Access to Maternal and Reproductive Health Services in 8 Post-Typhoon LGUs Rogelio M. Ilagan, MD, MPH Program Director Project HOPE – Philippines Email address: [email protected] Mobile Phone Number: +63-908-8197913

Project Sites

Project Goal: Contribute To The Reduction Of Maternal And Child Morbidity And Mortality

Strategy Strengthening the linkages between community and the health system for better maternal and newborn care

Pathways 1. Increase demand and access to and utilization of Basic Emergency Obstetric and Neonatal Care (BEmONC) 2. Improve ante-natal care, post-natal care and skilled birth attendant at delivery coverage and access to this for pregnant women and postpartum women 3. Increase demand and utilization of RH services

Intervention 1. Train health care providers on BEmONC, ante-natal and post-natal care and community outreach 2. Conduct follow up coaching post-training to ensure skill retention 3. Training health system and community to conduct health promotion, counseling and education 4. Establish start up development of Service Delivery Network

Outcomes 1. Improved utilizations of Maternal, Neonatal , Child Health and Reproductive (MNCH/RH) services 2. Improved MNCH/RH skills of health care providers 3. Improved community MNCH knowledge and practices 4. Improved partnership between community and health system

Impact Improved systems and actions to prevent M/C deaths

Objectives: 1. To strengthen demand for basic quality MNCHN/RH services through prioritization of communication and outreach to men, women and youth; 2. To strengthen the quality assurance in the delivery of integrated MNCHN/RH services through provision of programmatic training for MNCHN/RH programs, accreditation of facilities

Methods:  Establish Project HOPE humanitarian, Gift in Kind and developmental agenda in the country  Registration, staff recruitment and opening of Local Country Office  Advocacy meetings with Department of Health, affected LGUs and stakeholders

Methods:  Conduct of Baseline Survey involving 400 women-mothers respondents aged 15-49 in 8 local project areas. Used survey tool, KeyInformant-Interviews for Mayor, Facility based City and Municipal Health Officer and Midwife and review of secondary data from the health facilities

Methods:  Country-level KAP dissemination forum and planning with Regional DoH, Provincial Health Offices, key health staff and planners from Local Project Areas  Capacity building – Orientation to MNCHN program Manual of Procedure, Interpersonal Communication and Counseling, conduct of USAPAN series, facilitation of Basic Emergency Maternal and Obstetric Care training to selected Midwives

Major Findings: A. Capacity Building  All (156) FHW attended MNCHN/RH program training  Two fold (417) increase of frontline health workers trained on IPCC  More than 100% (659) increase in women’s CHT’s members trained on IPCC  Close to two fold (255) increase of frontline health workers trained in conducting USAPAN sessions

Major Findings: B. Access and Demand  More than 60% (47,507) increase in pregnant women, infants, children under five years old and their mothers accessed health services  80% (6,346) of pregnant and post-partum clients provided counselling on safe motherhood and delivery by FHW after conduct of IPCC

Major Findings: B. Access and Demand  45% (1,693) of men and women 15-49 years old consulted health facility for FP counselling after conduct of USAPAN  82% (30,263) increase in pregnant and postpartum women provided counselling services by frontline health workers and volunteer health workers

Major Findings: C. Service Delivery  65% (12,655) increase in Contraceptive Prevalence Rate  33% (10,455) increase in Pregnant women with 4 or more prenatal visit  25% (8,253) increase in pregnant women given TT2 plus  20% (6,052) increase in pregnant women given complete iron with folic acid supplementation

Major Findings: C. Service Delivery  Two fold (3,382) increase in infants exclusively breastfed until 6 months  All 159 facilities providing MNCHN/RH services  All 16 RHU facilities are MCP accredited and receiving PhilHealth reimbursements  All 159 facilities are ICV compliant

Challenges / Issues:  Simultaneous activities of the local health system  Data Quality Check  Available IEC materials for cascade training  Inter / Intra agency coordination  Non-functional Service Delivery Network  Community Involvement  Opportunities for income generating activities and family livelihood  Continuing funds for sustainability

Recommendations for Future Action:  Prompt Planning  Regular and sustained monitoring and supervision activities  Inter-collaborating agency coordination / meetings  Operational Service Delivery Network  Livelihood program support  Fund sourcing and mobilization