Health for Juan and Juana: Can local government make a difference?   Ernesto D. Garilao President Zuellig Family Foundation Health For Juan and Juana: Moving Forward with the Philippine Health Agenda Asian Institute of Management (AIM), Fuller Hall May 4, 2016

Philippine Health Status in 2008 Devolution of the Philippine healthcare system (1991) Fragmentation of health services Inequities in health outcomes Rich urban Poor rural Life Expectancy Over 80 years Less than 60 years Maternal Mortality Ratio Less than 15 More than 150 Infant Mortality Rate Less than 10 Over 90 Skilled Birth Attendant 92.4% 25.1% Source: Sec. Alberto Romualdez, MD, State of the Nation’s Health, Centennial Lecture, 2008

The Bridging Leadership Process The Bridging Leadership Process Multi-Stakeholder Processes/ Convening and Trust-Building Dialogue OWNERSHIP CO-OWNERSHIP CO-CREATION Responsive Programs and Services/ Social Innovations Collaborative Response Engagement Mechanisms Shared Vision & Mission New Relationships Among Stakeholders Empowered Citizenry Transformed Institutions New Institutional Arrangements Health Equity Bridging Leader Health Inequity/Divide and Personal Personal Response Source: AIM-TeaM Energy Center

The Bridging Leadership Process ZFF partner municipalities ZFF partner LGUs (as of end-December 2015) ZFF CHPP ZFF-USAID,UNICEF, UNFPA, MSD for Mothers ZFF-DOH 72 189 379 Total 640 5

Maternal Health Challenge 6

Addressing Three-Delays at the Local Health Level Delay in deciding to seek medical care DELAY 3 Delay in receiving appropriate and adequate care in the facility Unwanted pregnancies, Poor health seeking behavior of mothers, medical misconception of the mother/family members, High regard for traditional birth attendants, Expensive transportation fare, Previous negative experience in the health facility Improper management of cases at the hospital Lack of hospital equipment and medical supplies Unavailability of blood Long waiting time Gaps in continuity of care Hospital understaffing DELAY 2 Delay in identifying and reaching appropriate health facility Lack of appropriate transportation Long travel time to the health facility 7

Learnings from the Community Health Partnership Program (CHPP)

The Role of the Mayors and Health Leadership Teams Chart 2. Initial Health Scorecard of Lapuyan, 2010

The Role of the Mayors and Health Leadership Teams Chart 3. Health Scorecard of Lapuyan, 2012

The Role of the Mayors and Health Leadership Teams Chart 4. Health Scorecard of Lapuyan, 2015

Performance of the 72 CHPP municipalities

GIDA video

GIDA municipalities: Addressing 1st & 2nd Delays

GIDA municipalities: Addressing 1st & 2nd Delays

GIDA municipalities: Addressing 1st & 2nd Delays

Performance of the GIDA municipalities

Partnership with DOH

Partnership with DOH

Deaths in hospitals: The Third Delay

Deaths in hospitals: The Third Delay

Deaths in hospitals: The Third Delay

Systems Approach in Addressing TB

Systems Approach in Addressing TB

Performance of 175 ZFF-USAID,UNICEF and UNFPA partner cities and municipalities

Health for Juan and Juana: Can local government make a difference?   Ernesto D. Garilao President Zuellig Family Foundation Health For Juan and Juana: Moving Forward with the Philippine Health Agenda Asian Institute of Management (AIM), Fuller Hall May 4, 2016