In a bid to bring its health development framework to more rural areas in the Philippines, the Zuellig Family Foundation forged a partnership with the regional government of the Autonomous Region in Muslim Mindanao to accelerate improvements in local health systems.

The partnership will bring ZFF’s health leadership training program to mayors and municipal health officers of 37 municipalities in the region.

Under the agreement, local government units (LGUs) in the program can gain access to the regional government’s health fund—P1 million each LGU—which they can use to address issues on health personnel, medicines and service delivery.

Called “ARMM-ZFF Health Partnership,” the joint undertaking is seen to improve health service delivery systems and health financing capacities through stronger local health leadership and better health-seeking behaviour of residents.

ARMM Governor Mujiv Hataman and DOH-ARMM Secretary Kadil Sinolinding were present during the signing of the partnership agreement last July 7 in Quezon City.

For David Zuellig, trustee of the Zuellig Family Foundation, the decision to focus on health leadership and local governance to improve the health of the rural poor in the Philippines was logical yet counter-intuitive.

Zuellig spoke about the Foundation’s strategy in the session on innovative philanthropy during the Regional World Health Summit in Singapore, the first time the annual meeting was held outside Berlin since it started in 2009.
The summit’s theme, “Health for Sustainable Development in Asia,” underscored the challenge for governments and healthcare providers to meet the increasing demands for better healthcare at lower costs in the region. Amid Asia’s growing economy, public-private collaborations become more vital in coming up with sustainable strategies that will bring quality healthcare even to low-income populations.

According Zuellig, access of the Filipino rural poor is usually limited to those offered in the rural health units. So the Foundation focused on improving local health systems.

Zuellig said their strategy had the municipal mayor as the key element in improving the system. He said this was a logical move since mayors had the power to implement ordinances to improve rural health services. But Zuellig added that local politicians are generally perceived to be unresponsive to health and that is why their strategy also seemed counter-intuitive.

Yet, the Foundation proceeded to work with local chief executives, picking those who show genuine commitment for health reforms. In a relatively short time, their efforts paid off. Since piloting the strategy in 2009, 30 partner-municipalities have brought their maternal mortality ratio closer to the targeted Millennium Development Goal of 52. The MMR, accordingly, is a surrogate indicator of the quality of a health system.

To make sure gains are sustained, Zuellig emphasized the need to have a continuity protocol. “Policies that support the continuation of health programs must be in place. The motivation to improve health must come from leaders and the community itself, with or without external influencers.”

The rapid improvements in health outcomes in the municipalities came as a pleasant surprise to Zuellig himself. “I was pleasantly surprised to realize that health outcomes have improved faster than I thought was possible.” Such positive changes also caught the interest of other groups, including the Philippines’ lead agency in health. Partnership with the Department of Health will bring its health change strategy to 609 priority local government units. There are also existing partnerships with the United Nations Population Fund and global healthcare company Merck Sharp & Dohme.

For Zuellig, a number of lessons learned along the way also served as factors for their success. First, the Foundation focused on health because this was their area of expertise, further refining it to rural health because of serious inequities in rural areas. Then, there was the identification of a strategic intervention, which in this case was working with local health executives. Third lesson was the choice to have a systems approach over short-term interventions that do not address the root causes of problems. Lastly, Zuellig said they realized they had to take a long-term perspective because transforming systems take time.

In closing, Zuellig expressed optimism that for as long as the Foundation’s current crop of leaders hold public office, they will also continue to use its leadership and governance framework to address development challenges beyond health.

More mayors will become more adept in running their local health systems. This is what a newly-launched public-private partnership expects to achieve with the “Health Leadership and Governance Program”(HLGP). The joint undertaking between the Department of Health and the Zuellig Family Foundation will cover 15 regions, 54 provinces, and 609 cities and municipalities all over the country. The 609 local government units (LGUs) were identified as priority areas by the National Anti-Poverty Commission. The program will run from 2013 to 2016.

“The DOH recognizes the importance of good governance and leadership to achieve good health outcomes in the local government units; thus, this joint venture of DOH and ZFF,” said Health Secretary Enrique Ona in his keynote address.

The health chief also expressed optimism the program will help the country achieve its health-related Millennium Development Goals.

“By bringing this intervention to the 609 LGUs, we are optimistic that the country will achieve its health-related MDG targets while at the same time develop empowered leaders to improve not only the health outcomes but also the overall quality of life of all Filipinos.”

The project will adopt ZFF’s “Health Change Model” which according to ZFF chairman Roberto Romulo “is premised on the assumption that local leadership is the key to changing systems and innovating programs that can lead to better health outcomes.”

Romulo, in his response, said that since piloting the strategy in 2009, the foundation’s “97 municipalities have continuously decreased its maternal and infant mortalities.” He added that “while bringing down maternal mortality ratio of the country is proving to be a challenge” most of their municipalities have hit the MDG target of 52 last year.

The program is expected to cost P864 million of which ZFF, along with its partners United Nations Population Fund and MSD (Merck Sharp & Dohme), will fund P125 million. The foundation is currently in talks with other organizations like the UNICEF, USAID and AusAID that have all expressed interest in providing additional resources for the program.

Ona is also looking forward to having the program implemented in areas beyond the 609 priority LGUs.

By Ching Araneta

Three municipalities of Sibuyan Island in Romblon have been making sure every barangay health worker (BHW) is given security of tenure and rightful benefits as a volunteer. And for doing this, the Sibuyan Inter-Local Health Zone (ILHZ) won third place in the Department of Health’s 2013 Inter-Local Health Zone Good Practice. The award came with a P200,000 cash prize.

It was in June 2012 when mayors, BHW federation presidents and village captains in the three municipalities of Cajidiocan, Magdiwang and San Fernando formally agreed to adopt measures preventing the arbitrary removal of BHWs. They also installed a performance management system to protect the rights of BHWs and make sure they receive their benefits under the Barangay Health Worker’s Benefits and Incentives Act.

The measure, called the “Manual of procedures for BHW retention,” was put to test after the October 2013 barangay election. BHWs, who were subject for removal, were subsequently retained after undergoing due process in the municipal local health board.

This innovation of the ILHZ was nominated by DOH Regional Office IV-B. Representatives from the DOH central office conducted the assessment in Sibuyan in December 2013. The criteria for the award included leadership, governance and improvement of service delivery.

Awarding ceremony was held last February in Traders Hotel, Pasay City.

“What this program is showing us now is that public-private partnership is a good strategy toward the achievement of our goals. Together, we must continue to work hand-in-hand. Together we can do it.”

These were the words of Health Secretary Enrique Ona in his speech delivered on his behalf by DOH director Nestor Santiago Jr. during a forum on the DOH-Zuellig Family Foundation partnership program called the “Health Leadership and Governance Program” (HLGP).

The program aims to help the country achieve by 2015 its health targets under the Millennium Development Goals. It is also a program intended to strengthen the government’s Kalusugang Pangkalahatan (Universal Health Care agenda).
During what is called a “Gallery Walk,” in the forum, each regional director presented Ona their region’s maternal mortality ratio and infant mortality rate, and the strategies they have in minimizing mortalities and improving health outcomes in the different municipalities.

The forum, held in Antipolo City last March 26 and 27, discussed the gains made and the challenges encountered in implementing the HLGP, which began in the second half last year.

By Sealdi Gonzales

As aid pours into typhoon Haiyan (local name: Yolanda) affected municipalities, mayors are asking that a well-coordinated system be in place for speedier recovery and rehabilitation.

During a partnership meeting organized by Tabang Visayas and the Zuellig Family Foundation last month, Marabut Mayor Percival Ortillo Jr. noted the lack of a municipal system for donor assistance. “It is important to implement a centralized system at the municipal level to manage donor assistance with municipal priorities.”

Both Ambassador Howard Dee, lead convenor of Tabang Visayas and chairman of Assisi Development Foundation, and ZFF president Ernesto Garilao emphasized the need for partners and local government units to work together. “The role of Tabang Visayas [and its convenors] is to help the local government units harmonize the rehabilitation of their municipalities,” Garilao said.

The meeting aimed to match programs of various organizations with the specific needs of the municipalities. Former Health Secretary Jaime Galvez-Tan presented the Health Futures Foundation Inc. (HFI)’s “Sagip Samar!” (Save Samar) disaster response program and emphasized the need for psychological first aid to communities and local chief executives in the aftermath of major calamities.

Plan International-Philippines presented their six-month Country Strategy Programme, which supports the re-establishment of maternal, newborn, child health, nutrition, and water, sanitation and hygiene (WaSH) programs in affected municipalities in Samar island.

Presenting their respective agricultural, livelihood, micro-finance and enterprise assistance programs were the Philippine Business for Social Progress (PBSP), Hapinoy Sari-Sari Stores, Partnership for Development Assistance in the Philippines, Inc. (PDAP), and the Center for Community Transformation Inc. (CCT).

Stiftung Solarenergie-Solar Energy Foundation chairman Jaime Ayala was also present to discuss solar energy and distribute solar lamps to leaders of the 12 municipalities present.

The meeting that was held in Greenhills, San Juan was attended by the local government officials of Eastern Samar municipalities of Salcedo, Giporlos, Quinapondan, Gen. MacArthur, Balangiga, Balangkayan, Hernani, Lawaan, Mercedes, and Guiuan, and the Samar municipalities of Basey and Marabut.

These municipalities have partnership agreements with ZFF to help in the municipalities’ recovery program, especially in health. ZFF’s 6-month “Recovery Assistance Program for Mothers” (RAP for Mothers) is aimed at protecting women and infants by making sure pregnant and lactating women get proper natal care. Midwives and barangay (village) health workers are also given health kits they can use for delivery of health services. Under the program, mayors and municipal health officers are also required to attend ZFF’s leadership and governance program to arm them with skills to fix their health systems and sustain health gains beyond the 6-month recovery assistance program.

The RAP for Mothers is being implemented with the funding support from the Washington, D.C- based US-Philippines Society.

The challenges and progress in the Philippine public health became the focal points of discussion in a forum held last November in Washington D.C.

The forum, sponsored by the US-Philippines Society (US-PS), Center for Strategic & International Studies and Johns Hopkins Bloomberg School of Public Health-Center for Communications Programs, had as presenters former Health Secretary Esperanza Cabral, Zuellig Family Foundation president Ernesto Garilao and Merck for Mothers Executive Director Dr. Naveen Rao.

Topics discussed were challenges in reproductive health, private support for Universal Health Care and Millennium Development Goals, and local health leadership and governance. Joining the panel for the open forum were Dr. Rajeev Rimal, chair of Prevention and Community Health of George Washington University, Ann Hirschey, global health officer of USAID, and Basil Safi and Matthew Lynch, head and director, respectively, of the Center for Communication Programs of JHU Bloomberg School of Public Health.

Philippine Secretary Enrique Ona, who had to stay in the country due to super typhoon Haiyan (local name: Yolanda), delivered the keynote address through live streaming.

After the Washington D.C. forum, ZFF made similar presentations in the New York City Philippine Center before Fil-Americans involved in various health programs.

Since the forum happened just a few days after Haiyan struck the country, it also became an opportunity for US-PS to gather and give support for the relief and recovery efforts in Eastern Visayas, particularly Eastern Samar municipalities.
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ZFF has ongoing post-Haiyan/Yolanda recovery efforts in Eastern Visayas. To help in these efforts, please get in touch with Sealdi Gonzales, scgonzales@zuelligfoundation.org, or call her at (632) 8213329 local 117.

Recovery of health and livelihood programs formally begins in three Eastern Samar municipalities that suffered massive destruction in the aftermath of super typhoon Haiyan (local name: Yolanda).

Mayors Mark Biong of Giporlos, Nedito Campo of Quinapondan and Melchor Melgar of Salcedo recently signed their respective tripartite partnership agreements with the Zuellig Family Foundation and CARD Inc. to help their towns restore proper maternal and child healthcare (MCH) services.

Under the agreement, ZFF, with support from the US-Philippines Society, will provide funds to incentivize pregnant women to seek proper natal care and activate a pregnancy tracking system. ZFF will give computers for such system and will also finance the procurement of health kits for midwives, barangay health workers (BHW), mothers and newborns. Approximately 398 midwives and BHWs are expected to get kits. They will also receive P1,000 incentive within six months to start and maintain the tracking system.

The incentive program for mothers and health workers commences after the local governments conduct their respective Buntis (pregnant women’s) Congress. The town of Salcedo held their congress last December.
The MCH recovery program, which will run for six months beginning January, is estimated to benefit 700 mothers in the three municipalities.

CARD Inc., which has a wide membership base and satellite offices in the province, will manage and supervise the release of funds and incentives under the different programs identified, including the incentives for pregnant women and the enrolment of health workers and mothers in CARD-MRI Insurance Agency’s micro-insurance product. CARD, a micro-financing institution to help eradicate poverty, will collaborate with ZFF and the municipalities on the conduct of recovery efforts.

A restricted revolving fund will also be established to finance livelihood activities of mothers and communities.
ZFF is also planning to hold consultative meetings soon with mayors, municipal health officers and municipal planning and development officers of the three LGUs and other badly damaged Samar and Eastern Samar towns. The purpose is to have other funding and resource organizations discuss with the LGUs their specific recovery plans in health, livelihood and education.

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About the photo: Amid the massive destruction, a sign in Bagtong village in Salcedo, Eastern Samar serves as a reminder to residents. It says: “Tindog (Rise) Bagtonganon” and “All’s well,” written underneath.

ZFF has ongoing recovery programs in Eastern Visayas. To help in these efforts, please get in touch with Sealdi Gonzales, scgonzales@zuelligfoundation.org, or call her at (632) 8213329 local 117.

ZFF officers with the mayors of Eastern Samar municipalities

A wide stretch of white sand beach will enthrall first time visitors in this part of Salcedo, Eastern Samar. There is, however, a grim story behind this new “paradise.” Before super typhoon Haiyan, the landscape was dotted with tall coconut trees and several houses. Some houses were made of concrete. No house was left undamaged.

Lives, too, were not spared. An old couple brought their grandchildren to the evacuation center. The grandfather returned home to get more things and was followed by his wife when he did not return soon enough. Both perished during the storm surge. Members of a household living in a concrete house thought their place was strong enough to withstand the storm. They were wrong, two died.

The two villages, where the beach can be found, were the worst hit in Salcedo. Of the town’s 29 total casualty count, 21 came from the two villages. On the beach, one will find what has been left of the coconut trees washed away by the seawater—roots. One will also find what was once an asphalt road now completely covered in sand.

Similar stories of lives and livelihood lost are shared by Salcedo’s neighboring town of Giporlos, where 12 died.
Both are partners of the Zuellig Family Foundation. With funds from the US-Philippines Society (USPS) and the California based group Direct Relief, they received relief packs of hygiene kits, rice, noodles, canned goods and water. The first wave of distribution occurred between November 24 and 25 and benefitted over 4,000 families. Another batch of more than 4,000 relief packs for the two towns plus General MacArthur municipality will be distributed within the week.

Salcedo Mayor Melchor Mergal is grateful for the aid given to their town. He knows, however, that his town faces a tougher challenge ahead. Ninety-five percent of his town was affected by Haiyan. With acres of coconut trees devastated, majority who are into copra have lost their source of livelihood. Mergal says it will take at least five years for coconut to grow and bear fruit.

Fishermen in his town and in Giporlos also lost their gears and the motors of their boats. Farmers have been asking for seeds and fertilizers so they can start over.

Rural Health Units in both towns are in ruins, forcing both to treat patients in usable spaces in the municipal offices and making do with available equipment and medicines.

ZFF acknowledges the need to support the health and other needs of these local government units; hence, it has started making assessments. Like the help it got from the USPS and Direct Relief, ZFF hopes to mobilize resources to help rebuild lives of Haiyan victims.

The USPS is a non-profit organization based in Washington D.C. It aims to elevate Philippines’ profile in the US through its various programs on trade and investment, culture and education and community outreach. Direct Relief is a California-based non-profit organization that principally “provides medical assistance to people affected by poverty, natural disasters and civil unrest.”

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ZFF has ongoing recovery programs in Eastern Visayas (see related video here). To help in these efforts, please get in touch with Sealdi Gonzales,scgonzales@zuelligfoundation.org, or call her at (632) 8213329 local 117.