NUHRA Regional CAR Agenda
NUHRA Regional CAR Agenda
NUHRA Regional CAR Agenda
The Regional Consultation Workshop for Setting the Regional Health Research
Agenda was held last October 27, 2005 at the Golden Pine Hotel, Legarda Road, Baguio
City, from 8:00 a.m. to 4:00 p.m. The objective of the workshop was to formulate a health
research agenda based on priority areas, which would involve the participation of concerned
stakeholders at the provincial and regional levels.
The program of the said activity is shown on the next two pages, followed by a list of
the participants in the workshop.
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ACKNOWLEDGMENT
The Regional Facilitator would like to express her gratitude to the following:
The Department of Science and Technology (DOST) -- Philippine Council for Health
Research And Development (PCHRD) through:
Dr. Jaime C. Montoya, Executive Director;
Dr. Allan Fernail, Chief, Research Management Development Program;
Ms. Teresita O. Laguimun, Officer-in-Charge, Human Resources and Institution
Development Division;
Mrs. Angelina M. Aquino, Administrative Assistant, Office of the Executive Director;
Director Leonardo N. Quitos, Jr., Zonal Convenor; Faculty and Staff of the Saint
Louis University College of Medicine, Baguio City;
Workshop participants from the various government and private sectors;
And to all those who, in one way or another, contributed to the formulation of our
regional research agenda.
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Table of Contents
V. Annexes 23
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OVERVIEW OF THE HEALTH SITUATION / CURRENT HEALTH PROBLEMS
At the start of the workshop, Dr. Julius Alcala (Medial Specialist II) and Dr. Elvira
Belingon (Medical Specialist II) of the Department of Health – Cordillera Administrative
Region (DOH-CAR) presented an overview of the Regional Health Situation in terms of the
following:
The details of the presentation are depicted in the attached PowerPoint slides.
(Please see attachment: “health situation CAR”)
To set the stage for the workshop, Ms. Teresita O. Laguimun, Officer-in-Charge of
the Human Resources and Institution Development Division of the PCHRD, spoke on “The
Philippine National Health System: Creating Synergies.” In her talk, she focused on the task
at hand which was to set regional research priorities with the goal of developing and
strengthening regional research and development capacities.
The details of Ms. Laguimun’s presentation are also attached. (Please see
attachment: “overview of agenda setting”)
Outline of Presentation
• Vital Health Indices
- Based on the FHSIS
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Population Distribution
6
LEADING CAUSES OF MORTALITY, 2002 TO 2004
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LEADING CAUSES OF MORBIDITY
Number and Rate per 100,000 Population
CAR, 2004
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LEADING CAUSES OF INFANT MORTALITY
Number and Rate per 1,000 Livebirths
CAR, 5-Year Average (1999-2003) and 2004
Source: FHSIS
Unknown 3 .09
Dystocia 2 .06
Source: FHSIS
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MATERNAL MORTALITY BY PROVINCE/ CITY/,
CAR, 2004
Flora 1 Tabuk 4
Tanudan 1
Kabugao 1
MT. 1 0.33
Luna 1
PROVINCE
BENGUET 7 1.01
Natonin 1
Bakun 1 BAGUIO 2 0.21
Kibungan 1 CITY
La Trinidad 3 Baguio City 1
Tublay 2 Transient 1
No. of Fully
Elig. Pop. Percent
Province/City Immunized
TP x 3% FIC
Children
Abra 6,608 5,333 81
Apayao 3,236 2,423 75
Benguet 10,253 8,024 78
Ifugao 5,032 4,240 84
Kalinga 5,742 4,312 66
Mt. Province 4,539 3,067 65
Baguio City 8,608 7,530 45
CAR 44,018 34,929 79
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Three Most Nutritionally Depressed Municipalities in CAR
(Based on combined Severe and Moderate Underweight
Children 0-5 years old)
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CAR has the lowest infant mortality among regions
42.7
38.4
36.0
30.0
23.0
14.0
R
R
il
A
B
AR ga
R1
R2
R3
R5
R6
R7
R8
R9
0
1
Ca 12
M
Ph
NC
CA
R1
R1
R4
R4
M
R
ra
Philippines CAR
1993* NDS 1998* NDHS 2003 NDHS
Philippines CAR
12
Children in CAR were treated more with recommended home
fluids (RHF). Oral Rehydration Salts (ORS) packets were given to
children in the national level.
Among children who had diarrhea in 2 weeks prior to survey, percentage who
received oral rehydration therapy (ORT), Philippines vs. CAR: 2003
Percent 42.2
25.3 26.4
23.5
2.3 1.8
Philippines CAR
2003 P hilippine Na tiona l De mog ra phic a nd Hea lth S urvey (NS O, OR C Ma cro)
70.6
Philippines CAR
13
A decrease is seen for women in CAR who consulted a
health professional for antenatal care from 1993 to1998
but increased in 2003.
Percent of women with Antenatal Care
(ANC) from a Health Professional,
Philippines vs. CAR: 1993-2003
Percent 87.7
87.6
85.7 86.0
84.6
83.1
Philippines CAR
1998, 2003 P hilippine Na tiona l De mogra phic a nd Hea lth S urvey (NS O, OR C Ma cro)
49.8
R1
R2
R3
R5
R6
R7
R8
R9
0
1
Ca 2
R
R
M
AR ga
il
A
B
Ph
R1
R1
R1
NC
CA
R4
R4
M
ra
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CAR is among the regions with
women who gave birth in a health
facility higher than the national level.
Birth delivered in Health Facility* by Region: 2003
Percent
69.6 *Health Facility (Gov’t
hospital, Gov’t health
center and Private Sector)
49.4
44.8 45.8
39.8 41.0
37.9
33.4
29.1
25.7 28.9 26.1
21.9 23.1
20.7
M
AR a
R
4A
4B
AR
il
10
11
C 12
1
2
3
5
6
7
8
9
ag
Ph
M
R
R
R
R
R
R
R
R
C
R
R
R
R
R
C
N
15.7
ar
15.6
10.7
2003 Philippine National Demographic and Health Surv ey (NS O, ORC Macro)
Philippines CAR
1993, 1998, 2003 Philippine National Demog raphic and Health Survey (NSO, ORC Macro)
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Sources of Funds for Health 2003
National
15%
Out-of-
pocket
44%
Social Health
Insurance
10%
PhilHealth Coverage
• 179,749 individuals are currently enrolled with PHIC (translates to 65% coverage if each
individual has an average of 4 dependents)
• Increased enrollees in the individual paying sector and LGU sponsorship of indigents
Table 1: Matrix for Arriving at Regional Priorities for Health Research and
Development
Column 1: The participants were asked to list down the five issues of concern
which they perceived to be most important in the region. As a guide, a
checklist of Health Concerns and Issues to be Considered, also
recommended by the PCHRD, was distributed.
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Column 2: The participants were given the criteria for ranking of the areas i.e.
extent, prevalence, urgency, and burden to the community.
Column 3: The participants were asked to state the reasons for persistence of the
issue or problem e.g. lack of funds, poor utilization, poor knowledge,
etc.
Column 4: The participants were asked to indicate the type of research that can be
conducted to address the issue i.e. biomedical, product development,
operations, communications, etc.
Columns 5 through 8: The participants were asked to evaluate the identified
research areas in terms of the following parameters:
- Feasibility of research based on existing resources in the region
- Impact of research and development on the issue addressed
i.e.impact on the greater number or population, on the cost of
health care
- Lack of funds for the research area
- Priority status (high, medium, or low)
For Table 2, the participants were asked to cite specific research topics on the
issues that were identified in Table 1.
Copies of the matrices and instructions for accomplishing them were sent to the
participants beforehand, together with the letters of invitation. This was done to facilitate the
conduct of the workshop and to ensure a relevant and fruitful discussion.
The outputs of the groups were presented in a forum during the afternoon session.
The matrices of the groups are shown in the tables that follow. (Please see attachments.)
Thus, using this ranking system, the following are the Regional Health Research
Priority Areas for CAR:
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Examples of specific research topics identified by the groups are cited below:
- To determine the factors that affect the functionality of the Inter-Local Health
Zone
- To determine the impact of devolution on the effectiveness and efficiency of
the health care delivery system
- To determine the impact of health programs on intended beneficiaries as a
basis for future health policy implementation
Some of the priority areas for research identified by the participants were stated in
very broad terms i.e. “lifestyle related diseases,” “infectious diseases.” Thus, the PCHRD,
through Ms. Laguimun, recommended that the Regional Facilitator conduct an additional
small focus group discussion (FGD) to further refine the outputs of the workshop and to
make the health research prioritization more specific.
The FGD was scheduled on Wednesday, November 16, 2005 at 2:00 p.m. at the
SLU College of Medicine. However, the supposed participants were unavailable due to field
work and previous out-of-town commitments. Thus, the FGD was postponed and reset to
another date.
We conducted the focused group discussion last January 13, 2005 at the SLU
College of Medicine, to refine the outputs of the regional consultation workshop and to make
the health research prioritization more specific.
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We also invited the following to the focused group discussion but they could not
attend due to previous and simultaneous commitments:
1. Dr. Antonio Bautista Infectious Disease Control Cluster
DOH-CAR
The group discussed the regional health research priority areas in terms of specific
research projects that could be undertaken. The research projects were conceptualized
and prioritized based on the following criteria:
After discussion and deliberation, the group agreed upon five priority research areas
and six specific priority research topics. These are presented in the succeeding table
following the standard matrix.
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MATRIX FOR PRIORITY RESEARCH TOPICS
OUTPUT OF FOCUS GROUP DISCUSSION HELD AT THE SLU COLLEGE OF
MEDICINE ON JANUARY 13, 2006
Colum Column 2 Column 3 Column 4 Column 5
n1
Issue Specific Rationale for the General Objective of Agency
of Research Topic Research the Research Study Responsi
Concer ble for
n Implement
ation
Ranked Devolution: Despite devolution of To determine the To be
No. 1: Attitudes of funds for health care, it attitudes towards determined
Local Implementors has been observed devolution of by PCHRD
Health and End-Users of that basic health care implementors and
System the Local Health services remain end-users of the local
Care System in unavailable to many health care system in
Selected people in the selected
Municipalities of Cordilleras. municipalities of the
the Baguio- Baguio-Benguet area.
Benguet Area
Ranked Prevalence and Hypertension and its To determine the To be
No. 2: Risk Factors for associated diseases prevalence and risk determined
Lifestyl Hypertension have overtaken factors for by PCHRD
e Among Residents infectious diseases as hypertension among
Related of Selected leading causes of residents of selected
Disease Municipalities in morbidity and mortality municipalities in the
s the Cordillera in the Cordillera region. Cordillera
Ranked Knowledge, There are beliefs and To determine the To be
No. 3: Attitudes, and practices concerning knowledge, attitudes, determined
Women Practices of reproductive health and practices of by PCHRD
, Cordillera which are unique to the Cordillera women
Childre Women culture of the regarding
n, and Regarding Cordilleras. reproductive health
Adolesc Reproductive
ents in Health
Difficult
Circum
stances
Ranked Levels of Air Baguio City is said to To determine the To be
No. 4: Pollution in have the highest level levels of air pollution determined
Environ Various Areas of of air pollution in the in various areas of by PCHRD
mental Baguio City from country, but there has Baguio City during
Health January to been no study that different times of the
December 200_ measures air pollution year
in different areas of the
city in all months of the
year.
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Ranked Antibiotic Tuberculosis remains To determine the To be
No. 5: Sensitivity an important cause of antibiotic sensitivity determined
Infectio Patterns of morbidity and mortality patterns of isolates of by PCHRD
us Mycobacterium and is curable, but Mycobacterium
Disease tuberculosis there has been no tuberculosis in
s (1) Isolates in Baguio study of the antibiotic Baguio City
City sensitivity patterns of
Mycobacterium
tuberculosis isolates in
the Cordillera region.
Infectio Knowledge, There are beliefs and To determine the To be
us Attitudes, and practices concerning knowledge, attitudes, determined
Disease Practices Tuberculosis as a and practices of by PCHRD
s (2) Regarding disease which are residents of selected
Tuberculosis unique to the culture of municipalities in the
Among Residents the Cordilleras. Cordillera regarding
of Selected Tuberculosis
Municipalities in
the Cordillera
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ANNEXES
ANNEX A
PROGRAM
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1:00 – 2:00 p.m. Continuation of Workshop
Master of Ceremonies:
Dr. John Anthony A. Domantay
SLU College of Medicine
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ANNEX B
LIST OF PARTICIPANTS
Regional Consultation Workshop
On the Unified Health Research Agenda
October 27, 2005
Golden Pine Hotel, Baguio City
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11. Baguio Health Department Dr. Florence G. Reyes
City Health officer
16. Cordillera Women’s Education and Resource Center Ms. Lucille Lumas-i
Officials from the Philippine Council for Health Research and Development (PCHRD)
Workshop Facilitators
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Secretariat
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