2 Department of Health Center for Health Development Cordillera Administrative Region (DOH-CHD-CAR) Mission To lead the country in the development of a productive, resilient, equitable and people centered health system. Vision Filipinos are among the healthiest people in Southeast Asia by 2022, and Asia by 2040. Content Director’s Message Usapang Pangkalusugan ng mga Kabataan A MEANINGFUL CELEBRATION OF THE DOH 121ST ANNIVERSARY world blood donor day 3rd doh cordillera friendship games DOH-CHD-CAR on the move against measles and japanese encephalitis Galleria de Cordillera HFEP Projects Universal Health Care: Alamin mo, Kasama ka dito! Page 3 4 5 6 7 11 14 16 20 F1 Plus Strategic Goals Better Health Outcomes, More Responsive Health System, and More Equitable Healthcare Financing Strategic Pillars • Financing • Service Delivery • Regulation • Governance • Plus - Performance Accountability Health Voice Consultants: • Dr. Amelita m. pangilinan, oic-director iv • dr. janice z. bugtong, oic-director iii contributors • ms. joycelyn rillorta, nurse V • mr. vincent ingen, Nurse III • ms. ana karina a. lamsen, Training Specialist II • ms. jennifer valenzuela, Shpo • hfep team headed by engr. arianne paneda, engr iii layout/design/photography • mr. patrick p. pineda, HEPO III • mr. karl aldrail c. sam, HEPO I (jc) Editors • mr. patrick p. pineda, HEPO III • ms. shena G. gabon, HEPO I (jc) reproduced by • doh-chd-car health voice magazine january-june 2019 issue The Cover: Immunization: Free • Safe • Effective vaccine image from mass immunization campaign

3 HEALTH VOICE Greetings! The Department of Health-Center for Health Development-CAR has been doing its role in providing numerous Public Health Programs to all corners of the Cordilleras. Challenges such as proximity, time constraints, and weather conditions could not stop the passion of our frontliners and supporters. Regardless of gender, ethnicity, religion, political affiliation or disability, we make sure that quality health services are provided to everyone. Nonetheless, we reach out to every community whether in times of prevention or even in impending outbreaks from any kind of disease. This 2019 was a challenging year for us as we have encountered a significant increase of cases for v a r i o u s illnesses such as Measles, Japanese Encephalitis, Hand, Foot, and Mouth Disease, and others. On the other hand, we have displayed our resilience against these impending outbreaks through various interventions particularly by having a wider range of immunization coverage in our communities. With the effort to spearhead mass vaccination in the Cordilleras, we have launched the “Project Baby Come Back to Bakuna” and “Oplan Culex” Task Force. Also, we have launched the School-Based Immunization Program, with partner agencies such as the Department of Education, Department of Interior and Local Government, and other local government units. We are more than grateful as these interventions brought positive outcomes. Immunization: Free, Safe, and Effective is the theme of Cordillera Health Voice. With pride and joy, we have shared in this issue how we have collaborated and accomplished successful interventions to help our constituents amidst all the challenges in the recent months. We have proven that nothing is impossible through best practices, collaboration, passion, and grace from our Creator. In this lifetime, each one of us has a battle to face but we shall continually believe that these battles equip us to become better individuals. No situation is given to us without the purpose of learning and strengthening our God-given talents and skills- with the sole purpose of serving others. Truly, together we can look forward towards a brighter future where every Juan and Juana is provided with quality health care and services as we all aim for the betterment of every Cordilleran.

4 I n its effort to address the challenges and issues of adolescents in Benguet, the Department of Health – Center for Health Development – CAR (DOH-CHD-CAR) together with the other members of the Responsible Parenthood and Reproductive Health Regional Implementation Team (RPRHRIT) hosted “Usapang Pangkalusugan ng mga Kabataan” on April 16, 2019 at Strawberry Valley Hotel and Restaurant, La Trinidad, Benguet. The activity was highlighted by a series of workshops on the identification of good behaviors by adolescents, their bad behaviors and various reasons leading to these behaviors, and as well as the perceived services needed from different government agencies. The identified problems are increasing teenage pregnancy, liquor and computer addiction, bullying, rebellion to parents and disrespectful to elders, unhealthy lifestyle, absenteeism, laziness, and dependency to modern technology, among others. “I learned a lot of things today. I noticed that the problems of adolescents in our municipality are also prevalent in other municipalities. It is really a call for us to start addressing the problems of adolescents and we need government agencies to listen to our plea,” an adolescent participant said. Moreover, Ms. Magdalena G. Abellera, Regional Director of Commission on Population and Development - CAR, said that “no single agency can completely address the problem of adolescents. What is needed is inter-agency collaboration in order to create strategies and specific interventions that are responsive to needs of adolescents.” Director Abellera further reiterated that change starts within one’s self. Everyone should have the conscious effort in improving one’s attitude as we are all responsible for our actions. Meanwhile, DOH Benguet Team Leader Dr. Mercedes Calpito also said that it is a mandate for health workers in health facilities to provide services to all clients regardless of socio-economic and cultural background. “We appreciate that this time you know the importance of seeking health services. The Department of Health is capacitating our health workers in the Rural Health Units and Hospitals for them to respond effectively and efficiently to the needs and concerns of clients, Dr. Calpito added. The adolescent forum ended by enjoining the adolescent participants and national line agencies who are present in the forum to give their full support to the Vision, Mission and Objective of the Adolescent Health and Development Program through signing their pledge of commitment. “Usapang Pangkalusugan ng mga Kabataan” by Mr. Vincent Ingen, Nurse III

5 HEALTH VOICE A MEANINGFUL CELEBRATION OF THE DOH 121ST ANNIVERSARY by Ms. Ana Karina Lamsen, Training Specialist II Celebrating one’s milestone in life could vary in many ways. It could be simple yet showcases an act of kindness to humanity. This is how the DOH-CHD-CAR celebrated the 121st National Anniversary of the Department of Health through a tree planting activity last June 26, 2019 in Apalan Communal Forest, Itogon, Benguet. With the various agencies namely PhilHealth-CAR, BGHMC, PNP PRO-COR, BFP-CAR, and DENR-CAR who willingly participated with DOH-CHD-CAR, this activity was a success. A total of 150 pine tree seedlings were planted in the said activity. Dr. Mary Jane Grace Muñoz, Medical Officer IV, led the activity, and gave her inspirational message and welcomed all the participants. She emphasized that aside from simply having a tree planting activity in celebration of the DOH Anniversary, this activity is also an opportunity to honor mothers and the unborn children. With this advocacy in mind, it made the said activity more meaningful to everyone as the value of life was highlighted. Safe motherhood was also emphasized in her message. After Dr. Muñoz gave her inspirational message, some of the DOH-CHD-CAR personnel, shared their testimonies on how they faced a challenge in their lives- a miscarriage. They mentioned that it is good that we put value in the wonderful memories we gain in this lifetime. They advised that recalling these great memories in times of difficulty or even in a near death situation could enlighten us. They reminded the participants especially the future mothers to take care of one’s well-being. Pregnancy is a challenging stage in life yet a gift from above. Meanwhile, Ms. Marilou Besa-ang of the DENR-CAR led the demonstration of the proper planting of trees. The participants were able to plant the 150 pine tree seedlings while supporting the call for Safe Motherhood. To incorporate Safe Motherhood in the said event, #BinhiParaSaLahi, #PlantTreeSaveLife, and #TanimKalingaParaSaBata were the highlighted statements for this tree planting activity. Overall, all the participants enjoyed this activity in celebration of the 121st National Anniversary of DOH while making it more meaningful through Safe Motherhood Advocacy. Everyone was grateful to have joined the said celebration through a meaningful activity. Also, DOH-CHDCAR and other convening agencies are looking forward to go back to the said place to check on the progress of the planted seedlings.

6 world blood donor day by Ms. Jennifer Valenzuela, SHPO Every June 14, during the World Blood Donor Day, people around the world come together and celebrate the event to serve humanity selflessly. It is an occasion that serves to thank voluntary non-remunerated blood donors for their lifesaving gifts of blood. Millions of people owe their lives to people whom they might never meet – yet these people donated their blood freely without any payment. Donated blood will be used to save millions of lives. Blood and blood products are essential components in the proper management of women suffering from bleeding associated with pregnancy and childbirth, children suffering from severe anemia due to malnutrition and malaria, patients with blood and bone marrow disorders, victims of trauma, emergencies, disasters and accidents, as well as patients undergoing advanced medical and surgical procedures. This year’s slogan is “Safe Blood for All” as a campaign on blood donation and universal access to safe blood transfusion, as a component of achieving Universal Health coverage. The Department of Health – Center for Health Development- Cordillera Administrative Region, in support to the World Blood Donor Day, together with the Baguio-Benguet Blood Network (BGHMC, Baguio Health Services Office, PRC- Baguio and Benguet Chapter, SLU-HSH, and NDCH) conducted the First Youth Blood Olympics for selected universities in Baguio and Benguet at the BENECO main office last June 19, 2019 with a simultaneous in-house mobile blood donation at the Saint Louis University. The Olympics was opened by a cheer dance competition between the University of the Cordilleras and Benguet State University. The event was successfully culminated with a total of 101 units of blood collected from our student- blood heroes who participated in this rewarding event. It is the hope of the DOH that designating one special day each year to celebrate the roles of voluntary blood donors, a new generation of voluntary blood donors, especially the youth will follow this altruistic and heroic act thereby ensuring the availability of affordable supplies of safe and quality blood and blood products at all times – wherever and whenever it is needed to save a life. Be a hero, give blood, give now, give often….

7 HEALTH VOICE Yearly the DOH-CHD-CAR team joins the DOH Cordillera Inter Agency Friendship Games as a part of the agency’s advocacy on wellness and healthy lifestyle. This year’s host is the Luis Hora Memorial Regional Hospital and it was held in Bontoc, Mountain Province. Participating teams were Luis Hora Memorial Regional Hospital, Baguio General Hospital and Memorial Center, Far North Luzon General Hospital and Training Center, Conner District Hospital, and Philhealth-CAR. The activity’s objectives are to promote healthy lifestyle among DOH personnel, develop physical wellbeing of all participants through sports, and enhance teamwork and camaraderie for the delivery of quality health services. Group games, Individual games, and Indigenous games were played by the participants. There was also a Dance Exercise Competition and a pageant on the search for the Mr. and Mrs. Friendship Games 2019. Here are some snapshots during the activity: Registration and Acquaintance Party Parade and Opening Program Dance Exercise Competition 3rd doh cordillera friendship games by Health Promotion Section

8 Chorale Competition Folk Dance Competition

9 HEALTH VOICE Mr. and Ms. Friendship Games 2019 Sports Activities

10 Closing Ceremony and Awarding Overall, all the participants enjoyed the week-long activity, taking home friendship and fun memories from the event. These memories are truly priceless for everybody. Surely, the activity achieved its goals and objectives. Next year’s host will be the Far North Luzon General Hospital and Training Center to be held in Luna, Apayao. Everyone is looking forward to enjoy such friendly competition and witness another Friendship Game full of fun and teamwork!

11 HEALTH VOICE With the provisions mandated by the Universal Health Care Act, all concerned agencies particularly the Department of Health has been pouring its efforts and resources to provide quality health services to every Filipino in the country. Thus, the DOH will continuously strengthen its service to the public regardless of any health threats and challenges that the country may face. Recently in the entire Cordillera region, there has been an increase of measles suspect and laboratory confirmed cases during the first half of 2019. Based on the data below on Measles Suspect Cases, there were only 65 cases and no record of death for 2018, while there were 812 measles suspect cases and 3 deaths for 2019. This data was recorded from January 1 to June 27, 2019. Its percentage change between the previous and the current jumped into 1,149%. Also, Table 1 shows that Baguio City and Benguet Province listed most measles suspect cases with 306 and 314 respectively. This is a challenge for Benguet province as they have listed the most number of measles suspect cases including 3 death tolls. On the other hand, Mountain Province had the least number with only 21 reported cases. Table 1. Measles Suspect Cases. Cordillera Administrative Region, 2018 vs. 2019 Meanwhile, there is also an increase of confirmed laboratory measles cases with 2,871% increase for the entire Cordilleras. There were 7 laboratory confirmed cases for 2018 while 208 cases for the present year. Baguio City listed the most number of these cases with 106 while Benguet province listed 68 cases. As shown in Table 2, Mountain Province is showing the same trend with the least number of measles suspected and confirmed cases for the first half of 2019. Table 2. Confirmed Measles Cases. Cordillera Administrative Region, January 1 to June 27, 2019. DOH-CHD-CAR on the move against measles and japanese encephalitis by Ms. Joycelyn RIllorta, Nurse V

12 Alongside with this scenario in the Cordilleras, the drafting of the Implementing Rules and Regulations (IRR) for the Universal Health Act aims to execute stronger province-wide and city-wide health systems for population-based health services. Primary care provider network, epidemiologic surveillance systems, and health promotion programs shall be strengthened. With these goals at hand, the Department of Health-Center for Health Development-Cordillera Administrative Region unceasingly instituted its interventions against impending measles outbreak. Surveillance, Health Emergency Preparedness, Case Management, Vaccination, and Communication and Social Mobilization were the key strategies devised by the DOH-CHD-CAR as a response for this impending measles outbreak. For the disease surveillance, capability building of Epidemiology and Surveillance Units (ESU) of all Local Government Units (LGUs) and hospitals were executed. The DOH-CHD-CAR assured constant monitoring, on-site mentoring, and functionality assessment of Provincial/City ESUs, capital towns, provincial hospitals, and DOH Retained hospitals. Hence, regular surveillance activities and weekly data analysis were implemented along with the provision of daily disease surveillance reports and updated epidemiological profile to stakeholders. Through the updated set of data among the provinces of the Cordilleras, appropriate actions could be well executed. Moreover, the DOH-CHD-CAR immediately provided test kits, specimen collection kits, and augmentation of personal protective equipment. These kits were a primary need to monitor and mitigate measles cases. To ensure health emergency preparedness, the DOH-CHD-CAR raised the alert code of all the DOH retained hospitals, city and provincial hospitals. Align with this, the Health Emergency Response Team (HERT) was activated as to guarantee a fast paced response in all the provinces of the Cordilleras. All the operations centers in the region were on duty 24/7. When it comes to logistics, the DOH-CHD-CAR confirmed the availability of drugs and medicine at the Regional Office Warehouse worth Php 650,849.50. Also, the capacity of the various hospitals in the region was assessed based on their outbreak response. With the intervention for case management, Measles Fast Lanes in DOH-retained and other hospitals were monitored. The hospitals monitored were BGHMC (Baguio General Hospital and Medical Center), FNLHTC (Far North Luzon Hospital and Training Center), CDH (Conner District Hospital), LHRMH (Luis Hora Regional Memorial Hospital), and Benguet General Hospital. In addition, there was an allocation of 30 N95 masks to Baguio General Hospital and Medical Center worth Php 1,800.00. Meanwhile, the following hospitals were advised to strengthen triaging of suspected measles cases at the ER and verified the presence of preparedness plan for infectious diseases: Table 3. List of Hospitals closely monitored for intervention for their case management. The Department of Health Central Office spearheaded its intervention for vaccination nationwide. The Department Memorandum 2019-0048 dated February 1, 2019 entitled “Conduct of Mixed Method: Non-selective and Selective Mass Measles and Polio Vaccination for Targeted Population” was issued. Alongside with this, the DOH-CAR issued Memorandum Circular 2019-002 entitled “Regional Operational Guidelines for the Conduct of Selective Mass Measles and Polio Vaccination for Targeted Population (adopted from DM 2019-0048 dated Februarv 1, 2019) through “Project Babv Come Back to Bakuna”. Aside from this urgent action from the DOH national and regional level against measles outbreak, the DOH-CHD-CAR also advised its team to conduct mass immunization campaign on Japanese Encephalitis Vaccine through the DOH-CHD-CAR Personnel Order 2019-053-A entitled “Amendment to DCPO 2019-053 dated January 16, 2019 entitled “Creation of a DOHCHD-CAR Japanese Encephalitis Vaccine Mass Immunization Campaign (Oplan Culex) Task Force”. Table 4. Measles Outbreak Advisory

13 HEALTH VOICE With the Project Baby Come Back to Bakuna Coverage Report as of June 30, 2019, there are 74,780 vaccinated children (6 to 69 months old) with Measles Contained Vaccine (MCV) or 95% coverage from its total target of 79,002. For Japanese Encephalitis Vaccine, 113,781 children (9 to 59 months old) were recipients or 74% from its total target of 153,759, based on the actual Oplan Culex Immunization Coverage Report. Moreover, advisories on the Preparedness and Response to the increasing measles cases in CAR were sent out to all LGUs, Provincial/City/Municipal Health Officers, and other agencies such as the Department of Health-CAR, Department of Interior and Local Government-CAR, Department of Social Welfare and Development-CAR, and the Indigenous peoples Mandatory Representative in CAR. Thus, it highly encouraged the Cordillera Regional Disaster Risk Reduction and Management Council to create the Inter-Agency Task Group on the Cordilleras’ Measles Case Surveillance. This Inter-Agency Task Group had come up with vital agreements on its fight against measles. The intensification of Information Education Communication (IEC) on Measles were tasked to the Philippine Information Agency (PIA-CAR) and DOH-CAR. Most importantly, vaccination of selective and priority areas especially for children ranging from 6 months to 59 months was agreed to be initiated by the DOH-CAR and Health Services Office in various provinces. Also, there was a smooth coordination with external partners for augmentation of vaccination teams to be deployed in priority areas of Baguio City and Benguet. Table 5. Inter-Agency Task Group on Cordilleras’ Measles Case Surveillance As part of the interventions from the DOH-CAR, there were provision of vaccine and vaccine logistics all DOH retained hospitals and provinces worth Php1,798, 070 in total. These resources greatly helped out the mentioned institutions to provide quality service to the public. Furthermore, the interventions instituted by the DOH-CHD-CAR against measles will never be complete without the Communication and Social Mobilization to the public. Through the modern platform of the DOH-CHD-CAR Facebook, Measles information materials were posted. These posts earned 47,818 people reached: 3,512 engagements and 478 shares. Aside from these online engagements, the DOH-CAR had local media engagements for health information dissemination particularly radio plugging done by Kalinga PDOHO. Also, various “Kapihan” Sessions- a public forum which involved the local media and various government agencies as part and parcel of strengthening public’s awareness on measles. Amidst the impending measles outbreak and threat of Japanese Encephalitis, the DOH-CHD-CAR was able to immediately perform its role in protecting its stakeholders regardless of proximity and other challenges. Overall, as aligned with the recently approved Universal Health Care Act, quality health services can be achieved for the entire Cordilleras through a coherent action plan and collective efforts from the various institutions particularly the Department of Health.

14 Measles and Japanese Encephalitis Vaccine Mass Immuniztion

15 HEALTH VOICE Measles and Japanese Encephalitis Vaccine Mass Immunization

16 Note: This compilation of HFEP projects varies from Equipment, Newly/Under/For Construction and Under/For Renovation. Acronyms: BHS - Barangay Health Station RHU - Rural Health Unit DH - District Hospital GH - General Hospital MH - Municipal Hospital

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24 BGHMC Compound, Baguio City 2600 Tel. /Fax Nos. (074) 442-8097 to 98 TRUNK LINE #s: (074) 442-8096, 443-4858, 443-4859, 442-7591 Website: www.caro.doh.gov.ph Facebook Page: DOH CHD CAR Health Promotion Twitter: @dohchdcar Republic of the Philippines DEPARTMENT OF HEALTH CENTER FOR HEALTH DEVELOPMENT Cordillera Administrative Region