Outline of the Project

Title

Project for Strengthening Maternal and Child Health Services in Eastern Visayas, Philippines (SMACHS-EV Project)

Country

Philippines

Date of R/D Signed

February 19, 2010

Term of Cooperation

From July 15, 2010 until July 14, 2014

Subject

Health

Counterpart

Implementing Organization: Department of Health, Center for Health Development Eastern Visayas Office, Provincial Health Office (Leyte Province), City Health Office (Ormoc City)

Background

In the Philippines, due to the various risk factors such as closely spaced births and early maternity, the Maternal Mortality Ratio (MMR) was 162 per 100,000 live births in 2006. Although the number is decreasing, it is still far from the national Millennium Development Goal (MDGs) of MMR at 52 per 100,000 live births by 2015. Therefore, the Government of the Republic of the Philippines (GRP) needs to reduce the MMR at a faster rate to achieve the national MDGs. The Department of Health (DOH) gives priority to a maternal and child health program and has issued the Maternal, Neonatal and Child Health and Nutrition (MNCHN) policy, which focuses on improving the quality of services and delivery care. In response to the DOH request, JICA started a technical assistance project, SMACHS-EV Project (Project for Strengthening Maternal and Child Health Services in Eastern Visayas), in Leyte Province (except Tacloban City) with a population of 1,340,000, and Ormoc City with a population of 180,000, for the four-year period from July 15, 2010, to June 14, 2014.

Project summary

Main components of SMACHS-EV Project are;

1. Enhancement of Basic Emergency Obstetric and Neonatal Care (BEmONC) services provided at Rural Health Units and District Health Centers (RHU/DHC).
2. Strengthening of the RHUs/DHCs financial basis through promoting accreditation of PhilHealth MCP/MCP + Package.
3. Improvement of the system of LGUs for provision of sustainable MNCHN service.
4. Support promotion of community awareness and activity about BEmONC / MNCHN services.
5. Enhancement of technical skills of government service providers in BEmONC / MNCHN.

Project area

Eastern Visayas region is the site of the project which has identified the Province of Leyte and Ormoc City as the target areas.

Target facilities of the Project are 18 Rural Health Units (with red circle in the map), 1 Community Hospital, and 1 Municipal Hospital in Leyte, and 5 District Health Centers in Ormoc City. With ILHZ and MNDR related activities under output 3 and 5, the Project is approaching not only the target 18 municipalities but also all 41 municipalities in Leyte for the enhancement of BEmONC/ MNCHN services quality.

A combination of these five components of the Project will lead to the accomplishment of the goal on reducing maternal and infant mortality.

Overall Goal:

Maternal mortality and infant mortality in the target areas of Eastern Visayas are reduced.

Project Purpose:

The number of pregnant women and newborns receiving safe pregnancy, safe delivery and postpartum care services in the target area in Eastern Visayas is increased.

Output

Output 1:	Facilities providing BEmONC/MNCHN services are increased.
Output 2:	Technical skills of government service providers in BEmONC/MNCHN are enhanced
Output 3:	The function of Center for Health Development Eastern Visayas Office (DOH-CHD EV) and Leyte Province Health Office (PHO)/Ormoc City Health Office (CHO) in achieving and maintaining quality BEmONC/ MNCHN services is enhanced.
Output 4:	Community Health Teams (CHTs) are institutionalized and operate in areas covered by the proposed BEmONC facilities.
Output 5:	Political support for pregnant women and their families in accessing BEmONC/MNCHN services is enhanced in areas covered by the proposed BEmONC facilities.

Activities
Activities under Output 1

1-1	Assess equipment of the target facilities in terms of BEmONC and/or MCP accreditation* and to identify a gap.
1-2	Provide required medical equipment to selected RHUs/DHCs and CH/MH for BEmONC services and MCP accreditation.*
1-3	Assist the target facilities and BHSs to apply to the PhilHealth for MCP* and/or MCP+ accreditation and reimbursement.
1-4	Assist establishment of maintenance system of equipment at the target facilities.

Activities under Output 2

2-1	Provide capacity building and equipment support to the EVRMC as a BEmONC training institution.
2-2	Provide equipment necessary for training to the DOH-CHD EV Family Health Cluster.
2-3	Provide BEmONC training for Skilled Health Professionals from the target facilities.
2-4	Provide Capacity Enhancement on Maternal and Neonatal Health for Midwives training for midwives covering barangays in the catchment areas of the target facilities.
2-5	Conduct technical assessment on skills of ex-trainees of BEmONC.

Activities under Output 3

3-1	Conduct regular Joint Coordination and Regional Management Committee meetings including PIR.
3-2	Conduct Provincial and City Executive Committee (ExeCom) meetings in Leyte Province and Ormoc City.
3-3	Conduct project orientation to the ILHZ-TMCs in Leyte Province and to the District Medical Officers in Ormoc City.
3-4	Conduct project orientation to the ILHZ Boards in Leyte Province and to the Ormoc City Local Health Board.
3-5	Conduct regular MDR and NDR at ILHZ/PHO and CHO level.
3-6	Provide capacity building training in Japan in MNCHN program management.
3-7	Implement monitoring and supervision of BEmONC/MNCHN services for the target facilities.
3-8	Identify problems of the FHSIS and provide technical training/assistance to Skilled Health Professionals as necessary.
3-9	Assist implementation of referral system/service delivery network at all levels through the ILHZ as needed (e.g., conduct referral audits).
3-10	Disseminate/report project accomplishments and lessons learned in regional and national level health summits/conferences/meetings.
3-11	Ensure the reproduction and distribution of Mother and Child Books. Activities under Output 4

Activities under Output 4

4-1	Develop training materials including a CHT guidebook for CHT training.
4-2	Establish Core Team to organize CHT in Leyte Province and Ormoc City and formulate strategies to implement CHT activities.
4-3	Conduct orientation for trainers using the CHT guidebook.
4-4	Assist the target RHUs/DHCs in conducting CHT orientation using the CHT guidebook.
4-5	Monitor and support as needed CHT activities in their communities (home visits, and counseling, pregnancy and post-partum tracking, birth planning, and taking part in MDR/NDR).
4-6	Support promotion of community awareness about BEmONC/MNCHN services.
4-7	Hold CHT conventions including awards for best practices.
4-8	Conduct a study (e.g., questionnaire survey or focus group discussions) to assess functions of CHTs.

Activities under Output 5

5-1	Advocate increased budget in support of the MNCHN service delivery through the ILHZ.
5-2	Assist LGU to improve their financial and regulatory mechanism to ensure continuous/sustainable MNCHN services through the ILHZ.

Input

Input summary by the Japanese Government

• Japanese Experts
• Essential equipment necessary for BEmONC and the Philippine Health Insurance Cooperation (PhilHealth) MCP accreditation
• Training equipment for EVRMC
• Training equipment for DOH-CHD EV
• Essential equipment for project offices
• Cost of training in Japan and the Philippines
• Production cost of training, educational and promotional materials

Link to the materials which the Project developed

1. MNDR Manual
2. Supportive Supervision (SSV) Monitoring tool
3. BEmONC Monitoring Tool
4. MC Book (Translated in Cebuano)
5. MC Book (Translated in Waray)

Provision of medical equipment

Training for Midwives

Community Health Team Activity

Community Health Team Activity

Community Health Team Activity