegratedBarangayHealth PlanContraceptivePrevalenceRate (63%)System for BHWRecruitmentandRetentionMechanisms Creation ofCitizen’s ChraterOrdinance andSystem forClaimsDispositionand UtilizationMonitoringRatio ofCommunity-BasedPharmaccy(1 BNB/CBPcatchment or 1BNB perbarangay)Unmet Needs(50% under NHTS)WaSHSanitary Toilets(86%)Ordnance and TimelyProvisionof BHWHonorariumAccess to Safe Water(87% of HH)
Community Health PartnershipProgramThe Community Health PartnershipProgram (CHPP) incorporates localpartnerships among Mayors,Municipal Health Officers and Socio-civic leaders who are collectivelycalled the “Municipal HealthLeaders.”These leaders undergo trainingmodules to deepen theirunderstanding of health, initiatehealth programs in theircommunities, strengthen health-related institutions and gather theirconstituents’ support for health.
Community Health PartnershipProgramBenefits of the Partnership:• Leadership and Management Training on Health for three participants(municipal mayor, municipal health officer, and a community civicleader)• Opportunity to obtain community health partnership project support• Exposure to various innovative programs and best practices on health• Access to the foundation’s network of health partnersSelection criteria:• Needs improvement in health outcomes as reflected by alarming healthindicators• Presence of a Local Chief Executive (1st or 2nd term) and LocalGovernment Unit staff who are committed to participate and providecommunity health development equity above and beyond those alreadycommitted in their regular budget.
Capability Building ProgramInterventionHealth Leaders for the Poor TrainingAs needed
Critical Factors for Success Selection of LGUs and commitment of local health leaders(Mayors and MHOs) Quality of Training Intervention Accountability for Deliverables during Practicum Presence: Monitoring and Coaching Incentives
Expanding our Reach:DOH-ZFF Health Leadership andGovernance Program
Objectives of the Health Leadership andGovernance Program (HLGP)Department of Health1. Support and promote the leadershipand governance capability buildingto complement the existing technicalexpertise of DOH-CHDs in supportingprovincial and municipal healthleaders2. Institutionalize national policies andprograms that support strengtheningthe health leadership andgovernance at the local levelThe Program aims to create an immediate impact on achieving the healthMDGs by improving local health systems in the 609 priority municipalities.Local Government1. Develop the health leadership andgovernance capabilities of localchief executives needed for asustainable health system;2. Improve health outcomes3. Mobilize public-privatecollaboration to facilitate sharingof resources and replication of bestpractices for sustainability
Program ComponentsHealth Leadership and Governance Program ParticipantsRegions Health Leadership andManagement for the PoorProgram(HLMP)One-year, two-moduleleadership program(Six-months Practicum:Coaching and Monitoring)CHDs, PhilHealth RegionalOffice, DSWD Regional Office,DILG Regional Office, Regionaland Provincial Chief of hospital,Academic PartnerProvinces Provincial Leadership andGovernance Program(PLGP)Three-year,three-module program(Six-months Practicum:Coaching and Monitoring)Governor and PHOMunicipalities Municipal Leadership andGovernance Program(MLGP)One-year, two-moduleleadership program(Six-months Practicum:Coaching and Monitoring)Mayor and MHOCities MLGP-Short Course onUrban Health Equity(MLGP-SCUHE)One-year, two-moduleleadership program(Six-months Practicum:Coaching and Monitoring)City Mayors and City HealthOfficers
HLGP Operational FrameworkZFFHealth Leadership &Management for the Poor(HLMP)CHD “Core Team”:Regional Directors, HRDU Head, LHAD Head, PHTLsDOH Central OfficeBLHD, HHRDB, NCDPC, HPDPB, NCHFDDOH REPRESENTATIVESHealth Leadership &Management for the Poor(HLMP)• Training of Trainers• Training of CoachesAcademicInstitutionsMunicipal Leadership &Governance Program(MLGP) trainingPracticumProvincialLeadership &GovernanceProgram (PLGP)Better HealthOutcomesLower IMR/MMRLower malnutritionratesLower incidence ofcommunicable &non-communicablediseasesCoach and SupportCoachCoachSupport: technical,financial,logisticalfeedbackfeedbackZFF• Mayors• Municipal HealthOfficers• Governors• Provincial HealthOfficers
Three-YearTimeframeThree Waves:• First Cluster: January 2013(IV-A, IV-B, V, VIII, IX)• Second Cluster: June2013(CAR, I, XI, XII, XIII)• Third Cluster: June 2013(VI, VII , X, ARMM, NCR)** ZFF has started training someregions under the ZFF-UNFPApartnershipFour Batches:• First batch: October 2012(9 Provinces under ZFF-UNFPApartnership)• Second batch: August 2013(15 Provinces)• Third batch: September 2013(14 Provinces)• Fourth batch: October 2013(16 Provinces)** ZFF has started training someregions under the ZFF-UNFPApartnership2013•First Batch: August 2013 (at least 100municipalities from Cluster 1 and 2)2014•Second batch: February 2014 (200municipalities: at least 40 from Cluster 3and 160 from Cluster 1 and 2)•Third batch: July 2014 (300 municipalities)CITIES (MLGP-Short Course on Urban HealthEquity) from NCR and other Regions•First batch: January 2014; 30 cities•Second batch: January 2015; 30 cities** Academic Partners will be trained to runthe MLGP
Critical Factors for the Success of theProgram• Support from the DOH Top and Senior Leadership• Selection and commitment of local chief executives• Capability and competencies of the academic partners astraining institutions• Capability and competencies of the DOH-CHDs as coaches• Level of integration and institutionalization in the DOH CHDsand academic partners• Performance-based incentives
Health Leadership and Governance ProgramThank you.