hlmp doctor to the barrio
DESCRIPTION
Sharing of practices that actually workedTRANSCRIPT
The DTTB ExperienceSharing Experiences that Worked
By Bien Eli Nillos, MD DTTB Batch 23
“He has the right to criticize who has the heart to help.” ~Abraham Lincoln
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
Learning the Ropes
“A single conversation with a wise man is better than ten years of study.” – Chinese Proverb
• Substandard Health Indicators
• Inaccessibility of Health Care Services
• Limited Resources
• Poor Health Seeking Behaviors
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)
Maternal Mortality Rate per 1,000 LB
0
3.92
5.69
MMR
2006
2007
2008
Taking Care of the Mothers of Candoni
“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
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
NTP
Case Detection Rate TB Cure Rate
2007 2008 2007 2008
PTB 42%62%
(88% in 2009)
93%92%
(94% in 2009)
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%)
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
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%)
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
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
COMMUNITY HEALTH INITIATIVES PARTNERS (CHIP)
Relations and Advocacy Managers (RAM)
Legislative Action Network (LAN)
MONITORING team (MONITOR)
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
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
“Anything worth doing is difficult”
-Patch Adams