Chapter 1 The Provincial Health Situation introduction




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Figure 40: Province of Cagayan, Total Investments by F1


As gleaned from the table above, service delivery posted the highest with at 82.83%. This is in pursuit to the goal of creating BEmOC and CEmOC facilities in the different part of the province with the end in view of eradicating infant mortality and maternal death.

Under the financing portfolio, the PHIC shall be the partner of LGUs in the implementation of universal coverage of health insurance for the poor. The Provincial government likewise shall prioritize under its Annual Investment Plan the repair and rehabilitation of the different districts hospitals.


Financing Mechanism and Strategies

The overall financing strategy is governed by the following principles to wit: a) allocative efficiency or spending for the right things; b) technical efficiency or spending wisely and c) equity or spending for the right targets. The Provincial Government shall orchestrate all stakeholders and take the lead in the delivering and providing goods and services along the sector of health to its constituents. Through the IEC /Advocacy component of the plan it is expected that premiums remitted by the LGUs for PHIC contribution shall not only increase but remittances out of the paying members shall also increase. Cost saving measures could be realized through intensified IEC activities, access to health services as well as promotion of preventive health care. Effective internal audit system as well as efficient procurement system shall be ensured.

Fund sourcing activities through the different foreign funding institutions and other sources like the PDAF and Senator’s Fund shall likewise be topped as possible fund sources for this plan

Fiscal reforms like venturing into economic enterprises activities shall be adopted and implemented.

To ensure sustainability, revenue generation shall likewise be strengthened. Below is a consolidated income projection of the Province for the next five years.

Chapter 5

Timetable of Implementation

The table on the next page will show that for the next five years major expenditure will go to the procurement of medical supplies and equipments followed by the upgrading of facility development which include among others salaries and wages of proposed positions for creation and hiring together with the full implementation of the Magna Carta for the health workers. Activities under this two major type of expenditure shall conform to the requirement for the accreditation and licensing standards of the DOH and the PHIC.


Corollary to this, conduct of IEC / Advocacy activities shall also be intensified in order to empower the community and make them partners of government in bringing about an improved health system in the province.

Initiatives are focused on the first two years of implementation and shall gradually decrease towards the end of the planning period. With this trend it is expected that health performance together with the overall health system/outcome is improving. Expenditures on the first and second year will account more fore service delivery and financing while the remaining years will be more on regulation and governance to ensure the sustainability of all these activities.


Chapter 6

Plan Implementation and Management


  1. Preconditions to the Plan

The PIPH was crafted based on the implementation of FOURmula One in all LGU levels in the province, with due consideration to the foreseen development health scenarios that are likely to happen in the province for the next five (5) years. Therefore, the success of the plan is anchored on existing pre conditions namely:

  1. Harmonization of the PIPH with the different MIPH.

  2. Translation of broad strategies and targets into specific PPAs; and

  3. Integration of the PPAs in the Annual Investment Plan of the LGUs



  1. Parameters of an Effective Plan Implementation

The implementation of the PIPH will be integral to the existing mechanism and processes of the synchronized planning, programming and budgeting system of the LGUs.

The plan is viewed in a holistic manner where regional line agencies, municipal and barangays together with NGOs are considered partners in the implementation of the plan.



  1. Implementing Structure

The PIPH provides the overall policy direction and development framework of the health system in the province

The provincial planning team composed of the PHO, CHD and MHO shall ensure the objectives, strategies and targets contained in the plan and translated into PPAs.

In terms of implementation, the Governor shall be at the helm of the created LICT. He shall keep tract of the implementation of the F1 activities in the province through the Provincial Health Officer. Hand in hand the LICT shall work with the Local Health Boards in order to ensure the success of the plan. The civil society, private sector and the community shall play a crucial role in the implementation of the PIPH.


  1. Management Approaches

Efficient and effective implementation of Fourmula One for health shall be ensured through the adoption of the following management approaches:

  1. Creation of a Provincial Management Committee

  2. Institutionalization of monitoring and evaluation system

  3. Resource mobilization through convergence

  4. Intensification of IEC /advocacy on the overall health system of the province



  1. Function of key Players



  1. National Agencies (DOH, DILG, PHIC, NEDA, DBM, House of Representatives, PCSO, DSWD, DEPED, POPCOM and NNC): shall provide policy direction, financial and technical assistance.

  2. CHD - provides financial and technical assistance in the planning, implementation and monitoring and evaluation of the PIPH.

  3. LGU - shall ensure that the goals and objectives set forth in the plan are translated into PPAs.

  • Shall provide the financial counterpart in the investment plan.

  • Shall organize them into ILHZ in order to complement existing structure in the implementation of F1 activities.

  • Legislate ordinances in support to F1 implementation.

  1. Private Sector - shall assist the LGUs and CHD in the implementation of all activities enrolled in the plan particularly those which have direct impact grass root level.

  • Shall assist in the monitoring and evaluation.

  1. Foreign Agencies - shall provide financial as well as technical assistance in the implementation of F1 activities.


Chapter 7

Monitoring and Evaluation

The attainment of the goals, objectives and targets set for the plan shall be the primordial concern in plan implementation.

Thus, an effective plan monitoring and evaluation shall be put in place so that any deviation from the plan shall be immediately detected and remedial measures shall be instituted during the course of implementation.

The Local Implementation and Coordination Team (LICT) together with the Provincial Planning and Development Office shall keep tract of the implementation of PPAs in the province with the assistance of the members of the Provincial Interagency Monitoring Committee.

It is very essential to monitor the implementation of the plan through periodic check up so that deviation against the planned direction could be easily identified. With this, we are able to re-direct all actions and interventions towards the achievement of the overall goal of the plan. Through regular monitoring and evaluation we are able to identify the extent and level of responsibilities of every stakeholder.

In general, the feedback mechanism being put in place in this plan shall not only serve as a means to identify how much has been done but more so, the outcome as an aftermath of all these interventions which were accomplished through the process of convergence approach. Therefore the plan shall focus on the qualitative change in the lives of every Cagayano in the health aspect over the five year period.

As earlier mentioned, the LICT together with the PPDO and the established Interagency Monitoring Committee shall perform the in-house monitoring. The CHD together with the MHO shall also be organized as integral members of the team.

Finally, the collection of data/reports submitted by all Rural Health Units and District Hospitals shall also be intensified they are the primary source of inputs as we evaluate the outcome or impact of every intervention.



Monitoring Mechanisms:

The Provincial Government shall adopt some monitoring mechanisms in order to strengthen the plan implementation. These mechanisms include among others the following:



  1. Periodic Plan Implementation Assessment

Submission of periodic reports on the status of programs and projects is a given requirement of the plan monitoring and evaluation system. Thus, all concerned agencies/departments / shall be required to submit a quarterly program report which shall serve as basis for the periodic assessment of the plan implementation.

  1. Periodic Plan Review and Updating

Disasters brought about by natural occurrence as well as factors greatly affecting the health status of people brought about by the change of times demand a periodic plan review and updating in order for the province to attain its goals and objective as stated in the plan

Monitoring Tools

The F1 monitoring tool prescribed framework for PIPH implementation will be the primordial monitoring tool to be adopted for in this plan. This tool will be complemented by the ME3 otherwise known as the Monitoring and Evaluation System for Equity and Effectiveness. The ME3 uses the LGU scorecard and FHSIS as monitoring tools. The ME3 usually works best at the local level over the mid-term review. It will help LGUs and all stakeholders follow through the development of their F1key result areas. Specifically it aides in the evaluation of health outcomes particularly to its target clientele.

It shall also assess the extent of interventions of all key players in bringing about an improved health system performance. Since the goals of this plan is also based on the ME3 indicators which focuses on the outcomes of F1 for health the following shall therefore be highlighted in the monitoring and evaluation report:


  1. Final Outcomes - health status, financial risks protection, and responsiveness of health system which is based on the end goals of F1 for health.



  1. Intermediate Outcomes - access, quality, efficiency and financial burden help determine the level of performance of final outcome but are not in themselves ultimate objectives. This will serve as a critical link that connects to the root causes to final outcomes.



  1. Major Final outcome - thee are the products resulting from the four major components of health reforms namely: service delivery, financing, regulation and governance which will have a significant impacts on intermediate outcomes and ultimately final outcomes.

The implementation of the PIPH hall be monitored and evaluated on two aspects:

  1. Physical and Financial Monitoring - where physical targets shall be monitored vis a vis financial disbursement and / or expenditure;



  • It shall focus on the implementation of the key result areas of the PIPH. Issues and concerns affecting its accomplishment is also considered in this tool; and

  1. Outcome Monitoring - which focuses on the impact of all these initiatives

- provides the overall picture of the health performance of the province.

The table below shall be used to measure extent of physical and financial accomplishment on a quarterly basis.



Table 24: Physical and Financial accomplishment on a quarterly basis.

SERVICE DELIVERY

Accomplishment

As of _ Quarter

Remarks

Budget (PhP)

1. Disease Free Zone Initiatives

Target

(Actual

Allocated

Disbursed

(%)

a.) Schistosomiasis Elimination Services



















I. IEC/ADVOCACY

 

 

 

 

 

 

• Translation, production & distribution of IEC materials.

 

 

 

 

 

 

• Film viewing during barangay assembly

 

 

 

 

 

 

• local radio campaign presence of LGU owned)

 

 

 

 

 

 

• Installation of billboards to affected barangay.

 

 

 

 

 

 

• Training of BHW in snail survey/hunting.

 

 

 

 

 

 

• Training of RMT on integrated microscopy

 

 

 

 

 

 

• Training of RHU staff on (Serological test for schisto ) Gonzaga

 

 

 

 

 

 

• Training of RMT for ELISA

 

 

 

 

 

 

• Training on two way referral system

 

 

 

 

 

 

• Mass stool examination in high risk area

 

 

 

 

 

 

• Mass deworming in high risk area.

 

 

 

 

 

 

• Deworming of suspected animal hosts

 

 

 

 

 

 

• Networking / collaboration with NGA's/NGO's/GO's (i.e U.P. College of Public Health)

 

 

 

 

 

 

• Enhance and strengthen community participation.

 

 

 

 

 

 

• Provision of Toilet bowl in affected areas to barangay (communal located in the farms)

 

 

 

 

 

 

• Conduct monthly monitoring and supervision of Schistosomiasis Program

 

 

 

 

 

 

• Conduct semi annual Program Review of Schistosomiasis using harmonized- LGU score card tool

 

 

 

 

 

 

TOTAL

 

 

 

 

 

 

b. Rabies

 

 

 

 

 

 

I. IEC/ADVOCACY

 

 

 

 

 

 

• Translation, production & distribution of IEC materials.

 

 

 

 

 

 

• IEC during Barangay Assemblies

 

 

 

 

 

 

Ti-media campaign

 

 

 

 

 

 

II. CAPABILITY BUILDING

 

 

 

 

 

 

III. CASE MANAGEMENT

 

 

 

 

 

 

Program Management

 

 

 

 

 

 

• Networking / collaboration with NGA's/NGO's/GO's (i.e DA, RITM)

 

 

 

 

 

 

• Conduct monthly monitoring and supervision of Rabies Program

 

 

 

 

 

 

• Conduct Program Review of Rabies using harmonized- LGU score card tool

 

 

 

 

 

 

TOTAL

 

 

 

 

 

 

c.) Leprosy Control Program

 

 

 

 

 

 

I. IEC/ADVOCACY

 

 

 

 

 

 

• Tri- Media campaign during leprosy week

 

 

 

 

 

 

• Translation, production & distribution of IEC materials.

 

 

 

 

 

 

II. CAPABILITY BUILDING

 

 

 

 

 

 

• Training of Health workers on updates of National Leprosy Control Program

 

 

 

 

 

 

• Training of untrained midwives on diagnosis and case mgt of leprosy

 

 

 

 

 

 

• Training on two way referral system

 

 

 

 

 

 

III. CASE MANAGEMENT

 

 

 

 

 

 

• Immediate and Early treatment of positive cases( procurement of leprosy drugs)

 

 

 

 

 

 

IV. PROGRAM MANAGEMENT

 

 

 

 

 

 

• Networking / collaboration with NGA's/NGO's/GO's (i.e Fransiscan apostolate)

 

 

 

 

 

 

• Purchase of supplies and equipments

 

 

 

 

 

 

Conduct monthly monitoring & Supervision of Leprosy program

 

 

 

 

 

 

Conduct of annual PIR using SDIR

 

 

 

 

 

 

TOTAL

 

 

 

 

 

 

d.)Malaria Control Services

 

 

 

 

 

 

I. IEC/ADVOCACY

 

 

 

 

 

 

Production of IEC materials (LOCAL/DIALECT)

 

 

 

 

 

 

Installation of signage’s & billboards etc.

 

 

 

 

 

 

Trimedia campaign

 

 

 

 

 

 

IEC during brgy assemblies

 

 

 

 

 

 

II. CAPABILITY BUILDING

 

 

 

 

 

 

Training of sprayman on spraying operations
















 

Training on management of severe malaria for MHOs and private Clinicians

 

 

 

 

 

 

Training on Malaria epidemic management for MHOs

 

 

 

 

 

 

Establishment of new additional RDT sites

 

 

 

 

 

 

Establishment of additional BMMC

 

 

 

 

 

 

III. PROGRAM MANAGEMENT

 

 

 

 

 

 

Networking/collaboration w/ NGAs/NGOs/Gos(ie Global Fund)

 

 

 

 

 

 

Organization/reactivation of MMAC & BMAC

 

 

 

 

 

 

Provision of the following

 

 

 

 

 

 

Spraycans

 

 

 

 

 

 

Insecticides

 

 

 

 

 

 

Long lasting insecticide treated nets (LLITNs)

 

 

 

 

 

 

Malarial Drugs

 

 

 

 

 

 

Laboratory Reagents

 

 

 

 

 

 
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