program implementation review of community health partnership program zff 2015
TRANSCRIPT
Community Health Partnership Program
ZFF Program Implementation ReviewMidyear 2015
Social Problem to AddressOpportunity to contributePursuit for “Sense”Yearning to Grow and Expand
The Journey: Going to Places We’ve Never Been Before
ZFF’s Mission and VisionMDG’s Number 4 and 5
72 Mayors, Municipal Health Officers and “Community Leaders”
The Sojourners
Cohort LGUs1 92 123 84 65 66 47 11
UMAK1 8UMAK2 8
Total 72
Models Total LGUs
ARMM 17
GIDA 18
Poor 38
Number of years Number of LGUs
>5 213-5 24< 3 27
Cohort 4
2008 2009 2010 2011 2012 2013 2014 2015 2015
CurrentCohort 6Cohort 5
Cohort 3Cohort 2Cohort 1
Cohort 7
LGUs
ZFF 5 6 7 9 10 4 11 9
The Beginnings
CHPP ARMM GIDA Poor
145.0 128.9
350.0
130.0
Maternal Mortality Ratio BaselinesSeries1
CHPP ARMM GIDA Poor
47.5
21.2 22.745.0
90.0
Facilities-based Deliveries BaselinesSeries1
CHPP ARMM GIDA Poor
71.452.6
22.7
60.8
90.0
Deliveries attended by Skilled Birth Attendants Baseline Rates
Series1
CHPP ARMM GIDA Poor
7.711.0
23.5
6.6
Infant Mortality Rate BaselinesSeries1
The Ongoings
2010 2011 2012 2013 2014
145.0
108.7 115.6 102.2 92.2
128.9
98.8
48.337.7
57.3
350.0 350.1 342.7346.7
244.6
130.0
85.2 87.067.1 66.7
Maternal Mortality Ratios, per 100,000 live births
CHPP ARMM GIDA Poor National
The Challenges
Models Maternal Deaths(2013-2014)
Maternal Deaths including Referral
Hospitals(2013-2014)
Variance
ARMM 13 23 10GIDA 41 44 3Poor 31 67 36CHPP 85 134 49
Three Delays:FIRST DELAY factors= issues on availability and affordability and acceptability of health care servicesSECOND DELAY factors= issues on accessibilityTHIRD DELAY factors= issues on quality of health care services provided
The Ongoings
2010 2011 2012 2013 2014
47.5
34.6
56.862.5
70.8
21.2 19.4
29.9
41.6
51.7
22.7 22.7
42.1
66.4
74.5
45.051.2
74.7 73.5
81.9
Facilities-based deliveries rateCHPP ARMM GIDA Poor National
The Ongoings
2010 2011 2012 2013 2014
71.463.1
71.3 73.679.8
52.6
64.3 64.969.7
74.6
22.7
34.0
60.764.6
77.7
60.865.4
77.8 78.983.8
Deliveries Attended by Skilled Birth Attendants Rates
CHPP ARMM GIDA Poor National
The Ongoings
2010 2011 2012 2013 2014
7.75.7
6.95.5 5.7
11.0
3.3 2.8 3.0 2.9
23.5 23.5
18.2
15.914.4
6.65.4
6.4
4.35.5
Infant Mortality Rates, per 1,000 live births
CHPP ARMM GIDA Poor National
What Now? What will it take for the local government
units to sustain and/or further improve health gains?
Leadership and Governance:
Technical and AdaptiveReframeInnovate
Coach
SUPPLY SIDE(Availability, Accessibility,
Affordability)
DEMAND SIDE(Acceptability, Equitability)
IMPROVED QUALITY OF
HEALTH:Sentinel Indicators – Nutrition, Water and Sanitation and
Communicable Diseases
RESILIENT HEALTH SYSTEMS
EDUCATION AS A SOCIAL DETERMINANT
ECONOMIC DEVELOPMENT AS A SOCIAL DETERMINANT IMPA
CT O
N Q
UAL
ITY
OF
LIFE
Alumni CLHDP Framework
Emerging Insights from CLHDP
2010 2011 2012 2013 2014
114.4100.8 98.9
76.4 79.6
227.5
133.7
104.0
82.7 86.3
60.9 60.9
91.4
67.8 70.4
Non-ARMM Alumni LGUs MMR per 100,000
Alumni nonCLHDP CLHDP National
9 LGUs
33 LGUs
2011 2012 2013 2014 2011 2012 2013 2014Padre Burgos, Quezon 10.18 15.44 15.62 17.2 110 115 105 105Pilar, Sorsogon 13.4 11 13.9 15.69 95 102 155San Pablo, Zamboanga del Sur 8.11 7.5 6.82 5.2 37 32 29 32Tungawan, Zamboanga Sibugay 9.5 8.72 8.62 8.26 48 63 68 95Ivisan, Capiz 87 5 3.4 2.61 50 63 77 47Motiong, Samar 18 18 13 15 10 7 10 19Limasawa, Southern Leyte 2 2 1.9 1 4 10 11 7
MunicipalityMalnutrition Rate TB Cases
SDH Indicators of CLHDP Batch 1
2011 2012 2013 2014 2011 2012 2013 2014
Padre Burgos, Quezon 103.96 103.18 99.71 102.28 89.6 89.6
Bacolod, Lanao del Norte 94.36 95.27 95 94.88 92 92.5 93 92.50
Pilar, Sorsogon 0.00 0.00
San Pablo, Zamboanga del Sur 97.65 99.1 98.38 0.00
Tungawan, Zamboanga Sibugay 0.00 0.00
Ivisan, Capiz 98 98 98.00 83.5 84.62 88.21 85.44
Motiong, Samar 78 78 100 100 89.00 88.41 82.5 90.95 92.77 88.66
Kayapa, Nueva Vizcaya 92.87 94.02 95 93.96 11.3 10 12.52 11.27
Limasawa, Southern Leyte 99.44 99.44 99.28 99.74 99.48 91 89.36 92.82 94.16 91.84
Municipality
Municipal Participation Rate
Average AverageElementary High School
SDH Indicators of CLHDP Batch 1
2011 2012 2013 2014 2011 2012 2013 2014
Padre Burgos, Quezon 66.67 64.61 81.41 70.90 81.36 81.36
Bacolod, Lanao del Norte 91.15 90.19 90 90.45 91 91.5 92 91.50
Pilar, Sorsogon 0.00 0.00
San Pablo, Zamboanga del Sur 63.71 74.85 60.88 61.91 66.48 88.19 88.54 83.13 87.66 86.88
Tungawan, Zamboanga Sibugay 60.91 97.89 56.17 59.75 68.68 60.87 66.57 63.72
Ivisan, Capiz 84 88.95 86.48 70.92 74.18 70.86 71.99
Motiong, Samar 98 98 99.15 99.89 98.76 88.89 87.03 90.08 91.88 89.47
Kayapa, Nueva Vizcaya 81.17 89.59 79.84 83.53 61 68 81.5 70.17
Limasawa, Southern Leyte 91.26 92.69 95.28 93.14 93.09 65 61.98 64.66 73.15 66.20
Municipality
Municipal Completion Rate Average
Elementary HighschoolAverage Average
SDH Indicators of CLHDP Batch 1
Educational Indicators
2011 2012 2013 2014 2011 2012 2013 2014
Padre Burgos, Quezon 64.12 58.44 51.07 57.88 45.1 45.1
Bacolod, Lanao del Norte 81.22 78.3 79.33 79.62 82 80 81 81.00
Pilar, Sorsogon 0.00 0.00
San Pablo, Zamboanga del Sur 64.15 63.9 63.9 72.82 66.19 38.33 49.29 38.31 48.22 43.54
Tungawan, Zamboanga Sibugay 66.74 61.12 66.95 66.57 65.35 60.29 62.71 61.50
Ivisan, Capiz 82.2 82.44 83.76 82.80 48.47 58.9 62.48 56.62
Motiong, Samar 82 82.07 78.53 76.61 79.80 71.42 47.11 52.94 73.51 61.25
Kayapa, Nueva Vizcaya 66.75 71.31 70.02 69.36 53.21 56.3 54.76
Limasawa, Southern Leyte 75.66 81.03 88.44 81.71 68.49 73.02 74.59 72.03
Average
Municipality
Municipal NAT Scores
AverageElementary Highschool
Municipality2011 2012 2013 2011 2012 2013
Cervantes, Ilocos Sur 5.83% 3.47% 3.39% 19 8 15Looc, Romblon 11.28% 9.03% 10.10% 80 80 126Goa, Camarines Sur 10.50% 10 11 104 189 206Dao, Capiz 3.13% 3.02% 2.53% 66 84 70Hinatuan, Surigao del Sur 9.90% 9.90% 9.10% 98 107 274Tinambac, Camarines Sur 28% 21% 19% 122 134 122Santol, La Union 5.12% 5.79% 4.64% 31 12 12
Malnutrition rate TB cases
SDH Indicators of CLHDP Batch 2
2011 2012 2013 2011 2012 2013
Cervantes, Ilocos Sur
Looc, Romblon 97% 98% 98% 95.88% 96.36% 95.37%
Goa, Camarines Sur
Dao, Capiz 89.66% 92.61% 94.15% 86.72% 83.58% 83.68%
Hinatuan, Surigao del Sur 102% 97% 94% 76.59% 75.06% 77.15%
Tinambac, Camarines Sur 90.56% 90.61% 91.72% 76.47% 81.03% 83.54%
Santol, La Union 100% 98.12% 100% 89% 84.09%
Municipality
Municipal Participation Rate
Elementary High School
SDH Indicators of CLHDP Batch 2SDH Indicators of CLHDP Batch 2
2012 2013 2011 2012 2013
Cervantes, Ilocos Sur
Looc, Romblon 98% 98% 73.02% 70.97% 73.60%
Goa, Camarines Sur
Dao, Capiz 74.65% 84.67% 78.73% 73.52% 85.76%
Hinatuan, Surigao del Sur 64.52% 69.99% 77.15% 71.95% 66.08%
Tinambac, Camarines Sur 68.06% 83.07% 61.76% 66.53% 68.65%
Santol, La Union 90.81% 92.75% 97.30% 97.36% 84.04%
High SchoolMunicipality
Municipal Completion Rate
Elementary
SDH Indicators of CLHDP Batch 2
As of mid-year 2015
Where we are now
CohortMaternal
Deaths 2014
Maternal Deaths mid-
20151 10 02 6 33 3 54 7 15 6 16 3 17 15 4
UMAK1 2 2UMAK2 6 3
Total 58 20
REFERRAL HOSPITALIN TRANSITHOME DEATHS
DELAYS
INTERVENTIONS
40%
5%
55%
Place of Death
Home In TransitReferral Hospital
SBCC-Oriented IECIncentivization
Philhealth EnrolmentMaternal Shelters
TBA Referrals/Women’s Health Team
Functional Referral Communication SystemTracking System
DELAY ONE DELAY TWO DELAY THREE
Behavior Change Communication Barangay Health System
“Blood” and/or other supplies
Incentives Infrastructure (road) Inter-facilities communication
Leadership Leadership Leadership
Improved IEC Improved Transport Improved competencies
Social Support Strengthened Referral
Specialists/staff (HR)
Primum non nocereSecundo ne moram
B.I.L.I.S.
C-SOARChallenges Strengths Opportunities Aspirations Results
ARMM: Deaths moving to referral hospitals, persistent deaths at home, difficult areas in Maguindanao
ARMM Convergence has RAO/PAOTawi-Tawi has undergone PLGP through the USAID-ZFF partnership
Coordination with ZFF-USAID RAO/PAO
Zero maternal home deaths and Zero maternal hospital deaths
MMR = 0
Alumni LGUs: last term mayors
Last term mayors willing to be part of pool of resource persons
LGUs with new mayors
Sustainable health gains and social development
Zero MMR, Zero IMR,
GIDA persistently high MMR
Increasing FBD, increasing SBA
Technical support for maternal and child related health programs
Decrease home deaths
Deaths due to first delay and second delay factors = 0
Post-TWG Updates
Cohorts Type of TWG
Updates
Alumni RPRH Demand generation for utilization of available FP commodities and modern natural family planning methods. Exploring options on alternative ways of creating demand.
GIDA RPRH Partnering with local NGOs to generate demand for FP through community mobilization. Scheduled trainings for health workers to improve competencies (BIDA sa GIDA)
ARMM MCH Implementation of agreed action plans: focused heavily on demand generation and community mobilization.
What lies ahead
GIDA ARMM Alumni
Module 4 Cohort 7Roll out of BHLMP with FP modulesAdvocacy for MCIP and Mother’s Bonus
Module 4 Cohort 6Follow up TWG on MCH
Batch 2 Module 2 CLHDPTWG on Referral System StrengtheningTWG on specific SDH (Agriculture)Partnership with UPCM for SDH technical coaching
National Health Leaders Conference – November 19-20, 2015
It is a hopeless cause by B.E. Nillos
It is a hopeless causeAnd I do not believe that
What little I do makes a differenceIn the greater scheme of things
I have realized that“My work is significant!”
Is a lie, instead“this is not worth it!”
So I will tell every poor mother and child in my community thatThey are not important to me
The challenges are real butI am afraid…Troubled
It is a hopeless cause by B.E. Nillos
For the days ahead areToughI am
WeakI do not believe I am
Capable of doing the things I need to doI am convinced that I am
A Failure
It is a hopeless cause by B.E. Nillos
I cannot acceptThe work that lies ahead of me
I face todayWith disappointment and setbacks asI reject the idea that the future awaits
With hope for better and happier outcomes.I stand firm on this thought
It is expected that The future is caliginous and forlorn
I could not claim thatMy work can make a difference
It is clear that I am worthless.
It is senseless to think thatThere is hope.
CHPP 2015
Thank You
ZFF Program Implementation ReviewMidyear 2015