EDITORIAL

Health Status Is Dependent On Effective Collaboration

by ERNESTO T. SOLIDUM

“Health Services Delivery Program and Health Outcome Indicators” are topics of the Kapihan forum discussed on May 26, 2012. The guests are Dr. Cornelio V. Cuachon Jr. PHO I, Ms. Nuelia P. Zaldivar, Health Education and Promotion Officer and Ms. Marissa M. Carillo, Maternal and Children Coordinator.

Atty. Ronquillo C. Tolentino said, Article II Section 5 of the Philippines Constitution provides that the State shall promote the health of the people through sustainable, competent and efficient health delivery system. Toward this end, the Local Government Code of 1991 decentralized basic health services to LGU’s.

Dr. Cuachon discussed the Universal Health Care or Kalusugan Pangkalahatan, a priority program of Governor Carlito S. Marquez. Basis is the (2009-2013) Provincial Investment Plan for Health  with approved funding by DOH in the amount of P1 billion. Under the Plan renovation of hospital facilities and acquisition of equipment shall be instituted through hospital clustering which are A. Preventive Health Care I., Ibajay, Nabas, Tangalan, and Buruanga, II. Makato, Numancia, Lezo, Malinao, and Madalag, III. Batan and Altavas. B. Curative Health Care Centers are Malay (Boracay and Baptist Hospital), Ibajay and Kalibo.

DOH issued A.O. No. 201-006 to ensure Universal Health Care for all Filipinos. Rational is that 60 percent of our citizens die without seeing a doctor. The Philippines signed the UN Millennium Development Goal (MDG) pledging to reduce by half percent by 2015 the problems on child mortality, maternal health, HIV/AIDS and other infectious diseases.

This will be done in collaboration with Philhealth include: a) Conversion of 4 government hospitals from birthing service provider into obstetrics health facility. Insurance agency will provide funding up to P8,000 per beneficiary, b) financial risk protection where National Household Targeting System identifies 4,300 indigent families for free hospitalization benefits, c) health facilities enhancement program starting 2010 in six government hospitals funded with P21 million, P23 million in 2011, and P113 million in 2012.

Data of Provincial Health Office in 2011 show the total live births was 19,37/100,000 population, deaths – 6.72, infant deaths – 16.52, maternal deaths – 9, stillbirths – 5.19 and malnutrition – 6.34.

Deliveries attended to by skilled health workers totaled 7,956 or 76.4/100,000 population. Home deliveries were 4,641 or 44.57 and hospital – 5,738 or 55.10.

The number of households with access to safe water supply is 33,419 or 30.31/100,000 population. Sanitary toilets – 93,344 or 84.77, satisfactory garbage disposal – 82,269 or 74.64 percent.

The 10 leading causes of mortality are pneumonia, cardio-vascular arrest (CVA), myocardiac infraction, cancer, hypertension, accidents, chronic obstructive pulmonary diseases (COPD), heart failure, sepsis and hypovolemic shock.   

The 10 leading causes of infant mortality are sepsis, pneumonia, ARDS, unknown, prematurity, heart disease, CVA, congenital anomaly, aspiration and asphyxia.

The 10 leading causes of morbidity are upper respiratory tract infection, pneumonia, animal bites, bronchitis, hypertension, diarrhea, urinary tract infection, dyspepsia, accidents and wounds. 

Despite the problems encountered in health service delivery, 75 percent of the MDG have been reached. Substantial accomplishments are in arresting child mortality, malnutrition, and maternal deaths reported Dr. Cuachon.

A Philippine Daily Enquirer of March 25, 2011 quoted the World Health Organization report that 250,000 Filipino families fall into hardship every year due to high cost of health care and medicines. A year later, it reported about 11.1 million households considered themselves poor, up from 9.1 million in December 2011. According to Social Weather Station. 55 percent of households rated themselves poor, 10 points higher than the 45 percent 3 months earlier.

The high prevalence of morbidity and mortality in the country is traced to poverty, food availability and poor eating habits. The report on Food Consumption and Nutrition survey of Bureau of Agriculture Statistics found that “308.93 grams per day was eaten in 2010 up from 282.83 grams per day in 2000. The amount of rice provided 1,102.88 grams of calories and 23.17 grams protein. The average beef daily intake in 2010 went down to 6.57 grams from the base level of 7.70 grams in 2000. New dietary guidelines recommend that fruits and vegetables must occupy half of our plates and grains about one fourth. 

Efraim Rasco, Chief of Philrice reported the large portion of rice in the Filipino diet consists of more salt, sugar, and fat. This leads to hypertension, diabetes, and cardiovascular diseases. Furthermore, food consumption survey of Food and Nutrition Research Institute shows the average per capita intake of calcium is only 57.1 percent adequate due to the low consumption of milk and milk products that comprise 5.6 percent only of the total Filipino food intake. Calcium builds healthy gums and teeth. A 7-9 year old child needs 700 milligrams of calcium a day”.

In 2011, there were 33,419 households out of total 110,225 or 30.3 percent which have access to safe water supply. Only 60.5 percent had basic sanitation facilities. This is most unfortunate because water and sanitation claim more lives over the centuries than guns and bullets. 

Dr. Ambrosio R. Villorente aptly recommends crucial balance between agriculture target on food adequacy, affordability, and sustainability and health service delivery. It must be recalled that the Department of Agriculture (DA) was actively involved in National Nutrition Committee where Operation Timbang (OPT) was implemented in mid 1970’s. The DA implemented the key nutrition intervention schemes as food production (especially backyard gardening), nutrition education and information and family planning. This excellent relationship must be revived together with allied line agencies like Philhealth, DSWD, and DepEd. /MP