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ECO-BIO-SOCIAL FACTORS OF VECTOR DENSITY IN DEVELOPING AN EFFECTIVE APPROACH TO DENGUE CONTROL IN THE PHILIPPINES (PHASE 1)
Project Director:          Jesusa M. Marco
Funding Agency:        World Health Organization/TDR

This study used a selective, inter-sectoral approach to dengue vector control. The approach focused on epidemiologically important key containers identified by pupa surveys and applied during critical periods of dengue transmission, and was expected to result in long-term source reduction and effective dengue control in the Philippines. 

The questions the study sought responses to are:

  • How and how much do eco-biological and social factors affect dengue vector density in overcrowded, dense areas with unplanned urbanization and rapid population growth? 
  • How do these factors contribute to the cyclical increase in dengue cases?
  • How can this information be formulated into a rational strategy for dengue control?
  • Under a devoted system of health services and limited resources, who are the stakeholders for this strategy? What collaboration and linkages must be developed among them?
  • And lastly, what are the recommendations for more effective dengue control? 

In Phase I, the ecosystem of dengue in an urban setting was described within the following domains: vector ecology, socio-behavioral, and control program and activities.  The association of these factors with varying levels of vector density, as measured by pupa/person, and reported dengue incidence were analyzed. These served as a basis for identifying, through participatory processes, appropriate interventions that consider the influence of these factors on vector density. The intervention’s effect on vector density was analyzed and documented, and recommendations to the National Dengue Control and Prevention Program were developed from observations and experiences.

In summary, the findings of Phase I show that the approach to dengue vector control in Muntinlupa city is complex.  There are focal hotspots in the clusters for pupa positive water-holding containers.  There are also seasonal differences in a number of water-holding containers with pupa, the location of these containers, and pupa per person index (PPI).  Furthermore, during the rainy season, the distribution of houses with water-holding containers is skewed (San Jose Village and drums, respectively). The contribution of water-holding containers in public spaces to pupa productivity during the rainy season is also important.

Key words: Dengue vector control, rapid population growth, National Dengue Control and Prevention Program, pupa productivity

 

STUDY ON THE IMPACT OF DECENTRALIZATION ON THE AVAILABILITY AND ACCESS TO MEDICINES IN THE PHILIPPINES (CASE STUDIES FROM NCR, BENGUET, ILOILO AND DAVAO)
Project Director:          Jesusa M. Marco
Funding Agency:        World Health Organization

This study was conducted from July to September, 2007 supported by a research grant of the World Health Organization. It examined the impacts of decentralization on drug access, availability and procurement at selected LGUs in the Philippines using both qualitative and quantitative research tools. With the observed research gap on the subject matter, this study investigated whether or not the localization of health governance has affected the access of drugs and medicines at local health units over the years.

This research is valuable as it provides empirical evidence (in both qualitative and quantitative terms) on the impact of the government’s decentralization of health services on drug procurement, supply and access at the local levels.

The general aim of the study was to provide documentation on the impact of health service devolution on the procurement systems and the accessibility, availability and affordability of drugs in various LGU units in the Philippines.

Specifically the study sought to: a) document the impact of decentralization on the access, availability and prices of medicines at the local level; b) review the strengths and weaknesses as well as the relevance and effectiveness of drug procurement systems—including RA 9184—and methods of bulk/pool procurements to secure lowest medicine prices; and c) provide data that can guide the development of policies that would ensure the adherence of local government units to good procurement practices including proper selection, quantification, procurement, delivery and distribution of essential drugs and medicines.

Key words: localization of health governance, essential drugs and medicines procurement systems, RA 9184

 

A FAMILY HEALTH BOOK INITIATIVE: AN APPROACH TO INTEGRATING MATERNAL, NEWBORN AND CHILD HEALTH IN THE PHILIPPINES
Principal Investigator:  Jesusa M. Marco
Funding Agency:        United States Agency for International Development through the UP School of Economics

The Family Health Book (FHB) Initiative aimed to achieve sustainable family health by reducing a) maternal, neonatal and child mortality and morbidity; and b) the unmet need for family planning. Specifically, the initiative intended to: 1) improve access, especially by the poor and disadvantaged, to quality essential MNCH services, including family planning; 2) secure adequate financing of the FHB and MNCH services; 3) strengthen national and local public and private stakeholder commitment to MNCH; 4) increase demand for essential services and client participation in the Initiative; and 5) monitor the progress toward the achievement of improved MNCH outcomes.

The project’s objectives were to: 1) gather data from mothers, husbands and mothers/mothers-in-law on maternal and child health-seeking behavior, and preferred form and content of the FHB; and 2) develop the dummy version of the FHB based on the data gathered.

Results from the FGDs revealed that most of the participants, especially those living far from the health facilities, preferred to seek the services of the traditional birth attendants (TBAs) or hilots. Most of them claimed that these TBAs had certificates of training from the health centers. They chose the TBAs for prenatal, delivery and postnatal services mainly due to convenience, comfort, and the relatively lower fees/costs that they had to pay. Giving birth at home meant that the husband could be present in the actual childbirth, providing emotional support to his wife. Many of the FGD participants also expressed their trust in the TBAs to perform safe child deliveries. In the event that a delivery ended badly, with the mother dying, or the child, or both, their faith in the TBA was not affected.

With regards to the development of the Family Health Book, the participants were asked what contents would they like the book or the material to contain. A sample mother and child book was shown to them. In general, they appreciated all the contents and preferred that the new book have the same input, with minor changes in lay-out. They also suggested a number of titles in the local language.

Key words: maternal and child health-seeking behavior; family planning; maternal, neonatal, and child mortality and morbidity

 

COMPLEMENTING DILG ASSESSMENT OF MDG LOCALIZATION EFFORTS: CROSS CHECKING LGU DATA AND CAPACITY BUILDING ON DATA ANALYSIS AND UTILIZATION
Project Director:          Ma. Angeles Lapeña
Funding Agency:        United Nations Development Programme (through National  Economic and Development Authority Social Development Staff)

The main objective of the project was to ensure sustainability in the monitoring of the Millennium Development Goals (MDGs) through the regular or institutional use of DILG MDG tracking data and statistics for program evaluation.  This was done through a complementation of efforts by the Department of Interior and Local Government (DILG) and DLSU, with the support of the United Nations Development Program (UNDP) and the National Economic Development Authority (NEDA) to set the system in place and implement it among all LGUs. 

Several capacity building workshops were conducted for the project, with DILG regional and provincial point persons attending the capacity building workshops as trainers who would in turn train those in their regions.  The series of workshops covered the same topics and the same skills and competencies, revolving around how to encode data on the soft copies of the forms, how to “clean” the data, and how to consolidate the data.

Clustering of the regions was done by SDRC to make the capacity building work more manageable.   There were two clusters for the Luzon island group, one cluster for the Visayas, and two clusters for Mindanao.  Representatives from BLGD-DILG Central Office also attended all of the capacity building workshops conducted by SDRC. 

The Bureau of Local Government Development (BLGD-DILG) complemented the efforts of SDRC for the capacity building component of the project by identifying the participants for the workshops and issuing the necessary bureau orders to enable the participants to attend the workshops.

After the capacity building, data was submitted by the LGUs.  For complementation purposes, DILG managed the receiving of the hard copies and consolidating them while SDRC managed the receiving of soft copies and consolidating them.

The SDRC team participated in a series of project dissemination fora organized by DILG.  The project’s results were likewise presented to the NEDA.

Key words: Millennium Development Goals, program evaluation, data tracking


 

 

 

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