Tuesday, June 19, 2018

Supportive Supervision Boosts Competence of Health Workers

Harlene Villanueva (right) counsels a mother on family planning while being observed by Adelaida Quizon, a midwife from Lipa City District Hospital and member of the Provincial Supportive Supervisory Team

Harlene receives feedback from Adelaida on how to improve conduct of family planning counseling. 
(Photos by JBonifacio/RTI International)

Harlene Villanueva is a midwife at Cuenca Rural Health Unit in Batangas, south of Manila. Since undergoing the Department of Health’s Family Planning Competency Based Training Basic Course, she has been counseling men and women who desire to either limit or space childbearing. “There were times, however, when clients would ask questions that I could not answer right away…I usually just refer them to either our doctor or nurse who can better address their concerns,” Harlene shared.

These were the sentiments expressed by Harlene when the Provincial Supportive Supervisory Team of Batangas initially visited her and her fellow midwives to coach them on how to improve family planning service provision. With the coaching and mentoring, Harlene received technical updates on family planning from the visiting supervisors and her knowledge on family planning was reinforced.

Coaching and mentoring are integral parts of further developing the skills of health service providers after they undergo training. The Province of Batangas, with support from USAID's LuzonHealth Project implemented by RTI International, organized a Provincial Supportive Supervisory Team for Family Planning composed of selected program managers and service providers trained in supportive supervision. The team is tasked to conduct supportive supervisory visits every other month that include coaching and mentoring of health service providers assigned in barangay (village) health stations, rural health units, and district hospitals.

Recently, supportive supervision has also been linked to the conduct of diagnostic workshops which are now being used as an alternative process for the certification of health service providers. Through diagnostic workshops, the skills of trained health service providers in various areas of family planning service provision are assessed. Those found competent are endorsed for proficiency certification, while those who need further improvement in certain areas are scheduled for succeeding supportive supervisory visits. By doing this, service providers are assisted in improving their skills and building their confidence further as they provide quality service until they are ready for certification.

Since April 2018, the Batangas Provincial Supportive Supervisory Team has conducted supportive supervisory visits to 20 family planning-trained health service providers who have undergone the diagnostic workshop. To date, nearly 900 health service providers in USAID-assisted areas in Luzon, including Batangas, have been trained in supportive supervision. In Batangas, the sustained practice of supportive supervision is expected to further improve the quality of family planning services being provided by its 335 family planning-trained providers to benefit some 99,000 women with unmet need for family planning.

Friday, June 1, 2018

USAID Helps Sustain Family Planning Services in Times of Disaster

Using the Rapid Assessment Checklist, the Provincial Family Planning Program Coordinator of Albay (left), interviews a nurse assigned at an evacuation center. (Photo by VEstevez/RTI International) 
Mayon Volcano’s eruption in January 2018 displaced over 17,000 families (66,500 individuals) from three cities and six municipalities of Albay province, south of Manila. The Mayon Volcano — which rises some 8,077 feet (2,462 meters) above the Albay Gulf — is the Philippines most active volcano. By the end of March 2018, the disaster alert level was lowered and families were allowed to get back to their homes from 58 evacuation centers. 

In February 2018, USAID and RTI International’s LuzonHealth project, in collaboration with local health offices and local government units in Albay, tested its newly-developed Family Planning Rapid Assessment checklist to help ensure continuity of family planning services to these displaced families. Using the checklist, Albay provincial and municipal health offices staff conducted an inventory of current family planning users among women in the evacuation centers. Women with unmet need for family planning were also identified. Family planning supplies were then sent to the evacuation centers and health providers were mobilized to provide family planning counseling to potential clients and to dispense commodities to current users. 

Through this initiative, nearly 2,000 women of reproductive age were identified, 40 percent of whom were family planning current users. About 85 percent of these current users were provided with family planning supplies. Nearly 800 potential new users of family planning also received counseling services at the evacuation centers.

“This is the first time that we have used this type of tool,” said Olga Belen, Albay Provincial Family Planning Coordinator. “We are familiar with rapid assessments and disease surveillance but this checklist helps us to assess the capacity of the local government unit to ensure continuity of family planning service delivery. It also helps us to maintain quality recording and reporting of family planning services provided to displaced populations,” Olga shared.

The development and use of the Family Planning Rapid Assessment checklist is part of LuzonHealth’s climate risk management plan. Climate risk management is a USAID policy that involves assessing, addressing and adaptively managing climate risks to ensure resilience of development efforts amidst changing climatic conditions, such as community displacement. The checklist is being further tested based on its application in Albay before it is adopted and used in other disaster-prone areas.

Monday, April 30, 2018

USAID-Assisted Areas Bag Purple Ribbon Awards

Bayugan City, Agusan del Sur's Health Office Public Health Nurse Helen Saligan (2nd from left) accepts from regional and provincial health officials the Purple Ribbon Award conferred to the city that scored 100 percent based on the award criteria. (Photo by Gina Canonoy) 

Representatives from the six USAID-assisted Metro Manila cities pose for posterity after receiving their Purple Ribbon Award from the Department of Health. (Photos by RTI International) 
Eleven USAID-assisted cities and municipalities in Metro Manila and Mindanao received Purple Ribbon Awards from the regional offices of the Department of Health for exemplary accomplishments in family planning and reproductive health, paving the way for more women to access quality health service.

The Department of Health launched the Purple Ribbon Award in 2016 to recognize local government units and civil society organizations with exemplary accomplishments, practices and innovations in the implementation of the Reproductive Health and Family Planning Program. The Award aims to encourage institutions to bolster efforts to help couples achieve healthy timing and spacing of births and reduce maternal deaths.

“The Purple Ribbon Award serves as an inspiration to keep our commitment alive in providing quality services to all our clients,” said Dr. Bernadette Bordador, Family Planning Coordinator of Valenzuela City Health Department. Valenzuela City won the award along with other USAID-assisted cities -- Quezon City, Caloocan City, Malabon City, Pasig City, and Marikina City. The six bested 11 other local government units in Metro Manila.

In Mindanao, five USAID-supported areas were conferred with the Purple Ribbon Award. These were Bayugan City and Veruela Municipality in Agusan del Sur province, as well as Tagoloan, Villanueva and Lugait municipalities in Misamis Oriental. They won from among 12 nominees. Department of Health Northern Mindanao Family Planning Coordinator Fe Sumagpao shared, “These local government units showed excellent performance in delivering family planning and reproductive health services, most notably in the conduct of health outreach activities reaching clients, including those in far-flung communities.”

With USAID assistance, the award-winning cities and municipalities either established or strengthened their respective service delivery networks to ensure that clients receive services through a functional referral system. They identified clients with unmet need for family planning and tracked family planning commodity supply to prevent stock-outs. Their health facilities secured accreditation from the Philippine Health Insurance Corporation for their maternity and newborn care packages, enabling them to claim for reimbursements used in further improving their services. They increased demand for and improved supply of family planning services while observing the principles of informed choice and voluntarism in family planning.

Wednesday, April 11, 2018

USAID Helps Improve Quality of Care of Health Workers

Dr. Esperanza Arias performs competency assessment on a midwife trained in intrauterine device insertion, during a Diagnostic Workshop conducted among Quezon City health service providers. (Photo by DTeh/RTI International).

Shayne Pango, Population Program Officer from District V, Quezon City (upper right) assesses the skill of a health service provider in performing pelvic examination using a rubberized model. (Photo by PFernando/RTI International).
Since 2013, USAID has supported regional and provincial health offices train health service providers in competency-based family planning and maternal and newborn care courses. Yet, many trained health workers have not undergone post-training evaluation.They are either unable to provide the services or they provide the services without the benefit of an evaluation, compromising the quality of service.

To address this concern, starting August 2016, USAID, through the LuzonHealth project implemented by RTI International, introduced the diagnostic workshop. It is as an alternative process to fast-track competency certification among trained health service providers in family planning and basic emergency obstetric and newborn care. The diagnostic workshop systematically evaluates the knowledge and clinical skills of trained health workers. It also assesses the adequacy and appropriateness of the providers’ working environment and equipment.

As Dr. Esperanza Arias, head of Quezon City’s Population Program Office and Family Planning Program Manager, puts it: You can see right away the strengths and weaknesses of health workers in carrying out their duties. You can immediately correct practices that need improvement – all for the benefit of the clients, the mothers and children.”

Since August 2016, USAID and the local health offices in Luzon have conducted 17 diagnostic workshops to assess for certification the competencies of nearly 300 health service providers. “Through the tool, you can easily determine who among the health workers are competent and who needs retraining. So you actually save on training costs,” Dr. Arias further shared. More importantly, the conduct of diagnostic workshops has motivated service providers to improve on their weak points with a conscious effort to provide quality service, strictly following clinical standards.

Friday, December 8, 2017

Town Breaks Financial Barriers to Maternal and Child Health Services

Estella Tudio, with husband Almar and their two children, is a happy beneficiary of PhilHealth’s Point of Service Program. (Photo by RTI International)
In 2013, 31-year-old Estela Tudio of northern Luzon, gave birth at home to her first child despite the risks of home delivery. “We didn’t have money so I just gave birth at home,” recounted Estela, a homemaker who is married to a tricycle driver.

In 2017, Estela delivered her second child at the Bayambang Rural Health Unit. She also availed herself of free contraceptive pills from the facility after receiving family planning counseling. “I was happy to give birth here at the rural health unit. Everything is now free courtesy of the Point of Service Program,” Estela shared. In July 2017, PhilHealth, the national health insurance agency, launched the Point of Service Program, a new financing scheme that allows on-the-spot enrollment of underserved clients.

Estela is one of 500 beneficiaries of improved health financing in Bayambang. In collaboration with the Department of Health Regional Office for Ilocos Region, USAID, through LuzonHealth project, has partnered with Bayambang Rural Health Unit to build the capacity of staff to provide maternal and family planning services. As a result, the rural health unit was able to meet PhilHealth’s accreditation requirements for the maternity and newborn care packages. The facility became the first in Pangasinan Province to offer PhilHealth’s Point of Service Program.

Today, all pregnant women, including those in the lowest income quintiles, in Bayambang can now safely give birth in the rural health unit and access their chosen family planning methods without having to worry about out-of-pocket expenses. The facility has also improved its financial viability by claiming PhilHealth reimbursements amounting to $30,000 annually which helps improve clinic operations and augment salaries of health personnel. “Sustained financing leads to better health services. In turn, this brings higher demand which means that more PhilHealth reimbursements and resources can be used to improve our services,” Dr. Paz Vallo, Bayambang’s Municipal Health Officer said.

To date, 80 percent (295 out of 364) of the rural health units and health centers across all USAID-assisted cities and municipalities in Luzon have been accredited by PhilHealth for its maternity care package.

PHOTO: Estella Tudio, with husband Almar and their two children, is a happy beneficiary of PhilHealth’s Point of Service Program. (Photo by RTI International)