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III. HEALTH SITUATION OF THE LGU

The Municipality of Ilog has a total population of 60,610 for the year 2023. It has 15 barangays
with 1 Main RHU, 15 Barangay Health Stations and 2 Satellite Barangay Health Stations. Manpower
compliments include 2 permanent nurses, 4 contractual (COVID) nurse, 16 permanent midwives, 1
contractual midwife, 1 dentist, 1 MedTech, 1 sanitary inspector, and those deployed by the national
government such as: 1 DTTB, 8 NDP’s, 1 RHMPP-RS, and 1 MTDP. The municipality has no
Municipal Health Officer as of the moment so the DTTB stands as the Officer-in-Charge. Satellite BHS
are being put up by the Local Government Unit as identified by the Health Office to respond the
accessibility problem of the population. All these health facilities have corresponding midwives
assigned and NDPs alike.

There are two (2) existing private Lying-In clinics in barangay Dancalan which serves as birthing
facility. They are Philhealth accredited providing Maternity Care Package and Newborn Screening
package. Since they are private clinics, if the patient has no capacity to pay for their bills or those
without Philhealth, they refer them to the RHU.

It has been noted that for the past 3 years there is an increase of percentage in accomplishments
in major health programs especially on Maternal Care, Newborn care, Child care, Family Planning and
Nutrition. It was observed that the number of live births decreased as reported in the LCR, FHSIS and
TCL of every barangay and the high population which are based on projection. But for this year, the
population projection lowered, thus lowering also the target population.

Some pregnant women usually go to the health center for prenatal check-up on their 2 nd or 3rd
trimester of pregnancy. There are instances wherein young and single women deny their pregnancy due
to fear of judgement. Throughout the pandemic, it has been noted that teenage pregnancy is increasing.
Although all barangays have BHS and midwives, there are still mothers who are still hesitant to have
prenatal check-ups. Some working mothers that are not available on weekdays seek the attendance of
private practitioners on weekends. The migration and immigration of families to seek a living also
contribute to the low accomplishment in every program. We gather all the reports of the private clinics
but still noticed that there is only a very little increase in our prenatal accomplishment.

As shown in the table below, there has been a remarkable increase in the number of pregnant
women who has completed their 4 ante-natal check-ups. This is due to the strengthened advocacy and
tracking of the BHWs and Midwives.
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4 ANC
120%

98%
100%

80% 74%

61.11%
60%

40%

20%

0%
4 ANC
2019 2020 2021

The LGU has been working hard to provide quality care to both mother and child but
unforeseeable events can occur at any time. However, after 5 years of zero maternal deaths, 1 case has
been reported this year. Poor seeking behavior and lack of awareness of mothers regarding prenatal
services while others still prefer home delivery and hilot as birth attendants were some of the
contributing factors that led to maternal mortality. Teenage pregnancies are still increasing despite all
efforts in educating them. On the positive side, there is an increase in maternal accomplishment
particularly in family planning acceptors. There are several activities conducted by the LGU focused on
pregnant women such as buntis congress held every 6 months, family planning day celebration which
helped them become more knowledgeable about the benefits of having complete check-ups and the
services that they can avail themselves of in the health center.

With regards to the National Immunization Program, due to religious beliefs of some families
specifically the “Napulo ka sugo sg dios” and Dios Amahan cult, there are still children that are not
immunized. Even though we provide thorough health education and consistent home visitations these
families still stand on their belief. Our Fully Immunized Children on the year 2019 is 779(66%), 2020 is
756 (63.55%) and 993 on the year 2021, which indicates a significant increase than in the previous years
as shown in the chart below.
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FULLY IMMUNIZED CHILDREN

Our national childhood immunization program accomplishment has increased last year by 15%.
This was made possible through the efforts of the BHWs and midwives in reaching every child below 2
years old to be immunized. Unfortunately, it has lowered down this year. This may have resulted from
the decreasing birth rate due to an increase in FP users and vaccine hesitancy of some parents. Despite
the home visitations and health promotion done by health care workers, some families are still adamant
when it comes to having their children vaccinated.

The COVID- 19 pandemic had brought so many changes in the lives of Ilognons. Not being able
to travel freely, hold gatherings, and difficulty availing medical help without encoding in the One
Hospital Command System. The municipal health workers stand true to their commitment to protecting
their people against the disease. The Municipal Health Officer adopts the guidelines and protocols set by
the national IATF in terms of testing, isolation and tracing. Updates regarding COVID 19 response is
done through social media and through meetings with the local health board. Currently, we have a total
of 706 confirmed cases, 1 active case and 26 deaths due to the virus. Large portion of those affected are
elderly, with co-morbidities and are unvaccinated.

In terms of vaccination coverage, we had a total of 83.96 % fully immunized citizens. 3,858 of
them are senior citizens. Despite the efforts and strategies implemented by the local government,
including per purok visitations, house to house vaccination campaign, having fixed site for vaccination
so that it will be readily accessible to the community, there are still 16.04 % unvaccinated individuals.
Some of the reasons for refusal include: religious belief, misinformation and personal choice.

It has been noted that Family Planning Contraceptive Prevalence Rate (CPR) has increased this
year to 28.99% compared to previous years. At the barangay level, every barangay midwife and BHW’s
persuades women of reproductive age to avail the different Modern Family Planning methods like pills,
IUD, DMPA and the use of sub-dermal Implants. Another contributing factor would be the collective
efforts of South Negros Interlocal Health Zone’s (SNILHZ) good practice of initiating a program called
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Familia Extravaganza wherein all the RHU staff from 6 LGU’s are gathered together to conduct FP
activities per LGU as scheduled and the latest which we conducted outreach services in every barangay.

Operation Timbang (OPT) Plus is the annual weighing and height measurement of all
preschoolers 0-59 months old and below 5 years old in the community to identify and locate the
malnourished children. Data generated though OPT Plus are used for Local Nutrition Action Plan
particularly in quantifying the number of malnourished and identifying who will be given priority
interventions in the community.

Our OPT Plus coverage in the year 2019 was 87%, in the year 2020 it dropped to 81.20% due to
constant lockdowns following COVID-19 cases. But in the year 2021, our accomplishment has reached
87.30% because of the hard work of the RHM, BNS and BHWs to catch all the eligible children for
OPT Plus.

OPT PLUS
88%
87%
87%
87%
86%
85%
84%
83%
82%
81.20%
81%
80%
79%
78%
OPT PLUS
2019 2020 2021

Nutritional status has been defined as an individual’s health condition as it is influenced by the intake
and utilization of nutrients. Poor nutritional status is not confined to undernutrition. It may also result
from excessive intake or inadequate activity.

In 2019, the status of underweight children was approximately 6.20% whereas in the year 2020,
5% and in 2021, 4.20%. It was clearly showed that it dramatically declined with a difference of 2% from
2019 respectively.

However, the stunted children had significant increase in 2019 with 9.50%, 6.50% last 2020 and
5.70% in the year 2021. Like the underweight status, there is also a turndown of stunted children with
3.8% difference from 2019-2021. 3.80% of wasted children has been reported last 2019 and on 2020,
1.90%. it also reduced to 1.30% in the year 2021.
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While there are downswings of children who are underweight, stunted and wasted, the increase
of overweight plus obese children is also noticed. From 0.50% last 2019, it elevated to 1.50% in 2020
and 2.10% in 2021 with a difference of 2.10% from 2019-2021. This multiplication of overweight
children is believed to be brought about by the pandemic. Where all children spent most of their time at
home with passive lifestyle and inactivity.

NUTRITIONAL STATUS
10.00% 9.50%
9.00%
8.00%
7.00% 6.50%
6.20%
6.00% 5.70%
5.00%
5.00%
4.20%
4.00% 3.80%

3.00%
1.90% 2.10%
2.00% 1.50%
1.30%
1.00% 0.50%
0.00%
UNDERWEIGHT STUNTED WASTED OVERWEIGHT+OBESE

2019 2020 2021

Incidence of malnutrition (Severe Acute Malnutrition (SAM) and Moderately Acute Malnutrition
(MAM)) among 0-59 mos. old children declined compared to last year by almost 1%. There are a total
of 452 stunted and severely stunted children in the municipality. Among the 15 barangays, Barangay II
has the highest prevalence of stunting. Factors contributing to high prevalence of stunting include:
poverty, poor nutrition education, sub optimal prenatal conditions, and inadequate food security and
diversity.

The number of children 0-59 months who are overweight and obese has increased steadily,
consequently affecting 2.10% of the total population. This predisposes them to cardiovascular diseases.

The LGU together with the Barangay council and the Municipal Health Office through the
efforts of the midwives, BNS, and BHWs in the feeding program bring about a decrease in the number
of malnourished children by 1%. Another aid from the province is the Micronutrient Powder given to
children but most of them cannot tolerate the taste. Also, RUTF is given to Severe Acute Malnutrition
(SAM) only.

On the level of iron-deficiency anemia among pregnant women. Based on the FHSIS 2021 data,
there were a total of 622 pregnant women who were able to avail the CBC /hemoglobin-hematocrit
count exam during their prenatal checkup. 9.16% of those were identified to have iron-deficiency
anemia.

Hypertension and Diabetes had been noted as the most prevalent non-communicable diseases
among the older population. Unhealthy lifestyle and practices are the contributing factors in this present
situation. While respiratory diseases are the most common problems and concerns among the under five
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years old population. The precipitating factors to these problems are low-socioeconomic status, poor
environmental sanitation, overcrowding and a large number of children in the family. Another major
contributor would be poor nutritional food intake resulting a lowered resistance to infection. In addition,
Tobacco use is also one of the problems in our municipality that is hard to control. The LGU is making
an effort to release a Municipal Ordinance to resolve this issue.

NEWLY IDENTIFIED
700
700

600

500

400 328

300 211
154
200
69
100 32

0
HPN DM
2019 2020 2021

The implementation of the War on drugs program by the former President Duterte and the
Department of Health’s program on drug surrenderers, a few answered to the call of being assessed on
severity of drug use. During assessment, we could sense denials of drug use to justify that they have
already stopped using drugs. Drug testing were done after series of CBRP and we found out that there
are still 1% positive or still continue using drugs. Other problems identified are the huge amounts
incurred when they are referred to rehabilitation center. For the year 2019, there were only 9 graduates
on the community-based rehabilitation program. Since then, the municipal health office, in partner with
the Philippine National Police and the barangay councils, intensifies the rehabilitation program of the
municipality. A total of 8 barangays has been cleared of drug use on 2020, and 6 barangays has been
cleared on the year 2021.

Among the communicable diseases, tuberculosis remains in the top10 leading causes of mortality
in the municipality. There is still stigma attached to this disease wherein some infected individuals seek
medical help too late due to privacy concerns while others prefer private consultation. Since the
pandemic started, the people have associated symptoms of TB to Covid-19 thus preventing them to ask
for medical check-up fearing that they might have Covid-19, so some resort to self-medication and this
contributes to the lower-case detection rate. The disease continued to progress even though efforts were
made to control or lessen it.
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350

300 291

245
250
215
200

150

100

50

0
TB CASE

2019 2020 2021

Among the communicable diseases, Pulmonary Tuberculosis is still among the top10 leading
causes of mortality in the municipality. There is still a stigma attached to this disease. The disease
continued to progress even though efforts were made to control or lessen it. Free Chest X-ray conducted
annually by the PHO and free sputum exam offered by the LGU have been conducted for active case
findings of TB patients. Free medicines are available for all registered clients. Due to the devolution,
the supply of TB medications will be provided by both the provincial health office and the LGU.

Table below shows the leading causes of morbidity and mortality for the year 2021.

Table 1. TEN LEADING CAUSES OF MORBIDITY IN ALL AGES, 2021. Data adapted from
FHSIS Report January-December 2021.
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CAUSES No. of Cases

1. WOUNDS ALL TYPES 702

2. COVID-19 529

3. ARI 610

4. HEADACHE 263

5. HYPERACIDITY 238

6. ALLERGIES 251

7. ANIMAL BITES 173

8. ABDOMINAL PAIN 171

9. TUBERCULOSIS 130

10. HYPERTENSION 127

Table 1. TEN LEADING CAUSES OF MORTALITY IN ALL AGES, 2021. Data adapted from
FHSIS Report January-December 2021.

CAUSES No. of Cases

1. ACUTE MYOCARDIAL INFARCTION 59

2. HYPERTENSIVE CARDIOVASCULAR DISEASE 40

3. CEREBROVASCULAR DISEASE 36

4. DM, UNCONTROLLED 18

5. CANCER, ALL SITE 17

6. COPD 16

7. CARDIOVASCULAR ACCIDENT 12
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8. HPN, UNCONTROLLED 10

9. CONGESTIVE HEART FAILURE 9

10. CIRRHOSIS OF THE LIVER 9

In 2020, the world has been stunned with the outbreak of Covid-19 virus. The DOH together
with the LGU’s came up with different ways to prevent the spread of the disease however it continued to
affect millions of Filipinos. And this is due to the reluctance of some to get vaccinated and others do not
comply with the minimum health standards. The Municipality has recorded 584 cases last December
2021. Numerous closed contacts had been assessed. Compared to other LGU’s within the province, the
municipality of Ilog has recorded the least number of Covid-19 infections.

600
531
500

400

300

200

100
54

0
COVID -19 CASES

2020 2021

In 2019, the municipality has 1 reported case of HIV/AIDS that was treated under the DOH
HIV/AIDS program. Since 2021 to date, we are providing free HIV/AIDS testing and counselling to all
TB clients undergoing treatment and identified high risk adolescents, thus, last March we reported 1
HIV/AIDS positive, and is undergoing treatment until now.

Dengue and rabies cases are still increasing in spite of the extensive campaign of the Municipal
Health Office and Brgy. Council. Health education are being conducted in all areas, and prompt referrals
were emphasized, however there are still patients that stick on their superstitious beliefs and only seek
the help of a health practitioner during serious cases.

Blood program is essential in saving human lives. In 2019, the Municipality of Ilog reached its
1% (611) target for bloodletting program. But during the Pandemic (Year 2020-2021) we only reached
less than 1% of our target. Sometimes, encounters problems that hinders the continuity of the said
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activities such as lack of sufficient budget to sustain the activity until the year ends. Another problem
identified is the scarcity of blood donors during lean season wherein people in the upland community are
busy cultivating their lands for agricultural purposes. Lastly, the religious beliefs of some groups that it
is sinful to donate blood also hinders the success of the program.

According to DOH, the municipality of Ilog does not have any GIDA barangays based on the
GIDA profiling. But still, we do consider them GIDAs since the distance of the barangay is more than
an hour ride from the main health center. Some GIDA barangays are surrounded by rivers so midwives
assigned cannot go to their area whenever there are heavy rains. Also, the distance of households to the
health facility is another hindrance in availing regular and quality health care especially pregnant
women, so they gave birth at home instead of health facility.

Environmental sanitation is one of the major public health issues. Although our municipality is
surrounded by water, we lack safe water supply because most of our water sources are contaminated
with total coli form and Escherichia coli which is not safe for drinking and may cause different diseases.
There are number of levels I and level II water system but the municipality has no level III water system
that will provide water connection to every household. Most of the population gets their drinking water
in the refilling stations but those who can’t afford still get their drinking water on the deep well. Poor
environmental sanitation, improper disposal of human excreta and poor personal hygiene also help to
perpetuate and spread the diseases. In the past years, the LGU produces toilet bowls and distribute it to
households without toilet. For that reason, we achieved a 79.12% higher than the past years. But some of
these toilet bowls were not utilized. Some households have no space especially those situated in the
squatters and coastal areas. Households cannot afford to construct a toilet structure and lot owner will
not permit them to construct toilet in their land. Zero open defecation is hard to achieve due to these
reasons, but still Ilog manage to certify 1 ZOD barangay this September 2022.

Although Health Emergency Management/Operation center has no office in our RHU, we have
protocol to share DRRM OPCEN to answer/address the needs of our constituents in times of disaster.
LDRRM functions well and cater all emergencies in our area. They have vehicle, complete equipment
and supplies needed to respond disasters or calamities. The health facility lacks space or area to be used
as HEMS/ OpCen office, but in spite of the absence of Operation Center/office, the personnel are ready
to respond to any calamities or disasters that may occur.

The Barangay Health Stations have a non-functional health Information system. Distant
barangays and upland areas find difficulties in submitting their data because the health personnel have
no appropriate communication equipment. Despite the difficulties, health personnel find ways and
means to inform the health office of any unusual happenings in their area of responsibilities. Unstable
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Internet connection is also one of the problems encountered by our encoders. Sometimes they can
upload only 15 to 20 consultations per day.

The municipality has a functional Local Health Board, a body that oversees all the health needs,
problems and concerns of the office. However, due to overwhelming workload of the Local Chief
Executive, the responsibility is passed on to the administrative officer.

The ideal doctor to population ratio is 1:20,000 and 1 nurse for every 10,000 population. As of
August 1, 2022, we have no Municipal health officer since our previous municipal health office resigned
and transferred, we only have our Doctor to the Barrio as the MHO Officer-in-charge and 2 nurses to
handle all DOH programs. Nurses deployed by DOH are only in a 1-year contract basis and they are not
allowed to handle health programs due to their contractual status. Because of the Mandanas-Garcia
ruling, these DOH personnel will not be deployed in the municipality for the next year and the Local
Government can only managed to hire few additional nurses for the reason that the health budget of the
LGU has already reached the ceiling.

Our municipality has resolutions and ordinances related to health but some are not fully
implemented. Other ordinances like smoking and others are still to be adopted and passed by the Local
Government Unit so that there are mandates. Policies and guidelines in all programs are to be
formulated to serve as basis in doing our responsibilities as health care providers.

The Municipal Health Office has a Main Rural Health Unit accredited (MCP & NBS) by
Philhealth. Its midwife to population ratio is more than the required personnel to population ratio.
Considering that the municipality has thickly populated barangays, there is a need to put up satellite
BHS with corresponding midwives and these midwives need trainings in order to function effectively
and efficiently. Continuing education is also important for all health care providers to enhance their
knowledge, attitudes and skills towards work. The health office has PreVents fund to fund trainings that
are accredited by Philhealth. There is a plan to accredit to MCP the 2 upland BHS hence they are under
renovation now.

In summary, the Marcos administration is pushing the Universal Health Care which aims to
eliminate disparities in health outcomes especially among the poor and highly vulnerable population. No
balance billing policy for all patients who will be admitted in government hospitals to be implemented.
The overall strategic thrust is bringing together key stakeholders that will work towards improving
access to health services, at the same time greatly reducing out of pocket costs. Our goals stipulated in
this Local Investment Plan for Health will be achieved if all the people work hand and hand for the
betterment of the community. Thus, the battle cry “MALUSOG ANG LAHAT NG TAGA ILOG” will
be achieved.