MEDICAL EDUCATION FOR HEALTH DEVELOPMENT Fortunato L. Cristobal, MD, MPH, MPHed, FPPS, FSPGANH DEAN, School of Medicine Ateneo de Zamboanga University Zamboanga City, PHILIPPINES With Social Accountability

SETTING

DISCIPLINEBASED38MEDICALSCHOOLS ZAMBOANGA Biological Oriented Individual Health Care Focused Biological Oriented Individual Health Care Focused

4,000 MD – taking Nursing Galvez, 2004 Medical Diaspora Career Shift Medical Diaspora Career Shift 3,500 MD left for USA as Nurses 3,500 MD left for USA as Nurses MD - Nurse

REDESIGNING OF THE DOCTORS REDESIGNING OF THE DOCTORS

MOSTUNDERSERVEDAREAS Top Poorest Municipalities 28 - Mindanao 14 - Zamb. Peninsula Siay- ZDN – Phil Poorest Poorest Provinces 7 – In Mindanao 1 st – Tawi-Tawi 2 nd- ZDN 2007 Hunger Incidence - Region 2 nd ARMM 3 rd Zamb. Peninsula

8

ZAMBOANGAMEDICALSCHOOLFOUNDATION 1994 ADZU-SOM 2004 ADZU-SOM 2004

COMMUNITY IMMERSION 4 th Year 1 st Year 2 nd Year 3 rd Year Same Community

House to House surveys

Baseline Data Data NEEDSASSESSMENTS COMPREHENSIVE HEALTH PLAN COMMUNITYLEADERSHIP

Student Transforming Communities Student Transforming Communities

17YEARS RESOURCE CONSTRAINTS OPPOSITION

Solar Disinfection (SODIS)

StrategiesTime Frame Outcome Indicator Mothers Cooking Contest Vegetable Queen Oct Affordable menu Nutritious menu Reduce Malnutrition Kitchen Queen 80% attendance

StrategiesTime Frame Outcome Play Time under 5 children on nutritious foods August % attendance of children 75% identified healthy foods

StrategiesTime Frame Outcome Indicator Communal Garden Contest August 2011 Communal Garden Established Shared

INFANT WEIGHT MONITORING NORMAL UNDERWEIGHT % 88% 93% % 12% 7% N= 538 N (%) N

Infant Mortality Rate (Infant deaths per 1000 live births) Infant Mortality Rate (Infant deaths per 1000 live births) Area Zamboanga Del Norte Zamboanga Del Sur Zamboanga Sibugay Region 9 National Capital Region

Infant Mortality Rate

Admission Graduate Took-Board P-Board Performance Rate : 90.90%

95.4% Philippines 95.4% Philippines

90 % Region 9

50 % Rural Doctorless Areas

4.6% Abroad Served 6-8 yrs before they left Served 6-8 yrs before they left