By Cash Maghirang

Thanks to the municipality-sponsored basic life support (BLS) training for barangay (village) leaders, 81-year old Lola Sario Mistula continues to enjoy the company of her grandchildren while sitting on her favorite rocking chair.

It was during a rainy night in Barangay Lipason in Pilar, Sorsogon, when relatives of Lola Sario discovered her lying unconscious in her bathroom floor. Two barangay tanods (village watchmen) were the first to respond to the calls for help. Luckily for Lola Sario both Efren Reyes and Augusto Llabares attended the BLS training.
For several minutes while onboard a tricycle, the two performed continuous cardiopulmonary resuscitation (CPR) on the grandmother. Lola Sario regained consciousness before reaching the hospital.

For Llabares, the event was extra meaningful because in 2010, he failed to save the life of a mother who accidentally fell into the river while washing clothes. Back then, he did not know how to perform CPR properly. So when he heard a BLS training will be provided in his village by the local government, he immediately signed up for the program.

In the island-municipality of Daram in Samar, 11 midwives oversee a population of 40,567. This equates to about one midwife for every 3,700 people, which is a sufficient ratio. Despite this, a look into their maternal and child-related health statistics shows a serious problem exists. In 2010, there were 844 maternal deliveries. Out of these, only 383 or 45.37% were attended by skilled health workers. Worse, only 69 or 8.17% occurred in a health facility.

These numbers are actually modest improvements when compared to those of 2009 when only 38.35% of deliveries, which totalled 691, had the assistance of a skilled health worker while just 4.48% took place in a health facility. Three maternal deaths were recorded in 2010 while there were two in 2009.

Daram is a fourth class municipality that got into the Zuellig Family Foundation’s Community Health Partnership Program in mid-2010. For five straight years until 2011, it had no municipal health officer (MHO). Their rural health unit (RHU) was a dilapidated structure that could hardly accommodate the number of patients seeking medical attention.

Recently, a bigger and better-equipped RHU was inaugurated. This was done through the local government’s partnership with ZFF and the Asissi Development Foundation. The new facility along with a campaign for facility-based deliveries (FBD)somehow improved FBD ratio, which stood at 15.7% as of the third quarter of the year.

However, health personnel-assisted births remained low in the same period at 39.26%. No maternal death was recorded in 2011.

The ZFF has also been providing health leadership training for the town’s mayor, its new MHO and the president of its association of barangay (village) health workers (BHWs). These training activities are meant to make the leaders more accountable to the health of their constituents.

Health skills training were also given to their midwives and BHWs to increase their competency in maternal and emergency care.

Despite these programs, their health status remains worrisome. Eleven infant deaths were recorded in both 2009 and 2010. In 2011, infant deaths reached 21.

Frontline health workers, particularly midwives, though sufficient in number and competent enough, were found to be lacking in initiative to visit as regularly as possible the four villages assigned to each of them. One of the reasons given is the high cost in going to these villages which may run from P200 to P1,400 a month.

Similar costs can be incurred by locals who need to visit health facilities; hence, majority of pregnant women opt to seek the help of a hilot (traditional birth attendant) when giving birth while the sick do not get to see health professionals.

In efforts to address these, the ZFF discussed strategies with the local health leadership of Daram. One is the early deployment of Community Health Teams. The CHTs program of the Department of Health is envisioned to give direct health assistance to every family especially the poorest by making door-to-door visits. The municipality of Daram will be one of the municipalities in the country to implement this immediately in all its villages.
Among the main purposes of Daram’s CHT, which is composed of a local health councilor, village chief, village health worker and midwife, is to create a master list of all pregnant women to be able educate each woman about proper natal care and track their progress throughout their pregnancy.

Plans are also afoot to rationalize the distribution of midwives to different clusters of villages. Midwives will be assigned based on the proximity of their residences to the clusters. Regrouping of clusters will also be done such that each village is assured of a regular visit from the midwife.

An ordinance will also be made requiring the mandatory presence of midwives in their assigned posts.

Training programs focusing on Basic Emergency Obstetric and Newborn Care will also be given by the Foundation to the midwives. Local Community Health Teams will be strengthened through various meetings and dialogues to encourage the regular master listing and monitoring of pregnant women.

The Foundation has been supporting the health infrastructure and medical equipment needs of Daram and has also been seeking other organizations to support the same. Apart from the new RHU, a village health station funded by ZFF was also inaugurated last year. A “Buntis Congress” which is a gathering of pregnant women and their partners was held to educate attendees about proper natal care and the government health programs available to them.

These measures are expected to have an immediate and direct impact on the health status of the locals. It is hoped that with the continued cooperation shown by the local health leadership team, tough challenges in Daram will soon be overcome.

With reports from Jenny Macaraan

Zamboanga City Mayor Maria Isabelle “Beng” Garcia Climaco-Salazar’s brand of public governance has been anchored on SHE—security, health, and education. She served two terms as a city councilor before becoming vice mayor in 2004 and two terms as congresswoman before being mayor in 2013.

Even the “Zamboanga Siege,” which happened a few months after her election as mayor, did not stop Climaco-Salazar from solving her city’s health issues. Now in her last term, she shared a clear vision of engaging the barangays for a successful health program in the city, with the support of the national government agencies, the private sector, and non-government organizations.

Access to medicines
Climaco-Salazar enrolled her city in 2014 in the first cycle of the City Leadership and Governance Program (CLGP) by the Zuellig Family Foundation (ZFF) under a partnership with the United Nations Children’s Fund.

During the 18-month program, the city improved the access to essential medicines to combat malnutrition, and decrease infant and maternal mortality rates. The mayor increased the health and social services budget and improved the medicine tracking and inventory system. She also addressed the need for health human resources and health financing.

In 2017, Zamboanga City was named the “Most Improved Local Government Unit,” and even ranked fourth nationwide in terms of resilience. That same year, Zamboanga City engaged in the second cycle of the CLGP under a partnership with the United States Agency for International Development.

With the guidance of then-regional health director Dr. Emilia Monicimpo, Climaco-Salazar sought to eradicate preventable diseases among children aged two years and younger by increasing the fully-immunized children (FIC) rate from 89.9% in 2017 to 92.21% in 2018. The city health office (CHO), in partnership with private medical practitioners and the Philippine Pediatric Society- Zamboanga City chapter, supported the expanded immunization program. Climaco-Salazar also convened the city’s hospitals to gather support for the city’s service delivery network (SDN) and referral systems. She met with the presidents of the private hospitals to discuss the city’s health problems and how they may contribute to the continuity of care.

COVID-19 response
At the onset of the pandemic in 2020, Climaco-Salazar immediately formed and headed the Task Force on COVID-19 to prevent the entry and spread of the virus in Zamboanga City.

The mayor has also consistently appealed to her constituents to submit themselves for COVID-19 vaccination. As of January 2022, the CHO data showed that the city is leading in the vaccination rollout in the region. Of the target population, 86.7% is partially inoculated, and the remaining 13.3% is fully vaccinated. The city is even offering to share its vaccines with other LGUs in the region.

With Climaco-Salazar’s leadership, the city government proved its capacity to face serious health challenges.

By Sherwin Pontanilla, M.D.

For 30 minutes every weekday morning, residents of Upi and neighboring towns in Maguindanao can tune in to DXUP-FM 105.5 MHz to learn about illnesses and proper healthcare.

During the first episode of the 16-part “Gabay Kalusugan–Kalusugan N’yo, Toka N’yo ‘To!” (Guide to Health—Your Health, Your Responsibility) program, discussions centered on what it actually means to be healthy and how investing in one’s own health brings tremendous benefits in the long run. It aired last January 16 at the 7 to 7:30 a.m. timeslot and also talked about how every person can both be a part of the problem and solution to different health issues.

The radio program is part of the Health Education Advocacy on Radio (HEAR) program which is an offshoot of the collaboration between the Foundation for Information Technology Education and Development (FIT-ED) and the Zuellig Family Foundation (ZFF). Its aim is to educate the general public about common health issues, good quality healthcare, proper maternal and child care, infectious diseases and lifestyle diseases.

Succeeding episodes that have aired focused on generic drug’s similar potency with branded medicines;role of the people in improving health service delivery;importance of health insurance; and overview of what and how to avoid infectious diseases such as malaria, tuberculosis and dengue as well as what to do once infected.

Recorded in Tagalog, the program airs Monday to Friday and will run until February 6. The radio broadcast can also be heard in some parts of the provinces of Lanao del Sur, Lanao del Norte, Zamboanga Sibugay, Sultan Kudarat and North Cotabato. It can also be heard via live streaming at http://www.ustream.tv/channel/dxup-tv or at http://www.livestream.com/dxuptv.

Visayan version of the program is also available. In the town of Bongao (Tawi-Tawi), a ZFF partner-municipality like Upi, talks are ongoing to air the same program in Tausug.

By Liane May Punsalan

Typhoon notwithstanding, it was business as usual, or in this case, feeding as usual in five schools in the town of Pinabacdao in Samar.Since July, two hundred local elementary students have been eating nutritious lunch every school day.

This is being made possible through the “Busog, Lusog, Talino” (BLT) nutrition program which is a joint undertaking of the Jollibee Foundation (JF), Zuellig Family Foundation (ZFF) and the local government of Pinabacdao (LGU). It is aimed at addressing hunger among children, helping them stay in school and improving their learning. The program is also being implemented in ZFF’s 12 other partner-municipalities.

Despite the onslaught of typhoon “Ramon,” parents remained undaunted and proceeded to prepare food for students who are under the BLT program. Attendance was almost perfect in all five schools.

On the average, according to Barangay Nutrition Scholar (BNS) Marina Wenceslaso, “six to eight parents are helping out daily.” She adds that “pupils are really eager to eat their meals.”

While menu planning and cooking supervision is done by the school’s feeding coordinator, parents of the students do the marketing, cooking, and actual feeding.

According to JF, by having this set-up, no additional work is imposed on teachers while at the same allowing parents to learn about preparing affordable but nutritious meals. Given the parents’ critical roles in the feeding cycle, the LGU conducted a seminar on food safety and sanitation for them and mobilized the BNS and barangay (village) health workers (BHW) to help the parents.

Halfway through the program implementation, improvements have been observed.

According to BHW president and BLT point person Maria Rosario Achazo, “almost 65% of the pupils have already attained a normal body mass index level.” Jocelyn Solayao, teacher-in-charge of Madalunot Elementary School, also said “there are noticeable developments in the weight, general appearance, attendance, and academic performance of the pupils.”

Luzvie Tepase, a 30-year-old mother whose son is part of the feeding program, said her son is “heavier, looks healthier, and now enjoys eating vegetables even when at home.” According to Solayao, positive changes in the behavior of parents have also been observed.

“Parents are constantly learning new and exciting ways in cooking the meals.” Solayao added that parents have started growing their own vegetables like Tepase who has malunggay (moringga) growing in her backyard, while some are maintaining gardens in the school.

The program also managed to foster improved community participation and stakeholder support. The barangay and school officials in Laygayon organized a bayanihan (community cooperation) for the construction of their feeding center, tables and chairs. The parents contributed firewood, utensils, vegetables, and cash for additional feeding goods while the LGU provided cooking pots.

Success of the program has prompted Pinabacdao mayor Mario Quijano to think of implementing the program in other schools. “Given the initial results of the program, we are looking towards expanding BLT in five more schools.”

Acknowledging the gravity of maternal health problems in the country, governors where maternal deaths remain serious committed to implement programs that will address the problem. Three of these governors—Sol Matugas of Surigao del Norte, Paul Daza of Northern Samar and Sharee Ann Tan—also forged a partnership with the Zuellig Family Foundation by signing a Memorandum of Understanding (MOU).

The MOU stipulates that ZFF will be giving health leadership and skills training programs to selected municipalities of the region while the regional government provides the necessary financial and logistical support to participating municipalities as well as resources such as medical supplies, health personnel and trainers for frontline health personnel to boost local health reforms.

The signing was part of the “162-52 Summit” held recently at the Philippine International Convention Center. An initiative of a multi-sectoral coalition that was formed after the ZFF’s Third Health Outlook Forum held last December, the health summit was meant to bring to the consciousness of health stakeholders the serious maternal health problems in the country.

The numbers 162 and 52 are the maternal mortality ratios of the country, the former being the 2008 official figure while the latter is the 2015 Millennium Development Goal target which, at the rate things are going, the country might not be able to attain.

Over 200 individuals listened to resource persons from both the private and public sectors. Heading the list of speakers is Health Secretary Enrique Ona who delivered the speech of President Benigno Aquino III.

In his speech, the President reiterated the critical roles of local governments in sustaining the health programs initiated by the national government. “Let me appeal to our friends in the LGUs: facilities established through the national coffers need to be sustainable. We need more equipment; we need more medicines; we need more trained, compassionate, committed people to man our hospitals.”

He also said that private sector participation is very important to give the necessary boost to fast-track health improvements. “We need the private sector to bring us over the threshold, to shorten the final mile that women have to walk or travel to get to the nearest health facility and skilled birth attendant when they need it.”

He added that the innovations that private sector possess are most needed in the poorest municipalities and those considered geographically isolated and disadvantaged areas where most maternal mortalities occur. Accordingly, the government has lined up several opportunities to accommodate the private sector’s “enthusiasm and willingness to help.”

Another speaker, United Nations Population Fund (UNFPA) Country Representative Ugochi Daniels stated that “No Woman should die giving life. And no child should be robbed of his life because of his mother’s death.”

Daniels pointed out the three important elements that women must always have access to: contraception to avoid unwanted pregnancies, skilled birth attendant at the time of delivery, and quality and timely obstetric care. She also called on the expansion of public-private partnerships to maximize resources for exemplary practices and provide effective program models.

The summit also featured a gallery where participants were able to see the latest health statistics of 20 priority provinces with serious maternal health challenges. Also displayed were various public-private partnership models available to address the different existing health issues. Representatives of various organizations were also on hand to further explain their programs to those who signified interest.

More than the discussions, the summit was intended to get firm commitments of support for health from individuals and groups. Apart from that given by the governors, other organizations also signified their intention to do their share in improving maternal health in the country.

The USAID-Private Sector Mobilization for Family Health Project (PRISM) will give technical assistance and capability-building programs to various provinces. A Single Drop for Safe Water will provide water sanitation and hygiene governance courses; Pharmaceutical and Healthcare Association of the Philippines will give pharmaceutical management and good governance courses while Plan Philippines, Health Development Institute, University of the Philippines-Palo and University of Makati are committed to providing mayors and barangay (village) captains governance training programs.

The 162-52 Coalition is headed by the Department of Health. Other members include League of Provinces of the Philippines, Union of Local Authorities of the Philippines, Philippine Business for Social Progress (PBSP), ZFF, Ayala TBI/ACCESS Health Philippines, Sanofi-Adventis Philippines, Unang Yakap through World Health Organization-WPRO, United Nations Population Fund, Smart Communications Inc, Macare Medicals Inc. and Chamber of Mines.

After the summit, the coalition has been compiling and reviewing other expressed commitments submitted by participants. Meetings will soon be held to start gathering the collective efforts meant to improve maternal health.

Different programs of various groups will also be organized and matched with existing gaps found in the different provinces to achieve the necessary collective impact to speed up reforms and attain the MDG on maternal mortality.

Red Orchid Award. Champion for Health Leadership. Seal of Good Local Governance. Gawad Pamana ng Lahi. Seal of Good Housekeeping. These are just a few of the recent health recognitions conferred to the municipality of San Felipe, Zambales thanks to the powerhouse girl tandem of Mayor Carolyn Fariñas and municipal health officer Dr. Salome Arinduque.

Theirs is a story of persisting through personal struggles and turning experiences into motivation to bring better health outcomes to their people.

Mayor Fariñas had to leave her quiet private life to run for an elective post when her politician husband suddenly died in his sleep. Dr. Arinduque, meanwhile, went through financial difficulties when her father was diagnosed with cancer.

As they went through the struggles, they knew it could be worse for others. So they used their strengths to influence and improve the lives of people. And they did it by empowering the health workforce.

When Arinduque first came in as MHO in 2005, she saw the staff lacked passion. In her words, “’Yung motivation nila, papasok lang just for the heck of it! Mairaos lang ang 8 am to 5 pm.”

So she led by example by serving with passion. She also taught them technical skills.

“Naturuan ko na ang staff so pag wala ako, alam na nila paano mag-treat. Pati computations, nagpapa-exam ako to evaluate kung may natutunan sila. Tinuruan ko sila kung paano mag-refer ng pasyente, ano sasabihin nila sa doctor. Tinuruan ko sila kung anong laboratory ang gagawin para sa pasyente na ito, kung paano makipag-usap. From head to foot titingnan nila ang isang buntis kung bakit kailangan nila siya i-refer. Sinasabi ko palagi pakiready ang ambulance. Pag na-settle na at nakabalik na tatanungin ko ano nangyari.”

Mayor Fariñas, on the other hand, does not micromanage. She learned from the MHO who among the staff were rising up and based on that knowledge, assigned focal persons.

“I think they are inspired, they are capacitated, they are supportive. Much of them are given importance because they are being assigned as focal persons. In all our programs ginamit ko nga ‘yung management style na may focal person para merong humahawak talaga, merong primarily accountable, lahat tulong-tulong. Pero laging may primary lead, si doktora.”

Through engaging health staff and empowering them, the Fariñas-Arinduque tandem was able to gain more health champions who work toward optimum health for the people of San Felipe.

 

See related story here.

By Renzo Guinto

 

On the basis of the Local Government Code of 1991, the Philippines has developed what is called a devolved health system.

Devolution is a form of “administrative decentralization” wherein functions such as planning, decision-making, financing, and delivery of most health services are transferred from the central government to local government units (LGUs).

Hence, municipalities and provinces are responsible for a wide variety of tasks – from hiring local health workers and purchasing medical supplies, to running barangay health centers and hospitals and implementing disease prevention activities.

In most health policy discussions held in “Imperial Manila,” health system devolution is often deemed as the main reason why our national health system has failed to ensure healthcare access and improve health conditions.

Some argue that devolution led to healthcare fragmentation, lack of accountability, and even rampant corruption. To address these problems, one solution that was suggested was to recentralize healthcare and bring all health system functions back to the Department of Health (DOH).

One needs to be careful in making such sweeping statements and hasty recommendations.

Not a dead-end

Devolution is a complex feature of the health system with many components and dimensions. Unlike a medical intervention, it cannot be simply subjected to a clinical trial or a natural experiment.

Its effects on health system performance and ultimate health outcomes cannot be easily isolated, and attributing health system failure solely to devolution is both irresponsible and dangerous.

This is not to say that devolution cannot be understood and therefore must be treated as a given. Looking for local case studies that either demonstrate good or bad performance helps generate insights on how devolution is not really a dead-end, but rather can be fixed.

Last week, I attended the Health Leadership and Governance Symposium of the Zuellig Family Foundation (ZFF). For the past decade, ZFF, using its Health Change Model, has been training not only municipal and provincial health officers, but also mayors and governors on how to strengthen their local health systems and meet the health needs of their citizens especially the poor.

Engaging local chief executives and not just health professionals is critical, since in a devolved health system, they are the main decision-makers. Rather than countering the devolved system, ZFF instead “swam” with it.

One of ZFF’s sites, the province of Aklan, made huge investments in health – to improve existing hospitals, equip health workers, and strengthen referral systems. In 2018 alone, PhP 748 million or 38% of its entire provincial budget went to the health sector.

The provincial government also partnered with other local stakeholders to identify gaps and design solutions. As a result of these efforts, almost all of the top 10 causes of disease and death have decreased. “I want to make sure even the poor receives VIP treatment in our health facilities,” remarked Aklan Governor Florencio Miraflores during the symposium.

Bataan, another ZFF recipient, has set for itself the goal of becoming the province with the highest Human Development Index – which is a measure that combines health, education, and livelihood indicators.

Its governor, Albert Garcia, understands that to achieve this, the province must not only strengthen its healthcare system but also address the social determinants of health such as drunk driving and public safety. Interventions outside of the traditional health sector that target these factors have already shown decline in vehicular accidents and street crime.

Up to leaders, stakeholders

Unfortunately, despite the adequate decision space that LGUs do enjoy, not every municipality or province takes advantage of it in a way that truly benefits the people.

The problem is not that the decision space is too broad or too narrow, but how decision-makers are making good use of it, if not exploiting it for self-serving interests. And that is why organizations such as ZFF have been working hard to reorient local leaders to develop a genuine concern for health, adopt a broader systems-wide view, and make smart choices that improve health and save lives.

The problems with implementing devolution have a particular relevance to recent discussions around the proposed shift to a federal form of government.

Federalism, like devolution, decentralizes power and gives fiscal autonomy to sub-national units, specifically at the regional level. Because each region will have its own parliament, the decision space for health and other areas expands even further. However, similar to devolution, if the decision-making task goes to the wrong hands, intended health system goals will still not be achieved.

Hence, bigger decision space without the right safeguards such as the proposed Anti-Dynasty Bill will just perpetuate the culture of corruption that steals money away from people’s health.

Another ongoing development that relates to devolution is the proposal to create Service Delivery Networks (SDN).

The revitalized Universal Health Care bill that is currently deliberated in Congress enshrines SDN as an integrated unit of hospitals and primary care clinics convened by the province and covering different municipalities.

In theory, SDN should address health system fragmentation that comes with devolution, strengthen the referral system to ensure no patient falls into the cracks, and pool financial and human resources together for efficient and equitable use. SDN can also help enhance local government accountability – mayors and governors that are part of an SDN can exert pressure on each other to fulfill their commitments to public health.

At present, our devolved health system is characterized by islands of good practice in an archipelago still marked by underperformance and poor health outcomes.

3 recommendations

How can we spread a positive “virus” of good health governance across municipalities and provinces? Here are three general recommendations.

First, we must ensure that good decision makers occupy the “decision space.”

It begins with electing leaders with real concern for the health of their constituents. Citizens must question candidates about their vision for the public’s health even before they get elected. And once these politicians are sitting in power, communities must continue monitoring their actions and holding them accountable. The decision space is strengthened when leaders deliver and citizens participate.

Second, while I argued for keeping devolution and making it work, this is in no way to absolve DOH of its responsibility as the country’s public health steward.

It should rethink its strategy in working with LGUs. During the ZFF Symposium, Governor Adolph Edward Plaza of Agusan del Sur urged the DOH Central Office staff to do a “deep dive” in municipalities so that they can develop national guidelines that are not detached from ground realities.

In addition, DOH can design innovative strategies to nudge municipalities and provinces that don’t deliver without violating local autonomy as enshrined in the Local Government Code. The Philippines can learn from examples from other countries with decentralized health systems.

For instance, in Mexico, Brazil, and South Africa, the federal government, invoking the constitutional right to health, can intervene in provincial and municipal health governance if these subnational units are not achieving national health objectives.

One option within our disposal is to use PhilHealth reimbursements to incentivize LGU-administered clinics and hospitals to provide quality health care and leave no one behind.

Finally, leadership development programs such as ZFF’s must be strengthened, sustained, and scaled up. At present, not all provinces and municipalities in the country are covered by ZFF.

Moreover, while the goal is to institutionalize good governance that defy electoral cycles, the reality is that there is a high turnover of health workers especially in poor areas and culture change in any organization takes time.

Pulling out the program prematurely may reverse progress and even bring back communities to square one.

Renzo Guinto (@RenzoGuinto) is a physician and currently a Doctor of Public Health candidate at the Harvard T.H. Chan School of Public Health. He is also currently establishing PH Lab, a “glocal think-and-do tank” for generating innovative solutions for Philippine health, public health, and planetary health. He can be reached at https://scholar.harvard.edu/renzoguinto.

 

This article was published by Rappler.com on October 3, 2018. 

FROM THE STANDS – Domini M. Torrevillas

Beset and challenged both, three provincial governors hurdled difficulties in demonstrating genuine concern for the health and well-being of their constituents. In matters of health, they heard complaints of patients being turned away by hospitals for lack of downpayment money, of  relatives being transported from one hospital to a better equipped one and dying along the way, of  not having drinking water and sanitary toilets. It all boiled to one big problem – poverty, so evident and felt in rural areas. At a symposium Tuesday in Makati, the governors – Sharee Ann Tan of Samar, Florentino Miraflores of Aklan, and Adolph Edward Plaza of Agusan del Sur, shared their experiences in improving matters and allowing patients to have better care and at affordable cost.

The three governors have been “pupils’’ under the programs of the Zuellig Family Foundation, whose mission is ‘’to inspire health conditions in rural communities by training programs for local government health leaders to strengthen health leadership and improve governance.’’

The foundation’s focus in improving health systems is rooted in the Zuellig family’s long-standing business in health care. It began when Frederick E. Zuellig came to Manila in 1901 for business opportunities. After World War II, his sons Stephen and Gilbert rebuilt, diversified and expanded the firm internationally. In 1997, the  Zuellig grandsons, Daniel and David, established the Pharmaceutical Health and Family Foundation that catered to the health needs of the communities surrounding  the manufacturing plant of Zuellig’s Interphil  Laboratories Inc. in Canlubang, Laguna, and in 2008, changed the name to Zuellig Family Foundation.

A research paper by scholars noted the “great disparities in access to healthcare, resulting in significant difference in health status between the rich minority and the poor majority of Filipinos.”

ZFF addressed the gap by empowering local leaders with the proper tools and training to systematically implement reforms so their healthcare systems respond to the needs of the underprivileged. The leaders are coached and mentored on effective healthcare systems.

Grandson David told the symposium – attended by a good number of delegates from government and NGOs involved in healthcare services, on the occasion of the 10th year anniversary of ZFF, that the foundation is the vehicle of the family in “giving back to the country of our  birth.”

The foundation focuses on health leadership and governance of local executives since they control the health facilities where the poor go to for services. Over the past 10 years, its health leadership and governance model initially piloted in 72 municipalities is now in over 600 municipalities and 23 provinces. It has also cooperated with the Department of Health and its regional directors and their staff. It has trained 13 academic partners who share the leadership approach to other sectors.

In his remarks, Roberto R. Romulo, ZFF trustees chair, said the foundation developed a Health Change Model, which states that health indicators, especially of the poor, will improve if they have access to health services that are made available by an equitable health system, made possible by a responsive local chief executive and his team.

Romulo made it clear that ZFF president, Ernesto D. Garilao, has kept the foundation on track. For example, the Health Leaders for the Poor program he introduced, also known as the Bridging Leadership process, equipped the mayors with an understanding of the inequities in their health system. Model-tested in two years, its major focus was (and still is) maternal health.

In 2013, former Health Secretary Enrique Ona asked ZFF to adopt the approach and work with priority municipalities of the National Anti-Poverty Commission. All partnership policies, systems and  procedures are co-created with the DOH, with operating costs shouldered by ZFF.

In 2016, ZFF started working with provincial governors and DOH regional directors, the purpose being to let the poor have better access to health services. This mandated provincial governors to exercise direct supervision over the hospitals, where the political officers assigned there carry out the goals and objectives of the municipal health system.

The three governors mentioned above and regional directors spoke at the symposium of the approaches they used to improve their health systems. For one, they visited poor communities. They fixed rundown government and peripheral hospitals, put in more hospital equipment, and constructed toilets and water systems in the houses that had to be fixed, worked for the hastening of PhilHealth assistance, and adding more doctors and personnel to the staff. Results have been good, as indicated by more people going to the hospitals instead of suffering at home in silence, maternal deliveries managed by skilled nurses and hilots, high contraceptive prevalence rates, and very few deaths.

They acknowledged the cooperation and participation of government agencies and members of the community – the latter won over by the executives’ meeting face to face with them, and the core groups they created to help in the achievement of their goals.

Governor Plaza said a lot has yet to be done to improve the systems, but for his part, he is hopeful in time he can leave ‘’a legacy of a quality health system with a high standard of service felt by the people.’’

This article was originally published in Philippine Star on September 27, 2018.