Chapter 1 The Provincial Health Situation introduction




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Table 16.3: Hospital Plantilla Position

Name of Hospital

Midwife III

Midwife II

Midwife I

ND II

SWO I

Nursing Attendant II

Nursing Attendant I

1. Alcala Municipal Hospital

 

 

 

 

 

 

1

Existing

 

 

 

 

 

 

 

Vacant

 

 

 

 

 

 

 

2. Alfonso Ponce Enrile Mem. Hosp.

 

 

 

 

 

 

 

Existing

1

 

 

 

1

 

4

Vacant

 

 

 

 

 

 

2

3. Aparri District Hospital

 

 

 

 

 

 

 

Existing

 

1

 

1

 

1

4

Vacant

 

 

 

 

 

 

1

4. Aparri Community Hospital

 

 

 

 

 

 

 

Existing

 

 

 

 

 

 

3

Vacant

 

 

 

 

 

 

 

5. Baggao Municipal Hospital

 

 

 

 

 

 

 

Existing

 

 

 

 

 

 

2

Vacant

 

 

 

 

 

 

1

6. Baggao Community Hospital

 

 

 

 

 

 

 

Existing

 

 

 

 

 

 

 

Vacant

 

 

 

 

 

 

3

7. Ballesteros District Hospital

 

 

 

 

 

 

 

Existing

 

1

 

1

 

1

4

Vacant

 

 

 

 

 

 

 

8. Lasam District Hospital

 

 

 

 

 

 

 

Existing

 

 

 

1

 

2

6

Vacant

 

 

 

 

 

 

 

9. Matilde Olivas Dist. Hosp.

 

 

 

 

 

 

 

Existing

 

 

 

1

 

 

4

Vacant

 

 

 

 

 

2

1

10. Northern Cagayan Dist. Hosp.

 

 

 

 

 

 

 

Existing

 

1

 

1

1

1

2

Vacant

 

 

 

 

 

 

3

11. Nuestra Señora de Piat Dist. Hosp.

 

 

 

 

 

 

 

Existing

 

1

 

 

1

2

6

Vacant

 

 

 

 

 

 

1

12. Tuao District Hospital

 

 

 

 

 

 

 

Existing

 

 

 

1

 

1

4

Vacant

 

 

1

 

 

 

2

13. Gattaran Emergency Hospital

 

 

 

 

 

 

 

Existing

 

 

 

 

 

 

1

Vacant

 

 

 

 

 

 

 

14. Sta. Ana Community Hospital

 

 

 

 

 

 

 

Existing

 

 

 

 

 

 

1

Vacant

 

 

 

 

 

 

 

15. Abulug Emergency Hospital

 

 

 

 

 

 

 

Existing

 

 

 

 

 

 

2

Vacant

 

 

 

 

 

 

 

As gleaned from the above, the personnel complement of the different district hospitals is very sparse and we can therefore conclude they can hardly cope with the demands of the patients.

Utilization Rate

Authorized Hospital Bed Capacity - Of the 15 hospitals operated by the province, five or 33% have a hospital bed capacity of 25. These are the hospitals of Matilde A. Olivas District Hospital, Northern Cagayan District Hospital, Ballesteros District Hospital, Tuao District Hospital, and Alfonso Ponce Enrile District Hospital. Six or 40% have a bed capacity of 10 namely: Baggao Medicare Hospital, Baggao Community Hospital, Aparri Municipal Hospital, Aparri Community Hospital, Sta. Ana Community Hospital and Gattaran Emergency Hospital. Three (3) out of 15 have a bed capacity of 50. These are the Piat, Aparri and Lasam District Hospitals. The only hospital with a 5 bed capacity is Abulug Emergency Hospital because it is classified as an infirmary.

Figure 32: Province of Cagayan, Hospital Bed Capacity Rate, Year 2007



Hospital Bed Occupancy Rate – In the year 2007, Alcala District Hospital had the highest hospital bed occupancy rate of 170% followed by Aparri District Hospital and Baggao Municipal Hospital with a registered rate of 146%. On the other hand Abulug Infirmary and Gattaran Emergency had the lowest with 20%.

Figure 33: Province of Cagayan, Bed Occupancy Rate, Year 2007



Figure 8. Hospital Bed Occupancy Rate

Ideally, all hospitals aim to attain and maintain at least 85% BOR. Although as seen in the figure there are hospitals that exceeded this target, there are still around 12 hospitals that are below the 85% targeted BOR.



Average Hospital In-Patient per Day- The district hospital of Aparri and Ballesteros registered the highest in terms of average in-patient per day with 73 and 49 respectively followed by Piat District Hospital with 25. The lowest so far in this index is Gattaran Emergency and Abulug Infirmary.

Figure 34: Province of Cagayan, Average Hospital In-Patient per Day, Year 2007



Average Length of Hospital Stay – The district hospitals of Aparri and Gonzaga have the highest average of length of hospital stay with 5 and 4 days respectively. The rest are within the range of 2-3 days. The length of stay depends on the specialization being offered by the hospital.

Generally, the average length of stay as shown is too short.



Figure 35: Province of Cagayan, Average Length of Hospital Stay, Year 2007



Inter Local Health Zones

The Province of Cagayan started the ILHZ implementation in the year 2001. It was piloted in Sanchez Mira serving four municipalities with the Sanchez Mira District Hospital as its core referral hospital. One of its major accomplishments was the upgrading of the core referral hospital and its catchments municipalities which are the RHUs. All are PHIC accredited and three out of four was certified Sentrong Sigla. They were able to raise funds through LGU contributions plus initial funds from CHD II for operationalization. Proper two-way referral system was instituted and regular ILHZ meetings were held to address issues and concerns. All LCEs under the ILHZ were very supportive and regularly attend the ILHZ meetings. Four other ILHZ are in various stages of organization.



Rationalization of Facilities

Lifestyle and occupational diseases are among the leading causes of mortality and morbidity in the province. Diseases of the heart, pneumonia, tuberculosis, peptic ulcer, cancer and accidents plus assault are major causes of morbidity. All of these conditions require tertiary level care.

These health problems persist mainly because of the inadequacy of health facilities in the province. There is only one Level IV hospital in the province- the Cagayan Valley Medical Center (CVMC) located in Tuguegarao City down southwest. While CVMC has a 500-bed capacity, it can only accommodate 300 patients because the other 200 beds are prioritized for psychiatric patients. The other hospitals render limited surgical and ancillary services owing to their inadequate treatment facilities and equipment and human resource.

At least 17 municipalities do not conveniently receive level IV hospital services because of their distance to CVMC.

In 2001 the Provincial Government (PG) organized the first ever provincial health summit. This led to the consensus of strengthening the health and hospital service delivery system by proposing to construct a new tertiary hospital that shall address the health issues in the northern side of the province. This would effectively serve 17 municipalities of the Province.

In 2002, the Provincial Government submitted a proposal to the government of Japan for a grant aid for the establishment of a tertiary hospital but said proposal did not materialize.

Sometime in 2007, the Provincial Government under a supplemental budget allocated the amount of P20.0 Million for the construction of a new hospital at Matilde A. Olivas District Hospital which has been proposed as the provincial hospital owing to its strategic location.

With respect to the rationalization of hospital facilities, the Provincial Government is in the process of re-engineering the provincial hospital system. It aims to establish a more relevant and comprehensive health delivery plan by (1) improving the structures of all hospitals; (2) upgrading the capability of both manpower and facilities and equipments; and (3) provide adequate assistance to rural health units, barangay health stations and other health facilities in terms of supplies, materials, drugs and medicines, trainings and manpower.



HEALTH HUMAN RESOURCE
In 2007, a total of 31 rural health physicians, 54 public health nurses, 258 rural health midwives, and 25 dentists were posted in the different municipalities of Cagayan .

Taken as a whole, the province has inadequate health service providers considering that planning standards indicate that the ratio of rural health physicians should be 1:20,000 whereas the province posted a ratio of 1:36,964. Only the municipalities of Calayan, Rizal and Sta. Praxedes had met the requirements.

The present number of midwives for the entire Province meets the planning standard of 1:5,000 ratio. Some municipalities slightly exceeded the standard except for Sta. Praxedes who employed only one rural health midwife for its 3,519 population. Even far flung area like the coastal barangays of Patunungan, Zinagu of Sta. Ana, Bolos Point of Gattaran, Valley Cove of Baggao, with the exception of Baguio Point of Penablanca also have midwives.

The available number of nurses in the Province is 54 which give a provincial ratio of one nurse for every 21,220 of the population. This is inadequate since planning standards place the provincial requirement ratio at 1:20,000 (nurse to population). Only the municipalities of Calayan and Rizal meet the standard.

The number of dentists on the other hand only shows the low priority given by the Local Government Units on dental health. At present, the Province maintains a total of 23 dentists for a dentist–to-population ratio of 1:49,820 which is far behind the ideal ratio of 1:20,000. There are even municipalities that do not have a dentist in their RHU and these are the municipalities of Buguey, Gonzaga, Rizal, Sanchez Mira, Sta. Ana, Sta Praxedes and Sta. Teresita. Dentists assigned at the Provincial Health Office cater to the above mentioned municipalities on a scheduled basis in order to augment the manpower dental requirement.

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