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Health Situational Report
and Community DiagnosisMatuguinao, Samar
Matuguinao Profile
• One of the far-flung municipalities in Western Samar
• Became a municipality on June 19, 1965 through RA 4221
Matuguinao Profile
• town located along three river tributaries namely: Gandara, Pambujan and Las Navas
MatuguinaoCalbayog
Gandara San Jose de Buan
Jipapad
Silvino Lobos
Las Navas
NOTHERN SAMAR
EASTERN SAMAR
BOUNDARIES:
Source: Matuguinao Ecological Profile, MPDC
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
Matuguinao Profile
• Composed of 20 barangays• Most of the barangays can be reached by foot
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
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
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
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
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
Rural Health Unit Profile
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
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
RHU Information and Record Section
RHU Treatment and Emergency Area
Laboratory and Stock Room
Labor and Delivery Room
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.
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
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
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
PhilHealth Enrolment
Sponsor # of Enrolees
NHTS 1309
LGU 500
TOTAL 1809
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
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
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
Service Delivery
LGU Scorecard 2010
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
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
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
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
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)
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)
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)
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
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)
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
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
85%
15%
Home VS Facility Based Deliveries
Home DeliveriesFacility Based Deliveries
National Standard: >70% Facility Based Deliveries
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
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
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
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
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
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
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
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
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
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
Health and Sanitation
• No public dumping site, wastes are thrown to the river
• No proper waste disposal system• (+) Ordinance of Dog keeping (?)
2009 2010 2011300
320
340
360
380
400
420
349 349
414
Number of Household with Sanitary Toilet
30.57%
69.43%
Percentage of Households with San-itary Toilets
Households with San-itary Toilet
Households with No Sanitary Toilet
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
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)
Community Diagnosis
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
SWOT Analysis
• Assets– New MHO training on Health Systems
Development– Open lines of communication between different
levels of health offices (National, provincial and Local)
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
SWOT Analysis
• Weaknesses– Poor reporting from private Sectors– Safety and Sanitation issues: food handlers do not
have health certificates, sanitary permit
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
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
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
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
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.
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
Conclusions
We have a strong chance for STRATEGIC PLANNING for the year
2012 and subsequent years.
madamo nga
salamat!