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LEYTE PROVINCE

Health Investment Plan


2009-2013

Prepared by:
The Provincial Government thru the Provincial Health Office
And
The Ten (10) INTERLOCAL HEALTH ZONES of LEYTE

In cooperation with:
Dept. of Health Center for Health Development Eastern
Visayas
Philippine Health Insurance Corporation - 8
German Technical Cooperation (GTZ)

TABLE OF CONTENTS
1.0
2.0
3.0

4.0

5.0

6.0

7.0
8.0
9.0
10.0
11.0

Executive Summary
Introduction
The Province
3.1 Demographic and Ecological Profile
3.1.a Land ,Area, Location, and Climate
3.1.b Physical Environment
3.1 c Political Subdivision
3.1.d. Ethnicity and Religion
3.2 Socio-Economic Profile
3.2.a Economy, Trade and Industry
3.2.b Poverty Situation
3.2.c Literacy
3.2.d Peace and Order
Health Situation
4.1 Health Needs
4.1.a. Vital Health Indices
4.1.b Infant Mortality
4.1.c Maternal Mortality
4.1.d Morbidity
4.1.e Mortality
4.1.f Discharges (Hospitals)
4.1.g. Mortality (Hospitals)
4.2 Health Service Delivery
4.3 Health Financing
4.4 Health Governance
4.5 Health Regulation
Gaps and Deficiencies Identified
5.1. Health Service Delivery
5.2. Health Financing
5.3. Health Governance
5.4 Health Regulation
Overall Health Strategy and Specific Interventions
6.1 Health Service Delivery Component
6.2 Health Governance Component
6.3 Health Regulation Component
6.4 Health Financing Component
Critical Targets, Activities and Outcomes
Critical Investments
Financing
Timetable
Project Management

7-8
9-10
12
12
12
12
12
13
13
13
14
14
14
20
20
20
21
21
22
23
24
24
26
31
34
34
35
35
36
36
37
39
39
45
47
47
49-58

LIST OF TABLES
1A-1E

Profile of Municipalities
2

2
3
4
5
6
7
8
9
10
11A-J
12
13
14
15
16

17

18

Population By Age and Sex Distribution


Vital Health Indices
Leading Causes of Infant Mortality
Leading Causes of Maternal Mortality
Leading Causes of Morbidity
Leading Causes of Mortality
Leading Causes of Discharges of Hospitals
Leading Causes of Mortality of Hospitals
Hospitals Accomplishment 2008
Accessibility of Health Facilities
Accessibility of Health Facilities
Selected Health Performance Indicators by ILHZ
Five Years Projected Hospital Income
Phil Health Membership by Sector, Leyte Province
Summary of FAP S for the Health Sector, Leyte Province
Critical Investments, Service Delivery Component
16.1 Assumptions on the Cost Items in the Health Investment
Plan (Service Delivery Component)
16.2 Health Investment Costs by Activity by Year, Leyte
Province ( Service Delivery Component)
16.3 Health Investment Costs by Activity by Source of
Financing, Leyte Province ( Service Delivery
Component)
16.4 Health Investment Costs by Type of Expenditure by
Year, Leyte Province ( Service Delivery Component)
16.5 Health Investment Costs by Type of Expenditure by
Source of Financing, Leyte Province (Service Delivery
Component)
Critical Investments, Governance Component
17.1 Assumptions on the Cost Items in the Health Investment
Plan Leyte Province ( Governance Component)
17.2 Health Investment Costs by Activity by Year, Leyte
Province (Governance Component)
17.3. Health Investment Costs by Activity by Source of
Financing, Leyte Province ( Governance Component)
17.4 Health Investment Costs by Type of Expenditure by
Year, Leyte Province ( Governance Component)
17.5 Health Investment Costs by Type of Expenditure by
Source of Financing, Leyte Province ( Governance
Component)
Critical Investments, Regulation Component
18.1 Assumptions on the Cost Items in the Health Investment
Plan Leyte Province ( Regulation Component)
18.2 Health Investment Costs by Activity by Year, Leyte
Province ( Regulation Component)
18.3. Health Investment Costs by Activity by Source of
Financing, Leyte Province ( Regulation Component)
18.4 Health Investment Costs by Type of Expenditure by
Year, Leyte Province ( Regulation Component)
18.5 Health Investment Costs by Type of Expenditure by
Source of Financing, Leyte Province ( Regulation
Component)
3

19

20

21

Critical Investments, Financing Component


19.1 Assumptions on the Cost Items in the Health Investment
Plan Leyte Province ( Financing Component)
19.2 Health Investment Costs by Activity by Year, Leyte
Province (Financing Component)
19.3. Health Investment Costs by Activity by Source of
Financing, Leyte Province ( Financing Component)
19.4 Health Investment Costs by Type of Expenditure by Year,
Leyte Province ( Financing Component)
19.5 Health Investment Costs by Type of Expenditure by
Source of Financing, Leyte Province ( Financing
Component
Total Investment Costs of the Four F1 Components
20.1 Health Investment Costs by Year, Province of Leyte
20.2 Health Investment Costs by Activity by Source of
Financing, Province of Leyte
Projected Revenues, Leyte Province, 2009-2013

LIST OF FIGURES
1
2

Map of Leyte
Population by Age & Sex Distribution

LIST OF ACRONYMS
ADH
AGE
ARI
BCG
BDH
BHC
BHS
BHW
BNB
CALESAN
CBMIS
CBR
CDH
CDR
CFI
CHD
CHTF
COPD
CPG
DEPED
DM
DOH
DSWD
ECCD
EDF
EVRMC
FAP
FHSIS
FIC
GIDA
GO
Golden Harvest
Goodwill
GTZ
HCVD
HDH
HELP
HH
HOMIS
HPN
ICD -10
ICT
ILHZ
IMR
IRA
KAMMAO
KCH
LCE
LEAD
Leyte Gulf

Abuyog District Hospital


Acute Gastro Enteritis
Acute Respiratory Infection
Bacillus Calmette - Guarin
Burauen District Hospital
Barangay Health Council
Barangay Health Station
Barangay Health Worker
Botika ng Barangay
ILHZ for Calubian, Leyte and San Isidro
Community Based Management Information System
Crude Birth Rate
Carigara District Hospital
Crude Death Rate
Culion Foundation Inc.
Center for Health Development
Common Health Trust Fund
Chronic Obstructive Pulmonary Disease
Clinical Practice Guidelines
Department of Education
Diabetes Mellitus
Department of Health
Department of Social Welfare & Development
Early Childhood Care & Development
Economic Development Fund
Eastern Visayas Regional Medical Center
Foreign-assisted Project
Field Health Services Information System
Fully Immunized Child
Geographically Isolated & Disadvantaged Area
Government Organization
ILHZ for Alangalang, Pastrana and Santa Fe
ILHZ for Carigara, Barugo, San Miguel, Jaro and Tunga
German Technical Cooperation
Hypertensive Cardio Vascular Disease
Hilongos District Hospital
Hospital Enhancement for Leytes Progress
Household
Hospital Management Information System
Hypertension
International Classification of Diseases 10th Edition
Information & Communications Technology
Inter-local Health Zone
Infant Mortality Rate
Internal Revenue Allotment
Kananga, Albuera, Merida, Matag-ob, Ormoc District Hospital
Kananga Community Hospital
Local Chief Executive
Local Enhancement & Development
ILHZ for Palo, Tanauan, Tolosa and Dulag
5

Leyte Plains
LGU
LHA
LHSD
LPH
MABAHINHIL
Maharlika
MAINBAY
MBVMH
MD
MHO
MMR
MOA
MOOE
MSH
NGO
NNC
NWLDH
ODH
OPB
PDI
PHIC
PHN
PHO
PNDF
PO
PPM
PTB
RHM
RHU
SB
SDAH
SP
TA
TB
TBA
TB-DOTS
TCH
TEV
TMC
URTI
UTI
VCH
West Coast
WLDH

ILHZ for La Paz, Julita and Tabontabon


Local Government Unit
Local Health Accounts
Local Health System Development
Leyte Provincial Hospital
ILHZ for Matalom, Bato, Hindang, Hilongos
ILHZ for Abuyog, Javier, Mayorga and Macarthur
Mahaplag, Inopacan, Baybay
Manuel B. Veloso Memorial Hospital
Doctor of Medicine
Municipal Health Officer
Maternal Mortality Rate
Memorandum of Agreement
Maintenance & Other Operating Expenses
Management Services for Health
Non-government Organization
National Nutrition Council
Northwestern Leyte District Hospital
Ormoc District Hospital
Out-patient Benefits
Parallel Drug Importation
Philippine Health Insurance Corporation
Public Health Nurse
Provincial Health Officer
Philippine National Drug Formulary
People's Organization
Public - Private Mix
Pulmonary Tuberculosis
Rural Health Midwife
Rural Health Unit
Sangguniang Bayan
Sectoral Development Approach to Health
Sangguniang Panlalawigan
Technical Assistance
Tuberculosis
Trained Birth Attendant
TB - Directly Observed Treatment Strategy
Tabango Community Hospital
Traveling Expenses Voucher
Technical Management Committee
Upper Respiratory Tract Infection
Urinary Tract Infection
Villaba Community Hospital
ILHZ for Palompon, Villaba, Isabel, Tabango and San Isidro
Western Leyte District Hospital

1.0.

Executive Summary
The Province Investment Plan for Health (PIPH) a medium term five year period

plan (2009 -2013) contains the profile, health situation of the province, identified gaps
and deficiencies of the health system as defined by the Department of Health Formula
One (F1) Components in Service Delivery, Governance, Regulation and Financing. The
goals, targets, critical interventions and strategies are also included in the document. The
investment amounted to P1,101,096,619 shared by the 4 F1 components - P711,609,834
for Service Delivery (64.6%), P16,720,500 for Governance (1.5%), P13,625,500 for
Regulation (1.2%) and P359,140,785 for Financing (32.6%).
The cost of the interventions and activities is shared among the local
governments Municipal, Province, and the ILHZ Common Health Trust Fund (CHTF).
Other sources include our development partners namely: the Department of Health - EV
and JICA for the Womens Health Safe Motherhood Facility Network Investment
Requirements and GTZ for Technical Assistance. It is our aim to present the PIPH
document to other developing partners for them to fund some of the investments for the
next five years.
The planning process participated by various stakeholders was done in a series of
workshops conducted for the said purpose.
The proposed strategies and interventions in this plan are to be pursued in order
to achieve the following goals of the four components:
1. Governance Component: Strong commitment and capacity to support a well
coordinated, effective and efficient health care system with active community
participation. This will be realized through the Cooperative Mechanism of the Inter local
Health Zone (ILHZ), Planning Human Health Resource, Networking, Information,
Procurement, Logistics and Financial Management.
2. Financing Component: Optimize and sustained health care financing for the
Province through the Universal Health Insurance Coverage and the rational use of
government subsidies and resources generated by the local health facilities.
3. Regulatory Component: Institutionalized regulatory mechanisms that will
ensure affordable and quality health care services. This will be achieve through licensing,
accreditation and certification of health facilities; Ensuring availability of affordable
quality drugs and medicines; and Implementation of Health and Health-Related Laws.

4. Service Delivery Component: Improved access and coverage of quality health


care.
The implementation of this plan will be managed by the Provincial Health Office
together with the Ten (10) ILHZs. The Technical Management Committee (TMC) will
carry out the Programs, Projects and Activities (PPAs). The Provincial F1 Coordinator,
the Municipal LGU Focal Person, the ILHZ and Provincial Health Boards will be
responsible for formulating and passing policies intended for the implementation of the
plan.
The current Provincial Administration has made health services a top priority and
will support the said investments in the plan. The Hospital Enhancement for Leytes
Progress (HELP) will continue to improve the delivery of hospital services by investing
on infrastructure such as construction, rehabilitation and improvement of hospital
facilities, purchase of hospital equipments and machineries for the Provincial Hospital, 8
District Hospitals and 3 Community Hospitals.

2.0.

Introduction.
The Leyte Province-wide Investment Plan for Health (LEYTE PIPH) is a medium term plan

that covers a five (5) year period starting from 2009 to 2013. It presents an array of strategic
interventions, duly supported by quantifiable targets, and the corresponding investment
requirements for implementing the various programs, projects and activities on health care that
will be funded and implemented during the plan period. The proposed interventions are based
largely on the objective analysis and evaluation of the current situation and the intended goals to
be achieved. Further, this is aimed at achieving the desired state of a healthy and empowered
Leyteos.
The three pilot ILHZs namely MABAHINHIL, MAINBAY and KAMMAO started the
Fourmula 1 (F1) initiatives during the second half of 2007. The other seven ILHZs of Leyte started
the F1 initiatives last 2008. We were four to five years behind the provinces of Biliran, East Samar
and Southern Leyte who pioneered organization of the ILHZ in Eastern Visayas. In February 2006,
the Sanggunian Panlalawigan passed a resolution authorizing the governor to enter into a
memorandum of agreement with the other LGUs of Leyte to organize the different ILHZs. Hence,
the creation of three (3) Pilot ILHZs last February 15, 2007. The remaining seven ILHZs were
organized last October 16, 2008.
The Local Chief Executives (LCEs), the Vice Mayor and the Sanggunian Bayan (SB) of
the member municipalities were oriented personally by the PHO team during their SB sessions.
Emphasis was made on the achievement of better health outcomes and the rationale behind
investing on health. The contents of the MOA were also discussed. After the orientation, the SB
passed two resolutions: 1. Resolution of Intent to join the ILHZ, and 2. Resolution authorizing the
LCE to sign MOA with the other LCEs of other member municipalities, PHIC 8, Governor of Leyte,
and DOH-EV. This we considered a successful strategy for the province.
As soon as the two resolutions were received at the PHO, a pre-MOA meeting was
conducted to clarify all issues and concerns of the LCEs regarding the MOA. After the preparatory
phase, MOA signing for all the stakeholders involved in the ILHZs commenced. In less than two
years, all ten ILHZs were organized with the pilot areas already in the implementation phase.
The DOH-EV provided both financial and technical assistance. The German Technical
Cooperation (GTZ) funded our Province-wide Investment Plan for Health (PIPH) workshops
initially. Both agencies served as consultants during the workshops. The PIPH seed was planted
on October 6-10, and Oct 15-17, 2008. The process was divided in four phases.
Phase 1 was the Rationalization of Health Services and Situational Analysis done on
October 6-7, 2008. All the ILHZs together with the MPDOs, MHOs and the Chiefs of Hospital or
9

Technical Management Committee Chairperson, DOH Reps identified the priority issues and
challenges based on the LGU Score Card Results. The coordinators of the PHO and DOH-EV
acted as facilitators. Facilities were mapped as to which RHUs were SS II, RHU with MCP, OPB,
TB-DOTS, 3 in 1 package, number of functional BNBs, Hospitals either level 3 for Provincial,
level 2 for District and level 1 for Community, and EMONC facilities (BEMONC and CEMONC).
Phase 2 for the next three days was focused on the formulation of the ILHZ Strategic
Plan 2009-2013 and Annual Operation Plan 2009. We also invited the PPDO and PBO of the
province. At this point, the PHO F1 team consolidated the ten ILHZs Strategic Plan 2009-2013
and Operational Plans 2009 which was use for the third phase.
In Phase 3, the ILHZs were directed to craft Programs, Projects and Activities (PPAS) of
the F1 Components: Service Delivery, Governance, Regulation and Financing. After prioritizing the
PPAs, critical interventions and costing were identified for Table 1 Assumptions. This was
consolidated by the PHO F1 team and was included in the Provincial PPAS with Critical
Interventions and Costing. The work lasted for two months. Tables 2-5 were also prepared in the
next three months.
This document was made in four (4) versions. The first was during the PHO presentation
to the DOH 8 Leyte F1 Team on February 6, 2008 for comments and refinement. The second was
on February 22, 2009 when we were advised to include in our investment the Health Facility
Enhancement Project (HEFP) Budget 2009 for RHU Macarthur, Baybay City Health Unit and
selected hospitals in the province. This was presented during the PIPH Pre-Finalization Workshop
for Leyte, Samar and North Samar on March 10-12, 2009.
The third revision was made last March 22, 2009. The fourth version was made last April
5, 2009 when the province had a write shop and finalization on Womens Health and Safe
Motherhood Facility Network (WHSMFN) Investment Requirements for our twenty-nine facilities
(18 BEMONC RHUs, 2 BEMONC Community Hospitals and 9 CEMONC Hospitals) last March 1April 2, 2009.
From here, other preparations were made to include Financial, Planning and Management
Systems. On April 15-17, 2009 Finalization Write shop , the province presented Cost Tables 1-5,
AOP 2009, Financial Management and 5 Year Health Income Projections to DOH-8 Leyte team for
final comments and modification.
The Provincial Health Office designated an F1 and PIPH Core Team headed by the PHO 1
for Field Operations, with the Chief of the Technical Section as alternate. All Program Coordinators
were also designated as F1/PIPH/ILHZ Coordinators. This is to have focal points responsible for
the Province and the ten ILHZs implementation of the F1 Thrusts.
10

FIGURE 1
LEYTE

CALUBIAN
SAN ISIDRO

LEYTE

MAP

LEYTE

BABATNG
ON

SAN MIGUEL
CAPOOCA BARUG
O
TACLOBAN CITY
N
CARIGAR
ALANGALANG
MATAG-OB A
STA. FE
PALO
TUNGA
PASTRANA
KANANG
TANAUAN
JAR
PALOMPON A
TABON
TOLOSA
O
ORMOC CITY DAGAMI
DULAG
JULITA
ISABEL
BURAU
MERIDA
MAYORGA
EN LA PAZ
ALBUER
MACARTHUR
A
ABUYOG

TABANGO
VILLABA

LAND AREA:
5,712.8 sq.km.
NO. OF MUNICIPALITIES:
41
POPULATION 2008
1,337,616
POPULATION DENSITY 301/sq.km.
NO. OF BARANGAYS: 1,641

BAYBAY
INOPACAN
HINDANG

NAME OF ILHZ
NAME OF ILHZ
CALESAN
CALESAN
GOODWILL
GOODWILL
GOLDEN
HARVEST
GOLDEN HARVEST
KAMMAO
KAMMAO
LEYTE
GULF
LEYTE
GULF
LEYTE
PLAINS
LEYTE PLAINS
LEYTE
LEYTE
WESTCOAST
WESTCOAST
MAHARLIKA
MAHARLIKA
MABAHINHIL
MABAHINHIL

JAVIER
MAHAPLAG

HILONGOS
BATO
MATALOM

11

3.0. THE PROVINCE.


3.1. DEMOGRAPHIC AND ECOLOGICAL PROFILE.
3.1. a. LAND AREA, LOCATION, AND CLIMATE
The Province of Leyte lies South of the island of Samar, separated by the narrow San
Juanico Strait and east of the islands of Cebu and Bohol. South of it is the Province of Southern
Leyte. It is mountainous with a very rugged range cutting the province in half from the northwest to
the southeast. Two important plains sit on either side of the mountain ridge, the Ormoc plain in the
west and the Leyte plain in the east. The coast is very much indented, with several important bays:
Ormoc Bay at the west, Carigara Bay at the North and the Leyte Gulf at the east. Rain falls, more
or less, steadily throughout the year and the northern part of the province is often visited by strong
typhoons.
Leyte has a total land area of 5, 712 .8 square kilometers. This represents 26.7% of the
total land area of 21, 431.70 square kilometers of Eastern Visayas.
3.1. b. PHYSICAL ENVIRONMENT.
The municipalities of Burauen, Dagami, Tabontabon, Pastrana, Julita, Tanauan, Palo,
Jaro, Abuyog, Albuera and the cities of Ormoc and Tacloban are located in environmentallyconstrained areas where flooding is very severe which endanger lives and properties. Health risk
of flooding is expected to rise.
The province is subject to seismic hazards as this is traversed by the Philippine Fault
Zone and is within the vicinity of the Philippine Deep. The tectonic line of the Philippine Fault Zone
bisects the island of Leyte with its splays and smaller tensional faults occurring in Samar.
All the coastal Municipalities and barangays along the eastern side of Leyte, facing the
Pacific are prone to Tidal waves and Tsunamis, and mostly affecting low-lying places along the
coastal zones. The need to activate and organize the Health Emergency Management Staff
(HEMS) is of prime importance and likewise the preparedness and response of the Disaster
Coordinating Councils (DCC) at the Provincial, Municipal and Barangay Levels.
3. 1. c. POLITICAL SUBDIVISION.
12

By virtue of Republic Act No. 2227 enacted on May 22, 1959, the island of Leyte was
divided into the Provinces of Leyte and Southern Leyte, with Biliran as sub-province of Leyte. In
1992, Biliran was taken out of the political jurisdiction of the Province of Leyte when it became a
regular and independent province ratified through a plebiscite on May 11, 1992.
Today, Leyte is considered as a First (1 st) class province with 41 municipalities, three (3)
cities and 1,641 barangays. Of these barangays, 383 or 23.3% are urban while 1,258 or 76.7% are
rural. Tacloban City, the capital of the province, is also the capital of Eastern Visayas. The province
has five (5) Congressional Districts (See Table 1A-1E for the Profile of the Municipalities).
3. 1. d. POPULATION.
The province has a total population of 1,722,036 (including cities of Ormoc and Tacloban)
based on 2007 census of population. In terms of population, Leyte is the largest province in
Eastern Visayas and comprises 44.01% of the total regional population. Among the six (6)
provinces in the region, Leyte has the highest population density of 301 persons per square
kilometer of which figure is greater than the regions population density of 174 persons per square
kilometer.
In 2007, the population figure also showed an increase of 7.54% (or 129,864 persons)
over the 2000 population figure of 1.592 million. Over the 7-year period, an average annual
population growth rate was registered at 1.13%. This implies the province need a big allocation for
Health services compared to the other provinces.
3.1. e. ETHNICITY AND RELIGION.
The East side of the province is home for her Waray-speaking population (commonly
called the Warays), while the west side for the Cebuano-speaking. The central mountains dividing
the province have created different cultural and commercial orientations. The Warays are refuted
to be assertive and more free-wheeling than other Visayans. On the other hand, the Cebuanospeaking Leytenos are more restrained. All Leytenos, regardless of the dialects they speak, are
very fond of gatherings, whether it be a party, inuman (drinking sessions), or fiestas. The very
reason traumatic injuries like stab and hack wounds are prevalent and are treated in the hospitals.
Christian observances also form some of the most colorful pageant of Leytes history and
religion. The Pamalandong in the municipality of Palo during the Holy Week and the Sto Nino
fiesta of Tacloban City towards the end of June entice devotees to these two places.
13

However,Christian observances at times becomes a hindering factor in delivery of heath goods


and services.
3.2. SOCIO-ECONOMIC PROFILE.
3.2. a. ECONOMY, TRADE AND INDUSTRY.
The provincial economys concentration is predominantly in the services sector at 40.08%
comprised of household income derived from transport, communication, and storage, trade,
finance, dwelling, real estate, and government and private services. This is followed by the
agricultural fishery and forestry sector sharing 19.84%. Least concentration was in the industry
sector at 11.32% which household incomes were derived from mining and quarrying,
manufacturing, construction and electricity and water.
The industry sector of Leyte includes large-scale corporations engaged in the processing
of sugar and molasses, copra, copra oil and pellets, refined copper, soft drinks, bentonites,
industrial lime and phosphatic fertilizer. Cottage, small and medium-scale industries manufacture
products utilizing indigenous raw materials. These local producers are involved in the manufacture
of furniture, handicrafts, gifts/toys/house were making, food processing, metal craft, ceramics
molding and garments manufacturing.
Established at the 435-hectare Leyte Industrial Development Estate (LIDE) are the
Philippine Associated Smelting and Refinery Corporation (PASAR) and the Philippine Phosphate
Fertilizer Corporation (PhilPhos). These giant corporations contribute approximately 93% of the
total export earnings of Region 8.
Since the province is economically stable and is capable of improving the 12 hospitals, the
Hospital Enhancement for Leytes Progress (HELP) will continuously upgrade the said facilities.
3.2. b. POVERTY SITUATION.
In 2003, the Poverty incidence among Families in Leyte is 34.6% (117,288). This is lower
than the Regions 35.3% (266,423). This is increased in 2006 (40.5% or 147,900) and slightly
approximating the region (40.7% or 331,426). The poverty incidence among the population in 2003
is 42.3% with a magnitude of 692,391 slightly lower than the region of 43% (1,619,731). This is
also increased in 2006 (846,526 or 47.3%) while the region rate is 48.5% (1,947,323). (The
Source is National Statistics Coordination Board). With this poverty incidence, 5 of 10 every
14

Leytenos Health needs must be supported by the local health facilities and this add burden to the
local government units.
3. 2. c. LITERACY.
The province showed an improved literacy rate (LR) within a period of two consecutive
years from 88.19% in 2006 and 95.05% in 2007 per records of the Department of Education Leyte
Division. Other indicators on education which include simple literacy rate for males was lower at
87% and 93.3% for females or an average simple LR of 90.1% in 2007. On functional LR, the
pattern is similar at 71.1% for males and 82.1% for females or an average functional LR of 76.7%.
This information was based on the Functional Literacy Education and Mass Media Survey
conducted by the NSO covering a sample population aged 10 to 64 years.
In terms of health advocacies, only about 30% need to be help out understand Health
advisories and the like.
3.2. d. Peace and Order
In 2008, the Leyte Police Provincial Office (LPPO) reported a total of 713 cases. Of this
figure, 399 or 55.96% were Index crimes and the remaining 44.04% or 314 cases were Non-Index
crimes. As compared to previous years record of 850 incidents, a decrease of 16.12% or 137
cases in crime incidence was seen. The Average Monthly Crime Rate (AMCR) for the current year
was posted at 3.60 crime incidence per 100,000 Population, a decline of 0.70 or 15.94% from last
years crime incidence of 4.39.
Succeeding Tables 1A-1E describe the profile of the Municipalities in every district. All the
municipalities are accessible by land transportation and the Hospitals and the Rural Health Units
can be reached by land.

15

Table 1A: Profile of Municipalities- First District


Municipalities

Land

2008 Population
Density

Area
Name

Class

(sq. km.)

Distance

Number (person/sq. km)

No. of

from

Brgys

Tacloban
City

Alangalang
Babatngon
Palo
San Miguel
Sta. Fe
Tanauan
Tolosa

4th
4th
3rd
5th
5th
3rd
5th

150.5
137.8
67.6
120.10
81.90
68.10
31.70

43,813
24,532
58,114
16,726
16,028
47,762
17,183

258
143
638
121
167
598
439

54
25
33
21
20
54
15

Congressional
District

1st
1st
1st
1st
1st
1st
1st

29.27
33.05
11.57
40.42
21.27
17.64
23.8

Table 1B: Profile of Municipalities Second District


Municipalitie

Class

Land

2008

Area

Pop

Density

No. of Distance

Congres-

Brgys

from

sional
District
2nd
2nd
2nd
2nd
2nd
2nd
2nd
2nd
2nd
2nd

Barugo
Burauen
Capoocan
Carigara
Dagami
Dulag
Jaro
Julita
Lapaz
Macarthur

th

4
2nd
4th
3rd
5th
4th
4th
5th
5th
5th

78.5
178
185.4
94.9
160
39
148.7
53.30
171.5
48.60

27,660
48,806
28,499
46,014
30,622
40,806
38,988
12,340
18,796
17,716

343
265
149
458
153
997
252
227
103
347

37
77
21
49
65
45
46
28
35
31

Tacloban
51.57
42.98
59.47
54.59
31.49
36.64
37.32
45.10
51.6
48.33

Mayorga
Pastrana
Tabontabon
Tunga

5th
5th
5th
6th

61.60
79.3
22.9
38.20

13,975
16,251
9,688
6,236

205
181
350
100

18
20
18
8

43
27.95
33.21
44.81

2nd
2nd
2nd
2nd

Table 1C: Profile of Municipalities Third District


Municipalities

Calubian
Leyte
San Isidro
Tabango
Villaba

Class

4th
4th
4th
4th
4th

Land

2008

Density

No. of

Distance

Congres-

Area

POP

(person/sq.km)

Brgys

from

sional

137.6
238.3
109.2
129.20
126

30,161
35,511
29,689
30,629
38,092

207
148
269
243
268

53
30
19
13
35

Tacloban
157
86.3
175.87
159.5
148.65

District
3rd
3rd
3rd
3rd
3rd
16

Table 1D: Profile of Municipalities Fourth District


Municipalities Class

Albuera
Isabel
Kananga
Matag-ob
Merida
Palompon

rd

3
1st
2nd
5th
4th
3rd

Land

2008

Density

No. of

Distance

Congres-

Area

POP

(person/sq.km)

Brgys

from

sional District

18
24
23
21
22
50

Tacloban
123.62
154.09
86.5
101.3
134.20
124.38

4th
4th
4th
4th
4th
4th

181.20
97.5
144.2
75.40
122.7
104

39,921
40,480
46,878
16,867
26,420
52,780

189
385
297
222
206
488

Table 1E: Profile of Municipalities Fifth District


Municipalities Class

Abuyog
Bato
Baybay
Hilongos
Hindang
Inopacan
Javier
Mahaplag
Matalom

Land Area

2nd
4th
1st
3rd
5th
5th
4th
4th
4th

294.7
71.51
410.50
136.9
127.4
182.4
141.8
172
110.9

2008 POP

Density

56,416
34,064
103,515
54,258
20,133
19,360
23,536
27,179
31,172

No.

of Distance

Brgy

From

sional

Tacloban
61.62
153.68
107.81
145.72
138.7
130.5
65.05
88.80
158.20

District
5th
5th
5th
5th
5th
5th
5th
5th
5th

183
379
233
376
145
102
161
154
272

63
32
92
51
20
20
28
28
30

Congres-

Table 2: POPULATION BY AGE & SEX DISTRIBUTION


LEYTE NORTE, 2008
AGE
GROUP
Under 1
14
5 14
15 49
50 64
65 & Over
TOTAL

MALE

FEMALE

NO.

NO.

18,325
72,633
182,718
321,295
58,320
27,823
681,114

1.37%
5.43%
13.66%
24.02%
4.36%
2.08%
50.92%

17,255
68,620
174,291
301,365
60,059
34,912
656,502

1.29%
5.13%
13.03%
22.53%
4.49%
2.61%
49.08%

BOTH SEXES
NO.
%
35,580
141,253
357,009
622,660
118,379
62,735
1,337,616

2.66%
10.56%
26.69%
46.55%
8.85%
4.69%
100.00%

Figure 2
POPULATION BY AGE & SEX DITRIBUTION
LEYTE NORTE, 2008

17

Among the provinces of Region 8, North Leyte has the biggest population of 1,337, 616
(Population catered by the Provincial Health Office less the population of Ormoc and Tacloban
City) in 2008 with a population density of 28.65 persons/ sq.km.
The Population by age and sex of the Province shows that there is no significant
difference in number among males and females. It also depicts a young population predominating
with 39.91% belonging to the 0-14 years old. It can also be gleaned that the under 1 and 65 and
over comprises the least in the distribution (2.66% and 4.69% respectively).
The Health accomplishment of the province greatly affects the Region. The target for the
programs is dependent on the population.

4.0. HEALTH SITUATIONER


4.1. HEALTH NEEDS.
4.1. a. Vital Health Indices.
The Vital Health Indices of the province is taken from the Annual FHSIS and the Annual
Hospital Statistical Report. The current year data is 2008 and the past five years data reflects
2003-2007.
Table 3: Vital Health Indices 2008
LEYTE NORTE
Indicator
IMR, per 1,000 live births
MMR, per 100,000 live births
CBR, per 1,000 population
CDR, per 1,000 population

Province
6.07
99
24
4.51

Regional Data
(9.8)
(122)
(23.25)
(4.17)

National Data
29
132
(4.80)

18

The vital events of the province are presented in Table 3. For the past five years (20032007), 28,647 births were monitored with a Crude Birth Rate (CBR) of 21.17/1000 population. This
current year we had 32,111 births and registered a CBR of 24.01/1000 population and showed an
increase of 2.84%. This is high and this can be partly explained by a low CPR of 42%.
Registered deaths in 2008 is 6,029 with a Crude Death Rate (CDR) of 4.51/1000
population showing an increase of 2.6% compared to 2007 which is 4.05/1000 population. Infant
Mortality Rate (IMR) is 6.07/1,000 live births. This is lower than 2007 IMR of 6.83.
Maternal Mortality Ratio of 99/100,000 live births is low compared with the National data.
This indicates less maternal deaths for the province. However, it could be opined that the
monitoring of maternal deaths for the year would need enhancement.

4.1. b. INFANT MORTALITY


Table 4 : LEADING CAUSES OF INFANT MORTALITY
NUMBER & RATE/1,000 LIVEBIRTHS & PERCENTAGE DISTRIBUTION
5-YEAR AVERAGE (2003-2007) & 2008
5 - Year AVERAGE
(2003-2007)

CAUSES

2008

Number

Rate

Number

Rate

Percent

Pneumonia

78

2.72

91

2.83

66%

Cong. Heart and Cong. Debility

10

0.35

20

0.70

15%

AGE w/ DHN

0.28

13

0.46

9.5%

Sepsis Neonatorum (Non


Umbilicus Site)

18

0.63

13

0.59

9.5%

4.1. c. MATERNAL MORTALITY


Table 5: Leading Causes of Maternal Mortality
Number and Rate /1,000 live births & Percentage Distribution
5-year Average (2003-2007), & 2008
CAUSES

5 - Year
AVERAGE
(2003-2007)

2008

19

Number

Rate

Number

Rate

Percent

0.10

0.12

23.5

Uterine Atony

0.03

0.12

23.5

Post Partum Hemorrhage

0.10

0.06

11.76

Eclampsia

0.10
0.0
3

0.06

11.76

0.06

11.76

0.03

0.03

5.88

Placental Retention

Post Partum Sepsis


Ruptured Ectopic Pregnancy

1
1

Tables 4 and 5 illustrate data on infant and maternal deaths respectively comparing the 5
year average with that of the current year. Among the infant deaths, Pneumonia and diarrhea are
still on the top three and therefore the IMCI training for Health Workers must be implemented. The
number of Maternal deaths for 2008 of 17 is minimal but deeper review would show the province
has still Trained Birth Attendants (TBA) handling deliveries. A number which were handled by them
with delay referral to the ILHZ Referral Hospital resulted in maternal deaths. Delay in seeking care
by pregnant mothers must also be addressed. Thus for the next five years, handling of deliveries
will only be allowed for our Skilled Professionals or Skilled Birth Attendants (Doctors, Nurses and
Midwives). There will be regulation among TBA. High Risk mothers have to be followed up by the
Health Workers.
4.1 d. On Trends of Morbidity and Mortality in the Province.
The illnesses seen in the RHU facilities are shown in Table 6 and the Illnesses or other
causes of death in Table 7.
4.1. d. MORBIDITY
Table 6: Leading Causes of Morbidity
Number and Rate per 100,000 population
LEYTE Province
5 year average (2003-2007), & 2008
5 year - average
Causes
Number
Rate
1. Acute Respiratory Infection
25,645
1,895.06
2.Bronchitis/Bronchiolitis/B.Asthma
14,379
1,062.55
3. AGE/Diarrheas
11,308
840.94
4. Hypertensive Cardiovascular
5,864
433.33
Disease (Diseases of the
Heart/HPN)
5. Diseases of the Skin (All Forms)
1,644
121.49
6. Wounds (All Forms)
1,484
109.66
7. Kidney Disease (Renal Failure,
1,681
124.22
UTI, Acute Pyelonephritis)

2008
Number
Rate
47,679
3,564.48
17,332
1,295.74
10,726
801.87
6,925
517.71
2,412
1,844
1,575

180.32
137.86
117.75
20

8. Influenza
9. TB Respiratory
10. Musculoskeletal Disease

2,313
1,834
0

170.92
135.53
0.00

1,440
1,263
550

107.65
94.42
41.12

Table 6 reflects the leading causes of Morbidity in 2008. 70% of illnesses in the province
are Communicable or Infectious in nature (1, 2, 3, 5, 6, 8, and 9). The other three are lifestyle
related illnesses. The most common reason for seeing the health facilities is still Acute Respiratory
Infection. Bronchitis and Diarrhea are also included in the top three. Pulmonary Tuberculosis is
the 9th leading cause of Morbidity with a rate of 94.42 per 100,000 Population. This is one of the
major public health problems in the province. This must be addressed in this plan.

4.1. e. MORTALITY
Table 7: Leading Causes of Mortality
Number and Rate per 100,000 population
Leyte Province
5 year Average (2003-2007) & 2008
5 year - average
2008
Causes
Number
Rate
Number
Rate
1. Hypertensive
479
8,575.01
1,542
25,576.38
Cardiovascular Diseases
(Heart Diseases, Artery
Diseases, RHD, CVA
2.Pneumonia
1,009
18,063.01
1,156
19,173.99
3. Malignant Neoplasm (All
430
7,697.82
483
8,011.28
Forms)
4. Tuberculosis w/
338
6,050.84
349
5,788.69
Complications
5. Pulmonary Diseases
213
3,813.10
265
4,395.42
(COPD, Cor Pulmonale,
Bronchial Asthma)
6. Diabetes Melllitus w/
172
3,079.13
243
4,030.52
Complications
7. Bleeding Peptic Ulcer
164
2,935.91
203
3,367.06
Disease (BPUD)
8. Kidney Diseases (Renal
173
3.097.03
196
3,520.95
Failure, Acute Pyelonephritis,
Uremia
9. Hypovolemia /Severe Blood
0
0.00
178
2,952.40
21

Loss
10. Diseases of the Liver (Liver
Cirrhosis, Hepatitis )

0.00

147

2,438.32

Base on the above table, the Leading Causes of deaths in the province were more of noncommunicable diseases. Seven (7) are related to lifestyle (1, 3, 6, 7, 8, 9, 10). Only three are
Infectious Illnesses. Malignant Neoplasm (Carcinoma or Cancer) is not detected at early stage
thus not in the top ten morbidity. Health workers get these patients during late stage and usually
with fatal complications causing death. This has to be included as a priority program for the
province.
Healthy lifestyle must be initiated among Leytenos so they will not die young.

4.1. f. HOSPITAL DISCHARGES


Table 8: Leading Causes of Discharges
(Provincial, 8 District , & 3 Community Hospitals)
CAUSES

NUMBER

1. PUFT/Deliveries

5,989

2. AGE/AGE w/ DHN

5,794

3. Acute Respiratory Infection

4,017

(Pneumonia/URTI/ARI)
4. UTI

2,051

5. HCVD?HPN

1,163

6. APD/PUD

895

7. PTB

591

8. Traumatic Injury

441

9. Incomplete Abortion

384

10. Dengue Fever

242

4.1. g. MORTALITY IN HOSPITALS


Table 9: Ten Leading Causes of Mortality
22

(Provincial, 8 District & 3 Community Hospitals)


CAUSES
1. Hypertensive Cardiovascular Disease
2. Severe Pneumonia
3.PTB
4. AGE/AGE w/ DHN
5. Sepsis/Sepsis Neo

NUMBER
342
173
46
36
31

Cerebral Hemorrhage
6. UGIB/BPUD
7. Pulmonary Diseases
8. Renal Disease
9. Diabetes Mellitus

31
22
13
8
7

Malignant Neoplasm

10. Tetanus

ACTIVITIES
Authorized

ADH
75

Bed Capacity
Percent

TABLE 10: HOSPITAL ACCOMPLISHMENTS 2008


MBVM
BDH
CDH
HDH
LPH
NWLDH
H
75
25
25
50
75
75

ODH

WLDH

TOTAL

75

100

575

58.39

74.46

52.61

174.14

91.58

47.93

20.34

100.83

50.44

65.98

In-

43.79

55.84

13.15

43.53

45.79

35.95

15.25

75.62

50.44

379.38

Patient Days
Ave. Length

of Stay
Ave.
Daily

43.79

55.84

13.15

43.53

45.79

35.95

15.25

75.62

50.44

379.38

Census
Gross Death

2.88

2.02

4.93

3.7

2.16

2.8

2.44

4.00

2.9

3.08

Rate
Net

Occupancy
Rate
Ave.

0.99

0.81

2.25

1.25

1.40

2.00

0.50

1.41

1.30

1.42

Rate
Total

Death

3,195

3,036

1,585

3,822

5,833

3,542

1,436

7,343

6,284

36,076

Admission
Total

3,194

3,018

1,643

3,841

4,941

3,503

1,437

7,437

6,269

35,193

Discharges
Total
In-

15,985

20,383

4,801

15,890

16,713

13,121

5,568

27,602

18,412

138,475

Patient Days
Total

13,830

10,854

15,424

19,686

24,421

17,836

7,181

41,843

21,054

172,129

Consultation
Total Deaths
Referrals:

92
390

61
144

81
328

142
1,495

107
37

98
0

35
44

287
12

182
184

1,085
2,634

183

137

517

232

230

34

1,341

(Sent)
(Re
ceived)

Tables 8 and 9 are Hospital data on discharges and deaths. Table 9 shows that even normal
deliveries are still admitted in the Hospitals. This implies the need to capacitate BHS and MHC of
the Rural Health Units in the province to manage deliveries with out complications in their areas
and therefore lessening admissions in the hospitals.
23

Table 10 summarizes the Hospitals accomplishments. Majority of the hospitals (6 out of 9) whose
% bed occupancy is below 75%. The table also shows death rates as follows.
Gross Death Rate (Provincial and 8 District Hospitals) = 3.08%
Net Death Rate under 48 hours = 1.42%
Net Death Rate beyond 48 hours = 2.02%
Gross Death Rate (3 Community Hospitals) = 1.35%
Net Death Rate under 48 hours = 1.42%
Net Death Rate beyond 48 hours = 0.85%
Based on the hospital performance indicator a net death rate between 0.5 -2.5% is
acceptable.
4.2. HEALTH SERVICE DELIVERY.
The following Tables 11A-11J presents the Core Referral Hospital with the member
municipalities in each of the Ten (10) Inter-local Health Zones of the province. The accessibility is
mapped per municipality to discover the gaps and deficiencies. Two (2) Municipalities with two
Rural Health Units (Abuyog and Palompon) need to hire additional MHO to complete the required
number.
TABLE 11-A: ACCESSIBILTY OF HEALTH FACILITIES LEYTE GULF ILHZ
ILHZ Core Referral Hospital: Leyte Provincial Hospital
Municipalities POP
No.
No. of Distance Means of RHU w/
RHU w/
of

Brgys

MHO

(Km.)from

Transport

RHU

Ambulance
(No.)

toILHZ

Communication
Facilities

Hospital

Dulag
Tolosa
Tanauan
Palo
ILHZ

40,806
58,114
47,762
17,183
163,865

1
1
1
1
4

45
33
54
15
147

25
12
6
3

Land
Land
Land
Land
Land

2
1
1
1
5

YES
YES
YES
YES
All 4

TABLE 11-B: ACCESSIBILITY OF HEALTH FACILITIES GOLDEN HARVEST ILHZ


ILHZ Core Referral Hospital: Leyte Provincial Hospital
Municipalities POP

No.

No. of Distance

of

Brgys

(Km) from
RHU

MHO

Means of RHU
Transport

to

w/ RHU

Ambulance Communication
(No.)

ILHZ

w/

Facilities

Hospital

Alangalang
Babatngon
Pastrana

48,813
24,532
16,251

1
1
1

54
25
29

18
45
16

Land
Land
Land

1
1
1

YES
YES
YES
24

Sta. Fe
ILHZ

16,028
100,624

1
4

20
128

Land
Land

1
4

YES
All 4

TABLE 11-C: ACCESSIBILITY OF HEALTH FACILITIES MAHARLIKA ILHZ


ILHZ Core Referral Hospital: Abuyog District Hospital
Municipalities

POP

No. of

No. of

Distance

Means of

RHU w/

RHU w/

MHO

Brgys

(Km) from

Transport

Ambulance

Communication

RHU to

(No.)

Facilities

ILHZ
Hospital

Abuyog

56,416

Javier
Macarthur
Mayorga
ILHZ

23,536
17,716
13,975
111,643

1*
1
1
1
4*

63
28
31
16

Land,

YES

8
14
19

Water
Land
Land
Land
Land,

Lack 1
1
1
1
4

YES
YES
YES
All 4

Water
Abuyog has one MHO and by DOH standard another MHO has to be hired.

Abuyog need another Ambulance for there are two (2) RHUs.

Mayorga has to hire an MHO.

TABLE 11-D: ACCESSIBILITY OF HEALTH FACILITIES LEYTE PLAINS


ILHZ Core Referral Hospital: Burauen District Hospital
Municipalities

POP

Burauen
Dagami
Julita
Lapaz
Tabon
ILHZ

48,806
30,622
12,340
18,796
9,688
120,252

No.
of
MHO

No. of
Brgys

1
1
1
1
1
5

77
65
26
35
16
219

Distance
(Km)fro
m RHU
to ILHZ
Hospital

1
12
7
7
7

Means of
Transport

Land
Land
Land
Land
Land
Land

RHU w/
Ambulance
(No.)

1
1
1
1
1
5

RHU w/
Communication
Facilites

YES
YES
YES
YES
YES
All 5

25

TABLE 11-E: ACCESSIBILITY OF HEALTH FACILITIES GOODWILL ILHZ


ILHZ Core Referral Hospital: Carigara District Hospital
Municipalities

POP

No.
of
MHO

No. of
Brgys

Distance
(KM)from
RHU to
ILHZ
Hospital

Barugo
Capoocan

27,660
28,499

1
1

37
21

4
8

Carigara
Jaro
San Miguel
Tunga
ILHZ

46,014
38,988
16,726
6,236
164,123

1
1
1
1
6

49
46
21
8
182

1
9
8
5

Means of
Transport

Land
Land,
Water
Land
Land
Land
Land
Land,
Water

RHU w/
Ambulance

RHU w/
Communication
Facilities

1
1

YES
YES

1
1
1
1
6

YES
YES
YES
YES
All 6

TABLE 11-F: ACCESSIBILITY OF HEALTH FACILITIES CALESAN ILHZ


ILHZ Core Referral Hospital: Northwestern Leyte District Hospital
Municipalities

POP

No. of
MHO

No. of
Brgys

Calubian

Distance
(Km)fro
m RHU
to ILHZ
Hospital

30,161

53

Leyte

35,511

30

35

San Isidro

29,689

19

13

ILHZ

95,361

102

Means of
Transport

Land,
Water
Land,
Water
Land,
Water
Land,
Water

RHU w/
Ambulance

RHU w/
Communication
Facilities

YES

YES

YES

All 3

TABLE 11-G: ACCESSIBILITY OF HEALTH FACILITIES LEYTE WEST


COAST
ILHZ Core Referral Hospital: Manuel Veloso Memorial Hospital
Municipalities

POP

Isabel
Palompon

40,480
52,780

No.
of
MHO

No. of
Brgys

1
1*

24
25

Distance
(Km)fro
m RHU
to ILHZ
Hospital

20
1

Means of
Transport

Land
Land

RHU w/
Ambulance

1
2

RHU w/
Communication
Facilities

YES
YES
26

Tabango

30,629

13

24

Land,
1
YES
Water
Villaba
38,092
1
35
15
Land
1
YES
ILHZ
161,981
4
97
Land,
5
All 4
Water
*- Palompon RHU 1 and 2 need 1 MHO for each. At present only one, thus the need to hire
another MHO.
TABLE 11-H: ACCESSIBILITY OF HEALTH FACILITIES MAINBAY ILHZ
ILHZ Core Referral Hospital: Western Leyte District Hospital
Municipalities

POP

No.
of
MHO

No.
of
Brgy

Distance
(Km)from
RHU to
ILHZ
Hospital

Baybay
Inopacan

103,515
19,360

2
1

92
20

1
24

Mahaplag
ILHZ

27,179
150, 054

1
4

28
140

30

Means of
Transport

RHU w/
Ambulance

Land
Land,
Water
Land
Land,
Water

RHU w/
Communication
Facilites

2
1

YES
YES

1
4

YES
All 4

TABLE 11-I: ACCESSIBILITY OF HEALTH FACILITIES MABAHINHIL ILHZ


ILHZ Core Referral Hospital: Hilongos District Hospital
Municipalities

POP

No.
of
MHO

No.
of
Brgys

Bato

Distance
(Km)fro
m RHU
to ILHZ
Hospital

34,064

32

Hilongos
Hindang

54,258
20,133

2
1

46
20

1
7

Matalom

31,172

30

14

ILHZ

139,627

128

Means of
Transport

Land,
Water
Land
Land,
Water
Land,
Water
Land,
Water

RHU w/
Ambulance

RHU w/
Communication
Facilities

YES

2
1

YES
YES

YES

All 5

TABLE 11-J: ACCESSIBILITY OF HEALTH FACILITIES KAMMAO ILHZ


ILHZ Core Referral Hospital: Ormoc District Hospital
Municipalities

POP

Albuera
Kananga
Matag-ob
Merida
ILHZ

39,921
46,878
16,867
26,420
130,086

No.
of
MHO

No. of
Brgys

Distance
(Km)from
RHU to
ILHZ
Hospital

1
1
1
1
4

16
23
21
22
82

14
20
25
25

Means of
Transport

Land
Land
Land
Land
Land

RHU w/
Ambulance

1
1
1
1
4

RHU w/
Communication
Facilities

YES
YES
YES
YES
All 4
27

Table 12: Selected Health Performance Indicators by ILHZ, Leyte Province, 2008
Indicators
FIC (95%)
PNV4 (80%)
TB Cure Rate
(85%)
TB Case
Detection Rate
(70%)
HH w/ Access
to Safe Water
(95%)
HH w/ Access
to Sanitary
Toilets (90%)
Combined
BNL & BNVL
(%)

Leyte
Gulf
87

Golden
Harvest
98

KAMMAO
95

MAINBAY
89

83.4

90.16

85.75

80

61.6

74.6

85.75

78

86.3

88

89.3
18.57

Maharlika
100

West
Coast
100

Calesan
100

Leyte
Plains
100

Goodwill
100

72.3

90

82.63

72

80.6

66.8

49

66

66.6

56

56.6

89

91.6

87.18

88

87.67

93

89.75

83

76.5

86

80

72

72

81

66.5

18.57

18.02

13.52

26.33

13.92

17.42

17.26

20.00

19.37

MABAHINHIL
91

LGU Scorecard 2008 was the basis of looking into priority projects, programs and
activities for the next 5 years (2009-2013). See Annex.
The ILHZs in Leyte is a cooperative arrangement among contiguous municipalities whose
aim is to ensure the continuity of care and rationalize the management and delivery of health
services to optimize efficient use of resources in a local health system that will have 4 Es
Effectiveness, Efficiency, Equity and Empowerment.
The ILHZ Boards are chaired by the Governor of the province. Mayors of the member
LGUs , The TMC Chairperson, CHD8 Director or Representative, NGO Representative, PHO2 or
PHO1, Representative of PHIC8 are members of the Board. The Board meets quarterly. The TMC
is chaired by the Chief of Hospital of the ILHZ Core Referral Hospital except for Leyte Gulf and
Golden Harvest. Other members include the DNS, MHO of the member municipalities and an
NGO Representative.
The Public Health Care system in the province caters to Preventive and Curative service.
Two hundred ninety three (293) Barangay Health Stations

and 45 Rural Health Units are

responsible for the Preventive Care and Curative Care. Together with the network of the Barangay
Health Stations, the Rural Health Units provide preventive services to their constituents to include
preventive and curative management during Outbreaks or Epidemics.
28

For Curative Care services needing confinement either for further evaluation and
management and operative procedures , the Provincial, 8 District and 3 Community Hospitals are
readily available for those who need hospitalization.
Hospital records have shown that uncomplicated, normal spontaneous deliveries are one
of the most common admissions. This poses a burden to resource-stricken hospitals and added
services that need also manpower. These deliveries should have been done in BHS or RHU
Birthing Facilities. There is the need to upgrade RHUs as (Basic Emergency Management and
Obstetric and Neonatal Care (BEMONC) facilities and the BHS as BHS Birthing facilities.
The income generated by all government hospitals of the province (Provincial, District and
Municipal) from drugs, billed admissions, laboratory fees, etc are remitted to the Provincial Trust
Funds with separate accounts for each of the 12 Hospitals (Provincial, 8 District and 3 Community
Hospitals) at the Provincial Accounting Office. Fifty percent is retained for hospital improvement
Capital outlay and MOOE. This is the present administration strategy on Income Retention
Scheme of the Hospitals.
The Health Referral System Manual crafted by the Ten (10) Ilhzs will somehow enhance
the continuity of quality, effective and efficient services of the existing referral being implemented
province-wide.
4.3. Health Financing.
Major sources of financing are through the governments IRA,

from dedicated

Development Partners (Culion who just completed the Project, Global Funds for Tuberculosis and
German Technical Foundation for Technical Assistance ) and assistance from DOH through CHD
8, Phil Health reimbursement and facility revenues. Health financing in Leyte is geared towards
improvement of better services in all Hospital Facilities, the Rural Health Units and Barangay
Health Stations.

29

Table 13: FIVE YEARS PROJECTED HOSPITAL INCOME FOR LEYTE (2009-2013)
PROVINCE OF LEYTE
P R O J E C T E D H O S P I TA L I N C O M E
CY 2009 TO CY 2013
Name
of
Hospit
al

Actual
Income
for 2008

Projected Annual Income

TOTAL

2009

2010

2011

2012

2013

ODH

952,731.96
1,393,901.0
3
4,747,427.0
0
4,292,047.3
0
9,373,877.2
3

11,717,968.
35
3,908,836.4
8
11,508,840.
78
3,488,064.5
3
1,000,368.5
6
1,463,596.0
8
4,984,798.3
5
4,506,649.6
7
9,842,571.0
9

12,303,866.
77
4,104,278.3
0
12,084,282.
82
3,662,467.7
6
1,050,386.9
9
1,536,775.8
9
5,234,038.2
7
4,731,982.1
5
10,334,699.
65

12,919,060.
11
4,309,492.2
2
12,688,496.
96
3,845,591.1
5
1,102,906.3
4
1,613,614.6
8
5,495,740.1
8
4,968,581.2
6
10,851,434.
63

13,565,013.
11
4,524,966.8
3
13,322,921.
80
4,037,870.7
0
1,158,051.6
5
1,694,295.4
1
5,770,527.1
9
5,217,010.3
2
11,394,006.
36

14,243,263.
77
4,751,215.1
7
13,989,067.
89
4,239,764.2
4
1,215,954.2
3
1,779,010.1
8
6,059,053.5
5
5,477,860.8
3
11,963,706.
68

KCH

115,150.00

120,907.50

126,952.88

133,300.52

139,965.54

146,963.82

668,090.26

MCH

227,605.00

238,985.25

250,934.51

263,481.24

276,655.30

290,488.07

1,320,544.37

TCH

259,556.00

272,533.80

286,160.49

300,468.51

315,491.94

331,266.54

1,505,921.28

VCH

346,114.00

363,419.70

381,590.69

400,670.22

420,703.73

441,738.92

50,873,847
.75

53,417,540
.14

56,088,417
.14

58,892,838
.00

61,837,479
.90

64,929,353
.90

2,008,123.25
P
295,165,629
.08

LPH

ADH
WLDH
BDH
NWLDH
CDH
HDH
MBVMH

GRAND
TOTAL

11,159,969.
86
3,722,701.4
1
10,960,800.
74
3,321,966.2
2

P
64,749,172.1
2
21,598,789.0
1
63,593,610.2
5
19,273,758.3
7
5,527,667.7
7
8,087,292.25
27,544,157.5
4
24,902,084.2
2
54,386,418.4
0

a - Based on a 5% annual growth rate

From Table 13, it can be gleaned that the Hospitals for the five year period (2009-2013)
will be able to sustain its improvement and the maintenance of the facilities.
Table 14: Phil Health Membership by Sector, Leyte Province 2008
Philhealth Enrollment as of December 2008
(Number of Households)
Leyte
Province

Government

Private

IPP

NPM

OFW

SP

Abuyog

724

Albuera

577

Alangalang

896

Babatngon

383

Total

30

Barugo

606

Bato

2,109

Baybay

5,286

Burauen

678

Calubian

431

Capoocan

487

Carigara
Leyte
Province

142
Government

Private

IPP

NPM

OFW

SP

Dagami

499

Dulag

673

Hilongos

1,088

Hindang

847

Inopacan

1,739

Isabel

772

Jaro

744

Javier

475

Julita

264

Kananga
La Paz
Leyte

Total

1,158
283
1,436

Macarthur

632

Mahaplag

438

Matag-ob

1,005

Matalom

2,292

Mayorga

201

Merida

3,064

Palo

2,910

Palompon

665

Pastrana

961

San Isidro

3,805

San Miguel

217

Santa Fe

1,055

Tabango

1,102

Tabontabon

538

Tanauan

734

Tolosa

1,791

Tunga

226

Villaba

1,164

31

TOTAL
TotalHousehold
Population est. 2008
PhilHealth coverage (85% HH
Enrolled)

45,097
222,936
1,337,616
184,496

Province Phil Health Indigent sponsored enrollment for 2009 is 166,000 Households. The
total cost is P17, 000, 000.00 and paid by the Provincial Government. This is 74.5% of total
Households to be enrolled. However, a gap of 10% is still to be enrolled to reach the 85%
enrollment. This will be answered in the next 2 years.
In order to meet the health demands of the province, various Foreign-Assisted Projects
(FAPs) for the health sector have invested in the province (Table 15).

Table 15: Summary of FAPs for the Health Sector


Leyte Province
As of 2008
Name of FAP
Interventions/Programs
Current Status
Culion Foundation Inc.
Leprosy, ARI, TB, CDD
Completed
GTZ
Technical Assistance
On-going
World Vision
NTP
Completed
4.4. HEALTH GOVERNANCE.
The Hospital Reforms in the province started in 2004 through the Hospital Enhancement
for Leytes Progress (HELP) Initiative whereby a Committee was organized to look at the status of
the Hospitals and with their recommendations and consultation with the Chief of Hospitals and the
Provincial Health officer, the present administration acted on it. The Hospitals underwent
upgrading with improvement in the Infrastructures and also provision of needed supplies and
equipments. Five (5) new ambulances for the Provincial and 4 District Hospitals were procured
through the HELP program.
The Public Health Reforms started with the initiation and establishment of 3 pilot ILHZs in
2006 in response to the fragmentation of Health services and also in consonance with RA 7160
mandate government agencies can group themselves and organize for the benefit of the people.
The first three ILHZ (MAINBAY,MABAHINHIL and KAMMAO) were formalized by entering into a
MOA on February 15, 2007. Seeing the need to expand the ILHZs Province-wide, the seven (7)
added ILHZs were formalized in September 16,2008.
32

4.5. HEALTH REGULATION.


The province with the 41 municipalities had enacted Health-Related Policies and
Ordinances. Fines are imposed on Violators. However, this is not implemented to the fullest. The
Drug Management System in the Government Hospitals is not yet in place.
With the F1 Initiatives, Regulatory Standards of DOH for Health Facilities (Hospitals, RHU,
BHS, Infirmary, Maternity Clinics, Private owned lying in Clinics), Drug, Food and Water
Establishments will be utilized to upgrade the critical capacities of the facilities and establishments.
5.0. Gaps and Deficiencies Identified.
5.1. HEALTH SERVICE DELIVERY.
Concerning the quality of health care being provided in Leyte, it may be noted that the
levels of maternal and infant mortality rates are lower than regional averages. The infant mortality
rate is 6.07/100,000 live births, and the maternal mortality rate is 99/100,000 live births. The low
percentage of Quality Prenatal Care (PNV 4 of 41%) is partly due to the lack of resources
allocated for public health care by local government units. Other identified reasons are the poor
health-seeking behavior of the clients and the availability of quality maternity care services at the
RHU level. The 42 % Contraceptive Prevalence Rate in the province which is likewise low
compared to the national target of 60% gives rise to high birth rates and increase of unmet needs
in family planning.
Curative services at the primary level need to be improved in terms of equipment and
facilities. Referral system within the Inter-local Health Zone that facilitates referral to the core
referral hospitals (8 District and Provincial) from the respective RHUs and barangay health
stations is being implemented. However, the functionality and institutionalization of the referral
system has yet to be put in place. The ILHZ health Referral Manual to be reproduced and
implemented on the third quarter of this year will somehow answer the institutionalization of the
referral system.
There is also the problem of accessibility on the part of health workers to access far-flung
and hard-to-reach areas. These health workers are unable to extend basic health services in
remote areas as part of their outreach program because of geographical constraints and the lack
of transportation facilities and road condition. In some municipalities, peace and order situation
also becomes a hindering factor.
The Province Health Care Delivery System envisions to adhere to the Inter-local Health
Zones mandate wherein there is integration of hospital and public health for a more efficient and
33

holistic delivery of Health Services. This delivery system is characterized by a functional referral
system where there is inter-LGU collaboration and cooperation, especially in areas for
complementation with other stakeholders. Although at present, the Leyte Inter-local Health Zone is
far from perfect, the major role players are working hard together for the enhancement of every
component under the Health Sector Reform Agenda.
Apart from the insufficient supply of medicines and supplies for maternal and child health
programs other reasons are poor social marketing by health workers and weak inter-agency
participation and coordination. Health facilities need to be upgraded, and manpower skills both in
the hospital and RHUs have to be improved so that competent workers will manage the clients.
There is also the need to strengthen primary health care, establish maternity care benefits in
priority LGUs, and strengthen health education at the primary level through the use of the trimedia.
The high incidence of infectious disease is again due to lack of medicines and a poor
existing system, or the absence thereof, for managing these diseases. However, the high
incidence of emerging lifestyle diseases is due to unhealthy lifestyles of the affected population on
the one hand and poor advocacy on the part of health workers due to inadequate knowledge and
skills on lifestyle diseases, lack of information, education, and communication (IEC) materials,
increased workload, and mobility on the other.
For leprosy, several factors come into play preventing the successful elimination campaign
for leprosy, such as irregular supply for drugs and medicines from WHO and DOH, inadequate
training of health personnel, and the social stigma experienced by identified cases. With Rabies
Control Program, the problem is the continuous availability of vaccines, both human and animal
vaccine. Although the National government through the Department of Agriculture and Department
of Health provides for the vaccines, the supply is still not enough for dog and human population.
5.2. HEALTH FINANCING.
Out of pockets paying for health expenditures by the poor is burdened by several factors
that include the lack of supply of drugs and medicines in government health facilities, the
restrictive ceilings of Phil Health benefits, and the high cost of health goods in the private sector.
There is therefore a need to shift the burden of payment from out-of-pocket and direct
subsidies to insurance reimbursements. Majority of the municipal LGUs have not attained a
universal coverage for indigent sponsorship to PhilHealth of 85%. In such state, the province in the
next five years still need to attain a universal coverage for all sectors including formal and
34

informal. For this year, the provincial government enrolled 166,000 Households for Philhealth
Indigency Program and cost P17, 000,000.00. and this is 75% and a gap of 10% has to be
address to get 85% and over.
5.3. HEALTH GOVERNANCE.
The province of Leyte, like most LGUs is likewise adversely affected by the devolution of
health services. Health workers in the province, especially doctors and nurses, have left the
country to work abroad or seek greener pastures in foreign lands primarily because of financial
difficulties and work-related pressures.
Local Health Boards (Provincial, Municipal and ILHZ) must become functional, each
holding regular meetings. Further, networking, especially on TB program, needs to be improved.
There is also a need to review the different national and local policies and ordinances for health.
The health information system of Leyte builds upon the requirements of the DOH Field
Health Information System. It consists mostly of the accomplishments of national health programs,
reports on notifiable diseases, demographic data, natality and mortality reports. The Hospital
Management Information System needs to be strengthened. Hence, theres a need for different
cost-centers in the hospital to be computerized and linked to other services for efficient
management. Furthermore, the health workers must have sufficient knowledge in data utilization,
presentation and analysis that will be used for planning, monitoring and evaluation
5.4. HEALTH REGULATION.
The province of Leyte requires effective regulatory schemes to ensure the availability and
affordability of good quality health products and services. The health policies in all hospitals of
Leyte are satisfactorily implemented and such as policies on users fees (SP Ordinance 2004), the
use of ambulance, and the like. Other policy concerns are the clinical practice guidelines (CPGs)
and compliance with Philippine National Drug Formulary (PNDF) of medical doctors.
Additionally, various hospital committees should be organized and have regular meetings
conducted; feedback mechanisms and trainings should be instituted to ensure their functionality.
Therapeutic Committee and Maternal Death Review Committee are among the priority committees
in the hospital that need to be in place as of this time.
Proper drug management is another concern not only of the hospital but of the RHUs as
well, since the different therapeutic committees of the LGUs play crucial roles in this particular
aspect of health care.
35

Public health programs, such as sanitation, rabies control, and anti-smoking campaigns
need enabling ordinances that will add teeth to their full enforcement and implementation.
The effectiveness of these different regulatory measures also depend considerably on the
wider external environment, which is largely affected by socio-political factors, shared values and
societal norms. Furthermore, several regulatory mechanisms need sophisticated information
systems, sound financial management, social acceptance, and adequate political support both at
the local and national levels.
A diverse array of strategies (financial and non-financial incentives as well as sanctions)
should be backed up by regulations that are consistent with the overall aim of flexibility and equity.
Regulations are likely to be less effective if enforcement strategies, like granting financial
incentives, do not motivate providers to function effectively. Additionally, enforcement should use
the minimum and yet sufficient interventions to secure compliance.

36

6.0 Overall Health Strategy & Specific Interventions Proposed.


The F1 Components of the Health Sector Reform in the Province will initiate changes in the
way our Health Care is Delivered, Governed, Regulated and Financed.
The Overall Health Strategy and Specific Interventions proposed in this document are in
consonance with the Mid Decade Goals (MDG) attainment and our 5 Year Provincial Strategic
Plan 2009-2013. These include the following:
1. To reduce Maternal Mortality Ratio from 99/100,000 live births in 2008 to 61 in 2013.
2. To reduce Infant Mortality by 10 % in 2013 (at 2 % per year for 5 years based on the
2008 Benchmark of 6.07 per 1,000 live births).
3. Reduce death rates due to Infectious and Non Infectious Diseases
4. Eliminate the following diseases in the province by 2013:
4.1. Malaria
4.2. Rabies
4.3. Filariasis
4.4. Schistosomiasis
4.5. Leprosy
5. Increase Contraceptive Prevalence Rate (CPR) from 42 % in 2008 to 60% in 2013.
6. Sustain the prevalence of combined Below Normal Low (BNL) and Below Normal Very
Low (BNVL) at a rate < 23 % in all 41 Municipalities by 2013. (Province rate is 18%
but there are some municipalities with rate > 23%)
7. Reduce the incidence of Dental Caries among school children and preschoolers by
50% by end of 2013.
8. Increase Universal PhilHealth coverage to 85% in 2013. (Baseline : 42% in 2008)
Specifically, in addressing specific reform areas, the following strategies and specific interventions
are proposed in order to attain major goals for each of the F1 four (4) components.

37

1. SERVICE DELIVERY.
Goal 1. Improve Health Services by ensuring access to quality health care in all facilities in
the province.
A. Upgrade critical capacities of health facilities at all levels of care at the right time.
1. Upgrading of 24 RHUs to achieve Sentrong Sigla,Phase 2 (SSII) Level 1
certification by the end of 2011 so that all 45 RHUs are SS II facilities.
2. Renovation/construction/upgrading of Leyte Provincial Hospital (level 2 to level 3),
8 District Hospitals (level 2), 3 Community Hospitals (level1)
3. Renovation/construction of Macarthur RHU, Matalom RHU and Baybay City
Health Units
4. Provision of Equipment packages for 12 Hospitals and 45 Rural Health Units for
Sentrong Sigla Certification, DOH Licensing Standard and PhilHealth
Accreditation, 3 in 1 Philhealth Accreditation, BEMONC and CEMONC facilities,
5. Capability Building/skills enhancement of health workers needed to become
competent in the health facilities
B. Improve capacities of Health Manpower (Hospital and RHUs) on Basic Preventive and
Curative Care
1. Capability building / skills development on facility operations and management

Basic curative care

ICD 10

Financial Management

Disaster Preparedness and Response

Health Emergency Management

Basic and Advance Life Support

Clinical Practice Guidelines

Goal 2. Reduce Maternal Mortality Rate by 10% until 2013.


By end of 2013:
38

1. All RHUs, BHS and Hospitals are EMONC Facilities - 45 BEMONC RHUs, 9
CEMONC (Provincial and 8 District Hospitals) , 3 BEMONC Community Hospitals and
293 BHS Birthing Facilities
1.1. Provision of Equipments to EMONC Facilities
1.2. Capability building
2. 80% or more deliveries are attended by skilled birth attendants (SBA)
3. All deliveries are facility based
4. Regular Conduct of Maternal Death Review
5. Quality Prenatal (PNV4) is 80% or more
Goal 3. Reduce Infant Mortality Rate (IMR) and Under Five Mortality Rate (UFMR) by 10% in
2013
1. Decrease deaths from 7 Immunizable Diseases ( Primary Complex or Childhood TB,
Diphtheria, Pertussis, Tetanus, Poliomyelitis, Hepatitis B, Measles)
2. Delivery of Comprehensive Newborn and Infant Care through:
2.1. Provision of Equipments for Neonatal Intensive Care Units (NICU) of LPH, ODH,
WLDH and MBVMH
2.2. Capability Building of Health Workers on Comprehensive Newborn and Infant
Care
3. Integrated Management of Childhood Illnesses through the IMCI Approach
4. Strengthening of Referral System
Goal 4. Reduce Public health threats of infectious and non infectious diseases.
1. Tuberculosis.
1. Sustaining Sputum positive TB case detection (notification) rate to 70% or more and TB
cure rate of 85% (Baseline 2008: CDR- 77% and Cure Rate =82%)
1. a. Organize the participation of both government and private practitioners in TB
Control

Program (PPM DOTS or PPMD)

1. b. Integrated Quality Assurance Measures and Monitoring System


1. c. Enhanced DOTS implementation
1. d. Strengthen IEC activities and patient education
1. e. Accredit 35 RHUs as TB DOTS Center by 2011 and all 45 RHUs by 2013
1. f. Ensure timely and uninterrupted supply and distribution of Anti-TB drugs
2. Pneumonia and Other Childhood Infectious Diseases:

Train HW and implement Integrated Management of Childhood Illness (IMCI)


39

Ensure availability of affordable drugs for IMCI

3. Dengue

Intensify source reduction of dengue through the implementation of the


3 oclock habit and the organization of Brigada Pamilya in all Barangays

Implement 4S of Dengue Prevention

Early and Accurate Management of Cases

4. Lifestyle and Degenerative Diseases


a. Strengthen advocacy on lifestyle diseases
b. Enforcement of national and local laws related to lifestyle diseases
c. Capability building / skills enhancement of health workers on lifestyle diseases
d. Establishment of Hospitals as Centers for Wellness
-

Smoking cessation program

CVD program

Goal 5 . Declare Province as Disease Free for:


1. Rabies
a. Strengthen 3 pronged approach in rabies prevention and control in the province
(owner, community and government)
b. Increase local budget for the purchase of post-exposure prophylaxis and dog
vaccines
c. Intensify awareness campaign (Advocate responsible pet ownership (vaccination,
leashing, movement restriction of dogs)
d. Strict implementation of local ordinances on stray dogs
-

dog impoundment

e. Reactivate local rabies committee


f.
2.

Intensify Surveillance of Rabies cases

Leprosy, Filaria and Schistosomiasis


a. Strengthen collaboration with partners in services and other stakeholders for
social mobilization and advocacy activities
b. Integration of leprosy and filaria program to other health services
c. Provision of drugs and supplies for leprosy, filarial and Schistosomiasis
d. Annual mass drug treatment for Filaria and Schistosomiasis
40

e. Intensify active case finding and prompt treatment of leprosy


f.

Rehabilitation and prevention of disabilities of Leprosy patients

g. Provision of allowances for case finding and monitoring activities


h. Request Municipal Sanggunian to pass a Resolution or Ordinance extending
Mass Drug Administration (MDA) for Filariasis from 2009 to 2013 even if the
Municipality has completed the five years MDA until 85% MDA is achieved.
i.

Upgrade Abuyog District Hospital as Center for Management of Complicated


cases of Filariasis (Lymphangitis, etc)

j.

Intensify and initiate 85% or more MDA every year for the Municipalities of the
province with boundaries of Southern Leyte- Abuyog, Mahaplag, Bato and
Matalom

3. Sustain declaration of Leyte province as Malaria free even beyond 2013


a. Sustain malaria free status (Disease surveillance activities)
Goal 4. Enhance Survival and Management of these Programs
A. Womens Health and Safe Motherhood Program (WHSMP)
1. Improve quality of prenatal, natal and post-natal care
a. Accredit 42 RHUs by 2010 as PhilHealth Maternity Care Package (MCP)
Facilities
b. Capability building/skills enhancement of health workers on Emergency
Management Obstetric and Neonatal Care (EMONC) for Provincial and 8
District Hospitals (CEMONC) and 3 Community Hospitals and 45 Rural Health
Units (BEMONC)
c. Intensive advocacy for mothers: at least 4 prenatal visits; post-natal check up
at least once within a month
d. Renovation of BHS, RHUs, Provincial, District and Community Hospitals for
Maternal and Child Health Services
e. Provision of family planning commodities and supplies thru CSR+ strategy
and POPDEV program (Province to augment but Municipalities to allocate
and buy)
2. Establish 45 BEMONC RHUs and 3 BEMONC Community Hospitals; Establish 9
CEMONC Hospitals (Provincial and 8 District)
a.

Conduct Facility needs assessment and compute for Womens Health and

Safe Motherhood (WHSMP) Critical Investment Requirements


41

b. Training of BEMONC and CEMONC teams


c. Provision of equipment and supplies
d. Provision of Drugs and Medicines
e. Renovation/repair of existing health facilities.
B. Child Health and Nutrition
a. Implement the Province of Leyte Childrens Code 2008
b. Achieving and maintaining Fully Immunized Child (FIC) coverage of 95% or
more
c. Coverage of Vitamin A supplementation of 95% or more
1.

Routine Vitamin A during Measles Vaccination

2. Garantisadong Pambata (2x a year on April and October)


3. Clinical Supplementation of Vitamin A for High Risk/Sick
Children
d. Promotion of exclusive breastfeeding age 0 6 months at all levels of health
care
e. Implementation of Newborn Screening Program in all 12 Hospitals and 45
Rural Health Units
f.

Fortification of foods (rice, cooking oil, salt and sugar)

g. Enforcement of nutrition related laws i.e. Food Fortification Act; ASIN Laws
h. Capability building of Health Workers on:
a) Infant and Under-five mortality
b) Infant and young child feeding
c) IMCI for community training (enhanced child growth
monitoring)
C. Environmental Health & Sanitation
1. Reduce public health impact of food and water-borne diseases

2.

Increase household with access to sanitary toilet facilities:

Advocacy activities with other health programs

Capability building of health workers

Sustain high coverage of household with access to safe drinking water:

Regular chlorination of water

Construction of Level III in selected municipalities


42

3. Implement Health Care Waste Management in all health facilities

Training of Hospital and RHU personnel

Purchase of house keeping supplies and materials

Encourage LGUs to provide area for disposal of health care wastes

D. Oral Health Program

Reduce incidence of dental caries among school children and pre-schoolers:

a. Strengthen collaboration and partnership with DepEd


b. Provision of toothbrush and toothpaste
c. Provision of dental supplies for preventive and curative care.
E. Disaster Preparedness and Management
1. Intensify prevention and control of newly emerging diseases such as Avian Flu,
SARS, Acute Meningococcemia and Influenza A (H1N1)
2. Regular Inter-agency /taskforce meeting (MDCC, PDCC, RDCC)
3.

Designate

Surveillance

Sentinel

personnel

in

the

province

(MESU,DESU,PESU)
4. Earmarked budget for provision of Search and Rescue Equipment, Personal
Protective Equipments (PPEs), and other logistics
5 .Capability building for pre disaster; disaster and post-disaster management
6. Conduct regular Disaster simulation exercises/drills during disaster month
celebration (July of every year)
7. Strengthen capability of the Provincial Emergency Response Team, e.g. Search
and Rescue Team
8. Creation of Emergency Response Team at the municipal level
9. Regularly update the Disaster Management Plan for the province thru the Interlocal Health Zone
10. To sustain availability of Emergency Funds for Medicines and Supplies
F. Creation of Functional Epidemic Surveillance Units
1. Capability Building
1.1. PIDSR Training for Hospitals and RHUs
1.2. EPI Info
1.3. Orientation on the establishment of DESU, MESU, and
BHERT/BRIGADA
PAMILYA
2. Provision of Computer and Internet to all Hospitals and RHUs
43

2. Governance
Goal: Strong commitment and capacity to support a well- coordinated, effective and
efficient health care system through active community participation.
I. Increase technical and management capacities of Health Workers (HW) and Local Chief
Executives (LCEs)
1.1 Capability building of LCEs and HWs on health leadership and management and
project development capability courses.
II. Systems development of the ILHZ
1. Enhanced functionality of the ILHZ and the Local Health Boards (Provincial and
Municipal)
1.1. Sustain the share of Province and Municipalities for the ILHZ Common Health
Trust Fund (CHTF) with the Province earmarking P50, 000.00 per member
municipality of the ILHZ for 2009-2013 while municipalities earmarked 1% of
20% EDF for 2009-2013.
1.2. Conduct of regular ILHZ and LHB meetings.
1.3. Conduct of Monthly TMC Meetings
2. Improve competence of HW at all levels of care
2.1. Technical assistance on Human Resource Development and Management
Plan
2.2. Continuing Health Human Resource Development Program, i.e. In-ServiceTrainings,Short Courses, and Post Graduate Studies.
2.3. Implementation of Magna Carta Benefits Hazard Pay (Phase In)
2.4. Provision of Incentives for Provincial paid Hospital Health Workers in the
province.
3. Improve Management Information System
3.1. Information Communication Technology (ICT) Literacy Program for HW.
3.2. ICT equipment package for RHUs and Hospitals
3.3. Institutionalization of CBMIS, FHSIS and Hospital Statistics Report
3.4. Establishment of Hospital Operation Management Information System
(HOMIS)
44

3.5. Capacity building of HW and Planners on Data Utilization, Analysis and


Disease Surveillance.
4. Strengthen Referral System in the ILHZ and Province-wide
4.1. Production of Health Referral Manual of the ten ILHZs.
4.2. Provision of Health Referral Manuals to all health facilities and stakeholders
4.3. Implementation of two-way referral system.
4.4. Crafting and Production of Provincial Health Referral Manual.
III. Strengthen GOs, NGOs, POs Partnership
1. Increase involvement of different sectors through a regular Annual Provincial Health
Summit.
2. Regular Stakeholders Meeting
IV. Improve efficient and effective program management.
1. Sustain Semi Annual and Annual Program Implementation Review (PIR) of the ILHZs
with LGU Score Card as the Evaluation tool.
2. Presentation of LGU Score Card to LCEs during the ILHZ Board Meeting
3. Local Chief Executives to in initiate Municipal Health PIR
3. REGULATION.
Goal: Institutionalized regulatory mechanism that will ensure affordable and quality Health
Care service.
I. Ensure availability and access to Low Cost Quality Drugs
1.1. Establishment of Botica Ng Barangay (BNB) in all 41 Municipalities and achieve 1:2
ratio
1.2. Organize functional Therapeutic Committees at the ILHZ and Provincial Level with
Monitoring as expanded role.
1.2 Earmarked specific budget allocations for Program Drugs and Medicines.
II. Enhancement of skills and capability towards Technical Efficiency in procurement
system.
1. Capability building through Technical Assistance) on rational drug use, drug supply
and drug management.
III. Develop mechanisms for Enactment, Implementation and Monitoring of National and
Local Laws.
1. Technical assistance on establishing provincial regulatory framework
2. Formulation of ordinances on :
2.1 Regulating practice of Traditional Birth Attendants (TBAs)
45

2.2 Mandatory Dog Vaccination


4. FINANCING.
Goal: Optimized and sustained Health Care Financing for Leyte.
I. Increase and sustain enrollment of Health Insurance on different sectors.
1. Increase universal PhilHealth Insurance Coverage to at least 85% by 2013
2. Increase to at least 85% enrollment to indigency program (Baseline: 48 % in 2008).
3. Advocate Provincial and Municipla LCEs to enroll indigents from 2009-2013.
4. Initiate establishment of PhilHealth enrollment desk in all 41 municipalities.
II. Maximize utilization and expansion of PhilHealth benefits
1. Use PhilHealth benefits as incentives and for other operating expenses
1.1. Capitation Fund
1.2. OPB Benefit Package
1.3. TB DOTS
1.4. Maternity Care Package
III. Increase share for health expenditures in LGU Budget
1. Advocacy during Health Board Meetings
2. Passage of ILHZ Board Resolution on Adoption of Incremental Increase of LGU
Health Budget and increase the base contribution of each municipality to > 1%.

46

47

VISION: Healthy and empowered Biliranons with access to excellent health services
MISSION: To provide Biliranons with quality health services that are accessible, affordable, available and acceptable through an integrated and
expanded service coverage, upgraded equipment and facilities, appropriate health systems installed, skilled and committed health workers,
supportive Local Chief Executives and other stakeholders.
Table 12. LOGICAL FRAMEWORK

NARRATIVE SUMMARY
GOAL: Improve the health status of Biliranons through
greater and more effective coverage of national and local
health programs, increase access to quality health services
especially by the poor and reduce financial burden on
individual families.

COMPONENT GOALS/OBJECTIVES:

OBJECTIVELY VERIFIABLE
INDICATORS (OVI)

MEANS OF
VERIFICATION
(MOV)

After 5 years,
> MMR reduced from 240/100,000 LB to 50/100,000LB;
> IMR reduced by 50%
> TB death rate reduced from 29/100,00 popn to
15/100,000 popn
> morbidity due to infectious diseases reduced by 50%
> death rate due to infectious diseases reduced by 5%
every year

- FHSIS
- Baseline Monitoring
Surveys (BMS)
- TB registry
-CBMIS
- Hospital Statistics Report

> mortality rate due to lifestyle and degenerative diseases

IMPORTANT
ASSUMPTIONS/
RISKS
Assumption:
National
and
stability

LGU

Risk:
Adverse national policy
changes

GOVERNANCE COMPONENT:
Strong commitment and capacity to support a wellcoordinated , effective and efficient health care system with
active community participation
FINANCING COMPONENT:
Optimized and sustained health care financing for Biliran
Province.
SERVICE DELIVERY COMPONENT:
Improved access and coverage of quality health care
REGULATORY COMPONENT:
Institutionalized regulatory mechanism that will ensure
affordable and quality health services/

reduced by 5% every year


> rabies free province by 2010
> eliminate leprosy and filaria
> CPR increased from41.4 to 65%
> increased number of HH with access to sanitary toilet
facilities from 71% to 90%

- FHSIS
- Baseline Monitoring
Surveys
- Annual Accom Rpt
- TB registry
- CBMIS
- Hospital Statistics Report

> reduced incidence of dental caries among school


children by 50%
> increased and sustained Philhealth coverage at 85%
- Local Health Accounts
-Philhealth Reports

GOVERNANCE COMPONENT: Strong commitment and capacity to support a well coordinated, effective and efficient health care system with
active community participation
TARGETS / INTERVENTIONS

CRITICAL ACTIVITIES

OBJECTIVELY VERIFIABLE
INDICATORS

MEANS OF
VERIFICATION

IMPORTANT
ASSUMPTIONS/RISKS

GOVERNANCE COMPONENT: Strong commitment and capacity to support a well coordinated, effective and efficient health care system with
active community participation
TARGETS / INTERVENTIONS

CRITICAL ACTIVITIES

I. INCREASE TECHNICAL &


MANAGEMENT CAPACITIES OF
HEALTH WORKERS & LCEs
I.1 Capability building of LCEs and
health workers and LCEs
1.1 Installation of Human Resource
Management and Development
System

1. TA on technical / mgt capacities


2. Health Leadership /Mgt. Training
3. Project Development Capability Course
4. Lakbay - Aral

II. SYSTEMS DEVELOPMENT OF


ILHZ:
II.1 Enhance functionality of ILHZ
and LHBs
II.2 Improve competence of health
workers at all levels

1. Orientation training of HRMD system


2. Issuance of an A.O. re: adoption/
installation of HRMD
3. Monitoring and evaluation
1.1Regular stakeholders meetin
1.2 Contribution of LGUS in the
Common Health Trust Fund
2.1TA on human resource development /
mgt. plan

OBJECTIVELY VERIFIABLE
INDICATORS
TA done
Trainings and Lakbay Aral
done

MEANS OF
VERIFICATION
TNA report
Post travel report

Orientation training done


Approved A.O on HRMD

Training Certificate
A. O.

Coaching and tactic sessions


done
Biliran ILHZ functional per DOH
criteria

Monitoring/evaluation
report/Feedback
MOAs
Minutes of ILHZ board and
TMC meetings
ILHZ Treasurers report
TNA report

-Training needs of health


workers public health and

IMPORTANT
ASSUMPTIONS/RISKS
Commitment of development
partners to support
training/Lakbay - Aral

-Continued support of the


new set of LCEs for 2007
election
Availability of staff

49

II.3 Enhancing the capacity of LGU


personnel/staff in their local
development process

II.4 To improve management


information system

2.2. Continuing health human resource


devt program
2.3 Implementation of Magna Carta
Benefits (full implementation)
2.4 Provision of extra incentives for MDs
on dispersal from EVRMC
3.1 TA on Integrating gender responsive
population and development (Popdev)
approaches to local development
planning processes
3.2 Annual Integrated Health planning

hospital assessed
- Staff and client satisfaction
increases

-Annual Plan done

-Approved Annual Plan

4.1 Established HOMIS in the BPH


4.2 ICT Literacy Program for health
workers
4.3 Capacity building of health workers
and local planning officers on Data
Utilization and analysis
4.4 Institutionalization of BMS, and
integration of CBMIS, FHSIS et al
4.5 Provision of ICT equipment

- Hospital Mgt. Info System


operational
- Post Training Report
- Integrated info system
(CBMIS, FHSIS)
- equipment procured / installed

-HOMIS installed

Baseline Monitoring Survey

- POP Dev approach used in


local planning process

Technical support from DOH


is available

Availability of support
package

- External reviews
- BMS
- Inspection Report of
equipment procured

GOVERNANCE COMPONENT: Strong commitment and capacity to support a well coordinated, effective and efficient health care system with
active community participation
TARGETS / INTERVENTIONS

CRITICAL ACTIVITIES

II. SYTEMS DEVELOPMENT OF


ILHZ
II.5 Strengthen referral system

5.1 Installation of communication


equipment (VHF Radio) in 5 RHUs
5.2 Provision of 5 ambulances for
timely referral
5.3 Providing TA on system
improvement on referral system
5.4 Information dissemination on the
referral system thru various community
assemblies
5.5 Provision of Medical Assistance
Fund to EVRMC

II.6 Strengthen health care services

6.1 Strengthening of primary health

OBJECTIVELY VERIFIABLE
INDICATORS
- Installed communication
equipment in RHUs of Biliran,
Caibiran, Culaba, Maripipi,
Naval
- Ambulance utilized by Biliran,
Cabucgayan, Caibiran, Culaba,
Maripipi
- Reduction of inappropriate
referrals to BPH
- Number of referred patients
given medical assistance by
EVRMC
- improved primary health care

MEANS OF
VERIFICATION
- BPH report
- MOAs/Resolutions
- Memorandum Receipt
- Liquidation Report

DOH LHAD monitoring

IMPORTANT
ASSUMPTIONS/RISKS

Availability of support package

50

in GIDA areas

care system in Maripipi & Higatangan


islands
1. Annual Provincial Health Summit
2. Launching of Healthy Barangay
3. Launching of Healthy Municipality
4. Regular stake holders meeting

III. STRENGTHEN GO, NGOs


partnership

IV. IMPROVE EFFICIENT AND


EFFECTIVE PROGRAM
MANAGEMENT

1. Orientation on LGU scorecard and


other performance monitoring /
evaluation mechanism
2. Annual Program Implementation
Review (PIR)
3. Provision of vehicle for field
monitoring

indicators at the RHU level


- Summit, Local Health Board,
ILHZ meetings & other
scheduled fora & symposia
conducted
- Awards, recognition given
- LGU scorecard implementation
- PIR document

report
FHSIS, CBMIS report
Minutes of meetings
Documentation of event

Internal / External Review


Monitoring /Evaluation
report

Sustained support of different


stakeholders

Regular monitoring / evaluation

- Vehicle purchased

FINANCING COMPONENT: Optimized and sustained health care financing for Biliran Province.
TARGETS / INTERVENTIONS
I. I NCREASE & SUSTAIN
ENROLLMENT OF HEALTH
INSURANCE IN DIFFERENT
SECTOR

II. MAXIMIZE UTILIZATION /


EXPANSION OF PHILHEALTH
BENEFITS
III. INCREASE SHARE OF
HEALTH EXPENDITURES IN
LGU BUDGET
IV. CORPORATE
RESTRUCTURING OF BILIRAN

CRITICAL ACTIVITIES
1. Social Marketing
2. Tap congressional fund for Philhealth
enrollment of indigents
3. Establish enrollment desk in 8 RHUs and
hospital
4. Inclusion of PHIC Premium payment as
a requirement for availing mayors permit
for business establishment
1. TA- training of health workers /mgt.
support personnel on maximizing Philhealth
benefits and claims
1. Advocacy meetings during LHB and other
fora
2. Stakeholders meetings on resolution for
adoption of incremental increase in LGU
budget for health
1. Capability building on hospital operations
and financial mgt.

OBJECTIVELY VERIFIABLE
INDICATORS

MEANS OF
VERIFICATION
PHIC reports

IMPORTANT
ASSUMPTIONS/RISKS
-Legislation passed for inclusion
of premium payments in
availing Mayors permit
- sustained commitment of
LCEs to re-enroll indigents

- Philhealth members avail of


benefits
- TB DOTS package; MCP
accredited RHUs
- Incremental increase of LGU
budget for health

BMS result
PHIC reports

- Drugs /medicines available at


RHU and hospitals

LGU annual budget

- Sustained commitment of
LCEs

- Biliran Provincial Hospital


corporatized

MOAs, Resolutions
Financial statement

Available technical support from


DOH and other partners

85 % coverage by 2010

51

PROVINCIAL HOSPITAL

V. CHARGING OF USER FEES


FOR NON-POOR

2. TA on development of hospital business


plan
3. TA on development of mechanism to
retain income
1. TA on client segmentation (Social
Marketing initiatives)
2. Capability building of support staff on
user fees; cost and rate setting; patient
classification system
3. SP/SB meetings on Resolution for
adoption/implementation of user fees

- Client segmentation done


- Resolution passed for
implementation of user fees

Consultants report
Supportive LCEs
Copy of the resolution

SERVICE DELIVERY COMPONENT: Improved access and coverage of quality health care
TARGETS /
INTERVENTIONS
I. IMPROVE QUALITY OF
HEALTH SERVICES
I.1 To upgrade critical
capacity of health facilities at
all levels of care

I.2 To increase geographic


access of the people by
strengthening primary health
care
II. REDUCE PUBLIC
HEALTH THREATS OF
INFECTIOUS AND NON
INFECTIOUS DISEASES

CRITICAL ACTIVITIES
1.1 Upgrade RHUs for SS Phase 2 level 1
certification
1.2Upgrading of Biliran Provincial Hospital
from 25 -75 beds and capability as tertiary
care hospital
1.3 Provision of equipment package for SS 2
Certification; DOH Licensing
1.4 Capability building /skills development on
facility operations and mgt.
2.1Organize 132 Bgy Health Council (BHC)
2.2 Capability Building of BHC
2.3 Upgrading of strategically located BHS
2.4 Construct additional RHU in Naval
Tuberculosis:
1. Provision of BCG vaccines and supplies
2. Organize Public Private Mixed DOTS
2.a Regular meetings of Provincial TB

OBJECTIVELY VERIFIABLE
INDICATORS
- 8 RHUs are SS Phase 2 level
1 certified
- BPH upgraded from 25 75
beds and service capability as
tertiary care hospital

MEANS OF
VERIFICATION
- SS2, Level 1 Certification
- License issued by DOH
- Philhealth accreditation

IMPORTANT
ASSUMPTIONS/RISKS
Manpower available
Technical support available

- Monitoring report
- 132 BHCs are functional by
2010
- 3 BHS upgraded (1Maripipi, 2
Naval
- RHU 2 in Naval (see Sit Ana)
Tuberculosis:
- Achieved/maintained TB Case
Detection Rate to 89.5% and TB

List of members
Minutes of meetings
Structures in place

- TB registry
- Philhealth/DOH
accreditation

Logistics available
Inter and intra- agency support

52

Tuberculosis :
- Achieving and maintaining
sputum positive case
detection rate to 89.5% and
TB cure rate to 88%
(Baseline: 2004)
- Ensure BCG immunization
of infants to 95% (Baseline:
2004 88.61%)
- Strengthen participation of
both government / private
practitioners on TB control
program
. Ensure timely distribution of
anti TB drugs

Diagnostic Committee
3. Accredit 7 RHUs and hospital- basedTB
DOTS centers
3.a Refurbishment of RHUs and BPH for TB
DOTS accreditation
3.b Provision of lacking equipment
4. Setting up of Integrated Quality Assurance
Measures and Monitoring System
4.a Continuing education/ skills enhancement
of health workers
4.b TEV for monitoring activities
5. Provision of CAT III Anti TB drugs from
LGU source; Philhealth benefits

Cure Rate of 88%


- 7 RHUs and 1 hospital
based TB DOTs accredited

- FHSIS

SERVICE DELIVERY COMPONENT: Improved access and coverage of quality health care
TARGETS /
INTERVENTIONS
II. REDUCE PUBLIC
HEALTH THREATS OF
INFECTIOUS AND NON
INFECTIOUS DISEASES
Strengthen IEC activities
and patient education

Pneumonia and other


Childhood Infectious
Diseases
Improve the implementation
of Integrated Mgt of
Childhood Illnsses(IMCI)
Enhance mgt of infectious

CRITICAL ACTIVITIES

OBJECTIVELY VERIFIABLE
INDICATORS

MEANS OF
VERIFICATION

IMPORTANT
ASSUMPTIONS/RISKS

Tuberculosis:
Logistics available
- TB registry
- Minutes of Mtg
- Philhealth/DOH
accreditation

6.a Production of IEC materials in local


language
6.b Production of infomercial on priority public
health program
6.c Regular health education activities at all
levels of care
1. Capability building/skills enhancement of
health workers on IMCI
2. Provision of drugs/ medicines and supplies
3. TA on development of CPGs in RHU s and
BPH.
4. Skills development on mgt of infectious

Inter and intra- agency support

- FHSIS
Pneumonia other Childhood
Infectious Diseases:
IMCI implemented
Death rate due to Pneumonia
reduced by 5% every year
Reduced morbidity due to
infectious diseases by 50%by
2010

-FHSIS
- External review
- Monitoring Report

53

and non- infectious diseases

and non-infectious diseases on adult

Ensure the availability of


affordable drugs for
Pneumonia patients and
other infectious diseases of
all ages at the local level
Lifestyle and Degenerative
Diseases

1. Advocacy activities on lifestyle diseases


2. Enforcement of national and local laws
related to lifestyle diseases

Lifestyle and Degenerative


Diseases
Mortality rate reduced by 5%
every year

SERVICE DELIVERY COMPONENT: Improved access and coverage of quality health care
TARGETS /
INTERVENTIONS
III. DISEASE FREE ZONE
INITIATIVE
RABIES:
Strengthen 3-pronged
approach in rabies
prevention and control in the
province.

LEPROSY / FILARIA:
Strengthen collaboration
with partners in services and
other stakeholders for social
mobilization and advocacy
activities and resource
sharing
Integration of leprosy and
filaria program to other health
services

CRITICAL ACTIVITIES

OBJECTIVELY VERIFIABLE
INDICATORS

MEANS OF
VERIFICATION

1. Enforcement of Responsible pet ownership


2. Provision of vaccines for dog
3. Provision of post-exposure prophylaxis
immunization
4. Skills development of municipal agri tech
and provincial vet med

By the end of 2010


- Rabies free province

-FHSIS
- Health Mgt. Info system
(HMIS)
LGU Scorecard

1. Advocacy meetings
2. Training/skills development of health
workers
3. Provision of MDT drugs for leprosy
4. Annual Mass Drug Treatment for filaria 2
years old and above
5. Active case finding for leprosy and prompt
treatment of cases
6. Rehabilitation and prevention of disabilities

- Zero case of filaria


- Prevalence rate for leprosy is
maintained to less than 1 case
per 1000 population

- FHSIS

IMPORTANT
ASSUMPTIONS/RISKS
Logistics available

54

SERVICE DELIVERY COMPONENT: Improved access and coverage of quality health care
TARGETS / INTERVENTIONS

CRITICAL ACTIVITIES

OBJECTIVELY VERIFIABLE
INDICATORS

MEANS OF
VERIFICATION

IMPORTANT
ASSUMPTIONS/RISKS

IV. STRENGTHEN HEALTH


PROMOTION AND DISEASE
PREVENTION & CONTROL
A. Womens Health and Safe
Motherhood Program:
1. Improve quality of pre-natal,
natal and post-natal care

1.1 Refurbishment of 8 RHUs for Maternity


Care Package (MCP)accreditation
1.2 Provision of MCH equipment at all levels of
care (Hospital, RHU, BHS)
1.3 Capability building of health workers at all
levels on emergency obstetric care
1.4 Establishment of hospital NICU, OR/DR
complex for MCH services
1.5 Upgrading of BHS for MCH services
1.6 Provision of drugs and medical supplies

2. Improve access to
reproductive health services
and FP commodities and
supplies

2.1 Advocacy meetings and activities


2.2 Capability building
2.3 Provision of family planning commodities
and supplies thru CSR+ strategy and
POPDEV program

- 3 RHUs accredited for MCP by


2006
- 5 RHUs accredited for MCP by
2007
- Hosp, all RHUs and BHSs
provided with MCH equipment
- Midwives trained on
emergency obstetric care

Philhealth report
CBMIS
HOMIS

- NICU, OR/DR complex


constructed
- Upgraded BHS for MCH
services
- Drugs and medical supplies
provided
- FP commodities/supplies
available
- CPR increased from 41.4 to
65%

In place

Technical support and


Logistics available

RIV, MR, PO
Certificate

Inter and intra-agency


support

In place
RIV, PO
FHSIS
FHSIS
FHSIS
CDLMIS

55

SERVICE DELIVERY COMPONENT: Improved access and coverage of quality health care
CRITICAL ACTIVITIES
OBJECTIVELY VERIFIABLE
MEANS OF
INDICATORS
VERIFICATION

TARGETS / INTERVENTIONS
IV. STRENGTHEN HEALTH
PROMOTION AND DISEASE
PREVENTION & CONTROL
B. Childhealth and Nutrition
Achieving and Maintaining FIC
coverage to 95%
Reduce prevalence of
underweight children from
26.85% to 20%
Collaboration with other agencies
re:Bright Child Approach

IMPORTANT
ASSUMPTIONS/RISKS
Strong political support

1.
2.
3.
4.

Regular Stakeholders meeting


Provision of EPI vaccines
Advocacy activities /counseling
Implementation of Newborn Screening
Program at BPH
5. Enforcement of nutrition related laws and
ordinances
6. Provision of 66 weighing scales on
identified BHS
7. Supplemental Feeding Program
8. Deworming
9. Bio-intensive gardening & distribution of
vegetable seeds
10. Animal dispersal to families with
malnourished children
11. IEC on nutrition
12. Advocacy on exclusive breastfeeding

- FIC coverage & Vit. A


supplementation at 95%
- 4 priority food fortified ( rice,
cooking oil, salt and sugar)
- Prevalence of underweight
children reduced from 26.85%
to 20%
- % of infants below 6 mos
exclusively breastfed

Review of records
FHSIS

HOMIS monitoring report

FHSIS
C. Adolescent Health
Improving youth access to
information and services

1. Baseline study reg. Youth access to


information and services
2. Presentation of local study done to LGUs
and Partners
3. Discussion/consultaions on adolescent
health with LGUs and Partners.
4. Developed and test an appropriate model

Study conducted
No. of LGUs and Partners
oriented

Report of the study


Attendance sheet

Model for AH info and services

56

for providing AH info and services


5. Capability building of service provider (e.g.
peer counseling, parent education, human
sexuality)
6. Post training monitoring and coaching

adopted
Trainings conducted

Institutionalized model

Program implemented

Certifcation, Attendance
sheet

1. Advocacy activities
2. Trainings /skills enhancement of health
workers
3. Regular chlorination of water
4. Construction of level III water in selected
municipalities
5. Provision of toilet bowls

-% reduction in diarrhea cases


-HH with access to sanitary
toilet facilities increased from
71% to 90% by 2010
- HH with access to safe
drinking water increased from
53% to 80% by 2010

Monitoring tools
C. Environmental Health &
Sanitation
Increase HH with access to
sanitary toilet facilities from71%
to 90% by 2010
Increase HH with access to safe
drinking water from 53% to 80%
Inter and interagency
collaboration

TARGETS / INTERVENTIONS
D. Oral Health Program
Reduce incidence of dental
caries among school children and
pre-schoolers by 50% by 2010
Strengthen collaboration and
partnership with Dep Ed
Promotion of oral health at all
levels of health facilities

SERVICE DELIVERY COMPONENT: Improved access and coverage of quality health care
CRITICAL ACTIVITIES
OBJECTIVELY VERIFIABLE
MEANS OF VERIFICATION
INDICATORS
1. Regular stakeholders; meeting
2. Production of IEC
materials(infomercials)
3. Intensified orientation/advocacy
activities in pre and elementary
school
4. Provision of toothbrush and
toothpaste
5. Provision of dental supplies for
preventive and curative care

- 50% reduction of dental caries


among pre-school and school
children

DEP ed Report
FHSIS

IMPORTANT
ASSUMPTIONS/RISKS
Strong political support
Available manpower

57

Strengthen preventive and


curative care
E. Disaster Preparedness &
Management

1. Regular inter-agency / task force


meeting
2. Strengthen Provincial Search and
Rescue Team /BHERT
3.Hire/Designate
Surveillance
Sentinel personnel in the
province
4. Earmarked budget for provision
of Personal Protective
Equipments (PPEs), and other
logistics
5. Capacity building for pre
disaster; disaster and postdisaster management

-Trained health personnel in


pre-disater, disaster and postdisaster mgt
- Budget earmarked for disaster
preparedness / mgt
-Upgraded facilities to handle
emergency response

LHA
HEMS report

58

TARGETS /
INTERVENTIONS
I. ENSURE AVAILABILITY
AND ACCESS TO LOW
COST QUALITY DRUGS
Development of drug
procurement and
distribution system
Establishment of Functional
Therapeutic Committee at
the municipal and provincial
level with expanded role in
monitoring
Earmarked specific budget
allocation for program
drugs /medicines
II. ENHANCEMENT OF
SKILLS / CAPABILITY
TOWARDS TECHNICAL
EFFICINECY IN
PROCUREMENT SYSTEM
III. DEVELOP
MECHANISM FOR
ENACTMENT,
IMPLEMENTATION and
MONITORING OF
NATIONAL and LOCAL
LAWS

REGULATORY COMPONENT: Institutionalized regulatory mechanism that will ensure affordable and quality health services
CRTICAL ACTIVITIES
OBJECTIVELY VERIFIABLE
MEANS OF VERIFICATION
IMPORTANT
INDICATORS
ASSUMPTIONS/RISKS
1. Establishment of BNBs
2. TA on drug procurement and distribution
system ( Pooled procurement; PDI; drug
consignment)
3. Organize Functional Therapeutic
Committee
4. Capability building of Therapeutic
committee
5. Regular Meeting and monitoring
activities
6. SP/SB meetings on resolution to
earmarked specific budget

- 112 BNBs trained and seed


capital available
- Procurement system in the
province in placed
-80% Philhealth capitation fund
being used for procurement of
drugs
- Functional Municipal and
Provincial Therapeutic

1. Capability building on rational drug use;


drug supply and management
2. TA on financial management system

- Trained health workers on


rational drug use
- Therapeutic committee trained
on drug supply and
management
- Financial mgt. system in
placed
-Established provincial
regulatory framework

1. TA on establishing provincial regulatory


framework
2. Regular stakeholders meeting on
formulation of incentives/ disincentives
scheme on various laws/ordinances i.e.
regulating TBAs; mandatory dog
vaccination; anti - smoking

Technical Reports

Technical support from DOH

Internal / External reviews

Adherence to PNDF

Minutes of meeting
Baseline monitoring survey
Philhealth report
LHA

Technical Reports
Records Review

Logistics available

Technical report
LGU commitment for the passage
of health - related ordinances

59

Critical Investments GOVERNANCE COMPONENT


Table 13.1 Assumptions on the Cost Items in the Health Investment Plan
Version No.
Date: Dec 14, 2005
Unit Price/ Total
Cost
GOVERNANCE
1.A Increase technical and management capacities for health workers /LCEs
Cost Item

Description

Type of
Expenditure

Timing and
Duration

Source of Financing

Other
Remarks

MOOE
1. TA on technical/mgt capacities

Firm contract with


training institution

600,000 contract
price including VAT

1st half of 2007 x


6 months

GTZ

Training cost for


ILHZ board and
TMC
Training cost for
ILHZ board and
TMC
Visit to best
performing ILHZ for
technical exchange

10,000/pax/25pax=
250,000

2nd Q of 2006

EC

10,000/pax/25pax=
250,000

3rd Q of 2006

LEAD

200,000 for 25 pax


TMC /ILHZ Board

3rd Q of 2007

GTZ

Travelling expense
Travelling expense

800x2X25= 40,000
800x2X25= 40,000

2nd Q of 2006
3rd Q of 2006

PLGU/MLGU
PLGU/MLGU

Travelling expense

800x2X25= 40,000

3rd Q 2007

PLGU/MLGU

2. Training on:
a. Health Leadership and Mgt

b. Project Development
Capability Course
3. Lakbay - Aral

MOOE
1. TEVs for Health Leadership Mgt
2. TEVs for Project Development
Capability Course
3. TEVs for Lakbay - Aral

1.B Systems development of ILHZ


MOOE

1. Operating cost for ILHZ's


CHTF
2. Operating cost for
stakeholders' meeting /
orientation to new LCEs
MOOE
1. Planning workshop

1%of the 20% EDF

669773.25 /year

Regular
stakeholders' mtg

10,000/mtg/x12
months= 120,000
/year

2006 - 2010

CULION/GTZ/LEAD/PL
GU/MLGU

Integrated annual
planning workshop

75,000/ annually

2006-2010

DOH

60

2. TA on Pop Dev approach


MOOE
1. Installation of Human
Resource Mx and Deve system
1. TA on Human Resource
Dev't and Mgt. Plan

TA

2. Additional incentives for MD


on dispersal from EVRMC

Non-monetary
incentives

1,500,000

TA

1,224,100

Skills training on
Health human
resource

300,000

Free food accom


Lodging
Trans exp

2006 -2010

GTZ

2006

GTZ/PLGU

3rd Q of 2006

GTZ

2006 - 2010

PLGU

2006-2010

PLGU/MLGU

PS

MOOE
1. Training on ICT Literacy
Program
2. Operating Cost for
Institutionalization of BMS,
CBMIS, FHSIS, HOMIS
3. Training on data analysis
and utilization
4. Maintenance of new
equipment

Magna Carta
benefits

1,180,000/annum

RHU and hospital


personnel

300,000

1st Q of 2006

LEAD

2,000,000

3rd Q of 2006
-2007

GTZ/LEAD/PLGU/MLG
U/DOH

3500/pax/40pax=
140,000

2nd Q of 2006

DOH

8% of acquisition
cost 1 year after
purchase

336000 /year

Purchase of
software/hardware

100,000/RHU(8)
10(IPHO)
=1,800,000

2009

CO

1. ICT equipment package

3rd Q of 2007

EC

CO

1. Installation of communication network

2-way
radio
system

2. Provision of 5 ambulances

Purchase of 5
ambulances

4,500,000

1st Q of 2008

EC/Other Donors

3. Provision of service vehicle


for monitoring

For PHO technical


staff use

1,250,000

3rd Q of 2007

JICA/EC

61

MOOE
1. Community assembly

Community
orientation on
referral system

2. Medical Assistance Fund to


EVRMC
3. Maintenance of ambulances
4. Maintenance of service
vehicle

8% of acquisition
cost 1 year after
purchase
8% of acquisition
cost 1 year after
purchase

100,000

4th Q of 2006

LEAD

200,000 annually

2006 - 2010

PLGU

360,000/annum

2009-2010

100,000/year

2008-2010

800x2x40=
64,000/annum
800x2x40= 64,000

2006 - 2010

PLGU

OOE

1. TEVs for planning workshop


2. TEVs for data
analysis/utilization

2. Strengthening of
systems in GIDA areas
CO
1. Provision of sea
ambulance - Maripipi Island
CO
1. Construction of BHS Higatangan Island
2. Provision of basic
equipment package Higatangan Island

2nd Q of 2006

Sea ambulance

1,200,000

2008

DOH

BHS construction

300,000

2008

Other Donors

Purchase of basic
equipment
package

200,000

2008

Other Donors

3. Strengthen GO/NGOs ,
POs partnership
MOOE

62

1. Annual Provincial Health


Summit
2. Annual Launching of
Healthy Barangay
3. Annual Launching of
Healthy Municipality
4. Regular stakeholders'
meeting

200,000

2007-2010

150,000

2007-2010

LEAD/PLGU/MLGU/Other
Donors
PLGU/MLGU

150,000

2007-2010

PLGU/MLGU/DOH

10,000/mtg semiannually

2006-2010

PLGU/MLGU

2007

DOH

30,000/Q =
120,000/yr

2007-2010

PLGU/MLGU

75,000 annually

2006-2010

DOH

4. Improve efficient and


effective Program
management
MOOE
1. LGU orientation on LGU
scorecard and other M & E
tool
2. Implementation of M & E
of LGU scorecard
3. Annual Program
Implementation Review

100,000

Annual PIR at
Biliran

Table 13.2 Health Investment Costs by Activity by Year, Biliran


Province (Governance Component)
Version No.
Date: Dec 14, 2005
Component/ Subcomponent/ Activity

GOVERNANCE
1.A Increase technical and management capacities for
health workers /LCEs

2006

4,887,723
580,000

2007

2008

2009

8,763,72
3

11,973,723

840,00

4,211,72
3
-

2010

4,211,7
23
-

Total

33,998,6
16
1,420,
000

As a % of
Componen
t Total

As a %
of Grand
Total

100.0%

100.0%

4.2%

4.2%

63

MOOE
1. TA on technical/mgt capacities

600,00

600,

000

1.8%

1.8%

0.0%

0.0%

0.7%

0.7%

0.7%

0.7%

0.6%

0.6%

40,

0.1%

0.1%

40,

0.1%

0.1%

000

0.1%

0.1%

6,123,
616

18.0%

18.0%

9.8%

9.8%

2. Training on:
a. Health Leadership and Mgt

250,
250,000

000

b. Project Development Capability Course

250,
250,000

000

3. Lakbay - Aral

200,00

200,

000

MOOE
1. TEVs for Health Leadership Mgt
40,000

000

2. TEVs for Project Development Capability Course


40,000

000

3. TEVs for Lakbay - Aral

40,00

40,

0
1.B Systems development of ILHZ
1,664,723

1,114,72
3

1,114,723

1,114,7
23

1,114,
723

669,723.
25
120,0
00

669,723
.25
120,
000

MOOE
1. Operating cost for ILHZ's CHTF
669,723.25
2. Operating cost for stakeholders' meeting / orientation to
new LCEs

120,000

669,723.2
5
120,00
0

669,723.25
120,000

3,348,
616
600,
000

1.8%

1.8%

MOOE
1. Planning workshop
2. TA on Pop dev approach to local planning

75,000
500,000

75,000
250,00
0

75,000
250,000

75,000
250,0
00

75,000
250,
000

375,000
1,500,
000

1.1%
4.4%

1.1%
4.4%

0.9%

0.9%

0.0%

0.0%

31.8%

31.8%

17.3%

17.3%

0.0%

0.0%

MOOE
1. TA on Human Resource Dev't and Mgt. Plan

300,
300,000

000

2. Additional incentives for MD on dispersal from


EVRMC

2,120,000

4,480,00
0

1,180,000

1,180,00
0

1,180,000

1,516,0
00

1,516,
000

1,180,000

1,180,0
00

1,180,
000

10,812,
000

PS
1. Full implementation of Magna Carta (phase-in)

5,900,
000

MOOE
-

64

1. Training on ICT Literacy Program


300,000
2. Operating Cost for Institutionalization of BMS, CBMIS,
FHSIS, HOMIS

1,500,00
0

500,000

300,
000
2,000,
000

0.9%

0.9%

5.9%

5.9%

140,

0.4%

0.4%

672,

2.0%

2.0%

1,800,
000

5.3%

5.3%

31.3%

31.3%

7.0%

7.0%

13.2%

13.2%

3.7%

3.7%

0.3%

0.3%

2.9%

2.9%

2.1%

2.1%

0.9%

0.9%

320,

0.9%

0.9%

64,

0.2%

0.2%

0.0%
5.8%

0.0%
5.8%

3.5%

3.5%

0.9%

0.9%

0.6%

0.6%

3. Training on data analysis and utilization


140,000

000

4. Maintenance of new equipment

336,0
00

336,
000

000

CO
1. ICT equipment package

1,800,00
0

CO
1,464,00
0

428,000

7,264,000

724,0
00

724,
000

1. Installation of communication network


2,400,000
2. Provision of 5 ambulances
4,500,000
3. Provision of service vehicle for monitoring

1,200,00
0

10,654,
000
2,400,
000
4,500,
000
1,200,
000

MOOE
1. Community assembly
100,000
2. Medical Assistance Fund to EVRMC

200,00
200,000

200,000

3. Maintenance of ambulances
4. Maintenance of service vehicle
100,000

200,0
00
360,0
00
100,0
00

200,
000
360,
000
100,
000

100,
000
1,000,
000
720,
000
300,
000

OOE
1. TEVs for planning workshop
2. TEVs for data analysis/utilization

64,00
64,000
64,000

64,0
64,000

00

64,
000

000
000

2. Strengtheningof systems in GIDA areas

1,700,000

CO
1.Provisionof sea ambulance-Maripipi Island
2.Construction of BHS - HigatanganIsland
3. Provision of basic equipment package-Higatangan
Island
MOOE

1,200,000
300,000
200,000

142,0
00

142,
000

1,984,
000
1,200,
000
300,
000
200,
000

65

96,0

96,

1. maintenance of sea ambulance

00

2. maintenance of BHS

00

3. maintenance of basic equipment

00

000

520,0
00

000

000
30,0

520,00
20,000

520,000

0.6%

0.6%

60,

0.2%

0.2%

32,

0.1%

0.1%

2,100,
000

6.2%

6.2%

800,

2.3%

2.3%

600,

1.8%

1.8%

600,

1.8%

1.8%

0.3%

0.3%

2.8%

2.8%

480,

0.3%
1.4%

0.3%
1.4%

375,

1.1%

1.1%

30,
000

16,0

3.Strengthen GO,NGOs, POs partnership

192,
000
000

16,
000
520,

MOOE
200,00

1. Annual Provincial Health Summit

0
150,00

2. annual launching of healthy barangay

4. Improve efficient and effective program


management
MOOE

150,000
150,00

3. annual launching of healthy municipality


4. Regular stakeholder's meeting

200,000

150,000
20,00

20,000

20,000

75,000

295,000

195,000

1.LGU Orientation on scorecard

200,0
00
150,0
00
150,0
00
20,0
00

195,000

200,
000

000
150,

000

000
150,

000

000
20,
000

195,000

955,000

100,00

100,

0
2. Quarterly M/E LGU Scorecard

000
120,00

3. Annual program implementation review

100,

000

120,000
75,00

75,000

Grand Total
4,887,723

8,763,72
3

75,000

11,973,723

120,0
00
75,0
00

120,
000

000
75,

000

000

4,211,72
3

4,211,7
23

34,048,6
16

12.4%

12.4%

100.0%

100.0%

As a Percentage of Grand Total


14.4%

25.7%

35.2%

Table 13.3. Health Investment Costs by Activity by Source of Financing, Biliran Province
(Governance Component)
Version No.

66

Date: Dec. 14, 2005

Component/ Subcomponent/ Activity


GOVERNANCE
1.A Increase technical and management
capacities for health workers /LCEs

Provincial
LGU Budget

Municipal
LGU
Budget

7,578,
489
60,
000

6,87
0,127
60
,000

DOH Budget
3,270,0
00
-

EC Grant

LEAD

5,250,0
00
250,0
00

1,470,0
00
250,0
00

GTZ
3,220,0
00
800,0
00

Culion Foundtn

Philhealth
Cap/Claims
-

620,000
-

Other
Donors
/JICA
5,72
0,000

Total

33,998,616

1,420,000

MOOE

1. TA on technical/mgt capacities

600,0
00

600,000

2. Training on:

a. Health Leadership and Mgt

250,0
00

250,000

b. Project Development Capability


Course
3. Lakbay - Aral

250,0
00

250,000
200,0
00

200,000

MOOE

1. TEVs for Health Leadership Mgt

20,
000

2. TEVs for Project Development


Capability Course
3. TEVs for Lakbay - Aral

1.B Systems development of ILHZ

20
,000

20,
000

40,000
20

,000
20,

40,000
20

000

,000

1,652,
489

1,81
6,127

40,000
375,0
00

120,0
00

1,920,0
00

120,000

12
0,000

6,123,616
-

MOOE
1. Operating cost for ILHZ's CHTF
2. Operating cost for stakeholders' meeting
/ orientation to new LCEs
MOOE

1,592,
489
60,000

1,75
6,127

3,348,616

60,000

120,000

120,000

120,000

600,000
-

1. Planning workshop

375,0
00

2. TA on Popdev approach to planning

120,000

375,000
1,500,0
00

1,500,000

MOOE
1. TA on Human Resource Dev't and Mgt.
Plan

300,0
00

300,000

67

2. Additional incentives for MD on


dispersal from EVRMC

3,536,
000

3,53
6,000

2,950,
000

2,95
0,000

140,0
00

1,800,0
00

800,0
00

500,0
00

500,000

10,812,000
-

PS
1. Full implementation of Magna Carta
(phase-in)
MOOE

5,900,000
-

1. Training on ICT Literacy Program

300,0
00

2. Operating Cost for Institutionalization of


BMS, CBMIS, FHSIS, HOMIS

250,
000

25

300,000
500,0

0,000

00

3. Training on data analysis and utilization

500,0
00

500,000

2,000,000

140,0
00

4. Maintenance of new equipment

336,
000

140,000

33
6,000

672,000

CO

1. ICT equipment package

1,800,0
00

1,800,000

CO

1,780,
000

62

4,000

1. Installation of communication network


2. Provision of 5 ambulances

3,200,0
00
1,200,0
00
2,000,0
00

100,0

00

3. Provision of service vehicle for


monitoring
MOOE

4,90
0,000
1,20
0,000
2,50
0,000
1,20
0,000

4,500,000
1,200,000

100,0
00

4. Maintenance of service vehicle

2,400,000

1. Community assembly
2. Medical Assistance Fund to EVRMC
3. Maintenance of ambulances

10,604,000

1,000,
000
288,
000
300,
000

100,000
1,000,000
720,000

43
2,000

300,000

OOE

1. TEVs for planning workshop

160,
000

2. TEVs for data analysis/utilization

320,000

32

64,000

0,000
32,

000

16
,000

2. Strengtheningof systems in GIDA


areas
CO

28
-

4,000

1,200,0
00

50

1,984,000

0,000

68

1.Provisionof sea ambulance-Maripipi


Island
2.Construction of BHS - HigatanganIsland

1,200,0
00

1,200,000
30

300,000

20

200,000

0,000
3. Provision of basic equipment packageHigatangan Island

0,000
-

MOOE
1. maintenance of sea ambulance

2,000

2. maintenance of BHS

,000

3. maintenance of basic equipment

,000

3.Strengthen GO,NGOs, POs


partnership
MOOE

550,

100,

32

32,000

600,0

200,

200,0

20

200,

20

2,100,000

20

800,000

0,000
200,0

00

0,000

200,0

600,000

20

200,0

600,000

00
50

100,000

,000
-

00

0,000
50,

200,0
00

00

0,000

000

00
10

000
4. Improve efficient and effective
Program management
MOOE

60,000

0,000

000
3. annual launching of healthy
municipality
4. Regular stakeholders meeting

60

0,000

000
2. annual launching of healthy barangay

192,000

55

000

1. Annual Provincial Health Summit

19

955,000

955,000

1. LGU Orientation on LGU scorecard

100,0

100,000

480,0

480,000

375,0

375,000

00
2. Quarterly M/E of LGU score card
00
3. Program Implementation review
00
Grand Total
As a Percentage of Grand Total

7,578,
489
22.3%

6,87
0,127
20.2%

3,270,0
00
9.6%

5,250,0
00
15.4%

1,470,0
00
4.3%

3,220,0
00
9.5%

620,000
1.8%

0.0%

5,72
0,000
16.8%

33,998,616
100.0%

Table 13.4. Health Investment Costs by Type of Expenditure by Year, BILIRAN Province
GOVERNANCE COMPONENT
Version No.
Date: Dec. 14, 2005

69

Type of Expenditure

MOOE - Trainings/Workshops
1. Health Leadership & Mgt. Course
2. Project Development Capability Course
3. Planning Workshop
4. Program Implementation Review
5. ICT Literacy Program
6. Data analysis and utilization
MOOE - TA/Consultancy

2006
1,090,0
00
250,0
00
250,0
00
75,0
00
75,0
00
300,0
00
140,0
00
800,0
00

1. TA on technical/mgt capacities
2. TA on Human Resource Dev't and Mgt.
Plan
3. TA on Pop Dev approach
MOOE - Lakbay-Aral

1. Stakeholder's meeting
2. Community assembly
3. Regular stakeholders meeting

00

150,0

150,00
0

75,0
75,000

00

75,000

00

75,
000

75,00
0

250,0
00

150,

75,00

75,
000

250,00
0

500,0

250,0

00

250,000

00

250,
000

200,000

250,00
0

250,
000

200,000
240,0
00

640,0
640,000

00

120,000

00

120,0
00

640,00
0

120,0

640,
000

120,00
0

120,
000

100,000
20,0
00

20,0
20,000

00

200,000

00

150,000

00

150,000

00

20,00
0

200,0

200,00

150,0

1,169,7
23
669,723.
25

2,389,723
669,723.25

789,7
23
669,723.
25

14.8%

0.7%

14.8%

0.7%

22.2%

1.1%

22.2%

1.1%

17.8%

0.9%

8.3%

0.4%

100.0%

7.0%

25.0%

1.8%

12.5%

0.9%

1,500,0
00
200,0
00
200,0
00
2,800,0
00
600,0
00
100,0
00

62.5%

4.4%

100.0%

0.6%

100.0%

0.6%

100.0%

8.2%

21.4%

1.8%

150,

150,00
789,72
3
669,723.2
5

5.0%

3.6%

0.3%

100,0

3.6%

0.3%

800,0

28.6%

2.3%

600,0

21.4%

1.8%

00

000

100.0%

200,

150,00

150,0

1,690,0
00
250,0
00
250,0
00
375,0
00
375,0
00
300,0
00
140,0
00
2,400,0
00
600,0
00
300,0
00

00

000

As a % of
Grand
Total

20,
000

As a % of Type
of Expenditure

Total

000

0
75,0

850,000

2010

300,0

5. Annual Launching of Healthy Barangay

1. Operating cost for ILHZ Common Health

150,000

2009

00

4. Annual Health Summit

6. Annual Launching of Healthy


Municipality
MOOE - Operating Cost for ILHZ

2008

600,000

Technical exchange to best performing ILHZ


MOOE - Meetings/Orientation

2007

00
600,0

21.4%

1.8%

000

150,
00

789,
723
669,72
3.25

5,928,6
16
3,348,6
16

100.0%

17.4%

56.5%

9.8%

70

Trust Fund (CHTF)


2. Operating cost for institutionalization of
integrated health info system
3. Orientation on LGU Scorecard
4. LGU scorecard and other M & E tool for
implementation
MOOE - Equipment

500,0
00

1,500,000
100,000
120,0
00
-

100,0

96,00

96,
000

30,00
0

30,
000

16,00
0
100,0
00
200,0
200,0
200,000

3,050,000

00

100,00

100,
000

200,00
0

200,0
00
8,600,0
00

16,
000

0
200,0

00

200,
000

200,00
0

200,
000

1,800,000

1. Purchase of ICT equipment package


2. Purchase of communication equipment

2,400,000
4,500,0
00
1,200,0
00
300,0
00
200,0
00

3. Purchase of ambulances
4. Purchase of sea ambulance
5. Construction of BHS - Higatangan
6. Purchase of basic equipment package Higatangan
7. Purchase of service vehicle

1. TEVs for Lakbay-Aral

360,
000

4. Maintenance of BHS

OOE - TEVs

336,

360,00

3. Maintenance of sea ambulance

CO - Equipment/Ambulances

938,
000

200,000

1,250,000
208,0
00

64,0
104,000
40,000

100,0

1.7%

0.3%

480,0

8.1%

1.4%

1,976,0
00
672,0
00
720,0
00
192,0
00
60,0
00
32,0
00

100.0%

5.8%

34.0%

2.0%

36.4%

2.1%

9.7%

0.6%

3.0%

0.2%

1.6%

0.1%

300,0
00
1,000,0
00
1,000,0
00
11,650,00
0
1,800,0
00

15.2%

0.9%

100.0%

2.9%

100.0%

2.9%

100.0%

34.2%

15.5%

5.3%

2,400,000
4,500,0
00
1,200,0
00
300,0
00
200,0
00

20.6%
38.6%

7.0%
13.2%

10.3%

3.5%

2.6%

0.9%

1.7%

0.6%

1,200,0
00
504,0
00
40,0
00

10.7%

3.7%

100.0%

1.5%

7.9%

0.1%

00

000
336,00

2. Maintenance cost for ambulances

1. Medical Assistance Fund for EVRMC

938,00
0

00

5.9%

120,
000

1. Maintenance cost for equipment

MOOE - Incentives

120,00
0

00

5. Maintenance of basic equipment


package
6. Maintenance of service vehicle

33.7%

00

120,000
-

2,000,0
00

00

64,00
0

64,
000

71

2. TEVs for planning workshop


3. TEVs for Health Leadership Mgt
4. TEVs for Project Devt. Capability Course
5. TEVs for data analysis/utilization
PS
1. Magna Carta benefits

64,0
00

64,0
64,000

00

64,00
0

64,
000

40,0
00

320,0

63.5%

0.9%

40,0

7.9%

0.1%

00
00
40,0

7.9%

0.1%

00

40,0
00

64,0
00
1,180,0
00
1,180,0
00

64,0
00
5,900,0
00
5,900,0
00

7.9%

0.1%

100.0%

17.3%

100.0%

17.3%

1,180,000
1,180,000

1,180,0
00
1,180,0
00

1,180,00
0
1,180,00
0

1,180,
000
1,180,
000

Grand Total

100.0%
4,887,723

As a Percentage of Grand Total

14.4%

8,763,723
25.7%

11,973,723
35.2%

4,211,723
12.4%

4,211,723
12.4%

33,998,616
100.0%

Table 13.5 Health Investment Costs by Type of Expenditure by Source of Financing, Biliran
Province (Governance Component)
Version No.

72

Date: Dec. 14, 2005

Type of Expenditure

MOOE - Trainings/Workshops

Provincial LGU
Budget
-

Municipal
LGU Budget

DOH Budget

EC Grant

890,000

250,0
00
250,0
00

1. Health Leadership & Mgt. Course


2. Project Development Capability Course

550,000

Culion
Foundt
n

GTZ

375,000

4. Program Implementation Review

375,000

5. ICT Literacy Program

2,400,000
600,000

2. TA on Human Resource Dev't and Mgt. Plan

300,000

3. TA on Popdev approach to local planning


-

610,000
60,000

6. Annual Launching of Healthy Municipality

200,000

610,00
0
60,00
0

600,000

420,000

120,000

120,000

120,000

120,0
00
120,0
00

320,000
120,000

100,000
50,000

5. Annual Launching of Healthy Barangay

200,000

2. Community assembly

3. Regular stakeholder's meeting


4. Annual Health Summit

1,500,000

Technical exchange to best performing ILHZ

1. Operating cost for stakeholders' meeting

140,000

1. TA on technical/mgt capacities

MOOE - Meetings/Orientation

Other
Donors
/JICA

300,000

6. Data analysis and utilization

MOOE - Lakbay-Aral

Philhealth
Cap/Claim

250,000

3. Planning Workshop

MOOE - TA/Consultancy

LEAD

100,000
200,000
200,000

50,00
0
100,00
0
200,00
0
200,00
0

200,000

200,000

Total

As a % of
Type of
Expenditure

1,690
,000
250
,000
250
,000
375
,000
375
,000
300
,000
140
,000
2,400
,000
600
,000
300
,000
1,500
,000
200
,000
200
,000
2,800
,000
600
,000
100
,000
100
,000

100.0%

800

28.6%

600

21.4%

600

21.4%

200,000

14.8%
14.8%
22.2%
22.2%
17.8%
8.3%
100.0%
35.5%
12.5%

100.0%
100.0%
100.0%
21.4%
3.6%
3.6%

,000
200,000
,000
200,000
,000

73

MOOE - Operating Cost for ILHZ

1,842,489

1. Operating cost for ILHZ Common Health


Trust Fund (CHTF)
2. Operating cost for institutionalization of
integrated health info system

1,592,489
250,000

2,006,12
7
1,756,12
7
250,00
0

3. Orientation on LGU Scorecard

580,000

500,000

500,000

500,000

500,000

500,0
00

500,0
00

5,928
,616
3,348
,616
2,000
,000

100.0%

100

1.7%

480
,000
1,976
,000
672
,000
720
,000
192
,000
60
,000
32
,000
300
,000
1,000
,000
1,000
,000
11,60
0,000
1,800
,000
2,400
,000
4,500
,000
1,200
,000
300
,000
200
,000
1,200
,000
504
,000
40
,000

8.1%

100,000

56.5%
33.7%

,000
4. LGU scorecard and other M & E tool for
implementation
MOOE - Equipment

480,000
924,000

1. Maintenance cost for equipment

336,000

2. Maintenance cost for ambulances

288,000

3. Maintenance of sea ambulance


4. Maintenance of BHS
5. Maintenance of basic equipment package
6. Maintenance of service vehicle

300,000

MOOE - Incentives

1,000,000

1. Medical Assistance Fund for EVRMC

1,000,000

CO - Equipment/Ambulances

1,052,00
0
336,00
0
432,00
0
192,00
0
60,00
0
32,00
0

1,200,000

1. Purchase of ICT equipment package


2. Purchase of communication equipment
3. Purchase of ambulances
4. Purchase of sea ambulance

5,000,0
00
1,800,0
00
1,200,0
00
2,000,0
00

5,400,000

1,200,000
2,500,000

1,200,000

5. Construction of BHS - Higatangan

300,000

6. Purchase of basic equipment package Higatangan


7. Purchase of service vehicle

200,000

OOE - TEVs
1. TEVs for Lakbay-Aral

1,200,000
252,000
20,000

252,00
0
20,00
0

100.0%
34.0%
36.4%
9.7%
3.0%
1.6%
15.2%
100.0%
100.0%
100.0%
15.5%
20.7%
38.8%
10.3%
2.6%
1.7%
10.3%
100.0%
7.9%

74

2. TEVs for planning workshop


3. TEVs for Health Leadership Mgt
4. TEVs for Project Devt. Capability Course
5. TEVs for data analysis/utilization

160,000
20,000
20,000
32,000

PS

2,950,000

1. Magna Carta benefits

2,950,000

Grand Total

7,578,489

As a Percentage of Grand Total

22.3%

160,00
0
20,00
0
20,00
0
32,00
0
2,950,00
0
2,950,00
0

6,870,1
27
20.2%

320

63.5%

40

7.9%

40

7.9%

64
,000
5,900
,000
5,900
,000

12.7%

,000
,000
,000
-

3,270,00
0
9.6%

5,250,
000
15.4%

1,470,00
0

3,220,000

4.3%

9.5%

620,0
00
1.8%

0.0%

5,720,00
0

33,9
98,616

16.8%

100.00%

100.0%
100.0%

Critical Investments, FINANCING COMPONENT


Table 14.1 Assumptions on the Cost Items in the Health Investment Plan Biliran Province
FINANCING COMPONENT

75

Version No.
Date: December 14, 2005
Changes from the Previous Version
Cost Item
Description

Type of
Unit Price/ Total
Expenditure
Cost
FINANCING
Increase and sustain PhilHealth insurance coverage to 85%
1. Incremental premiums
35,173,200
Philhealth premiums on top of
premiums currently paid to
achieve yearly targets for
indigent population
2. Congressional funds for
300,000/annum =
PhilHealth enrolment
1,500,000
3. Establishment of enrolment
desk in 8 RHUs and BPH

3.a Training of LGU point


person

In-house training 5/ LGU by


PhilHealth officer

4. Orientation to business
establishments on inclusion of
premium payments for availing
mayor's permit

Series of orientation at the start


of the year

Timing and
Duration

Source of
Financing

2006 - 2010

PLGU/MLGU

2006 -2010

Congressional Fund

60 pax including
hospital personnel=
50,000
15 establishments x
2pax = 30 x 3
orientation = 5,000 /
orientation

2006

PhilHealth 8

2006 - 2010

PhilHealth 8

100,000 / year

2006 -2008

PhilHealth 8

15,000/ mtg X 2 =
30,000/yr

2006 - 2010

PLGU/MLGU

Other Remarks

Total premiums for 5


year - period =
36,673,200

Maximize utilization and expansion of PhilHealth benefits


MOOE
1. TA - training of health
workers / mgt support
personnel on maximizing
PhilHealth benefits and claims

Training for RHU and hospital


personnel

Increase share of health expenditures in LGU Budget


MOOE
1. Advocacy during LHB
meetings and other fora

Twice a year advocacy before


budget preparation

76

2. Stakeholders' meeting on
resolution for adoption of
incremental increase of LGU
budget for health

Stakeholders' meeting

4 meetings: 2,000/
mtg=8000/yr

2006 -2010

PLGU/MLGU

Corporate re-structuring of Biliran Provincial Hospital Resource Mobilization for RHUs


MOOE
1. TA on cost-recovery
scheme for Biliran Prov'l
Hospital
2. TA on development of a
Hospital Business Plan
3. TA on development of
mechanism to retain income
4. Training of hospital staff on
hospital operations and
financial management

TA / consultancy

Firm contract :
300,000

2006

GTZ

TA / consultancy

2006

GTZ

2006

EC

Training on hospital and


financial mgt. to include cost
and rate setting

Individual contract
300,000
Firm contract :
200,000
Training cost:
3500/pax Biliran for
25 pax

2006

DOH

5. TA on client segmentation
for charging of user fees
6. Meetings on passage of
resolution on user fees

TA / consultancy

Firm contract:400,000

2006

GTZ

Series of meetings

Meetings:
2,000/mtg=4 mtgs

2007

PLGU/MLGU

7. Capability building on
project proposal dev't

Training workshop on project


proposal development

Training cost:
3500/pax Tacloban for
25 pax

2006

LEAD

Travel allowance

800 X25 pax 2 days =


40,0000

2006

PLGU/MLGU

TA / consultancy

MOOE
1. TEVs for project proposal
development writing

Table 14.2. Health Investment Costs by Activity by Year, Biliran Province (Financing Component)
Version No.
Date: December 14, 2005

77

Component/ Subcomponent/ Activity

FINANCING
Increase and sustain PhilHealth insurance
coverage to 85%
1. Incremental premiums
2. Congressional funds for PhilHealth enrolment

2006

2007

5,285,32
0
3,732,32
0
3,367,320.00
300,00
0

3. Establishment of enrolment desk in 8 RHUs and


BPH
3.a Training of LGU point person

2008

5,661,9
80
5,515,9
80
5,200,9
80
300,0
00

2009

7,487,6
40
7,349,6
40
7,034,6
40
300,0
00

2010

9,321,3
00
9,183,3
00
8,868,3
00
300,0
00

As a
% of
Grand
Total

100.0%

100.0%

94.6%

94.6%

90.4%

90.4%

3.9%

3.9%

0.0%

0.0%

50,0

0.1%

0.1%

75,0

0.2%

0.2%

500,0

1.3%

1.3%

0.0%

0.0%

1.3%

1.3%

0.5%

0.5%

0.0%

0.0%

0.4%
0.1%

0.4%
0.1%

Total

11,154,96
0
11,016,96
0
10,701,9
60
300,0
00

38,911,2
00
36,798,2
00
35,173,2
00
1,500,0
00
-

50,00
0

4. Orientation to business establishments on


inclusion of premium payments for availing
mayor's permit
Maximize utilization and expansion of
PhilHealth benefits
MOOE

As a % of
Component
Total

00
15,00

15,0
00

100,00
0

15,0
00

100,0
00

15,0
00

100,0
00

15,0
00

100,0
00

00
100,0

00

00
-

1. TA - training of health workers / mgt support


personnel on maximizing PhilHealth benefits
and claims

100,00
0

100,0
00

38,00
Increase share of health expenditures in LGU
Budget

100,0
00

38,0
00

100,0
00

38,0
00

100,0
00

38,0
00

38,0
00

190,0
00

MOOE

30,00

1. Advocacy during LHB meetings and other fora


2. Stakeholders' meeting on resolution for adoption
of incremental increase of LGU budget for health

500,0
00

30,0
00

8,00
0

30,0
00

8,0
00

30,0
00

8,0
00

30,0
00

8,0
00

150,0
00

8,0
00

40,0
00

78

Corporate re-structuring of Biliran Provincial


Hospital Resource Mobilization for RHUs
MOOE

1,415,00
0

8,0
00

1,423,0
00

3.7%

3.7%

0.0%

0.0%

300,0

0.8%

0.8%

300,0

0.8%

0.8%

200,0

0.5%

0.5%

87,5

0.2%

0.2%

400,0

1.0%

1.0%

8,0

0.0%

0.0%

87,5

0.2%

0.2%

0.0%

0.0%

0.1%

0.1%

1. TA on cost-recovery scheme for Biliran Prov'l


Hospital
2. TA on development of a Hospital Business Plan

300,00
0

00
300,00

0
3. TA on development of mechanism to retain
income
4. Training of hospital staff on hospital operations
and financial management
5. TA on client segmentation for charging of user
fees
6. Meetings on passage of resolution on user fees

00
200,00

00
87,50

00
400,00

00
8,0
00

7. Capability building on project proposal dev't

00

87,50
0

00

OOE
1. TEVs for project proposal development writing
Grand Total
As a Percentage of Grand Total

40,00
0
5,285,32
0
13.6%

5,661,9
80
14.6%

7,487,6
40
19.2%

9,321,3
00
24.0%

11,154,96
0
28.7%

40,0
00
38,911,2
00
100.0%

100.0%

Table 14.3. Health Investment Costs by Activity by Source of Financing, Biliran Province (Financing Component)
Version No.
Date: December 14, 2005
Component/ Subcomponent/
Activity

Provincial
LGU
Budget

Municipal
LGU
Budget

DOH
Budget

EC
Grant

LEAD

GTZ

Culion
Foundtn

PhilHealth
Capitation/
Claims

Other
Donors
/JICA

Total

79

FINANCING

23,53
8,200

13,37
3,000

87,5
00

200,
000

Increase and sustain PhilHealth insurance


coverage to 85%

23,419,
200

13,254,
000

1. Incremental premiums

21,919,
200
1,500,
000

13,254,
000

2. Congressional funds for PhilHealth enrolment

8
7,500
-

1,0
00,000

625,000

38,911,
200

125,000

36,798,2
00

35,173,2
00
1,500,0
00
-

3. Establishment of enrolment desk in 8 RHUs


and BPH
3.a Training of LGU point person

50,000

50,00
0

4. Orientation to business establishments on


inclusion of premium payments for availing
mayor's permit
Maximize utilization and expansion of
PhilHealth benefits

75,000

75,00
0

500,000

500,00
0

MOOE

1. TA - training of health workers / mgt support


personnel on maximizing PhilHealth benefits and
claims
Increase share of health expenditures in LGU
Budget

500,000

500,00
0

95,
000

95,

000

190,00
0

MOOE

1. Advocacy during LHB meetings and other fora


2. Stakeholders' meeting on resolution for
adoption of incremental increase of LGU budget
for health
Corporate re-structuring of Biliran Provincial
Hospital Resource Mobilization for RHUs

75,

75,

000

000

20,000

20,000

150,00
0
40,000

24,
000

24,
000

87,50
0

200,0
00

87
,500

1,00
0,000

1,423,0
00

MOOE

1. TA on cost-recovery scheme for Biliran Prov'l


Hospital

30
0,000

2. TA on development of a Hospital Business Plan

0
30

0,000
3. TA on development of mechanism to retain
income

300,00

200,0
00

300,00
0
200,00
0

80

4. Training of hospital staff on hospital operations


and financial management

87,50
0

87,50
0

5. TA on client segmentation for charging of user


fees

40

400,00

0,000

6. Meetings on passage of resolution on user fees

4,
000

4,0

8,00

00

7. Capability building on project proposal dev't

87
,500

87,50
0

OOE

1. TEVs for project proposal development writing

20,
000

Grand Total
As a Percentage of Grand Total

23,538,
200
60.5%

20,

40,00

000
13,373,
000
34.4%

0
87,50
0
0.2%

200,0
00
0.5%

87
,500
0.2%

1,00
0,000
2.6%

0.0%

625,000
1.6%

0.0%

38,911,20
0
100.0%

Table 14.4. Health Investment Costs by Type of Expenditure by Year, Biliran Province (Financing Component)
Version No.
Date: December 14, 2005

81

Type of Expenditure
MOOE - Incremental premiums/
congressional fund
PhilHealth premiums
Congressional fund

As a % of
Type of
Expendit
ure

As a % of
Grand
Total

100.0%
95.9%

94.2%
90.4%

4.1%

3.9%

0.0%

0.0%

100.0%

3.1%

25.0%

0.8%

25.0%

0.8%

16.7%

0.5%

33.3%

1.0%

0.0%

0.0%

273

100.0%

0.7%

75,0

27.5%

0.2%

150,0

54.9%

0.4%

40,0

14.7%

0.1%

2.9%

0.0%

725

100.0%

1.9%

50,0

6.9%

0.1%

500,0

69.0%

1.3%

87,5

12.1%

0.2%

87,5

12.1%

0.2%

2006

2007

2008

2009

2010

Total

3,667
,320

5,500
,980
5,200,
980

7,334
,640
7,034,
640

9,168
,300
8,868,
300

11,001
,960
10,701,
960

36,673
,200
35,173,2
00

300,

1,500,0
00

3,367,320.0
0
300,
000

300,
000

300,
000

300,
000

000

MOOE - TA / consultancy
TA on cost recovery scheme in BPH
TA on development of Hospital Business
Plan
TA on dev't of mechanism to retain income
TA on client segmentation for charging user
fees

1,200
,000
300,
000
300,
000
200,
000
400,
000

1,200
,000
300,0
00
300,0
00
200,0
00
400,0
00

MOOE - Advocacy meetings/


orientation
Orientation to business establishments for
inclusion of premiums on business permit
Advocacy during LHB meetings and other
fora
Stakehoders' meeting on resolution for
adoption of incremental increase of LGU
budget
Meetings on passage of resolution on user
fees
MOOE - Training
Training of LGU point person
Training of health workers in maximizing
PhilHealth claims and benefits
Training on hospital and financial
management
Training workshop on project proposal dev't

53
,000

61
,000

15,
000

000
000

15,
000

30,
8,

53
,000

000
000

15,
000

30,
8,

53
,000

000
000

15,
000

30,
8,

53
,000

000
000

,000
15,

000
30,
8,

000
000

00
30,
8,

00
00

8,

8,0

000
325
,000
50,
000
100,
000

00

100
,000

100
,000

100
,000

100
,000

,000
00

100,
000

100,
000

100,
000

100,
000

00

87,
500

00
87,

82

500

00
-

OOE -

TEVs

Travel allowance for training workshop on


project proposal dev't

40

,000
000

40,

00

Grand Total

5,285,320

5,661,980

7,487,640

9,321,300

As a Percentage of Grand Total

13.6%

14.6%

19.2%

24.0%

11,154,960
28.7%

40

100.0%

0.1%

40,0

100.0%

0.1%

,000

38,911,200

100.0%

100.0%

Table 14.5. Health Investment Costs by Type of Expenditure by Source of Financing, Biliran Province (Financing
Component)
FINANCING COMPONENT
Version No.

83

Date: December 14, 2005

Type of Expenditure

Provincial LGU
Budget

MOOE - Incremental premiums/


congressional fund

23,419,200

PhilHealth premiums

21,919,200

Congressional fund

1,500,000

Municipal LGU
Budget
13,254,000

DOH Budget
-

EC Grant
-

LEAD

Culion
Foundt
n

GTZ
-

PhilHealth
Capitation/
Claims

Other
Donors
/JICA

Total
-

36,673,200

13,254,000

35,173,200
1,500,000
-

MOOE - TA / consultancy

200,000

TA on cost recovery scheme in BPH

1,000,00
0
300,00
0

300,000

300,00
0

TA on development of Hospital Business


Plan
TA on dev't of mechanism to retain income

1,200,000

300,000

200,000

200,000

TA on client segmentation for charging


user fees

400,000

400,00
0

MOOE - Advocacy meetings/ orientation

99,000

99,000

75,
-

Orientation to business establishments for


inclusion of premiums on business permit
Advocacy during LHB meetings and other
fora
Stakehoders' meeting on resolution for
adoption of incremental increase of LGU
budget
Meetings on passage of resolution on user
fees

273,000

000
75,000

75,
000
75,000

75,00

150,000

0
20,00
20,000

4,000

40,000

4,00

8,000
-

MOOE - Training

87,500

Training of LGU point person


Training of health workers in maximizing
PhilHealth claims and benefits
Training on hospital and financial

87,50
0

550,
000

50,
000
500,
000

725,000
50,000
500,000
87,500

84

management

87,500

Training workshop on project proposal


dev't

87,50
0

87,500
-

OOE - TEVs

20,000

20,000

Travel allowance for training workshop on


project proposal dev't

20,000

20,000

Grand Total
As a Percentage of Grand Total

40,000

40,000

23,538,200

13,373,000

87,500

60.5%

34.4%

0.2%

200,000
0.5%

87,50
0
0.2%

1,000,00
0
2.6%

0.0%

625,
000
1.6%

38,911,200
0.0%

100.0%

Critical Investments, Service Delivery Component


Table 15.1. Assumptions on the Cost Items in the Health Investment Plan
SERVICE DELIVERY

85

Version No.
Date: December 14, 2005
Changes from the Previous Version
Cost Item

Description

Type of
Expenditure

Unit Price/ Total Cost

Timing and
Duration

Source of Financing

Subcomponent 1. UPGRADE CRITICAL CAPACITIES OF HEALTH FACILITIES AT THE RIGHT LEVELS AND RIGHT TIME
1. Renovation / Construction/ Upgrading Upgrade Physical Structure
building and other
111,724,000
of Hospitals
Following Standards
structure outlay

2010

HFEP

2. Construction of RHU'S

Upgrade Physical Structure


Following Standards

building and other


structure outlay

9, 094,764.67

2010

HFEP

3. CONSTRUCTION OF CITY HEALTH

Upgrade Physical Structure


Following Standards

building and other


structure outlay

4,400,000

2009

HFEP

improvement of existing
rooms to meet tb standards for
accreditation construction of
sink, division, cabinets and
paintings.
provision of equipment in
compliance to deficiencies

building and other


structure outlay

4,200,000

2009-2010

MUN. LGU (42)


Excluding Baybay 1,
Bato and Merida

machineries and
equipment outlay

97, 648,000

2009-2010

HFEP/Cong. Funds

PROVISION OF BUDGET
FOR MAINTENANCE OF
STRUCTURES 3%
INVESTMENT COST and
EQUIPMENTS 10%
PURCHASED VALUE
BEGINNING SECOND (2ND)
YEAR AFTER

REPAIRS AND
MAINTENANCE

P122,842.94
P132,000.00

2010-2013
2010-2013

Macarthur LGU
Baybay LGU

P9, 764,800

2010-2013

Prov/ District Hosp

Other Remarks

SERVICE DELIVERY

UNIT

4. construction of tb rooms for 42 rhu's


excluding (bato, baybay i and merida)

5. equipment package for hospitals

MAINTENANCE OF
RENOVATED/CONSTRUCTED AREAS
and MACHINERIES AND EQUIPMENT

P15M for 1+E for


community hosp.
P15M for 1+E for
MBVMH &
Kananga
Community
Hospitals

86

EQUIPMENT PACKAGE FOR 24


RHU'S SS PHASE 2
EQUIPMENT PACKAGE FOR (5)
BIRTHING BHS FACILITIES
EQUIPMENT PACKAGE FOR 20
BEMONC FACILITIES (18 RHU'S AND
2 COMMUNITY HOSPITALS)
EQUIPMENT PACKAGE FOR 9
CEMONC HOSPITALS

Provision of budget for


equipments
EQUIPMENT PACKAGE AS
BHS BEMONC
EQUIPMENT OUTLAY FOR
BEMONC FAC ILITY ( RHU
AND HOSPITAL) SEE ANNEX
FOR SPECIFIC EQUIPMENT
EQUIPMENT OUTLAY FOR
CEMONC HOSPITAL

EQUIPMENT
OUTLAY
EQUIPMENT
OUTLAY
MACHINERIES
AND
EQUIPMENT
OUTLAY
MACHINERIES
AND
EQUIPMENT
OUTLAY

4,800,000

2010

MUN LGU

P1,572,500

2010

JICA

P 6, 296,000

2010

WHSMFN
INVESTMENT

P 69, 078,700

2010

WHSMFN
INVESTMENT

2006-2007

MLGU

Subcomponent 2. Upgrading, improvement of 8 RHU's to become Sentrong Sigla Phase 2 Level 1 certification
1. Upgrading of 2 RHU's for Phase II, Facility upgrading required to
Capital Outlay
200T/RHU/1.2M
Level SS certification
meet SS quality standards
(see annex_for details)
2. New equipment for 8 RHU's for SS
certification

Lacking equipment in SS
quality standards list in each of
the 8RHU's (see annex_for
details)
Facility upgrading required to
meet maternity care package
standards (see annex_for
details)

Capital Outlay

304,500 / RHU X 8

2006 - 2007

MLGU

Capital Outlay

5,600,000
700T/RHU

2006-2008

EC/JICA

4. New equipment for 8 RHU's for


Maternity Care Package

Lacking equipment in
maternity care package
standards list in each of 8
RHU's (see annex_for details)

Capital Outlay

216,500/ RHU X 8

2006-2007

EC/JICA/PHILHEALTH

5. New equipment for 8 RHU's and


hospital - based TB-DOTS

Lacking equipment in TBDOTS standards list in each of


7 RHU's (see annex_for
details) and hospital - based

Capital Outlay

600,000.00

2006

CULION

3. Expansion of 8 RHU's to avail of


Maternity Care Benefits & TB-DOTS
Packages

87

6. Maintenance of renovated areas

(See Annex _ for details)


MOOE
84,000/ RHU

Yearly from year


after renovation
(2008)

Respective MLGU

7. Maintenance of equipment
a. SS certification

(See Annex _ for details)

30,450/ RHU

b. Maternity Care Package

(See Annex _ for details)

21,650 / RHU

c. TB-DOTS Package

(See Annex _ for details)

6,000/ RHU

MOOE

8. Training of RHU personnel

8 RHU's on SS
8 RHU's on MCP
7 RHU's /1 hosp basedon TBDOTS

Subcomponent 3. Create additional RHU in Naval


1. New plantilla position for MD, Medical Ideal ratio of health worker
Technologist
population
1 Doctor: 20, 000 Pop
1 Med. Tech: 20, 000 Pop
2. Construction of new RHU
3. New equipment for new Naval RHU
4. Training of personnel in new RHU
Basic training onL EPI, ARI,
CDD, FP, Sputum Microscopy
(MHO, Med.Tech)
5. Maintenance of newly constructed
RHU
6. Maintenance of new equipment
7. Incremental supplies

Add'l supplies required by the


projected increasing clients

MOOE

500,000
300,00O
170,000

Yearly for 4 years


beginning year after
purchase (2006)
8% acquisition cost

Respective MLGU

2006-2007
2006-2007
2006 - 2007

LGU/DOH/

Yearly beginning
January 2009

MLGU

2009
2009-2010
2nd half of 2009,
2010

EC
EC/MLGU
DOH

Personal Services

1,030,000.00

Capital Outlay
Capital Outlay
MOOE

MHO: 335,700/yr
MT: 179,300/yr
2,500,000
1,000,000
800,000.00

MOOE

400,000

2010

MLGU

MOOE
MOOE

200,000

2009-2010

MLGU

Subcomponent 4. Establish Barangay Health Councils provincewide

88

1. TA - Organization of BHC's

Firm contracts, covering


installation of councils,
organizing and training of
council members to implement
the system

3. Capability building of BHC's

MOOE

1,300,0

2006 - 2010

LEAD/Other Donors

00

Tng Cost on-Enhance Mgt


Leadership Tng
Subcomponent 5. On Tuberculosis Prevention and Control
1. Organize PPM - DOTS
Operating Expense on
organizing

MOOE

350,000.00

2007 onwards

LEAD

MOOE

200,000.00

2006

DOH/CFI/LEAD

2. Regular meetings of provincial TB diagnostic committee

Operating Expense on
meeting

MOOE

15,000/Q

2006-2010

DOH/CFI/LEAD

Skills/Traing cost
Provision of drugs/meds for
Category III patient (See
annex_for details)

MOOE
MOOE

105,328.00

Quality assurance activities

OOE

3. Capability building of health workers


on basic health care & infectious
diseases
4. Provision of drugs & medicines for
Category I, II, & III patients

2006 - 2010
2006 onwards

3 personnel x 400x4
2006 onwards
(QUARTERLY
5. TEV s for monitoring
25 pax 800x 2
6. TEVs for training
Travelling allowance
OOE
=P40,000
Subcomponent 6: On Pneumonia and other childhood infectious diseases; and other infectious/ non - infectious on adult

LEAD
PhilHealth/CFI/LGU

PLGU

MLGU/PLGU

1. Multimedia set for IMCI

Purchase of Multimedia set


use of information with other
programs

Capital Outlay

600,000.00

2006

EC/JICA

2. Capability building of health workers


on IMCI
3. Provision of drugs & medicines for
pneumonia patients
4. TA on development of CPGs in RHUs
and BPH

(see summary of trainings)M


WITH tevS
(See annex_for details)

MOOE

500,000.00

2006-2007

MOOE

905,900.00

2006

DOH/Culion/JICA/
EC/LEAD
PLGU/MLGU/Phil
Health Capitation

Firm contracts

MOOE

00

300,000.
2006

89

Subcomponent 7. On Lifestyle and Degenerative Diseases


1. Advocacy activities
2. Capability building for health workers
with TEVs

Operating expense
(See annex_for training
details)

3. Provision of drugs, medicines for


lifestyle & degeneratives diseases

MOOE
MOOE
MOOE

20,000 / RHU /yr and


Hosp
300,000.00
400,000.00

2006 - 2010
2006-2008

PLGU/MLGU
EC/PLGUMLGU/DOH

2006 onwards

PLGU/MLGU/DOH

Subcomponent 8: On Rabies
1. Advocacy activities

Operating expense

MOOE

2. Training / skills development of health


workers
3. Provision of vaccines for dogs
3. Provision of post - exposure
prophylaxisanti-rabies vaccines through
animal bite centers

Training of mun. veterinarians


& AT's
Provision of vaccines for dogs

MOOE

200,000.00

2006

LGU

MOOE
MOOE

600,000.00
400,000.00

ONGOING
2006-2010

LGU
LGU

Operating expense

MOOE

50,000/yr

2006 onwards

CFI

Training cost /TEV inclusive

MOOE

112,500

2006 onwards

CFI

Provision of drugs

MOOE

766666/ yr x 3 years

2006 onwards

CFI

Provision of anti - filaria drugs

MOOE

800,000 for 3 yrs

2006 onwards

DOH

2006 onwards

CFI

Subcomponent 9 : On Leprosy and


Filaria
1. Advocacy meetings
2. Training / skills development of
health workers
3. Provision of MDT drugs for
leprosy
4. Medicines for Annual mass drug
treatment for filaria 2 y old and above

5. Regular active case finding


activitiy
Operating expense
Subcomponent 10: Women's Health & Safe Motherhood Program

MOOE

75,000

75,000 / yr

2006 onwards

PLGU/MLGU

90

1. Refurbishments of8 RHUs for MCP


accreditation

Renovation cost

2. Provision of appropriate
equipment at all levels of care

Purchase of equipment

MCH

35 BHS renovation cost


3. Renovation of BHS and hospital for
MCH
1. Training of health workers on
emergency obstetric case
2. Operating expense on maternal
death review
3. Advocacy activities

Training cost inclusive of TEV

Operating expense

Capital Outlay

2006-2008

JICA
JICA

Capital Outlay

35 BHS @
200,000/BHS

last Q of 2006

JICA

MOOE

160,000.00

2006

LEAD

MOOE-TA

40,000.00

2006

PLGU/JICA/DOH

MOOE
MOOE

200,000.00
3000000:
P600,000/YR

2006
2006-2010

LEAD
PLGU/MLGU/
Philhealth capitation

MOOE

19,800,000.00

2006 ONWARDS

DOH/PLGU/MLGU

4. Provision of family planning


commodities and supplies
Subcomponent 11. Childhealthand Nutrition

Incorporated in
SS
refurbishments
Hospital
Renovation
includes MCH
program of work

1. Regular stakeholders' meeting


incorporated in MCH activities
2.Provision of EPI vaccines and
supplies
3.Advocacy actvities/ counselling

incorporated in MCH activities

4. Operating expense for


implementation of Newborn Screening
5. Operating expense on
enforcement of nutrition related laws
andordinances
6. Training of Barangay Nutrition
Scholars (BNS) (Nutrition)
7. Trainors' Training of BNS
(Nutrition)

include reagents /transport

MOOE
MOOE

200,000/YR

BPH/ PLGU

For the BNS of the 8


municipalities
Modular courses for BNS
trainors

MOOE

500,000.00

2006-2007

ECCD

MOOE

80,000.00

2006

ECCD

91

8.. Purchase of 66 weighingscales


on identified BHS(Salter type)

330,000.00

Subcomponent 12:Environmental Health& Sanitation


1. Advocacy activities
incorporated in other public
health programs
2. Training / skills enhancement of
incorporated in other public
health workers
health programs
3. Operating expense on regular
chlorination of water

4. Construction of level III water

selected municipalites
identified see annex___

5. Provision of toilet bowls


Subcomponent 13: Oral Health Program
1. Regular stakeholders'
meeting
2. Production of IEC materials
3. Orientation / advocacy activitiies
4. Purchase of toothbrush /
toothpaste for school children

collaboration with Dep ed


Production of
(INFOMERCIALS)
advocacy activities in school
and food establishments
purcase of toothbrush/
toothpaste

5. Purchase of dental supplies for


preventive / curative care
supplies et al
Subcomponent 14: Disaster Preparedness & Management
1. Regular stakeholders' meeting
2. Capability building for Provincial
Search and Rescue Team
3. Purchase of PPEs and other
supplies

inter-agency meeting on
disaster preparedness
Basic and Advance Lif
eSupport Training
see Disaster Preparedness
Plan __

MOOE

2006

15000/LGU

Capital Outlay

ECCD

PLGU/MLGU

2009

OTHER DONOR

2006-2010

DOH/PLGU/MLGU

Capital Outlay

8,236 HH witout
sanitary toilets 3,
200,000
P60,000/yr
QUARTERLY mtg

2006 onwards

GTZ

MOOE
MOOE

700,000

2007

GTZ

MOOE

2006 onwards
2006 onwards

DEPeD; PLGU/MLGU
PLGU/LEAD

MOOE

50,000/yr
P206,800/yr total
eligible pop'n 8270

MOOE

75,000/yr. per RHU &


province

MOOE
MOOE
MOOE

60,000/yr quarterly
mtg
3 batches 25
pax/batch at P87,500
per batch
Estimated : PPE s/
LGU: 200,000

PLGU/MLGU

PLGU
2006
2006 -onwards

GTZ Rural Dev't


EC /DOH

Province will
designate
Sentinnel Officer

92

3. Designate Surveillance
Sentinel Officer
ASSUMPTIONS:

2006

PLGU

Province will
designate
Sentinnel Officer

Maintenance Cost of Civil Works at 8% per annum


Maintenace cost of equipment is at 10% acquisition cost
VAT,Freight & Handling incllusiveof the equipment cost
Training by other donor agencies inclusive of TEVs

Table 15.2. Health Investment Costs by Activity by Year, Province of Biliran


(Service Delivery Component)
Version No.
Date: December 14, 2005

Component/ Subcomponent/ Activity


SERVICE DELIVERY

2006
39,645,411.33

2007
65,884,411.33

2008

2009

2010

Total

As a % of
Component
Total

14,994,494.67

14,541,961.33

11,361,961.33

146,428,240.00

100.0%

As a % of
Grand Total

100.0%

93

Subcomponent 1. Increase bed capacity of Biliran


Provincial Hospital from 25 to 75 and upgrade
capabilility to tertiary care hospital
Capital Outlay
1. Const. & renovation of BPH
2. New equipment for BPH
MOOE
1. Maintenance of constructed & renovated areas of BPH
2. Maintenance of new equipment
3. Training of hospital personnel

22,197,250.00

40,357,250.00

11,369,000

6,160,000
18,140,000.00

1,793,333.33

1,793,333.33

1,793,333.33

67,934,500.00

46.4%

46.4%

0.0%
30.1%
12.4%
0.0%
2.4%
1.3%
0.2%
0.0%
10.9%

1,180,000.00
613,333.33

1,180,000.00
613,333.33

1,180,000.00
613,333.33

3,540,000.00
1,840,000.00
320,900.00

0.00

1,040,800.00

1,040,800.00

15,989,600.00

0.0%
30.1%
12.4%
0.0%
2.4%
1.3%
0.2%
0.0%
10.9%

7,010,000

9,140,000

13,480,000

44,093,600.00
18,140,000.00

160,450.00

160,450.00

4,919,500.00

8,988,500.00

600,000.00
2,100,000.00

1,000,000.00
2,436,000.00
3,500,000.00

1,600,000.00
2,436,000.00
5,600,000.00

0.0%
1.1%
1.7%
3.8%

0.0%
1.1%
1.7%
3.8%

4. Equipment package for 8 RHU's for Maternity Care


Package

649,500.00

1,082,500.00

1,732,000.00

1.2%

1.2%

5. New equipment for 7 RHU's and hospital based TB-DOTS

600,000.00

600,000.00

0.4%

0.4%

0.0%
0.8%

0.0%
0.8%

0.3%
0.2%
0.1%
0.3%
3.8%
0.0%
0.7%
0.0%
1.7%
0.7%

0.3%
0.2%
0.1%
0.3%
3.8%
0.0%
0.7%
0.0%
1.7%
0.7%

Subcomponent 2. Upgrading, improvement of 8


RHU's to become Sentrong Sigla Phase 2 Level 1
certification
Capital Outlay
1. Upgrading of 8 RHU's for SS certification
2. New equipment for 8 RHU's for SS certification
3. Expansion of 8 RHU's to avail of Maternity Care
Benefits & TB-DOTS Packages

MOOE
1. Maintenance of RHU renovated areas
2. Maintenance of equipment
a. SS certification

b. Maternity Care Package


c. TB-DOTS Package
3. Training of RHU personnel
Subcomponent 3. Create additional RHU in Naval
Personal Services
1. New plantilla position for MD, Medical Technologist
Capital Outlay
1. Construction of new RHU
2. New equipment forNaval RHU 2

970,000.00
0.00

970,000.00
0.00

0.00

576000

576000

1,152,000.00

243,600.00
173,200.00
48,000.00

243,600.00
173,200.00
48,000.00

4,015,000.00

1,515,000.00

487,200.00
346,400.00
96,000.00
1,940,000.00
5,530,000.00

515,000.00

515,000.00

1,030,000.00

2,500,000.00
500,000.00

500,000.00

2,500,000.00
1,000,000.00

94

MOOE
1. Training of personnel in new RHU

400,000.00

2. Maintenance of newly constructed RHU


3. Maintenance of new equipment
4. Incremental supplies

Subcomponent 4. Establish Barangay Health


Councils provincewide
MOOE
1. TA - Organization of BHC's
3. Capability building of BHC's

Subcomponent 5. On Tuberculosis Prevention


and Control

1,650,000.00

1,300,000.00
350,000.00
510,128.00

0.00

270,128.00

0.00

270,128.00

0.0%
0.5%

0.0%
0.5%

100,000.00

0.00
200,000.00

0.0%
0.0%
0.1%
0.0%

0.0%
0.0%
0.1%
0.0%

0.00

1,650,000.00

1.1%

1.1%

170,128.00

1,300,000.00
350,000.00
1,390,640.00

0.0%
0.9%
0.2%
0.9%

0.0%
0.9%
0.2%
0.9%
0.0%

200,000.00

0.0%
0.1%

300,000.00

0.2%

0.2%

300,000.00

0.2%

0.2%

400,000.00

800,000.00

100,000.00

0.00

170,128.00

MOOE

1. Organize PPM - DOTS


2. Regular meetings of provincial TB - diagnostic
committee
3. Capability building of health workers on basic
health care & infectious diseases
4. Provision of drugs & medicines for Category I, II,
& III patients
5. TEV s for monitoring
6. TEVs for training

Subcomponent 6. On Pneumonia and other


childhood infectious diseases; and other
infectious / non -infectious diseases on adult
1. Multimedia set for IMCI
2. Capability building of health workers on IMCI
3. Provision of drugs & medicines for pneumonia
patients

200,000.00

60,000
100,000.00

60,000
100,000.00

60,000
100,000.00

60,000

60,000

105,328.00

105,328.00

105,328.00

105,328.00

105,328.00

526,640.00

0.4%

0.4%

4,800.00

4,800.00

4,800.00

4,800.00

4,800.00

24,000.00
40,000.00

0.0%
0.0%

0.0%
0.0%

905,900.00

5,929,500.00

4.0%

4.0%

905,900.00

600,000.00
500,000.00
4,529,500.00

0.4%
0.3%
3.1%

0.4%
0.3%
3.1%

40,000

1,455,900.00

1,755,900.00

250,000.00
905,900.00

600,000.00
250,000.00
905,900.00

905,900.00

905,900.00

905,900.00

905,900.00

95

4. TA on development of CPGs in RHUs and BPH


Subcomponent 7. On Lifestyle and
Degenerative Diseases

300,000.00
660,000.00

480,000.00

480,000.00

480,000.00

480,000.00

300,000.00
2,580,000.00

0.2%
1.8%

0.2%
1.8%

0.0%
0.1%
0.3%
1.4%

0.0%
0.1%
0.3%
1.4%

200,000.00

1.0%
0.0%
0.1%

1.0%
0.0%
0.1%

MOOE

1. Advocacy activities
2. Capability building for health workers
3. Provision of drugs, medicines for lifestyle &
degeneratives diseases
Subcomponent 8: On Rabies
MOOE
1. Training of Mun. Veterinarians & Agricultural
Technicians
2. Provision of vaccines for dogs
3. Provision of anti-rabies vaccines through animal bite
centers

180,000.00
80,000.00
400,000.00

80,000.00
400,000.00

80,000.00
400,000.00

80,000.00
400,000.00

80,000.00
400,000.00

180,000.00
400,000.00
2,000,000.00

475,000.00

275,000.00

275,000.00

275,000.00

195,000.00

1,495,000.00

200,000.00
120,000.00
80,000.00

120,000.00
80,000.00

120,000.00
80,000.00

120,000.00
80,000.00

120,000.00

600,000.00
320,000.00

0.4%
0.2%

0.4%
0.2%

75,000.00

75,000.00

75,000.00

75,000.00

75,000.00

375,000.00

0.3%

0.3%

1,158,333.33
50,000.00

1,270,833.33
50,000.00

1,158,333.33
50,000.00

125,000.00
50,000.00

0.00

3,712,500.00
200,000.00

766,666.67

112,500.00
766,666.67

766,666.67

112,500.00
2,300,000.00

2.5%
0.1%
0.1%
1.6%

2.5%
0.1%
1.6%
0.5%

266,666.67

266,666.67

266,666.67

800,000.00

0.5%

0.0%

75,000.00
1,000,000.00

75,000.00
4,640,000.00

75,000.00
3,640,000.00

300,000.00
10,560,000.00

0.2%
7.2%

0.2%
7.2%

7,000,000.00
160,000.00

0.0%
4.8%
0.1%

0.0%
4.8%
0.1%

0.1%
0.1%
2.0%

0.1%
0.1%
2.0%

14.6%
0.0%
0.0%

14.6%
0.0%
0.0%

4. Advocacy activities

Subcomponent 9 : On Leprosy and filaria


1. Advocacy meetings
2. Training / skills development of health workers
3. Provision of MDT drugs for leprosy
4. Medicines for Annual mass drug treatment for
filaria 2 y old and above
5. Regular active case finding activitiy
Subcomponent 10: Women's Health & Safe
Motherhood Program
1. Renovation of BHS and hospital for MCH
2.Training of health workers on emergency
obstetric case
3Operating expense on maternal death review
4. Advocacy activities
5. Provision of family planning commodities and
supplies
Subcomponent 11. Childhealthand Nutrition
MOOE
1. Regular stakeholders' meeting

75,000.00
640,000.00

640,000.00

4,000,000.00

3,000,000.00

40,000.00
200,000.00

40,000.00

40,000.00

40,000.00

40,000.00

200,000.00
200,000.00

600,000
4,820,000.00

600,000
4,410,000.00

600,000
4,160,000.00

600,000
3,960,000.00

600,000
3,960,000.00

3,000,000
21,310,000.00

160,000.00

96

2.Provision of EPI vaccines and supplies


3.Advocacy actvities/ counselling

4.Training of Barangay Nutrition Scholars (BNS)


(Nutrition)
5.Trainors' Training of BNS (Nutrition)
4. Operating expense for implementation of Newborn
Screening
Capital Outlay
1. Purchase of 66 weighingscales on identified BHS

Subcomponent 12:Environmental Health&


Sanitation
1. Operating expense on regular chlorination of
water
2. Provision of toilet bowls
Subcomponent 13: Oral Health Program

3,960,000.00

3,960,000.00

250,000
80,000
200,000.00

250,000
200,000.00

3,960,000.00

3,960,000.00

3,960,000.00

200,000.00

330,000.00

19,800,000.00
0.00
500,000.00

13.5%
0.0%
0.3%

0.0%
0.0%
0.0%

80,000.00
600,000.00

0.1%
0.4%

0.0%
0.4%

0.00

0.0%

0.0%

330,000.00

0.2%

0.2%

135,000.00

1,735,000.00

1,735,000.00

135,000.00

135,000.00

3,875,000.00

2.6%

2.6%

135,000.00

135,000.00

135,000.00

135,000.00

135,000.00

675,000.00

0.5%

0.5%

1,600,000.00

1,600,000.00

3,200,000.00

316,800.00

1,641,800.00

316,800.00

941,800.00

266,800.00

3,484,000.00

60,000.00

60,000.00
700,000.00

60,000.00

60,000.00

60,000.00

300,000.00
700,000.00
100,000.00
1,034,000.00

2.2%
2.4%
0.0%
0.2%
0.5%
0.1%
0.7%

2.2%
2.4%
0.0%
0.2%
0.5%
0.1%
0.7%

206,800.00

206,800.00
1,350,000.00

0.9%

0.9%

MOOE

1. Regular stakeholders' meeting


2. Production of IEC materials
3. Orientation / advocacy activitiies
4. Purchase of toothbrush / toothpaste for school
children
5. Purchase of dental supplies for preventive /
curative care
Subcomponent 14: Disaster Preparedness &
Management
1. Regular stakeholders' meeting
2. Capability building for Provincial Search and
Rescue Team
3. Purchase of PPEs and other supplies
4. Designate Surveillance Sentinel Officer

Grand Total
As a Percentage of Grand Total

50,000.00
206,800.00

50,000.00
206,800.00

206,800.00

675,000.00

675,000.00

347,500.00

60,000.00

260,000.00

60,000.00

260,000.00

987,500.00

0.7%

0.7%

60,000.00

60,000.00

60,000.00

60,000.00

60,000.00

300,000.00
87,500.00

0.2%
0.1%

0.2%
0.1%

200,000.00

600,000.00

0.4%

0.4%

11,361,961.33
7.8%

146,428,240.00
100.0%

87,500.00
200,000.00

39,645,411.33
0.27

200,000.00

65,884,411.33
45.0%

14,994,494.67
10.2%

14,541,961.33
9.9%

100.0%

97

Table 15.3. Health Investment Costs by Activity by Source of Financing, Province of Biliran
(Service Delivery Component)
Version No.
Date: December 14, 2005
Component/ Subcomponent/
Activity
SERVICE DELIVERY
Subcomponent 1. Increase bed capacity
of Biliran Provincial Hospital from 25 to
50 and upgrade capabilility to
secondary care hospital

Provincial
LGU Budget

Municipal
LGU Budget

DOH

EC Grant

LEAD

10,961,667.00

15,177,933.00

17,250,900.00

54,132,800.00

2,870,000.0
0

320,900.00

40,196,800.00

5,380,000.00

CULION
Foundation

PhilHealth
Cap/Claims

2,962,500.00

10,206,140.00

GTZ
1,387,500.0
0

JICA/Other
Donors
(ECCD)

Total

31,478,800.00

146,428,240.00

22,036,800.00

67,934,500.00

98

Capital Outlay
1. Const. & renovation of BPH

22,056,800.00
18,140,000.00

2. New equipment for BPH

22,036,800.00

MOOE
1. Maintenance of constructed &
renovated areas of BPH
2. Maintenance of new equipment

3,540,000.00
1,840,000.00

3. Training of hospital personnel


Subcomponent 2. Upgrading,
improvement of 8 RHU's to become
Sentrong Sigla Phase 2 Level 1
certification
MOOE

320,900.00
10,667.00

2,670,933.00

600,000.00

1. Upgrading of 8 RHU's for SS


certification
2. New equipment for 8 RHU's for SS
certification
3. Expansion of 8 RHU's to avail of
Maternity Care Benefits & TB-DOTS
Packages

1,970,000.00

5,836,000.00

970,000.00

0.00

4,532,000.00

2,436,000.00

2,436,000.00

2,800,000.00

600,000.00

b. Maternity Care Package

10,667.00

5,600,000.00

1,732,000.00

1,732,000.00

0.00
1,152,000.00
0.00
487,200.00
346,400.00
96,000.00
0.00

2. Maintenance of equipment
a. SS certification

2,800,000.00

600,000.00

1,152,000.00

1. Maintenance of RHU renovated areas

1,840,000.00
320,900.00
0.00
15,989,600.00

0.00
1,600,000.00

MOOE

3. Training of RHU personnel

0.00

1,000,000.00

4. Equipment package for 8 RHU's for


Maternity Care Package
5. New equipment for 7 RHU's and
hospital - based TB-DOTS

c. TB-DOTS Package

0.00

0.00
44,093,600.00
18,140,000.00
0.00
3,540,000.00

487,200.00
346,400.00
85,333.00

970,000.00

970,000.00

1,940,000.00

99

Subcomponent 3. Create additional


RHU in Naval

0.00

1,430,000.00

800,000.00

3,300,000.00

0.00

0.00

0.00

Personal Services
1. New plantilla position for MD, Medical
Technologist
Capital Outlay
1. Construction of new RHU
MOOE

800,000.00

2. Maintenance of newly constructed


RHU
3. Maintenance of new equipment
4. Incremental supplies

0.00
200,000.00
0.00

200,000.00

Subcomponent 4. Establish Barangay


Health Councils provincewide

1,650,000.0
0

1,650,000.00
0.00
1,300,000.00

MOOE

1,300,000.0
0
350,000.00

1. TA - Organization of BHC's
3. Capability building of BHC's
Subcomponent 5. On Tuberculosis
Prevention and Control

32,000.00

32,000.00

500,000.00

826,640.00

350,000.00
0.00
1,390,640.00

300,000.00

0.00
200,000.00
300,000.00

MOOE
1. Organize PPM - DOTS

200,000.00

2. Regular meetings of provincial TB diagnostic committee


3. Capability building of health workers on
basic health care & infectious diseases

300,000.00

4. Provision of BCG vaccines and


supplies; drugs for TB patients
5. TEV s for monitoring
6. TEVs for training

300,000.00
526,640.00

24,000
8000

32000

5,530,000.00

0.00
2,500,000.00
1,000,000.00
0.00
800,000.00
0.00

2,500,000.00
800,000.00

200,000.00

1. Training of personnel in new RHU

0.00

0.00
1,030,000.00

1,030,000.00

2. New equipment forNaval RHU 2

0.00

526,640.00
24,000.00
40,000.00
0.00

100

Subcomponent 6. On Pneumonia and


other childhood infectious diseases;
and other infectious / non -infectious
diseases on adult
Capital Outlay

500,000.00

600,000.00

4,529,500.00

0.00
600,000.00

500,000.00

2. Capability building / skills enhancement


of health workers on IMCI

500,000.00

3. Provision of drugs & medicinesand


supplies

4,529,500.00

Subcomponent 7. On Lifestyle and


Degenerative Diseases

90,000.00

90,000.00

1. Advocacy activities
2. Capability building for health workers

90,000.00

90,000.00

400,000.00

3. Provision of anti-rabies vaccines


through animal bite centers
4. Advocacy activities
Subcomponent 9 : On Leprosy and
filaria
1. Advocacy meetings

5. Regular active case finding activitiy

2,000,000.00

2,580,000.00

2,000,000.00

180,000.00
400,000.00
2,000,000.00

0.00

425,000.00

400,000.00
320,000.00

200,000.00

600,000.00
320,000.00

150,000.00

225,000.00

0.00

0.00

375,000.00
0.00
3,712,500.00

800,000.00

0.00

0.00

0.00

0.00

0.00

2,912,500.00
200,000.00
112,500.00

0.00

0.00

0.00

0.00

0.00

0.00
1,495,000.00
200,000.00

1,070,000.00
200,000.00

2. Training / skills development of health


workers
3. Provision of MDT drugs for leprosy
4. Medicines for Annual mass drug
treatment for filaria 2 y old and above

300,000.00

400,000.00

3. Provision of drugs, medicines for


lifestyle & degeneratives diseases

2. Provision of vaccines for dogs

4,529,500.00
300,000.00

4. TA on development of CPGs in RHUs


and BPH

1. Training of Mun. Veterinarians &


Agricultural Technicians

5,929,500.00

600,000.00

1. Multimedia set for IMCI and other public


health programs
MOOE

Subcomponent 8: On Rabies

300,000.00

0.00

200,000.00
112,500.00

2,300,000.00
800,000.00
300,000.00

300,000.00

101

Subcomponent 10: Women's Health &


Safe Motherhood Program

450,000.00

1,050,000.00

260,000.00

3,000,000.00

250,000.00

50,000.00

1,500,000.00

0.00

4,000,000.00

10,560,000.00

4,000,000.00

7,000,000.00

Capital Outlay
1. Renovation of BHS and hospital for
MCH

3,000,000.00

MOOE
2.Training of health workers on emergency
obstetric case
3Operating expense on maternal death
review
4. Advocacy activities
5. Provision of family planning
commodities and supplies

Subcomponent 11. Childhealthand


Nutrition
MOOE

160,000.00

160,000.00

100,000.00

50,000.00

50,000.00

200,000.00

200,000.00
450,000.00

1,050,000.00

2,580,000.00

7,920,000.00

200,000.00
3,000,000.00

1,500,000.00

9,900,000.00

0.00

0.00

0.00

0.00

0.00

910,000.00

21,310,000.00
0.00

1. Regular stakeholders' meeting


2.Provision of EPI vaccines and supplies

1,980,000.00

7,920,000.00

9,900,000.00

19,800,000.00
0.00

3.Advocacy actvities/ counselling


4. Operating expense for implementation
of Newborn Screening

600,000.00

600,000.00

6.Training of Barangay Nutrition


Scholars (BNS) (Nutrition)
5.Trainors' Training of BNS
(Nutrition)

500,000.00

500,000.00

80,000.00

80,000.00

330,000.00

0.00
330,000.00

0.00

3,875,000.00

Capital Outlay
1. Purchase of 66 weighingscales on
identified BHS

Subcomponent
12:Environmental Health&
Sanitation
1. Operating expense on regular
chlorination of water
2. Provision of toilet bowls
Subcomponent 13: Oral Health

75,000.00

1,400,000.00

75,000.00

600,000.00

1,034,000.00

800,000.00
100,000.00

1,200,000.00

1,200,000.00

0.00

0.00

0.00

0.00

675,000.00

1,200,000.00
0.00

1,200,000.00
0.00

0.00

0.00

1,350,000.00

1,000,000.0

0.00

3,200,000.00
3,484,000.00

102

Program

MOOE

1. Regular stakeholders' meeting


2. Production of IEC materials
3. Orientation / advocacy
activitiies
4. Purchase of toothbrush /
toothpaste for school children
5. Purchase of dental supplies for
preventive / curative care
Subcomponent 14: Disaster
Preparedness & Management

0.00
300,000.00
700,000.00
100,000.00

300,000.00
700,000.00
100,000.00

1,034,000.00
1,034,000.00
1,350,000.00
1,350,000.00
987,500.00
240,000.00

60,000.00

600,000.00

87,500.00

MOOE

1. Regular stakeholders' meeting


2. Capability building for
Provincial Search and Rescue
Team
3. Purchase of PPEs and other
supplies
4. Designate Surveillance
Sentinel Officer

Grand Total
As a Percentage of Grand Total

240,000.00

0.00
300,000.00
87,500.00

60,000.00

87,500.00
600,000.00
600,000.00

10,961,667.00

15,177,933.00

17,250,900.00

54,132,800.00

7.5%

10.4%

11.8%

37.0%

2,870,000.0
0
2.0%

2,962,500.00

10,206,140.00

2.0%

7.0%

1,387,500.0
0
0.9%

31,478,800.00

146,428,240.00

21.5%

100.0%

103

Table 15.4. Health Investment Costs by Type of Expenditure by Year, Biliran


Province (Service Delivery Component)
Version No.
Date: December 14, 2005

Type of Expenditure
MOOE - Training/Workshops
Training of BPH personnel
Training of RHU personnel on SS, Maternity
Care & TB-DOTS packages
Training of personnel in new Naval RHU
Capability building of BHC's

2006

2007

2008

2009

2010

Total

As a % of
Type of
Expenditure

As a %
of
Grand
Total

2,600,450.00
160,450.00
970,000.00

1,922,950.00
160,450.00
970,000.00

180,000.00
0.00
0.00

480,000.00
0.00
0.00

480,000.00
0.00
0.00

5,750,900.00
320,900.00
1,940,000.00

100.0%
5.6%
33.7%

3.9%
0.2%
1.3%

0.00
350,000.00

0.00
0.00

0.00
0.00

400,000.00
0.00

400,000.00
0.00

800,000.00
350,000.00

13.9%
6.1%

0.5%
0.2%

104

Capability building of health workers on basic


health care & infectious diseases

100,000.00

100,000.00

100,000.00

0.00

0.00

300,000.00

5.2%

0.2%

Capability building of health workers on IMCI


Capability building of health workers on lifestyle
& degenerative diseases

250,000.00
80,000.00

250,000.00
80,000.00

0.00
80,000.00

0.00
80,000.00

0.00
80,000.00

500,000.00
400,000.00

8.7%
7.0%

0.3%
0.3%

Training of municipal veterinarians & agricultural


technicians
Capability building for health workers on filaria /
leprosy
Capability building for health workers on
emergency obstetrics
Training of BNS
Trainors' Training of BNS
Capability building for Provincial Search /Rescue
Team

200,000.00

0.00

0.00

0.00

0.00

200,000.00

3.5%

0.1%

112,500.00

2.0%

0.1%

112,500.00
160,000.00

0.00

0.00

0.00

0.00

160,000.00

2.8%

0.1%

250,000.00
80,000.00
87,500.00

250,000.00
0.00
0.00

0.00
0.00
0.00

0.00
0.00
0.00

0.00
0.00
0.00

500,000.00
80,000.00
87,500.00

8.7%
1.4%
1.5%

0.3%
0.1%
0.1%

1,600,000.00
1,300,000.00

0.00
0.00

0.00
0.00

0.00
0.00

0.00
0.00

1,600,000.00
1,300,000.00

100.0%
81.3%

1.1%
0.9%

TA -on development of CPGs in RHU and BPH

300,000.00

0.00

0.00

0.00

0.00

300,000.00

MOOE - Meetings, Orientation, Advocacy, etc.


Organize PPM -DOTS
Regular meetings of provincial TB - diagnostic
committee
Advocacy activities on lifestyle and degenerative
diseases
Advocacy activities on rabies
Advocacy activities on leprosy / filaria
Advocacy activities on women's health and safe
motherhood
Regular stakeholders' meeting on childhealth
and nutrition
Advocacy activities and counselling on
childhealth and on nutrition

935,000.00
200,000.00
60,000.00

305,000.00

405,000.00

305,000.00

255,000.00

60,000.00

60,000.00

60,000.00

60,000.00

2,155,000.00
200,000.00
300,000.00

18.8%
0.0%
100.0%
9.3%
13.9%

0.2%
0.0%
1.5%
0.1%
0.2%

180,000.00

0.00

0.00

0.00

0.00

180,000.00

8.4%

0.1%

75,000.00
50,000.00
200,000.00

75,000.00
50,000.00

75,000.00
50,000.00

75,000.00
50,000.00

75,000.00
0.00

375,000.00
200,000.00
200,000.00

17.4%
9.3%
9.3%

0.3%
0.1%
0.1%

0.00

0.00

50,000.00

0.00

0.00

0.00

0.0%

0.0%

0.0%

0.0%

MOOE - Technical Assistance/Consultancy


TA - Organization of BHC's

Regular stakeholders' meeting on oral


health program

60,000.00

60,000.00

60,000.00

60,000.00

60,000.00

300,000.00

13.9%

105

Orientation / advocacy activitiies on oral


health program

50,000.00

Regular stakeholders' meeting on disaster


preparedness and management

60,000.00

60,000.00

60,000.00

60,000.00

1,756,000.00

576,000.00

1,180,000.00

1,180,000.00

0.00

1,180,000.00

576,000.00

576,000.00

0.00

0.00

MOOE - Buildings and Structures


Maintenance
Maintenance of constructed & renovated areas
of BPH
Maintenance of RHU renovated areas
Maintenance of newly constructed Naval RHU

MOOE - Equipment Maintenance


Maintenance of new equipment for BPH
Maintenance of equipment for SS certification
Maintenance of equipment for Maternity Care
Package
Maintenance of equipment for TB-DOTS
Package
Maintenance of new equipment in new Naval
RHU
MOOE - Supplies
Incremental supplies for new Naval RHU
Provision of drugs, medicines for Category I, II, &
III TB patients
Provision of drugs, medicines for pneumonia
patients
Provision of drugs, medicines for lifestyle &
denegerative diseases
Provision of vaccines for dogs
Provision of anti-rabies vaccines through animal
bite centers
Provision of MDT for leprosy
Provision of drugs, medicines for Filariasis
Provision of drugs, other supplies for
immunization

50,000.00

613,333.33
613,333.33

100,000.00

4.6%

60,000.00

300,000.00

13.9%

1,180,000.00

1,180,000.00

4,692,000.00

100.0%

3.2%

1,180,000.00

1,180,000.00

3,540,000.00

75.4%

2.4%

1,152,000.00

24.6%

0.8%

100.0%
66.4%
17.6%
12.5%

1.9%
1.3%
0.3%
0.2%

3.5%

0.1%

1,078,133.33
613,333.33
243,600.00
173,200.00

1,078,133.33
613,333.33
243,600.00
173,200.00

2,769,600.00
1,840,000.00
487,200.00
346,400.00

48,000.00

48,000.00

96,000.00

100.0%

25.8%

0.5%
1.4%

0.1%
0.4%

7,411,361.33

7,411,361.33

7,411,361.33

6,478,028.00

6,398,028.00

0.00
105,328.00

0.00
105,328.00

0.00
105,328.00

100,000.00
105,328.00

100,000.00
105,328.00

37,760,140.0
0
200,000.00
526,640.00

905,900.00

905,900.00

905,900.00

905,900.00

905,900.00

4,529,500.00

12.0%

3.1%

400,000.00

400,000.00

400,000.00

400,000.00

400,000.00

2,000,000.00

5.3%

1.4%

120,000.00
80,000.00

120,000.00
80,000.00

120,000.00
80,000.00

120,000.00
80,000.00

120,000.00
0.00

600,000.00
320,000.00

1.6%
0.8%

0.4%
0.2%

766,666.67
266,666.67
3,960,000.00

766,666.67
266,666.67
3,960,000.00

766,666.67
266,666.67
3,960,000.00

0.00
0.00
3,960,000.00

0.00
0.00
3,960,000.00

2,300,000.00
800,000.00
19,800,000.0
0

6.1%
2.1%
52.4%

1.6%
0.5%
13.5%

106

Provision of FP commodities & other supplies


Provision of toothbrushes, toothpaste to pre and
schoolchildren
Production of IEC materials
Purchase of dental supplies for preventive /
curative care
Purchase of PPEs and other supplies
OOE - Other Expenses
Active case finding on leprosy
TEV for monitoring
TEV for training
Operating expense for newborn screening
Operating expense for maternal death review
Operating expense forregular chlorination of
water
Capital Outlay - Buildings and Structures

200,000.00
119,800.00
75,000.00
4,800.00
40,000.00
200,000.00
40,000.00
135,000.00

Construction & renovation of BPH


Upgrading of 8 RHU's for SS certification
Expansion of 8 RHU's for Maternity Care & TBDOTS
Construction of new RHU in Naval
Renovation of BHS and hospital for MCH
Capital Outlay - Machineries and Equipment
Equipment for BPH
Equipment for 8 RHU's for SS certification
New equipment for 8 RHU's for Maternity Care
Package
New equipment for 8 RHU's for TB-DOTS
Package
New equipment for new Naval RHU
Multimedia set for IMCI
Provision of weighing scales
Provision of plastic bowls
PS - Salaries, Other Benefits
New plantilla position for MD, Medical

600,000.00
206,800.00

600,000.00
206,800.00

600,000.00
206,800.00

600,000.00
206,800.00

600,000.00
206,800.00

3,000,000.00
1,034,000.00

7.9%
2.7%

2.0%
0.7%

700,000.00
675,000.00

0.00
0.00

0.00
675,000.00

0.00
0.00

700,000.00
1,350,000.00

1.9%
3.6%

0.5%
0.9%

0.00
79,800.00
75,000.00
4,800.00

200,000.00
79,800.00
75,000.00
4,800.00

0.00
79,800.00
75,000.00
4,800.00

200,000.00
4,800.00
0.00
4,800.00

200,000.00
40,000.00
135,000.00

200,000.00
40,000.00
135,000.00

0.00
40,000.00
135,000.00

0.00
40,000.00
135,000.00

600,000.00
1,839,000.00
300,000.00
24,000.00
40,000.00
600,000.00
200,000.00
675,000.00

1.6%
100.0%
16.3%
1.3%
2.2%
32.6%
10.9%
36.7%

0.4%
1.3%
0.2%
0.0%
0.0%
0.0%
0.0%
0.0%

24,736,800.00

30,556,800.00

3,000,000.00

2,500,000.00

0.00

100.0%

41.5%

22,036,800.00

22,056,800.00

0.00

0.00

0.00

72.5%

30.1%

600,000.00
2,100,000.00

1,000,000.00
3,500,000.00

0.00
0.00

0.00
0.00

0.00
0.00

60,793,600.0
0
44,093,600.0
0
1,600,000.00
5,600,000.00

2.6%
9.2%

1.1%
3.8%

0.00
2,179,500.00

0.00
4,000,000.00
21,658,500.00

0.00
3,000,000.00
0.00

2,500,000.00
0.00
500,000.00

0.00
0.00
500,000.00

4.1%
11.5%
100.0%

1.7%
4.8%
19.1%

0.00

18,140,000.00

0.00

0.00

0.00

64.7%

12.4%

0.00
649,500.00

2,436,000.00
1,082,500.00

0.00
0.00

0.00
0.00

0.00
0.00

2,500,000.00
7,000,000.00
28,038,000.0
0
18,140,000.0
0
2,436,000.00
1,732,000.00

8.7%
6.2%

1.7%
1.2%

600,000.00

0.00

0.00

0.00

0.00

600,000.00

2.1%

0.4%

0.00
600,000.00
330,000.00

0.00

0.00

500,000.00

500,000.00

0.00
1,600,000.00
0.00
0.00

0.00
1,600,000.00
0.00
0.00

0.00
0.00
515,000.00
515,000.00

0.00
0.00
515,000.00
515,000.00

1,000,000.00
600,000.00
330,000.00
3,200,000.00
1,030,000.00
1,030,000.00

3.6%
2.1%
1.2%
11.4%
100.0%
100.0%

0.7%
0.4%
0.0%
0.0%
0.7%
0.7%

0.00
0.00

107

Technologist
Grand Total
As a Percentage of Grand Total

41,338,911.33

62,510,411.33

12,869,494.67

13,115,961.33

10,410,961.33

28.2%

42.7%

8.8%

9.0%

7.1%

146,428,240.
00
100.0%

100.0%

100.0%

108

Table 15.5. Health Investment Costs by Type of Expenditure by Source of Financing, Biliran
Province (Service Delivery Component)
Version No.
Date: December 14, 2005

Type of Expenditure

MOOE - Training/Workshops

Provincial
LGU Budget

Municipal
LGU Budget

200,000.00

800,000.00

DOH

EC Grant

2,650,900.00

Training of BPH personnel

320,900.00

Training of RHU personnel on SS, Maternity Care &


TB-DOTS packages

970,000.00

Training of personnel in new Naval RHU

0.00

LEAD

1,320,000.00

CULION
Foundation

PhilHealth
Cap/Claims

112,500.00

0.00

GTZ

87,500.00

JICA/Oth
er
Donors
(ECCD)
580,000.00

Total

5,750,900.00
320,900.00

970,000.00

1,940,000.00

800,000.00

800,000.00

Capability building of BHC's

350,000.00

350,000.00

Capability building of health workers on basic health


care & infectious diseases

300,000.00

300,000.00

Capability building of health workers on IMCI

500,000.00

500,000.00

Capability building of health workers on lifestyle &


degenerative diseases

400,000.00

400,000.00

0.00

200,000.00

Training of municipal veterinarians & agricultural


technicians
Capability building for health workers on filaria /
leprosy

200,000.00

112,500.00

112,500.00

160,000.00

160,000.00

Capability building for health workers on emergency


obstetrics
Training of BNS

500,000.00

500,000.00

80,000.00

80,000.00

Trainors' Training of BNS


87,500.00

87,500.00

Capability building for Provincial Search /Rescue


Team
MOOE - Technical Assistance/Consultancy
TA - Organization of BHC's
TA -on development of CPGs in RHU and BPH

1,300,000.00
0.00

0.00

0.00

0.00

1,300,000.00

300,000.00
0.00

0.00

0.00
300,000.00

0.00
0.00

1,600,000.00
1,300,000.00
300,000.00

109

MOOE - Meetings, Orientation, Advocacy, etc.


Organize PPM -DOTS
Regular meetings of provincial TB - diagnostic
committee
Advocacy activities on lifestyle and degenerative
diseases
Advocacy activities on rabies

480,000.00

475,000.00

200,000.00

0.00

200,000.00

300,000.00

300,000.00

0.00

90,000.00

90,000.00

150,000.00

225,000.00

300,000.00
180,000.00
375,000.00

200,000.00

Advocacy activities on women's health and safe


motherhood
Regular stakeholders' meeting on childhealth and
nutrition
Advocacy activities and counselling on childhealth
and on nutrition
Advocacy activities on oral healthprogram

200,000.00

200,000.00

200,000.00

100,000.00

100,000.00
300,000.00

240,000.00

60,000.00

MOOE - Buildings and Structures Maintenance

3,540,000.00

1,152,000.00

Maintenance of constructed & renovated areas of


BPH
Maintenance of RHU renovated areas

3,540,000.00

2,155,000.00
200,000.00

300,000.00

Advocacy activities on leprosy / filaria

Regular stakeholders' meeting on oral health


program
Regular stakeholders' meeting on disaster
preparedness and management

200,000.00

200,000.00

300,000.00
300,000.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

4,692,000.00
3,540,000.00

1,152,000.00

1,152,000.00

Maintenance of newly constructed Naval RHU

0.00

MOOE - Equipment Maintenance

1,850,667.00

Maintenance of new equipment for BPH

1,840,000.00

918,933.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

2,769,600.00
1,840,000.00

Maintenance of equipment for SS certification

487,200.00

487,200.00

Maintenance of equipment for Maternity Care


Package
Maintenance of equipment for TB-DOTS Package

346,400.00

346,400.00

10,667.00

85,333.00

96,000.00

4,184,000.00

9,370,000.00
200,000.00

Maintenance of new equipment in new Naval RHU


MOOE - Supplies
Incremental supplies for new Naval RHU
Provision of drugs, medicines for Category I, II, & III
TB patients
Provision of drugs, medicines for pneumonia
patients
Provision of drugs, medicines for lifestyle &
denegerative diseases

11,300,000.00

0.00

0.00

2,300,000.00

9,906,140.00

700,000.00

0.00

37,760,140.00
200,000.00

526,640.00

526,640.00

4,529,500.00

4,529,500.00

2,000,000.00

2,000,000.00

110

Provision of vaccines for dogs

400,000.00

Provision of anti-rabies vaccines through animal bite


centers
Provision of MDT for leprosy

320,000.00

200,000.00

320,000.00
2,300,000.00

Provision of drugs, medicines for Filariasis


Provision of drugs, other supplies for immunization
Provision of FP commodities & other supplies
Provision of toothbrushes, toothpaste to pre and
schoolchildren
Production of IEC materials

1,980,000.00

7,920,000.00

450,000.00

1,050,000.00

800,000.00

800,000.00

9,900,000.00

19,800,000.00
1,500,000.00

TEV for training


Operating expense for newborn screening

700,000.00

Capital Outlay - Buildings and Structures

632,000.00

100,000.00

600,000.00
0.00

50,000.00

0.00

0.00

8,000.00

1,839,000.00
300,000.00
24,000.00

32,000.00

40,000.00

600,000.00

600,000.00
100,000.00

75,000.00

600,000.00

0.00

600,000.00

50,000.00
30,356,800.00
22,056,800.00

600,000.00

50,000.00

200,000.00
675,000.00

1,000,000.00

28,836,800
.00
22,036,800
.00

1,000,000.00

3,000,000.00

2,800,000.
00

2,500,000.00

1,000,000.00

1,200,000.00

Equipment for BPH


Equipment for 8 RHU's for SS certification

24,376,000.00

600,000.00

200,000.00

28,038,000.00

1,732,000.00

600,000.00

600,000.00

800,000.00

1,000,000.00

Provision of weighing scales

600,000.00
330,000.00

1,200,000.00

7,000,000.00

2,436,000.00
1,732,000.
00

600,000.00
800,000.00

5,600,000.00

18,140,000.00

2,436,000.00

Multimedia set for IMCI

44,093,600.00

2,500,000.00
4,000,000.
00
2,062,000.
00

18,140,000.00

New equipment for 8 RHU's for Maternity Care


Package
New equipment for 8 RHU's for TB-DOTS Package

60,793,600.00

1,600,000.00

Renovation of BHS and hospital for MCH

Provision of plastic bowls

0.00

300,000.00

2,800,000.00

New equipment for new Naval RHU

350,000.00

24,000.00

Expansion of 8 RHU's for Maternity Care & TBDOTS


Construction of new RHU in Naval

Capital Outlay - Machineries and Equipment

1,350,000.00

600,000.00
707,000.00

Construction & renovation of BPH


Upgrading of 8 RHU's for SS certification

700,000.00

1,350,000.00

Operating expense for maternal death review


Operating expense forregular chlorination of water

3,000,000.00
1,034,000.00

Active case finding on leprosy


TEV for monitoring

2,300,000.00

1,034,000.00

Purchase of dental supplies for preventive / curative


care
Purchase of PPEs and other supplies
OOE - Other Expenses

600,000.00

1,200,000.00

330,000.00
3,200,000.00

111

PS - Salaries, Other Benefits

0.00

1,030,000.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

1,030,000.00

New plantilla position for MD, Medical Technologist

0.00

1,030,000.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

1,030,000.00

10,961,667.00

15,977,933.00

16,450,900.00

54,732,800.00

2,870,000.00

2,962,500.00

10,206,140.00

1,387,500.

31,478,800

146,428,240.

7.5%

10.9%

11.2%

37.4%

2.0%

2.0%

7.0%

0.9%

21.5%

100.0%

Grand Total
As a percentage of grand total

112

Critical Investments, Regulatory Component


Table 16.1. Assumptions on the Cost Items in the Health Investment Plan : REGULATORY
Version No.
Date: December 14, 2005
Changes form the Previous Version
Cost Item

Description

Type of
Expenditur
e

Unit Price/ Total


Cost

Timing and
Duration

Source of
Financing

Other Remarks

REGULATORY
Subcomponent 1: Ensure availability of low-cost quality drugs
A. Establishment of BNBs
MOOE
1. Seed capital for BNBs

2. Training of BNB operators

At least 1 BNB in every


barangay; 110 BNBs in 5
years.

25,000 seed capital per


BNB = 2,750,000

2006 - 2010

DOH/PCSO

5 days training for BNB


operators in Biliran

Training Cost: 2500/pax


110 operators x 2 per BNBs
=550,000

2006 -2010

PLGU/MLGU

700,000/year for 5 years =


3,500,000

2006- 2010

PLGU/MLGU

TA cost = 600,000
3,500,000

2006
2006 -2010

GTZ
PLGU/MLGU

300,000

2006 -2010

LEAD for organization


/DOH for consultative
mtgs.
Source of
Financing

B. Establish a functional Drug


Management System
B.1. Earmark specific budget
allocation for drugs and medicines
MOOE
1. TA on pooled/bulk procurement
2. Purchase of drugs and
medicines

Consultancy
Drugs/Meds

B.2. Functional Therapeutic


Committee
MOOE
1. Organizational/consultative
meetings of Therapeutic
Committee
Cost Item

Description

Type of
Expenditur
e

Unit Price/ Total


Cost

Timing and
Duration

Other Remarks

113

REGULATORY
2. Training on drug supply and
management

5 days training for


Pharmacist; Budget Officer;
AO ; COH and MHOs in
Tacloban

5,000 per pax for 25 pax =


125,000

2006

GTZ

3. TA for Therapeutic Committee


to include training on rational drug
use

TA and 5 days training for


Therapeutic Com and TMC in
Biliran

Training Cost: 2500/pax 25


pax= 87,500 TA
Consultancy: 200,000

2006

DOH / EC

MOOE
1. TEVs for training of BNB
operators

TEV allowance

800/dayx2x110= 176,000

2006

PLGU/MLGU

TEV allowance

800/dayx2x25= 80,000

2006-2010

PLGU/MLGU

200,000.00

1st quarter of 2006

LEAD

125,000.00

2007

DOH

2. TEVs for Therapeutic


Committee

Subcomponent 2. Develop Mechanisms for Enactment / Implementation of National and Local Laws
MOOE
1. TA for health workers Consultancy
incentives/disincentives
mechanism for TBAs, mandatory
dog vaccination, smoking - free
province
2. TA on establishing provincial
Training workshop
regulatory framework
3. Stakeholders' meetings for
adoption of laws and ordinances

Stakeholders' meeting

15,000 / mtgs 4Q/yr =


300,000

2006 - 2010

PLGU/MLGU/ Capitation
Fund

4. Writeshop on the formulation of


ordinances and resolutions

3 days writeshop at Biliran

3,500.pax x 15 pax x
3days= 157,500

4th quarter 2006

EC

5. TEVs for writeshop

TEV allowance

800X2X15 pax= 24,000

4th quarter 2006

PLGU/MLGU

Table 16.2. Health Investment Costs by Activity

114

by Year, Biliran Province (Regulatory


Component)
Version No.
Date: December 14, 2005
Component/ Subcomponent/
Activity
REGULATORY
Subcomponent 1: Ensure
availability of low-cost quality
drugs
A. Establishment of BNBs

2006

2007

2008

2009

2010

3,170
,000
2,728
,500

1,595
,000
1,410
,000

1,470
,000
1,410
,000

1,470
,000
1,410
,000

1,470
,000
1,410
,000

9,17

As a % of
Componen
t Total
100.0%

As a % of
Grand
Total
100.0%

8,36

91.2%

91.2%

0.0%

0.0%

Total

5,000
8,500

MOOE
1. Seed capital for BNBs
2. Training of BNB operators

550,000
110,
000

550,
000
110,
000

550,
000
110,
000

550,
000
110,
000

550,
000
110,
000

000

0.0%

0.0%

30.0%

30.0%

6.0%

6.0%

0.0%

0.0%

0.0%

0.0%

0.0%

0.0%

6.5%

6.5%

38.1%

38.1%

0.0%

0.0%

0.0%

0.0%

300,

3.3%

3.3%

125,

1.4%

1.4%

287,

3.1%

3.1%

0.0%

0.0%

1.9%

1.9%

As a % of
Componen
t Total
0.9%

As a % of
Grand
Total
0.9%

2,750,
550,

000

B. Establish a functional Drug


Management System
B.1. Earmark specific budget
allocation for drugs and medicines
MOOE
1. TA on pooled/bulk procurement
2. Purchase of drugs and medicines

600,
000
700,
000

600,
000
700,
000

700,
000

700,
000

700,
000

3,500,
000

B.2. Functional Therapeutic


Committee
MOOE
1. Organizational/consultative
meetings of Therapeutic Committee

100,
000

2. Training on drug supply and


management
3. TA for Therapeutic Committee to
include training on rational drug use

125,
000
287,
500

50,
000

50,
000

50,
000

50,
000

000
000
500

OOE
1. TEVs for training of BNB
operators
Component/ Subcomponent/
Activity
2. TEVs for Therapeutic

176,
000
2006

176,
000
2007

80,

2008

2009

2010

Total
80,

115

Committee

000

000

Subcomponent 2. Develop
Mechanisms for Enactment /
Implementation of National and
Local Laws
MOOE

441
,500

1. TA for health workers incentives/disincentives mechanism


for TBAs, mandatory dog vaccination,
smoking - free province

200,
000

60

,000

60

,000

60

,000

6,500

80

8.8%

8.8%

0.0%

0.0%

200,

2.2%

2.2%

125,

1.4%

1.4%

300,

3.3%

3.3%

157,

1.7%

1.7%

24,

0.3%

0.3%

2. TA on establishing provincial
regulatory framework
3. Stakeholders' meetings for
adoption of laws and ordinances

000

4. Writeshop on the formulation of


ordinances and resolutions

157,
500

5. TEVs for writeshop

185
,000

000

60,

000

125,
000
60,
000

000
000

60,

000

60,

000

60,

000
500

24,

000

Grand Total

3,170,
000

1,595,
000

1,470,
000

1,470,
000

1,470,
000

As a Percentage of Grand Total

34.6%

17.4%

16.0%

16.0%

16.0%

9,175,
000

100.0%

100.0%

Table 16.3. Health Investment Costs by Activity by Source of Financing, Biliran

116

Province (Regulatory Component)


Version No.
Date: December 14, 2005
Component/
Subcomponent/ Activity
REGULATORY
Subcomponent 1: Ensure
availability of low-cost
quality drugs
A. Establishment of BNBs

Provincial
LGU Budget

Municipal
LGU Budget

2,165,00
0
2,153,00
0

2,165,00
0
2,153,00
0

DOH
Budget
1,787,5
00
1,662,5
00

EC Grant
357,500
200,000

LEAD
300,
000
100,
000

GTZ
725,
000
725,
000

CULION
Fndtn
-

PhilHealth
Capitation
/Claims
300,
000

PCSO
1,375,
000
1,375,
000

Total
9,175
,000
8,368
,500

As a % of
Component
Total

As a % of
Grand
Total

100.0%

100.0%

91.2%

91.2%

0.0%

0.0%

0.0%

0.0%

30.0%

30.0%

6.0%

6.0%

0.0%

0.0%

0.0%

0.0%

0.0%

0.0%

6.5%

6.5%

38.1%

38.1%

0.0%

0.0%

0.0%

0.0%

As a % of
Component
Total

As a % of
Grand
Total

MOOE
1. Seed capital for BNBs
2. Training of BNB operators

1,375,0
00
275,00
0

1,375,
000

275,00
0

B. Establish a functional
Drug Management System
B.1. Earmark specific budget
allocation for drugs and
medicines
MOOE

2,750
,000
550
,000
-

1. TA on pooled/bulk
procurement
2. Purchase of drugs and
medicines
B.2. Functional Therapeutic
Committee
OOE

600,
000
1,750,00
0

600
,000
3,500
,000

1,750,00
0

Component/
Subcomponent/ Activity

Provincial
LGU Budget

Municipal
LGU Budget

DOH
Budget

EC Grant

LEAD

GTZ

CULION
Fndtn

PhilHealth
Capitation
/Claims

PCSO

Total

117

1. Organizational/
consultative meetings of
Therapeutic Committee
2. Training on drug supply
and management

200,
000

100,
000
125,
000

3. TA for Therapeutic
Committee to include
training on rational drug use
OOE

87,

200,000

500

300
,000

3.3%

3.3%

125
,000

1.4%

1.4%

287
,500

3.1%

3.1%

0.0%

0.0%

1.9%

1.9%

0.9%

0.9%

0.0%

0.0%

8.8%

8.8%

0.0%

0.0%

200
,000

2.2%

2.2%

125
,000

1.4%

1.4%

As a % of
Component
Total

As a % of
Grand
Total

300
,000

3.3%

3.3%

157
,500

1.7%

1.7%

1. TEVs for training of


BNB operators
2. TEVs for Therapeutic
Committee

88,00
0

88,00

176
,000
8
0,000

0
40,00

40,00
0

Subcomponent 2. Develop
Mechanisms for
Enactment /
Implementation of National
and Local Laws
MOOE

12,00
0

12,00
0

125,
000

157,500

200,
000

300,
000

806
,500

1. TA for health workers incentives/disincentives


mechanism for TBAs,
mandatory dog vaccination,
smoking - free province
2. TA on establishing
provincial regulatory
framework
Component/
Subcomponent/ Activity
3. Stakeholders' meetings
for adoption of laws and
ordinances
4. Writeshop on the
formulation of ordinances

200,
000

125,
000
Provincial
LGU Budget

Municipal
LGU Budget

DOH
Budget

EC Grant

157,500

LEAD

GTZ

CULION
Fndtn

PhilHealth
Capitation
/Claims
300,
000

PCSO

Total

118

and resolutions
5. TEVs for writeshop

12,00
0

Grand Total
As a Percentage of Grand
Total

2,165,00
0
23.6%

12,00

0
2,165,00
0
23.6%

0.3%

0.3%

4,000
1,787,5
00
19.5%

357,500
3.9%

300,
000
3.3%

725,
000
7.9%

0.0%

300,
000
3.3%

1,375,
000
15.0%

9,175
,000
100.0%

100.0%

119

Table 4. Health Investment Costs by Type of Expenditure by Year,


Biliran Province (Regulatory Component)
Version No.
Date: December 14, 2005
Type of Expenditure
MOOE - Training/Meetings

2006

TA on bulk/pooled procurement

640
,000
110,
000
125,
000
87,
500
100,
000
60,
000
157,
500
1,000
,000
600,000

TA for Therapeutic Committee

200,000

Training of BNB operators


Training on drug supply and management
Training on rational drug use
Organization /Consultative Meetings of TC
Stakeholders' meeting for adoption of laws
Writeshop on the formulation of
laws/ordinances
MOOE - Technical Assistance

TA on incentives/disincentives scheme for


TBAs, mandatory dog vaccination, smoking
- free province
TA on establishing provincial regulatory
framework
MOOE Supplies/Drugs/Medicines/Seed
Capital
Purchase of drugs and medicines
Seed capital for establishment of BNBs

2007

2008

2009

2010

220
,000
110,
000

220
,000
110,
000

220
,000
110,
000

220
,000
110,
000

50,
000

50,
000

60,
000
125
,000

50,
000

60,
000

50,
000

60,
000

60,
000

700,000
550,000

As a % of
Grand
Total

36.2%

6.0%

8.2%

1.4%

5.8%

1.0%

19.7%

3.3%

19.7%

3.3%

10.4%

1.7%

100.0%

12.3%

53.3%

6.5%

17.8%

2.2%

200,

17.8%

2.2%

11.1%

1.4%

100.0%

68.1%

56.0%

38.1%

44.0%

30.0%

Total
1,520
,000
550,
000
125,
000
87,
500
300,
000
300,
000
157,
500
1,125
,000
600,000
200,000

200,
000

1,250
,000

As a % of
Type of
Expenditu
re
100.0%

16.6%

000
125,
000
1,250
,000

1,250
,000

1,250
,000

1,250
,000

125,
000
6,250
,000

700,
000
550,000

700,
000
550,000

700,
000
550,000

700,
000
550,000

3,500,
000
2,750,000

120

Type of Expenditure
OOE - Other Expenses
TEVs for BNB operators
TEVs for Therapeutic Committee
TEVs for writeshop

Grand Total
As a Percentage of Grand Total

2006
280
,000
176,
000
80,
000
24,
000
3,170
,000
34.6%

2007

1,595
,000
17.4%

2008

1,470
,000
16.0%

2009

1,470
,000
16.0%

2010

1,470
,000
16.0%

Total
28
0,000
176,
000
80,
000
24,
000
9,175
,000
100.0%

As a % of
Type of
Expenditu
re
100.0%

As a % of
Grand
Total

62.9%

1.9%

28.6%

0.9%

8.6%

0.3%

3.1%

100.0%

121

Table 16.5. Health Investment Costs by Type of Expenditure by Source of


Financing, Biliran Province (Regulatory Component)
Version No.
Date: December 14, 2005
Type of Expenditure

Provincial
LGU Budget

Municipal
LGU Budget

275,

275,0
00
275,0
00

MOOE - Training/Meetings
000
Training of BNB operators

275,
000

Training on drug supply and


management
Training on rational drug use

DOH
Budget
28
7,500

EC Grant
157,5
00

GTZ

10
0,000

125,0
00

8
7,500
20
0,000

As a % of
Grand Total

1,520,00
0
550,00
0
125,00
0
87,50
0
300,00
0
300,00
0
157,50
0
1,125,00
0
600,00
0
200,00
0
200,00
0

100.0%

16.6%

36.2%

6.0%

8.2%

1.4%

5.8%

1.0%

19.7%

3.3%

19.7%

3.3%

10.4%

1.7%

100.0%

12.3%

53.3%

6.5%

17.8%

2.2%

17.8%

2.2%

11.1%

1.4%

1,37
5,000

125,00
0
6,250,00
0

100.0%

68.1%

56.0%

38.1%

1,37
5,000

3,500,00
0
2,750,00
0

44.0%

30.0%

300,
000

10
0,000
300,
000

12
5,000

157,5
00
200,0
00

20
0,000

TA on bulk/pooled procurement
TA for Therapeutic Committee

Seed capital for establishment of


BNBs

As a % of
Type of
Expenditure

PCSO

125,0
00

Organization /Consultative Meetings


of TC
Stakeholders' meeting for adoption of
laws
Writeshop on the formulation of
laws/ordinances
MOOE - Technical Assistance

TA on incentives/disincentives
scheme for TBAs, mandatory dog
vaccination, smoking - free province
TA on establishing provincial
regulatory framework
MOOE Supplies/Drugs/Medicines/Seed
Capital
Purchase of drugs and medicines

PhilHealth
Capitation/
Claims

CULION
Fndtn

LEAD

600,0
00
600,0
00

200,0
00
20
0,000

1,750,
000

1,750,0
00

1,750,
000

1,750,0
00

12
5,000
1,37
5,000

1,37
5,000

Total

122

Type of Expenditure

Provincial
LGU Budget

Municipal
LGU Budget

140,

140,0
00
88,0
00
40,0
00
12,0
00

OOE - Other Expenses


000
TEVs for BNB operators

88,0
00

TEVs for Therapeutic Committee

40,0
00

TEVs for write-shop

12,0
00

Grand Total
As a Percentage of Grand Total

2,165,
000
23.6%

2,165,0
00
23.6%

DOH
Budget

EC Grant

LEAD
-

PhilHealth
Capitation/
Claims

CULION
Fndtn

GTZ
-

PCSO

As a % of
Type of
Expenditure

As a % of
Grand Total

280,00

100.0%

3.1%

176,00

62.9%

1.9%

80,00

28.6%

0.9%

24,00

8.6%

0.3%

#REF!

Total

0
0
0
0

1,78
7,500
19.5%

357,5
00
3.9%

30
0,000
3.3%

725,0
00
7.9%

0.0%

300,
000
3.3%

1,37
5,000
15.0%

9,175,00
0
100.0%

0.0%
100.0%

TOTAL INVESTMENT COSTS OF THE FOUR F1 COMPONENTS


Table 17.1. Health Investment Costs by Year, Province of Biliran
2006

2007

2008

2009

2010

Total

GOVERNANCE

4,887,723.00

8,713,723.00

11,973,723.00

4,211,723.00

4,211,723.00

33,998,615.00

FINANCING

5,285,320.00

5,661,980.00

7,487,640.00

9,321,300.00

11,154,960.00

38,911,200.00

39,645,411.33

65,884,411.33

14,994,494.67

14,541,961.34

11,361,961.33

146,428,240.00

3,170,000.00

1,595,000.00

1,470,000.00

1,470,000.00

1,470,000.00

52,988,454.33

81,855,114.33

35,925,857.67

29,544,984.34

28,198,644.33

SERVICEDELIVERY

REGULATORY

9,175,000.00
228,513,055.00

123

Table 17.2 Health Investment Costs by Activity by Source of Financing, Province of


Biliran
Component/
Subcomponent/
Activity

Provincial LGU
Budget

Municipal LGU

DOH

EC Grant

LEAD

GOVERNANCE

7,578,489.00

6,870,127.00

3,270,000.00

5,250,000.00

1,470,000.00

FINANCING
SERVICE
DELIVERY

23,538,200.00

13,373,000.00

87,500.00

200,000.00

87,500.00

10,961,667.00

15,177,933.00

17,250,900.00

54,132,800.00

2,870,000.00

REGULATORY

2,165,000.00

2,165,000.00

1,787,500.00

357,500.00

300,000.00

TOTAL

44,243,356.00

37,586,060.00

22,395,900.00

59,940,300.00

4,727,500.00

CULION
Foundation

PhilHealth
Cap/Claims

620,000.00

2,962,500.00

3,582,500.00

GTZ

3,220,000.00

JICA/Other
Donors (ECCD)

5,720,000.00

Total

33,998,616.00

625,000.00

1,000,000.00

38,911,200.00

10,206,140.00

1,387,500.00

31,478,800.00

146,428,240.00

300,000.00

725,000.00

1,375,000.00

9,175,000.00

11,131,140.00

6,332,500.00

38,573,800.00

228,513,056.00

124

Table 18. PROJECTED REVENUES


BILIRAN PROVINCE 2006 2010
PRO

Province

MUNICIPALITY

PROJEC
TED
Indigent
Househo
ld

Income
Class
Popn

AREA OF CONCERN:

CY 2005

YEAR NUMBER OF
IMPLEMENTATION

BILIRAN

ALMERIA

5th

BILIRAN

BILIRAN

5th

18,089

1,259

BILIRAN

CABUCGAYAN

5th

19,859

1,382

BILIRAN

CAIBIRAN

5th

22,155

1,542

BILIRAN

CULABA

5th

16,277

1,133

BILIRAN

KAWAYAN

5th

18,890

1,315

BILIRAN

MARIPIPI

5th

8,586

598

BILIRAN

NAVAL

4th

43,250

3,010

8
8

16,607

1,156

2006

2007

2008

*100% SS certified,
*100%RHU
accredited:
6/8OPB,TB DOTS
6/8MCP
*Hospital
Secondary(Philhealth)
*4th to 5th class
Municipalities

*100% SS
certified,
*100%RHU
accredited:
6/8OPB,TB
DOTS
6/8MCP
*Hospital
Tertiary
(Philhealth)
*4th to 5th
class
Municipalities

1,040

ENROLLED FAMILIES:

*100% SS
certified,
*100%RHU
accredited:
6/8OPB,TB
DOTS
6/8MCP
*Hospital
Tertiary
(Philhealth)
*4th to 5th
class
Municipalities

2009
*100% SS
certified,
*100%RHU
accredited:
6/8OPB,TB
DOTS
6/8MCP
*Hospital
Tertiary
(Philhealth)
*4th to 5th
class
Municipalitie
s

*100% SS
certified,
*100%RHU
accredited:
8/8OPB,TB
DOTS
6/8MCP
*Hospital
Tertiary
(Philhealth)
*4th to 5th
class
Municipalities

1,054

1,253

1,265

1,282

1,007

1,020

1,365

1,378

1,396

1,106

1,120

1,498

1,513

1,533

925

937

1,671

1,688

1,710

906

1,033

1,228

1,240

1,256

1,183

1,198

1,425

1,439

1,458

545

598

604

611

2,744

2,709

2,736

2,771

YEAR OF IMPLEMENTATION

CONDITIONS AND ASSUMPTIONS

538
2,408

2010

125

163,713

11,39
5

Total Sponsored sector


enrolled BILIRAN PROVINCE

7,067

7,577

9,129

9,221

9,339

PREMIUM LGU SHARE

120

120

180

240

300

TOTAL PREMUIM REQUIREMENT

847,980

909,186

1,643,274

2,212,942

2,801,585

2,119,951

2,272,965

2,738,790

2,766,178

2,801,585

1,271,970

1,363,779

1,095,516

553,236

PHILHEALTH PAYMENTS:
SPONSORED SECTOR
-OPB Capitation
PCF LESS PREMIUM PAYT'S
YEAR OF IMPLEMENTATION
-Maternity Care
-TB DOTS
-Admission
-Day Surgery and
Procedures (DSP)
- Emergency

2006

2007

2008

2009

2010

19,079,555

20,456,689

24,649,111

17,426,921

15,128,559

1,879,690

2,015,363

2,428,394

2,452,678

1,242,036

19,432,880

20,835,517

25,105,576

25,356,631

25,681,196

5,299,876

5,682,414

6,846,975

6,915,445

7,003,963

1,766,625

1,894,138

2,282,325

2,305,148

2,334,654

48,730,597

52,247,900

62,407,896

55,010,059

51,390,408

5,273

5,537

5,814

6,104

Enrolled Informal (IPP)

5,022
3,125

1,453

1,816

1,997

2,179

TOTAL FORMAL & IPP

8,147

6,726

7,353

7,811

8,283

1,833,075

2,269,939

3,308,653

4,393,677

5,591,188

-DSP

611,025

756,646

827,163

1,171,647

1,553,108

-Emergency

407,350

504,431

735,256

976,373

1,242,486

2,851,450

3,531,016

4,871,072

6,541,696

8,386,781

1,941,521

2,081,658

2,508,275

2,533,358

2,565,785

Sub-total SS
FORMAL AND INFORMAL
SECTOR
Enrolled Formal

-Admission

Sub-total formal & IPP


OTHER POTENTIAL INCOME
- Pharmacy
- Laboratory
User Fees for non- poor

332,832

356,856

429,990

434,290

439,849

1,664,161

1,784,278

2,149,950

2,171,450

2,199,244

3,938,515

4,222,791

5,088,215

5,139,098

5,204,878

55,520,562

60,001,707

72,367,184

66,690,853

64,982,068

- Project Grants
- Donations
Sub-total
PROJECTED TOTAL REVENUES

To be initiated.

126

POVERTY INCIDENCE LEVEL CONSTANT AT 34.8%


POPULATION GROWTH RATE 1.28%

127

11.0

Program Management
The ILHZ Board, being the highest body for health concerns at the local level, shall provide

the direction and set the policies for the successful implementation of this plan. It shall oversee the
smooth and efficient implementation of the different interventions and projects under a unified
health program. Considering that the province has a lone ILHZ, and that the Governor chairs the
Board with all the municipal mayors sitting as members, the Board is in the best position to manage
the implementation of this investment plan. The Sangguniang Panlalawigan through a resolution
authorized the creation of the ILHZ in Biliran Province. Further, a Memorandum of Agreement
among local chief executives, the DOH, PhilHealth, and the GTZ for the establishment of an
effective and efficient ILHZ in the province already exists.
The management structure shall be so designed that decisions are made with proper
consultation and involvement of concerned stakeholders, especially the institutions at various levels
of governance such as but not limited to existing health boards, regional agencies of the national
government like the DOH-CHD and PHIC Regional Office, the GTZ, and private sector providers.
To ensure effective and responsive local health governance, the institutionalization of the
management structure shall be consistent with that of Fourmula One implementation.
Further, a reliable and updated management information system need to be established in
order to provide informed decisions to the members of the Board. The information system to be
adopted should facilitate the integrated and synchronized implementation of interventions. It shall
evolve from previously adopted systems that have been proven to work for the health sector, and
shall complement and integrate information systems, such as the FHIS, that are currently in use.
Where appropriate, the Health Investment Plan shall be endorsed by the Provincial
Development Council to the Sangguniang Panlalawigan upon the recommendation of the Interlocal Health Zone Board. To lend legitimacy to the plan document, the SP has to adopt it and
approve its implementation.
Budget support intended to make the plan fully operational shall be channeled directly from
the central office to the provincial government through the Department of Budget and Management.

Enforcement of agreements shall be in the form of contract of services between the DOH and the
LGU that shall implement the project.
The task of actually carrying out the interventions in term of specific projects and activities
that are proposed in this Health Investment Plan shall be vested upon the Technical Management
Committee (TMC), the implementing arm of the ILHZ Board. The Provincial Health Officer chairs
this body, which is consists of Municipal Health Officers, the Chief of Clinics and the Senior
Supervising Nurse of the BPH, and representatives of the DOH Reps, PhilHealth and GTZ.
Project monitoring shall be in accordance to a monitoring and evaluation system that shall
be developed for the Fourmula One for Health and the Sectoral Development Approach for Health.
Monitoring tools prescribed for the project shall be adopted.
In case there shall be a start-up fund, the money for such purpose shall be allocated
directly to the provincial government from the central office to avoid delays in implementation.
Monitoring and accounting shall be adopted based on the Memorandum of Agreement formulated
to implement the plan.

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