Interview Session With Madam Emily Laroya Chief Nurse of City Health Office

1. What are the objectives/goals of the health agency? Answer: the vision and mission of CHO Provide basic & high quality social & economic services. Establish close coordination & partnership with the private sector. Align programs, projects & activities with the thrusts & priorities of the provincial, regional & national governments. Encourage community-level initiative & participation in program implementation & responsive leadership & clientoriented workforce who will serve in highest degree of courtesy & professionalism. 2. What are the existing policies or thrusts/strategies in order to meet it s objectives and goals? Answer: a.) Quality of service rendered. There should be access to health in the 59 barangay stations with health stations and establishment of lying in clinics; City Health Office Saoay lying in clinic Bangbangolan lying in clinic Poro lying in clinic Pao Sur Lying in clinic Sibuan Otong lying in clinic b.) Capacity of Employers/Capability of Employers. The employees should have continous education. Hindi dapat magstop hindi porket empleyado ka na. Our goal is mapaganda ang service through training. At Kahit nga ako,head na, at si Dr. Posadas are still taking masterals. c.) Flexibility(Multi-Tasking). Nurses do the physicians role and function, as long as they know the procedure. Dapat flexible ka sa lahat ng Gawain. Ako nga I wash dishes, I sweep the floor at I also wah the soiled linens. Kung isa kang community health worker, hindi ka namimili ng trabaho. In hospital they only take care of the individual. In CHO, we take care of the individual, his family and the entire San Fernando. We render our service in a holistic way. d.) Punctuality and wearing of prescribed uniform. Bawal ma-late. And lahat ng nale-late at absent, we reprimand them. 3. How is the flow of functions and responsibilities of the health care system of your agency? (organizational structure) Answer: Kung ano man ang sasabihin ng mayor, yun ang gagawin naming. 2010-2013, We make San Fernando City our HOME and H stands for health. Maswerte nga tayo Our local executive really focuses on health not like the other municipalities.

4. What is the most important illness? Answer: Based on CHO s morbidity table the following illness are the most important:

Acute Respiratory Infection Acute Tonsillopharyngitis Anemia Hypertension

Age Bronchitis Bronchial Asthma Animal bite Allergy Urinary Tract Infection

5. What are the most common causes of death reported? Answer: Based on CHO s mortality table the most common causes of death reported are the following:

Pneumonia Cancer Hypertension Diabetes Myocardial Infarction Prematurity Pulmonary Tuberculosis Ischemic Heart Diseases End Renal Diseases Cardio-Vascular Diseases

6. In response to the health problems affecting the province/region, what are the health services provided by the agency? Answer: In CHO the following services are rendered in response to health problems affecting the province/region:

Safe Mother and Family Planning Child Health Office Dental Health Care Healthy Lifestyle Health Promotion Nutrition Services Environmental Sanitation Services Lab Services Mental Health Program Physical therapy Ambulance Service/Emergency Medical Services (EMS)

7. What is the ratio of health personnel to care recipients in your province region? Answer: In terms of population ratio, there is a lack of dentist and physicians while in terms of midwives and nurses, there is no problem. We meet the national standard. In terms of services, there is a lack of employment. Sometimes, nurses do the physicians work and Dr. Posadas will be responsible to our negligence. For every physician there is 20,000 populations of clients. We didn t met the national standard because the government of San Fernando City can t afford to pay. Supposed to be there should be six physicians but we only have four na nafill-upan.

8. What is the ratio of health facilities to care recipient? Answer: In terms of facilities, we are waiting for the approvement of computerized records. In CHO, their record department is too much crowded with documents and folders without enough ventilation, that s why the chief nurse is requesting for computerized record from our City government to make their work easier but because of the new elected officials in our City they still have to wait for the new mayor s approval. We are also hoping for bigger facilities na dapat itong buong munisipyo eh CHO na lang. 9. How do you resolve the issue of lack of health personnel, lack of health care facilities? Answer: Because of lack of health personnel, nurses here renders 120-200 hrs of work, in fact 60 hrs lang ang binabayaran ng government, they said that we should not go beyond 60 hrs. But we do overtime as a contribution to resolve health problems. In terms of supplies, CHO had enough and their services are being budgeted. Nagkukulang lang in terms of national budget but there are augmentation funds to back it up.

City of San Fernando Profile Population: 127, 685 (plus 20,000 during weekdays) Land Area: 10,526 hectares Number of Barangays (village): 59 Urban Land Area: 2, 919 hectares (24 Barangays) Rural Land Area: 7,606 hectares (35 barangays) Location: Clinic available in City of San Fernando VISION The Botanical Garden City- a healthy city and springboard for regional progress 1. The City of San Fernando wants to be known as an environment-conscious place. 2. The City of San Fernando wants to be known as a business friendly city. 3. The Botanical Garden symbolizes the city s recognition that it wants to be known as a clean and green city. MISSION Provide basic & high quality social & economic services. Establish close coordination & partnership with the private sector. Align programs, projects & activities with the thrusts & priorities of the provincial, regional & national governments. Encourage community-level initiative & participation in program implementation & responsive leadership & clientoriented workforce who will serve in highest degree of courtesy & professionalism.

San Fernando City Government Health Clinics:

1. 2. 3. 4. 5. 6.

City Health Office-main health Center Saoay lying in clinic Bangbangolan lying in clinic Sibuan Otong lying in clinic Pao Sur Lying in clinic Poro lying in clinic

City Health Office Personnel: Physician - 04 Dentist - 02 PHN - 16 PHM - 28 Sanitation Instructors - 08 Medical Technologist - 01 Ambulance driver 02

IMPACT PROGRAM AND SERVICES A. Safe Mother And Family Planning 1. pre-pregnant, prenatal and post-natal care 2. Family Planning 3. Tetanus Immunization B. Child Health Office 1. Child and infant immunization 2. Integrated management of childhood illness 3. Adolescent health care C. Dental Health Care 1. Oral prophylaxis 2. Temporary filling 3. Tooth extraction D. Healthy Lifestyle 1. Risk assessment and counseling 2. Cancer screening 3. Prevention and control of diabetes, hypertension, and asthma 4. Exercise program E. Health Promotion 1. Health Education classes 2. IEC materials F. Infectious Diseases Control 1. Prevention and control of Tuberculosis, Dengue, Rabies, Leprosy and STD/AIDS G. Nutrition Services 1. Food and micronutrients supplementation 2. Growth monitoring 3. Diet counseling H. Environmental Sanitation Services 1. Water and Food Sanitation 2. Monitoring of human waste and garbage disposal 3. Disease surveillance

4. Fogging 5. Safe Water Supply I. Lab Services 1. CBC; urinalysis 2. Stool examination; FBS 3. Platelet count; gram stain 4. Sputum examination; slit skin exam J. Mental Health Program 1. Assessment of new employees 2. Assessment of mentally deranged 3. Counseling of walk-in referred clients K. Physical therapy 1. Restoring function of an individual 2. Improving balance, coordination and endurance L. Ambulance Service/Emergency Medical Services (EMS)

Male Female Total Rate Total Death Population 355 259 614 4.91 per 1000 Neonatal Death 19 5 24 6.28 Infant Death 7 4 11 3.01 Fetal Death 10 13 27 6.31 Maternal Death 0 0 0 0 Total Births 1640 2005 3465 29.13

MORBIDITY Causes: Male Female Total Rate 1. Acute Respiratory Infection 3320 3497 6798 32.22 2. Acute Tonsillopharyngitis 520 607 1135 5.38 3. Urinary Tract Infection 732 292 1024 4.85 4. Hypertension 236 392 628 --5. Age 276 281 557 2.64 6. Bronchitis 177 275 452 2.14 7. Bronchial Asthma 214 203 417 1.98 8. Animal bite 210 188 398 1.89 9. Allergy 139 210 349 1.65 10. Anemia 47 187 234 ---

MORTALITY Causes: Male Female Total Rate 1. Pneumonia 0.87 76 0.163 1.38 2. Cancer 40 32 72 0.58 3. Hypertension 33 23 56 0.45 4. Diabetes 16 13 29 0.23 5. Myocardial Infarction 17 11 28 0.22 6. Cardio-Vascular Diseases 12 10 23 0.18 7. Pulmonary Tuberculosis 11 8 19 0.15 8. Ischemic Heart Diseases 7 10 17 0.14

9. End Renal Diseases 8 8 16 0.13 10. Prematurity 7 7 14 0.11 FETAL DEATH Causes: Male Female Total 1. IUFD 7 4 11 2. Prematurity 0 4 4 3. Congenital Anomaly 1 1 2 4. Immaturity 0 2 2 5. Hydrops Fetale 1 1 2 6. Absruptio Placenta 0 1 1 7. Asphyxia Neonaturom 1 0 1 Total 10 13 23

NEONATAL DEATH 0-28 days Causes: Male Female Total Rate 1. Prematurity 7 3 10 2.74 2. Pneumonia 4 1 5 1.37 3. Sepsis 3 1 4 1.09 4. Depressed Baby 2 0 2 0.54 5. Congenital Anomaly 1 0 1 0.27 6. Hyaline Membrane Disease 1 0 1 0.27 7. Irreversible Hypothermia 1 5 6 0.27 Total 19 10 29 6058

INFANT DEATH Causes: Male Female Total Rate 1. Pneumonia 4 0 4 1.09 2. Sepsis 2 2 4 1.09 3. Chronic Liver Disease 0 1 1 0.27 4. Asphyxia 1 0 1 0.27 5. Coronary Heart Disease 0 1 1 0.27 Total 7 4 11 3.02 CHILD DEATH Causes: Male Female Total Rate 1. Pneumonia --- 1 1 0.27 2. Bacterial Meningitis 1 --- 1 0.27 3. Tuberculosis Meningitis 1 --- 1 0.27 4. Bronchial Cancer --- 1 1 0.27 5. Leukemia 1 --- 1 0.27 6. Acute Gastroenteritis 1 --- 1 0.27 7. Malnutrition 1 --- 1 0.27 8. Multi-Organ Injury --- 1 1 0.27 9. Intestinal Obstruction --- 1 1 0.27 10. Intestinal Parasitism --- 1 1 0.27 11. Renal Failure 1 --- 1 0.27 Total 6 5 11 3.01