Eastern Visayas Area Cooperation for Health

(Enhancing Maternal & Family Health Services to Selected Underserved Sectors in Eastern Visayas through the Co-operative Enterprise System)
With support from:

Overview
1. Challenge and opportunity 2. Our response 3. What we intend to accomplish in 3 years 4. How we do it 5. The partners

The Challenge ... and Opportunity

11 Filipino mothers die every day in the Philippines EV one of the top 5 worst places to be a mother EV Maternal Mortality Rate (Deaths per 100, 000 live births) 229.8 (2004)* EV Total Fertility Rate(number of children within reproductive years) 4.3 (2008) top 4 regions * compared with 110 in Thailand, 62 in Malaysia and 14 in Singapore; only 62% of births are supervised by skilled personnel
Challenge and opportunity

http://web.evis.net.ph/neda8/index2.php?option=com_content&do_pdf=1&id=131; accessed: 19January2011

2nd highest region in terms of teen pregnancy HIV infections rising (Cebu outbreak: 1 in 2 IDUs is infected!) Worsening poverty in EV: 35.3% in 2003 to 40.7% in 2006 Under-five mortality is second highest (64 deaths) ARMM (94 deaths) Prevalence of Underweight Children (0-6 years old) 18.1 % (2009)
(NDHS, 2008)

Challenge and opportunity

http://web.evis.net.ph/neda8/index2.php?option=com_content&do_pdf=1&id=131; accessed: 19January2011

Basic Literacy Rate 90.1% (2003) Functional Literacy Rate 76.7% (2003) 79.7% (1994) Elementary Net Enrolment Ratio 76.2% (SY 2008-2009) Secondary Net Enrolment Ratio 44.7% (SY 2008-2009) Elementary Cohort Survival Rate 61.6% (SY 2008-2009) Secondary Cohort Survival Rate 63.6% (SY 2008-2009)
Challenge and opportunity

Reasons for high maternal mortality:

1. biological causes and risk factors 2. poor access to health facilities and quality maternal services 3. inadequate political support as manifested by lack of budget and unsupportive policy environment 4. societal and cultural factors

Challenge and opportunity

The Health Care System

Dilapidated shacks for the poor and gleaming palaces for the rich . i.e., public health system inadequate to meet growing needs; private health system highly commercialized PNoy government emphasis on universal access to health care Health financing schemes on offer, e.g., DBP loan for PPPs on health Back to primary health care approach: can we put health back into the hands of communities?
Challenge and opportunity

Self-reliant, healthy and prosperous family (and communities)

Our Response: rd Leg The 3

Government Sectorbased Healthcare Coop Sectorbased Healthcare

Business Sectorbased Healthcare Our response

COOPERATIVE-BASED HEALTH SYSTEM STRENGTHENING FOR MFH

Coop-operated MFH facilities/programs
Access to efficient and effective maternal and family health including family planning and HIV prevention services
OBJECTIVE

Women, young girls and men

Business-operated MFH facilities/programs

Government-operated MFH facilities/programs

CLIENTELE GROUPS SERVICE POINTS

PRINCIPLES: community ownership; gender equity; continuum of quality care APPROACHES: primary health care approach; CO/CD approach; social enterprise approach
STRATEGIES: behavior change communication; coop-based service delivery; linkaging & networking

Our response

DOMAINS & INTERVENTIONS

SYSTEMS LEVEL Coordination and consolidation for synergy (see: Results 5 & 6)

OBJECTIVE
ORGANIZATIONAL LEVEL Enterprise development for service delivery (see: Result 4)
Enhance access to efficient and effective maternal and family health including family planning and HIV prevention services

INPUTS funds, technology and human resources

GOAL
Reduce maternal mortality and morbidity

INDIVIDUAL LEVEL Learning processes for behavior change and competency development (see Results 1, 2 & 3)

Our response

CONCEPTUAL FRAMEWORK

1 Objective
To enhance access to efficient, effective, quality and affordable maternal and family health including family planning and HIV prevention services to underserved groups in selected communities in Eastern Visayas.

What we intend to accomplish

3 Performance Indicators
1. Improved level of KASP of target population 2. Increased percentage of co-op women, girls and men accessing health services 3. Increased percentage of coverage (by area, by type of client groups) and reach of health service/s provided by co-operatives

What we intend to accomplish

5 Planned Results within 3 Years

 Result 1: Effective behavior change communication (BCC) modules  Result 2: Fully-informed and motivated clients availing of services  Result 3: Capable health workforce  Result 4: Viable coop-based health-focused initiatives/enterprises (11)  Result 5: Effective project management and support mechanism
What we intend to accomplish

After 3 years: 11 viable health enterprises

at least 15,000 clients served by at least 70 well-trained health promoters a co-op based social health enterprise technology package in at least 10 model towns/areas with a regional support mechanism (EVAcoh + TAF)
What we intend to accomplish

What s in it 4my co-op?

1. Additional service/benefit to members => better use of loan => more productivity 2. Convert a cost-center to another profit-center => more profitability 3. Compliance to social audit => more community relevance and impact
What we intend to accomplish

EVAcoh PROJECT FUNDING AND FUND USE SCHEME

Using the EU grant + counterpart: 1. Technical assistance (e.g., trainings, etc) 2. Equipment/tools/ commodities/etc. (case-to-case, depending on approved business type/plan)

TOTAL PROJECT BUDGET = EUR 645,400

EUROPEAN COMMISSION GRANT = EUR 580,860 COUNTERPART = EUR 64,540 (Health Enterprise Fund, HEF c/o 10 primary co-ops as subgrantees) = EUR 35,000
(@35% of subgrant amount)

PHANSuP-VICTO

3. Subgrant (equivalent to EUR 10,000 max inclusive of counterpart @ 1:3 leverage ratio)

COOP-BASED SOCIAL HEALTH ENTERPRISE (SHE)

PRIMARY CO-OP
Using the subgrant: 1. Staffing 2. Equipment/tools/ commodities/etc. 3. Space lease (if outside of co-op property

NET INCOME >10% TAF

+ PHANSuP-VICTO cash counterpart = EUR 29,540 )

How we do it

NOTES: Amount of subgrant will be based on approved business plan. TAF = Technical Assistance Fund

PROJECT MANAGEMENT STRUCTURE

PROJECT STEERING COMMITTEE

PHANSuP = 3 (1 Chair, 2 members) VICTO = 3 (1 Vice-chair, 2 members) DOH Region 8 = 1 (member)

PROJECT DIRECTOR (3 years)

PROJECT MANAGER (3 years) ASST MGR FINANCE & ADMIN (3 years) ACCOUNTING ASSISTANT (3 years) OFFICE ASSISTANT (3 years) DRIVER/MESSENGER (3 years) HEALTH ENTERPRISE PROMOTION TEAM LEADER (1 year) TRNG & CAP BLDG SPECIALIST (2 years) KM & COMMS OFFICER (3 years) LIAISON & ADVOCACY OFFICER (3 years)

PROJECT COORDINATOR (3 years)

PROJECT COORDINATOR (2 years)

PROJECT COORDINATOR (1 year)

How we do it

Key Activities: Year 1

PMO set-up Baseline research BCC materials development Trainings and workshops SHE establishment Mentoring Annual review and planning

How we do it

Learning Domains
Learning Domain 1 Maternal and Family Health Indicative Learning Areas Prevention of infectious diseases (TB, hepa, etc) Family planning / responsible parenthood Prevention of HIV/AIDS Gender and prevention of violence against women and children Maternal and neonatal health and nutrition 2 Social Health Enterprise Business planning and establishment Business operations (marketing, finance, service delivery) Business impact and sustainability

How we do it

Community-based Partners
1

Silago Multi-Purpose Cooperative (SMPC)

Silago, Southern Leyte

Sts. Peter & Paul Multi-Purpose Cooperative (SPPMPC)

Hinunangan, Southern Leyte

San Isidro Parish Multi-Purpose Cooperative (SIPMPC)

St. Bernard, Southern Leyte

Bontoc Multi-Purpose Cooperative (BCCI)

Bontoc, Southern Leyte

Abuyog St. Francis Xavier Credit Coop (AFCCO)

Abuyog, Leyte

Palapag Teachers and Employees Cooperative

Palapag, Northern Samar

Help First Basey MPC (HFBMPC)

Basey, Samar

Northern Samar Development Workers Credit Cooperative (NSDWCC)

Catarman, Northern Samar

Biatungangan Multi-Purpose Cooperative

Tinambacan, Calbayog City

10 Libagon Area Multi-Purpose Cooperative Libagon, So. Leyte

The partners

Allen Palapag Calbayog

Basey Abuyog Silago Bontoc Hinunangan St Bernard The partners Libagon

The Joint Venture Partners: 18 + 41

Philippine NGO Support Program, Inc. (PHANSuP)

started in 1993 as one of the two country-level pilot projects in Asia and Africa of a group of donor agencies and international organizations to test a model to accelerate support to grassroots organizations in response to HIV in 1994, it was incorporated into a non-stock, non-profit institution and kept its name, PHANSuP, becoming 1 of the 2 pioneer linking organizations of the International HIV/AIDS Alliance in 2008, it widened its development pathway to cover the entire sphere of community development with health and enterprise development, anchored on human rights, as the entry points.
The partners

VICTO National Co-operative Federation and Development Center (VICTO National) established in 1970 in Hinundayan, Southern Leyte in 1991, VICTO was the first country awardee on Development Management given by the Asian Institute of Management (AIM) in 2003, it was recognized by the Benigno S. Aquino Foundation (BSAF) as one of the 20 organizations in the country that continues to work with the legacy of Ninoy in disadvantaged communities one of the largest secondary co-operative organizations in the Philippines with 215 active affiliate co-operatives that continue to be a mechanism for collective action to social transformation. it has spun off its financing arm called the Visayas Co-op Central Fund Federation (VICTO-VCF), which has 210 member co-ops and total assets of over P210 million.

10+2 = ?
The partners