Sometime in 2010, we started running medical missions to help the Kaya Natin Champions in their area. This effort was made in order to deepen our commitment to help them win and to make good governance felt in their communities.
Since then, our efforts have born several initiatives that have become very effective in promoting good governance in public health.
KAYA NATIN SENIOR WELLNESS
What started with a medical mission in Nueva Ecija is now a Senior Wellness program that helps the local government develop a sound NCD Program (Non Communicable Disease).
The med-missions were reformatted to enable the community to profile and target the seniors in their town and barangay. Every week, the community holds a Senior Wellness session supervised by Kaya Natin. These wellness sessions are checkups that include health awareness programs with the seniors. Mary Ann Pantaleon heads one of them and said, “Sa programang ito, nagkakaroon ng pagkakataon ang mga lolo at lola na pangalagaan ang kanilang kalusugan”. 50% of the seniors that go to the wellness sessions return regularly as monitoring patients because they are either hypertensive, diabetic, or both. Many are also stroke patients.
In Nueva Ecija, Kaya Natin has partnered with Mayor Christian Tinio of Gapan City. Kaya Natin health leaders work together with Gapan Health Head, Dr. Robert Marcelo, to present a statistical profile of the community that enable the Local Government to target the senior market. We developed a marketing approach in zeroing in on the seniors in order to maximize the services. From 2010 to 2011, we engaged as much as 79 barangays in the 4th district of Nueva Ecija and about 8,000 seniors. We found that, on the average, 26% of the senior population are hypertensive and 12% are diabetic.
In Gapan City, from September to December last year, 1,800 visited the Senior Wellness sessions. We found that 44% of the patients were hypertensive and suffer from heart problems. 16.5% are Diabetic. 14% have pulmonary problems.
As we profile these seniors in the community, we also promote the health programs. In an interview, Dr. Marcelo said, “Ang laki ng nagagawa ng Kaya Natin upang palakasin ang demand ng serbisyo ng city health.” The health leaders and the wellness sessions effectively increased the health seeking behavior of the seniors. By February, we will be launching our Pneumonia awareness program in order to address the growing problem with the seniors.
We deepened our public health engagement with a unique perspective to help our good governance champions to also be elected. In Nueva Ecija, we worked to integrate this program and realize this platform in Mayor Sonia Lorenzo’s campaign for the 4th District. These programs are also a take-off of her award winning Public Health program in San Isidro that enabled the town to achieve more than 95% PhilHealth coverage.
HL4M: HEALTH LEADERS FOR MOTHERS
In Quezon City, we helped Congressman Bolet Banal engage the community thru maternal health development.
HL4M is a partnership with Merck, Sharpe, and Dhome and the office of Congressman Banal that is aligned with the Millennium Development Goals of improving maternal health. This effort seeks to lower the maternal deaths in the district by encouraging the mothers to give birth in health facilities. Our partnership with MSD and Cong. Bolet will enable us to target 5,000 pregnant women over 3 years. This is done by strengthening leaders on the ground and creating the proper incentives for the mothers and the health workers. We found that if we create a good environment for maternal checkups, the mothers become more willing to attend. During these checkups, we seek to increase their awareness in pre-natal and post-natal care. From our efforts, we were able to engage over 1,200 pregnant women and were able to increase the pre-natal checkup rate from 30% to 95%. Last year, 87.6% of those that participated in the HL4M Wellness gave birth in health facilities. That is up more than 10% from the citywide average. Our efforts have been appreciated by the District Health Office. They have now adopted the program in the health centers that cover Barangay Loyola Heights/Pansol, E. Rodriguez/Ermin Garcia, Soccorro, Tagumpay/Milagrosa, Silangan, and Bagumbuhay.
During our engagement, and in a survey done by a group from PhilHealth and Ateneo, we found that the District Health facilities are run well. Out of 1,200 people that were surveyed, 58% utilize the City Health Centers. However, 60% of them leave without seeing the health servers due to long waits. Of those that go on to see the health providers, 83% are satisfied with the doctors and the nurses.
“This start of the year we have more than doubled our rate of engagement of the mothers,” says Mixie Rivera, the Kaya Natin Team head in charge of this program. In just a month, we profiled over 780 women, over 300 of them pregnant. We have encouraged them to consistently attend the pre-natal checkups and we are confident that they will give birth in health facilities. Soon we will be providing coordination and feedback to the Health Centers in order to market the pre-natal checkups with mothers.
Mona Yap, Program Manager and part of the Kaya Natin Team adds, “From this engagement, we also noticed that a big part of the effort is to address the demand, or the health seeking behavior of the community. We found that the government is just half of the equation. We need to run innovative programs in order to gain traction on the ground and attract our target market - in this case, the pregnant mothers”.
Recently, UNICEF met with us at the recommendation of the City Health office and Former Department of Health Usec. Dr. Mario Villaverde. Dr. Mario is presently the associate dean of the Ateneo School of Government and in talks with UNICEF. Dr. Don Matheson was researching selected areas for an evidenced based policy recommendation from UNICEF. After the long meeting, he affirmed us and said, “You are already doing what we are hoping. You positioned yourself in bringing together the community to spur demand and engaged the health facilities while at the same time being very aware of the governance perspective. You bring in the private corporations and you market your efforts. I found the approach you were taking to governance and community issues very innovative. I am intrigued and amazed that you also developed a unique political insight in advocating your program. Your work is certainly one of those we wish to highlight.”
Recently, Kaya Natin launched the “Dakilang BHW” (Barangay Health Worker) in partnership with Kaya Natin Champion Sen. TG Guingona. “Many Filipinos don't know that, all over the country, there are these selfless health volunteers who live to serve their communities. These are true servant-leaders who deserve to be honored and recognized,” Paula Apines, the Kaya Natin Team Program Manager. These BHW Awards highlight frontline leaders who have served in the communities and try to gather their stories and good practices. This is part of an integrated effort in developing good governance constituencies. Senator TG is one of our strong advocates towards good governance. Aside from his good governance advocacy thru the Blue Ribbon, we are also helping him bring down good governance to the different areas in the country by partnering with LGU’s and Health Leaders. Together with this initiative, Kaya Natin and the office of Sen. TG is also running BHW Congresses in strategic parts of the country in an effort to gain more insights from health leaders. This is also part of a “Bottom-up” approach to Public Health development. On February 15, we are scheduled to have the first awarding for Metro Manila entries. On Feb. 28-March 1, we plan to have a BHW Summit in Iloilo - April for Bacolod, and May for Ilocos Sur.
Apart from this, Kaya Natin, together with Merck, is launching the Public Health awards focused on local governments. On January 17, Kaya Natin will start the process of taking in entries from LGU’s who wish to participate in these awards. This initiative hopes to increase the local government awareness in strengthening the Local Health Board. Last November, Kaya Natin, in partnership with Senator TG and the Ateneo School of Government, ran the Champions of Good Governance in Public Health in Cebu. It was well attended by a few governors, 20 LGU heads, and 34 LGU representatives. As local governments participate in these programs, Kaya Natin and Senator TG hope to enable them to delve into the dynamics and intricacies of good governance that are contextual and relevant to their communities. At the same time, their innovations are also shared with other local executives. These venues serve as learning areas where we also hope to build and harvest future Kaya Natin Champions from. While we provide these opportunities, we also hope to strengthen Sen TG’s profile as a good governance advocate with the LGU’s.
In Kaya Natin, we are working with our champions to innovatively translate good governance so people can experience this. We go beyond talking about good governance and we create areas of engagement for people to understand. We adjust the scope of our engagement based on the constituencies of the champions. It is our hope that as the communities become part of these programs, the people and the local leaders also become empowered and they see their part in our good governance agenda. In Nueva Ecija, Vonel Panes, one of our health leaders said, "Dati, sumali ako sa Kaya Natin wellness para dagdag kita… nang natuto ako, nabago ako. Dati puro inom ako, ngayon naiisip ko na ang mga pasyente ko."
Mayor Christian Tinio of Gapan City, in a conversation with Senator TG said, “Dapat itong ganitong samahan at usapan bagay na bagay sa mga bagong Mayor. Madalas kasi, sa unang taon ng pagsisilbi, nangangapa ang mga bagong luklok. This is a good place to learn from other good mayors and governors.”
As we create these venues of engagement, we also see the importance of using these programs as a tool to market the Good Governance advocates. We maintain a healthy balance between development and politics because we understand that these champions need to have sound development programs that will contribute to their political victory.
This is a continuous learning for us in Kaya Natin. Much of this philosophy is rooted in what we learned from former DILG Secretary, Jesse Robredo.
In a forum with the mayors, Sec. Jesse Robredo was discussing the balance between politics and Good Governance. He said, “The important part of it is timing, Ang mga pagbabago mo dapat within the term so that you earn political capital. Baka kasi yung gestation period ng pagbabago mo might be too long. Babagsak ka doon sa eleksyon na hindi handa. Kailangan managed ang pagbabago.” Sec. Jesse stressed and summed it by saying, “Reform should be programmatic, it should have a significant political base, otherwise it will be wasted.”
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Jess Lorenzo is currently the program director of Kaya Natin! Movement for Good Governance and Ethical Leadership's public health initiatives. www.kayanatin.org @kayanatin on Twitter