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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:
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
The Challenge ... and Opportunity
ā€¢ 11 Filipino mothers die every day in the
  Philippines
ā€¢ EV one of the top 5 worst places to be a mother
ā€¢ EV Maternal Mortality Rate (Deaths per 100, 000
  live births) 229.8 (2004)*
ā€¢ EV Total Fertility Rate(number of children within
  reproductive years) 4.3 (2008) ā€“ 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 opportunityā€¦
http://web.evis.net.ph/neda8/index2.php?option=com_content&do_pdf=1&id=131; accessed: 19January2011




ā€¢ HIV infections rising (Cebu outbreak: 1 in 2
  IDUs is infected!)
ā€¢ Worsening poverty in EV: 35.3% in 2003 to
  40.7% in 2006
ā€¢ Under-five mortality is second highest (64
  deaths) ā€“ ARMM (94 deaths)                                                                          (NDHS, 2008)



ā€¢ Prevalence of Underweight Children (0-6 years
  old) 18.1 % (2009)

 Challenge and opportunityā€¦
http://web.evis.net.ph/neda8/index2.php?option=com_content&do_pdf=1&id=131; accessed: 19January2011




ā€¢ Basic Literacy Rate 90.1%
  (2003)
ā€¢ Functional Literacy Rate 76.7%
  (2003) 79.7% (1994)
ā€¢ Elementary Net Enrolment
  Ratio 76.2% (SY 2008-2009)
ā€¢ Secondary Net Enrolment Ratio
  44.7% (SY 2008-2009)
ā€¢ Elementary Cohort Survival
  Rate 61.6% (SY 2008-2009)
ā€¢ Secondary Cohort Survival Rate
  63.6% (SY 2008-2009)
 Challenge and opportunityā€¦
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 opportunityā€¦
The Health Care System
ā€¢ ā€œDilapidated shacks for the poor and gleaming
  palaces for the richā€ ā€¦. i.e., public health system
  inadequate to meet growing needs; private
  health system highly commercialized
ā€¢ PNoy government emphasis on ā€˜universal accessā€™
  to health care
ā€¢ Health financing schemes on offer, e.g., DBP loan
  for PPPs on health
ā€¢ Back to ā€˜primary health careā€™ approach: can we
  put health back into the hands of communities?

Challenge and opportunityā€¦
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 ā€¦
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 ā€¦
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 ā€¦ā€¦
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 accomplishā€¦
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 ā€¦
5 Planned Results within 3 Years
ļ‚§ Result 1: Effective behavior change
  communication (BCC) modules
ļ‚§ Result 2: Fully-informed and motivated clients
  availing of services
ļ‚§ Result 3: Capable health workforce
ļ‚§ Result 4: Viable coop-based health-focused
  initiatives/enterprises (11)
ļ‚§ Result 5: Effective project management and
  support mechanism

                What we intend to accomplishā€¦
After 3 years: 11 viable health
          enterprises
      ļƒ¼at least 15,000 clients
      ļƒ¼served by at least 70 well-trained
       health promoters
      ļƒ¼a co-op based ā€˜social health
       enterprise technology packageā€™
      ļƒ¼in at least 10 model towns/areas
      ļƒ¼with a regional support mechanism
       (EVAcoh + TAF)

         What we intend to accomplishā€¦
Whatā€™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 accomplishā€¦
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 ā€¦ā€¦
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 ā€¦ā€¦
Key Activities: Year 1
  ā€¢   PMO set-up
  ā€¢   Baseline research
  ā€¢   BCC materials development
  ā€¢   Trainings and workshops
  ā€¢   SHE establishment
  ā€¢   Mentoring
  ā€¢   Annual review and planning

How we do it ā€¦ā€¦
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 ā€¦ā€¦
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 Teachersā€™ 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 ā€¦ā€¦
Allen

                   Palapag

                   Calbayog



                    Basey


                   Abuyog


                    Silago


                    Bontoc

                  Hinunangan

                  St Bernard


The partners ā€¦ā€¦    Libagon
The Joint Venture Partners: 18 + 41
  Philippine NGO Support Program, Inc. (PHANSuP)

  ā€¢ 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
  ā€¢ in 1994, it was incorporated into a non-stock, non-profit
    institution and kept its name, PHANSuP, becoming 1 of the 2
    pioneer ā€˜linking organizationsā€™ of the International HIV/AIDS
    Alliance
  ā€¢ 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 ā€¦ā€¦
VICTO National Co-operative Federation and Development Center
  (VICTO National)

  ā€¢ established in 1970 in Hinundayan, Southern Leyte
  ā€¢ in 1991, VICTO was the first country awardee on Development
    Management given by the Asian Institute of Management (AIM)
  ā€¢ 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
  ā€¢ 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.
  ā€¢ 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 ā€¦ā€¦
Ev acoh project

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Ev acoh project

  • 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 ā€¢ 11 Filipino mothers die every day in the Philippines ā€¢ EV one of the top 5 worst places to be a mother ā€¢ EV Maternal Mortality Rate (Deaths per 100, 000 live births) 229.8 (2004)* ā€¢ EV Total Fertility Rate(number of children within reproductive years) 4.3 (2008) ā€“ 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 opportunityā€¦
  • 4. http://web.evis.net.ph/neda8/index2.php?option=com_content&do_pdf=1&id=131; accessed: 19January2011 ā€¢ HIV infections rising (Cebu outbreak: 1 in 2 IDUs is infected!) ā€¢ Worsening poverty in EV: 35.3% in 2003 to 40.7% in 2006 ā€¢ Under-five mortality is second highest (64 deaths) ā€“ ARMM (94 deaths) (NDHS, 2008) ā€¢ Prevalence of Underweight Children (0-6 years old) 18.1 % (2009) Challenge and opportunityā€¦
  • 5. http://web.evis.net.ph/neda8/index2.php?option=com_content&do_pdf=1&id=131; accessed: 19January2011 ā€¢ Basic Literacy Rate 90.1% (2003) ā€¢ Functional Literacy Rate 76.7% (2003) 79.7% (1994) ā€¢ Elementary Net Enrolment Ratio 76.2% (SY 2008-2009) ā€¢ Secondary Net Enrolment Ratio 44.7% (SY 2008-2009) ā€¢ Elementary Cohort Survival Rate 61.6% (SY 2008-2009) ā€¢ Secondary Cohort Survival Rate 63.6% (SY 2008-2009) Challenge and opportunityā€¦
  • 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 opportunityā€¦
  • 7. The Health Care System ā€¢ ā€œDilapidated shacks for the poor and gleaming palaces for the richā€ ā€¦. i.e., public health system inadequate to meet growing needs; private health system highly commercialized ā€¢ PNoy government emphasis on ā€˜universal accessā€™ to health care ā€¢ Health financing schemes on offer, e.g., DBP loan for PPPs on health ā€¢ Back to ā€˜primary health careā€™ approach: can we put health back into the hands of communities? Challenge and opportunityā€¦
  • 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 ā€¦
  • 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 ā€¦
  • 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 ā€¦ā€¦
  • 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 accomplishā€¦
  • 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 ā€¦
  • 13. 5 Planned Results within 3 Years ļ‚§ Result 1: Effective behavior change communication (BCC) modules ļ‚§ Result 2: Fully-informed and motivated clients availing of services ļ‚§ Result 3: Capable health workforce ļ‚§ Result 4: Viable coop-based health-focused initiatives/enterprises (11) ļ‚§ Result 5: Effective project management and support mechanism What we intend to accomplishā€¦
  • 14. After 3 years: 11 viable health enterprises ļƒ¼at least 15,000 clients ļƒ¼served by at least 70 well-trained health promoters ļƒ¼a co-op based ā€˜social health enterprise technology packageā€™ ļƒ¼in at least 10 model towns/areas ļƒ¼with a regional support mechanism (EVAcoh + TAF) What we intend to accomplishā€¦
  • 15. Whatā€™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 accomplishā€¦
  • 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 ā€¦ā€¦
  • 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 ā€¦ā€¦
  • 18. Key Activities: Year 1 ā€¢ PMO set-up ā€¢ Baseline research ā€¢ BCC materials development ā€¢ Trainings and workshops ā€¢ SHE establishment ā€¢ Mentoring ā€¢ Annual review and planning How we do it ā€¦ā€¦
  • 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 ā€¦ā€¦
  • 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 Teachersā€™ 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 ā€¦ā€¦
  • 21. Allen Palapag Calbayog Basey Abuyog Silago Bontoc Hinunangan St Bernard The partners ā€¦ā€¦ Libagon
  • 22. The Joint Venture Partners: 18 + 41 Philippine NGO Support Program, Inc. (PHANSuP) ā€¢ 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 ā€¢ in 1994, it was incorporated into a non-stock, non-profit institution and kept its name, PHANSuP, becoming 1 of the 2 pioneer ā€˜linking organizationsā€™ of the International HIV/AIDS Alliance ā€¢ 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 ā€¦ā€¦
  • 23. VICTO National Co-operative Federation and Development Center (VICTO National) ā€¢ established in 1970 in Hinundayan, Southern Leyte ā€¢ in 1991, VICTO was the first country awardee on Development Management given by the Asian Institute of Management (AIM) ā€¢ 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 ā€¢ 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. ā€¢ 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 ā€¦ā€¦