Chapter 1 The Provincial Health Situation introduction




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Figure 23: Province of Cagayan, Pre-Natal with at least 3 or more PN visits, Year 2007



Figure 24: Province of Cagayan, Post-Natal with at least 1 visit



Natality – In 2007, of the 17,997 deliveries in Cagayan, 20% (3,608) were delivered in hospitals and 74 % (13,271) were delivered at home. 98% (17,717) of all deliveries were normal spontaneous deliveries (NSD) while 1.5% (280) were either delivered through Caesarian section and forceps. Aparri II has the lowest hospital delivery at 3% and Camalaniugan has the highest hospital delivery at 31%.

Table 12: Cagayan Natality, 2007


Municipality

HOME

% Home

HOSPITAL

% Hospital

TOTAL

Abulug

537

67

260

30

864

Alcala

416

67

206

30

689

Allacapan

436

79

113

18

628

Amulung

671

83

134

15

888

Aparri I

410

71

167

26

674

Aparri II

448

97

15

3

563

Baggao

974

78

281

21

1,354

Ballesteros

555

91

52

8

706

Buguey

318

75

105

21

519

Calayan

245

93

19

5

362

Camalaniugan

233

63

136

31

463

Claveria

358

77

104

19

558

Enrile

443

78

123

19

663

Gattaran

786

69

358

30

1,243

Gonzaga

467

86

77

12

642

Iguig

154

76

48

17

295

Lallo

567

80

145

18

810

Lasam

469

78

131

19

697

Pamplona

325

87

50

11

473

Peñablanca

574

73

215

25

887

Piat

317

82

68

15

482

Rizal

141

77

42

16

276

Sanchez Mira

213

72

84

23

392

Sta. Ana

507

89

61

9

666

Sta. Praxedes

32

56

25

22

135

Sta. Teresita

161

64

91

29

345

Sto. Niño

275

72

109

24

480

Solana

1,079

82

244

17

1,422

Tuao I

672

88

89

10

859

Tuao II

488

90

52

8

638

CAGAYAN

13,271

79

3,604

21

16,954



Tetanus Toxoid 2+ - The DOH benchmark for pregnant women given with at least 2 doses of Tetanus Toxoid is 80%. In the province we were able to cover 86% of all pregnant women based on actual targets but based on projected population the coverage was only 60% .


Figure 25: Province of Cagayan,,Pregnant Women given TT2 Plus, Year 2007


Iron Supplementation – Basing from the DOH guidelines, all pregnant women should be given Iron supplementation starting at 5th month of pregnancy until delivery but if anemia is detected early, iron can be given during the first month of pregnancy. Iron supplementation should be continued until the baby is two months old.

The province was able to provide supplemental iron to 56% of pregnant women and 57% of post partum women.



Vitamin A Supplementation – For the year 2007, there was a very low accomplishment, about 10%, of Vitamin A supplementation for pregnant mothers.

Contraceptive Prevalence Rate – From 2005 to 2007, the 3 year average CPR of the province was 53.70%. This is way below the DOH benchmark of 80% (couples practicing family planning). Low CPR is seen in 17 of the 30 RHUs of the province. The bar graph below shows how Cagayan Province compares with the other provinces of Region 02. Oral contraceptives and injections are the most common methods used by family planning acceptors

Figure 26: Province of Cagayan, Contraceptive Prevalence Rate, 2005-2007



Figure 27: Region II, Contraceptive Prevalence Rate (Region 02), 2007



Adolescent Health and Other Reproductive Health Initiatives

When the University of the Philippines Population Institute conducted the first and then subsequently, second Young Adults Fertility and Sexuality Survey (YAFFS 1 and YAFFS 2), the findings were very alarming, e.g. 18% of young people indulged in casual premarital sex with multiple partners. Deeply alarmed because of the implications of the findings (teen-age pregnancies, spread of STDs, abortions, etc.), the Provincial Government of Cagayan in partnership with the UNFPA launched the Adolescent Reproductive Health Program in 2000. Piloted in five colleges/universities and one public high school, the program started with the establishment of Teen Centers in these schools. Activities included convocations, film showing, orientation on sexuality, peer counseling and organization of peer counseling groups.



When the UNFPA left Cagayan at the end of the 5th Country cycle in 2006, Teen Centers were also established in Ballesteros, Lallo and Sanchez Mira. ARH Program is being maintained and subsumed under the Population Management Program and is being implemented by the PPDO. Activities of the program are training of peer counselors, orientation on sexuality in the different high schools of the province and the conduct of the Youth Congress usually done to coincide with the observance of World Aids Day.

HEALTHY LIFESTYLE AND MANAGEMENT OF HEALTH RISKS

Advocacy for risk behaviors (diet, exercise, smoking): The Hataw Para sa Kalusugan Program of the Provincial Government is an effort to promote public health and well-being of the people. The Provincial Health Office which is at the forefront of this program would like to emphasize the need to pursue an active lifestyle in order to reduce the risk of contracting cardiovascular diseases and cancer. Through this program, the benefits of exercise to health and well-being and is being promoted in all offices and schools within the province. It has already been institutionalized in the Provincial Capitol where Hataw exercises are held every Wednesdays.

Water & Sanitation Programs

Access to Potable Water: From the year 2000 to 2007, there was a marked increase in households with access to safe water from 68% to 80%. However, this is below the DOH benchmark of 94% of total households. The increase can be attributed to the improvement of open dug wells with cover and the rise in installation of hand pumps in households. Another reason could be that the municipal and provincial LGUs provided pump wells to indigent families. Still another reason is the establishment of Level III water facilities (LWWA) in some municipalities. Lastly, there was a rise in the establishment of purified water refilling stations in most municipalities in the province.

Table 13: Cagayan Percentage of Households with Access to Safe Water, 2003-2007

Year

% of Households

2003

75%

2004

76%

2005

78%

2006

78%

2007

80%


Figure 28: Province of Cagayan, Percentage of Households with Access to Safe Water, 2003-2007

Access to Sanitary Toilets: From the year 2000 to 2007, households with access to sanitary toilets increased from 89.7% to 92%. The DOH benchmark is 90%.


Table 14: Cagayan Percentage of Households with Access to Sanitary Toilets, 2003-2007


Year

% of Households

2003

89%

2004

90%

2005

90%

2006

91%

2007

90%

Figure 29: Province of Cagayan, Percentage of Households with Access to Sanitary Toilets, 2003-2007


Waste Management System – Proper waste disposal as mandated in Republic Act 9003 or the “Solid Waste Management Law” is not fully and properly implemented by the different LGUs. Some of the LGU’s complied with the establishment of their controlled dump sites while material recovery facilities can rarely be seen in these dump sites. Waste segregation at source is a common practice in most public and private institution but not in the individual households. In the province, 93% of all households have satisfactory garbage disposal. Most Government Hospitals complied with the requirements of “Clean Air and Water Act”.

  1. SURVEILLANCE & EPIDEMIC MANAGEMENT SYSTEM

Since the establishment of the Cagayan Provincial Epidemiology Surveillance Unit (PESU) in year 2002, this said unit had been actively monitoring and doing surveillance in the occurrence of diseases with epidemic potential like Malaria, Dengue, typhoid fever, etc. On the same year, the Municipal Epidemiologic surveillance unit of every municipality was established and manned by the Rural Sanitary Inspectors (RSI). The PESU and MESU’s not only do surveillance and monitoring but also give immediate information in the prevention and control measures to avoid occurrence of new cases.

  1. DISASTER PREPAREDNESS & RESPONSE

The province of Cagayan because of its geographical location and general terrain, is very prone to natural disasters particularly landslide and flooding in upland areas, or flooding and storm surges in coastal communities caused by recurring typhoons. Invariably these cause isolation of communities and economic debility affecting government and people’s ability to cope. On the average, Cagayan suffers from the effects of typhoons roughly six to 10 times a year.
As a consequence, diarrheal and other water-borne diseases are common after a disaster due to contamination of water sources. Currently, every local government unit has an established disaster coordinating council (DCC), a mandated body tasked with the responsibility of overseeing rescue and relief operations during disasters. Being ad hoc, some members are not technically prepared to act accordingly; hence many of such councils have failed to live up to expectations. In the health sector, the MESU and the PESU serve as the basic units that are charged with these tasks.
The Local Government Code (RA 7160) provides a more generally responsive and decentralized local government structure to organize disaster control groups and quick response teams in all health institutions. This is to provide support to all respective disaster coordinating councils during emergencies and to undertake necessary measures to prevent the occurrence of communicable diseases and other health hazards which may affect the population. Primarily, health service units are tasked to do the following:


  • Sort cases at the scene of a disaster;

  • Administer first aid;

  • Attend to the cases referred to emergency aid station;

  • Evacuate patients to emergency hospitals; and

  • Detect and control communicable diseases in coordination with other agencies specifically assigned for the purpose.



  1. HEALTH PROMOTION & ADVOCACY

Health promotion is the primary concern of the Provincial Health Office. However, in order for it to carry out its mandated function, advocacy is the best approach when it is trying to get support from the local chief executive. Support from the LCE is very important if we are to ensure that there is funding support for its various health programs. Information, education campaign and advocacy is also a very important tool when we want to get our message across to the general public especially on very important issues like dengue, malaria and rabies.
Dental Health – Oral diseases are predominant and alarming among Filipinos. Latest DOH survey showed that 92.4% suffer from dental caries/tooth decay while 78% of them suffer from periodontal/gum disease. This has considerable impact on the quality of life of an individual. The accomplishment of Provincial Dental health program in 2007 is as follows:


Table 15: Provincial Dental Health Program Accomplishment, 2006-2007


Target Groups

2006

2007

Average

Provided curative treatment to pre-schoolers

49

59.83

54.41

Provided preventive treatment to pregnant women

79

78.70

76.35

Provided Curative treatment to pregnant women

34

43.97

38.98

Provided curative treatment to adults

58

61.28

59.64
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