Health Sector

SECTORAL PLANNING A. Assessment of Existing Situation A.1 Data Requirements Data Requirements a. Demographic Data 1. Population by barangay 2. Projected population of the planning period b. Health Status 1. Livebirths by sex and by barangay 2. Fertility, Mortality, and Morbidity Rates 3. Deaths in age group 50 years and over in calendar year.

Source NSO/Demographic Sector Demographic Sector

Local Civil Register To be computed Municipal Health Office/ Local Civil Registrar/ Primary Survey

4. Number of deaths, all causes in calendar year

-do-

5. Number of deaths, less than one year of age in calendar year; number of live births in the same year.

-do-

6. Deaths all causes, 1-4 years of age in calendar year; population.

-do-

7. Deaths in a calendar year among in pregnancy, labor and puerperium. 8. ten leading causes of mortality and morbidity (as reflected by the recorded consultation and hospitalization)over the past three (3) years to five (5) years. 9. Epidemic Occurance the last five (5) years. 10. Number of Malnourished children by barangay and by degree of malnourishment.

Deaths in a calendar year among women in pregnancy, labor Local Civil Register

Deaths in a calendar year among women in pregnancy, labor Local Civil Register -do-

c. Health Resources 1. Number and location, areas served, personnel composition and services offered in all medical/health facilities in the municipality including Rural Health Units, Puericulture Center and Hospital.

Municipal Health Office/ Primary Survey

2. Number of hospital beds in calendar year 3. Number of physicians, nurses, midwives, sanitary inspector, dentist, vaccinators in the municipality.

-doInterview with an authority e.g. Municipal Health Officer

4. Health Programs (National Government, Local Government People’s Organization, Non-Government Organizations.)

LGU’s/ Primary survey/NSO

4.1 Type of Programs, Frequency, beneficiaries 4.2 Financial Resources e. Solid Waste Disposal 1. GarbageDisposal System in the city/municipality a. Management personnel b. Disposal Equipment/Facilities - Number and capacity of trucks - frequency of collection - general condition of trucks - location of motorpool c. existing garbage disposal practices within the city/municipality d. description of the existing solid waste disposal method, dite and operations. LGU’s/ Primary survey f. Industrial Waste Disposal 1. Number and Types of industrial establishments by industry classification according to degree of hazards and pollution. 2. methods of waste disposal 3. disposal sites

g. Sanitary toilet Facilities

LGU’s/NSO

h. Hospital Waste Disposal

LGU’s/Primary Survey

1. Kind of Hospital 2. Methods of waste disposal i. Cemeteries and Burial Grounds

LGU’s/DOH

1. crude death rate of the city/municipality 2. number, location, and area cemeteries 3. slope or elevation of lands where the cemeteries are located 4. distance from any dwelling unit 5. distance from any source of water supply 6. susceptibility of the are to flooding and other problems

A.2 Data Gathering 1. Field Surveys/ Questionnaires/Direct Interview 2. Complied/Published Document/Report A.3 General Health Indicators a. Fertility Indicacies A.1 Crude Birth Rate (CBR) Crude Birth Rate is the ratio between numbers of live births and number of individuals in a specified population and period of time often expressed as number of live births per (1) thousand population in a given year. CBR =

Number of Live Births Total Population

x 1000

b. Morbidity Indicators General medical consultations rates and hospitalization rates are employed to reflect the morbidity situation. b.1 GMCR- general medical consultation rte is the number of general consultation in a calendar year per 1,000 populations. GMCR= nos. of general medical consultation in a calendar year Population in a calendar year

x 1000

b.2 Hospitalization Rate Hospitalization rate is the number of hospitalization in a calendar year per 1,000 populations. HR.=

Nos. of hospitalization in a calendar year Population in a calendar year

x 1000

c. Mortality Indicators Mortality indicators will include the crude death rate and the proportional mortality ratio of age fifty (50) years and over, current infant mortality, young child mortality (1-4 years) and maternal mortality. c.1 Swarrop-Uemura index or proportional Mortality Ratio (PMR) Age fifty and over. This is the death in age fifty (50) years and over in a calendar year per one thousand (1,000) death all causes, all ages in the same year. PMR=

Death in age group 50 years and over calendar year Death all causes, all ages same year

x 1000

c.2 Crude Death It is the number of deaths per one thousand (1,000) mid-year population of a given area. Data on the number of deaths are generated through the vital registration system although this is adjusted under registration. CDR=

Number of death all causes in a calendar year Population in a calendar year

x 1000

c.3 Infant Mortality Rate (IMR) Infant mortality ration is the number of deaths to infant under one year (1) of age one thousand live births in a given year or it is the risk of a child dying before his first birth or during infancy. IMR=

Number of death less than one year of age in a calendar year Number of Live Births in Same Year

x 1000

c.4 Young Child Mortality (YCM) This is the number of death all causes aged one (1) to four (4) in a calendar year per one thousand (1,000) population YCM=

Death all causes 1-4 years of age in a calendar year Population of age group 1-4

x 1000

c.5 Maternal Mortality Rate (MMR) This is the number of woman who dies as a result of child bearing in a given year per one thousand (1,000) births in that year. Maternal deaths are those caused by complications of pregnancy and child birth. MMR= Deaths in calendar Year among Women in pregnancy labor & puerperium x1000 Number of Live Births in Same Year A.3.2 Cause of Malnutrition State the 10 causes of morbidity and mortality of the year for the last 5 years. A.3.3 Epidemic Occurrences for the last 5 years A.3.4 Rate of Malnutrition A.3.5 Health Resources, Facilities, and Services

A.3.6 Waste Disposal •

Solid Waste Disposal o Pick-up Garbage Trucks o Dumping in individual Pit o Burning o Compositing o Burying o Feeding to Animals o Others (Thrown in esteros, vacant Lot, Rivers, Etc)

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Industrial Wastes o Determine Which of the existing industries are hazardous and pollutive (Based on Inventory Conducted) o Determine if anti-pollution devices are used by these industries. o From DENR-Reports the degree of pollution problem created by these industries.

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Sanitary Toilet Facilities o Water Sealed, Sewer/Septic Tank- House Hold o Water Sealed, Sewer/Septic Tank- Share With other House Hold o Water Sealed, Other Depository- House Hold o Water Sealed, Other Depository- Share With other House Hold o Close Pit- without a water-sealed bowl and the depository is constructed with a large circular tubes made of concrete or clay. o Open Pit – Same as Closed pit without coverings. o Others (pail System, etc.) o None- House hold without toilet facilities.

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Hospital Wastes o Determine the methods used by the hospitals in disposing their wastes. o Determine which the hospitals do not practice proper sanitary waste disposal.

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Cemeteries and Burial Grounds o Existing Condition of these cemeteries or burial grounds through (Location (Barangay), Number, Area (hectares), Number of burials, Type (Gov’t/Private)) o Evaluate if they conform to the existing rules and regulations, such as the sanitation code, water code, and guide lines covering memorial parks. o Determine the capacity of each burial ground

o Reflect these existing burial grounds/cemeteries on the municipal map. B. Determination of problems and development needs b.1 Man Power Requirements (MPR) MPR correlate with the adequacy of health service rendered based on health status. Assess manpower requirement vis-a’-vis Rural Health Unit (RHU) personnel. b.1.1 Man power Determination o For out patient care No. of Man power =

no. of man-hours required Available professional time in hours

Man-hour required for = (no. of cases) x (Frequency of visit ) x (duration in min.) Out patient 60 minutes/hour Professional time available = (272 days) x (no. of available professional time) Professional Time available for: Municipal Health officer = 4 hours for direct patient care and 4 hours for administrative/auxiliary time Public Health Nurse (PHN) = 5 hours for direct patient care and 3 hours for administrative/auxiliary Rural Health Midwife (RHM) = 6 hours for direct patient care and 2 hours for administrative/auxiliary Rural Sanitary Inspector (RSI)= 6 hours for direct patient care and 2 hours for administrative/auxiliary Vaccinator = 7 hours for direct patient care and 1 hours for administrative/auxiliary Dentist = 5 hours for direct patient care and 3 hours for administrative/auxiliary

b.1.2 For Rural Health Units (RHU’s) This is computed based on staffing pattern of rural health units as required by law. There are 8 RHU categories considered depending on the population bracket. 1. Municipal Health Officer (MHO) – later designated as a rural health physician, 2. Public health Nurse (PHN), 3. Rural Health Midwife (RHM), 4. Rural Sanitary Inspector (RSI), Etc. o o o o

One Municipal Health Officer (MHO) per 20,000 population One health Nurse (PHN) per 20,000 population One Rural Health Midwife (RHM) per 20,000 population One. Rural Sanitary Inspector (RSI) per 5,000 population

C. Services/facilities Requirement c.1 the required bed days are converted into bed requirements. 1. Assumption that patients suffering from acute communicable disease would need an average of 7 days. 2. with chronic degenerative diseases would need an average of 15 days. c.2 a bed population ration of one is to two thousand (1:2000) Suggested Bed Requirements by facility type o o o o

Municipal Hospital = 6 -24 beds Provincial Hospital = 100-199 beds Regional Hospital = 200- 299 beds Medical Centers = 300 and over.