The Province of Maguindanao is quite peaceful in the year 2010 despite of some isolated cases occurred in some municipalities due to election related incidents. From May to June, 2010, the municipalities of Datu Montawal, Sultan Sa Barongis,Rajah Buayan, Datu Blah Sinsuat, Ampatuan, Datu Abdullah Sangki and Parang were affected by these election related incidents that caused the displacement of families. Displaced families already returned home.
All walks of life in the entire provinces in business enterprises, agricultures and aquatic resources.
Most of the IDP’s which was the spill -over of the August 2008 armed conflict were already returned to their place of origin, others were resettled, relocated and reintegrated. Out of more than 50 thousands displaced families, only 3 thousand plus remained in the evacuation centers (see summary of assessment and validation of August 2008 IDP’s).
There were 3,403 units of Modified Core Shelter were provided in 22 municipalities funded by DSWD Central Office. (See attached Status of Implementation of the Shelter Assistance for Internally Displaced Persons)
First & second quarter of 2010 has been a transition month for the implementation of our programs and services as newly installed local officials was designated to continue on the delivery of programs and services of the province. Despite this setbacks, still the agency has managed to do its functions.
The continuing collaboration among various GO’s and NGO’s both local and international using the cluster approach have brought advantages to the workers as their knowledge were enhanced and improved thus benefiting our clienteles.
Specifically, the first quarter of 2009 was highlighted by the simultaneous distribution of the KATAS NG VAT : Tulong Para Sa Lolo at Lola. The program covered the 33 municipalities of Maguindanao Province where – senior citizen ages 70 years old and up were given the amount of 500 pesos.
Further, the UNICEFs Country Program for Children VI has supported different intervention for the Parents and the children of the Province especially on the conduct of training of the Day Care Workers on Revised Manual and Supervised Neighborhood Play, Parent Effectiveness Service and the Organization of Local ECCDCCs in selected municipalities and barangays. Worth to mention is the launching of the “ECCD on Horse” in the selected 2 barangays of Buldon & South Upi. These barangays were given full support by the JP Morgan thru UNICEF. Likewise, the Child Protection Network wherein DSWD as an implementing partner of it has put more focus on the Psychosocial Services/Training to benefit mostly by our affected children.
Healthy Start Feeding Program and Food for School Program were continuously implemented in the province as a continuation of the 2009 initiative.
The ASFP Project in which it covers PC8 (JICA) & PC7 (WB) had reached more depressed communities especially in the construction of the small scale infrastructure projects needed to uplift the living condition of the poor communities. PC 8 has just commenced late in March 2010 and PC 7 to end up this May 2010. Series of supervision missions, evaluation and monitoring were done to track down project deliverables.
Furthermore, DSWD Field Workers attended series of Training/Seminars for them to enhance their potentials and capabilities of implementing the newly introduced programs by the National Government.
The 3rd & 4th quarter accomplishment report of the province was focused on the implementation of the ARMM Social Fund Project, Social Preparation on Pantawid Pamilyang Pilipino Program (4 Ps), Early Recovery and Rehabilitation program for the IDPs, Family Tracing and Reunification System supported by UNICEF, UNFPA Activities and the regular program activities conducted in the municipal level.
The province has been so busy in meeting simultaneously the demands of the program by mobilizing the coordinators, team leaders and in-charges.
DSWD- MAGUINDANAO MAJOR PROGRAMs:
A. Family & Community Welfare Program (FCWP)
- 1,000 families’ recipient of Philhealth sponsored by the MLGU.
- 3,000 families’ recipient of Philhealth sponsored by Provincial Government
- 1,145 families’ target of the 4PS program.
- Conducted Marriage Counselling Services to couples.
B. Child & Youth Welfare Program (CYWP)
- Out of 30,160 Day Care Children served , 21,986 served under the Food For School (FFS) Program
- There were 370 Barangays under the ECCD Program with 639 number of Day Care Center with 636 Day Care Workers from.
- Organized Pag-asa Youth Federation in the Province of Maguindanao.
Court Related Cases:
- Child In Conflict with the Law (CICL) – 2 cases on court trial
- Child Trafficking – 17 returned to family
- 8 still at Visayan Forum, Manila, pending family assessment.
- Minor Travelling Abroad – 12
- Rape Case – 2 cases on court trial; 2 pending cases, perpetrators at large
C. Women Welfare Program (WWP)
- 44-Conducted Maternal and Child Care Self Enhancement, discussed personal hygiene, ways of caring children, and other cleanliness habits and practices at home and community
- 4-referrals to CRMC for medical treatment (Mayoma, goiter, abdominal problem for CT-SCAN,)
- 11-Referred to Mabuhay Deseret Foundation for check-up of their goiter for possible free operation, and out of 11, 8 were evaluated and further assessed and 3 were successfully operated. LGU of Parang extended cash assistance amounting to 3,000 pesos for transportation expenses from Parang to Davao City
- 122 women’s referred to Medical Mission for conjsultation, medication and treatment (dental, diabetic, eye problem and other illness.)
D. Emergency Assistance Program (EAP)
- Facilitated provision of assistance on relief goods (food and non-food), shelters and livelihood to returned, resettled and E.C. remained IDP’s of August 2008 Armed conflict.
- Assistance to 1,535 displaced families affected by the Maguindanao Massacre in the municipalities of Ampatuan, Shariff Saydona, Upi and DOS
- Facilitated provision of relief assistance to 3,318 displaced families affected by Family Feuds in the municipalities of Datu Montawal, Sultan Sa Barongis, Datu Blah
- Financial assistance under the AICS(Assistance to Individual in Crisis Situation).
E. Person With Disability Program (PWDs)
- Singing and Draw & Tell Contest in all categories. Participants received gift packs consisting of assorted grocery items.
- Hanging of Streamers in support to the celebration of the province of Maguindanao also celebrated the National Disability Prevention and Rehabilitation Week (NDPR) by allocating an amount of P1,500.00 for the meals and snacks of the Differently Abled Persons. Activities undertaken are: Socialization and Election of Officers.
- 2,130 PWD’s availed of different services such as; ID’s , crutches and wheelchairs.
- 9,781 Senior Citizens availed of the SC ID.
- Elderly Person’s Week Celebration “Lakbay Aral” sponsored by the LGU of Upi.
INTEGRATED PROVINCIAL HEALTH OFFICE (IPHO)
The Integrated Provincial Health Office – Maguindanao spearheads the health services delivery in the entire province. Though working in a non-devolved set-up, it closely coordinates with the Provincial Government of Maguindanao in its mandate to provide quality health services which is clearly stated in its vision and mission.
The IPHO – Maguindanao has a limited health resource in the delivery of health services. Health facilities are few and inequitably distributed across the province. There are seven government hospitals though only five are under the administrative supervision of IPHO – Maguindanao, namely, Maguindanao Provincial Hospital in Datu Hoffer, Buluan District Hospital in Buluan, Datu Blah District Hospital in North Upi, Dinaig Municipal Hospital in Datu Odin Sinsuat and South Upi Municipal Hospital in South Upi. There are only total of one hundred and five (105) hospital beds giving the ratio of one hospital bed for every ten thousand population (1:10,268). Main health centers can be found in only twenty-four municipalities out of the thirty-six towns in the province. Barangay Health Stations are even few in numbers, only two hundred in the four hundred ninety-two barangays. The IPHO – Maguindanao was able to establish one hundred forty-five (145) Botika ng Barangays in the past two years.
Table 1. Health Facility and Number, IPHO – Maguindanao, 2010
The human resources for health are way below the standard proportion to deliver quality health services.
The Provincial Government and some Municipal Governments hire some human resource for health though on a temporary basis. On August, 2010, the DOH-ARMM assigned more than fifty (50) midwives for Maguindanao under the Midwives in Every Community in ARMM (MECA) Project. The National Government through the Nurses assigned in Rural Services (NARS) Project also augments this inadequacy in human resources.
However, the inadequacy of professional health workers is somehow augmented by the community volunteers for health. Through the years, the IPHO was able to organized several community support groups, these are the Barangay Health Workers, Trained Birth Attendants, Muslim Religious Leaders, Community Health Action Teams, Microscopy in Wheels and many others from different sectors.
Leading causes of illness in 2010 are mostly infectious in nature though in the last five years, cases of lifestyle related illnesses are reportedly increasing in number. Leading causes of death are mainly due to cardiovascular diseases and other lifestyle related illnesses though some infectious diseases also cause fatality.
Table 3. Leading causes of illness, 2010 Table 4. Leading causes of deaths,
Leading causes of infant and under-five deaths are mainly infectious in nature which clearly shows inadequacy of services related to newborn, infant and child care and can even be traced back to material care services provided to the mother during her pregnancy.
Table 5. Leading Causes of Infant Deaths, 2010 Table 6. Leading Causes of Under-five Deaths
Leading causes of maternal deaths are more worrisome because it clearly gives a picture of the inadequacy of the maternal care provided to the mothers during pregnancy, during labor and delivery and even at the post-partum period.
Table 7. Leading Causes of Maternal Deaths, 2010
IPHO-MAGUINDANAO MAJOR PROGRAMS:
Maternal, Newborn, Child Health Care and Nutrition (MNCHN)
Provision of health care services to mothers, newborns and children is one of the priority programs of IPHO-Maguindanao. This is aims to provide comprehensive services to all women in preparation for their pregnancy and delivery to ensure healthy mothers and eventually healthy children. Specific services and accomplishments are as follows:
• Maternal Health Care Program
One of the critical indicators to determine the quality of ante-natal care is the number of visits to the health facility wherein specific pre-natal care services should be given to the clients. In 2010, seventy-two percent (72.3%) of the estimated women to get pregnant were able to obtain at least for pre-natal care from the health workers which are the same accomplishment in 2009. Almost ninety (89.6%) percent pregnant women had at least two doses of tetanus toxoid immunization. Sixty three (62.9%) percent of these pregnant women completed their iron doses in the duration of their pregnancy.
Unfortunately, less than half (46%) of the total deliveries in 2010 were attended by skilled birth attendants and even worse, only fourteen (13.8%) were facility based deliveries. More than half of deliveries are still attended by traditional birth attendants or hilots and most of these deliveries happened at home.
Post-partum visits are equally important to prevent maternal complications. In 2010, ninety (90%) percent of post-partum women had at least two post-partum visits by health workers where specific health care services should be provided to the clients. Ninety four (94%) percent of those women who gave birth were initiated to breastfeeding within twenty-four hours. This is a very critical intervention to prevent post-partum hemorrhage for the mother and promote close bonding between the mother and newborns. Ninety-seven percent of the post-partum women were given 200,000 IU Vitamins A capsule within 28 days after delivery. Eighty one percent of post-partum women completed their iron doses in the next two months after delivery.
• Newborn Care Program
In 2010, there were a total of 27,719 live birth reported. Only fifty five (55) percent was given routine newborn care while forty two (42) percent was given routine care within the next three to five days. The importance of newborn screening is not yet fully disseminated, thus, only one percent of the total live births underwent newborn screening.
• Child Care Program
Almost ninety six (95.7%) percent of the estimated infants were fully immunized which means that they were given complete doses of the required immunizations before they reach one year old. Eighty percent of the six months old seen were exclusively breastfed.
Common childhood illnesses were managed properly. Ninety five percent of those children seen with diarrhea are advised to be given oral rehydration therapy while only seventy-eight percent was actually given Oresol. Almost eighty nine (88.6%) percent of pneumonia cases were given treatment and advised on home care.
• Nutrition Program
Operation Timbang is usually done at the 1st quarter of each year. In 2010, almost ninety-five (94.4%) of the targeted children were weighed to determine their nutritional status. Malnutrition rate slightly increased at almost ten (9.74%) percent of the children weighed.
Vitamin A supplementation coverage increased in 2010 at 96% when compared with Garantisadong Pambata coverage in 2009 at 93%.
• Family Planning Program
Family Planning accomplishments slightly decrease in 2010 when compare with 2009 accomplishment. Contraceptive Prevalence Rate in 2010 was almost twenty nine (28.4%) per cent which was lower when compare with 2009 at almost thirty four (33.4%) per cent. Among the artificial contraceptive methods, oral pills remain to be most widely used method in the province Followed by injectable contraceptives while among the natural family planning methods, Lactational Amenorrheic method is the most popular observed method. Permanent family planning methods were not widely accepted in the Province specifically vasectomy.
Infectious Disease Prevention and Program
• Tuberculosis Control Program
Pulmonary TB remains one of the common infectious diseases in the province. This rank ninth in the leading causes of deaths. One of the many reasons why TB remains to be a major public health problem is the inadequacies in program management. Resources are insufficient and there seems to be very little attention given to resolve this problem. Case Detection Rate in 2010 is sixty-five (65 %) percent which is lower when compared with 2009 at seventy-eight (78 %). Cure Rate is seventy two (72 %) percent in 2009 which is lower when compared with 2008 at seventy seven (77 %) percent.
• Other Infectious Disease Prevention and Control Program
- Schistosomiasis – this disease is endemic in eighteen (18) barangays in ten (10) municipalities in the province. Mass treatment coverage in 2010 is lower at only twenty - three percent while it was ninety–three percent in 2009. The very low coverage was due delayed arrival to required drugs.
- Filariasi. The province is on its fourth year of Mass Drugs Administration for filariasis. However, the MDA coverage in 2010 is very low at only thirty eight (38 %) percent of the targeted population as compared with sixty nine (69 %) percent in 2009.
- Malaria – this disease is endemic in eighteen (18) municipalities in the province. Not much improvement was seen in terms of controlling the malaria cases as there seems to be more cases seen in 2010 than in 2009. Annual parasite incidence is 0.4/1000 in 2010 while it was 0.5/1000 population in 2009.
- Dengue – there were three hundred twenty seven (327) cases of dengue reported in 2010.
- STI, HIV/AIDS – some health workers are trained on sexual transmitted infections syndromic case management. However, very few cases were reported due to poor finding and also due to sensitivity of these infections. Many interventions and IEC activities were done in the past to disseminate information on this thought not much improvement was seen in terms of increasing case findings.
• In 2010, the Provincial Epidemiological and Surveillance Unit (PESU) reports the following:
- Higher number of cases reported for infectious diseases. Dengue cases increased by 374% at 327 reported cases in 2010 while only 69 cases in 2009.
- There were 141 cases of typhoid fever in 2010 while only 32 cases in 2009 hence it was 341 % higher.
- Measles cases reported in 2010 were 79 while only 46 cases were seen in 2009.
- There were 13 cases of neonatal tetanus in 2010 while only 10 cases were reported in 2009.
- Malaria cases were lower in 2010 at 181 while 204 cases in 2009.
Non-communicable Diseases Prevention and Control
• There is not much attention given to these programs. Limited efforts are more on IEC activities promoting healthy lifestyle.
Environmental Heath and Sanitation
• Environmental health and sanitation indices generally went down in 2010 when compared with 2009. Households with access to safe water went down from fifty seven (57%) per cent in 2009 to fifty three (53%) per cent in 2009. There were only forty (40%) per cent households with sanitary toilet in2010. In 2009 there were forty one (41%) households with basic sanitation facilities while only thirty eight (38 %) per cent in 2010.
• Food sanitation is also not ideal basing on the sanitation indicators. Only fifty one (51 %) per cent food establishment in the province have sanitary permit and only fifty three (53 %) per cent food handlers have health certificates.
• Health Emergency Management Staff (HEMS)
- Nutrition cluster – 2 Health workers were trained on Nutrition in emergencies last June 30 – June 28 – July 2, 2010. Blanket Supplementation program for pregnant and lactating mother and 6-59 months old children were conducted in the conflict affected areas in partnership with the World Food Program and the CFSI.
• Completion of Maternal & Child Pavilion at MPH
• Construction of Technical Services Division Building
• Drug Testing Center / Treatment & Rehabilitation Center
• Operation Center
• Refurbishment of Maguindanao Provincial Hospital (CEmOC)
• Renovation of RHU North Upi
• Renovation of RHU Buluan
• Renovation of SSB
Training Seminars Workshops.
• DOH – ARMM Enhance FHSIS Training
• Woman’s Health Team Training
• Workshop on Quality Assurance and Policy Development in the Hospital
• Date Reconciliation & Validation Workshop
• Parent –Care Giver Functional Literacy Training
• TB DOTS Training for Doctors and Nurses
• Workshop on Continuous Quality Improvement Orientation
• Workshop on Formulation and Packaging of the Maguindanao Provincial Hospital policies and Procedures
• Orientation and Planning Workshop on “Garantisadong Pambata’’/ Pre- Scholars Health Week
• Roll- out Training for Female Functional Literacy Program
• Orientation and Training on Water Testing
• Orientation on Deployment and use of the Pandemic AH1N1 Vaccines
• Training on Snail Surveillance for Rural Sanitary Inspectors
• Gender Responsive and Rights Based Integrated RH for Imam
• Basic Life Support Training
• BNB Operators Trainings
• Symposium on the Prevention of Kidney Diseases
• Symposium on Schistosomiasis, REDCOP Dengue and Blood Program
• Training on Laboratory Diagnosis and Quality Control of Schistosomiasis for Medical Technologist
• Basic Life Support/Control Life Support Cum Emergency Management Training
• Orientation on TB DOTS and Harmonization Workshop of CHAT and WHT
• Family Planning Competency-Based Training
• Maguindanao Health Forum and program Implementation Review
• EPI Basic Skills Training and Cold Chain Management
• Caring for Mothers and Newborn in the Community (CMNC) Training
• Training on Interpersonal Communication and Counselling TB Clients