Eastern Visayas Area Cooperation for Health (Enhancing Access to and Utilization of Maternal & Family Health

Services by Selected Underserved Sectors in Eastern Visayas through the Co-operative Enterprise System)

With support from:

Overview

1. Challenge and opportunity

2. Our response

3. What we intend to accomplish in 3 years

4. How we do it

5. The partners

The Challenge ... and Opportunity

• 11 Filipino mothers die every day in the Philippines

• EV one of the top 5 worst places to be a mother • EV Maternal Mortality Rate (Deaths per 100, 000

live births) 229.8 (2004)* • EV Total Fertility Rate(number of children within

reproductive years) 4.3 (2008) – top 4 regions * compared with 110 in Thailand, 62 in Malaysia

and 14 in Singapore; only 62% of births are supervised by skilled personnel

Challenge and opportunity…

http://web.evis.net.ph/neda8/index2.php?option=com_content&do_pdf=1&id=131; accessed: 19January2011

• HIV infections rising (Cebu outbreak: 1 in 2 IDUs is infected!)

• Worsening poverty in EV: 35.3% in 2003 to 40.7% in 2006

• Under-five mortality is second highest (64 deaths) – ARMM (94 deaths) (NDHS, 2008)

• Prevalence of Underweight Children (0-6 years old) 18.1 % (2009)

Challenge and opportunity…

http://web.evis.net.ph/neda8/index2.php?option=com_content&do_pdf=1&id=131; accessed: 19January2011

• Basic Literacy Rate 90.1% (2003)

• Functional Literacy Rate 76.7% (2003) 79.7% (1994)

• Elementary Net Enrolment Ratio 76.2% (SY 2008-2009)

• Secondary Net Enrolment Ratio 44.7% (SY 2008-2009)

• Elementary Cohort Survival Rate 61.6% (SY 2008-2009)

• Secondary Cohort Survival Rate 63.6% (SY 2008-2009)

Challenge and opportunity…

Reasons for high maternal mortality:

1. biological causes and risk factors

2. poor access to health facilities and quality maternal services

3. inadequate political support as manifested by lack of budget and unsupportive policy environment

4. societal and cultural factors

Challenge and opportunity…

The Health Care System

• “Dilapidated shacks for the poor and gleaming palaces for the rich” …. i.e., public health system inadequate to meet growing needs; private health system highly commercialized

• PNoy government emphasis on ‘universal access’ to health care

• Health financing schemes on offer, e.g., DBP loan for PPPs on health

• Back to ‘primary health care’ approach: can we put health back into the hands of communities?

Challenge and opportunity…

Our Response: The 3rd Leg

Government Sector-based Healthcare

Business Sector-based Healthcare

Coop Sector-based Healthcare

Self-reliant, healthy and prosperous family (and

communities)

Our response …

APPROACHES: primary health care approach; CO/CD approach; social enterprise approach

PRINCIPLES: community ownership; gender equity; continuum of quality care

Women, young girls and men

Access to efficient and

effective maternal

and family health

including family

planning and HIV

prevention services

Coop-operated MFH facilities/programs

Business-operated MFH facilities/programs

Government-operated MFH facilities/programs

STRATEGIES: behavior change communication; coop-based service delivery; linkaging & networking

COOPERATIVE-BASED HEALTH SYSTEM STRENGTHENING FOR MFH

CLIENTELE GROUPS OBJECTIVE SERVICE POINTS

Our response …

GOAL

Reduce maternal and child/

family mortality

and morbidity

OBJECTIVE

Enhance access to

efficient and effective

maternal and family health

including family

planning and HIV

prevention services

SYSTEMS LEVEL

Coordination and consolidation for synergy (see: Results 5 & 6)

ORGANIZATIONAL LEVEL

Enterprise development for service delivery (see: Result 4)

INDIVIDUAL LEVEL

Learning processes for behavior change and competency development (see Results 1, 2 & 3)

INPUTS

funds, technology and human resources

DOMAINS & INTERVENTIONS

CONCEPTUAL FRAMEWORK Our response ……

1 Objective

To enhance access to efficient, effective, quality and affordable maternal and family health including family planning and HIV prevention services to underserved groups in selected communities in Eastern Visayas.

What we intend to accomplish…

3 Performance Indicators

1. Improved level of KASP of target population

2. Increased percentage of co-op women, girls and men accessing health services

3. Increased percentage of coverage (by area, by type of client groups) and reach of health service/s provided by co-operatives

What we intend to accomplish …

5 Planned Results within 3 Years

Result 1: Effective behavior change communication (BCC) modules

Result 2: Fully-informed and motivated clients availing of services

Result 3: Capable health workforce

Result 4: Viable coop-based health-focused initiatives/enterprises (11)

Result 5: Effective project management and support mechanism

What we intend to accomplish…

After 3 years: 11 viable health enterprises

at least 15,000 clients

served by at least 70 well-trained health promoters

a co-op based ‘social health enterprise technology package’

in at least 10 model towns/areas

with a regional support mechanism (EVAcoh + TAF)

What we intend to accomplish…

What’s in it 4my co-op?

1. Additional service/benefit to members => better use of loan => more productivity

2. Convert a cost-center to another profit-center => more profitability

3. Compliance to social audit => more community relevance and impact

What we intend to accomplish…

NOTES: Amount of subgrant will be based on approved business plan. TAF = Technical Assistance Fund

COOP-BASED SOCIAL HEALTH

ENTERPRISE (SHE)

PHANSuP-VICTO

PRIMARY CO-OP

EUROPEAN COMMISSION GRANT

= EUR 580,860

Using the EU grant + counterpart: 1. Technical assistance (e.g., trainings, etc) 2. Equipment/tools/ commodities/etc.

(case-to-case, depending on approved business type/plan)

Using the subgrant: 1. Staffing 2. Equipment/tools/ commodities/etc. 3. Space lease (if outside of co-op

property

3. Subgrant (equivalent to EUR 10,000 max inclusive of counterpart @ 1:3 leverage ratio)

TOTAL PROJECT BUDGET =

EUR 645,400

COUNTERPART = EUR 64,540

(Health Enterprise Fund, HEF c/o 10

primary co-ops as sub-grantees) = EUR 35,000

(@35% of subgrant amount)

+ PHANSuP-VICTO cash

counterpart = EUR 29,540 )

NET INCOME

>10% TAF

EVAcoh PROJECT FUNDING AND FUND USE SCHEME

How we do it ……

PROJECT STEERING COMMITTEE

PROJECT DIRECTOR (3 years)

LIAISON & ADVOCACY OFFICER (3 years)

PROJECT MANAGER (3 years)

KM & COMMS OFFICER (3 years)

TRNG & CAP BLDG SPECIALIST (2 years)

ACCOUNTING ASSISTANT (3 years)

DRIVER/MESSENGER (3 years)

ASST MGR FINANCE & ADMIN (3 years)

PROJECT COORDINATOR

(3 years)

PROJECT COORDINATOR

(2 years)

PROJECT COORDINATOR

(1 year)

OFFICE ASSISTANT (3 years)

PHANSuP = 3 (1 Chair, 2 members) VICTO = 3 (1 Vice-chair, 2 members) DOH Region 8 = 1 (member)

PROJECT MANAGEMENT STRUCTURE

COMMUNITY ENGAGEMENT TEAM LEADER

(1 year)

How we do it ……

Key Activities: Year 1

• PMO set-up

• Baseline research

• BCC materials development

• Trainings and workshops

• SHE establishment

• Mentoring

• Annual review and planning

How we do it ……

Learning Domains Learning Domain Indicative Learning Areas

1 Maternal and Family Health Promotion of maternal and neonatal health and nutrition

Prevention of infectious diseases (TB, hepa, influenza, etc)

Promotion of AYSRHR and prevention of STI/HIV/AIDS

Prevention and management of lifestyle diseases

Gender and prevention of violence against women and children

2 Social Health Enterprise Business planning and establishment

Business operations (marketing, finance, service delivery)

Business impact and sustainability

How we do it ……

Co-operative Venture Partners (CVPs) 1 Silago Multi-Purpose Cooperative (SMPC)

Silago, Southern Leyte

2 Sts. Peter & Paul Multi-Purpose Cooperative (SPPMPC)

Hinunangan, Southern Leyte

3 San Isidro Parish Multi-Purpose Cooperative (SIPMPC)

St. Bernard, Southern Leyte

4 Bontoc Multi-Purpose Cooperative (BCCI)

Bontoc, Southern Leyte

5 St. Francis Xavier Housing MPC (SFXHM)

Abuyog, Leyte

6 Help First Basey MPC (HFBMPC)

Basey, Samar

7 Palapag Teachers’ Cooperative

Palapag, Northern Samar

8

Northern Samar Development Workers Credit Cooperative (NSDWCC)

Catarman, Northern Samar

9 Biatungan Multipurpose Cooperative

Calbayog City, Samar

10

Libagon Area Multi-porpuse Cooperative Libagon, Southern Leyte

The partners ……

Allen

Calbayog

Palapag

Basey

Abuyog

Silago

Bontoc

Hinunangan

St Bernard

The partners …… Libagon

The Joint Venture Partners: 18 + 41

Philippine NGO Support Program, Inc. (PHANSuP)

• started in 1993 as one of the two country-level pilot projects in Asia and Africa of a group of donor agencies and international organizations to test a model to accelerate support to grassroots organizations in response to HIV

• in 1994, it was incorporated into a non-stock, non-profit institution and kept its name, PHANSuP, becoming 1 of the 2 pioneer ‘linking organizations’ of the International HIV/AIDS Alliance

• in 2008, it widened its development pathway to cover the entire sphere of community development with health and enterprise development, anchored on human rights, as the entry points.

The partners ……

10+2 = ?

VICTO National Co-operative Federation and Development Center (VICTO National) • established in 1970 in Hinundayan, Southern Leyte • in 1991, VICTO was the first country awardee on Development

Management given by the Asian Institute of Management (AIM) • in 2003, it was recognized by the Benigno S. Aquino Foundation

(BSAF) as one of the 20 organizations in the country that continues to work with the legacy of Ninoy in disadvantaged communities

• one of the largest secondary co-operative organizations in the Philippines with 215 active affiliate co-operatives that continue to be a mechanism for collective action to social transformation.

• it has spun off its financing arm called the Visayas Co-op Central Fund Federation (VICTO-VCF), which has 210 member co-ops and total assets of over P210 million.

The partners ……