The document summarizes a project to improve maternal and family health in Eastern Visayas, Philippines. The project will establish 11 cooperative-based health enterprises over 3 years to increase access to services for underserved groups. It aims to serve at least 15,000 clients through trained health promoters. The project will be funded by an EU grant and counterparts, with subgrants going to primary cooperatives to operate social health enterprises.

1. Eastern Visayas Area Cooperation for Health
(Enhancing Access to and Utilization of Maternal & Family Health
Services by Selected Underserved Sectors in Eastern Visayas
through the Co-operative Enterprise System)
With support from:

2. Overview
1. Challenge and
opportunity
2. Our response
3. What we intend to
accomplish in 3 years
4. How we do it
5. The partners

3. The Challenge ... and Opportunity
• 11 Filipino mothers die every day in the
Philippines
• EV one of the top 5 worst places to be a mother
• EV Maternal Mortality Rate (Deaths per 100, 000
live births) 229.8 (2004)*
• EV Total Fertility Rate(number of children within
reproductive years) 4.3 (2008) – top 4 regions
* compared with 110 in Thailand, 62 in Malaysia
and 14 in Singapore; only 62% of births are
supervised by skilled personnel
Challenge and opportunity…

4. http://web.evis.net.ph/neda8/index2.php?option=com_content&do_pdf=1&id=131; accessed: 19January2011
• HIV infections rising (Cebu outbreak: 1 in 2
IDUs is infected!)
• Worsening poverty in EV: 35.3% in 2003 to
40.7% in 2006
• Under-five mortality is second highest (64
deaths) – ARMM (94 deaths) (NDHS, 2008)
• Prevalence of Underweight Children (0-6 years
old) 18.1 % (2009)
Challenge and opportunity…

5. http://web.evis.net.ph/neda8/index2.php?option=com_content&do_pdf=1&id=131; accessed: 19January2011
• Basic Literacy Rate 90.1%
(2003)
• Functional Literacy Rate 76.7%
(2003) 79.7% (1994)
• Elementary Net Enrolment
Ratio 76.2% (SY 2008-2009)
• Secondary Net Enrolment Ratio
44.7% (SY 2008-2009)
• Elementary Cohort Survival
Rate 61.6% (SY 2008-2009)
• Secondary Cohort Survival Rate
63.6% (SY 2008-2009)
Challenge and opportunity…

6. Reasons for high maternal mortality:
1. biological causes and risk factors
2. poor access to health facilities and quality
maternal services
3. inadequate political support as manifested by
lack of budget and unsupportive policy
environment
4. societal and cultural factors
Challenge and opportunity…

7. The Health Care System
• “Dilapidated shacks for the poor and gleaming
palaces for the rich” …. i.e., public health system
inadequate to meet growing needs; private
health system highly commercialized
• PNoy government emphasis on ‘universal access’
to health care
• Health financing schemes on offer, e.g., DBP loan
for PPPs on health
• Back to ‘primary health care’ approach: can we
put health back into the hands of communities?
Challenge and opportunity…

8. Self-reliant, healthy and
prosperous family (and
communities)
Our Response:
The 3rd Leg
Coop Sector-
Government Sector- based
based Healthcare Healthcare
Business Sector-
based Healthcare
Our response …

9. COOPERATIVE-BASED HEALTH SYSTEM STRENGTHENING FOR MFH
Access to
Coop-operated MFH facilities/programs
efficient and
effective
maternal
and family
Business-operated MFH health
Women, young facilities/programs including
girls and men family
planning
and HIV
Government-operated prevention
MFH facilities/programs services
CLIENTELE GROUPS SERVICE POINTS OBJECTIVE
PRINCIPLES: community ownership; gender equity; continuum of quality care
APPROACHES: primary health care approach; CO/CD approach; social enterprise approach
STRATEGIES: behavior change communication; coop-based service delivery; linkaging & networking
Our response …

10. DOMAINS & INTERVENTIONS
SYSTEMS LEVEL
Coordination and
consolidation for synergy
(see: Results 5 & 6)
OBJECTIVE
ORGANIZATIONAL LEVEL
Enhance GOAL
Enterprise development access to
INPUTS for service delivery efficient and Reduce
(see: Result 4) effective maternal
funds, maternal and and child/
family health
technology family
including mortality
and human INDIVIDUAL LEVEL
family and
resources Learning processes planning and morbidity
for behavior HIV
prevention
change and
services
competency
development
(see Results 1, 2
& 3)
CONCEPTUAL FRAMEWORK
Our response ……

11. 1 Objective
To enhance access to efficient, effective, quality
and affordable maternal and family health
including family planning and HIV prevention
services to underserved groups in selected
communities in Eastern Visayas.
What we intend to accomplish…

12. 3 Performance Indicators
1. Improved level of KASP of target population
2. Increased percentage of co-op women, girls
and men accessing health services
3. Increased percentage of coverage (by area,
by type of client groups) and reach of health
service/s provided by co-operatives
What we intend to accomplish …

13. 5 Planned Results within 3 Years
 Result 1: Effective behavior change
communication (BCC) modules
 Result 2: Fully-informed and motivated clients
availing of services
 Result 3: Capable health workforce
 Result 4: Viable coop-based health-focused
initiatives/enterprises (11)
 Result 5: Effective project management and
support mechanism
What we intend to accomplish…

14. After 3 years: 11 viable health
enterprises
at least 15,000 clients
served by at least 70 well-trained
health promoters
a co-op based ‘social health
enterprise technology package’
in at least 10 model towns/areas
with a regional support mechanism
(EVAcoh + TAF)
What we intend to accomplish…

15. What’s in it 4my co-op?
1. Additional service/benefit to
members => better use of loan
=> more productivity
2. Convert a cost-center to
another profit-center => more
profitability
3. Compliance to social audit =>
more community relevance
and impact
What we intend to accomplish…

16. EVAcoh PROJECT FUNDING AND FUND USE SCHEME
Using the EU grant + counterpart:
1. Technical assistance (e.g., trainings, etc)
2. Equipment/tools/ commodities/etc.
TOTAL PROJECT (case-to-case, depending on approved
BUDGET = PHANSuP-VICTO business type/plan)
EUR 645,400
EUROPEAN COOP-BASED
COMMISSION GRANT SOCIAL HEALTH
= 3. Subgrant (equivalent to EUR
EUR 580,860 10,000 max inclusive of ENTERPRISE
counterpart @ 1:3 leverage ratio) (SHE)
COUNTERPART =
EUR 64,540
(Health Enterprise PRIMARY CO-OP
Fund, HEF c/o 10
primary co-ops as sub-
grantees) = Using the subgrant: NET
EUR 35,000 1. Staffing INCOME
(@35% of subgrant amount)
2. Equipment/tools/ commodities/etc.
+
PHANSuP-VICTO cash 3. Space lease (if outside of co-op >10%
counterpart = property
TAF
EUR 29,540 )
NOTES: Amount of subgrant will be based on approved business plan.
TAF = Technical Assistance Fund
How we do it ……

17. PROJECT
PROJECT STEERING PHANSuP = 3 (1 Chair, 2 members)
MANAGEMENT COMMITTEE VICTO = 3 (1 Vice-chair, 2 members)
STRUCTURE DOH Region 8 = 1 (member)
PROJECT DIRECTOR
(3 years)
PROJECT MANAGER
(3 years)
ASST MGR FINANCE & TRNG & CAP BLDG
ADMIN (3 years) SPECIALIST (2 years)
ACCOUNTING KM & COMMS
ASSISTANT (3 years)
OFFICER (3 years)
OFFICE ASSISTANT
(3 years) LIAISON & ADVOCACY
OFFICER (3 years)
COMMUNITY ENGAGEMENT
DRIVER/MESSENGER TEAM LEADER
(3 years) (1 year)
PROJECT PROJECT PROJECT
COORDINATOR COORDINATOR COORDINATOR
(3 years) (2 years) (1 year)
How we do it ……

18. Key Activities: Year 1
• PMO set-up
• Baseline research
• BCC materials development
• Trainings and workshops
• SHE establishment
• Mentoring
• Annual review and planning
How we do it ……

19. Learning Domains
Learning Domain Indicative Learning Areas
1 Maternal and Family Health Promotion of maternal and neonatal health and
nutrition
Prevention of infectious diseases (TB, hepa,
influenza, etc)
Promotion of AYSRHR and prevention of
STI/HIV/AIDS
Prevention and management of lifestyle
diseases
Gender and prevention of violence against
women and children
2 Social Health Enterprise Business planning and establishment
Business operations (marketing, finance,
service delivery)
Business impact and sustainability
How we do it ……

20. Co-operative Venture Partners (CVPs)
1 Silago Multi-Purpose Cooperative (SMPC)
Silago, Southern Leyte
2 Sts. Peter & Paul Multi-Purpose Cooperative (SPPMPC)
Hinunangan, Southern Leyte
3 San Isidro Parish Multi-Purpose Cooperative (SIPMPC)
St. Bernard, Southern Leyte
4 Bontoc Multi-Purpose Cooperative (BCCI)
Bontoc, Southern Leyte
5 St. Francis Xavier Housing MPC (SFXHM)
Abuyog, Leyte
6 Help First Basey MPC (HFBMPC)
Basey, Samar
7 Palapag Teachers’ Cooperative
Palapag, Northern Samar
Northern Samar Development Workers Credit Cooperative
8 (NSDWCC)
Catarman, Northern Samar
9 Biatungan Multipurpose Cooperative
Calbayog City, Samar
Libagon Area Multi-porpuse Cooperative
10 Libagon, Southern Leyte
The partners ……

21. Allen
Palapag
Calbayog
Basey
Abuyog
Silago
Bontoc
Hinunangan
St Bernard
The partners …… Libagon

22. The Joint Venture Partners: 18 + 41
Philippine NGO Support Program, Inc. (PHANSuP)
• started in 1993 as one of the two country-level pilot projects
in Asia and Africa of a group of donor agencies and
international organizations to test a model to accelerate
support to grassroots organizations in response to HIV
• in 1994, it was incorporated into a non-stock, non-profit
institution and kept its name, PHANSuP, becoming 1 of the 2
pioneer ‘linking organizations’ of the International HIV/AIDS
Alliance
• in 2008, it widened its development pathway to cover the
entire sphere of community development with health and
enterprise development, anchored on human rights, as the
entry points.
The partners ……

23. VICTO National Co-operative Federation and Development Center
(VICTO National)
• established in 1970 in Hinundayan, Southern Leyte
• in 1991, VICTO was the first country awardee on Development
Management given by the Asian Institute of Management (AIM)
• in 2003, it was recognized by the Benigno S. Aquino Foundation
(BSAF) as one of the 20 organizations in the country that continues
to work with the legacy of Ninoy in disadvantaged communities
• one of the largest secondary co-operative organizations in the
Philippines with 215 active affiliate co-operatives that continue to
be a mechanism for collective action to social transformation.
• it has spun off its financing arm called the Visayas Co-op Central
Fund Federation (VICTO-VCF), which has 210 member co-ops and
total assets of over P210 million.
10+2 = ?
The partners ……