POST DISASTER REPORT

WASH Cluster

WATSAN FACILITIES
EVACUATION CENTERS (as of June 28, 2007)

13 (87%) – shelter standards (1 rm:20 persons)
13 (87%) – safe drinking water standards
(1 water point: 200 persons)
6 (40%) – latrine standards (1 toilet:20 persons)
15 (100%) – meets the garbage disposal standards

12 evacuation centers
3 transit sites (Taysan, Anislag & Travesia)

What has been done
Conducted initial rapid health assessment
Erected tent hospital in Lidao City
Established joint PHO-DOH CHD 5 command post
Provision of drugs, medicines, water tanks and tents to hospitals and RHUs
Distribution of cadaver bags and lime to local DCCs
Deployment of medical teams to devastated sites and evacuation centers
Distribution of compact food to service providers and victims
Provincial issuance LGUs re: disposal of dead persons
Coordination with provincial agencies for evacuation center needs
Disease surveillance in the evacuation centers and fast- tracked FHSIS reports
Emergency purchase of drugs, medicines and supplies (P 5.4M)
Daily health bulletins re: WATSAN
Coordination with local health workers (15 mun. and 3 cities)
Regular weekly cluster meetings
Drinking water safety monitoring and sanitation needs in evacuations centers and in the community
Nutrition assessment surveys
Vaccination activities in evacuation centers
Health infrastructure damage assessment
Hospital equipment inventory
Fumigation of evacuation centers
Supervision of latrine construction, hand pump installations and water filtration systems
Health information dissemination
Critical incident stress debriefing
Seminar workshops for health personnel on Sphere standards, health promotion, bio-sand filters
Distribution of health kits, drugs/medicines and supplies
Seminar workshops for health personnel on Sphere standards, health promotion, bio-sand filters
Distribution of health kits, drugs/medicines and supplies
Receipt of donations equipment, drugs/medicineswater tanks, bladders, filtration machines and analysis kitshealth kits, hand pumps, chamber pots
Continued implementation of regular health programs in the evacuation centers
Establishment of databases for health
Rehabilitation plans formulation for: health infrastructures and equipment and health programs : environmental sanitation, CDD, EPI, disease surveillance and nutrition
Request for assistance on information processing soft wares from NGOs

INTERNATIONAL HUMANITARIAN RESPONSE
Donations/Assistance from Foreign Governments, Aid Agencies and INGOs
Canada
OXFAM
Malaysia
USAID
Spain
AusAid
Singapore
Telecoms Sans Frontier
Indonesia
World Vision
Japan
Care Philippines
China
Mercy Malaysia
Sweden
JICA
Republic of Korea
U.S.A
Medicins sans Frontieres

UN-OCHA CERF ( Central Emergency Response Fund) = $2,654,255

Components:
Health
Nutrition & WASH (Water, Sanitation and Hygiene)
Food Aid & Logistics Support
Emergency Shelter
Non-Food Items & Logistics
Emergency Family Care & Support Packages
Emergency Maternal Care
Agriculture

Water & Sanitation
OXFAM GB - latrines, water containers, bath areas and hygiene kits, test kits, water bladders
Spanish Government – water purification machine - Guinobatan
Global Medic / PMSEA / MGB – water purifiers - Daraga, Legazpi
UNICEF – declogging of septic tanks by trucks; water tanks, latrines, hand pumps, school toilets, tents, water containers, water pipes
World Vision – Sto. Domingo, Bacacay– garbage collection
Mercy Malaysia – hygiene kits
Agua Vida – water purifier – Guinobatan
Daughters of Charity – latrines – Daraga
IFRC – water containers, water pump, hygiene kits
UNFPA – hygiene & reproductive kits, health promotion, generators
WHO – medical kits, hygiene kits, health promotion, generators
TzuShi Foundation – water purification machine in Daraga
IFRC/PNRC – household toilet in selected communities
City Government of Manila – water purification machines

Medical Teams – conducted consultations
Mercy Malaysia –Malilipot, Malinao, Legazpi
Mercy Singapore –Malilipot, Legazpi
Adventist Development and Relief Agency (ADRA) - Daraga
Veterans’ Memorial Medical Center – Daraga
PAGCOR – Legazpi
Tsu-Zhi Medical – Daraga (with minor surgery)
Australian Aid International – Legazpi, Daraga
Philippine Public Safety College – Legazpi
Handicapped International – Daraga, Camalig, Guinobatan
ABS-CBN Foundation – Sto. Domingo
Association of Medical Doctors of Asia (AMDA)
Manila Doctors Hospital Med. Mission Group
Bureau of Fire Protection Medical Team – Sto. Domingo
Daughters of Charity – Daraga
Lions International – Tabaco & Legazpi Cities

Drugs and Medicines
UNICEF
Ministry of Health of Indonesia
Ministry of Health of Malaysia
Medicins sans Frontier
UNESCO - ITT
ABS-CBN Foundation
DZGB/DWGB fm
Daughters of Charity
WHO

Stress Debriefing Services
Scientology – Daraga
World Vision Dev’t Foundation – Daraga, Sto. Domingo
Ateneo de Manila/LaSalle – Daraga, Sto. Domingo
UERMMC – Guinobatan
DSWD – Legazpi City, Daraga, Camalig & Guinobatan
SAC/COPE/Coastal Core/Christian Aid

Rehabilitation of Health Infrastructure
Medicins sans Frontieres
WHO
UNFPA

Logistics
World Food Program (WFP)
International Organization for Migration (IOM)

Others
Operation Compassion (OC)
Albay Disaster Response Network (ADRN)
A Single Drop
AQ Foundation
Bicol Center for Community Development (BCCD)
Peace Corps
U.S. Navy (PELELIU)
U.S. Marine Expeditionary Forces

HEALTH REGULATION

Regulation Function
The present regulatory structure of the PHO is narrowly focused on sanitary clearances only because the health regulatory function was not devolved and has stayed with the DOH.

Clearances & Certifications
Sanitary and Site Clearances :
1. Drinking Water Site Survey and Clearances – issued before the issuance of the certificate of potability of water which is a requisites to a propose construction or repair/improvement of any water supply systems (Level I, II and III).
2. School Site Sanitary Survey and Clearances – issued before a school, whether private or public school is to be established or constructed.
3. Transport/Vehicle Sanitary Clearance – issued to all vehicle use for the transportation of any food, drinking water, wine and beverages for human consumption.
4. Other Sanitary Survey/Inspection and Clearances – such as sanitary inspection of burial ground/cemetery, sanitary inspection of crematorium, sanitary inspection of funeral establishment/morgue, sanitary survey and clearances of industrial hygiene, markets and abattoirs, public swimming and bathing places, hotels, motels, lodging/boarding houses and the likes, restaurants and other food establishments, clinics, parlors and sauna bath, and other public places.

Certificate of Drinking Water Potability – issued to certify that the water quality of any water supply system has passed the Philippine National Standard for Drinking Water as prescribed under the Code on Sanitation of the Philippines(PD 856).
Environmental Health Impact Certificate – issued to all proposed construction, repair or improvement of any projects, future programs and policies which may have a potential effects on health of the population and the distribution of these effects within the population and to help identify and consider the potential or actual health and equity impacts of a proposal on a given population and environment.

Monitoring
Public Health
ACT for Health = Albay Composite Team
DOH Program Coordinators
PIR = Program Implementation Review (PHO)

Hospitals
Internal Control Unit (PGA)
DOH Standards & Licensing
PhilHealth Accreditation Team

INTERLOCAL HEALTH ZONE, Albay, 2006

AID FOR HEALTH [Albay Integrated Developers for Health] (First District)
Tiwi
Malinao
Tabaco City
Bacacay
Malilipot
Sto. Domingo
Ziga Mem. Dist. Hosp.

CRADLEMAN Health Zone {Second District)
Camalig
Rapu-Rapu
Daraga
Legazpi City
Manito
Bicol Regional Teaching & Training Hosp.

JOLLIPPOGUI Health Zone (Third District)
Jovellar
Ligao City
Libon
Pioduran
Polangui
Oas
Guinobatan
JB Duran Mem. Dist. Hosp.

Drinking Water Quality Monitoring Committee

Municipalities/Cities with DWQMC:
Legazpi City
Rapu-Rapu
Malinao
Oas
Guinobatan
Camalig
Malilipot
Tiwi
Polangui
Bacacay
Sto. Domingo
Tabaco City
Libon


Municipalities/Cities without DWQMC:
1. Manito
2. Daraga
3. Jovellar
4. Pioduran
5. Ligao City

Diabetes Club, Albay, 2006
Municipalities/Cities with Diabetes Club

Malinao
Guinobatan
Tiwi
Oas
Malilipot
Polangui
Tabaco City
Manito
Sto. Domingo
Libon
Daraga
Bacacay
Camalig
Ligao City
Jovellar
Legazpi City

Municipalities without Diabetes Club
Pioduran
RapuRapu

Sentrong Sigla Facilities, Albay, 2006

With Accreditation
Malinao
Bacacay
Tabaco City
Sto. Domingo
Malilipot
Legazpi City
Daraga
Camalig
Guinobatan
Ligao City
Oas

Without Accreditation
Manito
Jovellar
Pioduran *
Rapu-Rapu
Libon
Polangui
Tiwi *

* on process

TB LINC

LINKING INITIATIVES and NETWORKING to CONTROL TUBERCULOSIS

TB situation
Global Rank: 9th among 22 high TB burden countries
Regional Rank: 3rd among WPR countries
TB Incidence (new smear +) = 133/100,000
Case detection rate (2005) = 73%
Cure rate (new smear +) = 81%
Success rate (new smear +) = 89%

Challenges
Wide variation in program performance across regions and provinces
Inaccessible DOTS services in some areas
Low level of participation by the private practitioners
Poor health-seeking behavior of communities
Weak local health systems

Background of TB LINC
USAID-funded
Managed by the Philippine Business for Social Progress (PBSP) with 5 consortium partners
5 years (2006-2011) $12.5 Million
Primarily, will provide technical assistance (TA)
Will be implemented in 21 provinces / cities

Project Goal
Assist the GOP attain the MDGs (reduce by half the TB prevalence and mortality) by contributing to the achievement of the following targets;
70% case detection rate
85% success rate

Project Objectives
1. Improve the policy, financing and regulatory environment
2. Improve human and systems capacity for quality DOTS implementation
3. Improve utilization of DOTS facilities and services, and influence behaviors/attitudes

Project targets
80% of LGUs increased case notification rate
80% of LGUs with success rate of at least 85%
75% of LGUs purchased Cat. 3 anti-TB drugs
70% of DOTS facilities are PhilHealth-accredited
100 PPMDs established
90% of microscopy centers providing DSSM according to national standards
90% of DOTS facilities are without drug stock-outs
Increased proportion of community adopting appropriate health-seeking behavior

Consortium Partners
CODE NGO
League of Provinces of the Philippines
Philippine Academy of Family Physicians
Philippine College of Occupational Medicine
Philippine Pediatrics Society
Chemonics International (U.S.)

Project Approaches
DOH will be the lead agency
Collaborative and coordinated multi-stakeholder involvement
Complementarity other USAID-funded project
Linkage of national, subnational, and local approaches
Sustainable interventions

Other USAID-funded projects
Health Governance (Health-Gov)
Health Policy and Development Program (HPDP)
Sustainable Health Improvement through Empowerment and Local Dev’t (SHIELD)
A2Z
Health promotion and communication (HPC)**
Private Sector Social Mobilization (PRISM)

Project Components

Component 1
Policy and Finance
Component 2
Systems Strengthening
Component 3
DOTS utilization

PROJECT COMPONENTS
Linking Initiatives and Networking to Control Tuberculosis
Strategic Objective: Desired family health sustainably achieved
ARMM: - Participating units achieving at least 85% treatment success rate for TB
National: - Participating units achieving at least 85% treatment success rate for TB

Component 1:
Policy, Financing and Regulatory
Environment for DOTS Implementation Improved
Subcomponents
1.1: Policy environment improved
1.2: Financing improved
1.3: PPMD DOTS scaled-up and sustained
1.4: Coordination and collaboration strengthened

Component 2:
Systems Capacity for Quality DOTS
Implementation
Improved
Subcomponents
2.1: Human resources and institutional capacity for TB control strengthened
2.2: TB lab network strengthened
2.3: Management and supply of quality anti-TB drugs improved
2.4: Management of MDR-TB improved (PMTM)

Component 3:
Utilization of DOTS Facilities/Services and Behavior and Attitude for TB Control and Treatment
Improved
Subcomponents
3.1: Knowledge and health behaviors improved
3.2: Community involvement in TB detection and treatment improved

Component One – Policy and Finance
1.1 Improved Policy Environment
1.2 Improved and Sustained Financing
1.3 Scaled Up and Sustained PPMDs
1.4 Strengthened Coordination and Collaboration

Goal
Improve national and local policy and financing environment to ensure quality and sustainable DOTS implementation

Key Result areas
National and local policies supportive of DOTS (includes localization of issued-policies like CUP and DOLE guidelines)
Increased financial resources for TB control (include LGU support and PhilHealth)
Financially sustainable public and private DOTS clinics
Stakeholder partnerships for TB control

Component Two – Systems Strengthening
2.1 Strengthened Human Resources and Institutional Capacity for TB Control
2.2 Strengthened TB Laboratory Network
2.3 Continued Supply of Quality Anti-TB Drugs and improved TB drug selection and use
2.4 Improved Management of MDR-TB

Goal
Ensure that health care providers, both public and private, provide quality DOTS

KRAs
All DOTS providers had been trained
200 PPMDs are established
Functional TB laboratory network
TB microscopy laboratories are providing diagnostic services according to standards
DOTS services are accessible in difficult areas
Anti-TB drugs are always available
Contributed to addressing MDR-TB

Component Three – DOTS utilization
3.1 Improved Knowledge and Health Seeking Behavior for TB
3.2 Improved Community Involvement in Improving TB Case Detection and Treatment

Goal
Improve utilization of DOTS facilities and services, and behavior and attitudes to TB control and treatment.

KRAs
Community and households adopting appropriate health-seeking behavior
Increased proportion of TB symptomatics promptly consulting DOTS center
Improved adherence to treatment
Empowered TB clients to do advocacy, communication, and social mobilization (ACSM)
More groups supporting TB control

Some key interventions
Geographic convergence of TB initiatives in supply, demand and policy environment
Strengthening local governance
Networking of DOTS providers
Inter-LGU collaboration to TB control
TB control initiatives in resource-poor areas

Engagement process
Series of CA meetings with DOH, other government agencies, developmental partners,
LGU engagement to be coordinated by HealthGov in non-ARMM areas and by SHIELD in ARMM areas
Orientation of the regional / provincial stakeholders
Coordinated planning with province / LGUs
Regional / provincial investment planning in ARMM
TA to be provided based on local needs

Challenges in ARMM
Making DOTS services available in difficult areas: geographically isolated, conflict-areas
DOTS for mobile TB patients e.g. those traveling to Malaysia or Zamboanga City
Culturally sensitive TB communication materials
LGU support to TB control in non-devolved set-up
PhilHealth accreditation of DOTS facilities in resource poor areas

How to contact TB LINC
Dr. Dolores C. Castillo
Chief of Party
TB LINC
Suite 903, 9F Ma. Natividad Bldg.
470 T.M. Kalaw Avenue corner
Cortada St., Malate, Manila 1000
02-5671434

HealthGov

Strengthening Local Governance for Health

Cooperating Agencies

RTI International
In partnership with
JHPIEGO
CEDPA
PNGOC

Where we are:
Over 500 LGUs
23 provinces
6 HIV/AIDS high risk zones
Luzon, Visayas and non-ARMM Mindanao

HIV/AIDS zones:
Clark Development Zone (Angeles, San Fernando)
Metro Manila (Pasay City, Quezon City)
Iloilo-Bacolod
Metro Cebu (Lapu-Lapu, Mandaue, Cebu City)
Zamboanga City
Davao City-General Santos

Our Goal
Together with DOH-CHD, work with LGUs, NGAs, NGOs/CSOs, help to strengthen LGUs’ commitment to and support for public health services, and capacity to provide, manage, and finance quality health services sustainably by providing assistance in:
Developing LGU capacity for continuous participatory problem solving supported by advocacy (DEMAND)
Developing TAP capacity to provide high quality, customer-oriented TA services needed by LGUs (SUPPLY)

Program Areas
Family planning
Maternal and child health
Vitamin A and Micronutrients Supplementation
Tuberculosis
HIV/AIDS
Emerging Infectious Diseases e.g. Avian influenza, severe acute respiratory syndrome (SARS)

What are the Areas for Technical Assistance ?

F1 Reform mechanisms:
Financing (more, better and sustained financing for health)
Regulation (assured quality and affordability of health goods/services)
Service delivery (ensured access and availability of essential basic health packages)
Governance (improved health system performance)



Strengthening key LGU management systems
Improving and expanding LGU financing of key health services
Improving service provider performance
Increasing advocacy on service delivery and financing

Impact/outcomes
Better health outcomes (Improved health sustainably achieved)
Equitable health care financing
More responsive health system (public satisfaction)

Approach
Synergy with FOURmula ONE
Promoting governance for health
Market-driven framework
Strategic use of technical assistance providers (TAPs)
Partnering with DOH, POPCOM, and PhilHealth, NGOs/CSOs

Key Interventions
Strengthen key LGU management systems (IR 1.1)
Improve and expand LGU financing for key health services (IR 1.2)
Improve service provider performance (IR 1.3)
Increase advocacy for service delivery and financing (IR 1.4)
Scoping - consultation meetings
- all regions, provinces
- HIV areas, NGOs/CSOs
Visit to Governors
NGO/CSO Consultation
SDIR / CSR / Financial Mgmt Orientation
Advocacy Activities
Health Planning

USAID TA Teams’ Partnership with DOH, CHDs and LGUs
Facilitate common understanding of health and development, local governance for health, CSR and family health concerns among partners.
Assist LGUs and partners to strengthen local information system for evidence-based participatory decision making.
Assist LGUs and partners adopt HSR consumer/stakeholder participation strategies
Assist in strengthening institutional mechanisms for participatory decision-making.
Assist in developing tools for planning and systems development (local information system; M&E; procurement and logistics; financing and public finance management; quality improvement systems, etc.)
Establish clear policy links between DOH Central Office, CHDs and LGUs.

USAID Technical Assistance Program for Health

SOAG
USAID’s assistance to the Government of the Philippines is defined by a Strategic Objective Agreement (SOAG) between the two parties through DOH, signed in September 2006
SOAG aims to support the DOH’s national health program, represented by the FOURmula ONE for Health Strategy
USAID program also supports other GRPs agencies’ needs for technical assistance. These agencies include PHIC, NNC, POPCOM; DOF, DILG and DOLE

DOH’s FOURmula ONE (F1):
reform mechanisms and impact/outcomes

F1 Reform mechanisms:
Financing (more, better and sustained financing for health)
Regulation (assured quality and affordability of health goods/services)
Service delivery (ensured access and availability of essential basic health packages)
Governance (improved health system performance)

Impact/ outcomes

Better health outcomes
Equitable health care financing
More responsive health system (public satisfaction)

STRATEGIC OBJECTIVE
Improved family health sustainably achieved

INTERMEDIATE RESULT 1
LGU Provision and management of FP/MCH/TB/HIV-AIDS services strengthened

IR 1.1
Key management systems to sustain delivery improved
IR 1.2
LGU financing for key health programs improved
IR 1.3
Performance among service providers improved
IR 1.4
Advocacy for the financing and delivery of health services at the local level increased

INTERMEDIATE RESULT 2
Provision of quality services by private and commercial providers expanded

IR 2.1
Number of TB DOTS and FP service providers in the commercial sector increased
IR 2.2
Quality of commercial sector provision of TB DOTS and FP improved
IR 2.3
Sales of unsubsidized contraceptives increased
IR 2.4
Supply of affordable fortified foods increased

INTERMEDIATE RESULT 3
Greater social acceptance of family planning achieved

IR 3.1
Communications adequately portraying FP as a mainstream health intervention increased
IR 3.2
Key segments of society advocating for the use of FP increased
IR 3.3
Acceptance of FP as a part of routine service package increased

INTERMEDIATE RESULT 4
Policy environment and financing for provision of services improved
IR 4.1
Policies and financing to ensure supply of contraceptive established
IR 4.2
Appropriate legal and regulatory policies to promote provision of services established
IR 4.3
Policies to mobilize financing and resources for key services established

USAID aims to support the Philippines national health strategy, represented by FOURmula ONE

F1 Reform mechanisms:
Financing (more, better and sustained financing for health)
Regulation (assured quality and affordability of health goods/services)
Service delivery (ensured access and availability of essential basic health packages)
Governance (improved health system performance)

USAID’s strategic assistance
IR.1 LGU provision and management of FP/MCH/TB/HIV-AIDS services strengthened
IR.2 Provision of quality services in the commercial sector increased
IR.3 Greater social acceptance of family planning achieved
IR.4 Policy environment and financing for provision of services improved

Impact/outcomes
Better health outcomes (Improved family health sustainably achieved)
Equitable health care financing
More responsive health system (public satisfaction)

USAID Projects

USAID strategic assistance

IR 1. LGU provision and management of FP, MCH, TB, HIV/AIDS services strengthened
IR 2. Provision of quality services in the commercial sector increased
IR 3. Greater social acceptance of family planning achieved
IR 4. Policy environment and financing for provision of services improved

Leads to:
HealthGov, TB LINC, A2Z, ARMM-SHIELD
PRISM, TB LINC, A2Z
Health Communications Project
HPDP

FOURmula 1 FOR HEALTH

By: MA.GLENDA A. FORTUNO, M.D., MPH
Medical Specialist IV
DOH Representative for Albay

Another topic during the Albay Health Summit...

Fourmula One for Health (F1):
DOH Strategic Plan to implement health reforms (2005-2010)
Implementation framework for health sector reforms in the Philippines
Designed to implement critical health interventions as a single package backed by effective management infrastructure and financing arrangements
Engages the entire health sector to get involved in the implementation of health reforms
Invitation to join the collective race against: a. fragmentation of the health system; b. Inequity of health care; c. Impoverishing effects of ill health

General Objective:

To achieve critical reforms with speed, precision and effective coordination directed at improving the quality, efficiency, effectiveness and equity of the Philippine Health system in a manner that is felt and appreciated by Filipinos especially the poor.

Local governance in health (realizations):

There are major health problems. LGU resources are limited. Need for health interventions that are effective, efficient and equitable.
Individual interventions implemented in isolation will not work, it might even do more harm. Need to implement an integrated package of mutually supporting interventions.
Health sector is not just the public health sector but includes the private sector as well. LGU health governance includes involving the private sector.
LGUs should view NGOs/CSOs not as adversaries but as partners in health.
Health sector reform is a complex undertaking; it requires participatory decision-making for it to succeed.

The Micronutrients: Vitamin A, Iron and Zinc

MICRONUTRIENTS

“Called micronutrients because they are needed only in miniscule amounts; these substances are the “magic wands” that enable the body to produce enzymes, hormones, and other substances essential for proper growth and development. As tiny as the amounts are, however, the consequences of their absence are severe” (WHO 2006)

Vitamin A, iron and zinc are micronutrients

What is Vitamin A?
It is an essential nutrient needed by the body for normal sight, growth, reproduction, cell differentiation and immune competence

What are the Consequences of Vitamin A Deficiency Disorders?
23% higher child mortality
More severe infections
Major cause of preventable childhood blindness
Weaker immunity
Poorer growth

What are the Community Consequences of Vitamin A Deficiency Disorders?
More child deaths
More children in hospitals
Higher health care cost
Life-long burden of caring for the blind
More underweight children

How will you know that your Community has Vitamin A Deficiency Disorders?
High Rates of Child Malnutrition, Persistent Diarrhea, Respiratory Infections, Measles
Low Rates of Breatsfeeding
Low intake of Vitamin A - rich foods
Under Five Mortality Rate - (U5 MR > 50 per 1,000 live birth)

What can the Governor/Mayor and Sanggunian do?
Extend your political leadership to the Garantisadong Pambata (GP) Campaign
Ensure enough supply of Vitamin A Capsules at the health center for children with measles, severe pnuemonia, persistent diarrhea and underweight and post partum women

What is Iron?
Essential trace mineral needed for hemoglobin formation
Stored in the liver, bone marrow and spleen
Better absorbed with Vitamin C

What are the Consequences of Iron Deficiency?
Adults:
Fatigue, low work productivity, apathy

Infants:
Low birth weight, increased illness

Children:
Poor attention span, reduced memory
Lower scores on achievement tests
Poor cognitive development

Mothers
Increased illness and maternal deaths



What can the Governor/ Mayor and Sanggunian Do?
Ensure supply of iron supplements for pregnant women, lactating women, infants and children in the health center
Promote exclusive breastfeeding up to 6 months
Promote use of appropriate complementary foods
Ensure supply of deworming drugs in the health center

New Developments
Zinc supplementation decreases the episodes, reduces the duration and severity of diarrhea

Why use Reformulated Oral Rehydration Salts (ORS)?
Reformulated or improved ORS - has reduced glucose and salt (NaCl) concentrations

Shortens diarrhea episodes
Reduces the severity of diarrhea
Minimizes fluid and electrolyte losses
Prevents malnutrition
Prevents complications

A2Z

I am now posting the lectures from the Albay Health Summit where I have attended and Board Member Borja (Uncle Nonon).

A2Z
The Micronutrient Project

Background

1. Vitamin A deficiency and anemia are public health problems.
- the prevalence of VAD and anemia have been increasing in the past decade - the country’s attainment of the MDGs is seriously compromised unless the MN situation is improved

2. Pneumonia, diarrhea and measles are leading causes of child deaths. These childhood illnesses are preventable through MN.

3. The multiple causes of VAD and anemia include inadequate intake of bioavailable vit A and iron, frequent and persistent infections, poor sanitation and hygiene and poor women’s health.

4. Government addresses VAD through vit A supplementation for children 6–59 mo. and high-risk population groups.
- VAS coverage has been declining, while not all LGUs procure VACs for high-risk groups

5. There is no comprehensive National Anemia Reduction Plan, thus no package that addresses the multiple causes of the problem.

6. Deworming which addresses anemia was a component of Garantisadong Pambata in 2006 and 2007 but not in earlier years.

7. While DOH adopted iron supplementation in the control of anemia(DO#181,s2000), provision of iron supplements(along with other health services), is the LGU responsibility.

8. Zinc as an adjunct therapy for diarrhea is not yet in place in the public sector.
- Guidelines for the use of zinc with the low osmolar Oral Rehydration Solution(ORS) have been incorporated in the IMCI algorithm but not all of the health staff has received training/updates

9. While there is a Food Fortification Law (The Philippine Food Fortification Act of 2000 or Republic Act 8976), it has not been fully implemented.
- the quality and coverage of wheat flour and oil fortification are still inadequate
- rice and sugar fortification have been beset with major difficulties
- the Sangkap Pinoy Seal (SPS) Program for processed foods is mainly increasing Vitamin A intake

Overall Approach
Technical Assistance at the National Level

Support policy and program development
Policy review/revision (Micronutrient Supplementation, Food Fortification),
Formulation of National Strategic Plans (Anemia Reduction, Food Fortification) and Policies (use of zinc for diarrhea treatment),
Analysis of national nutrition data for policy
Development, of monitoring and quality control systems for the Food Fortification program)
Strengthening LGU capability to assess, plan, implement and monitor micronutrient programs
Development of management and monitoring tools
Conduct of LGU advocacy fora for support to micronutrient interventions
Communication micro-planning on micronutrient program



A2Z Secondary Objectives
• Increase in VAS coverage among high-risk (severe pneumonia, persistent diarrhea, measles and undernutrition) children
• Increase VAS among post partum women, within one month after delivery
• Increase supplementation coverage for complete iron dosage(1tablet/day for 6 mo or 180 days) among pregnant women
• Increase iron supplementation coverage among children, 6-59 months
• Increase deworming coverage among children, 12-59 months

A2Z Technical Assistance to 29 USG Assisted Areas
Health Gov: 23 Provinces

LUZON
- Albay
- Bulacan
- Cagayan
- Isabela
- Nueva Ecija
- Pangasinan
- Tarlac

VISAYAS
- Aklan
- Bohol
- Capiz
- Negros Occidental
- Oriental Negros

MINDANAO
- Agusan del Norte
- Bukidnon
- Compostela Valley
- Davao del Sur
- Misamis Occidental
- Misamis Oriental
- Sarangani
- South Cotabato
- Zamboanga del Norte
- Zamboanga del Sur
- Zamboanga Sibugay

SHIELD - 6 Provinces

ARMM
- Basilan
- Lanao del Sur
- Maguindanao
- Sharif Kabunsuan
- Sulu
- Tawi-tawi