HLMP Doctor to the Barrio

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


Reduced Morbidities and Mortalities

DONEPHILCAT accredited

TB DOTS accreditation

DONERenovated main health center

Renovation of Dispensary

DONEHL resolution

Heart Month

Institutionalize HL


NTP

Case Detection Rate TB Cure Rate

2007 2008 2007 2008

PTB 42%62%

(88% in 2009)

93%92%

(94% in 2009)


DONEDec. morbiditiesThursday as well-baby clinic

ACHIEVEDInc. NBS to 50%NBS accreditation

ACHIEVEDInc. FIC to 90%Intensified Immunization


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


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


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


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)


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

Health & Medicine

HLMP Doctor to the Barrio