Nuhra Region2 Agenda PDF
Nuhra Region2 Agenda PDF
Nuhra Region2 Agenda PDF
Now, more than ever, the health of the Filipino people should not be the sole
responsibility of DOH through CHD-CV (as initial chair of the Regional R&D Coordinating
Council of the consortium) rather the unified efforts of allied agencies/institutions, NGOs and
most importantly, the individual himself.
It is in this light that through the stewardship of PCHRD, through its Executive
Director Jaime C. Montoya and DOST Regional office through Dir. Rustico B. Santos, DOH-
CHD-CV through Dir. Purita S. Danga and her Asst. Dir.,Dr. Tita N. Callueng; NEDA. Dir
Milagros Rimando; other allied agencies/institution/academe, this Health Research and
Dev’t. Agenda evolved.
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ACKNOWLEDGMENT
“Great things start from small beginnings” This Health Research and Development
Agenda has evolved through the perseverance and concerted efforts of the following
persons who we owe gratitude:
- Director Rustico B. Santos, DOST, for his unrelentness zeal and persuasion to make
this R & D Agenda a reality;
- Director Purita S. Danga, CHD-CV, for her wholehearted support towards research
development;
- Asst. Director Tita N. Callueng, CHD-CV for her unwavering enthusiasm for pro-
activeness in research initiatives/innovations;
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Table of Contents
I. Foreword 2
II. Acknowledgement 3
VI. Methodology 11
VIII. References 14
IX. Annexes 15
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EXECUTIVE SUMMARY
Cagayan Valley as it is best strategically called, abounds with natural resources and
development potentials that consist of rich agricultural areas, forestlands, grasslands,
minerals and marine resources. With a total land area of 26,858 sq./cm, it is the 4th largest
region of the country. The region is skirted by the Pacific Ocean on East Coast and Bashi
Channel on the north. Inland, the enormous Cagayan Valley River- the longest river in the
country crisscrosses it. It is located at the northeastern tip of the Philippines, making it
close to potential export markets in East Asia.
In the year 2004, it sheltered 3,078,581 with a population density of 102.1 persons
per square kilometer and an average annual population growth of 2.25 (NSCB 2004).
The top leading causes of mortality (for 2004 and 5-year average) are pneumonias,
hypertensive vascular diseases, neoplasm, diseases of the heart and accidents/assaults.
Whereas, the top leading causes of morbidity of the same year and 5-year average are
influenzas, bronchitis, diarrheas, hypertensive vascular diseases and pneumonias (taken
from the DOH Annual Accomplishment Report). For the other vital indices of the region, it
has a birth rate of 20.48, a death rate of 3.87 (rates at 1,000 population); and a maternal
mortality rate of .60 while an infant mortality of 6.80 (rates at 1,000 live births).
The process of setting the research agenda for region 02 consisted of 3 (three)
phases. The 1st one was an informal in-depth interview of some local health officials, DOH
reps and supervisors on how the health programs and projects are being implemented,
reviewed and monitored. A form of feedback was taken and consolidated as valuable
inputs in the next phase of the setting process.
The second phase was a formal consultative meeting of all stakeholders in health,
both government, private and NGOs. This was done through interactive discussion and
workshops with the discussion of important topics, issues and problems relating to the
health situation in the region. The topics or agenda covered consisted of the following:
Millennium Development Goals (MDGs), the Vital Health Indices, National Objectives for
Health via the Health Sector Reform Agenda, the Regional Research Agenda (RRA),
Regional Research and Development Committee (RRDC), PNHRS thrusts and the survey
results of the Research and Development resources available in the region. A technical
working group was tasked to facilitate and fine tune workshop outputs and research areas
identified during the consultative workshop.
The last phase was the prioritization of health issues; concerns and research areas
that would appropriately address research problems of the region.
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The following are the identified priority areas for research in Region 02.
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SOCIO-DEMOGRAPHIC PROFILE
Socio-economic Characteristics
The following shows the poverty rank, Poor Families and Poverty Thresholds of the
5 provinces in the region (according to poverty index by NEDA report), to wit:
Table 2: Poverty Index, Magnitude of Poor Families and Per Capita Thresholds
of the Provinces in Region 02
Provinces Rank/Class Magnitude of Per Capita/ Poverty
Poor Families Thresholds
Batanes Rich 249 12,976
Nueva Vizcaya Rich 12,069 11,271
Cagayan Rich 39,682 10,119
Isabela Middle 79,001 11,662
Quirino Middle 9,508 10,665
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Overview of the Health Situation
The health status and the available health resources are presented in the portion
where possible; the health situation is compared with the DOH targets and plans.
Health Status
It can be gleaned that the CDR is below the national figures of 4.0 (2003). It follows
with MMR, which is .7; the IMR of 10.2 while the CBR is very much comparable with the
national figure of 20.7. It was observed that there was decreasing trend in the malnutrition
rate using the Phil. Reference Standards (PRS) and still can’t be compared yet with the
International Reference Standards (IRS).
It can be noticed in the report that the provinces of Batanes and Nueva Vizcaya
have the highest in CBR (22.1 & 22.86 respectively) while in CDR, almost all the provinces
have comparability except in Batanes with a high rate of 6.86. It is notable that Batanes and
Quirino have no cases of maternal deaths with almost comparable degrees in the rest of the
provinces. In the percentage of malnutrition, Cagayan has the highest number (6.87) of 2nd
degree malnourished children.
The leading causes of mortality in the region are shown in table 5 with Pneumonia
as the topnotcher, followed by Hypertensive Vascular Diseases, Neoplasm, Heart Diseases
and Accidents/Assaults. Pulmonary related diseases are also found in the top level of the
list.
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Table 6: Leading Cause of Mortality by Province/City, Region 02 – 2004
Causes Bat. Cag. Isa N. V. Qui. Cau. Sant Tug. Reg.
Pneumonia 1 1 1 2 1 1 4 1 1
Hypertensive Vas. Dis. 2 2 2 2 2 2
Neoplasm 3 3 4 3 3 3 3 2 3
Disease of the heart 4 3 6 4
Accidents/Assaults 5 6 4 4 5 5 3 5
Coronary Disease 6 5 7 4 1 6
Cerebro- Vas. Disease 2 10 1 7
TB (all forms) 5 7 7 6 6 6 5 8
COPD 9 9 5 5 7 5 5 9
Peptic Ulcers 4 8 8 7 5 6 4 10
It is noted that among the provinces compared, Pneumonias topped first except in
Santiago and Nueva Vizcaya, which ranked 4th and 2nd respectively. While, Hypertensive
Vascular Diseases ranked 2nd in most of the provinces except Batanes, Nueva Vizcaya and
Tuguegarao City and Neoplasm as 3rd rank except Isabela and in Tuguegarao City.
The leading causes of Morbidity in the region are shown in Table 7. The first 5
leading causes are the following: Influenza, Bronchitis, Diarrheas, Hypertensive Vascular
Disease and Pneumonias. Accidents and TB (of all forms) are also in the top list just like in
the causes of mortality.
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Health Resources
Tables 9 & 10 represent the manpower resources and available health facilities or
units in the region.
>Prenatal Care
-% of APs w/ TT2 plus 67.65
-% of APs provided w/ 300 more visits 63.61
>Post Partum Care
-% of PPs with at least 1 visit
-% of PPs initiated w/ Breastfeeding 70.66
>Expanded Program on Immunization 68.90
-% of FIC (Fully Immunized Children)
>Deliveries 82.07
-% of Deliveries attended by
MDs,Nurses, and Midwives
-% of Exclusive Breastfeeding 75.0
91.21
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It is shown in the figures above that comparing with the national accomplishment
of 2003, FIC result is almost the same, 82% vs. 84%; AP TT2 plus reflects higher,
67.65 vs. 59.6%; AP provided w/ 3 or more visits have comparable results, while in
the PP performance, PP w/ 1 visit has a little higher result. Regarding Breastfeeding
performance, there is a high accomplishment of Exclusive Breastfeeding of 91.21%
compared to those initiated or counseled for BF, which is 68.90%. It is very
surprising that our performance to deliveries has much higher result, 75% than the
national of 67.8%.
METHODOLOGY
The process of setting the research agenda for region 02 comprised of three (3)
phases: 1. The analysis of the health situation/ health programs 2. Identification of
relevant issues and problems relating to the need for health research 3. Discussion
and prioritization of health issues/concerns/research areas that would best address
the priority research problems of the region.
Health Research
Agenda
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The analysis of the health situation was a process to determine the extent of the
attainment of the 2004 targets and which are found in the document on the National
Objectives for Health (NOH) through the Health Sector Reform Agenda
(FourmulaOne) of the new secretary of Health. The feedback and reports of
concerned health staff and officials provided valuable inputs in the next phase of the
cycle. The health data or the situationer served as relevant reference in the
discussion in identifying related problems and issues in health.
After the consolidation of all these data and information, a multi sectoral meeting
was held to consult and discuss (1st group for the list of participants) relevant issues
and problems in the health sector. A technical working group was organized to follow
up /fine tune workshop outputs as a result of the general consultation. A facilitator
was assigned in each of the reform agenda in health so that extensive discussion
and refinement should be made. It took more than two (2) weeks to settle all of these
activities.
The final process came with another consultative meeting by the same or similar
group of participants (2nd group- list of participants). This was a time to finalize and
prioritize researchable areas previously discussed. With a given matrix or format, the
group came out with a list of researchable areas in health for region 02. This was
presented by no less than the ARD, Dr. Tita N. Callueng on a meeting held on
October 5, at the RRDC, RDC, NEDA Conference Hall, Carig, Tuguegarao City.
Some comments were raised and discussed for the improvement of the said
document which was later presented to the Zonal Meeting held on November 2005,
Baguio City.
* Topics included in the discussion & consultation are as follows: Millennium Development
Goals, 10 Point Agenda of the Arroyo Administration, Regional Research Agenda, PCHRD-
PNHRS thrusts, R&D Profiles. An intensive workshop on health research areas/priorities in
health and fine-tuning/refinement of research outputs were done making use of the two
required matrices suggested by the PCHRD, DOST. Workshop session included the
assignment of key facilitators by health sector reform to guide every one in the current
directions of health.
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Topics included the presentation and critiquing of enhanced/fine-tuned researchable
areas/priorities through comprehensive exchange of views, ideas and deliberation, they
eventually came up with the final list of prioritized research areas in health.
In the same manner, a draft of the Regional Health Research and Development
Consortium was presented and discussed among the participating members through the
spearheading of Dr. Rustico Santos, Chair, RRDC and Zonal Facilitator.
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References
Field Health Services Information System Annual Report, Annual Report, 2003
National Objectives for Health, DOH, Central Office, 1999 and 1998-20004
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ANNEXES
ANNEX A
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ANNEX B
List of Participants
Regional Consultative Workshop on the Regional Health Research Agenda
August 30, 2005
RHTC Conference Hall, CHD-CV, DOH, Carig, Tuguegarao City
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Officials and Guests from the Philippine Council for Health Research & Development
(PCHRD)
Workshop Facilitators
Dr. Myriam Tabian, MO VII, DOH-CHD-CV
Dr. Marian Lynn de Laza, MS III, DOH-CHD-CV
Dr. Leonora Palattao, MS III, DOH-CHD-CV
Dr. Bambina Reyes, MS II, DOH-CHD-CV
Ms. Sandra Sangab, Nurse V, DOH-CHD-CV
Secretariat
Ms. Visitacion Derada, AA VII, DOH-CHD-CV
Ms. Remedios Tunque, AA III, DOH-CHD-CV
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ANNEX C
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ANNEX D
Schistosomiasis Emerging • Health Worker not capable • conduct explorative study on DOH,LGU Foreign/
#1 disease in to handle disease because parasitic, animal, environmental Partner Agency Local
Region 02 of lack of training problems and socio-cultural practices
• Animals can be source of of the 6 municipalities of
disease northeastern Cagayan in relation to
Schistosmiasis
Rabies #1A KAP on Rabies • The incidence of Rabies in • Determine the Knowledge, Practice DOH,LGU Foreign/
Assessment of the region is high despite & Attitudes of households on Rabies Partner Agency Local
the New on the presence of municipal Control & Prevention.
Rabies ordinance on Responsible • Assess the implementation of the
Pet Ownership ordinance on Responsible Pet
• Reports submitted by Ownership thru multi-sectoral
animal bite treatment approach.
centers, reveal that there
were 24 human rabies
cases in 2004, majority of
which are caused by dog
bite
• CV ranks 3rd in terms of
cases next to Bicol &
Western Visayas
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Broad R & D Specific Topic Rationale Objective/s Responsible Funding
Area Agency Agency
TB #1B Effectiveness of • Cagayan province has been • To determine the DOH, LGU Foreign/ Local
PPMD Strategy consistently on top with a 5-year effectiveness of the PPMD Partner
(1999-2003) due incidence of 16 strategy of the NTP in Reg.
deaths/year. 02
• The National TB program has
adopted the DOTS strategy which
when effectively applied, results to
95% cure rate, prevents new
infectious among children/adults &
prevents resistance & is cost
effective
• However, a number of TB cases
still need medical care from the
private sector. Hence, the need to
reach out to these patients &
private physicians.
• with this, the NTP adopted the
PPMD strategy and was
implemented in 4 pilot areas in
Region 02.
Accidents #1C Incidence of vehicular • No program to address the public • To determine the incidence DOH, LGU Foreign/ Local
accidents to health problems. of vehicular accidents. Partner
substance abuse • negligence by caregivers
• substance abuse, poor
observance of traffic rules, poor
road signs condition.
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Broad R & D Specific Topic Rationale Objective/s Responsible Funding
Area Agency Agency
Healthy Lifestyle Effects of stress on • Increasing trend of lifestyle • To determine the DOH/LGU Foreign/
#3 the lifestyle diseases diseases relationship of stress to Partners Local
• Effects of poverty lifestyle diseases.
Reproductive Child rearing, personal • Health care & practices have been • to gain insights on the health DOH/LGU Foreign/
Health #4A hygiene & illnesses or found to be at its lowest among care & practices among Partners Local
Health Care ailments practiced by Aetas. The use of herbal Aetas in terms of:
Practices among the Aetas and IPs medicines & other practices is o Child rearing
IPs in Region 02 ideal avenue to gain insights o Personal Hygiene
o Illness or ailments.
• To determine the current
health status/practices of the
Aetas.
#4B Knowledge, KAB of husbands • the need to study due to low • to determine husbands DOH/LGU Foreign/
Attitudes & about RH on the ff: participation of males in RH knowledge, attitudes & Partners Local
Behavior (KAB) • symptoms & • Seeming disparity in terms of behavior about RH.
of Husbands on complications practice relative to RH • to determine sexual
RH of pregnancy; • Low level of knowledge of males in attitudes & behavior of
• STD RH husbands outside of
• STIs & other marriage.
related
concerns
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Broad R & D Specific Topic Rationale Objective/s Responsible Funding
Area Agency Agency
Training & Effectiveness of • Increase in number of Nursing • To determine the effect of DOH/LGU Foreign and
Affiliation of affiliating units & Schools who are assigned in the the presence of affiliates in Partner local
Students in Gov’t training hospital in hospital as base the health care delivery Agencies
Hospitals/Units catering to the needs • Not clear guidelines of CHED & • To determine the
#5 as affiliating schools DOH regarding the Affiliation of effectiveness of affiliating
Students/base units & hospitals in catering
Effectiveness of • Many schools have failed in pass to the needs of affiliating
service delivery of board exams schools
hospitals with • Loose monitoring activities • To recommend appropriate
affiliating schools feedback guideline in improving
hospital/ched & other
governing units.
Health Care Perception and • Poor compliance of stakeholders to • To determine the level of PHIC Local & Foreign
Financing & satisfaction of set standards in the different compliance of stakeholders DOH
Regulation # 6 stakeholders towards category of hospitals. based on standards CVHRDC
health regulation for • Fragmented quality of hospital • To determine the level of
sustainable health services satisfaction of
care financing. • Lack of information on hospitals/members to
availability/accessibility/device/tech reimbursements provided
nologies of this units by PHIC
• Problems on PHIC benefits • To identify issues &
requirements concerns affecting health
care regulation & financing
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Broad R & D Specific Topic Rationale Objective/s Responsible Funding
Area Agency Agency
Water Quality of Quality of drinking • People complain of the presence of • To determine the physical, ISU NESWM
drinking or water water from the impurities from the existing water chemical, & biological DENR
in Metro pipe & deep well supply. quality of the water supply. DOH/LGU
Tuguegarao & (NAWASA/LUWA) • Buying mineral water is an additional • To produce a baseline
Ilagan Isabela =2 strain to the budget information on water quality
• Diarrhea has been one of the top ten of drinking water for decision
leading cause of morbidity for the past makers.
five years
Financial Utilization of • income of devolved hospitals are • income of devolved DOH LGU Local & Foreign
Management #7 income generated treated as general funds of the hospitals are treated as partners
by hospitals province making the hospitals in general funds of the
adequate or in sufficient of their province making the
resources hospitals in adequate or in
sufficient of their resources
Hospital Service Quality of Health • Management problems that affect the • Determine extent of Quality Partner DOH-National
Delivery #8 Service Delivery of service delivery (All QA components) of Health Service Delivery in Agencies WHO
a Government • Fragmented service delivery in the the government/LGU JICA
Hospital LGU hospitals hospitals GTZ
• loose funds appropriated for basic
health services of the hospital.
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Broad R & D Specific Topic Rationale Objective/s Responsible Funding
Area Agency Agency
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