MEETING THE CHALLENGE OF MILLENIUM DEVELOPMENT GOALS ON HEALTH by: Gov. Carmencita O. Reyes Marinduque

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Philippines . Political Subdivision and Classification • Lone Congressional District • Six (6) municipalities namely: Boac, the capital town, Buenavista, Gasan, Mogpog, Sta. cruz and Torrijos • 218 Barangays

Land Area in Hectares by Municipality, Income Class and Rural/Urban Category

Municipality Land Area No. of Income Rural / Urban (has.) Barangay Class Marinduque 95,925 218 4th Class Partially Urban

Boac 21,270 61 1st Class Partially Urban

Buenavista 7,860 15 4th class Partially Urban

Gasan 11, 930 25 3rd Class Partially Urban

Mogpog 8,770 37 3rd Class Partially Urban

Sta. Cruz 24,665 55 1st class Partially Urban

Torrijos 21,430 25 4th Class Partially Urban Land Area in Hectares, 2007 Population and Average Growth Rate (2000-2007) Per Province, MIMAROPA MIMAROPA Land Area in Has. 2007 Population Average PROVINCES Growth Rate (2000-2007)

Occidental 587,985 421,952 1.44 Mindoro Oriental 436,472 735,769 1.06 Mindoro Marinduque 95,925 229,636 0.76

Romblon 135, 593 279, 774 0780.78

Palawan 1,489,626 682,152 1.94

MIMAROPA 2,745,601 2,5598,791 1.49

Philippines 30,000,000 88,574,614 2.04 Annual IRA Share, 2007 to 2011

Calendar Year Annual IRA Share 2011 Php 347,776,304.00 2010 Php 326,921,778.00 2009 Php 276,485,390.00 2008 Php 247,671,336.00 2007 Php 215,322,507.00 Technical grant assistance from the WB-ASEM in 2004 entitled, “Strengthening the Government Capacity for Poverty Assessment , Plan Formulation and Monitoring”, which led to the implementation of CBMS in 2005. Who are the poor?

Where are th e poor?

Why are they Poor? CBMS Survey 2005 & 2008 (proportion of population below poverty threshold) 2008 - 47.91% (24,000 hh) from the 2005 data of 62.7% (28,324 hh) CBMS Survey 2005 & 2008 (proportion of population below poverty threshold)

Buenavista – from 77. 9% in 2005 to 61. 2% in 2008 CBMS Survey 2005 (Proportion of Population Below Food Threshold) 2008- 33.82% (85,213) from the 2005 data of 56.% (114,327) CBMS 2005 8. 0% (1, 876)- prevalence of underweight children under 5 years old 83%8.3% - female 7.9% - in the rural areas 96%9.6% - highest proportion is in Buenavista 3.8% - lowest proportion is in Boac CBMS 2005 s hows tha t there were 1, 876 ma lnour is he d children in Marinduque and went up to 2,557 in 2008. CBMS 2005 & 2008 (Proportion of population who are experiencing food shortage 2008- 5.1% (11,898) from the 2005 data of 4.1% equivalent to 8,396 population CBMS Survey 2005 & 2008 (proportion of population below poverty threshold)

Buenavista – from 77. 9% in 2005 to 61. 2% in 2008 Meeting the MDG Challenges on Health MDG 4 – REDUCE CHILD MORTALITY MDG 5 – IMPROVE MATERNAL HEALTH MDG 6 – COMBAT HIV/AIDS AND OTHER COMMUNICABLE DISEASES Goal 4. Reduce Child Mortality Target: Reduce child mortality by two- thirds between 1990 to 2015. CBMS 2005 (Proportion of Children 0 to less than 1 year old who died) 4,228 - population of children aged 0 to less than 1 yr old 87 infants died (2.0%), 2.1% are females (40) and 1.9% males (41). Most number of incidence are found in the urban areas (2.4%)

Mogpog had the highest number with 23 deaths (3.7%) followed by Buenavista with 9 deaths CBMS 2005 (Proportion of children o to less than 5 years old who died)

24,093 - population of children aged 0 to less than 5 years old 0.6% or 136 died and majority were males with 71 deaths Mogpog had the most number of children who died having 26 deaths, followed by Torrijos with 19 deaths.

Torrijos consistently had high infant child death based on the CBMS 2005 and 2008.

There was a decelerating trend in the number of FIC from 2001 to 2006 ( 85.3% to 71.00%) based on the NSCB Reg’l. Social and Economic Trend. Infant mortality rate – 18.11 (81/1,000 livebirths (ave. past 5 yrs, 2004-2008, PHO-Marinduque) and went Up to 19.21 % or 87/1,000 livebirths in 2009.

11.41% in 2004 and went up to 19.99 in 2006 (DOH – MIMAROPA) – the highest rate in the region

At the national level, infant mortality rate is in a decreasing trend from 28.7% in 2003 to 24.7% in 2008. (source: www.nscb.gov.) Seven (7) in every 1,000 children aged 0-4 yy,ears old died, based on 2008 CBMS Survey or158 children aged 0-4. The highest proportion was found in the municipality of Gasan. Programs and Strategies to Meet the Challenge CdtfEConduct of Essenti tilNbal Newborn Care (1 hour after delivery) Six (6) months exclusive breatfeeding, thereafter complementary foods are given to the infatant Free immunization every month. Training for health personnel on Infant and Young Child Feeding (IYCF). GOAL 5. REDUCE MATERNAL MORTALITY Target: Reduce maternal mortality rate by three quarters by 2015 and half by 2000 13 women died (0.35) mostly were from the rural areas (12 deaths), with Boac having the highest (5 deaths or 0.6%) based on the CBMS 2005 and went up to 29 deaths in 2008.

0 % Maternal Mortality in Buenavista & Gasan 0. 88% or 4 maternal mortality rates in the ave . past 5 yrs (PHO -Marinduque), rate increased from 5 deaths in 2008. Some pregnant moth ers still pre fer traditi ona l birth attendants or “hilots” since it costs them less and accessible, too.

Dist ance and accessibilit y a lso pose a problem. There are 21 geographically isolated and disadvantaged areas (GIDAs) in the province. Transporting patients to the nearest referral health facility would mean traversing mountains, crossing rivers and seas. Travel Time from RHU to its Referral Hospital

Lucena City

TRAVEL TIME:

Less than 30min

30min to 1 hr

More than 1 hr

LEGEND: GIDA 3 GIDA 1 Municipal Hospital GIDA 2 District Hospital GIDA 1 Brgys: GIDA 3 brgy Provincial Hospital Tumagabok, Talawan Tambunan, Sabong

RHU GIDA 2 Brgys: Canat,Boi,Bayuti Level I

Level II

Level III

Sentrong Sigla I Programs and Strategies to Meet the Challenge Es tabli s hmen t o f Bloo d Ban k Fac ility s ince blood loss is one cause of maternal mortality. Increased number of Facility-based deliveries. Basic Emergency Obstetric and Newborn Care (BEMONC) and Comprehensive Emergency Obstetric and Newborn Care (CEMONC) serve as Halfway Homes. Ordinance will be passed for non-birth delivery at home. Increase doctor in the barrios. Intensive training for Barangay Health Workers as counterpart of doctors in the barrios. Intensifyyp prenatal care visits. Improved maternal and pre-natal care througgpph proper health and nutrition practices. GOAL 6. COMBAT HIV/MALARIA AND OTHER DISEASES Incidence of Malaria – Marinduque is a Malaria-free province

Incidence of Pulmonary Tuberculosis –  ranks 7th in the 10 leadinggy causes of mortality with 44 cases (19.85%) in the past 5 yrs (2003-2007)  although detection rate is high at 78.0% to 100% in 2004 to 2008, cure rate remained low at 71% (PHO-Marinduque) CBMS 2005- Incidence of Pulmonary Tuberculosis 81 cases (40.0%) – PTB incidence  Sta.Cruz had the higgg,hest number of case having 26, mostly are male (63) and are found in the urban areas. PTB cases went down to 44 in 2008. Programs and Strategies to Meet the Challenge MitiMaintain st ttatus as mal ari a-fifree province thru conduct of surveillance activities and monitoring Setting up of Social Hygience Clinics Advocacy and A wareness on th e Prevention of and Control of STD Co lla bora te w ith organ iza tions like Philippine Coalition Against TB. Con duc t if Prov inc ia l Sita tion Ana lys is on PTB in Marinduque Other Programs/Projects and Strategies to Meet the MDG Challenge on Health . Boac telemedisina/telerad (best practice in Boac) . Continue/Strengthen tie-ups with organizations like Marinduque International for Medical Missions . All Barangays must have Botika ng Barangay . Universal coverage of Philhealth Insurance . Distrib ut ion o f Hea lt h Car d for t he In digent (local initiative) . Strengthening of the InterLocal Health Zone . Full implementation of Health Rationalization Plan . Improvement and Upgrading of the 3 Hospitals (Dr. Damian Reyes Memorial Hospital, Sta.Cruz District Hosppjpital and the Torrijos Municipal Hospital . Strengthening of the Preventive Department . Strong collaboration with NGOs for Medical Missions . Increase budget allocation for Health

ANNUAL BUDGET AlifEAnalysis of Expen ditures For CY 2007

General Public 0.22 Other Services 25.34 Economic Services Serv ices 37. 65 Gen. Pu blic Services Education, Culture, Sports and Manpower Development Health Services

Social Welfare 1.76 Social Services Welfare Services Economic Services 1.23 Education, 33.81 Health Culture, Sports Services and Manpower Other Purposes Devt.

“ Poverty is not a fate nor a punishment but a condition that can and must be changed. Let us bring the government closer to the people and elevate the status of a common man to the level of human dignity – this will be our paramount bequest for the nation.” - Nanay Carmencita Thank you and Mabuhay!!!!