Against Malaria Foundation LLIN Distribution Programme – Detailed Information
Summary
# of LLINS Country Location When By whom Municipality of San Local April-June 15,090 Philippines Mariano in the government 2011 Province of Isabela units of Mariano
Further Information
1. Please describe the specific locations & villages to receive nets and the number to each? Please provide longitude/latitude information. (Important note: If the distribution is approved, approval will be for the nets to be distribution to these specific locations. Location changes will only be considered, and may be refused, if due to exceptional/unforeseen circumstances.) The province of Isabela can be found in the Northern part of the Philippines. It has a total population of 1,401,495 and is composed of 37 municipalities, 27 of which are malaria endemic areas. Distribution of bed nets is proposed to be done in the 33 rural barangays (villages) in the municipality of San Mariano which is located approximately on the grid coordinates of 160o 57’41” to 170o 00’08” north latitude and 121o 58’39” to 122o 01’20” east longitude. Distribution in this municipality will be requiring about 15,090 bed nets. The following factors were considered in the computation of the total number of bed nets to be distributed: the number of households in the rural barangays, estimated average number of members in a household (6 per household), and estimated capacity of the bed net (~3 persons per bed net).
There is actually no policy on the recommended number of persons per net. The basis for our computation on the number of persons per net was based on family size betnet (Olyset) that can hold up to 3 persons. The number of nets will really have to depend on the capacity of the bednet that will be distributed. For example, Olyset nets come in 5 sizes (single to extra-large family size) that can accommodate 1 to 5 persons.
The relative location of San Mariano is shown in Figure 1. The list of the barangays in the municipality of San Mariano with the corresponding population and estimated number of bed nets is shown in Table 1.
The estimates were computed to cover all rural barangays which may include non-endemic ones. We are still waiting for barangay level data to further narrow down the list of barangays that will be included in the distribution. Therefore, it may be the case that the total number of nets requested is already an overestimate.
Page 1 of 8 2. Is this an urban or rural area and how many people live in this specific area? The municipality of San Mariano has a total population of 44,718. It is composed of 36 barangays, 33 of which are rural barangays (37,728 total rural population) (NSO, 2007). Projected population (for 2010) for the municipality of San Mariano is 45,652 as reported in the 1995 Census-Based City/Municipal Population Projections of the National Statistics Office.
3. Is this a high risk malaria area? If yes, why do you designate it as high? Yes. According to the Department of Health (DOH) Field Health Service Information System reports, the province of Isabela ranked fourth among the provinces with the highest number of malaria cases in the Philippines from 2004-2007. It was classified category A (having ≥1,000 annual cases) under the DOH macrostratification of malaria endemic provinces.
4. Baseline malaria case information. How many reported cases of malaria and malaria deaths were there in this specific area in the most recent period available? We are looking for data from health clinics in the area. Month by month information is strongly preferred. We are NOT looking for regional level/national level information. Please cite your source. Baseline malaria case information forms the basis of comparison post-distribution. In 2007, there were 1,459 reported cases of malaria, 783 (53.7%) were male and 676 (46.3%) were female. A majority of the cases, 785 (53.8%), were from the 5 to 14 age group, while 417 (28.6%) were from the 15 to 49 age group, and 214 (14.7%) from the 1 to 4 age group (DOH FHSIS, 2007). There were 293 reported cases of malaria with 1 reported malaria death in the province of Isabela in 2008. Of the reported cases in 2008, 86 (29.4%) were from San Mariano (Isabela Provincial Health Office Data). Currently, there is no available data on the age and sex distribution of malaria cases for 2008.
There are 3 Global Fund-trained barangay malaria microscopists in San Mariano that are stationed in different barangay health stations (BHS). Patients from nearby barangays exhibiting symptoms are brought to these BHS for blood smear. Patients positive for malaria are referred to the rural health unit (RHU). Malaria cases are treated at the level of the RHU by the rural health physician/municipal health officer, Dr. Arlene Lazaro.
5. Is this distribution of nets ‘blanket coverage’ of an area/village or to a select/vulnerable group? If the latter, please describe this group. ‘Blanket coverage’ distribution will be employed, covering all households in the rural barangays in the municipality of San Mariano.
6. What is the existing level of ITN use in this area? Are there existing bednet distribution programmes in this area? An existing ITN distribution program by the TDF (with support from the Round 6 malaria grant of Global Fund) done through the Provincial Management Committee (PMC) of Isabela is being
Page 2 of 8 implemented in the area. The PMC is composed of the Isabela Provincial Health Officer, the Provincial Malaria Coordinator of the Department of Health – Malaria Control Project and the Provincial Project Coordinating Officer of TDF. The PMC is responsible for performing ITN pre-distribution and overseeing distribution activities performed by the local government units with the aid of non-government organizations and community-based organizations.
In 2008, the municipality of San Mariano received 1,273 ITNs (Isabela Provincial Health Office Data). Currently, there is no available data on the extent of ITN use in this area.
7. Why was the area/villages chosen for bednet distribution and who made this decision? Please provide the name, position and organisation of the person/s making the decision. The province of Isabela was chosen since it has ranked fourth among the provinces with the highest number of malaria cases from 2004 to 2007, and among the municipalities endemic for malaria in the province, San Mariano had the highest incidence rate (1.92/1,000 population) (Provincial Health Office Data, 2008).
The top three malaria-endemic provinces (Palawan, Tawi-tawi, and Sulu) are all being supported by at least 3 non- government organizations (i.e. Pilipinas Shell Foundation Inc., World Health Organization, and Tropical Disease Foundation). The said NGOs have implemented the programs such as Movement Against Malaria1 (implemented by Pilipinas Shell Foundation Inc. in collaboration with Globe Telecom which started in June 2006), Roll Back Malaria (initiated by the World Health Organization in 2004 as supported by Australian Agency for International Development) and the TDF Malaria Project (supported by Global Fund and has been implemented since 2003). The province of Isabela, however, is only currently being supported by the TDF Malaria Project alongside 24 other endemic provinces. In addition, the area has favorable peace and order situation.
Person making the decision: Vicente Y. Belizario, Jr., MD, MTM&H Deputy Director for Research Management and Development National Institutes of Health University of the Philippines Manila
8. Have you consulted with the country’s National Malaria Programme about this distribution and what was their response? Please provide the name, position and contact details of the person/s with whom you have liaised. Yes. We were made aware that there are existing bed net distribution programs being conducted in 40 provinces nationwide, supported by different organizations and foundations (i.e. Pilipinas Shell Foundation, Rollback Malaria Project, Movement Against Malaria, Australian Agency for International Development, and Tropical Disease Foundation). However, there is no data available to measure the sufficiency of the support that is being given to the endemic areas. Nevertheless, support in terms of additional
Page 3 of 8 bed nets is important to provide a more widespread allocation of limited resources to other priority areas. The Department of Health has embarked on a goal to be declared the country “Malaria-free” by 2020, and support coming from our possible collaboration can greatly contribute towards the achievement of this goal.
Mario S. Baquilod, MD, MPH Coordinator of the National Malaria Control Program Medical Officer VII Infectious Disease Office National Center for Disease Prevention and Control 3rd Flr., Bldg.13, Department of Health, Rizal Avenue, Sta. Cruz, Manila 1014, Philippines Email: [email protected] Telephone: (+632) 743-8301 loc. 2350 Fax: (+632) 711-6808
9. Please give the name and contact information for the (government) head of the district health management team for the/each area. Please ensure you include contact information. Dr. Romulo Turingan Regional Malaria Coordinator Center for Health Development – Region 2 Department of Health Landline: (078) 846-7261
Dr. Susan Canciller Provincial Malaria Coordinator Isabela Provincial Health Office Mobile: (+63 917) 865-2861 Email: susancanciller AT yahoo.com
Dr. Arlene Lazaro Municipal Health Officer – San Mariano Municipal Health Office Mobile: (+63 917) 890-1320
10. Please confirm the nets will be distributed free-to-recipients, a requirement for us to fund nets. Yes
11. Please describe all pre-distribution activity, including how the size of the target group and number of nets required will be ascertained and how the local community and leaders will be involved in this phase of the work? Consultation and collaboration with the concerned LGUs and the Department of Health will be done. Data on the exact number of households in the selected areas will be requested and retrieved from the municipal and barangay LGUs. A masterlist of the heads of the family, as well as the number of household members will be retrieved from the barangay LGUs.
Information on the status of rural barangays regarding malaria endemicity will be obtained from the municipal health
Page 4 of 8 officer. This information will be used to narrow down the number of barangays to be included in the bednet distribution.
Data on the exact number of households in the selected areas will be requested and retrieved from the municipal and barangay local government units (LGU). A masterlist of the heads of the family, as well as the number of household members will be retrieved from the barangay LGUs. The number of LLINs to be given per household will be computed by dividing the number of family members in a specific household by the capacity of the bednets to be distributed.
Local personnel (municipal/barangay officials and members of the municipal health office) will be consulted regarding the most appropriate date and venue for the distribution at the barangay level. One day will be allotted for distribution in each of the barangays, which will be conducted on 1 fixed site. Community members will be informed on the date and venue of the bednet distribution through barangay health workers (BHW) and local announcements 2 weeks prior to the distribution date.
The sponsoring organization (Phi Kappa Mu) in collaboration with the University of the Philippines Manila-National Institutes of Health (UPM-NIH) and the Department of Health (DOH) will organize the community preparation and orientation of LGU personnel on the distribution procedures. LGU personnel will also be oriented on the proper use and care of bednets.
All LLINs will be brought to the municipal health office of San Mariano. LLINs will be bundled per barangay, which will also include a masterlist containing information on the names of the heads of each household as well as the number of LLINs to be given to each of them. Duplicates of the masterlists will be provided to the municipal health officer.
12. Please describe how the bednets will be distributed and by whom. Please give detail. Please indicate over what time period (typically, the number of days or weeks) the distribution will occur. Distribution will be spearheaded by the local government units at the municipal and barangay level. The sponsoring organization (Phi Kappa Mu) in collaboration with the University of the Philippines Manila-National Institutes of Health and the Department of Health will organize the community preparation and training of LGU personnel. Barangay health workers will also be requested to assist in the distribution. Distribution is expected to take about 1 month.
LGUs at the municipal and barangay level will distribute the LLINs. BHWs will also be requested to assist in the distribution. Members from the Phi Kappa Mu, UPM-NIH and the DOH will oversee the distribution activity. Representatives from the Phi Kappa Mu can assist personnel from the municipal health office in giving information education campaign (IEC)
Page 5 of 8 on malaria control and prevention, and on the proper use and care of the bednets during distribution.
Barangay health workers or local barangay officials will help identify the recipient of the bednet, assuring that the bednets are being given to the right person. The recipient will be asked to affix his signature on the masterlist as proof of receipt.
Distribution per barangay will be conducted in 1 day. Distribution teams (representatives from the Phi Kappa Mu, the DOH and the UPM-NIH) may be divided into 2 so that distribution may be conducted simultaneously. The whole distribution is expected to be completed in 3-4 weeks.
13. Please describe the malaria education component of the distribution. Please give a detailed answer. Information and education campaign (IEC) will be conducted alongside bed net distribution. IEC will include disseminating information on the diagnosis, treatment, control and prevention of malaria. Importance of proper utilization and care for/maintenance of bed nets will be emphasized.
14. Please confirm: a) you will conduct immediate post-distribution follow-up to assess the level of usage (hang-up %) of the nets; b) this take place within four weeks of the distribution; c) you will provide us with the findings. Yes
15. Please confirm you will send a Post-Distribution Summary when the distribution is complete.** Yes
16. Please confirm you will send us, post-distribution, at least 60 digital photos per sub-location*, taken at the distribution/s, to be added to our website as we report on the distribution to donors.** Yes
17. Please confirm you will provide at least 15 minutes video footage from each sub- location. It does not need to be ‘broadcast’ quality and can be taken with a handheld digital video camera.** Yes
18. Please confirm: you will carry out longer-term Post-Distribution Reviews (PDRs)** to assess the level of usage (hang-up %), correct usage and condition of the nets; b) this will take place 6, 18, 30 and 42 months after the distribution of the nets; c) you will provide us with the findings. Yes
Page 6 of 8 19. Please provide your name, role and organisation and full contact information. Romeo L. Isidro, MD Immediate Past President Phi Kappa Mu, International, Inc. 10 Stallion Road Bell Canyon, CA 91307 USA Mobile Phone 818-943-0605 Email: [email protected]
*Sub-locations are mutually agreed and are typically a portion of the total distribution ie A 20,000 net distribution, for photo and video reporting purposes, might be divided into 5 sub-locations. **Information on the provision of photos, video, Post-distribution Summary and Post-Distribution Reviews is included in the attached document. Ends— THANK YOU!
Table 1. List of the villages in the municipality of San Mariano with the corresponding population and estimated number of ITNs required
Number of Rural villages Population* ITNs required Alibadabad 1,412 565 Balagan 1,024 410 Binatug 1,581 632 Bitabian 1,697 679 Buyasan 705 282 Cadsalan 1,138 455 Casala 1,033 413 Cataguing 1,436 574 Daragutan East 1,042 417 Daragutan West 1,420 568 Del Pilar 1,374 550 Dibuluan 1,248 499 Dicamay 1,328 531 Dipusu 636 254 Disulap 1,866 746 Disusuan 522 209 Gangalan 1,248 499 Ibujan 688 275 Libertad 755 302 Macayucayu 603 241 Mallabo 551 220 Marannao 905 362 Minanga 2,588 1,035 Old San Mariano 1,900 760 Palutan 860 344 Panninan 569 228 San Jose 1,708 683 San Pablo 740 296 San Pedro 492 197 Santa Filomina 2,094 838 Tappa 742 297 Ueg 1,465 586 Zamora 358 143 TOTAL 37,728 15,090
*Based on the August 2007 National Census
Source: National Statistics Coordination Board http://www.nscb.gov.ph/activestats/psgc/municipality.asp?muncode=023131000®code=02&provcode= 31
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Figure 1. Location of the municipality of San Mariano Source: http://en.wikipedia.org/wiki/San_Mariano,_Isabela
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