On August 15, 2024, the University of the Philippines-College of Public Health (UP-CPH) and the Zuellig Family Foundation (ZFF) hosted the webinar titled “Health Equity in Focus: Lessons from Early Implementation of UHC in Selected Regions.” The event, streamed via Zoom and Facebook Live, attracted over 1,500 participants eager to discuss the progress and challenges of rolling out the Universal Health Care (UHC) Law.

The webinar opened with a warm welcome from Dr. Fernando Garcia, UP-CPH Dean, who emphasized the importance of collaboration among different stakeholders to improve health outcomes and achieve health equity. Dr. Leizel Lagrada, UP-CPH Program for Health Equity Coordinator, noted that true UHC cannot be achieved without health equity, stressing the need for a strong primary health care system as the foundation.

The session featured key presentations from Dr. Catherine Chung, ZFF Local Health Systems Portfolio Director, and Dr. Anthony Faraon, ZFF Deputy Executive Director, who introduced the Bayang Malusog Program. This program focuses on training regional, provincial, and municipal leaders to speed up UHC implementation. They discussed data from the program’s target areas and shared the challenges faced, particularly in the rollout of PhilHealth’s Konsulta program. Slow implementation and technical issues with PhilHealth’s information systems, and difficulties in meeting licensing and accreditation requirements of primary care facilities were identified as significant barriers.

A panel discussion followed, where experts shared their experiences and strategies in implementing UHC at the local level. They discussed the need for better coordination, especially in areas with poor infrastructure and internet connectivity, which hampers the Konsulta registration and service delivery:

Regional Strategies for UHC Implementation: Dr. Paula Paz Sydiongco, Department of Health-Center for Health Development (DOH-CHD) Regional Director for Ilocos Region provided examples where targeted interventions and localized strategies have been employed to address specific health challenges. Dr. Sydiongco emphasized the need for regional adaptability, noting that what works in one area may not be as effective in another, and thus, tailored strategies are essential for achieving the goals of UHC.

Leadership and Governance in Health Equity: Dr. Anna De Guzman, Provincial Health Officers Association President, shared her experiences in leading health initiatives at the provincial level and how strong governance structures can drive meaningful change in health outcomes. Dr. De Guzman underscored the importance of leadership that is both visionary and grounded in the realities of the communities it serves, ensuring that policies and programs are inclusive and equitable. She said, “It’s not [about] how big you are in the implementation of UHC, but it’s more on the commitment and your passion to really push for the vision and to achieve the goals of UHC.”

The Role of Performance Monitoring in Health Equity: Lindsley Jeremiah Villarante, DOH Performance Monitoring and Strategy Division Chief, discussed how consistent and accurate data collection is crucial for identifying disparities in healthcare delivery. He pointed out that without proper monitoring and strategic evaluation, efforts towards achieving health equity could fall short, as there would be no clear understanding of which areas need improvement or further support.

Quality Assurance as a Pillar of Universal Health Care: Dr. Francisco Z. Soria Jr., PhilHealth Quality Assurance Group Vice President, explained that ensuring quality in healthcare services is not just about meeting standards but also about creating a system that consistently delivers high-quality care across all levels of the healthcare system. He stressed that quality assurance mechanisms must be in place to maintain trust in UHC and ensure that all Filipinos receive the care they deserve.

In closing, ZFF President Austere Panadero acknowledged the ongoing challenges in achieving UHC, especially in reaching the most vulnerable populations. He urged for faster and more innovative strategies to ensure that UHC benefits are felt by all Filipinos. “Ramdam ba ng bawat Pilipino ang UHC?” Panadero asked, pushing for more effort in making health services accessible to everyone.

On August 9, 2024, the Provincial Leadership Development Program (PLDP) for the Cordillera Administrative Region (CAR) concluded with a colloquium at The Heritage Hotel Manila led by the University of the Philippines-College of Public Health (UP-CPH), academic partner of the Department of Health-Center for Health Development (DOH-CHD) in CAR,  and the Zuellig Family Foundation (ZFF). 

The event, themed “Strengthened Leadership Towards Redesigning Health Systems for the Acceleration of UHC in Cordillera,” gathered the five provinces of CAR (Apayao, Benguet, Kalinga, Ifugao, and Mountain Province) through their respective governors to share lessons and strategies on how they structured and organized their health service delivery.

The colloquium featured reflections from the governors of five provinces:

Collective Action for Health: Governor Elias C. Bulut, Jr. of Apayao believes that a whole-of-society and whole-of-government approach is essential to tackle the social determinants of health. He shared how Apayao has mobilized various sectors—from local government units to community organizations—in a concerted effort to improve health outcomes. He pointed out that only by working together can communities address issues such as poverty, lack of education, and inadequate access to healthcare, which are the root causes of many health problems.

Comprehensive Approaches to Health: Governor Melchor D. Diclas of Benguet spoke on how socio-economic status, education, and access to resources significantly influence health outcomes. He shared that Benguet’s health programs now consider these factors, ensuring that interventions are more tailored to the specific needs of the community. By recognizing and addressing these underlying issues, Benguet aims to create a more equitable health system that reaches even the most vulnerable populations.

Leadership and Critical Thinking: Governor Jerry U. Dalipog of Ifugao shared how Ifugao’s leadership team adopted a proactive stance, anticipating potential obstacles and crafting strategies to overcome them. He said that such foresight and adaptability have been crucial in redesigning Ifugao’s health services, particularly in the face of emerging public health threats.

Strategic Partnerships for UHC: Governor James S. Edduba of Kalinga called on the DOH to invest more in workforce development, infrastructure, and digital health. He also urged the DOH to strengthen support for primary care and service delivery networks and to provide technical assistance on the operationalization of the Special Health Fund (SHF). For ZFF, he recommended enhancing partnerships with community-based organizations to empower local leaders and improve service delivery. Additionally, he suggested that UP-CPH  integrate UHC into its curriculum and offer short courses to build capacity in health leadership.

Local Empowerment and Health Equity: Governor Bonifacio C. Lacwasan, Jr. of Mountain Province reflected on the ‘Barangay Muna’ initiative, which focuses on empowering local communities to take charge of their health. He discussed how this grassroots approach has been pivotal in addressing issues like malnutrition and non-communicable diseases, which often stem from deep-rooted socio-economic challenges. Governor Lacwasan emphasized the importance of working closely with barangays to ensure that health interventions are not only effective but also sustainable.

The event featured a keynote address from Dr. Maria Rosario Vergeire, DOH Undersecretary, who highlighted the progress made and the ongoing challenges in UHC implementation. Dr. Vergeire urged leaders to strengthen connections between municipalities and provinces to create more coordinated health care networks. Panel discussions included insights from former Regional Directors Dr. Rio Magpantay, Dr. Amelita Pangilinan, and Dr. Myrna Cabotaje, providing valuable perspectives on health system improvements.

PLDP, a two-year initiative led by DOH and UP-CPH and supported by ZFF, has empowered provincial leaders with the skills needed to transform health systems. Through a mix of classroom learning and practical experience, participants have developed strategies to accelerate UHC and create sustainable health solutions for their communities. This closing colloquium marks a new chapter in CAR’s health leadership, with strengthened governance and innovative approaches paving the way for better health outcomes across the region.

From August 7-9, 2024, youth leaders in Catbalogan City, Samar, came together for a three-day training under the Barangay Expanded Youth Leadership and Governance Program (BEYLGP). This event, led by the Zuellig Family Foundation (ZFF), under the Joint Programme on Accelerating the Reduction of Adolescent Pregnancy in Southern Leyte and Samar (JPARAP), focused on finding ways to reduce the high rates of adolescent pregnancies in Catbalogan City.

Sangguniang Kabataan (SK) Leaders Share Their Challenges and Plans

Jenine Ortiz, an SK Councilor from Barangay Payao, spoke about the struggles her community faces in getting young people interested in the issue. Many of them find it boring or do not see how it benefits them. Parents are not pushing their kids to join the discussions either, thinking it is only relevant for married people. Some parents are uncomfortable talking about these topics, especially when it involves sex. Ortiz also mentioned that barangay officials do not show much interest, and it is unclear if teachers are addressing the problem. Feeling isolated, she wondered if they were approaching the issue in the right way.

Paul Lawrence Tizon, an SK Member from Barangay Canlapwas, talked about the importance of collaboration among different groups in the community to address adolescent pregnancies. Canlapwas currently has the highest number of adolescent pregnancy cases in Catbalogan, according to the City Health Office. Paul stressed that only by working together can they bring these numbers down.

Charles Andrei Bañar, the SK Chairperson of Barangay San Andres, presented a plan that focuses on changing behaviors to reduce adolescent pregnancies. He emphasized that the success of this plan depends on the involvement of everyone in the community.

Other Community Leaders Speak Out

Marissa Rodriguez, a Parent Leader from San Andres, emphasized the need for understanding and empathy in leadership. She pointed out that leaders need to connect with the community to make a real difference. “To truly understand the challenges faced by our adolescents, genuine leaders must step into their shoes,” Marissa said.

Barangay Chairperson Eduardo Villanueva of Canlapwas acknowledged the seriousness of the problem in his area. He called on everyone in the barangay to unite and help address the issue. Eduardo also committed to enforcing stricter rules to prevent young people from getting into risky situations.

Rebeca Prudenciado, a youth leader from Barangay Mercedes (locally known as Burak), introduced their plan called ‘Usad Buraknon’, which aims to reduce adolescent pregnancies in their area. She said, “There can be no meaningful growth (usad) in our barangay if our fellow youth are getting pregnant at a very tender age.”

The BEYLGP training provided a platform for these leaders to share their experiences and develop strategies. With their dedication, the community is hopeful for positive changes ahead.

When Mayor Jul-Adnan P. Hataman won the election in Sumisip, Basilan in 2019, he knew little about nutrition. He admitted, “I used to think that nutrition was just about school feeding and a nutrition month celebration.”

Despite his initial lack of knowledge, Sumisip saw some improvements in nutrition in recent years. From 2020 to 2021, stunting rates dropped from 34.8% to 27.74%, wasting decreased from 9.57% to 3.57%, and low birth weight rates fell from 1.34% to 0.37%.

However, other indicators worsened. Operation Timbang (OPT) coverage dropped from 65.2% in 2020 to 59.5% in 2021, below the 90% national target. Indicators like Iron Folic Acid (IFA0, facility-based delivery (FBD), skilled birth attendants (SBA), and fully immunized child (FIC) were also below the national target.

In early 2019, Dr. Maria Rosalie De Guzman, a doctor to the barrio (DTTB) from Cavite, came to Sumisip. She continues to serve the municipality to this day—three years more than the required 2-year service for DTTB. Dr. De Guzman inspired local health workers to work and serve in their own communities. Mayor Hataman supported her by providing transportation and accommodation. 

The municipality faced challenges filling health office positions due to safety concerns. Mayor Hataman appointed a Municipal Nutrition Action Officer (MNAO), and the Ministry of Health in Bangsamoro Autonomous Region in Muslim Mindanao (MOH-BARMM) assigned an additional nutrition officer to help.

Involving the youth in initiatives like Kamakanakan Sumisip (Youth of Sumisip) also helped. Despite these efforts, the nutrition situation remained challenging.

When the Zuellig Family Foundation (ZFF) invited Mayor Hataman to join the Municipal Nutrition Governance Program (MNGP) in January 2022, he immediately agreed.  He knew he would learn a lot from the initiative, since his father was once a participant of a ZFF program. He knew, too, that he needed all the support that he could get to improve the municipality’s nutrition situation.

Challenging Situation

Sumisip, a municipality in Basilan with 567.60 square kilometers and a population of 47,345, faces significant health and nutrition challenges. Mayor Hataman and his team joined the MNGP in early 2022 to address these issues, focusing on improving health and nutrition for women and children.

Key challenges include an inactive nutrition committee, a lack of human resources, and harmful cultural beliefs and feeding practices. Some caregivers introduced solid food to infants too early, leading to health problems, while others failed to provide a varied diet.

In July 2022, as part of the MNGP, Mayor Hataman and his team participated in a Deep Dive activity in Barangay Mangal, the municipality’s most populated area, to understand these challenges firsthand. They visited a family struggling with poverty and poor nutrition practices. The mayor, disguised as a nurse, learned about the family’s struggles, including the lack of immunization and proper feeding for their child, baby Sirkan.

“Before I joined the MNGP, I didn’t have any knowledge about nutrition. But the opportunity has been given to us through this program so that we can calibrate ourselves and learn new nutrition theory to improve services,” he said. “[Through the Deep Dive,] I was able to see the magnitude of the malnutrition problem. It made me realize our roles not only as LGU officials but even as parents. We neglected the program, from the stage of pregnancy up to the proper rearing and care of children in our locality.”

This experience highlighted the importance of health workers and the impact of poverty and education on nutrition and family planning. Inspired by these insights, Mayor Hataman and his team developed Sumisip CARES (Community Assistance Reforms through Emerging Synergy), launched in September 2022, to provide immediate and long-term interventions to combat malnutrition.

Initiatives and Actions

Mayor Hataman and his team implemented the following initiatives:

• Strengthening the Local Nutrition Committees. Mayor Hataman and his team improved the local nutrition committees by reorganizing and expanding the Municipal Nutrition Committee (MNC) members. They held regular meetings to discuss nutrition issues, involving 10 out of the 29 barangays and forming Barangay Nutrition Committees (BNCs).
• Developing Policy-Based Investment Mechanisms. They created a three-year Local Nutrition Action Plan (LNAP) for 2023-2025 with a budget of Php 48,297,800 to ensure the sustainability of nutrition programs. The plan itemized the budget for sectors like agriculture, social protection, and health. Mayor Hataman approved this plan in March 2023.

• Rallying Support of Barangays for Nutrition. Understanding the severity of malnutrition, Mayor Hataman identified 10 barangays with the highest stunting rates. He held an executive session with barangay leaders, urging them to address the problem together. Seven barangay captains attended and became more active in tackling malnutrition issues.
• Recognition Program for Barangays. Mayor Hataman announced a recognition program to incentivize barangays improving their nutrition indicators through the Seal of Good Local Governance (SGLG).
• Crafting Six-Month Action Plans with Barangays. During the executive session, they developed six-month action plans, reorganized the BNCs, and identified Barangay Nutrition Action Officers to ensure coordinated nutrition activities.
• Mainstreaming Nutrition in Sumisip CARES. The program, which aims to make basic and social services accessible, now includes nutrition interventions. It prioritizes households with severely malnourished children, providing food assistance, agricultural seeds, and regular monitoring. The Sumisip HELPS (Heightening Employment Livelihood Program and Services) program extends livelihood assistance to poor families. The Municipal Government of Sumisip also collaborates with the Provincial Government of Basilan, which provides agricultural and livestock resources and ensures that nutrition services are always available.

Way Forward

Three years into Mayor Hataman’s leadership, Sumisip still faces challenges with malnutrition despite various efforts. Issues like unstable peace and order, migration, and difficult access to health facilities have made progress slow.

However, there have been some positive changes. The coverage for Operation Timbang (OPT) increased from 45.8% in 2022 to 54.98% in 2023, though it’s still below the national target of 90%. Stunting rates also dropped from 36.54% in 2022 to 31.25% in 2023 and 24.10% in 2024, though they remain above the national target of 21.4%.

These improvements, while modest, are steps in the right direction. Mayor Hataman remains committed to bettering the situation with support from the province, barangay leaders, his nutrition team, and ZFF. He encourages everyone to celebrate the progress and continue working towards a healthier future. He said, “This is us, healing from the wounds of the past. And this is us, proving na malayo na tayo sa Basilan noon (that we have come a long way from the Basilan of old). May we continue to rise above the shadows of our jarring past. May we sustain the gains our leaders have worked for through the years.”

On July 18, 2024, the Zuellig Family Foundation (ZFF) held its second Bayang Malusog Community of Practice (CoP) session. This event focused on sharing good practices and finding innovative solutions for financial sustainability within Universal Health Care (UHC) implementation. 

During the two-hour session, Dr. Kristine Villaseñor, the Provincial Health Officer of Quezon Province, shared how they have integrated financial management into their system as a Primary Care Provider Network (PCPN) sandbox site of the Department of Health (DOH). J-Lorenz Dionisio, UHC Focal Person for Aklan, talked about their governance model for managing the Special Health Fund. Aklan is one of the four Health Care Provider Network (HCPN) demonstration sites of DOH, alongside Benguet, Laguna, and Sarangani.

Quezon’s Financial Integration and Challenges

In Quezon, the journey towards effective health financing has been marked by both progress and hurdles. Dr. Villaseñor highlighted the opening of their Special Health Fund (SHF) Depository account as a key achievement. This step, led by the UHC Coordinator and the Provincial DOH Office (PDOHO), ensures that funds are properly managed and allocated. One of their notable practices is the collaboration between the Planning and Research Unit and other provincial units, which has been crucial in maintaining compliance with health policies.

Mayors or their representatives are active members of the Provincial Health Board (PHB), which strengthens the governance structure. Additionally, the Konsulta Operational Management Group has been working hard to intensify the Konsulta program. Despite these efforts, challenges remain. The primary source of the SHF is the Konsulta frontload, supplemented by funding from DOH and various tranches. However, frequent system downtimes, inadequate hardware, and slow internet have hindered progress. Monitoring the Konsulta program has also been difficult.

To address these issues, Quezon plans to continue the Konsulta Network Sandbox and develop QuezonHealthCare.com, an online platform for better health service management. They are also working on guidelines for the allocation and utilization of funds within the SHF.

Aklan’s District Health System and Governance Model

Meanwhile, Aklan’s approach to health financing is centered around the establishment of a functional Aklan District Health System. J-Lorenz Dionisio explained their goal of creating six District Health Systems (DHS) to streamline healthcare delivery and improve access to services.  

The organization of these DHS and their respective management teams is ongoing. Aklan has been drafting a Memorandum of Agreement (MOA) for provincial and municipal collaboration, including a policy on sharing resources. They are expanding their Management Support Unit (MSU) to support district operations and have been hiring additional accountants and district health managers.

The MSU assists the Provincial Health Office of Aklan implement the updated health care Konsulta package for the province having been selected as an HCPN demonstration site. They are also working on a draft manual for the HCPN referral system to ensure responsiveness within each district.

The Provincial Governor convenes Aklan’s expanded PHB regularly, with all the mayors, Provincial and Municipal Health Officers present or represented. ZFF’s Provincial and Municipal Leadership and Governance Programs assisted the local government units to align with the #oneAklan vision for health.

Collaborative Efforts and Future Directions

Both Quezon and Aklan are navigating the complexities of health financing with determination and innovative solutions. Through the Bayang Malusog CoP virtual sessions and the Bayang Malusog Exchange (BMEx) online platform, accessible at https://healthinnovex.org, they continue to share insights and strategies, supporting each other in their journey towards achieving their UHC goals.

Dr. Kathrine Flores of the DOH – Bureau of Local Health Systems Development said, “It is important for us to document this journey and share experiences with each other so that we know what we can replicate to our locality.” Alongside Quezon and Aklan are Apayao, Baguio City, Benguet, Biliran, La Union, Laguna, Northern Samar comprising the first batch of the Bayang Malusog CoP. The next virtual session is in September.

From July 17 to 19, barangay officials and youth leaders from Barangays Babaclayon, Can-aponte, Poblacion 1, and Poblacion 4 of the Municipality of San Jose de Buan, Samar gathered to address a growing concern: adolescent pregnancy. They took part in the Barangay Expanded Youth Leadership and Governance Program (BEYLGP), focusing on the Behavior-Centered Design method to tackle this issue head-on.

The BEYLGP, led by the Zuellig Family Foundation (ZFF), under the Joint Programme on Accelerating the Reduction of Adolescent Pregnancy in Southern Leyte and Samar (JPARAP), aims to equip community leaders with the tools and knowledge needed to combat adolescent pregnancy effectively.

San Jose de Buan has seen 19 cases of adolescent pregnancies in the latest quarter of 2024. Over three days, participants learned to implement campaigns and initiatives tailored to their community’s needs, emphasizing teamwork and support for adolescents.

“By equipping our youth leaders and barangay officials with the right tools and knowledge, we aim to empower them to take proactive steps in reducing adolescent pregnancies,” said Dr. Phoebe Dela Cruz, Municipal Health Officer. “Our goal is to foster a culture of health and awareness that will benefit the entire community.”

Stories of Change and Determination

During the training, 24-year-old Barangay Chairperson Jimar Mañozo from Can-aponte shared his journey. Moving from a rural area to a city for education, he faced bullying and discrimination, shaping his resolve to prepare his young constituents for future challenges.

Beatrice Ebias, Chairperson of the Committee on Health in Can-aponte, also shared her story. Pregnant at 15, she once thought this was her destiny, a fate later shared by her eldest daughter. The BEYLGP training changed her perspective, and now she is determined to prevent adolescent pregnancies in her barangay. “Now that I know this is not normal, I am determined to curb this problem,” Beatrice said. 

Barangay Chairperson Jovito Rebato of Babaclayon reflected on his past mistakes. His strict approach to his adolescent daughter, who became a young mother, created a chasm between them. The BEYLGP training made him realize the need for empathy and support. He pledged to combat adolescent pregnancies with renewed purpose, aiming to create a more supportive environment for the youth in his barangay.

Inspiring Youth Leaders

Karen Pacios, a youth leader from Babaclayon, came out of the training inspired to make a difference. Seeing the struggles in her barangay, she pledged to share her knowledge and advocate for better support systems for adolescents. “I vow to end this vicious cycle in our poor communities,” Karen declared.

Keith Kelvin Rapatan, Supreme Student Government President from Poblacion 1, also committed to guiding his peers away from premature sexual activities. “Together, we can navigate the challenges of adolescence and build a future we can all be proud of,” he said, exemplifying true leadership and empathy.

The BEYLGP initiative is expected to play a crucial role in reversing the trend of rising adolescent pregnancies in San Jose de Buan and serve as a model for other communities facing similar challenges. With ongoing support and monitoring, the program aims to achieve sustainable results and create a better future for the youth.

Provincial officers from Northern Samar, Zamboanga del Norte, Basilan, and Sarangani shared their strategies for improving health and nutrition, offering valuable insights for other provinces to consider. These were presented during the Zuellig Family Foundation (ZFF)’s first Pook Malusog Community of Practice (CoP) in Nutrition last June 26, 2024 with the theme “Building One Community for Nutrition”.

Northern Samar: Building Capacity and Improving Facilities

Hannah Bautista shared the progress made since their involvement in ZFF programs. Initially, the province faced challenges with overstocked and expired malnutrition commodities, and inadequate facilities for treating severe acute malnutrition (SAM). They improved by building capacity for the Philippines Integrated Management of Acute Malnutrition (PIMAM), with help from UNICEF, establishing in-patient therapeutic care in two district hospitals, and strengthening referral systems. The province adopted a policy in March 2023 to designate specific facilities for malnutrition treatment, aiming for wider adoption by 2024.

Zamboanga del Norte: Innovating with Nutritional Solutions

Alein Khio shared their solution for children not qualifying for PIMAM support through the Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI) Malnutrition Reduction Program. This program, offering rice-mongo blends and curls, reached 3,200 individuals. Challenges remain with high production costs limiting reach and the need for better packaging of the rice-mongo blends and curls. DOST-FNRI’s commitment to help with packaging could broaden distribution. The province established a food processing plant, ensuring continuity of nutrition interventions despite administrative changes.

Basilan: Establishing and Standardizing Nutrition Programs

Nadzwa Sabandal discussed starting their nutrition program with minimal resources. With ZFF’s support, they established a fully operational PNAO position and held an LGU Forum to encourage prioritization of nutrition programs. They aim to standardize incentives for Barangay Nutrition Scholars (BNS) across barangays to ensure fair compensation and greater involvement.

Sarangani: Data-Driven Nutrition Management

Dr. Arvin Alejandro introduced their HCPN intervention—dealing with politics, collaboration, political will, and nurturing partnerships. They developed the Sarangani Health Information and Management System (SHIMS) for profiling the population’s nutritional status. This data-driven approach identifies community needs and monitors social determinants of health. The system, initially developed for free with Mahintana Foundation’s help, later enhanced by the province’s Information Technology team, offers a cost-effective solution compared to commercial options. They plan to establish a comprehensive healthcare network and improve connectivity for telehealth services.

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The discussions and insights shared during the session highlight the diverse approaches these provinces are taking to enhance health and nutrition. Their experiences provide valuable lessons and inspiration for building healthier communities across the Philippines.

Select municipalities representing Basilan, Samar, Northern Samar, Sarangani and Zamboanga del Norte presented their innovative strategies focused on collaboration, empowerment, and sustainability. The Zuellig Family Foundation (ZFF) held the first Pook Malusog Community of Practice (CoP) in Nutrition last June 26, 2024, themed “Building One Community for Nutrition”.

Tipo-Tipo, Basilan: Collaborative Healthcare and Empowerment

Community Coordination and Co-ownership. Dr. Nur Khan Istarul explained their approach to healthcare. They believe in working closely with barangay officials, especially the barangay captain, to understand and meet the community’s specific needs. This helps them address the unique challenges of coastal, upland, and midland areas.

Empowering Barangay Health Workers (BHWs).  By collaborating with barangays, they ensure that every sitio has a BHW. They increased the number of BHWs from 70 in 2023 to 135 in 2024. Additionally, they secured more support, raising BHWs’ monthly stipend from 2,000 to 4,000 pesos.

Skill Training and Cooperatives. They plan to train BHWs in additional skills like baking and sewing through TESDA, providing them with extra income opportunities. They also aim to set up a cooperative for malnourished families, buying their agricultural produce to ensure a steady supply of fresh, nutritious food.

Partnerships for Clean Water. Partnering with other NGOs, like the Manila Water Foundation, has helped them improve access to clean water, which is essential for good nutrition.

Pagsanghan, Samar: Comprehensive Early Childhood Nutrition Programs

Stunting Rehabilitation Project. Jovelle Royandoyan shared their approach to early childhood nutrition. They run the Hangkop stunting rehabilitation project, which provides resources like rice and toys to undernourished children through a voucher system.

Dietary Supplementation Program. Another program, Sakto ngan Epektibo nga Dietary (SED) Supplementation Program, ensures children receive essential dietary supplements.

Integrated Nutrition Action Program. They also have the Pagsanghan Integrated Nutrition Action Program for the First 1,000 Days of Life, focusing on the critical early childhood development period.

Collaborative Partnerships. By partnering with national government agencies and academic institutions, they ensure a well-rounded approach to tackling childhood malnutrition.

Bobon, Northern Samar: Overcoming Challenges through Community Engagement

Multi-Sectoral Approach. Natividad Lao talked about their progress since joining UNICEF’s Water, Sanitation, and Hygiene (WASH) program from 2016 to 2019. Initially, nutrition was not a major focus, but the introduction of ZFF’s Municipal Nutrition Governance Program in 2021 changed this. Training sessions stressed the importance of involving the whole community, not just Nutrition Action Officers (NAOs).

Funding and Resource Mobilization. They faced funding challenges in rolling out the program to all barangays, but with help from the Department of Interior and Local Government (DILG), they managed to secure the necessary resources.

Functional Nutrition Councils. Now, all 18 barangays have functional Barangay Nutrition Councils (BNCs) and dedicated nutrition budgets. Community involvement in feeding programs has led to impressive results, with average coverage data reaching 72.1% to 82.1% in 2023.

Kiamba, Sarangani: Community-Driven Development and Sustainability

Community Empowerment. Ronilyne Moneva presented the Kiamba Cares A+++ project, which renewed their focus on nutrition. They prioritize community-driven development, creating BNCs through capacity-building workshops on financial management, Philippines Integrated Management of Acute Malnutrition (PIMAM) program implementation, and integrating local culture.

Indigenous People’s Projects. They also address the unique needs of Indigenous People (IP) communities through specific projects like the IP Barangay Nutrition Gulayan Projects.

Strengthening Nutrition Councils. Strengthening BNCs and forming Municipal Nutrition Action Plans ensures long-term impact.

Partnerships for Resources. Partnerships with organizations like the Seaoil Foundation provide valuable resources for food security and nutrition initiatives.

Brgy. Manil, Leon Postigo, Zamboanga del Norte: Sustaining Nutrition and Health Initiatives

Training and Knowledge Sharing. Melgian Saquilan discussed the steps their barangay has made in improving nutrition and well-being. Training in programs like Barangay Leadership for Nutrition and Development (BL4ND) has equipped them with the knowledge and tools to address nutritional needs, especially for children and pregnant mothers.

Backyard Gardening and Food Security. Despite challenges like El Niño and limited water supply, they remain committed to ensuring access to fresh and nutritious food. They implemented a barangay ordinance promoting backyard gardening, resulting in 90% of households having their own gardens.

Prenatal Care Services. They also provide comprehensive prenatal care services through the Prenatal sa Martes, Pakan on ang Buntis program, offering regular checkups, immunizations, and counseling.

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The stories shared by these municipalities showcase the power of teamwork and innovative thinking in addressing health and nutrition challenges. By empowering community health workers, forming strong partnerships, and implementing sustainable programs, these areas are creating healthier futures for their residents. As they continue their work, the lessons learned and the successes achieved serve as an inspiration for other communities striving to improve their own health and nutrition outcomes.

Eastern Visayas, known for its resilience in the face of significant health inequities, is one of the poorest regions in the Philippines. Three of its six provinces rank among the top 20 poorest in the country. The region’s challenging geography, with numerous island municipalities and mountainous areas, poses logistical challenges for healthcare delivery. Additionally, peace and order issues further hinder access to health services.

Dr. Exuperia Sabalberino’s journey to leadership in public health mirrors her region and is a testament to her commitment and resilience. Born and raised in Eastern Samar, she witnessed the lack of reliable public healthcare firsthand. These experiences inspired her to give back to her community, leading her to a career in a district hospital in Eastern Samar and later training in pathology at the Lung Center of the Philippines in Manila. Her involvement with a public health NGO, working on projects such as blindness eradication and medical missions, ignited her passion for public health and set her on a leadership path.

Returning to Eastern Visayas in 1996, Dr. Sabalberino took on various roles at the Department of Health (DOH), handling programs like disease prevention and control, voluntary blood donation and local health systems development, among others. By 2020, she was promoted to  DOH-Eastern Visayas Regional Director, a role she embraced with a vision to improve health outcomes in the region.

Strategic Initiatives and Achievements

The Universal Health Care (UHC) Law, Republic Act No. 11223, aims to provide every Filipino with affordable health services. However, UHC implementation varies across regions due to diverse healthcare needs, resource capabilities, and differences in government leadership. In Eastern Visayas, the focus has been on addressing these unique challenges through strategic health financing and strengthening local health systems.

Dr. Sabalberino’s approach to implementing UHC involves fostering collaboration among local government units (LGUs), healthcare workers, and various stakeholders. She says, “”I realized early on that we need help in accelerating the implementation of UHC  in the region. We asked various stakeholders for help because we know our limitations.”

Health financing, a critical aspect of UHC implementation, is primarily facilitated through the Special Health Fund (SHF). The SHF consolidates resources at the provincial and city levels, dedicated to financing various health services. Efforts have been made to align policies and improve collaboration with entities like PhilHealth, the Department of Health (DOH), DILG and the Commission on Audit (COA), ensuring healthcare delivery’s sustainability, equity, and effectiveness.

Leadership development programs, supported by the Zuellig Family Foundation (ZFF), have significantly contributed to deepening regional leaders’ accountability and ownership. These programs have also provided valuable training to local health leaders, enhancing their ability to address health challenges in their respective areas.

Members of the Regional UHC Coordinating Team (RUCT) completed training under the Bayang Malusog Regional Leadership Development Program (LDP). This program focuses on deepening accountability and ownership of regional leaders in UHC implementation. Training modules cover practicum experience, leadership acts, and lessons in implementing UHC and nutrition projects and programs.

The Strategic Dialogue on UHC Implementation and Health Financing Implications for Enhanced Health Service Delivery focused on the practical implementation of the UHC Law. Participants discussed their roles in addressing challenges, high-impact interventions, and the status of policy/COA guidelines on the SHF. Theory U and the Bridging Leadership Framework have been instrumental in processing and implementing these strategies.

Community-based initiatives, a cornerstone of UHC implementation, have been championed to address specific regional needs. For instance, in mountainous areas with protein deficiency, interventions included high-protein crop cultivation and free-range chicken farming, ensuring strategies fit the unique challenges of different communities.

Adaptive leadership and conflict management are essential aspects of Dr. Sabalberino’s strategy. Training sessions managing conflicts, team dynamics, and applying the adaptive leadership toolkit to mobilize people and resources helped leaders develop strategies to address health challenges effectively.

“I am so thankful, especially for the governance program for our health leaders. It’s really helping us a lot. It allowed our health leaders to appreciate and be more aware of the health challenges in their respective areas,” Dr. Sabalberino states.

Impact of UHC in Eastern Visayas

Under Dr. Sabalberino’s transformative leadership, UHC implementation in Eastern Visayas has brought significant changes. By upgrading health facilities and establishing specialty centers, the region has witnessed a remarkable increase in accessibility to health services. Health indicators have shown a positive trend, with reductions in maternal and child mortality rates and better outcomes in nutrition and disease prevention programs.

Enhanced health financing through the SHF will ensure a more equitable distribution of resources, providing financial protection to those most in need. More robust local health systems have emerged, with leadership development and strategic dialogues making these systems more responsive and capable of addressing community-specific health challenges.

Looking Forward

Dr. Exuperia Sabalberino’s efforts have improved health outcomes in one of the Philippines’ most challenging regions but also set a benchmark for other regions striving to implement UHC. Her vision is a dream and a roadmap for a healthier, more equitable future for all Filipinos.

When asked about the legacy she wants to leave in Eastern Visayas, she muses, “I reflected on this. I asked, Lord, why did you put me in this situation, what do you want from me? I thought, if I can help improve health outcomes in the region and reduce health inequities, I will be very happy with that. To give opportunities and provide more access to health services, that will be a very good legacy for Eastern Visayas.”