BUCAS supporting DOH 8 Health Priorities

1
The 8 Priority Health
Outcomes and
Recommended Services for
BUCAS and PuroKalusugan
National Convention of the DOH Representatives
November 14, 2024
Link: bit.ly/DPCB-DOHRepPresentation

Department of Health
/doh.gov.ph
Republic of the Philippines
2
Part I.
Overview of Targets and Key Strategies for 2025

1. Immunization: Increase Fully Immunized Children to 95% from 72%
2. Nutrition (First 1,000 Days): Decrease stunting to 13.5% from 27% (Half)
3. Water Supply, Sanitation and Hygiene (WASH): Increase percentage of population with access to safe water
from 88% to 100%
4. Maternal Health: Decrease maternal deaths to <111 per 100,000 live births from 154 per 100,000 live births
5. Tuberculosis and HIV: Tuberculosis - Zero TB Case Mortality Rate from 34 per 100,000 population and HIV -
85% of PLHIV should be diagnosed, 85% of those diagnosed with HIV should be receiving antiretroviral
therapy (ART), and 85% of all those receiving ART should achieve viral suppression
6. Road Safety: Decrease death rate attributed to road injuries to 4 per 100,000 population from 8 per 100,000
population
7. Non Communicable Diseases, specifically Hypertension and Diabetes: Increase coverage for hypertension
and diabetes mellitus management
8. Non Communicable Diseases, specifically Cancer: Increase early detection, screening, and treatment
of cancer
Primary Care - 8 Priority Health Outcomes
DOH Strategic Focus
3

D
Functional data
monitoring
system
B
Ensure Adequate
Human
Resources
A
Ensure
Adequate
logistics
CIncrease
demand
1. Immunization
Indicators and Targets:
Program
Indicators
Baseline (2023) 2024 2025 2026 2027 2028
% of Fully Immunized
Child (FIC)
62.3% 95% 95% 95% 95% 95%
% of infants 0-12mos
old who received 1st
dose of Pentavalent
vaccine
78% 95% 95% 95% 95% 95%
% of infants 12 mos old
who received 2 doses
of Measles Mumps
Rubella (MMR) vaccine
69% 95% 95% 95% 95% 95%
National and Regional Milestones for 2025
At least 25% of all municipalities have developed policies supporting immunization
Fully functioning National Immunization Technical Advisory Group (NITAG) and National
Immunization Committee (NIC)
Full implementation of the NIP Acceleration Plan 2024-2025 and Initiation of the National
Immunization Strategy 2025-2030
Updated Administrative Order on the National Immunization Program Across the Life course
Procurement of 100% required vaccines and ancillaries, eliminating stock-outs
All NIP managers and coordinators have undergone training on at least Basic Immunization
Principles, with opportunity to receive training on Reaching Every Purok Strategy, Vaccine
Cold Chain and Logistics Management, Mid-level Management training face to face or through
e-modules from the DOH Academy
Fully functional dashboards to monitor accomplishments and tracking of logistics for
monitoring
*All antigens across the lifecourse with 95% immunization coverage annually
4

D
Integrating Maternal and
Child Nutrition Services in
Healthy Settings and
Flagship Programs
A
Policies
Improving
Access to
Nutrition
Interventions
C
Ensuring
Adequacy of
Commodities
B
Mobilization of Community
Volunteer Workers and
Institutionalization of
Nutritionist Dietitians in
Primary Care Facilities
2. Nutrition
Program Indicators Baseline (2023) 2024 2025 2026 2027 2028
Impact
Prevalence of Stunting (0-5 years
old)*
26.7
(2021 ENNS)
24.5
22.3 13.5
Program Indicators
1. Proportion of Pregnant Women
completed Iron Folic Acid/MMS
supplementation
38.63%
(2023 Partial
FHSIS data)
65% 70% 75% 80%
85
%
2.1 Proportion of live births
initiated on breastfeeding within 1
hour after delivery
83.54%
(2023 Partial
FHSIS data)
85% 87% 89% 91%
95
%
3. Proportion of children given
Vitamin A supplementation
disaggregated by age group and
dose (6-11 mos given 1 dose of
100,000 IU and 12-59 mos given 2
doses 200,000 IU)
90.58 %
(6-11 mos)
37.86%
(12-59 mos)
(2023 Partial
FHSIS data)
95%
80%
40%
95%
85%
45%
95%
90%
50%
95%
95%
55%
95
%
95
%
60
%
*Official Source NNS (every 3 years), Annual OPT for local
planning purposes
Malnutrition is caused by multiple factors, hence, will need
multisectoral actions and cannot be solved by the health sector alone.
National Guidelines on Establishment of Nutrition Support Groups
Expansion of Maternal Care Package
Development of SBCC for IYCF
Capacity Building of Assessors on Harmonized Validity Guidelines and Standards for
Facilities and Workplaces
Digitalization for Nutrition Phase 1 (NNC-NSD)
Mobilization of Community Volunteer Workers (BHW, BNS)
Increase Fund Support for Nutrition Program Implementation
Timely and Adequate Procurement of Nutrition Commodities
5

3. Water Supply, Sanitation and Hygiene (WASH)
Program Indicators Baseline
(2023)
2024 2025 2026 2027 2028
1. Increase percentage
of households with
access to safe water
88% 92% 94% 96% 98% 100%
2. Percent LGUs
declared as Zero Open
Defecation (ZOD)
33% 46% 60% 73% 86% 100%
A
Capacity building
of LGUs on
sanitation and
drinking water
quality monitoring
E
Strengthen
regulation and
enforcement
on water and
sanitation
services
B
Increase
investments for
WASH
D
Strengthen
coordination and
networking among
national water and
sanitation agencies
C
Provision of technical
assistance for zero open
defecation program
LGUs declared as ZOD
Implementation of output based aid with blended ﬁnancing (OBA-BF) for
household sanitation in 16 regions or at least 30 sanitation projects.
67% (1000/1642) of LGUs with functional local drinking water quality
monitoring committee
13 functional regional water laboratories
20 drinking water quality improvement project completed
6

1. Maternal Mortality
Ratio
MMR = 154
(PSA, 2021) <124 <114 <104 <94
<84
[SOH
directive]
<111
1.a. Maternal deaths
by age group
10-14, 15-19,
20-49
*Maternal deaths disaggregation
to be included in the FHSIS
2,478
(PSA, 2021);
914
(FHSIS, 2022)
<1,692 <1,556 <1,419
<1,28
3
<1,146
[SOH
directive]
1,515
2. Demand Satisfied with
Modern FP Methods (Ds) Ds = 58.1
(NDHS, 2022)
62.4% 64.5% 66.6% 68.7% 70.8%
4. Maternal Health
D
Hiring of
Community
Navigators, &
Continuous
Capacity
Building of
healthcare
workers
A
Review
compliance on
MOA of birthing
facilities and
referral pathways
E
Standardization
of health
promotion and
IEC materials
B
Strengthening
the reporting of
maternal deaths
and conduct of
Maternal and
Neonatal Death
Surveillance and
Response
C
Ensure availability of
life-saving drugs and
other maternal and FP
commodities
7

D
Sustain
Initiate System for TB
Death Review
Stronger Private
Sector Engagement
A
Find
Maximizing use of
new technologies
and approaches
to find and
diagnose TB
cases
CPrevent
Access to
shorter TPT
regimen and
SBCC for TPT
B
Treat
Use Shorter
treatment regimen,
Digital Adherence
Tools and iDOTs
expansion
5A. Tuberculosis
2024 2025 2026 2027 2028
TB case mortality rate
from 34 per 100k
population towards Zero
34/100,000 (2022)
Source: WHO Global TB Report
2023
(39,000)
29
20 10 3 0
- TB Case Notification -
(include Notification
from the private
providers)
612,002
575,770 705,075 660,095 618,219 576,397
- TB Treatment Success
Rate, DS and DRTB
DS: 77%
DR: 63%
DS: 80%
DR:75% DS: 85%
DR:80%
DS: 90%
DR:85%
DS: 90%
DR:90%
DS: 90%
DR:90%
- % TPT Coverage -
(include PLHIV)
17% 45%
50% 55% 65% 75%
100% of P/CWHS with established referral system and access to new
technologies for screening and testing
90% of private sector reporting cases and treatment outcomes
100% of CHDs with budget for 1Q buffer of FLDs
Policy on TPT for HWs and PDLs
100% of regions with RCC (Governance structure)
At least 1 province demonstrated for zero TB deaths
8

5B. HIV-AIDS and STIs
Program Indicators
Baseline
(2023)
2024 2025 2026 2027 2028
1. % of PLHIV know their status 63%* ≥70% ≥75% ≥80% ≥85% ≥85%
2. % of diagnosed PLHIV on
life-saving ART (alive on ARV)
63%* ≥70% ≥75% ≥80% ≥85% ≥85%
3. % of PLHIV on established ART
are virally suppressed
36%* ≥50% ≥60% ≥70% ≥80% ≥85%
D
Sustain
Legislation, policy
development, collaboration
with other relevant
stakeholders and resource
mobilization
A
Find
rHIVda expansion
One online HIV
platform via
user-friendly app
(prevention, test, treat
and care), streamlined
and upgraded OHASIS
C
Prevent
Prevention
combination
strategies
(IECs, condom
and lubes,
PrEP, and PEP)
B
Treat
Use of safer treatment regimen
Expansion of treatment hubs and
enhancement of service delivery
with appropriate manpower
complement
OPLAN PROPEL
PrEP enrollment: 96,600
50% of treatment hubs (hospital- based) and primary HIV care facilities
(stand- alone/ RHU) should be rHIVda sites
Streamlined and upgraded OHASIS that is comprehensive and responsive
to the needs of the end-users and program which include commodity
inventory and monitoring module
Issuance of relevant policies on combination prevention (IEC, PrEP, PEP),
testing and treatment
Full transition to dolutegravir-based regimens (TLD) among those on
efavirenz based regimens.
25% of government-owned PCFs have trained HIV counselors and are able
to provide at least HIV screening. 9

D
Inter-Agency/Multi
Sectoral Collaboration
with other
government agencies
and stakeholders A
Policy
Development
Advocate for the
passage of the
EMSS bill and Local
Ordinance
C Training Package on
Emergency
Preparedness and
Response for Road
Crashes (Medical
First Responders
Course, Emergency
Medical Responders
Course, Hospital
Preparedness for
Emergencies
Course)
B
Training
Emergency Preparedness
and Response Program for
LGUs; ONEISS
6. Road Safety
1. Number of DOH hospitals
(aligned with HFDB -Phil Health
Facility Development Plan)
recognized as :
- 20 Trauma Care
(Advance/Basic)
15 Trauma
centers
(Per DO
2021-0001
Designation of
Specialty
Hospitals)
15 Trauma
Centers
1
Trauma
Center
2
Trauma
Centers
1
Trauma Center
1
Trauma Center
2. Percentage of LGUs
Capacitated to respond to road
crashes
℅ DRRMOs
(Lay
Responders
BLS-CPR)
30% of
LGUs with
EMS linked
with Trauma
Centers
60%
of LGUs
with
EMS
linked
with
Trauma
Center
80% of
LGUs with
EMS linked
with
Trauma
Center
100%of LGUs
with EMS
linked with
Trauma Center
100%of LGUs
with EMS
linked with
Trauma Center
3. Percentage of health facilities
implementing the ONEISS
- Government/Private
Hospitals
156/1,772
(8.80%) trained
hospitals
implementing
ONEISS
ONEISS
Review/
Capacity
Developm
ent
75% 100% Sustain/
Expansion
to RHUs
Sustain/
Expansion
to RHUs
Training of Trauma Centers and LGUs to manage/ respond to road crashes
Procurement of Technical Services/ Equipment
Health Promotion Strategies
10

D
Collaboration and
Partnership
A
Formulation of
guideline
implementation
tools
C Inclusion of
multidrug
combination
therapy in the
PNF
Procurement
and provision
of NCD drugs
B
Revision of
PhilPEN Protocol
Conduct of
capacity building
7. Hypertension and Diabetes Mellitus
Indicators and Targets
2024 2025 2026 2027 2028
1. Proportion of patients who
were risk assessed using
the PhilPEN protocol
a. Adult (20-59 years old)
b. Elderly (60 years old
and above)
10.57%
(FHSIS,2022)
30% 35% 40% 45% 50%
2. Proportion of identiﬁed
hypertensive adults and
elderly provided with
antihypertensive
medications
83%
(PMIS, 2020)
For
base-lining
(℅ FHSIS)
87.25% 91.5% 95.75% 100%
3. Proportion of type 2
diabetes mellitus adults and
elderly provided with
diabetes medications
63%
(PMIS, 2020)
For
base-lining
(℅ FHSIS)
80% 85% 90% 100%
Updating of the PhilPEN Protocol
Development of training module on updated PhilPEN Protocol
Inclusion of additional risk factor indicators in the FHSIS
Procurement and provision of medicines
11

A
Health promotion
and cancer
prevention
E
Reduced financial
burden across the
continuum of care
B
Early detection
(screening and early
diagnosis) for treatable
cancers
D
Increased treatment
completion and
improved
survivorship care
C
Timely diagnosis and
prompt treatment of
cancer patients
Indicators Baseline
(2023)
2024 2025 2026 2027 2028
Cervical Cancer
1. HPV Vaccination Coverage - All Regions
(9-14yo)
4.7% 5%
20% 35% 50% 65%
2. Proportion of women 30-65 years old
screened for cervical cancer using Visual
Inspection with Acetic Acid (VIA) or Pap
Smear or Human Papillomavirus
Deoxyribonucleic Acid (HPV DNA)
0.44% 3%
5% 15% 20% 25%
3. Proportion of women 30-65 referred
for treatment
TBD
(For HBCR
Review)
60%
70% 80% 90% 100%
4. Proportion of referred women
provided with treatment
TBD
(For HBCR
Review)
80%
80% 80% 80% 80%
Breast Cancer
1. Proportion of women screened for
breast mass under the Konsulta Package
1.78% 5%
10% 15% 20% 30%
3. Proportion of enrolled breast cancer
patients who completed the prescribed
multimodality treatment
TBD 10%
20% 30% 40% 50%
Finance for Treatment
1. Proportion of enrolled patients
provided with Cancer Assistance Fund
(CAF) support
100%
100% 100
%
100% 100%
12
8. Cancer
NITAG and HTAC recommendation on single dose regimen released
New guidelines on Breast Cancer screening approved
HTAC recommendation on the use of HPV DNA kits released
CAF AND CSPMAP Evaluation. Revised AO on CSPMAP approved; and
CAF utilization expanded to other cancers
Five (5) Digital PBCR Institutionalized
ALL Access sites with dedicated patient navigator

/doh.gov.ph
13
Part II.
Recommended Services for
BUCAS and PuroKalusugan

Recommended Referral
Adapted from Annex C of Administrative Order 2020-0019 and BUCAS Primer v2 as presented during the 3rd NHSM
14
BUCAS

Priority Health Outcome BUCAS Centers PuroKalusugan
1. Immunization ● BCG vaccine (1 dose)
● OPV (3 doses)
● Pentavalent vaccine (3 doses)
● Measles-containing vaccine (2 doses)
● Vaccination schedules per purok for FIC antigen
● Social mobilization
2. Nutrition ● Screening during routine consultation (history + PE)
● MUAC and anthropometrics
● Supplementation (Maternal Iron and folic acid, Vitamin A)
● Nutritional screening, including MUAC + anthropometrics
● Supplementation (Maternal Iron and folic acid, Vitamin A)
● Advocacy on exclusive breastfeeding
● Community engagement for nutrition-sensitive
interventions
3. WASH ● Screening during routine consultation (history + PE) ● Proﬁling of household for WASH access
● Health promotion and education activities
4. Maternal Health ● Antenatal, Postnatal & Emergency Services
● Iron and Folic Acid Supplementation
● Calcium carbonate supplementation
● Provision of Family Planning Services (Counselling, provision of
preferred method and Follow up care)
● Screening and Diagnostic Services for Pregnant Women
● Screening during Antenatal Care Visit
● Linking of pregnant patients to birthing facilities
● Postnatal care services
● Family planning counseling
● Provision of Family Planning Commodities (condoms and
OCP only)
● Iron and Folic Acid Supplementation
● Calcium carbonate supplementation
● Demand generation activities
Recommended Services
based on AO 2022-0018: Development and Utilization of the Omnibus Health Guidelines per Lifestage
15

5A. TB ● Screening during routine consultation (history + PE)
● Bacteriological test - use of Rapid Diagnostic Tool (RDT) (e.g.
Sputum Xpert MTB/RIF or Xpert Ultra)
● Radiologic Test - Chest Xray
● i-DOTS Facility for initiation of treatment, monitoring of treatment
adherence, sputum follow-up tests, clinical assessment of TB
condition, contact-tracing for provision of TB preventive Therapy
(TPT), TB education and information activities
● Reporting to the i-TIS (integrated TB information system) for
Program monitoring and disease surveillance
● Screening and active case-ﬁnding
● Referral to TB-DOTS facilities and case monitoring
5B. HIV ● Screening during routine consultation (history + PE) to include
syphilis screening
● HIV RDT, CD4 count
● Comprehensive eye exam
● CBC, Basic Blood chemistry, Urinalysis
● Dispensing of ART; PrEP and PEP with condoms and lubes
● Point of care Viral Load Testing
● Screening for TB
● Provision of TB Preventive Therapy (TPT)
● Referral to i-DOTS facility for TB Diagnosis and TB treatment
● Reporting to the One HIV, AIDS, STI Information System (OHASIS)
for Program monitoring and disease surveillance
● Screening activities, including HIV self-testing
● Support to Treatment/Case monitoring
● Referral to Social Hygiene Clinics
● Provision of Combination Prevention (CombiPrev)
commodities such as, IEC, condoms, lubes, and PrEP, PEP
● Symptom-based screening on TB Referral for TB services
● Demand generation activities
16

6. Road Safety ● Routine advice for road safety and driving safety during routine consultation
● Basic Life Support and CPR (Including bag-valve ventilation)
● Basic Emergency Care for Trauma and Injuries
● Referral to trauma and related
health services
● Health promotion and education
7. Hypertension and Diabetes
Mellitus
● Screening and risk assessment during routine consultation (history + PE)
● BP measurement (office and ambulatory); waist circumference; BMI
● Visual Acuity Screening
● Recommended additional labs for hypertension at primary care (12-L ECG, FBS, Lipid
Profile, Serum Creatinine, Sodium, Potassium, eGFR, urinalysis)
● Recommended labs for DM at primary care (FBS or HbA1c, 75g OGTT, urinalysis)
● Treatment/ Provision of recommended maintenance medications
● Risk assessment
● Referrals
activities
8. Cancer ● Screening and early detection of cancer (history + PE)
● Vaccination
● High-risk HPV testing or Cervical cytology or Visual inspection with acetic acid (VIA)
● Mammography (in BUCAS that are within the hospital compound)
● Clinical breast exam
● Digital Rectal Exam
● Prostate Specific Antigen Test
● Liver ultrasound + alpha-fetoprotein (AFP)
● Low-dose CT (in BUCAS that are within the hospital compound)
● Upper GI series (in BUCAS that are within the hospital compound)
● Upper Endoscopy (in BUCAS that are within the hospital compound)
● EBV DNA or Nasopharyngoscopy (in BUCAS that are within the hospital compound)
● FOBT or FIT
● Colonoscopy (in BUCAS that are within the hospital compound)
● HPV and HBV vaccination
● Screening for cervical cancer and
clinical breast examination
● Early detection (e.g. childhood
cancer symptoms) using Physical
Examination
● Navigation of financial assistance
within LGUs
activities (smoking and vape
prevention; alcohol use prevention;
improving healthcare seeking
behavior)
17

Recommended Activities
Guide for PuroKalusugan Teams
Checklist of Recommended Activities Recommended Services to be Provided
Step 1: Announcement of Services
Step 2: PuroKalusugan Lectures / Assembly ✓ Health promotion and education on the
PuroKalusugan initiative
✓ Demand generation on the PuroKalusugan
initiative
Step 3: Household Visits for Health Profiling, if yet to be done. Can skip to Step 4 if
health data among the constituents is already available
✓ Household Profiling
✓ Screening
Step 4a: Referral of patients needing
services not offered within RHU (e.g Konsulta
enrollment, TB-DOTS, Social Hygiene Clinic)
Step 4b: RHU-level microplanning for
scheduling of visits for missed and/or
other targeted recommended services
✓ Referral
✓ Prioritization of programs, among the 8,
that the PuroKalusugan team will focus on
Step 5a: Check household if referred patients
visited the facility
Step 5b: Go to household to deliver
services based on microplan
✓ Provision of health services
✓ Program-specific health promotion and
education
✓ Program-specific demand generation
18

/doh.gov.ph
Part III.
Role of the DOH Representatives
19

/doh.gov.ph
(2021)
Attainment of the 8 Priority Health Outcomes
Role of DOH representatives
• Advocate to the LCEs and other stakeholders for the prioritization of the 8 priority health outcomes in the activities
to be done by the LGUs for F.Y. 2025-2026
• Provide support in the development, review, and monitoring of the the local plans for health service delivery
References for development of work plans
• 2025 Milestones: National Action Plan bit.ly/8Priorities-ActionPlan
• Regional Activities: Regional Action Plan bit.ly/3rdNHSM-RegionalPlan
• Delivery of interventions through BUCAS and PuroKalusugan: 3rd NHSM Outputs bit.ly/3rdNHSM-8Priorities
Reference on other services for integrated and comprehensive primary care in BUCAS Centers and PuroKalusugan
• Omnibus Health Guidelines for Children (0 to <10 years old), Adolescents (10-19 years old), Adults (20-59 years old),
and Elderly (>60 years old) https://doh.gov.ph/dpcb/omnibus-health-guidelines/
• DOH-approved CPGs https://doh.gov.ph/dpcb/doh-approved-cpg/
• Health Examination Forms bit.ly/DC2023-0556-HEF or
https://doh.gov.ph/dpcb/implementation-of-national-practice-guidelines/
• NTP MOP 6th Edition https://ntp.doh.gov.ph/download/ntp-mop-6th-edition/
• PrEP and PEP Guidelines for PLHIVs
20

/doh.gov.ph
21
Maraming salamat po!

BUCAS supporting DOH 8 Health Priorities

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BUCAS supporting DOH 8 Health Priorities