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Health Situational Report and Community Diagnosis Matuguinao, Samar

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Page 1: Health Situational Analysis

Health Situational Report

and Community DiagnosisMatuguinao, Samar

Page 2: Health Situational Analysis

Matuguinao Profile

• One of the far-flung municipalities in Western Samar

• Became a municipality on June 19, 1965 through RA 4221

Page 3: Health Situational Analysis

Matuguinao Profile

• town located along three river tributaries namely: Gandara, Pambujan and Las Navas

Page 4: Health Situational Analysis

MatuguinaoCalbayog

Gandara San Jose de Buan

Jipapad

Silvino Lobos

Las Navas

NOTHERN SAMAR

EASTERN SAMAR

BOUNDARIES:

Source: Matuguinao Ecological Profile, MPDC

Page 5: Health Situational Analysis
Page 6: Health Situational Analysis

Matuguinao Profile

• Total land area of 36, 420 hectares• Majority of the terrain are rugged and

moderately rolling that the use of land vehicle is difficult

Page 7: Health Situational Analysis

Matuguinao Profile

• Composed of 20 barangays• Most of the barangays can be reached by foot

Page 8: Health Situational Analysis

Barangays Distance from Poblacion (kms)

Approximate Travel Time (hrs)

Means of Transportation

Angyap 4 1-1.5 Foot/canoeBag-otan 1.5 0.5-1 FootBarruz 3 0.5-1 Foot/pump boatCamono-an 7 3-4 FootCarolina 18 5-6 FootDeit 7 2-3 Foot/canoeDel Rosario 9.5 5-6 FootInubod 20 7-8 FootLibertad 9 2-3 FootLigaya 10 7-8 FootMabuligon 0 - -Maduroto 0 - -Mahanud 3 0.5 FootMahayag 18 4-5 FootNagpapacao 7 2-3 Foot/canoeRizal 19 4-5 FootSalvacion 4 0.5-1 FootSan Isidro 7 2 FootSta. Cruz 6 1 FootSan Roque 28 9-10 Foot

Page 9: Health Situational Analysis

Matuguinao Projected Population• 1346 households with an average household size of 6• Population density of 37 persons per square kilometre

2009 2010 2011 20125800

6000

6200

6400

6600

6800

7000

7200

7400

7600

6591

6471

7418

6826

Page 10: Health Situational Analysis

Population Distribution among Barangays

AngyapBag-otan

BarruzCamono-an

CarolinaDe-it

Del RosarioInubod

LibertadLigaya

MabuligonMadurotoMahanudMahayag

NagpapacaoRizal

SalvacionSan Isidro

San RoqueSta. Cruz

0 200 400 600 800 1000 1200 1400

162184

65691

141230

145251

17193

13631254

308175

369290

161273

392117

Page 11: Health Situational Analysis

Socio-Economic ProfileIncome Class 5th Class

Basic Agricultural Products Coconuts, Abaca, Rootcrops, Rice, Banana

Available Machine for Livelihood Tractor, Rice Mill

Communication Facility Smart Communications satellite receiver, privately owned Dream and Cignal cable television

Transportation Facility Motorboat, motorcycle (habal2x)

Literacy Rate 47.59%

Religion Roman Catholic, UCCP, United Pentecostal Church

Language Waray-waray, Tagalog

Beliefs Tambalan, Parapanhingugmad, Panluon, Paragtigo, Parapantimughat

Page 12: Health Situational Analysis

Municipal Government ProfileMayor Melissa A. Dela Cruz, CPA

Vice Mayor Salvador Floquencio

SB Chair on Health Christopher dela Cruz

LIGA President Norbito Diaz

Treasurer Cresilda Alegria

Accountant (Designate) Engr. Jobert Alegre

Budget Officer (Designate) Mathilda Morillo

MPDO Engr. Jobert Alegre

MSWDO Arlyn Alegria

MAO Alejandro Paller

ME Engr. Felimon Cobilla

MASSO Rebecca Alarcon

HRMO Mathilda Morillo

MNAO Cleofe Belonio

BHW Federation President Aida Gonzaga

Page 13: Health Situational Analysis

Rural Health Unit Profile

Page 14: Health Situational Analysis
Page 15: Health Situational Analysis

Health Human Resource

November 20104 permanent MIDWIVES

1 Casual Nurse

1 Detailed Nurse

2 Utility Workers

1 Visiting Dentist

July 20124 permanent MIDWIVES

1 permanent NURSE

1 Detailed NURSE

2 Utility Workers

1 Visiting Dentist

5 RN Heals

Page 16: Health Situational Analysis

Health Human Resource64 Barangay Health Workers• 31 Accredited• 19 Registered• 31 Without Basic Training

43 Barangay Nutrition Scholars

• 0 with Basic Training

• 12 with Training on Promotional Good Nutrition~ 20 Active Hilots/TBAs

Page 17: Health Situational Analysis
Page 18: Health Situational Analysis

RHU Information and Record Section

Page 19: Health Situational Analysis

RHU Treatment and Emergency Area

Page 20: Health Situational Analysis

Laboratory and Stock Room

Page 21: Health Situational Analysis

Labor and Delivery Room

Page 22: Health Situational Analysis

EquipmentsEQUIPMENT QUANTITY STATUS

Electric Microscope 2 Functional

Nebulizer 1 Functional

Drop Light 2 Functional

Delivery Table 1 Needs Repair

Treatment table 1 Functional

Desk fan 1 Functional

Ceiling Fan 5 Functional

Weighing scale (Detecto) 1 Needs replacement

Bathroom Scale 3 Functional

Computer desktop 1 Functional

Printer 1 Non-functional

Currently there are no ambulance, oxygen tank, intubation set, newborn weighing scale, Examination Table, Water Tank, and Laboratory equipments like centrifuge and WBC Counter.

Page 23: Health Situational Analysis

Status of the Implementation of Magna Carta Benefits to PHW

2009 2010 2011

Subsistence and Laundry Allowance

1650.00 1650.00 1650.00

RATA (MHO) 7700.00 7700.00 7700.00

Medico-legal allowance

None None None

Hazard Pay None None 25% of basic pay

Overtime Pay None None None

Remote Assignment Allowance

None None None

Longevity/Step Increment

None None None

Page 24: Health Situational Analysis

Health Financing

2009 2010 2011 20120

1

2

3

4

5

6

3.7%4.2%

4.8%5.45%

Prce

ntag

e of

Hea

lth B

udge

t fr

om M

unic

ipal

Bud

get

National Standard Budget for Health = 15% of the Total Municipal Budget

Page 25: Health Situational Analysis

MOOE To Total Health Budget

National Standard: 45% of the Total Health Budget

2009 2010 2011 20120%

2%

4%

6%

8%

10%

12%

14%

16%

18%

4%

6%

8%

16%

Percentage of MOOE to Total Health Budget

Page 26: Health Situational Analysis

PhilHealth Enrolment

Sponsor # of Enrolees

NHTS 1309

LGU 500

TOTAL 1809

Page 27: Health Situational Analysis

Health Facilities

• 1 Rural Health Unit/Lying-in Facility (dilapidated)• 2 Barangay Health Stations– BHS Nagpapacao (dilapidated)– BHS San Isidro (dilapidated)

• 5 Botika ng Barangay• 2 BnBs are pending• No private clinics, birthing unit, and pharmacies• No Ambulance

Page 28: Health Situational Analysis

Medicines and Technology20 ESSENTIAL MEDICINES

MEDICINE AVAILABILITY MEDICINE AVAILABILITY

Paracetamol Tablets only Rifampicin Available

Oresol None Quinolones None

Amoxicillin None Hydrochlrothiazide From CCT

Co-trimoxazole Available Metformin Available

Lagundi From CCT Hyoscine NBB Available

Ferrous Sulfate Available Mebendazole None

Vitamin A Available Salbutamol Available

Isoniazid Available Oxytocin Available

Pyrazinamide Available Akapulko ointment None

Oral Contraceptives Available Oral Contraceptives (Progestin only)

Available

Page 29: Health Situational Analysis

Information System

• Updated Consolidated and Barangay FHSIS, Maternal & Neonatal Death Report, Safe Motherhood, NTP report, OPT

• Regular and on-time submission of Reports to PHO

• No system yet of submitting reports to the LGU

Page 30: Health Situational Analysis

Service Delivery

LGU Scorecard 2010

Page 31: Health Situational Analysis

Vital Health IndicesLeading Causes of Mortality

2009 2010 2011

1. PNEUMONIA2. STILLBIRTH / LIVER CIRRHOSIS3. PTB/DIARRHEA/ SEVERE ANEMIA/TYPHOID FEVER4. HYPERTENSION5. GUNSHOT WOUND

1. CVA2. PNEUMONIA3. GUNSHOT WOUND4. STABWOUND / ASPHYXIA5. STILLBIRTH/ DROWNING TYPHOID FEVER

1. CVA / COPD2. PNEUMONIA3. STILLBIRTH / GUNSHOT WOUND4. STABWOUND /HACK/DM POLMUNARY/SEVERE DEHYDRATIONNEONATAL SEPSIS.5. MALNUTRITION /HEMORRHAGEDROWNING/ASPIRATION PNEUMONIA/MIPREMATURE DELIVERY/PLACENTAL RETENTION

Page 32: Health Situational Analysis

Vital Health Indices

Leading Causes of Morbidity2009 2010 2011

1. URTI2. FEVER3. HEADACHE4. BRONCHIAL ASTHMA5. BRONCHITIS

1. URTI2. FEVER3. ANEMIA4. HEADACHE5.BRONCHIAL ASTHMA

1. URTI2. ABSCESS/HEADACHE3. FEVER/AFI4. ARTHRITIS5. HPN6. DENTAL CARRIES7. DIARRHIA8. WOUND/SKIN INFECTION9. GASTRITIS10. PNEUMONIA

Page 33: Health Situational Analysis

Vital Health Indices

Crude Birth Rate 25/1000

Crude Death Rate 6/1000

Maternal Mortality Rate 10/1000

Infant Mortality Rate 54/1000

Neonatal Mortality Rate 21/1000

Page 34: Health Situational Analysis

Vital Health Indices

2006 2007 2008 2009 2010 2011 2012

INFANT DEATH 7 10 7 12 9 10 2

MATERNAL DEATH 2 1 1 1 2 2 1

1

3

5

7

9

11

13

7

10

7

12

910

221 1 1

2 21

NUMBER OF INFANT & MATERNAL DEATH

Page 35: Health Situational Analysis

Angyap

Bag-otan

Barruz

Camono-an

Carolin

aDe-it

Del Rosa

rio

Inubod

Liberta

dLig

aya

Mabulig

on

Maduro

to

Mahanud

Mahaya

g

Nagpapacao

Rizal

Salva

cion

San Is

idro

San Roque

Sta. C

ruz

0

0.2

0.4

0.6

0.8

1

1.2

0 0 0 0

1

0

1

0 0 0 0 0 0 0 0 0 0 0 0 0

Maternal Deaths (2011)

Page 36: Health Situational Analysis

10 Infant Deaths or 54/1000

Angyap

Bag-otan

Barruz

Camono-an

Carolin

aDe-it

Del Rosa

rio

Inubod

Liberta

dLig

aya

Mabulig

on

Maduro

to

Mahanud

Mahaya

g

Nagpapacao

Rizal

Salva

cion

San Is

idro

San Roque

Sta. C

ruz

0

0.5

1

1.5

2

2.5

0 0

2

0

1

0 0

2

0 0 0

1

0 0

1

2

0 0

1

0

Infant Deaths (under 1 years old)

Page 37: Health Situational Analysis

Angyap

Bag-otan

Barruz

Camono-an

Carolin

aDe-it

Del Rosa

rio

Inubod

Liberta

dLig

aya

Mabulig

on

Maduro

to

Mahanud

Mahaya

g

Nagpapacao

Rizal

Salva

cion

San Is

idro

San Roque

Sta. C

ruz

0

0.2

0.4

0.6

0.8

1

1.2

0 0 0 0

1

0 0

1

0 0 0

1

0 0 0

1

0 0 0 0

Neonatal Deaths (0-28 days old)

Page 38: Health Situational Analysis

Health Outcomes

Deliveries attended by Doctor

Deliveries Attended by Nurse

Deliveries Attended by Midwives

Deliveries Attended by Hilots/TBAs

0

50

100

150

200

250

300

350

400

13 5

32

137

Deliveries by Attendant

201120102009

Page 39: Health Situational Analysis

Health Outcomes

73%

27% Deliveries Attended by Hilots/TBAs

Deliveries Attended by Skilled Health Workers (Doctor, Nurse, Midwife)

National Standard: >70% of Births Attended by Skilled Birth Attendants (Doctor, Nurse, Midwife ONLY)

Page 40: Health Situational Analysis

Angyap

Bag-otan

Barruz

Camono-an

Carolin

aDe-it

Del Rosa

rio

Inubod

Liberta

dLig

aya

Mabulig

on

Maduro

to

Mahanud

Mahaya

g

Nagpapacao

Rizal

Salva

cion

San Is

idro

San Roque

Sta. C

ruz

0

2

4

6

8

10

12

14

16

18

20

Skilled Birth Attendants VS Hilots/TBAs

Deliveries Attended by Skilled Birth Attendants Deliveries Attended by Hilots/TBAs

Page 41: Health Situational Analysis

Health Outcomes

2009 2010 20110

20

40

60

80

100

120

140

160

180

200

176 180

162

4 9

28

Place of Delivery

Home Deliveries

Facility Based Deliver-ies

Page 42: Health Situational Analysis

85%

15%

Home VS Facility Based Deliveries

Home DeliveriesFacility Based Deliveries

National Standard: >70% Facility Based Deliveries

Page 43: Health Situational Analysis

Angyap

Bag-otan

Barruz

Camono-an

Carolin

aDe-it

Del Rosa

rio

Inubod

Liberta

dLig

aya

Mabulig

on

Maduro

to

Mahanud

Mahaya

g

Nagpapacao

Rizal

Salva

cion

San Is

idro

San Roque

Sta. C

ruz

0

5

10

15

20

25

30

Home VS Facility Based Deliveries by Barangay

Home DeliveriesFacility Based Deliveries

Page 44: Health Situational Analysis

Health Outcomes

National Standard: >85% of MWRA

2009 2010 20110%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

11%

9%

18%

Contraceptive Prevalence Rate

Page 45: Health Situational Analysis

National Standard: >95%

2009 2010 20110.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

40.60%

63.20% 62.50%

Percentage of Fully Immunized Children

Health Outcomes

Page 46: Health Situational Analysis

Angyap

Bag-otan

Barruz

Camono-an

Carolin

aDe-it

Del Rosario

Inubod

Liberta

dLig

aya

Mabuligon

Maduroto

Mahanud

Mahayag

Nagpapacao

Rizal

Salvacion

San Isidro

San Roque

Sta. Cru

z0%

50%

100%

150%

200%

250%

300%

350%

120%

300%

106%

0% 0%

100%

75%

13%

83%

0%

169%

56%

33%

75%

100%

22%

50%

200%

27%

166%

Percentage of FIC by Barangay

Page 47: Health Situational Analysis

National Standard: >85% of Newborns

2009 2010 20110%

10%

20%

30%

40%

50%

60%

70%

80%

38.00%

74.40% 67.00%

Percentage of Newborns Ini-tiated with Breastfeeding

Health Outcomes

Page 48: Health Situational Analysis

Health Outcomes

National Standard <12%

2008 2009 2010 20110.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

45.00%

50.00%

42.90%36.09%

36.60%

28.30%

Malnutrition Rate

Page 49: Health Situational Analysis

Angyap

Bag-otan

Barruz

Camono-an

Carolin

aDe-it

Del Rosario

Inubod

Liberta

dLig

aya

Mabuligon

Maduroto

Mahanud

Mahayag

Nagpapacao

Rizal

Salvacion

San Isidro

San Roque

Sta. Cru

z0%

20%

40%

60%

80%

100%

120%

140%

160%

180%

84%

143%

76%

106%

140%

70%

136%

76%83%

162%

56%63%

70%

104%

61% 59%

110%

74%

0%

140%

Percent Coverage of Opera-tion Timbang

Page 50: Health Situational Analysis

Number of Malnourished Children by Barangay

BARANGAY # OF MALNOURISHED

CHILDREN

BARANGAY # OF MALNOURISHED

CHILDRENANGYAP 5 MAHANUD 12

BARRUZ 29 MAHAYAG 10

CAMONO-AN 5 NAGPAPACAO 23

CAROLINA 10 RIZAL 7

DEIT 14 SALVACION 9

DEL ROSARIO 10 SAN ISIDRO 5

LIBERTAD 12 SANTA CRUZ 13

LIGAYA 5 BAG-OTAN 10

MABULIGON 23 INUBOD 20

MADUROTO 21 SAN ROQUE No data

Page 51: Health Situational Analysis

Health Outcomes

National Standard: >85%2009 2010 2011

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

18%

15%

37%

Percent coverage of target population in with mass treatment for FILARIASIS

Page 52: Health Situational Analysis

Angyap

Bag-otan

Barruz

Camono-an

Carolin

aDe-it

Del Rosario

Inubod

Liberta

dLig

aya

Mabuligon

Maduroto

Mahanud

Mahayag

Nagpapacao

Rizal

Salvacion

San Isidro

San Roque

Sta. Cru

z0%

20%

40%

60%

80%

100%

120%

140%

160%

180%

38%

24%

59%

0% 0%

54%

0% 1%

72%

21%

168%

86%

22%

5%

24%

0%

27% 25%

0%

18%

Percentage Coverage of Filariasis Mass Treatment

Page 53: Health Situational Analysis

Health and Sanitation

• No public dumping site, wastes are thrown to the river

• No proper waste disposal system• (+) Ordinance of Dog keeping (?)

Page 54: Health Situational Analysis

2009 2010 2011300

320

340

360

380

400

420

349 349

414

Number of Household with Sanitary Toilet

Page 55: Health Situational Analysis

30.57%

69.43%

Percentage of Households with San-itary Toilets

Households with San-itary Toilet

Households with No Sanitary Toilet

Page 56: Health Situational Analysis

Number of HH with Sanitary ToiletsBARANGAY # WITH

TOILETSBARANGAY # WITH

TOILETSAngyap 13 Mahayag 2Barruz 54 Nagpapacao 15Camonoan 1 Rizal 0Carolina 0 Salvacion 11De-it 9 San Isidro 14Del Rosario 1 Santa Cruz 3Libertad 1 Bag-otan 3Mabuligon 139 Inubod 3Maduroto 123 San Roque 1Mahanud 8 Ligaya 0

Page 57: Health Situational Analysis

65%

23%

12%

Households as to Type of Water Supply Facilities

Level 1 (Point Source)

Level 2 ( Communal Faucet System)

Level 3 ( Individual House Connection)

Page 58: Health Situational Analysis

Community Diagnosis

Page 59: Health Situational Analysis

SWOT Analysis

• Strengths– Self empowered/ Nationalistic Staff– New and Supportive Local Government Leaders– Emerging Strong partnerships with organizations

(ZUELLIG FAMILY FOUNDATION)– Strong data collection during the last quarter

allowing for strategic planning– MHO undergoing multiple trainings

Page 60: Health Situational Analysis

SWOT Analysis

• Assets– New MHO training on Health Systems

Development– Open lines of communication between different

levels of health offices (National, provincial and Local)

Page 61: Health Situational Analysis

SWOT Analysis

• Weaknesses– Poor data reporting from past years– Overworked yet underpaid staff (overtime pay,

Magna Carta)– Small budget allocation for health below national

recommendations– Inactive Nationally-implemented programs and

progressively declining health status– New MHO still familiarizing with regulations

Page 62: Health Situational Analysis

SWOT Analysis

• Weaknesses– Poor reporting from private Sectors– Safety and Sanitation issues: food handlers do not

have health certificates, sanitary permit

Page 63: Health Situational Analysis

SWOT Analysis

• Liabilities– Cultural acceptance of poor personal health care– May garner some negative reports from patients due

to recurrent absences from MHO while on trainings– Abusive behaviour of patients (Full time Weekend

Consults and Night time Consults that are non-emergencies)

– Difficult Communications and Frequent Out-of-Town coordination with National and Provincial Government

Page 64: Health Situational Analysis

Needed Ordinances/Resolutions

• Facility-Based Deliveries and Regulation of Traditional Birth Attendants

• Breastfeeding• Healthy lifestyle/”Hataw Sayaw”• Medical Certification Rules• Sanitary Permit Ordinance• TB-Free Matuguinao Political Commitment

Resolution• “No Smoking” Ordinance

Page 65: Health Situational Analysis

Conclusions

• The Municipality primarily suffers from:– Non-existent regulations and programs (eg. TBAs)– Inadequate financing in terms of Municipal

allocations– Lack of health human resource (eg. Medtech,

Dentist, Sanitary Inspector)– double burden of disease: infectious respiratory

diseases and lifestyle diseases should be the focus of public health programs

Page 66: Health Situational Analysis

Conclusions

• The Municipality primarily suffers from:– emerging and growing infections especially

Filariasis and TB need the collaboration of the National and Provincial Offices, the RHU, and the leaders of the Municipality and Barangay to free Matuguinao of these diseases

Page 67: Health Situational Analysis

Conclusions

–We must call to attention the respective BHWs and Barangay Captains, with the help of DILG, as to the different priority areas to improve rates in Immunization, Nutrition, and Sanitation.

– Improvement of RHU services, likewise, would need Rebuilding of the health Facility and empowering the Overworked and underpaid staff.

Page 68: Health Situational Analysis

Conclusions

• We should maximize the help of the ILHZ and District Hospital (GDH) to improve data reporting and delivery of services.

• There should be a strong inter-sectoral collaboration in promulgating Health Ordinances and Municipal Health Programs

Page 69: Health Situational Analysis

Conclusions

We have a strong chance for STRATEGIC PLANNING for the year

2012 and subsequent years.

Page 70: Health Situational Analysis

madamo nga

salamat!