hlmp doctor to the barrio
DESCRIPTION
Sharing of practices that actually workedTRANSCRIPT
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The DTTB ExperienceSharing Experiences that Worked
By Bien Eli Nillos, MD DTTB Batch 23
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“He has the right to criticize who has the heart to help.” ~Abraham Lincoln
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Highlights• Deployed in 2007
December
• Candoni, Negros Occidental
• 4th class municipality, one of the poorest towns in Negros Occidental
• Infamous for its history of insurgency – CHICKS area
• Mountainous, no costal areas, largely agricultural
• No health system in place
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Learning the Ropes
“A single conversation with a wise man is better than ten years of study.” – Chinese Proverb
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• Substandard Health Indicators
• Inaccessibility of Health Care Services
• Limited Resources
• Poor Health Seeking Behaviors
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Problem No. 1: Substandard Health Indicators
Reduce Maternal Mortality
Pending…MDR-trainedTraining for MDR/LSS
DONE (9/9)Inc. facility-based deliveries
Ordinance for Facility based
deliveries
DONEInc. Facility-based deliveries
Facility (DR) upgraded
StatusTarget OutputProposed Plans
24% (2007) to 74% (2008) and 85%
(2009)
Attended by skilled workers = 79% (from 58%) and 87% (2009)
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Maternal Mortality Rate per 1,000 LB
0
3.92
5.69
MMR
2006
2007
2008
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Taking Care of the Mothers of Candoni
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“My piece of bread only belongs to me when I know that everyone else has a share, and that no one starves while I eat” ~Leo Tolstoy
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Problem No. 1: Substandard Health Indicators
Reduced Morbidities and Mortalities
DONEPHILCAT accredited
TB DOTS accreditation
DONERenovated main health center
Renovation of Dispensary
DONEHL resolution
Heart Month
Institutionalize HL
StatusTarget OutputProposed Plans
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NTP
Case Detection Rate TB Cure Rate
2007 2008 2007 2008
PTB 42%62%
(88% in 2009)
93%92%
(94% in 2009)
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Problem No. 1: Substandard Health Indicators
DONEDec. morbiditiesThursday as well-baby clinic
ACHIEVEDInc. NBS to 50%NBS accreditation
ACHIEVEDInc. FIC to 90%Intensified Immunization
StatusTarget OutputProposed Plans
From 85%(2007) to 100% (2008)
NBS Accredited!NBS% = 65%
(2009) (from 7.1%)
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Problem No. 2: Inaccessibility of Basic Services
PLANNING Stage
Certified laboratory
Laboratory
DONEReach target of at least 3 BnBs
Botika ng Barangay
StatusTarget OutputProposed Plans
10 BnB’s
Pending
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Problem No. 3: Limited Financial and Human Resources
ACHIEVEDReach target of 15% of total HH
Enrollment of PHIC indigents
DONE
3-in-1 accreditation
OPB/TB DOTS and MCP
accreditation
StatusTarget OutputProposed Plans
2-in-1 accredited
MCP pending: target is June
2,035 HH enrolled (223%)
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Problem No. 3: Limited Financial and Human Resources
DONE but still not fully implementing
At least 5% of Hazard Pay
Implementation of Magna Carta
DONEUser Fee Ordinance enacted
Ordinance on User’s Fee
StatusTarget OutputProposed Plans
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Problem No. 4: Poor Health Seeking Behaviors
DONELHB resolutions, projects, etc.
Active LHB, ILHZ and BHWF
DONEInc. community participation
Establishment of CHART
(Community Health Allies and Reform
Team)
StatusTarget OutputProposed Plans
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COMMUNITY HEALTH INITIATIVES PARTNERS (CHIP)
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Relations and Advocacy Managers (RAM)
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Legislative Action Network (LAN)
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MONITORING team (MONITOR)
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Innovations• Midwife In Charge of DR
• Liaison Officer
• BnB Monitoring Team
• C.H.A.R.T.
• Database CBMIS/FHSIS
• Logistics Officer
• Alkansiyang Pampamilya/Buntis Baby Bag
• CANDONI’S BEST (outstanding BHS, outstanding Barangay Advocate for Health)
• Additional TB microscopist
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Struggles of a DTTB
“Between the great things that we cannot do and the small things we will not do, the danger is that we shall do nothing.” -Adolph Monod
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“Anything worth doing is difficult”
-Patch Adams