Category: Citizen-centered Services

The project aimed to increase the knowledge of the youth of Ubay, Bohol about reproductive health and sexual issues, and to improve their self-esteem for them to harness the capability on deciding to abstain from premarital sex. The project sought to guide, equip, arm, and capacitate the youth for them to develop a stronger stance against becoming a victim of the negative consequences of an unwanted pregnancy.

Background and Problem

Teenage pregnancy is a reproductive health issue that needs to be addressed because failure to do so can severely affect the achievement of the sectoral and societal goal of the DOH.  Both the health and economic problem can affect the youth and her family because of unwanted pregnancy. The eventual maternal complication of teenage pregnancy, maternal death, and poor neonatal outcome can ensue. Teenage pregnancy also brings about social burden of incipient poverty. According to the World Bank, the Philippines is among the top ten countries where there are an increasing number of teenage mothers. In Ubay, Bohol, 20 percent of the population is comprised by 11 to 18 year old group. In Don Emilio Del Valle Memorial Hospital (DEDVMH), for example, there were 117 recorded cases of teenage pregnancy admitted which represents a 234 percent growth over a period of three years admitted in the same hospital. After conducting a problem tree analysis, it was found out that the lack or absence of information program about teenage pregnancy in Ubay was the possible cause of the rising trajectory in the admissions of teenage pregnancy in DEDVMH. Because of the absence of a preventive program, the teenagers in Ubay practice low abstinence to early sexual practices and have low motivation to actualize their academic and leadership potentials. The problem is high and is continually rising as noted in the past decade.

Solution and Impact

In order to address the problem, a two-armed approach is employed which are as follows:

  • Specifically designed and presented materials disseminated using the Internet and social media. The material’s content includes answers to frequently asked reproductive health questions by the youth. Economic and social impact and health facts about teenage pregnancy were also incorporated to emphasize its consequences; and
  • Self-esteem building activities such as trust building sessions and sports are offered and conducted in the schools and youth centers to build the inner fortress of positive values that the youth can draw from. Using new and refreshed values, they can decide against engaging in risky sexual behavior and say NO to early sexual practices or premarital sex that could lead to unwanted pregnancy.

Four hundred fifty four (454) students aged 10 to 19 from seven barangays and eight schools in Ubay, Bohol were given pretest to measure their knowledge on reproductive issues and value formation. The pre-test results demonstrated poor information about the negative economic and health consequences of teenage pregnancy among the responders. High exposure to sexual materials on the Internet and social media was also revealed. The youth showed low values formation. Their knowledge on the reproductive health issues was also weak. The post-test conducted after 3 months showed an increase in the awareness of the study subjects about reproductive health issues as well as negative consequences of teenage pregnancy.  Eventually, seventy-seven percent (77%) of them signed an abstinence to sex commitment form.

Milestones

The project has four (4) phases: initiation, planning, implementation, and closeout. During the initiation phase, a memorandum of agreement was prepared and signed after the initial focus group discussion with collaborating agencies and the selection of the technical working group members. The memorandum gave permission to conduct activities to the primary beneficiaries. After which, identification of stakeholders and partners was done. The team members and the resource person for youth self-esteem building were also identified. Finalization of information content for the website and webinar was done, as well as the communication plan, supplies and logistics, training needs for information technology and youth leaders, and capacity building of the team.

Meetings about the objectives of the project were conducted with the team, stakeholders, and youth groups and leaders, followed by an evaluation and monitoring of the project activities.

Note: This initiative is based on the Public Management Development Program (PMDP) Re-Entry Plan of Dr. Mutya Kismet T. Macuno of the PMDP Middle Manager Class Batch 4 (Bato-Balani).

The CSIS Utilization Conference is an avenue to formally present the CSIS results to the local government functionaries and other stakeholders. It aims to inform local government units (LGUs) and other participants, including representatives from civil societies, academe, and national government agencies, on the value of the collected feedback from a cross-section of the population regarding the different assessments on the availability, reach, and quality of local public services. All stakeholders were encouraged to participate in the discussion of the results in the context of their knowledge on local development issues.

Background and Problem

The DILG envisions LGUs that are self-reliant, development-centered, safe, peaceful, socially protective, business-friendly, environmentally protective, as well as transparent, accountable, and participative. In scaling up local government performance in these areas, it is not enough that LGUs have the internal capacity of providing services. The greater challenge is for LGUs to ensure that their service delivery performance is felt by their constituents, satisfying their needs, and meeting expectations in improving their quality of life. The DILG has been utilizing performance measurement tools for LGUs as early as the 1980s. As local governance is a vast domain in terms of conceptual breadth, interventions were focused on building the internal capacity of LGUs and on developing outcome indicators on a number of thematic performance areas. Despite having the Local Governance Performance Management System and thematic performance audits in place, like the Seal of Good Local Governance, there was a need for a performance measurement tool that will incorporate the citizens’ perspective in the equation as the ultimate fulfillment of the rationale of government providing public services.

Solution and Impact

To address the said issue, the CSIS was conceptualized and eventually implemented to serve as a tool for drawing in applicable information for gauging citizen satisfaction. Local Resource Institutes (LRIs), or local academic institutions that offer research and extension services, are commissioned to undertake the CSIS fieldwork and report generation protocols. They also assisted in presenting the technical details of the CSIS survey results during the utilization conference, as well as share their experiences in undertaking the protocols of the CSIS vis-à-vis the requirements of the project. Then, the representatives from the DILG central and/or regional/field offices presented an overview of the theories, concepts, procedures, and leadership perspectives on the CSIS. The CSIS Utilization Conference contributed in transforming the mindset of local government officials and functionaries towards viewing citizen feedback as information for identifying policy and program decisions. The conference also put the citizens at the center of planning and implementation, and in assessing results and impact of programs and services. The CSIS, through the Conference, scaled up the focus of performance management from internal measures to external and client-based assessment measures. It entailed delving on the impact of local public policies, expenditure, and program/service implementation. It is expected that responsive governance would increase citizen’s satisfaction that will be supported by the CSIS surveys for the succeeding years. It was also envisioned that the CSIS Utilization Conference model could also be replicated in other DILG-managed projects that generate data on LGU performance in different areas of governance.

Milestones

The CSIS has covered 140 cities from 2013 to 2015. These surveys were fully subsidized by the DILG, while subsequent implementation of surveys are targeted to be funded by the LGUs. DILG central, regional and field office staff who are involved in the CSIS implementation are trained with LRIs to have a better understanding on the concept, theories, data gathering and processing protocols, and reporting, monitoring and evaluation results relating to CSIS. The DILG field officers helped explain to concerned local chief executives and local officials the results of the CSIS survey, prior to the conduct of Utilization Conferences.  

Conduct of the CSIS Utilization Conferences in Region III and CARAGA.
Representatives from other Bureaus and Services, including the Commission on Audit, are also invited to participate in the conferences and other CSIS activities to share useful data/information and for appreciation on how the implementation cycle works, with the Utilization Conference as the culminating activity. The planning workshop on the formulation of the Citizen-Driven Priority Action Plan (CPAP) is an essential part of the Utilization Conference. Facilitated by DILG staff, this activity enabled the participants to translate policy directions into specific activities, and to determine the outputs, resources needed, and accountabilities. The output of the workshop is the CPAP, which is a set of initiatives programmed to address the service delivery gaps based on the citizen satisfaction survey results. The interventions are expected to be completed within the term of the local officials but may be expanded to long-term goals and targets for the LGU to undertake.  
Turnover of CSIS results to the local government of Pateros.
The workshop is followed by a ceremonial agreement signing through a Pledge of Commitment between the DILG, LGUs, and civil society organizations (CSOs). The LGUs committed to undertake the items in the plan. The DILG committed to provide technical assistance to the LGUs in implementing the identified interventions, and with the CSO partners, monitor the implementation and outcomes of those interventions, in terms of success in addressing the gaps. A monitoring and evaluation process proceeded after a year from the approval of the CPAP.  
The signing of the pledge of commitment during CSIS Utilization Conferences held at Regions VI, IX, and XII.

Listahanan, or the National Household Targeting System for Poverty Reduction (NHTS-PR), is an information management system that employs geographic targeting, household assessment, and validation in order to provide national government agencies, development partners, and other social protection actors with information on who and where the poor are in the Philippines. This information is then used for the identification and selection of potential beneficiaries for various poverty alleviation and social protection programs.

Background and Problem

The DSWD has relied in the past on program-specific targeting mechanisms, which employed varied and often inconsistent methods—an approach which was short on uniformity and objectivity, and often relied on self-declared data from potential beneficiaries. This lack of standardization meant inefficiency and high costs, as each new program would have to bring its own targeting approach to bear. Results were also unsatisfactory, with cases of leakage (the inclusion of non-poor beneficiaries) and deprivation (the exclusion of poor beneficiaries) in the delivery of services to the poor. This, coupled with limited resources, means that ensuring the equitable distribution of services to the poor through a standardized, accurate, and reliable targeting system is essential in addressing poverty.

Solution and Impact

NHTS-PR reduces both the leakage and deprivation of social protection programs and services by establishing an objective targeting system that compiles information to create a database of identified poor families and households. Utilizing a unified set of criteria for identifying the poor ensures that resources and efforts are concentrated on those who most need assistance, ensuring lower costs, better impact, and increased transparency and credibility of social protection programs. The identification of poor households follows a four-phase project cycle.

This begins with the Preparatory Phase where target areas for household assessment and the appropriate data collection strategies are identified. This is followed by the Data Collection and Analysis Phase. During this phase, DSWD-hired enumerators conduct household interviews to gather basic and socio-economic information through a standardized questionnaire called the Household Assessment Form (HAF), which is then processed through a proxy means test (PMT) that estimates family income and compares it to the provincial poverty threshold. For the last phases, the results of the PMT are then validated locally, finalized, compiled, and generated into National and Regional Profiles of the Poor. Data sharing partnerships with various social protection stakeholders are established through a memorandum of agreement to ensure data privacy and to guarantee that the data will only be used as guide for selecting beneficiaries and developing various poverty alleviation and social welfare and development programs.

Milestones

In 2009, the NHTS-PR conducted the first round of assessment which resulted to the identification of 5,255,118 poor out of 10,909,456 households assessed. In 2010, Executive Order No. 867 entitled, “Providing  for  the  Adoption  of  the National  Targeting  System  for  Poverty  Reduction  as  the  Mechanism  for  Identifying  Poor Households  Who  Shall  Be  Recipients  of  Social  Protection  Programs  Nationwide” was issued. This mandated government agencies to use the NHTS-PR data as basis for selecting beneficiaries of their social protection programs. The data generated from the first assessment were shared with 1,256 data users comprising of 55 National Government Agencies (NGAs), 1,095 Local Government Units (LGUs), 56 Non-Government Organizations (NGOs), 34 legislators, and 15 academic institutions and researchers. NHTS-PR became the basis for selecting beneficiaries of notable government programs such as the PhilHealth Indigent Program and Pantawid Pamilyang Pilipino Program (4Ps). The former subsidized the insurance premium of all 5.2 million poor households while the latter provided health and education grants to 4.2 million. These are only among social protection programs that provided targeted services to the poor in the fields as diverse as education, employment, health and nutrition, maternal and childcare, water and sanitation, shelter, electricity, and environmental protection. NHTS-PR is also supported by international partners such as the World Bank and the Australian Department of Trade and Industry.

In compliance with Section 2 of EO 867 which requires the DSWD to update the NHTS-PR every four years, the Department embarked on its second nationwide assessment. In preparation for the said assessment, new guidelines, protocols and systems were put in place to maintain transparency and objectivity, ensure faster and efficient implementation, and prevent political interference in its implementation. A new PMT model was also developed using variables lifted from the 2009 Family Income and Expenditure Survey (FIES), Labor Force Survey (LFS), and 2007 Census of Population and Housing (CPH). It features a 2nd stage screener that weeds out possible inclusion errors. These improvements in the PMT model lowered its model-based error rates, from having 22-25% and 31-35% inclusion and exclusion rates, respectively, in the 2009 model to having 10.6-13.8% and 6.8-19.3% inclusion and exclusion rates in the 2013 model. The said assessment resulted in the identification of 5.1 million poor out of 15.1 million households assessed.

With the result of second assessment, the Department was able to track changes in the status of previously identified poor households, particularly of 4Ps beneficiaries. Of the 4.2 million beneficiaries of the said program, 1.3 million households registered as non-poor. After two assessment cycles, the NHTS-PR data continues to be a vital information resource for the government, providing an objective basis for beneficiary selection and a rich data resource for planning, developing and monitoring program interventions.

Testimonial

Excerpt from the Country Director of the World Bank Philippines, Dr. Mara Warwick, during her Remarks at the 2015 Listahanan Launch

“Grounded in empirical studies, the World Bank recognizes Listahanan as a leading “good practice example” for a growing number of countries that aspire to introduce such registries. This brings me back to my original question: why is Listahanan so important? I would like to highlight four key reasons. First, by enabling the Government to target programs to the poor and vulnerable, Listahanan is increasing both the efficiency and effectiveness of public spending. It is also improving the governance of Social Protection in the Philippines by removing political patronage from distribution of public resources to citizens. Let me elaborate. Listahanan tells the Government who poor families are and where they live. It ensures that the intended beneficiaries of public funds for poverty reduction have names and faces. This enables objective selection of the beneficiaries of government programs through the use of transparent, objective and verifiable criteria, validated by the community, to estimate poverty in Filipino families. Using the so called “proxy means test method,” poverty lines determined by the Philippines Statistics Service and community validation, Listahanan 2015 has identified 5.1 million households who are poor.

Targeting anti-poverty programs to those 5.1 million households will be critical to realizing the aspiration to end poverty in the Philippines within a generation. Listahanan is the key platform for such targeting, just as Listahanan 2010 was used to identify beneficiaries of government programs. Second, Listahanan is important because its impact is far-reaching across the Philippines. Listahanan is currently used by 59 national agencies to target programs where they are needed most, including the Pantawid, and the PhilHealth subsidized health insurance. It enables transparent and fair selection of beneficiaries of government programs. How? Programs draw initial lists of poor and vulnerable families from Listahanan, and the families are then checked for program specific eligibility requirements. When the families meet the requirements, they receive the benefits. In addition to Pantawid and PhilHealth, Listahanan is also used by 1,095 Local Government Units, 56 Civil Society Organizations, 34 legislators, and 15 universities and research institutions.

Looking ahead, we hope that Listahanan 2015 will add value to all government agencies and LGUs towards maximizing the impact of public funding and ensuring that the poor and vulnerable benefit from their respective programs. Third, Listahanan is important because of what it means for all citizens. Listahanan is an anchor for an objective and transparent approach to selecting beneficiaries. Such transparency is important for citizens, affecting how people perceive their government. Citizens are able to see that public funding and government services are deployed fairly, rather than as gifts or as favors. This in turn signals an important shift and the beginnings of a deeper transformation in state-society relations: people start seeing government services as public goods rather than as personal rewards.

Fourth, as I mentioned before, Listahanan is important because its targeting performance is excellent by international standards based on the available empirical evidence. While there is no such thing as perfect targeting, the tool that you have developed does an excellent job in identifying the poor and vulnerable. Listahanan is supporting impressive results and must continue to evolve and adapt over time for even greater impact.”

Motivated by the national government’s efforts toward Universal Healthcare “Kalusugan Pangkalahatan”, PHC embarked on an ambitious program to provide greater access to specialized cardiovascular care by enabling existing regional medical centers to serve as regional heart centers. Regional medical centers are supported with manpower expertise, heart surgery equipment and supplies, vital endorsements to the Department of Health for infrastructure funding, and endorsement to PhilHealth Z-benefit for accreditation.

Background and Problem

Driven by their shared desire to improve the health status of the Filipino people, the PHC provides comprehensive cardiovascular care enhanced by education and research that is accessible to all. In the past years, cardiovascular treatments, especially surgery for heart disease, was concentrated in big hospitals in the Greater Manila Area due to lack of confidence of local medical practitioners for specialized procedures.  There is, however, a long waiting list for surgery usually lasting for 3-5 years.

Solution and Impact

PHC conceptualized a strategic initiative to decentralize cardiovascular care to the regions. To increase access to cardiovascular care in the country, bringing the “brand” of PHC (i.e. patient-focused and compassionate care) to the regions were necessary. Performing pilot procedures as proof of concept was not the real goal of PHC. Enabling these regional heart centers to perform procedures independently with the shortest possible incubation period is the structured and definitive program for PHC. The maturity scale designed by PHC for the certification of PhilHealth Health Care Institutions (HCI) both private and government will be used to evaluate the capabilities to serve as regional heart centers. The impact for stakeholders was numerous, especially for patients.  No balance bill for cardiac surgery among PhilHealth members assured government subsidy to the marginalized; and reduced costs by 50 percent at 100 to 200 thousand pesos for those who can afford. “Kalusugan Pangkalahatan” for all Filipinos was felt by the Filipinos for heart surgery. Training of physicians to practice in the regions was also encouraged. The leadership commitment for regional hospitals has gained ten (10) surgical missions in the last three years since 2013, with 148 patients operated and 60 personnel trained (for both nurses and doctors).

Milestones

The initial five regional heart centers were:

  1. Southern Philippines Medical Center (Davao, Southern Mindanao, Region XI)
  2. Northern Mindanao Medical Center (Cagayan de Oro, Region X)
  3. Vicente Sotto Memorial Medical Center (Cebu, Central Visayas, Region VII)
  4. Bicol Regional Training and Teaching Hospital (Legazpi, Region V)
  5. Mariano Marcos Memorial Hospital and Medical Center (Batac, Ilocos Norte, Northern Luzon, Region I).

A five year development plan through a Memorandum of Agreement was signed with the regional hospitals. Ten outreach open heart surgeries have been performed in all five regional heart centers and interventional catheter-based device closures in Bicol, Cebu, and Davao. For each mission, at least 20 personnel were sent.

The training of cardiovascular specialists for all these five centers have been prioritized so that candidates for highly competitive training slots in cardiovascular surgery, adult and pediatric cardiology, perfusion, and critical care nursing will be accepted in their requested programs provided that they commit to return to their regional centers. Full support for pilot procedures was extended to all regional centers with the dispatch of multiple heart teams capable of simultaneous cases including complete heart equipment and supplies for the recent Region I open heart surgery mission.

To ensure sustainability, these regional heart centers have been endorsed for certification for the PhilHealth Z-Benefit program which provides financial subsidy for cardiac surgery. PHC also strengthened linkages through institutional partnerships with private organizations that are supportive of PHC vision. A Multi-Sectoral Governance Coalition (MSGC- Heartlink) was established with institutional partners like Mending Kids International, Children’s Heart Foundation, and Philippine Airlines.

The PEDAL is the centerpiece strategy of DTI Region 02 in bringing its service right in the heart of its clientele. It is a strategy that creates a web of productive partnership among the members of the community where it operates. With the Department’s two-pronged mission of “Enabling Business and Empowering Consumers”, the PEDAL impacts strongly on leadership, strategic planning and deployment, and customer and citizen focus.

Background and Problem

The DTI is committed in the improvement of the quality of life of Filipinos and in the reduction of poverty through inclusive economic growth and employment generation, with a focus on expanding exports, increasing investments, supporting and strengthening micro, small, and medium enterprises (MSMEs), ensuring value for money of consumers, and pursuing good governance. However, DTI Region 02 identified the following operational deficiencies:

  • Visibility of DTI Region 02 was only observed in few municipalities (about only 20% at the time);
  • The visitation of different staff to Local Government Units (LGUs) within the locality to coordinate various aspects of DTI services resulted to confusion as the Local Chief Executive would be dealing with several DTI personnel which further resulted to non-congruity/non-synchronization of project implementation;
  • No staff was responsible/accountable for the municipalities’ concerns;
  • Complete package of programs, projects, and services were not delivered;
  • There was no equitable and rationalized distribution of programs, projects, and resources; and
  • No standardization of staff workloads and targets

Solution and Impact

To address the said deficiencies, the PEDAL was designed which underlies the general scenario that all DTI personnel operate in the municipalities with their respective constituents. In order to do this, DTI Region 02 modified its official organizational structure and came up with an operational one to accelerate and upgrade its services, with the designation of Municipal Trade and Industry Officers (MTIOs), who are assigned to a number of municipalities, to handle: five to six Senior Trade and Industry Development Specialist (STIDS);  three to four Trade and Industry Development Specialist (TIDS); and two to three Trade and Industry Development Analyst (TIDA), depending on the size of the provinces. In this case, it is imperative for a technical staff to know and learn the programs, activities, and projects of DTI. The said strategy was enforced throughout the whole organization. While initially, there was resistance from other staff, this is now well accepted and has proven to be effective and efficient in the delivery of services and in empowering the personnel of the organization, thus deepening their service commitment. The initiative also made the DTI more visible in the municipalities. The constituents of the municipalities have now an array of awareness levels with regards to DTI programs, activities, and projects. The number of MSMEs created had also increased; consumers are better informed of their rights and responsibilities; and compliance to the Fair Trade Laws are strictly being monitored.

Milestones

The PEDAL is both a managerial and an operational initiative that was envisioned to reach out and cover all the ninety-three (93) municipalities of Region 02, comprising the Provinces of Batanes, Cagayan, Isabela, Nueva Vizcaya, and Quirino. DTI Region 02, through the PEDAL, was able to:

  • Address the above-mentioned organizational deficiencies;
  • Paved the way for the “Ramdam-effect” of the projects (i.e. the projects were really felt by the citizens) of DTI which include the Industry Clustering, Shared Service Facilities, and Bottom-Up Budgeting; and
  • Became more innovative in the implementation of programs, activities, and projects such as:
    • Village enterprises;
    • The Progressive Operation of Women in Entrepreneurship Revolution (POWER) of 37;
    • Filipino Consumer on Patrol (FILCOP);
    • Improved Market Operations for Vigilant, Efficient and Responsive Services (I-MOVERS);
    • Modified SME Roving Academy; and
    • Trade Fair Facilitation.

The LGU of Carmona, through its Information Technology (IT) Unit, initiated the development and implementation of the Electronic Business Permit and Licensing System (eBPLS) which offers end-users with innovative features to make the business permit process more accurate and speedy. The system introduces a systematic approach to streamline the business permit and licensing process of the LGU.

Background and Problem

The LGU envisions to be a premier investment hub in the province of Cavite, with ecologically balanced community and fast growing economy steered by empowered citizenry and dynamic leadership. However, a number of complaints were received by the LGU in terms of business permit and licensing service because of its slow processing and release which tends to decrease clients’ satisfaction and eventually impact economic growth within the locality. Inefficiency in delivering the said service was also rampant in other cities which led to the simple automation established through the Business One-Stop-Shop (BOSS) mandated by the national government to LGUs.

Solution and Impact

From a simple automation process, the LGU makes use of its IT Unit to realize the impact of integrating information and communications technology to the daily operations of the LGU. The eBPLS has become a useful tool to support the LGU’s effective management of information in terms of speedy knowledge processing to achieve organizational objectives. It greatly contributed to the improved performance and competitiveness of the LGU’s business permit and licensing process. The unique features of the system, such as the assignment of unique code to business permit for tracking purposes and the generation of customized reports, make information management efficient and effective. Through eBPLS, time and effort in business registration and renewal was trimmed down. The improved process brought about positive change to the performance of service personnel which created a positive image to the LGU as a whole in terms of service delivery and transparency. More than 2,000 business establishments as of 2015 benefitted from the convenient processing of business permit registration and renewal.

Milestones

The eBPLS was used as a tool to improve the business permit and licensing process of BOSS. The system was introduced to end-users prior to installation for consultation and test of user-friendliness. BOSS front line personnel were provided with capacity-building trainings to become reliable and competent users of the system. Aside from the positive feedback and commendation earned from satisfied clients, the effective implementation of the eBPLS has garnered awards such as Most Business-Friendly Municipality in the Philippines – Hall of Fame Award (2009, 2010, and 2011), eGov4MD Award, 4th Most Competitive Municipality in the Philippines (2014), and Best in eGov Business Empowerment Award (3rd Place).

Carmona has also become a Lakbay-Aral destination of LGUs, academe, and various international groups for benchmarking. The LGU became a model LGU to local governments who wants to embrace the positive results of the practice.

In a quest to improve the quality of services and benefits provided by PhilHealth, the project was introduced as an innovation that aims to bring PhilHealth services and benefits closer and more directly accessible to every Filipino which can be realized by:

  • Bridging PhilHealth and the people – This means removing the gap that separates the people from PhilHealth and hinders them from availing the basic health services and packages of the National Health Insurance Program (NHIP) of the government;
  • Direct PhilHealth services to the people – This refers to cascading PhilHealth services within the proximity of every household in the barangay; and
  • Mobilizing the Barangay as extension of PhilHealth – As the smallest unit of government, the barangay plays a vibrant and important role in reaching the people to extend basic health services of the government.

Background and Problem

Through this project, the following problems that obstruct the people from availing the benefits of the NHIP of the government have been identified:

  • Distance and Geographical Barrier – PhilHealth offices are limitedly situated in cities and provincial capitals with at least 50 kilometers away from some or most barangays of Western Pangasinan which are situated in isolated islands and/or mountainous areas;
  • Time Element and Transportation Expenses – Due to distance and geographical location, people in Santiago Island, Bolinao, Pangasinan spend so much of their time and money in availing PhilHealth services and benefits. A marginalized fisherman, for instance, spends at least five hundred pesos (Php 500.00) to avail of the basic government services such as those from PhilHealth; and
  • Limited Number of PhilHealth personnel – Due to the limited number of staff and personnel, PhilHealth Western Pangasinan Local Health Insurance Office has not adequately brought the services and benefits of PhilHealth to the people especially to those from remote and isolated barangays. People in these areas are obstructed by these circumstances in utilizing the services of PhilHealth. And, in view of these problems, people in the barangays have lost interest in joining the NHIP of the government. This, in turn, resulted to the non-attainment of the Universal Health Coverage in the municipality of Bolinao, Pangasinan.

Solution and Impact

To address these problems, the proponent interacted with the people from the community to listen to their stories, discover their real needs, and assess the actual situation at the grassroots level. An actual analysis on these concerns was conducted to discover the root causes and find possible solutions to these problems. Through PhilHealth Sa Barangay, solutions that would probably address the problems were introduced. Goals were set, focus was placed on the objectives, and deliverables were committed to realize the purpose of the project. Barangay Health Workers and Barangay Officials were trained, empowered and mobilized as advocates and implementers of the project. They gained confidence from the capability building conducted for the proper administration and implementation of the project. Through the competence of these barangay health workers and officials, PhilHealth Sa Barangay is progressively gaining ground in bringing PhilHealth services and benefits nearer, faster, and more manageable to everyone. Moreover, through the PhilHealth Sa Barangay, people are able to get rid of the add-on expenses for transportation and are able to save their time because right in their neighborhood, PhilHealth services are readily available.

Milestones

To realize the purpose of the project, collaboration was established with groups of individuals, government agencies and other stakeholders who are dedicated and committed to help and willing to serve the people unconditionally. Partnership with the Local Government Unit in bringing PhilHealth services and benefits in the heart of every barangay was forged through a Memorandum of Agreement (MOA) which legalized the identity of PhilHealth Sa Barangay. The institution of the noble purpose of the project, that is, to bring the services of PhilHealth in the very heart of each of the seven barangays of Santiago Island, Bolinao, Pangasinan was then put in place.

A PhilHealth sa Barangay handbook was also developed which is a detailed and comprehensive compilation of systems, processes, and procedures for PhilHealth membership enrolment, payment of PhilHealth premium contribution, and PhilHealth benefits availment. Eventually, the project was also promoted and advertised in radio programs and through tarpaulins and notices.

Note: This initiative is based on the Public Management Development Program (PMDP) Re-Entry Plan of Mr. Abraham A. Ballares of the PMDP Middle Manager Class Batch 10 (Binhi).

The project analyzed BMC’s challenge on overstaying patients, and proposed and installed systems and operational innovations to help alleviate this problem and improve the discharge process of the Center. Eventually, this should lead to the provision of improved quality of patient care services.

Background and Problem

One major challenge in the Philippine health sector is broadening access to appropriate and adequate health facilities for the poor and the marginalized sectors of the society. But with the institutionalization of the Department of Health Facility Enhancement Program (DOH-FEP) , quality and affordable health care will be assured and be available to everyone. As a DOH-retained hospital, the BMC is mandated to provide high quality health care services to all patients requiring hospitalization. The current BMC administration has already installed programs to continuously upgrade its quality of health services. However, one problem has persistently encumbered the hospital with increasing economic costs, leading to the diminution of the quality of service to the people. This is the case of overstaying patients.

Solution and Impact

A system-level approach in designing and implementing innovations in specific stages of the discharge process was utilized to reduce the incidence of overstaying. A higher level of inter-organizational communication and coordination was integrated in the discharge process as well as the strategies adopted from other health institutions to address the overstaying problem. The project was implemented in three phases. Phase 1 is the assessment phase, where the status of the hospital was analyzed, and its key needs and concerns were identified. The second phase is the implementation and interventions designed to reduce the incidence of overstaying patients through an integrated discharge system. The third is composed of activities to monitor and evaluate the operations of the discharge process and identify specific areas for improvement. At the onset, the impact of the improved discharge process on overstaying days from June to August 2014 did not present a clear trend.

However, the average number of overstaying days showed a decreasing trend of about 10.5 percent between June to July, and July to August, or an overall reduction of 19.9 percent from June to August of 2014. This is validated by the August 2013 and August 2014 data, which also showed an 8 percent decrease of the average number of overstaying days. The cross-departmental coordination needs of the system require changes in long-standing procedures and practices, the probable reason for the lack of immediate and substantial effects. Nonetheless, the statistical results already showed evidence of fledgling successes even after only a few weeks of interventions. Figures on patient satisfaction of services and personnel showed an initial negative movement from the period of April to June, and June to July.

This, however, improved from July to August as a sign of a more effective discharge system slowly being felt. The assessment of factors for overstaying showed that about two-thirds of the cases are due to the lack of patients’ capacity to promptly settle their accounts. This socio- economic issue is being addressed by an information campaign on estimating hospital expenses and financial aid availment. The internal discharge processes are also noted to have minimal effects on overstaying. This reveals a likelihood that the streamlining is already reducing the procedural bottlenecks.

The early successes can be mainly attributed to the strong support extended by the BMC management, and the active coordination and engagement of stakeholders – both within the organizational structure of the hospital, and from external entities.

Milestones

The major deliverables of the project are: (1) the design and installation of an integrated discharge process from access to discharge of patients; (2) the adoption of a patient classification system as to the type of discharge planning; (3) the computerization of the discharge system; and (4) improving customer satisfaction levels. The system was installed in the Obstetrics-Gynecology Department. To monitor changes in the incidence of overstaying, the number of patients who stay beyond what is necessary and the number of days of overstaying was measured.

A longer time frame to track changes, more focused monitoring and assessments, a more comprehensive database, and programs for behavior and attitude modification for the staff may be required for the new system to manifest significant improvements in the satisfaction levels of patients and watchers. To ensure the effectiveness of the integrated discharge process, a continual quality improvement had been implemented to all clinical areas of the Bicol Medical Center. At the start of the conceptualization of the project in 2014, only 54.9 percent of patients were discharged within 24 hours considering the limited number of patients registered in the discharge process.

By 2015, 70.8 percent were discharged within 24 hours. On the succeeding year, 86.8 percent were discharged within 24 hours. At present from January to August, 2017, 91.5 percent were discharge within 24 hours. The result of the data monitoring from 2014 to present shows a progressive improvement on discharges of patients. The strict implementation of the integrated discharge process contributed to the enrichment of other systems in the hospital such as the IHOMIS (Integrated Hospital Operation Management Information System) where all the data of the patient were captured from admission to discharge.

The prompt processing of PhilHealth requirements helped the indigent patients (classified as NBB or no balance billing patients) to be enrolled to point of care PHIC services and the provision of the medical assistance program. The billing section promptly provides the patients’ bill in all clinical areas to ensure early discharges of patients. At present, BMC started an online prescription where all patient needs for medication where automated to ensure that they will be treated immediately, thereby facilitating speedy discharge. The institutionalization of the integrated discharge process has indeed made a great impact on the provision of quality care to the patients of Bicol Medical Center. It did not only improve patient satisfaction but also the enhancement of the different systems and processes of the organization, and made a vast amount of savings amounting to 12 million pesos from 2015 to present.

Note: This initiative is based on the Public Management Development Program (PMDP) Re-Entry Plan of Ms. Wilhelmina C. De Castro of the PMDP Middle Manager Class Batch 4 (Bato-Balani).

The MMDA Traffic Navigator (TNAV) is a multi-platform program that provides users with updated data on Metro Manila traffic conditions and almost real-time reports on incidents happening on the road. Available either on the web or in mobile app form, the program indicates whether traffic on selected major thoroughfares is light, moderate, or heavy, as presented in either a System, Line, or Map view of Metro Manila.

Background and Problem

Metro Manila has one of the worst traffic situations in any major city in the world, with over 2,000,000 registered vehicles and a vehicle density higher than that of Singapore or Tokyo. This is compounded by limitations in the availability, scope, reliability, and safety of public transportation in the city, with the three main rail lines (LRT-1, LRT-2, and MRT-3) consistently overworked and often breaking down, buses regularly cited as overloaded and breaking traffic laws, and high rates of commute-related crimes. The traffic situation has even led to the forecast that Metro Manila may become uninhabitable in the near future.

Solution and Impact

Though not providing a direct solution to traffic, the MMDA TNAV allows users to make informed decisions on how and when to traverse Metro Manila’s roads, especially at peak hours. The system relies primarily on the MMDA closed circuit televisions (CCTVs) to get the traffic situation in an area and, secondarily, by reports sent in by traffic enforcers in the field, especially in areas where there are no surveillance cameras. To date, four apps have been launched in line with MMDA TNAV. The first two applications, MMDA for Android and MMDA for iOS, enable users to view the traffic situation of major Metro Manila roads such as Epifanio de los Santos Avenue (EDSA), Commonwealth Avenue, Quezon Avenue, España Road, Circumferential Road No. 5 (C-5), Ortigas Avenue, Marcos Highway, Roxas Boulevard, and South Luzon Expressway (SLEX). The Navigator does not require Global Positioning System (GPS) for accurate data—users only need an Internet connection to access it.

Two other apps, MMDA Accident Alerts and MMDA Road User Assistance, provide more focused services to road users. The former provides updates on accidents in Metro Manila, allowing users to anticipate the congestion and detours that result from such accidents. MMDA Road User Assistance, on the other hand, allows those requiring MMDA assistance to request help to address their own possible road mishaps.

Beyond these mobile apps, MMDA now also has a dedicated website for the TNAV, in conjunction with the TV5 news platform Interaksyon. The traffic information is updated every 10-15 minutes and can be viewed in three ways: system view, line view and Google map. The website also provides direct updates to other media outlets, allowing radio and television stations to accurately report road conditions to their listeners and viewers. A dedicated Traffic Mirror website has also been launched, which allows users to access direct real-time video feeds of key junctions in Metro Manila.

Through the innovation, motorists and commuters are now empowered to avoid heavily congested roads and make informed decisions on where to pass to get to their final destination. It is also a useful tool for the public to plan their trips accordingly and to save fuel and time. Delays on the movement and turnover of goods for consumption and/or production purposes can also be avoided. More number of trips for public transport, delivery trucks, and shuttle services can also be catered.

Milestones

Within the same year of its launching, the TNAV already bagged two awards namely the Bronze Boomerang for Innovation and the IT product of the Year, from the Internet and Mobile Marketing Association of the Philippines and the Cyberpress, also known as the IT Journalists Association of the Philippines, respectively. The following year, the innovation was recognized as the 2012 Best Design under the Interactive category bestowed by the Adobo Magazine. To date, the number of downloads of the app has reached over 1.2 million for both Android and iOS platforms, accounting for more than 20,000 daily users. After the successful implementation of the TNAV, MMDA created a team who is on duty 24/7 at the agency’s Command and Communications Center (Metrobase). The team operates and maintains the digitized traffic information database.

Testimonials

“A must-have and noteworthy app that can help any public transport commuter or private vehicle driver slip through Metro Manila traffic.” – Tech in Asia   “MMDA Traffic Navigator FTW! A really good start and a good way to catch up with the times and employ some really usable online services.” – YugaTech   “It is the first Philippine government agency mobile application. It allows you to view Metro Manila’s traffic situation in an easy to use and convenient app.” – TopGear

The PHC Performance Governance System’s (PGS) main goal is to bring the hospital strategy down to the employees in all services, encouraging each one to contribute to the realization of the goals as set in PHC’s 26 balanced scorecard measures. With PGS, compliance to lead measures are monitored daily and the effect on breakthrough results are monitored weekly.   

Background and Problem

The PHC was conceived and continues to function as a specialty hospital for heart surgery and cardiovascular interventions. However, the many challenges in cardiovascular care delivery convinced the PHC leadership and its executive committee to refresh the governance charter and adapt a clear strategic plan which will provide a roadmap and guide for future program direction, sensitive to the ever changing healthcare environment. Such roadmap can remain consistent despite the series of management change to ensure that the development of new programs are still aligned with the PHC mission as well as any future directions from the Philippine Department of Health.

Solution and Impact The PHC-PGS, focusing on individual compliance from employees in all services to unit breakthroughs, has maintained overall outstanding performance (133% accomplishment).  By the innate nature wherein each unit has a scoreboard to which compliance is noted per employee per division, PGS becomes innovative. Now, performance is not based on the usual attendance and routine office work but by the duty in which the office has been created, where performance is monitored against fixed and defined measures and targets. While most hospitals would have a quality assessment management office, up to this writing, only PHC as a Government-Owned and –Controlled Corporation and after 40 years of existence, has adopted the PGS. Each employee has now a conscious effort on how to contribute to the attainment of unit lead measures for hospital breakthrough targets on excellent healthcare delivery for all. PHC-PGS won the Excellence Award of the Hospital Management Asia last August 2013. It also received the Silver Trailblazer Award after an oral revalida last 2015. Because of the PGS process, validated by an external audit, PHC received a citation as an “Island of Good Governance” during the Asia-Pacific Economic Cooperation (APEC) Summit last November, 2015.

Milestones

Rapid cascading sessions were conducted for all departments. All units drafted their 2nd level breakthrough targets and lead measures. Each of the scoreboards were plotted to directly or indirectly affect the 26 measures in the Balanced Scorecard on the following perspectives:  (1) social impact, (2) people empowerment, (3) internal process, and (4) organization and fund resources.  Last July 2013, a hospital-wide Unit Scoreboard Launching was conducted. Weekly breakthrough meetings are conducted eventually and the Office of Strategy Management (OSM) monitored the results. Commitments to improve breakthrough results are done immediately during the meetings when the target is not attained and each individual commits to attain the unit goal.

By the end of December 2013, 81 percent of the units had winning scoreboards, with more than 100 percent accomplishment; while 14 percent have at least 90 percent accomplishment. From 2014 to 2015, all units have drafted their scoreboards, with an increase of 5 to 10 percent breakthrough targets per year. All the strategic units have functional cascading frameworks. Second-level scoreboards were validated from the three services– Medical, Nursing, and Administrative. Copies of third-level dashboards/ scoreboards of each department are submitted to the OSM. Presence of individual scorecards are also noted per division and submitted bi-annually to the human resource department. Institutional monitoring of the balanced scorecard is done quarterly.