2018

This is an Entry to the Government Best Practice Recognition Awards

Title

Dok-hang: Katok sa Maysakit Doc-to-Door Program

Organization

LGU Noveleta

Best practice Focus Area(s)

Leadership

Year Implemented

2017

Summary

“Dok-hang: Doc to Door” is an institutionalized innovative program of LGU Noveleta where doctors and nurses knock on houses of patients who are bedridden and incapable of visiting the health center. The principal notion of this program is that “If you cannot go to the health center, we will be the one to bring our services personally to your doorstep”. It was started by Mayor Dino Chua in 2017 as a response to the challenge of DOH to end the inequities in health. It aims to focus on those who need health services the most and to reach out and make services available to all.

Background and Problem

The objective of the Doc to Door Program is to make health services available to all and to focus on providing for the health needs of those who needed it most. It aims to provide comprehensive health services from the womb to the tomb.

During the distribution of senior citizen pension of the  Municipal Social Works and Development (MSWD), there were a lot of senior citizens who needed to be visited at home due to their being bedridden. Mayor Chua joined the MSWDO in visiting the homes of these indigent senior citizens. Their situation inspired him to provide not just financial assistance but also a much needed comprehensive health service. Moreover, during a free wheelchair distribution project, people enlisted their bedridden family members. The number was unexpectedly high bringing forth the realization that there truly are a lot of constituents that are incapable of going to the health center in acquiring needed medical attention.

One of the initial challenges was the lack of manpower. Regular visits to homes of bedridden patients also mean unavailability of the Municipal Health Officer (the only physician at that time) at the health center. Mayor Chua answered this challenge by hiring two additional physicians to ensure that the health center is always manned by a physician and the health needs of those who can’t go to the health center are also provided upon. A designated vehicle for the sole use/purpose of the Doc to Door Program was also made available.

Solution and Impact

Theory of Change:

  • Input: health commodity and manpower, transport service
  • Activities: door-to-door visits to bedridden senior citizens, cancer patients and other terminally ill patients, cerebral palsy patients, amputees and patients with debilitating neurological conditions (i.e. Parkinson’s Disease, Alzheimer’s Disease)
  • Output: patients provided health services at their doorstep which include vaccination, BP checks, provision of medicines and basic laboratory services (blood sugar, cholesterol, and uric acid determination), health education and prescription updating
  • Outcome: decrease in mortality; decongestion of the health center with its limited space

Impact: Efficient, acceptable, and accessible health services for all; comprehensive health services from the womb to the tomb; client satisfaction for the citizens

Methodology:

  • Preparatory Stage
    •  Ensure adequate manpower
    • Provision of uninterrupted supply of medicines, vaccines, diagnostic tests, wheelchairs, etc.
    • Provision of Forms and Individual Treatment Records
    • Availability of transport vehicle specific for this purpose/program
    • Announcement to the community of the program through social media, community assemblies and posters
    • Provision of a help desk with point person for people’s queries and requests
  • Implementation Stage
    • Master listing of bedridden patients through the established help desk and senior citizen and PWD master list from Municipal Social Works and Development Office (MSWDO)
    • Door to Door visit
    • Follow-up visit
  • Monitoring and Evaluation
    • Client Satisfaction analysis
    • Electronic Recording of clients/patients
    • Tabletop records review

Milestones

  1. Awards/Recognition:
    • DOH Health Leadership and Governance Program Outstanding Health Innovation
    • 2018 DOH Region IV-A Outstanding LGU for LGU Scorecard and Monitoring and Evaluation for Equity and Effectiveness
    • People’s social media comments

Next Steps:

  • Conduct program implementation review twice a year
  • Expansion of services to include physical therapy
  • Create more teams for more frequent household visits
  • Integrated services with MSWDO, GSO, and other relevant Offices