THE CHALLENGE The Municipality of Del Carmen is a fifth-class island municipality of Siargao Del Norte.Their Local Health Board identified five key priority health issues, namely: 1) low facility-based delivery/high maternal deaths (75% facility based child delivery in 2010; 4 maternal deaths in 2009, 3 of which were home deliveries)[2], 2) high infant/perinatal deaths (2 infant deaths in 2013; 3 perinatal deaths in 2013)[2], 3) malnutrition (0-5 y.o.) (32% in 2012)[1], 4) poor sanitation (54% coverage of sanitary toilets in 2012)[1], 5) high incidence of infectious diseases/vector borne diseases [tuberculosis (detection rate of 68, cure rate 33 in 2013)[2], leprosy (1 case in 2013)[2], schistosomiasis (49% mass treatment coverage in 2013, Filariasis (61% mass treatment coverage in 2013), dengue (5 cases in 2013)][2]. THE SOCIAL INNOVATION The Seal of Health Governance (SOHG) is a monitoring and evaluation program developed by the Local Government Unit of Del Carmen. It aims to ensure the implementation and sustainability of health programs at the municipal, barangay and purok levels. Accomplishments of each barangay are visualized through a Seal of Health Governance Board, a summary table of the barangay’s score for each health indicator collaboratively identified. The program provides annual financial and in-kind incentives to the best performing barangays of the municipality. The Municipal Health Office perform their assessment on a quarterly basis and scores are consolidated annually. The program culminates in their annual Health Summit organized every July where awarding of the winning barangays for the seal of health governance are given. IMPACT ON HEALTH seal of health DELIVERY Engaging the barangay officials from the outset increased the local health leaders and health workers participation in health-related efforts. This ensured sustainable governance and participatory involvement in tackling local and systemic health challenges of the municipality. The active participation of the barangays of Del Carmen has led to positive changes such as a functional Barangay —local government of Health Board, increase in the allotment of health budget, improvement of facility-based deliveries (95% in 2014) [2], decrease in malnutrition rate (2.7% in 2015), improved access to toilet facility (100% in 2015), decreased incidence del carmen of infectious diseases/vector borne diseases [(tuberculosis (detection rate of 118, cure rate of 3 in 2014)[2], leprosy (0 cases in 2014)[2], schistosomiasis (67% mass treatment coverage in 2014), filariasis (76% mass treatment coverage in 2014), dengue (8 cases in 2013)][2]. OPPORTUNITY FOR SCALE The Seal of Health Governance program has already been adopted by several mayors in different parts of the country to better the health of their communities. KEY LESSONS 1 Good leadership—the need of a strong political will and the support of the local officials and health care workers. 2 Finding the common interest — finding the common ground wherein you and the stakeholder are able to understand each other and have a conversation towards finding the solution together. 3 Feedback — measuring performance by letting all stakeholders know the results in a timely manner improves performance and motivates stakeholders to do better. __________ [1] - Zuellig Family Foundation. (2016). Policy Brief: Mobilizing villages to achieve greater health equity in a rural town. Retrieved from: http://zuelligfoundation.org/wp-content/uploads/2016/12/ Policy-brief_December-6.pdf [2] - Vizconde, M., Corro, A. (2015). Health Innovation: Seal of Health Governance, Municipality of Del Carmen, Surigao Del Norte. Retrieved from: https://drive.google.com/file/ d/0B2XCjJNR5J1WNHRTbnl1aFhLd1U/view A monitoring tool that ensures the sustainability of health programs at the barangay and purok level www.socialinnovationinhealth.org.