Last May 2, 2024, health leaders in Quezon Province visited the Rural Health Unit (RHU) of Pagbilao, deep diving into their health services specifically in providing its constituents financial protection towards the full realization of Universal Health Care (UHC) in the province. As part of the Quezon Provincial Health Office (PHO)’s practicum for Bayang Malusog Provincial Leadership and Development Program of the Zuellig Family Foundation, the Quezon PHO and Pagbilao Municipal Health Office, as well as representatives from the Department of Health (DOH) and PhilHealth Regional Office IV-A gathered to learn and share insights, successes, and challenges.

The activity commenced with an overview of RHU-Pagbilao’s services, followed by interviews with health personnel and patients. These interactions provided valuable on-ground insights into the e-Konsulta Program and the overall implementation of the UHC Program.

Health personnel emphasized the importance of streamlining the e-Konsulta process, highlighting the need for efficient computer systems and reliable internet connectivity. Despite these challenges, their dedication was evident in the high registration numbers, which have yet to be fully reflected in PhilHealth’s system due to technical and manpower limitations.

PhilHealth IV-A Regional Vice President Dr. Danilo Reynes advocated for improved infrastructure and personnel support, calling for stronger partnerships with local health insurance companies to effectively navigate technical challenges.

Dr. Kristin Villaseñor, Provincial Health Officer II of Quezon Province reaffirmed the UHC vision of providing accessible health services to all Filipinos with minimal financial burden. She stressed the urgency of increasing registration numbers and enhancing facility capacities to meet ambitious targets. This, she noted, could be achieved through constant collaboration with stakeholders, such as DOH and PhilHealth.

However, significant challenges remain. Many residents are unaware of the free services available, prompting calls for intensified information dissemination efforts. Engaging Barangay Health Workers (BHWs) in grassroots campaigns emerged as a promising strategy to boost registration rates.

Pagbilao Mayor Angelica Tatlonghari, who is also a nurse, prioritizes health and pledged ongoing support for procurement and process refinement, emphasizing the elimination of service delivery bottlenecks. Collaboration with community leaders and mobilization efforts were deemed essential to maximize the Program’s reach.

Dr. Juvy Purino, Provincial Health Team Leader of Quezon Provincial DOH Office  highlighted the critical need for manpower augmentation and increased health literacy. Addressing challenges in pharmacy and dispensing, along with encoding deficiencies, were identified as immediate priorities. She said, “Ang goal natin sa implementation ng UHC ay walang maiiwan, lalong-lalo na sa mga nakakaranas ng kahirapan. Hindi katanggap-tanggap na marinig na hindi sila makakita ng doktor at makabili ng gamot dahil wala silang pera.”

The meeting concluded with a strong commitment from all stakeholders to overcome obstacles and advance the UHC agenda. Multi-sectoral collaboration was identified as the backbone for realizing the Program’s transformative potential, ensuring a healthier, more inclusive future for all.

Gathering health teams from different parts of the country, the Zuellig Family Foundation (ZFF) hosted “Championing Health Together”, the launching Bayang Malusog Community of Practice (CoP) last April 12, 2024. Shared during the event is one victory in pushing for Universal Health Care (UHC): the province of Aklan’s Governance Model for Special Health Fund (SHF).

Innovative District Health Systems

Dr. Leo B. Ismael of the Provincial Health Office (PHO) in Aklan, presented the province’s accomplishments. He highlighted the innovation of Aklan to institutionalize District Health Systems (DHS). With DHS, the government aims to have an effective health care delivery and health system management in Aklan. Additionally, they hope to streamline healthcare delivery by improving patient access through efficient navigation and referral systems through the DHS.

The DHS are managed by the District Health Board (DHB), assisted by the Technical Management Committee (TMC),  which helps enhance the integration of municipalities to DHS. In his testimony, Dr. Ismael shared that he personally facilitated all the DHB meetings and elections for each DHS. Through the meetings, they were able to discuss the challenges being faced by each municipality and their plans as the DHB. 

A challenge mentioned was the creation of guidelines on patient navigation and referral systems. To counter these challenges, the DHB planned to finalize the DHS ordinance, agreement on provincial and municipal sharing, and hiring of additional accountants and managers.

SHF Funding and Distribution

Budgetary appropriations from Aklan’s provincial government and its constituent LGUs are required to be contributed to the SHF in order to fund health-related projects, initiatives, and activities. Initially met with reluctance from some local chief executives regarding percent contribution, the PHO assured them that they will not be at a disadvantage. “If you give your share [to the SHF], the province will also give its share, which is greater than your share, so hindi kayo lugi,” Dr. Ismael said in his discussion. 

A resolution on the distribution of the funds for SHF is set to be issued. The mechanism, sum, or percentages will be considered for the distribution to the respective health districts. The signing of the  agreement will also be held for the 1% sharing of the Provincial Development Fund and 1% Municipal Development Fund.

One key to the success of the program is the support shown by Aklan Governor Jose Enrique Miraflores in accelerating health initiatives.  According to Dr. Ismael, this was vital in materializing the shared vision of an excellent and responsive healthcare system powered by UHC through #OneAklan. He also expressed gratitude for the recent Municipal Leadership and Development Program Module 2 training of ZFF, which aided in initial planning. Majority of MHOs and mayors were present and expressed support for the initiative during this activity.

As mentioned by Dr. Manuel Dayrit, ZFF Trustee and former Secretary of the Department of Health, and one of the invited reactors: “Change is happening before our very eyes; the presentations are a glimpse of the future.” Through the narratives told  during the program, one could see how the steps taken towards the betterment of the implementation of UHC in the country can serve as a reminder that the goal of equitable and quality healthcare for the Filipinos is within our reach. With proper mechanisms and support from the people and the government, we will be able to achieve better health outcomes. The future of UHC is bright and through collective leadership and learning, we can forge healthier and better communities for the Filipinos. 

“I aspire to be remembered as a leader who genuinely cared about the well-being of every member of our community. This is not just a position for me; it is my heartfelt passion to create a positive impact in your lives.”

At 24, Arcam Istarul became Mayor of Tipo-Tipo, inheriting a legacy of public service from his father and accomplished siblings. His father, Ingatun “Tong” Istarul, was a respected three-term mayor, while his siblings held prominent positions in the community. Despite being the fourth of nine siblings and facing societal expectations, Arcam embraced his role, starting as a youth council member and eventually becoming the youngest municipal councilor. He took on the mayoral seat at 24, defying norms and leveraging his family’s achievements to lead Tipo-Tipo to new heights, particularly in nutrition initiatives.

Tipo-Tipo, a third-class municipality in Basilan, has a population of 25,531 as of 2020. Historically plagued by conflict, Mayor Tong during his last term, played a pivotal role in supporting Governor Jim Hataman-Salliman’ peace efforts to counter violent extremism, paving the way for progress in the municipality.

Long-time relationship with ZFF

The Zuellig Family Foundation (ZFF) initially partnered with Tipo-Tipo in late 2014 through the Health Leaders for the Poor-Municipal Leadership and Governance Program (HLP-MLGP). Mayor Tong Istarul spearheaded initiatives such as obtaining PhilHealth accreditation for the Rural Health Unit, establishing a 24/7 Birthing Facility, recruiting more Barangay Health Workers (BHWs), providing additional benefits for BHWs, and enhancing the functionality of the Local Health Board. These efforts led to significant improvements in health indicators, particularly in Facility-Based Delivery (FBD) rates, which rose from 0% in 2014 to 21% by 2016.

Mayor Arcam, the second local chief executive (LCE) engaged by ZFF-KGJF (Kristian Gerhard Jebsen Foundation), joined the Partnership for Nutrition Governance Program (PNGP) after expressing his commitment to participate. The program, which aimed to strengthen nutrition governance, launched the Municipal Nutrition Governance Program (MNGP) approximately one year later. In January 2022, Tipo-Tipo, along with Maluso, Sumisip, Isabela City and Lamitan City, joined Batch 1 of the MNGP.

Nutrition situation before the MNGP

Dr. Nurkhan Istarul, the Municipal Health Officer (MHO) of Tipo-Tipo and brother of Mayor Arcam, was among the first group of trainees in the Philippine Integrated Management of Acute Malnutrition (PIMAM) program in the now defunct Autonomous Region in Muslim Mindanao (ARMM). Attended medical school to serve his community, Dr. Nurkhan remains the MHO of Tipo-Tipo despite several job offers, including a post at the Ministry of Health-Bangsamoro ARMM. During Mayor Tong’s term, only two municipalities in Basilan have a doctor; one of these is Dr. Nurkhan.

His exposure to the nutrition situation in Tipo-Tipo, particularly rehabilitating a Severely Acute Malnourished (SAM) child, ignited his determination to enhance nutrition efforts. Although nutrition work was established, it primarily focused on service delivery, neglecting crucial building blocks.

In 2021, the stunting prevalence in Tipo-Tipo was at 32.1%. When it comes to healthcare accessibility, all key indicators remain low due to the geographical makeup of the municipality. The diverse ethnic population, presence of geographically isolated and disadvantaged areas (GIDA) barangays, sporadic armed encounters, and the proximity of large barangays to Lamitan City, where residents often prefer to access health services, contribute to the limited coverage. The complex nature of the problem of malnutrition, coupled with limited resources, means that finding a solution is not straightforward.

Deepening understanding of nutrition gaps through the MNGP

The MNGP aims to empower the Municipal Nutrition Committee (MNC) to tackle malnutrition effectively through comprehensive service delivery. Mayor Arcam identified key gaps contributing to high stunting prevalence, including unemployment, limited access to family planning, poor health-seeking behavior, and inadequate financial support. These issues are influenced by factors like early marriages, misconceptions about stunting, fragmented programs, and security concerns. Mayor Arcam advocates for a multi-sectoral approach to address these challenges.

Drawing on his accounting background (as a BS Accountancy graduate from Western Mindanao State University), Mayor Arcam envisions improved fiscal management, sustainable food supply, and enhanced quality of life for Tipo-tipo. He aims to achieve these goals by focusing on fiscal management for health and nutrition, access to basic services, and food security. Priority actions include activating the MNC, issuing relevant policies, formulating a comprehensive action plan, hiring additional nutrition-focused staff, targeting poverty reduction, engaging barangays, and masterlisting vulnerable populations. These actions aim to strengthen nutrition governance, enhance service delivery, and uplift the community’s well-being, particularly for vulnerable groups.

Leadership acts in a snapshot

Mayor Arcam spearheaded the expansion of the MNC in Tipo-Tipo, benefiting from strong legislative support due to his father’s role as vice mayor. Regular MNC meetings lead to the issuance of supportive policies, including the groundbreaking Municipal Ordinance No. 23-04, s. 2023, which serves as a model for addressing malnutrition in Basilan.

Recognizing the importance of nutrition, the Sanggunian significantly increased the nutrition budget from Php 1 million in 2022 to Php 10 million in 2023. This reflects their commitment to effective programs and interventions.

In August 2022, the expanded MNC core team formulated a three-year Comprehensive Nutrition Action Plan (CNAP), making Tipo-tipo the first LGU with an approved Local Nutrition Action Plan (LNAP). This achievement underscores Mayor Arcam’s dedication and strategic planning.

Under Mayor Arcam’s leadership, Barangay Nutrition Committees (BNCs) were organized in a significant number of barangays by the end of 2022, promoting community involvement and ownership of nutrition programs. The BNCs collaborate with the core team to address issues like teenage pregnancies, enhancing community support for comprehensive nutrition initiatives.

Deep Dive

Mayor Arcam’s understanding of nutrition issues, influenced by his brother’s expertise and his own experiences, was deepened through a firsthand Deep Dive experience in December 2022. Originally planned for remote areas, security concerns redirected the Deep Dive to Barangay Tipo-tipo Proper, uncovering the additional challenge of teenage pregnancies.

In this barangay, Mayor Arcam encountered a young couple struggling with multiple births and severe malnutrition, residing in challenging family circumstances. This encounter underscored the harsh realities faced by vulnerable constituents.

This experience prompted Mayor Arcam to reevaluate nutrition strategies, leading to the revitalization of the Sanyang Collaborative Action for Mobilization (CAM) initiative. Combining experiential insights with data analysis, Mayor Arcam refined Sanyang CAM to address specific community needs effectively.

Notably, there was a considerable reduction in stunting prevalence, from 28.18% in 2022 to 19.45% in 2023. Wasting prevalence decreased from 4.82% to 2.20% during the same period. These achievements highlight the effectiveness of the implemented strategies and the dedication of Mayor Arcam and his team in addressing the nutritional challenges faced by the municipality of Tipo-tipo.

Mayor Alexander Bryan Reganit, Jr., son of former Mayor Reganit, Sr. of Maitum, Sarangani, did not imagine a life of public service. Growing up, he lived life for himself, with no purpose and direction. 

He once wrote about himself: “[My father] made me enter a convent school so I can get an education, but I went to Notre Dame. I got kicked out of school. I took up Civil Engineering but I did not finish it. I finished something else: my marriage. I was embarrassed to face my father, so I left home. I handled jobs during that time, like being a taxi driver. In between, I became a driver for Uber/Grab.”

In his narrative, the younger Reganit shared that shortly after his marriage ended, he went back home to Maitum with his son. It was then that his relationship with his father saw a dramatic turn for the better, especially when he landed a job under the administration of President Arroyo. Sadly, in 2008, the older Reganit died, devastating the family. 

“I thought we could never recover; I had no intention of entering politics,” Mayor Reganit, Jr. wrote.

In April of 2009, he met Senator Manny Pacquiao who convinced him to help the sports legend run for a seat in congress. Senator Pacquiao offered him a good salary, which allowed him to pay for his siblings’ education. 

In 2019, the younger Reganit did what a decade ago was unthinkable. He ran for mayor in his town of Maitum—and won. 

Of his win, he wrote: “I won because of my surname.”

While acknowledging the family name as the reason for winning, Mayor Reganit made sure to show he deserved the people’s trust. He vowed to his family and his constituents to serve his fellow Maitumians well, having finally learned upon the birth of his son what having a “sense of duty” entailed. 

A town rich in heritage

Maitum, known for its anthropomorphic burial jars found in historical caves, is a second-class municipality in Sarangani province, bordered by Kiamba to the east, Lake Sebu to the north, and Palimbang to the west. It boasts a diverse population, including Ilocanos and T’bolis from South Cotabato, and faces challenges as a coastal town with several Geographically Isolated and Disadvantaged Areas (GIDA) among its 19 barangays, leading to a high migration rate.

Mayor Reganit Jr.’s leadership was enhanced with progress in Maitum’s health governance, thanks to its participation in the Health Leadership and Governance Program (HLGP) initiated by the Department of Health (DOH) Region XII and Zuellig Family Foundation (ZFF) in 2016. This partnership resulted in notable improvements in leadership, health service delivery, and the implementation of a robust Health Information System (HIS) with essential technological upgrades for barangay health stations and midwives.

The municipality’s success in health governance, particularly in maternal and child health interventions, earned recognition from the DOH as the best Maternal, Newborn, and Child Health and Nutrition (MNCHN) project implementer in the province by December 2019, achieving over 95% coverage. Despite these achievements, nutrition remains a challenge, with a stunting prevalence rate of 12.86% among children aged 0-5 years old, highlighting the ongoing need for targeted nutritional interventions.

Municipal Nutrition Governance Program

In June 2022, Mayor Reganit, Jr. and his core team participated in ZFF’s Municipal Nutrition Governance Program (MNGP) aimed at enhancing health and nutrition outcomes in Sarangani’s municipalities. The program provided valuable insights into the importance of nutrition, particularly focusing on the critical first one thousand days (FK1D) of a child’s life.

During this period, Mayor Reganit appointed Ms. Marife Cambel as the new Municipal Nutrition Action Officer (MNAO) for Maitum. With her background as a registered Nutritionist-Dietician and experience in community nutrition work, Ms. Cambel brought expertise and leadership to the role.

Despite being new, Ms. Cambel’s coordination skills and understanding of local government processes led to improvements in Maitum’s nutrition system. She collaborated with key stakeholders such as the Social Welfare Development Officer, Agriculturist, Budget Officer, Health Officer, and others to streamline efforts.

Participation in MNGP Module 1 training further empowered Mayor Reganit, Jr. and the MNAO to revitalize the Municipal Nutrition Council. This revitalization focused on implementing targeted interventions for vulnerable groups, including families with malnourished children and nutritionally-at-risk pregnant mothers. These efforts aimed to address nutrition challenges comprehensively and improve health outcomes in Maitum.

Information management and communication strategy for nutrition

Mayor Reganit, Jr. effectively utilized limited resources in Maitum by leveraging existing platforms to promote quality interventions in nutrition. One such platform was “Radyo Kasaganaan”, a mainstream media program broadcasted on DXNI-FM 99.7, reaching 15 out of 19 barangays in Maitum. This Nutriskwela Community Radio Network Program, in partnership with the National Nutrition Council (NNC) Region XII and the DOH Region XII, helped in improvements in health and nutrition outcomes since its launch in 2017, notably reducing stunting prevalence by almost 6% in the 2018 Operation Timbang Plus results.

Mayor Reganit Jr. employed various strategies through the radio program to influence positive health and nutrition behaviors, such as promoting the “10 Kumainments”, preparing nutritious meals for families, sharing local nutrition news, and discussing legislated policies. Live broadcasts engaged local listeners, fostering conversations on healthy lifestyles.

Recognizing the program’s effectiveness, Mayor Reganit Jr. increased investment in its operations, prioritizing funding under the municipality’s Annual Investment Plan. This led to expanded personnel, equipment upgrades, and technical training to ensure quality production. The MNAO now oversees the station’s management, conducting regular content quality checks and team evaluations.

By 2022, signal mapping confirmed the station’s reach in 15 out of 19 barangays, despite some weak radio signals in four barangays, mitigated by satisfactory internet signals. Daily feedback from listeners and online followers guides program improvements, reflecting a desired behavioral change. Stunting and wasting numbers were reduced from 19.59% in 2017 to 5.1% in 2022.

Through this dedicated platform, Maitum’s Community Radio has become a success story, delivering context-specific interventions, healthy conversations, and active information campaigns for maternal, newborn, and child health initiatives, making it a proud achievement for the municipality.

Resource mobilization and forging partnerships for food security and nutrition 

Despite Maitum’s status as the “rice granary” of Sarangani, it faces shortages in essential food groups crucial for the nutritionally at-risk, particularly children and vulnerable groups. Recognizing these challenges alongside limited resources, Mayor Reganit Jr. forged key partnerships to enhance nutrition and food security.

These partnerships span national agencies, non-governmental organizations, private sector entities, and community organizations. Collaborating with the Department of Agriculture, programs were tailored to support nutritionally at-risk pregnant women and families with malnourished children. Mayor Reganit also leveraged his co-founded volunteer group, the Eagle’s Organization, to distribute egg-laying chickens at his own expense to families in need.

A Memorandum of Understanding was also established with the Philippine Carabao Center (PCC) to set up a “Dairy Box” in Maitum, providing dairy products to the local market. This initiative involved distributing 50 carabaos to farmers within the Pangi Multipurpose Cooperative (PAMULCO), enhancing agricultural productivity and economic well-being. The PCC buys milk from these carabaos, which are processed into various dairy products for sale. This venture has been profitable, with daily sales reaching up to P10,000 during municipal events, benefiting cooperative members.

Under the guidance of the new MNAO, Maitum incorporated food fortification and salt iodization processes into its nutrition program. Collaborations with government agencies such as the Department of Science and Technology-Food and Nutrition Research Institute, NNC, and DOH facilitated these initiatives, including salt-testing in local markets to ensure adequate iodine content in food items. 

Deep Dive in an indigenous community

In February 2023, Mayor Reganit, Jr. embarked on ZFF’s Deep Dive, a guided community immersion, in Barangay Kalaneg, a T’boli community located about 20 minutes from Maitum. This barangay is among the top 10 in Maitum with the most malnourished cases. Joining the Mayor and his Nutrition Team was Sangguniang Bayan member Frediman Wanan, formerly an Indigenous Person Mandatory Representative (IPMR).

During the visit, they met “Francis”, a malnourished child born with an abdominal defect called “omphalocele”. Despite being advised to undergo surgery, Francis remained untreated due to concerns about the operation’s success and post-operative costs. Mayor Reganit Jr. discovered this and realized there were deep-seated trust issues among the T’boli community, especially concerning healthcare workers from outside their group.

To address this, the municipality enhanced a program training and deploying T’boli women as healthcare providers, which improved health-seeking behavior among pregnant T’boli women. This initiative led to a remarkable increase in prenatal check-ups from 70% in 2019 to 100% in 2022. These efforts resulted in a steady decline in malnutrition rates, with stunting dropping from 9.10% in 2020 to 4.81% in 2022, and wasting decreasing from 2.10% to 0.85% during the same period. These outcomes reflect the success of the municipality’s targeted interventions and community engagement strategies.

Behavior-centered designing workshop 

In March 2023, Mayor Reganit and his team took part in Module 2 of the MNGP, leveraging their insights from the Deep Dive. This module focused on adopting a behavior-centered approach to health and nutrition.

During this workshop, the team reviewed Maitum’s ongoing challenges despite progress in reducing malnutrition, highlighting issues like rising teenage pregnancies and early marriages among the T’boli community. They recognized arranged marriage among teenage IPs as a problem.

In response, they outlined interventions as part of their Behavior-Centered Design (BCD) project named “OPLAN ISULONG”, including providing health kits and check-ups for pregnant women, rewarding traditional birth attendants who refer patients to facilities, conducting weekly sessions for teenagers on health education, launching an information, education, and communication (IEC) campaign and health services in a selected barangay, and supporting the establishment of a community garden.

Additionally, they planned to establish a community assembly for dialogues on teenage pregnancies, draft a municipal ordinance against early child marriage, reward barangays with no teenage pregnancy cases, and recognize tribal leaders discouraging early child marriage.

Moreover, Maitum is looking to further enhance their nutrition interventions by forging active partnerships externally and internally. Mayor Reganit Jr. understands that in order to expand the nutrition program and attain their goal of “no new stunting by 2025,” he has to actively engage all sectors, especially community leaders and volunteers, including the private sector. In fact, he and his team already forged partnerships with San Miguel Corporation to expand the reach of his livelihood and food production initiatives (e.g., carabao and poultry farming to help parents with malnourished children).

Indeed, Mayor Reganit, Jr. may have envisioned a different path for himself as a young man, but having eventually chosen to become a leader, he has been keen on showing that he has what it takes to respond to the needs of his constituents. 

He believes that together with his core team, they will be able to make their vision come true—that is, Maitum becoming a “fully-empowered municipality where the peace-loving people are nutritionally resilient, healthy, and living abundantly.”

“Improving nutrition outcomes is important to me, because I dream of an Isabela cradled in strong, competent, and nurturing arms of future Isabeleños.”

Determined to improve health and nutrition, Isabela City Mayor Sitti Djalia “Dadah” Turabin-Hataman, decided to participate in the Municipal Nutrition Governance Program (MNGP) by the Zuellig Family Foundation (ZFF).

Born in Manila and married to Representative Mujiv Hataman, a prominent figure in Basilan, Mayor Dadah brings a wealth of experience in human rights and governance. After serving two terms in Congress, she returned to Isabela City, driven by a desire for grassroots impact and community service.

Isabela City, nestled in the southern Philippines, is a vibrant hub of diverse cultures and traditions, home to various ethnic groups living harmoniously alongside Christianity and Islam. Despite its classification as a fourth-class city with a population of 130,379, Isabela City is vital to the commerce and industry of Basilan Province. Distinguishing it from the province of Isabela located in northern Luzon, Isabela City has become known colloquially as Isabela de Basilan.

Improved transportation links have reduced travel time to neighboring Zamboanga City, fostering economic growth and cooperation between the two regions. Despite these advancements, challenges persist, especially in remote areas like Malamawi Island, where health services and nutrition education require targeted interventions.

Persistent malnutrition problem

While Isabela City saw a notable reduction in poverty rates from 53% in 2018 to 23.7% by 2021, malnutrition persists, largely stemming from poverty. First-time mothers often lack essential knowledge about proper nutrition, resulting in harmful feeding practices like early introduction of solid food or inappropriate bottle feeding. 

Mayor Dadah emphasized the importance of Local Chief Executive (LCEs) like her, stating: “The support of LCEs plays a major role in strengthening our programs, particularly when it comes to addressing nutrition.” She continued, “When the focus is solely on the compliance with the program, the true essence and importance of nutrition is somehow compromised.”

Realizing the vision

Governor Jim Hataman-Salliman recommended Isabela City to be part of ZFF’s Nutrition Governance Program. Mayor Dadah was invited through a network of ZFF’s development workers in Basilan, who often spoke highly of the Mayor’s abilities and leadership skills.

Initially, Mayor Dadah was content with Isabela City’s ongoing feeding program and was surprised by the invitation. Reflecting on her administration’s efforts, she realized that while their feeding program had merit, it fell short in addressing the multifaceted challenges of malnutrition comprehensively. She admitted that nutrition had been a blind spot and that malnutrition encompasses more than just children being underweight or had stunted growth. Participating in ZFF’s MNGP workshop was eye-opening, especially in identifying the need for a nutrition expert, which led to the prompt hiring of a Registered Nutritionist-Dietitian (ND) for the city.

The MNGP experience highlighted the intricate dynamics of nutrition issues and the pivotal role of leaders in effecting change, particularly for malnourished children and at-risk pregnant women. Mayor Dadah now aims to expand the program to barangays through their Local Government Units (LGUs), recognizing their crucial role in promoting the health of vulnerable populations.

Forward-looking initiatives

Under Mayor Dadah’s leadership, the City Nutrition Committee Technical Working Group (CNC TWG) was established to closely monitor program implementations such as the Operation Timbang (OPT) program,  Maternal, Early Childhood, and Learning Program Intervention, and supplemental feeding for nutritionally at-risk and malnourished children.

The collaboration extended beyond the CNC, with departments like the City Social Welfare and Development Office contributing to feeding programs and cash assistance initiatives. The City Agriculture Office (CAO) promoted food security through backyard gardening programs, while the City Health Office focused on delivering quality Maternal, Newborn, Child Health, and Nutrition services, leading to successful outcomes such as exceeding antenatal care targets in 2022.

Further, nutrition interventions have been strategically integrated into the approved annual investment plans and the Disaster Risk Reduction and Management – Health (DRRM-H) plan for 2023 in Isabela City. This integration encompasses crucial aspects such as procuring nutrition commodities and equipment, promoting breastfeeding, and managing malnutrition. Health workers diligently educate mothers about the significance of breastfeeding during prenatal checkups, emphasizing its role in preventing malnutrition.

In addition to hiring an ND, the City Population Commission Office also employed four more ND Job Order personnel. These personnel are crucial in implementing the 90 and 120-day supplementary feeding programs in selected barangays identified during OPT. Their efforts have significantly increased the OPT coverage in the city, nearing the national target of 90%.

Partnerships with educational institutions and organizations like Basilan State College and the National Nutrition Council (NNC) of Region IX have been strengthened. Collaborative programs such as the “Tutok Kainan” Program and partnerships with NGOs like ASA PHILIPPINES aim to improve food and nutrient intake for vulnerable populations, including pregnant women and malnourished children.

Acknowledging the needs of marginalized sectors, Isabela City supports initiatives for youth, provides assistance to solo parents, promotes women’s participation in local bodies, and celebrates Women’s Month annually to empower women and recognize their achievements. These efforts collectively contribute to a more holistic and impactful approach to address health and nutrition challenges in Isabela City.

The path ahead

In the last quarter of 2023, Isabela City initiated the development of its City Nutrition Action Plan covering 2023 to 2025. This comprehensive plan involved collaboration with the LGUs to ensure the inclusion of all necessary resources for demand generation and nutrition commodities. The agriculture sector also aligned its interventions, focusing on improving food security programs.

“Nutrition has always been a top priority for our administration,” Mayor Dadah affirmed. “We have implemented effective interventions backed by research and development to tackle persistent malnutrition issues. With our substantial budget allocation of 10,959,813.63 pesos for nutrition, we stand as a capable agent of change at the community level. Our efforts have borne fruit, as evidenced by the recent decline in stunting and overweight cases in 2022.”

Looking ahead, the City Nutrition Council aims to progressively eliminate malnutrition and achieve a zero-case target. Mayor Dadah said, “We will work vigorously to achieve scale-up inclusive nutrition interventions and build resilience among our target sectors with an emphasis on the vulnerable ones. I will continually express my solidarity together with our partners and stakeholders in building food and nutrition security for a happy and dignified life for all Isabeleños.”

Mayor Dadah emphasized the importance of unity and commitment, stating, “Coming together is just the beginning, but it is the right beginning. From this point forward, we commit to delivering what is expected from us, going above and beyond.”

In 2022, the province of Apayao became among the last Universal Health Care implementation sites (UIS) in the Cordillera Administrative Region (CAR). Nonetheless, the province swiftly completed all preparatory requirements in the first quarter of the following year. By the end of 2023, it had achieved 61.1% of organizational and 30% of functional level requirements.

Much of the progress may be owed to the proactive leadership of Governor Elias C. Bulut Jr., who enjoyed abundant support from the Department of Health (DOH) regional office. DOH-CAR enrolled provincial health leaders to the University of the Philippines Manila for the Provincial Leadership Development Program (PLDP), which is among the courses under the Zuellig Family Foundation’s Bayang Malusog health leadership programs.

A seasoned politician, Bulut successfully convened and persuaded all seven municipal mayors to actively participate in realizing UHC. He provided clear direction and ensured agreement among his provincial health team on their respective deliverables, facilitating rapid progress under the province’s banner project called BUTSY (Bringing Universal health care services Towards a Sustainable program implementation Yielding to a resilient Apayao). 

Bulut was also cognizant of the fact that health is a social issue so it is vital to address social determinants to ensure sustainability. As an initiative, his administration institutionalized mechanisms to provide livelihood projects, educational and medical assistance to Iyapayaos through the ASENG (Apayao Socio-Economic Efforts Necessary for Growth) Program. In fact, its sub-program, the ASAP (Apayao Student Assistance Program), envisions each Iyapayao household to produce at least one professional. Through these projects, Bulut hopes for a sustainable improvement in the overall well-being of every Iyapayao.

Demonstrating accountability for his province’s health outcomes, Bulut promptly acknowledged their shortcomings when questioned about the increase in maternal mortality ratio (253 in 2023 from 68 in 2019) and significant decline in child immunization rate (16% in 2023 from 71% in 2019). However, he possessed a clear understanding of necessary actions.

Bulut prioritized human resources, allocating a supplemental budget to fill critical positions in the provincial health office (PHO), which is ably headed by Dr. Mark Joleen Calban, the provincial health officer.

They now boast a senior officer each for surveillance and public health units. Additionally, they appointed a head for the health promotion section, crucial for realizing Bulut’s vision of educating and fostering acceptance of medical services and health programs among the province’s population, which includes over 50% indigenous peoples. This aims to reduce unskilled home deliveries, irregular checkups, and vaccine hesitancy. 

Recognizing the important role of the Barangay Nutrition Scholars (BNS) and Barangay Health Workers (BHWs) as health educators and workers on the ground, Bulut spearheaded the institutionalization of incentive mechanisms for them. For 2023 alone, the province allocated at least 4.5 million pesos as cash incentives for all accredited BNSs and BWHs on top of the 1.2 million pesos worth of kits.

Efforts were intensified to train health workers in service delivery, promotion, and supply chain management. There was a challenge to extend services to 54 hard-to-reach villages but the provincial government incentivized doctors and specialists to serve in extension clinics by offering higher daily per diems and free board and lodging. Although Apayao’s doctor-to-population ratio currently stands at 1:9567, contractual physicians stand to alleviate the health burden. 

Before the end of 2023, Bulut also approved the 5-year Health Facility Development Plan for the 5 provincially-operated infirmaries amounting to almost half a billion pesos covering personnel services, training needs, equipment, and infrastructure. He also envisioned these facilities to each have add-on specialty services such as Dialysis Center, Radiologic and Imaging, Upgraded Maternal, Neonatal and Child Health, and Drug Testing Laboratory. This is on top of the upgrading of the 2 infirmaries to level 1 hospitals, one for Lower Apayao and one for Upper Apayao.

In 2024, the PHO plans to recruit an information analyst and a senior program officer for planning. They are also considering hiring a senior program officer for supply chain management to oversee the recently centralized procurement system that has prevented medicine stock outs across their seven facilities, comprising two level-2 hospitals and five infirmaries. Consignment arrangements for drug supply are also being explored.

Despite the province’s significant strides, Apayao’s health team remains vigilant, recognizing the need for further dialogue with local health leaders to refine the patient referral system to align with UHC requirements. They must also address the persistent issues of teenage pregnancy and malnutrition, acknowledging that their solutions extend beyond the health sector.

With unwavering commitment, strategic foresight, and invaluable coaching support from DOH’s Charlyn Tagabing, Governor Bulut is poised to see his people enjoying the benefits of UHC sooner than expected.

She’s driven by a singular mission: to grant Filipinos unfettered access to quality healthcare services. With unwavering determination, she ensures that her fellow leaders and teammates walk alongside her on this transformative journey.

Dr. Paula Paz Sydiongco, the Regional Director of the Department of Health (DOH)-Ilocos, seized an opportunity to engage with governors and the city mayor in the Ilocos Region to advance Universal Health Care (UHC) through the Bayang Malusog leadership training program by the Zuellig Family Foundation (ZFF). She capitalized on this opportunity through sustained meetings, courtesy calls, and coaching sessions with local chief executives. Additionally, she has been conducting regular technical working group sessions with provincial health officials and inter-agency cluster meetings for her team at the Ilocos Region Center for Health Development (CHD).

The result is a shared commitment to expedite the fulfillment of all UHC requirements. In 2023, the UHC maturity level in all UHC implementation sites (UIS) improved from the previous year. The provinces of Ilocos Sur, Ilocos Norte, La Union, Pangasinan, and Dagupan City have reached 100% of the preparatory level key result areas. At the organizational level, the accomplishment of the five sites ranged from 72 to 86%, while at the functional level, Region 1 UIS attainment was between 25 and 70% of KRAs.

Sydiongco is encouraged by the governors’ receptiveness to her advice and has provided tangible support by augmenting the provinces’ necessary health personnel and offering financial grants to enhance health facilities. She acknowledges the need for improvements in maternal and child care outcomes. The region’s maternal mortality ratio, at 52, is below the country’s target of 90 but infant mortality rate, at 20, is above the national target of 15.

To address preventable maternal and infant deaths, she advocates for Basic Emergency Obstetric and Newborn Care (BEmONC) training and organized supportive supervision to enhance skills in caring for pregnant women and babies, investigating causes of deaths, and implementing interventions to address underlying issues.

Sydiongco empowers her staff to work towards UHC by providing necessary skills through training, mentoring, and coaching, supported by various programs of the ZFF. Regular monitoring of indicators, outcomes, and developments allows her team to share evidence-based information, earning the trust and confidence of provincial and city leaders.

Having weathered various natural disasters, including the impact of super typhoon Haiyan in the Eastern Visayas region during her tenure as assistant regional director, Sydiongco prioritizes accountability for outcomes and engaging stakeholders effectively given the various organizations she had to face and work with after Haiyan. With the government’s emphasis on establishing more Bagong Urgent Care and Ambulatory Centers (BUCAS) Centers, she recognizes the need to enhance her management skills, acknowledging her ongoing learning process as a Regional Director. 

Sydiongco’s commitment to self-improvement despite regional successes signifies promising prospects for the area. Her dedication echoes the resounding call of “Region 1 Number 1 (sa Kalusugan)”, ensuring that excellence remains the guiding beacon for healthcare in the region.

Zuellig Family Foundation (ZFF) provides a competitive compensation package, a hybrid work arrangement, customized training and development program, and more.

ZFF offers a competitive benefits package:
• Hybrid work arrangement
• 30 days incentive leave (combination of vacation and medical/ sickness leaves), plus 5 emergency leaves
• Annual Physical Examination leave
• HMO and Life Accident insurance coverage
• Customized training and development (synchronous and virtual instructor-led training)
• Monthly communication/ internet allowance
• Annual clothing allowance
• Semestral Inflation-based Financial Aid

The Zuellig Family Foundation (ZFF) Internship program provides a training ground for students looking to deepen understanding of work in the public health sector and non-profit organization processes. The program, relaunched in 2021, has produced 3 full-time employees who started out as interns in the organization.

ZFF opens opportunities for students enrolled in the following courses:
Human Resources Intern: BS Psychology/ Human Resources Development Management /other courses related to Human Resources
Corporate Communications Intern: Public Relations/ Communications/ Journalism or any related courses
Management Information System Intern: Computer Engineer or any related courses
Finance Intern: Financial Management/ Accounting or any business related courses
Portfolio Management Intern: Health or Public Health-related courses

SUBMIT APPLICATIONS HERE