This is an Entry to the Government Best Practice Recognition Awards
San Agustin Romblon Multi-Specialty Rural Health Unit
Local Government Unit — San Agustin Romblon
Best practice Focus Area(s)
Leadership, Strategic planning and deployment, Customer and citizen focus
Last April 2019, the Municipal Mayor, recognizing the lack of doctors in the town, with concurrence from the Sanggunlang Bayan officials, proposed and funded for additional physicians to serve in the Rural Health Unit along with the Municipal Health Officer and staff. Presently, the facility is and has been providing multi-specialty clinic services such as: Internal Medicine; Pediatrics; General Surgery; and Ear, Nose, Throat (ENT). This was a first in the history of the municipality and also was a first among all the 17 LGUs with their respective RHUs in the whole province of Romblon.
Background and Problem
Late last year, there were no regular doctors-on-duty at a nearby strict hospital so patients were continually referred to the RHU, and so the time to do preventive public health programs in the barangays became less and less. When patients step in at the Center in the morning, the MHO could not leave and attend to other functions, even when requested by the local officials. Moreso, community health advocacies on LGU’s smoke-free environment policies and anti-rabies program were put on hold. The RHU operates entirely on clinic consultations only and there are difﬂcult or complicated cases that need to be seen by medical specialists. If patients are able, they commit to see specialists. Those who could not afford it choose to continually follow up with the MHO. The Mayor felt the urgency of the health situation and the need for an immediate solution.
Solution and Impact
The concern was among the issues discussed in a Local Health Board last February 19, 2019. To determine a possible source of funding for the proposed additional doctors at the Center, a meeting with the Commission on Audit (COA) Representatives was set at the time of the LGU Exit Conference with COA. When told that it was possible, a supplemental budget was proposed and approved by the Sangguniang Bayan Ofﬁce in the amount of P1 Million under the Medical Consultancy Program under the Municipal Health Office fund. Guidelines and policies for RHU Medical Consultants were drafted by the MHO and were approved by the Mayor. Immediately, last April 16, 2019, a Pediatrician, an Internist, and a General Surgeon were on duty at the center on Job Order status. The Consultants were on duty on a speciﬁc day of schedules. The latest addition was that of an ENT Specialist last July 12, 2019.
Since then, the Center has been catering to a large volume of consultations at the Outpatient Clinic. The nearby district hospital has also been referring their patients to the specialists at the center. Those who have been traveling to Odiongan, Romblon waited for the schedules of the consultants at the center and became part of regular follow-ups. There has also been a demand for more drugs and medicines which were being given for free by the center. Disease conditions are detected and managed earlier. Disabilities are identiﬁed. Good health practices to be observed at home are emphasized. Further, there has been adequate space and time to do public health functions, such as resuming usual barangay health visits and advocacies and information dissemination.
This has been the ﬁrst time in the history of Romblon Province that an ordinary Rural Health Center has become a multi-specialty center. The availability of specialists at the center led to an increased volume of patients being seen by the generalist and specialists at the same time. Minor surgeries have been performed and those needing hospital surgeries were managed by the surgeon himself, while those seeking further check-ups were immediately seen and managed by the pediatrician and the internist. The MHO and staff had the opportune time to conduct barangay health visits and do preventive health activities. At present, the plan is to obtain services from an OB-Gynecologist and Ophthalmologist to join the pool of specialists and ensure budget allocation for the sustenance of the Medical Consultancy project.