Barangay Leadership and Management Program Workbook PDF

Barangay Leadership and Management Program LEARNING JOURNAL AND WORKBOOK  INTRODUCTION The Barangay Leadership and Management Program (BLMP) aims to contribute to the improvement of provincial and municipal health outcomes through th...

Barangay Leadership and Management Program LEARNING JOURNAL AND WORKBOOK  INTRODUCTION The Barangay Leadership and Management Program (BLMP) aims to contribute to the improvement of provincial and municipal health outcomes through the development of barangay health systems co-produced and co-managed by barangay health leaders, families and communities. The BLMP incorporates concepts and guiding principles of Primary Health Care and the Universal Health Care (UHC) Law. The program is designed for barangay leaders such as but not limited to Punong Barangay, Midwife, Barangay Kagawad on Health, Barangay Secretary, Barangay Treasurer, Barangay Health Workers, Barangay Nutrition Scholar, Barangay Day Care Worker, SK Chairman, BHW President, 4Ps Parent Leader, and School Representative for them to organize functional and sustainable Barangay Health Governance Body (BHGB). BLMP RUNWAY BLMP Runway is designed for one year. The intervention of the program is primarily on capacity building and leadership formation of barangay leaders and their team. Year 1 Q1 Year 1 Q2 Year 2 Q1 Barangay Leadership BLMP 1 BLMP 2 Core Team Municipal Training & TRAINING HCPN-aligned Practicum Colloquim or Bridging Leadership for a Functional barangay Provincial and Sustainable Barangay Health health service Awards and Governance Body delivery Recognition PRACTICUM system Barangay Leadership Team Formation Competent Activated Barangay Health Board Health workers Diffusing Team Deep Dive Healthy and community Launching of a community-driven resilient health program towards healthy and resilient families and innovations families communities Bayang Malusog MLDP: Mentoring and Monitoring | Practicum to support Province and barangays Municipality Program Implementation Support Bayang Malusog PLDP: Provincial Health Team Mentoring and Coaching | Technical Sessions | Practicum to support municipalities Figure 1. Barangay Leadership and Management Program Runway Barangay Leadership and Management Program 1 There will be two modules, each designed with a 2-day training. Module 1 aims to develop the knowledge and capacities of the Barangay Leadership Core Team to activate and functionalize their Barangay Health Governance Body, understand the complex realities of their communities, and implement a community-driven program towards healthy and resilient families. Module 2 aims to deepen the leadership competencies of the barangay leaders and their team in addressing their health issues and establishing a sustainable, resilient barangay health systems that is aligned with their province-wide health system. Through out the project, the Province-led BLMP project implementation team will coordinate with municipal leaders to provide mentoring sessions to the barangay leaders as well as monitoring of the practicum deliverables of the barangay core team. At the provincial level, technical trainings, coaching and mentoring support will be provided to the PHO and BLMP Implementation team to ensure proper roll-out of the program to the municipalities and barangays. OBJECTIVES At the end of Module 1 training, the barangay health team leaders will be able to: Help organize and put together an active Barangay Health Governance Body Promote collaboration with other sectors and community participation in barangay activities to achieve good health. Barangay Leadership and Management Program 2  UNIVERSAL HEALTH CARE: Health Situation in the Philippines and the Community DEFINING INEQUITIES Inequities are differences in the availability of opportunities to access health and other social services of different individuals. In an inequitable society, individuals have varying access to social services necessary for better outcomes and improved quality of life. Pantay-pantay Patas Realidad HEALTH SITUATION IN THE PHILIPPINES The average lifespan of a person is expected to reach up to 72 years. The Maternal Mortality Ratio increased Does this reflect the to 144 in 2020, vs. 114 in 2015. experience of your The Infant Mortality Rate increased to barangay? 22 in 2022, vs. 21 in 2017. Only 50% of people have access to a primary care facility within 30 minutes. Only 21% of provinces have an adequate number of primary care facilities. There is a significant shortage of health workers, especially doctors and nurses. Only 35% of Filipinos aged 18 and above have comprehensive knowledge when it comes to health. In 2022, the typical out-of-pocket expense of Filipinos for health reached Php 10,000. Tiisin ko na lang ito... Because of insufficient funds for medicine or hospitalization, people choose not to consult with doctors or undergo check-ups. Source: Department of Health. National Objectives for Health 2023-2028, Philippine Statistics Authority - National Health Accounts Barangay Leadership and Management Program 3 WHAT IS A SYSTEM? Group of interconnected elements and it moves together Every element has a purpose or function SYSTEM STRUCTURES IN HEALTH The health system is composed of Six Building Blocks. Governance provides the opportunity for the five other blocks to function effectively. It is critical for barangay leaders to not limit their focus on the provision or procurement of medicines. They should also look at the other blocks to make the system more effective and responsive. SOCIAL DETERMINANTS OF HEALTH Where is health produced? These are the drivers of the social determinants of health (SDH). According to the county health rankings by the University of Wisconsin, social and economic factors account for 40% of factors affecting health outcomes further reinforcing the importance of SDH. For constituents to enjoy the changes to ensure access to quality health services, we have to ensure the SDH factors are also addressed. Intervention Areas Healthy Public Policies Healthy Settings Schools Communities Workplace Health facilities Medicines and equipment Human resources Health financing Source: Adapted from Waters Centers for Systems Thinking Institute for Clinical Systems Improvement, Going Beyond Clinical Walls: Solving Complete Problems (Oct 2014) www.healthypilipinas.ph Barangay Leadership and Management Program 4 ACTIVITY: FACILITY AND TRANSPORTATION MAPPING 1. Prepare a map (spot map) of your barangay. The following should be shown: Barangay boundaries and physical features (i.e. river, bridges, mountains) Villages, houses, road network, barangay hall, church, school, etc. 2. Mark the locations of all health facilities and disaster response sites (i.e. BHS, Evacuation centers). Identify the functional and non-functional health facilities. If available, include municipal or provincial health facilities such as RHU, hospital, or private facilities. Functional: Operates from 8am to 5pm daily for BHS, with water, electricity, essential medicines, visited weekly by assigned health worker. Non-Functional: Lack of any of the above 3. Show the mode, cost, and availability of transportation from the furthest village to BHS, RHU, or hospital. Include travel time from home to BHS/RHU (i.e. 1 hour) Commute: habal-habal, tricycle, jeep, etc. LGU-provided transportation: ambulance, sea ambulance Cost of transportation and availability: P400 rent; P20 but 1 trip/day at 9am) UNIVERSAL HEALTH CARE LAW or RA 11223 All Filipinos are guaranteed equitable access to quality and affordable health care goods and services, and protected against financial risk. The Philippine UHC Law addresses the inequities faced by the country’s health system because of fragmented service delivery and inefficient financing systems. Under the UHC Law, every Filipino is entitled to the following health coverages to protect and promote the rights to health of all. % Population Coverage Service Coverage Financial Coverage Automatic inclusion of Immediate eligibility and Reduce out-of-pocket every Filipino citizen into access to population-based expenditure for health the National Health and individual-based health Insurance Program services Barangay Leadership and Management Program 5  OWNERSHIP AND ACCOUNTABILITY The identified health challenges demand having leaders who understand the issue and see the importance of working and engaging other stakeholders, the Bridging Leadership approach is needed. BRIDGING LEADERSHIP PROCESS: OWNERSHIP In ownership, the leader needs to understand the problem and relate the challenges to who they are as What are the qualities of a good and genuine leader? a leader and by knowing who they are and what will the response or commitment be. The leader own the responsibility to the issues. Understands the system and knows the interest of each stakeholder Takes personal action on the issue. Will take the first step. YOU CAN ASK YOURSELF What happened? What caused the problem? Who am I as a leader? What does this mean to me? What should I do? Can I do this on my own? Source: AIM-TeaM Energy Center, as modified Barangay Leadership and Management Program 6 BRIDGING LEADERSHIP PROCESS: CO-OWNERSHIP In co-ownership, the bridging leader understands that he cannot do it alone. Hence, he/she shares his personal vision to other stakeholders and gathers them to co-own the problem. As leaders who take ownership regarding the issue, they involve other leaders to co-own the problem and have a common goal to address the issue. YOU CAN ASK THE QUESTION Who can help me? How can I encourage them to help? What activities should we do together? BRIDGING LEADERSHIP PROCESS: CO-CREATION Finally in co-creation, the bridging leader with his stakeholders work together to achieve equity. As leaders who are working towards a common goal, they collectively develop and create new programs and initiatives to achieve change and achieve the desired future. YOU CAN ASK THE QUESTION What new things should be done? How can I empower the voice of the community? How can the programs be made more effective? EQUITY LIDER SISTEMA PROGRAMA KALUSUGAN The leaders in the barangay are not just the MAYOR and the MHO, not just the Punong Barangay and the Midwife, but also the community members in the barangay who owns the problem in the community and is responsive to it. Source: AIM-TeaM Energy Center, as modified Barangay Leadership and Management Program 7  RESPONSIBILITIES OF BARANGAY HEALTH GOVERNANCE BARANGAY HEALTH GOVERNANCE BODY (BHGB) or BARANGAY HEALTH BOARD This is a group of individuals from various sectors in the barangay who regularly communicate and collaborate to achieve a proper health situation in the barangay The organization of the Barangay Health Governance Body (BHGB) will help in delivering basic health services to the barangays and ensure the participation of every community member in building a healthy barangay. The qualities of an active and functional BHGB/BHB includes the following: Presence of resolution or ordinance on the establishment of the Barangay Health Governance Body. Conduct regular quarterly meetings and provides updates to the ABC/Local Health Board. Implement and monitor the health plan included in the Barangay Investment Plan. All members of the barangay are participants in health programs. BARAGNGAY HEALTH GOVERNANCE BODY MEMBERS AND THEIR ROLES The recommended members of the BHGB or BHB include the Punong Barangay, Barangay Kagawad on Health, Midwife assigned in the barangay, Barangay Secretary, Barangay Treasurer, BHW President, Barangay Nutrition Scholar, SK Chairman, 4Ps Parent Leader, IP Leader (if present), School Principal/ representative, and AdHoc Member as sectoral representation BARANGAY CAPTAIN as Chairperson should lead in: Organizing the BHGB Formally appointing other BHGB members. Conducting regular quarterly meetings Systematic reporting during ABC meetings on health events in the barangay. Calling for an increase of barangay funds for health. Barangay Leadership and Management Program 8  As Vice-chairperson, the MIDWIFE should take the lead in: Sharing technical knowledge on health. Keeping inventory of equipment and materials for medical treatment at BHS Leading the implementation of basic health services at the Barangay Health Station or Birthing Unit under their sector. KAGAWAD ON HEALTH should: Lead in drafting/creating resolutions and/or ordinances for health programs. Support the increase of barangay funds for health. Support the expansion of benefits provided to health workers. BARANGAY HEALTH WORKERS should: Lead the promotion to fellow barangay residents about the health programs being implemented by the RHU. Assist in emphasizing the importance of health to fellow barangay residents. Assist midwives in the inventory equipment and materials for medical treatment at the Barangay Health Facility. Assist midwives in maintaining the physical structure of the Barangay Health Facility and its equipment. BARANGAY NUTRITION SCHOLARS should: Have information about the activities for various health programs, especially in Nutrition, and their respective committees, and support their immediate implementation. HEAD OF PARENT LEADERS should: Ensure the participation of all barangay members in the Barangay Health Assembly and health programs. SK CHAIRPERSON or YOUTH REPRESENTATIVE should: Find out the activities for various health programs, especially for the youth. SCHOOL REPRESENTATIVE should: Be aware and knowledgeable of the health programs and services especially those that involve the students. What are your thoughts and feelings after learning about your responsibilities as a member of the BHGB or BHB? Barangay Leadership and Management Program 9  HEALTH IN THE HANDS OF THE COMMUNITY It is important to prioritize community participation. Members of the community should be part in decision-making and the development of plans and programs with clear roles and responsibilities. To encourage community involvement and empowerment, we have to identify first the various levels of community participation, as well as the barangay members' existing involvement. LEVELS OF COMMUNITY PARTICIPATION Community as PARTNERS Community as ADVISERS KATUWANG at TAGA-DESISYON Community as REVEIVER (Charity) TAGAPAYO TAGATANGGAP COMMUNITY AS RECEIVER (Charity) The community is a recipient of programs or services created solely by LGU leaders. There is no participation or opportunity to give suggestions or feedback on services or programs for the community. COMMUNITY AS ADVISER The community is only consulted and asked for information and their opinions, and is not included in the formulation and implementation of programs. Feedback mechanisms are often informal (without proper process or system) The role of the community is to listen and be heard, but they are not or hardly involved in the planning and implementation of programs. COMMUNITY AS PARTNERS They play an active role from planning, implementing programs, to monitoring and evaluating them. Actively encouraged to become part/members of committees and groups in the LGU. There is a formal process in getting feedbacks. There are organized sectors. Barangay Leadership and Management Program 10  Do people in your community actively or freely request the health services or programs they need? If Yes, how do they do it and how do you respond? If No, what could be the possible reasons why they don’t ask or request? Do you think they should demand it? BARRIERS TO COMMUNITY PARTICIPATION Only LGU officials can make a decision. LGU Officials are the ones who determine what needs to be done and what direction should be followed by the entire community. Over reporting of accomplishments and being forced to provide immediate results. Picking/Selecting who will participate in LGU programs. Ang mamamayan ay may karapatan at tungkulin na More attention is given to makilahok sa pagpaplano financial, physical, and material at pangangalaga ng programs and projects. kanilang kalusugan. Source: The 1978 Declaration of Alma Ata The community is not interested in participating. Notes Barangay Leadership and Management Program 11  ACTION PLANNING There will be three parts of the planning process: First part is the planning for the activation/ functionalization of the BHB and improvement of their barangay health system guided by their Barangay Roadmap Second part is the barangay health system development plan address priority health issues using the six building blocks system framework and strategies to collaborate with relevant stakeholders Third part is planning for their deep dive with the puroks or sitios through a series of dialogue sessions, priority problem identification and their proposed solutions. Barangay Community Leadership Equity Health System Participation Engaged and co-decision making individuals, People- Health at the Bridging families, centered Hands of the Leadership communities, Health System People informal carers and vulnerable sectors in health THE 3-MONTH PRACTICUM Battle Cry! Prepare for UHC Implementation 3 months = 12 weeks Formation of Barangay Leadership Team Activate BHGB “Deep Dive” with sitios/puroks Barangay Leadership and Management Program 12  ACTION PLANNING Barangay Munisipyo Petsa Punong Barangay Iba pang miyemro Midwife Petsa at Oras ng Unang/Sunod na BHGB Meeting: Lugar ng Meeting Mga iimbitahin Mga kailangan ihanda para sa meeting: Barangay Leadership and Management Program Part A. BHB Activation/Functionalization/Membership Expansion Sector and Gawaing Status individuals affected Resource Source (Accomplished/ Priority para Timeframe or with interest in Needed of Fund On going/ Makilahok Not yet started) the problem Based on the discussions and output from the Identify the List activities in Input the List the Identify Problem Prioritization Worksheet, identify the stakeholders for each engaging target date to needed the sector you should engage to help address the identified problem. stakeholders accomplish resources. source of issues. Note: You may change the priority (FGDs, the activities fund. problem that is not reflected in the Problem meeting, (initial plan is Prioritization Worksheet but based on the assembly, etc.). within six discussions from the group months). 13  ACTION PLANNING Part B. Barangay Health System Development Based on your discussion on the priority health challenge, discuss how to address the challenge. Refer to your baseline Barangay Roadmap and address the yellow and red indicators aligned with your priority problem challenge. PRIORITY PROBLEM 1: (hal. Mental health ng teenage mothers) Anu-ano ang Anong Ano ang gusto Sino ang target Ano ang Kailan ito Sinu-sino ang activities na resources ang natin na mangyari population ating outputs gagawin ating partners gagawin kailangan Health Information System Barangay Leadership and Management Program Health Service Delivery Health Human Resource 14  ACTION PLANNING Part B. Barangay Health System Development Anu-ano ang Anong Ano ang gusto Sino ang target Ano ang Kailan ito Sinu-sino ang activities na resources ang natin na mangyari population ating outputs gagawin ating partners gagawin kailangan Medicines and Technologies Barangay Leadership and Management Program Health Financing Leadership and Governance 15 LEADERSHIP JOURNEY: DIALOGUE WITH INDIVIDUALS AND FAMILIES WHAT IS “DEEP DIVE?” It is a leadership learning journey where the participant or learner directly experiences the challenges of a system from the perspective of other stakeholders. Seeing with fresh eyes. Sensing from the field. It is an intentional engagement with the families and communities in the identification of health problems and finding ways to involve them in the process of planning and creating solutions to their identified problems HOW TO EXECUTE OR DO A DEEP DIVE? Identify your stakeholders based on their classifications/context (household, sitio, BHS, RHU) Observe Ask questions to understand Do not judge Always keep in mind to value and to appreciate. After their deep dive, the team can create a community-driven program to complement the improvement of the barangay health system. DISCOVER AND ANALYZE THE BARANGAY 1 LISTEN AND DISCOVER Meeting per purok Identify the important health and social issues of the community. 2 CONSOLIDATE AND ANALYZE Consolidate purok health and social issues and priorities Analyze commonalities and themes 3 CRAFT CRITERIA FOR PAMILYANG KAMPYON Gather the different sectors related to the identified issues. Conduct workshop for the criteria to be considered as Pamilyang Kampyon Finalize criteria and mechanics of the program. 4 PROGRAM LAUNCH Launch Pamilyang Kampyon Program 5 IMPLEMENT AN MONITOR Barangay Leadership and Management Program 16 REFERENCES 1. Adapted from the Waters Centers for Systems Thinking. Understanding Systems 2. Administrative Order No. 2023-0015. (2023). Adoption of the 8-Point Action Agenda as the Medium-Term Strategy of the Health Sector for 2023-2028. Retrieved from: https://doh.gov.ph/uhc/8-point-agenda/ 3. AIM-Team Energy Center. (2020). Bridging Leadership for a Society without Divides. Retrieved from https://aim.edu/research-centers/team-energy-center- bridging-leadership 4. Botes, L. & van Rensburg, D. (2000). Community Participation in Development: Nine Plagues and Twelve Commandments. Retrieved from https://utad1112gdl.wikispaces.com/file/view/CDJ_Participation.PDF 5. Department of Health. (2023). National Objectives for Health Philippines 2023- 2028. Manila, Philippines: Department of Health 6. Institute for Clinical Systems Improvement. (2014). Going Beyond Clinical Walls: Solving Complete Problems 7. International Conference on Primary Health Care (1978). Declaration of Alma- Ata. WHO chronicle, 32(11), 428–430. 8. Philippine Statistics Authority. (2023). Philippine National Health Accounts. Quezon City, Philippines 9. Republic Act No. 11223 (2019). Universal Health Care Act. Retrieved from https://www.officialgazette.gov.ph/2019/02/20/republic-act-no-11223/ 10. World Health Organization. Universal Health Coverage. Retrieved from https://www.who.int/westernpacific/our-work/universal-health-coverage Barangay Leadership and Management Program 17