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HEALTH LEADERSHIP

SITUATIONAL ANALYSIS
I. INTRODUCTION
According to the WHO 2011 report, despite the improvements through the years, health
conditions in the Philippines remain among the poorest in Asia. Health inequities continue to
exist, and many poor families have yet to access quality and critical health services. The
Philippines has committed to achieve the Millennium Development Goals (MDG) – four of
which are on health which was due in 2015, the need to intensify efforts in addressing health
problems is more urgent.

The Department of Health (DOH) recognizes this need and takes on the challenge to
address such problems. As a national policy maker and regulatory institution, it acknowledges
the critical role it plays in creating an immediate impact on improving health outcomes at the
national level by implementing interventions that strengthen leadership and service delivery
at the local level. During the DOH’s Executive Committee meeting in November 2012,
Secretary Enrique Ona indicated his desire to see in the Department a leadership and
governance program that would involve more local chief executives in addressing health
issues, hence, the decision to adopt a leadership and governance program which was based
on the results of ZFF’s Health Change Model and employs the Bridging Leadership framework
that allows individuals to undergo transformative processes of ownership of health issues,
engagement of stakeholders, and generation of collective responses.

In May 2013, the DOH and ZFF entered into a three-year partnership to implement the
Health Leadership and Governance Program (HLGP) to strengthen leadership and service
delivery both at the national and local level with ZFF as the lead provider of the leadership
capability building programs and technical support to the DOH Regional Offices. The HLGP is
a three-year joint program of the DOH and ZFF that is designed under the Aquino
government’s Kalusugang Pangkalahatan (Universal Health Care) Program which aimed to
improve the health status of Filipinos through ensuring financial risk protection, access to
quality healthcare facilities, and achievement of health-related MDGs. It will run from 2013
until 2016, covering _____ provinces and ____ municipalities all over the the Cordillera
administrative Region (CAR). These areas were selected from the 609 municipalities
identified by the National Anti-Poverty Commission as priority municipalities for poverty
reduction.

The HLGP employs a combination of technologies and approaches:


1. bridging leadership for local health leaders to increase ownership of the issues and
challenges;
2. health systems approach or Technical Roadmap using WHO’s six building blocks of a local
health system development;
3. strengthening community health teams and local health boards towards improving health
governance, health seeking behavior and service delivery at the community level; and,
At the regional level, the Regional Director, Assistant Regional Director, HLGP
Coordinators, Provincial Health Team Leaders, DOH Representatives, and other regional staff
critical to the program undergo the Health Leadership and Management for the Poor (HLMP)
and Training of Coaches (TOC).

Provincial Leadership and Governance Program (PLGP) is given to the Governors,


Provincial Health Officers, Chief of Hospitals, and their identified health teams. Municipal
Leadership and Governance Program (MLGP) is provided for the Local Chief Executives (LCE)
and their Municipal Health Officers (MHOs). On the other hand, City Leadership and
Governance Program (CLGP) is also available for City Mayors, City Health Officers (CHO), and
their health team.

To go full swing and interweave the program into the smallest unit of governance, the
Barangay Health Leadership and Governance Workshop is conducted for the Barangay
Captains together with their identified members of the barangay health board such as the
barangay council on health, midwife, and barangay health workers.

II. OBJECTIVES
1. To effectively harness and mobilize health leadership towards creating sound policies;
2. To develop leadership and governance capabilities of local chief executives and other
local health leaders;
3. To strengthen service delivery mechanisms and deploy competent health human
resources;
4. To build a sustainable financing environment that are all responsive to health needs of
the communities

III. ACCOMPLISHMENTS
1. Change Management Training Program (CMP) and Guiding Coalition Formation (GC)
2. Health Leadership and Management Program (HLMP) and Training of Coaches (TOC)
3. Coaching System
4. Provincial Leadership and Governance Program (PLGP)

Ifugao and Mt. Province have completed the 3 modules in the span of 3 years and are
for colloquium on November 10, 2016. Aside from the modules given, coaching sessions
were provided by identified senior coaches, Prof. Ernesto Garilao for Ifugao and Dr. Jaime
Galvez Tan for Mt. Province, to continuously support them as they take actions in
improving the local health system in their respective provinces. The provincial health
leaders in these two provinces have been supportive to the program wherein they have
consistently attended the trainings and coaching sessions. The provincial roadmaps of
the two have shown improvements in the leadership and governance.
5. Municipality Leadership and Governance Program (MLGP) and Municipal Health
System Improvement

NUMBER OF MLGP AREAS PER PROVINCE AND STATUS, AS OF SEPTEMBER 2016


# of On-Going
# of MLGP
Province Municipaliti Alumni For For Dropped
Areas
es Colloquium Module 2
Abra 27 4 1 1 2 0
Apayao 7 3 1 1 1 1
Benguet 13 7 7 0 0 0
Ifugao 11 8 6 0 2 1
Kalinga 8 4 2 0 2 0
Mt. Province 10 6 6 0 0 0
TOTAL 76 32 23 2 7 2

There are a total of 25 mayors and 25 MHOs who completed MGLP Modules 1 and
2. However, there are 23 mayors and 22 MHOs WHO made it to the colloquium and
received their Certificate Course on Community Health Development from BSU. The
alumni municipalities are: Sallapadan in Abra; Pudtol in Apayao; Kibungan, Buguias,
Kapangan, Mankayan, Sablan, Bokod, and Kabayan in Benguet; Aguinaldo, Alfonso Lista,
Asipulo, Hingyon, Hungduan and Lamut in Ifugao; Pasil and Tinglayan in Kalinga; and
Bauko, Besao, Bontoc, Sadanga, Sagada and Tadian in Mountain Province. San Juan of
Abra and Sta Marcela of Apayao are for colloquim while Luna, Lubuagan, Pidigan, Rizal,
Dolores, Lagawe and Tinoc municipalities are still for MLGP Module 2. There were two (2)
municipalities who dropped, Banaue and Kabugao.

IV. STATUS OF PROGRAM IN CAR


As of September 2016, 32 of the 75 municipalities of CAR are enrolled in the MLGP.
Of the 32 MLGP areas, 59% (19 of 32) of these have been accredited by PhilHealth for
MCP, NBS, PCB/Tsekap, and TB DOTS. There are MLGP areas who have not been
accredited for MCP since it is near a Level I hospital which maternal delivery services
such as in Besao and Sagada. All of the MLGP areas have a functional emergency
transport, pregnancy tracking system and local health boards. Nine (9) of the 32
MLGP areas have so far implemented an incentive system for mothers who gave birth
in health facilities which are the municipalities of Dolores and Sallapadan of Abra
province; Bokod, Kabayan, Kibungan, Mankayan and Sablan of Benguet province;
Aguinaldo of Ifugao province; and Tinglayan of Kalinga.

In terms of health outcomes, it has been a challenge for the region to achieve the
national target. For the provinces of Ifugao and Mt. Province included in the PLGP,
both have reached 90% SBA but have not yet achieved the target of 65% for CPR and
90% for FBD. Of the 32 MLGP areas, 50% have reached 90% FBD target, 78% achieved
90% SBA, and only 34% attained a 65% CPR. Albeit a mountainous topography and
being an indigenous region, the critical maternal indicators for these PLGP and MLGP
areas are moving towards the national target.

V. PROBLEM ANALYSIS

Engaging and motivating the stakeholders to embrace health reforms and changes
towards a common goal remains a challenge. Strengthening and sustaining the
partnership with current networks and partners while being steadfast in employing
fairness and balance between processes and needs is also a tough responsibility.
Lastly, improving health outcomes of an indigenous region like the Cordillera while
preserving culture being a link to their roots and ancestor.

VI. PLANS 2016/ Next steps


1. DOH RO CAR is planning to conduct MLGP Module 2 for the seven remaining
municipalities of Dolores, Pidigan, Lubuagan, Rizal, Tinoc, Lagawe and Luna.
2. The 7 municipalities for Module 2 together with San Juan and Sta. Marcela are
targeted to have their colloquium.
3. Conduct of Training of Coaches for the 2 batches who finished the HLMP 2 in
2015 & 2016
4. Preparation and production of briefer for use of DMOs
5. Refresher course for DMOs on Training of Coaches
6. PLGP for one (1) province
7. Bridging Leadership Retreat for the Regional Director, Assistant Regional Director
and the HLGP Coordinator
8. Conduct of MLGP Modules 1 & 2 for 10 municipalities
9. Conduct of HLMP Modules 1 & 2 and TOC for 20 DOH CAR employees
10. Coaching and mentoring of MLGP areas
11.
12. Leadership capacity building trainings are also targeted to be conducted to
ensure that the regional staff are given the opportunity to enhance their
leadership competencies. To further promote MLGP to the municipalities,
promotion strategies has been included in the working financial plan of HLGP
such brochures and radio guesting.

PROBLEM TREE
OBJECTIVE TREE
LOGICAL FRAMEWORK