Albay Health Strategy towards Early Attainment of the Millennium Development Goals
Mayon Volcano comes to mind when the Province of Albay is mentioned because it is its most prominent landmark and tourist attraction. It is an active volcano that has erupted 47 times since 1616, with the recent ones occurring in August 2006 and December 2009. Albay also happens to be one of the most typhoon-prone provinces in the Philippines. In late 2006, the province was also hit by two major typhoons, Milenyo and Reming. These series of disasters in that year posed a significant threat to the health situation of the people in the province.
In the following year, the newly elected governor’s policy declaration was to “make MDG the goal and the rest follows.” He meant that policies, resource mobilization, program implementation and institution building should be geared towards achieving the Millennium Development Goals (MDGs). The MDGs are eight international development goals that all United Nations member states have agreed to achieve by the year 2015. They include eradicating extreme poverty, reducing child mortality rates, fighting disease epidemics such as AIDS, and developing a global partnership for development, to name a few.
To improve the health situation of Albay’s residents, the provincial LGU implemented a health improvement strategy that was aimed at mitigating the negative impacts of the 2006 disasters and hastening the attainment of the health-related MDGs. The LGU aimed to “build a health system by and for the public which is sustainable through multi-sectoral contributions, revenue shares, and a domestic-universal health insurance to help anchor the provincial health reform program on a realistic solid base.”
The Albay Health Strategy towards Early Attainment of MDGs became a focused approach to health reform implementation to ensure that all Albay residents, especially the poor, could receive the benefits of health reform and the province can attain the health-related MDGs much earlier than 2015.
The health program is composed of six strategic instruments, namely: providing financial risk protection through reimbursements; improving access to quality medical facilities; ensuring equitable access to health services, medicines and technologies; establishing mechanisms for efficiency, transparency and accountability and public-private partnerships; enhancing the capacities of health workers; and, supporting the immediate and efficient provision of health care through health information.
To date, Albay is either close to achieving or has achieved the major indicators under MDG 4 (Reduce Child Mortality), MDG 5 (Improve Maternal Health Care), MDG 6 (Combat HIV/AIDS, Malaria and Other Diseases), MDG 1 (Eradicate Extreme Poverty and Hunger) and MDG 7 (Ensure Environmental Sustainability). Albay has been certified by Philhealth as having close to universal health coverage. The health budget of the province likewise increased from 2007 to 2010 by 67.66%. This improved access to health services and expanded the supply of health services.
A total of 30 Basic Emergency Obstetric and Newborn Care Centers and 3 Comprehensive Emergency Obstetric and Newborn Care Centers cater to expectant mothers. Community Health Teams actively track pregnant women and help them with their birth plan. The province has 63 ambulances distributed among the local LGUs and deployed to hard-to-reach areas to ferry expectant mothers to birthing centers. The province also conducts an annual door-to-door immunization program for children.
The DOH and the World Health Organization have certified Albay as a malaria-free province and the provincial government is now aiming to eradicate measles, filariasis and leprosy in the next five years. To combat rabies, the LGU implements a responsible pet ownership program and offers free treatment to dog bite victims. It also implements a DOH approved program to combat dengue.
With the support of AECID, a Spanish donor agency and DOH, Albay has started to renovate and re-equip all the hospitals and health centers throughout the province, including the water systems of five resettlement sites. Its disaster risk reduction program was enhanced to include preemptive medical care, post-disaster health intervention, and rapid health assessment surveys of evacuation centers and establishment of the Albay Health Emergency Management (AHEM) for pre-hospital care. Bicol University conducts LGU-subsidized emergency paramedic training for government personnel and the province now has 457 paramedics.
In terms of policy support, the Committee Chairman on Health in the Sangguniang Panlalawigan pushed for the passage of evidence-based ordinances for the TB, Rabies, Dengue Programs and for the Maternal, Child Health and Nutrition Programs. The province also issued ordinances for Smoke-Free Albay and the creation of the Albay AIDS Council.
By identifying strategic priorities through the five year provincewide investment plan for health and the annual operations plan, the Albay provincial government managed to build on its health initiatives. The provincial government also utilized DOHmandated governance structures such as the Local Health Boards (LHBs) and the Inter-Local Health Zones (ILHZs), Public Finance Management (PFM) and Local Health Accounts (LHA).
The skills of Albay’s health workers are continually improved through trainings, orientation seminars and refresher courses. The provincial doctors also enhance their skills through the residency program of the Bicol Regional Training and Teaching Hospital. In sum, the provincial government managed to successfully pursue its strategy because of the involvement of various stakeholders in program implementation and during the planning stage of the Province-Wide Investment Plan for Health in Albay. The health sector alliances that have been organized include the federations of barangay health workers, the TB patrol (TB management councils in the barangays) and the organization of Tambal-Tandok healers. There are also organizations that are actively involved in specific health programs in their respective target areas like MIDAS (Mayon Integrated Development Alternatives and Services) and Gay-on Bicol for STI and HIV/ AIDS.
Ordinances and executive orders are already in place, ensuring the sustainability of Albay’s health sector reform strategy. When the province-wide investment plan for health is completed by 2012, another sector-wide planning session for the next 5 years will be undertaken to sustain the gains and to scale up community participation in the program.
Pursuing the attainment of the MDGs diligently has worked for Albay. The strategy could work wonders for other provinces as well.