ABBREVIATIONS
BHW
BNS
CARI
CBMIS
CBT
CDD
CDS
COH
CVD
CVHW
DA
DCP
DF
DMMH
DOH
DSPH
DTTB
EPI
ES
FDRO
FP
FP-CSP
FSAC
GAD
GF
GMDH
GO
HEPO
HP
LGU
LMT
MBFHI
MCH
MCP
MDH
MHO
MHP
MMCH
MOOE
MT
NFP
NHIP
NLCP
NP
NTP
PCCP
PHD
PHIC
PHN
PHO
PMC
PS
RHM
RHU
RPP
RSI
SCP
SMH
SS
STD
TLDH
WAD
-
BARANGAY HEALTH WORKER
BARANGAY NUTRITION SCHOLAR
CONTROL OF ACUTE RESPIRATORY INFECTION
COMMUNITY BASED MANAGEMENT INFO SYSTEM
COMPETENCY BASED TRAINING ON FP
CONTROL OF DIARRHEAL DISEASES
CONTRACT DISTRIBUTION SYSTEM
CHIEF OF HOSPITAL
CARDIO VASCULAR DISEASE
COMMUNITY VOLUNTEER HEALTH WORKER
DENTAL AIDE
DENGUE CONTROL PROGRAM
DEVELOPMENT FUND
DON MARCELINO MUNICIPAL HOSPITAL
DEPARTMENT OF HEALTH
DAVAO DEL SUR PROVINCIAL HOSPITAL
DOCTOR TO THE BARRIO
EXPANDED PROGRAM ON IMMUNIZATION
ENVIRONMENTAL SANITATION
FOOD AND DRUG REGULATION OFFICER
FAMILY PLANNING
FAMILY PLANNING-CHILD SURVIVAL PROGRAM
FIELD SERVICE ASSESSMENT CHECLIST
GENDER AND DEVELOPMENT
GENERAL FUND
GREGORIO MATAS DISTRICT HOSPITAL
GOVERNMENT ORGANIZATION
HEALTH EDUCATION AND PROMOTION OFFICER
HEALTH PASSPORT
LOCAL GOVERNMENT UNIT
LACTATION AND MANAGEMENT TRAINING
MOTHER & BABY FRIENDLY HOSPITAL INITIATIVE
MATERNAL & CHILD HEALTH
MALARIAL CONTROL PROGRAM
MALITA DISTRICT HOSPITAL
MUNICIPAL HEALTH OFFICER
MENTAL HEALTH PROGRAM
MATANAO MEDICARE COMMUNITY HOSPITAL
MAINTENANCE AND OTHER OPERATING EXPENSES
MEDICAL TECHNOLOGIST
NATURAL FAMILY PLANNING
NATIONAL HEALTH INSURANCE PROGRAM
NATIONAL LEPROSY CONTROL PROGRAM
NUTRITION PROGRAM
NATIONAL TUBERCULOSIS PROGRAM
PHILIPPINE CANCER CONTROL PROGRAM
PUBLIC HEALTH DENTIST
PHILIPPINE HEALTH INSURANCE CORPORATION
PUBLIC HEALTH NURSE
PROVINCIAL HEALTH OFFICE
PRE-MARITAL COUNSELING
PERSONAL SERVICES
RURAL HEALTH MIDWIFE
RURAL HEALTH UNIT
RABIES PREVENTION PROGRAM
RURAL SANITARY INSPECTOR
SCHISTOSOMIASIS CONTROL PROGRAM
SARANGANI MUNICIPAL HOSPITAL
SENTRONG SIGLA
SEXUALLY TRANSMITTED DISEASE
TOMAS LACHICA DISTRICT HOSPITAL
WORLD AIDS DAY
1
EXECUTIVE SUMMARY
This is the Integrated Provincial Health Plan of the Province of Davao del
Sur for the year 2007. This is a consolidated strategic plan from different rural
Health Units and Provincial Hospital. The Fourmula One components like health
delivery, good governance, health regulation and health financing are also
incorporated in the composed of the plans for public health, local health systems,
hospital development, health regulation and health care financing. The vision,
mission, health situational analysis of the Province as well as the summary of the
Provincial Health Board’s overall health initiatives for the province are made part
and was considered in the formulation of this plan.
The plan for public health includes all health programs for province-wide
implementation through the rural / city health units of the fourteen (14)
municipalities and one (1) city of the province of the 2 congressional districts.
The plan for hospital development is an integration of the plans from
seven (7) hospitals (1 Provincial Hospital / 3 District Hospitals / 3 Municipal
Hospitals).
This three (3) year strategic plan is targeted towards the attainment of
Millennium Development Goal and PhilMedium Development plans as the plan
for local health system includes strategies to upgrade health facilities in the entire
province.
With paradym shift of sustaining/achieving the plan for health care
financing includes strategies for the implementation of the PHICs “indigent
program” in the province/devaluation of health services.
The implementation of all the activities / strategies within the period
indicated in this plan will greatly improve the health care delivery system of the
province.
2
VISION / MISSION
THE PROVINCIAL GOVERNMENT OF DAVAO DEL SUR – VISION
Effective and self-reliant Municipal and Barangay government that are
empowered through managerial capability building, a data banking system,
effective LGU coordination and financial assistance that promotes civic
governance to generate the inherent capabilities of people and communities to
contribute and participate in development under an atmosphere of teamwork,
professionalism and transparency with the end in view of becoming partners in
basic service delivery with an agri-ecosystem that is protected and sustained and
promoting the dignity of man and his capability to respond to local needs given
available sustained resources and support from the government.
Satisfied investors, NGOs, POs, Service Providers and FFAs who are
enterprise partners in local development for growth towards the Provincial Vision
of Agri-Industrial Development and empowered through enhancement of Peace
and Order, Infrastructure and service effective policies/incentives and outlined
manpower development and propelled by a coordinated and pro-active effort of
local government and empowered citizenry.
THE PROVINCIAL HEALTH OFFICE / HOSPITALS - MISSION
Davao del Sur PHO, District Hospitals, Municipal Hospitals, Community
Medicare Hospital and RHUs including BHSs working in collaboration with its people /
stakeholders are managerially and technically capable in the efficient delivery of quality,
accessible, affordable, professional and available health care services through committed
institutions and health associations in extending support services in the upgrading of
medical equipment and technology in a socio-cultural environment that is protected and
sustained.
3
HEALTH SITUATIONAL ANALYSIS
CHAPTER I- GENERAL PHYSICAL CHARACTERISTICS
Geographical Location. Davao del Sur lies on the southern portion of Mindanao
between 125 degrees-12 minutes and 125 degrees-43 minutes east longitude and between
5 degrees-20 minutes and 6 degrees-58 minutes north latitude. It is bounded on the east
by the Davao Gulf; on the west by the provinces of Sarangani, South Cotabato, and North
Cotabato; on the north by Davao City; and on the South by the Celebes Sea.
Political Subdivision. Republic Act No. 4867 issued on May 8, 1967 divided the then
province of Davao into three provinces, namely: Davao del Sur, Davao Oriental, and
Davao del Norte. Davao del Sur consists of 15 municipalities, which was further
subdivided into 2 congressional districts with 337 barangays (Table 1). District I is
composed of 1 city (Digos) and 6 municipalities, namely: Bansalan, Sta. Cruz,
Magsaysay, Matanao, Hagonoy, and Padada while District 2 comprises the municipalities
of Malita, Malalag, Kiblawan, Sta. Maria, Don Marcelino, Jose Abad Santos, Sarangani,
and Sulop. The seat of the government was established in Digos City.
Table 1.
Number of Barangays by City /
Municipality, Davao del Sur: 2005
Municipality
No. of Barangays
Bansalan
25
Digos City
26
Hagonoy
21
Magsaysay
22
Matanao
33
Sta. Cruz
18
Padada
17
Kiblawan
30
Sulop
25
Malalag
15
Sta. Maria
22
Malita
30
Don Marcelino
15
Jose Abad Santos
26
Sarangani
12
TOTAL
337
Natural Resources. The province is endowed with mineral deposits both metallic and
non-metallic such as gold, silver, lead, copper, chromium, limestone, white clay,
molybdenum, sulfur, phosphate and guano.
Climate. The climatic of the province falls under Type II characterized by a relativity
dry season from November to May and a wet season, June to October. The coldest
months are usually in December and January while the hottest during April and May. The
average temperature is 27.2 degrees Centigrade. There is more or less evenly distributed
rainfall pattern, with no mark seasonality. The province falls south of the typhoon belt
and therefore, not normally affected by tropical depressions.
Land Area. Davao del Sur has a total land area of 3,934.01 square kilometers, which
represents about 14.65 percent of the regional total of 31,692.75 square kilometers. The
municipality of Jose Abad Santos has the largest land area recorded at 734.43 square
kilometers or 18.67 percent of the aggregate provincial land area, followed by Malita
with 512.59square kilometers and Don Marcelino with 407.30 square kilometers. On the
other hand, the municipality of Padada has the smallest land area of 45.03 square
kilometers.
4
Table 2. Land Area by Municipality, Davao del Sur: 2005
Municipality
Land Area
Bansalan
157.75
Digos City
267.87
Hagonoy
116.64
Magsaysay
109.87
Matanao
202.40
Sta. Cruz
277.72
Padada
45.03
Kiblawan
390.07
Sulop
106.18
Malalag
186.12
Sta. Maria
204.78
Malita
512.59
Don Marcelino
407.30
Jose Abad Santos
734.43
Sarangani
155.26
TOTAL
3934.01
% Distribution
4.00
6.81
2.96
4.32
5.14
7.06
1.14
9.92
2.71
4.73
5.21
13.03
10.35
18.67
3.95
100.0
Topography. Of the total land area, 65 percent is rolling and mountainous with ranges
running southward. Among the mountain ranges found in the province, Mt. Apo is the
longest and highest range with an elevation of 2,953 meters above sea level. The general
topography of the province is flat with scattered hills and isolated mountains. The flat
areas are found in the city of Digos and municipalities of Matanao, Magsaysay, Bansalan,
Kiblawan, Hagonoy, Padada and Sulop, which comprise the Padada Valley.
The province has three major rivers, namely: a) Mal River which drains from Cotabato
to Matanao and Hagonoy; b) Bulatukan River which comes from the foot of Mt. Apo and
flows down to Bansalan, Hagonoy and Magsaysay; and c) Sibulan River which also
originates from the foot of Mt. Apo and runs through Todaya Falls then flows down to
Sta. Cruz.
Slopes. Upland is defined as those areas with more than 18% slopes. Davao del Sur is
dominantly upland with an area of 60.43% of the total land area. While lowland
comprises 39.57%, with 1,036.22 square kilometers fall under 0-8 percent and the
remaining 520.47 square kilometers comprise the 8-18 percent slope.
Land Classification. The alienable and disposable lands cover about 1,375.18 square
kilometers or 34.96 percent while forest lands covers 558.83 square kilometers or 65.04
percent.
On the whole, 1,967 square kilometers or 50 percent of the provincial land area is
devoted to agriculture; 1,257 square kilometers or 31.95 percent is grass or shrub land
area including pasture land; 670 square kilometers or 17.02 percent are classified a
forest land; 30 and 10 square kilometers or 0.77 and 0.25 percent are wetland and
miscellaneous areas including residential and commercial area, respectively.
Natural Resources. The province is endowed with mineral deposits both metallic and
non-metallic such as gold, silver, lead, copper, chromium, limestone, white clay,
molybdenum, sulfur, phosphate, and guano.
Climate. The climate of the province falls under Type II characterized by a relatively dry
season from November to May and a wet season, June to October. The coldest months
are usually in December and January while the hottest during April and May. The
average temperature is 27.2 degree Centigrade. There is more or less evenly distributed
rainfall pattern, with no mark seasonality. The province falls south of the typhoon belt
and therefore, not normally affected by tropical depressions.
5
CHAPTER II -ECONOMIC BASE/ SECTOR
Agriculture: the most significant economic activity of Davao del Sur is agriculture.
Among the agricultural crops, corn is the widely grown food crop. In 2005, a total of
403.21 sq. kms. has been planted to corn. Bansalan, Digos, Don Marcelino, Jose Abad
Santos, Kiblawan, Magsaysay, Malita and Sulop are the main suppliers of corn.
Rice, the staple food of about 70% of the population is grown in 265.85 sq. kms.
Matanao, Magsaysay, Hagonoy, Bansalan and Digos are major producers of rice.
Coconut is the most widely grown commercial crop in the province with Jose Abad
Santos being the top-producing town as to the total production. Other commercial crops
are mango, sugarcane, banana, cotton, coffee and cacao. Mango, sugarcane and banana
have an increasing area of these crops planted but there is a decline in area planted with
cotton and cacao due to the decreasing demand both in export and local market.
Livestocks and Poultry: Poultry production registered a surplus in 2005 while livestock
production decline. Pork and beef supplies are insufficient to meet the demand of the
province.
Fishing: Davao del Sur has 11 coastal municipalities wherein fishing is the major means
of livelihood. Major fishing areas are found in the towns of Malalag, Malita, Santa Cruz,
Santa Maria and Sarangani. The most common specie caught throughout the year are
yellow-fin tuna, skip jack, anchovy, sardines, slip mouth, round scad, big-eyed scad,
squid, moon fish, goat fish, shrimps, crabs, mullets, bangus, siganid, flying fish and
groupe. Inland fishing is derived mainly from brackish fishponds, producing milkfish
(bangus), crabs and carps. Seaweed, both culture and natural, shellfish, clams and sea
anemones are also abundant in the area.
Sand and Gravel Concessions: Mineral resource development is one of the projects
being implemented by the province. This is a devolved regulatory function which caters
to matters relative to the extraction of sand, gravel and other quarry resources. Existing
quarry sites are in Bansalan, Digos, Hagonoy, Kiblawan, Magsaysay, Malita, Matanao,
Padada and Santa Cruz. Hagonoy and Santa Cruz are the major sources of quarry
materials.
Commerce and Industry: As of 2005, 27 major manufacturing firms engaged business
here, which are agri-based industries. Most of them are doing business in the field of
agriculture like sugarcane, coconut banana and cacao, which are in demand in
international market. Majority of these industries are located in agro-industrial centers of
Hagonoy, Santa Cruz and Malalag. Others are engaged into wood and bamboo crafts,
ceramics, loamweaving and others.
A total number of 6,230 commercial establishments venture in retail business, on
services, wholesale, banking, insurance’s, cooperatives, financing and real estates. Worth
mentioning are the 10 commercial banks; 3 major commercial centers, which are
concentrated in the urban area of Digos City. As to recreational establishment, no movie
house and a lot of food establishments including restaurants, videoke bars, bakeries,
snack bars and others with sprouting numbers of internet café’s.
Tourism: the province has been developed and promoted to become one of the tourist
destinations in Region XI. Various scenic spots, both man-made and natural are scattered
in the different municipalities. There are hot springs, caves, hill mountain parks, beach
resorts, waterfalls and swimming pools. Also, historical landmarks are present like
fortress remnants, Japanese tunnels and foxholes. Mount Apo is the favorite site for
mountain climbing, which resulted to the denudation of the area. There are 12 lodging
houses, inn, and hotels with good amenities. There are convention centers/hotels that can
hold seminars and conventions. Almost all municipalities have recreational and sport
facilities like parks, basketball and volleyball courts. The only drawback of the province
is that there is no sports complex which deter us to hold a big sports competition or
events like regional or national sports / athletics meets.
6
CHAPTER III- INFRASTRUCTURE NETWORKS/ UTILITIES
Roads and Bridges: As of 2005, the total road network is 3,892.619 kilometers of a)
barangay roads, 71.76%; b) provincial roads, 10.76% c) national roads, 8.32% and
municipal roads, 9.14%. Public roads are mainly gravel easily washed out during the
rains and flood. Gravel surface has a total length of 2060.629 kms., representing 52.98%
of the total road network. Asphalt road comprises only 1.42%; concrete, 7.45% and earth
surface, 38.19%. The increase in the number of roads has been slow over the years. The
total road density of the province is computed at 1.01 kilometer per square kilometer of
land. This is still below the national standard of 1.5 sq. kms. of land of the total land area,
indicating inadequacy of roads in the province.
Table 3. By Type of Surface, Davao del Sur, 2005
Type of
National
Provincial Municipal
Pavement
Concrete
83.405
64.482
73.367
Asphalt
40.157
4.500
8.732
Gravel
174.154
350.066
199.449
Earth
26.318
74.429
Total
324.034
419.048
355.977
Percent
8.3
10.8
9.1
Barangay
Total
Percent
68.81
1.80
1336.96
1385.99
2793.560
71.8
290.064
55.189
2060.629
1486.737
3892.619
100.00
7.45
1.42
52.94
38.19
100.00
There are 38 bridges along the national road with an aggregate length of 943.83 lineal
meters and 34 bridges along provincial roads with total span of 1,024.852 lineal meters.
These bridges were either Reinforced Concrete Deck Guilder (RCDG) or bailey/timber
bridges. The absence of road and bridges has many implications. Besides lack of access
to health, it also means reduced access to other social services particularly education.
Economic opportunities are also lost.
Transportation: From Davao City, Digos City, the capital town of the province, can be
reached through land transportation in one hour passing through an asphalt road
stretching around 55 kilometers. Different barangays and municipalities within the
province can be reached through land and sea transportation. The municipality of
Sarangani and some barangays of Jose Abad Santos, Don Marcelino and Santa Maria can
only be reached through the use of motorized banca or “pumpboat” as a means of
mobility for cargoes and passengers. The people in the other areas use public utility
vehicles, jeeps, buses, tricycles, trucks, and the like. The most commonly used vehicle in
going to and around the different sitios, puroks and barangays is a motorcycle and/or a
“skylab”, a motorcycle with an extended wooden appendage connected within the body
that can accommodate 5-6 passengers.
Transportation fares are fixed of those vehicles with specific route but most often are
negotiated or hired exclusively to carry passengers to and from your areas/destination at
your own convenience. These negotiated/hired are paid in the amount fixed in a particular
area by the drivers themselves tantamount to the total passengers that could be carried in
a vehicle especially for the hired pumpboat or hired motorcycle.
Power and Energy: Power supply has reached 14 municipalities and 1 city of the
province. Sarangani, Jose Abad Santos and Don Marcelino have power generators that
could supply only 8-10 hours of electricity daily usually from 5 PM to 11 PM only. As of
2005, only 72,602 house connection were made or 64.82% of the 112,000 potential
consumers. Likewise 246 barangays of 337 barangays or 72.99% are energized. Among
the 15 energized towns/city, Padada, Matanao and Digos City have the highest
percentage with 100.0% of household served with power supply. In Jose Abad Santos
only 8% of the household were served and only 2 of the barangays are energized.
7
Table 4. Davao del Sur STATUS OF ELECTRIFICATION As of May 2005
Municipality Potential
Actual
House
Percent No. of
Brgys.
Energized
Connection
Covered
Consumers Members
Served
Sta. Cruz
Digos
Matanao
Bansalan
Magsaysay
Hagonoy
Padada
Kiblawan
Sulop
Malalag
Sta. Maria
Malita
JoseASantos
D. Marcelino
Sarangani
TOTAL
10,477
22,393
6,179
9,146
5,846
7,004
4,029
5,391
4,739
5,296
6,370
12,105
6,372
3,969
2,684
112,000
6,978
16,819
4,407
6,486
3,926
4,630
4,012
2,098
2,187
2,893
2,664
4,388
428
438
220
62,574
7,810
22,053
4,637
7,176
4,155
5,299
4,966
2,094
2,307
2,998
2,899
4,864
379
614
351
72,602
75
98
75
78
71
76
100
39
49
57
45
40
6
15
13
65
18
26
33
25
22
21
17
30
25
15
22
30
26
15
12
337
16
26
33
21
18
19
17
22
16
13
18
18
2
3
3
229
Percent
Served
89
100
100
84
86
90
100
73
64
87
82
60
8
20
25
73
Telecommunication: Widespread coverage of mass communication plays a vital role in
the economic and political development of a country. Telecommunication refers to the
transmission of voice or data through electronic or in any form. Generally, it includes
broadcasting and other mass communication like print media but will be discussed further
in the separate chapter.
There are a total of 2,486 telephones connection in Digos City and 101 telephone lines in
Malalag. This means that for every 100 Filipino families, there are 11.6 and 1.6 telephone
in Digos and Malalag respectively. The telephone lines are installed and operated by a
Filipino private firm (PILTEL) in Digos City, while in Malalag, the local government
manages it. PILTEL has expanded to 8 towns namely: Bansalan, Hagonoy, Kiblawan,
Magsaysay, Matanao, Padada, Santa Cruz, and Sulop. Also, a government-owned firm
Department of Transportation and Communication (DOTC) has started operating in Santa
Cruz.
In cellular telephone system, there are 5 companies or carrier being permitted to operate
in the province. 2 radio-paging networks popularly known as pager or beepers have
already operated in Digos. Due to expensive rate and structure of the industry, limited
number of people has access to this type of communication. The user actually uses this
for business or as a mere status symbol. Fax machines are seen and used in many offices
both private and government offices.
There are also amateur radios, a 2-way person-to-person short wave communication
serving for non-commercial purpose. It is a means of communication especially when
there is an emergency situation or disaster. These familiar hand held radio systems for
public monitoring and radio services are used by 2 different groups REACT and RECON.
There are also 2-way radios being used by the Philippine National Police and by the LGU
in every municipality to send messages to different municipalities especially transmittal
of important messages by the provincial government to the municipal level or
intermunicipal messages.
There are 2 large cargo forwarder company in the province, which include mail and
packages sent to different parts of the country. Electronic mail and internet are common
now a days but only in Digos City.
8
Water Supply: Potable water supply is served to 80.96% of households, divided into
Level III, 36 functional water system (35.83 %); 180 Level II water system supplying
(26.67 %) of households and 5,793 Level I water system supplying (21.13%) of
households. On the other hand, 16.38% of the household gets their water supply from
doubtful sources such as dug well, rain water, and rivers. In Sarangani, more than half of
the population does not have access to safe water supply. They are dependent on
rainwater and dug well. Significantly, water salting and water salination can be found in
Don Marcelino, Malita, Malalag, Sulop and Padada causing hardness of water.
Table 5. WATER SUPPLY FACILITIES, By Municipality/City: 2005
Municipality
Bansalan
Digos
Don Marcelino
Hagonoy
Jose Abad Santos
Kiblawan
Magsaysay
Malalag
Malita
Matanao
Padada
Sta. Cruz
Sta. Maria
Sarangani
Sulop
Davao del Sur
Level 1
Level 2
30
1978
126
893
368
238
863
297
267
165
108
442
574
27
422
5,793
Level 3
11
14
3
4
9
4
7
6
77
7
2
23
5
2
6
180
2
11
2
2
2
2
1
4
3
3
1
2
1
36
Doubtful Source
40
78
75
87
125
117
37
50
43
65
3
27
89
83
73
992
Irrigation and Flood Control: Two types of irrigation system exist, the communal
irrigation system and national irrigation system. A total of 16,125.42 hectares or 68.31%
of the total potential area of 23,605 hectares have been irrigated. There are also 6 mini
dams, which are part of the irrigation system. Part of the coastal areas lies within the
tsunami prone areas. In addition, the province is constantly threatened with various
forms of erosions caused by natural calamities such as flood, tidal waves and even
quarrying considered to cause unclassified erosion.
To prevent the occurrence of flood that may affect agricultural areas, loss or damage of
lives and properties, seven (7) river controls were constructed in 5 municipalities. Also,
21 drainage systems were placed in Digos, Santa Cruz, Bansalan and Padada.
Environmental Hazards and Management Programs. Part of the coastal areas of
Davao del Sur lie within the tsunami prone area. In addition, the province is also
threatened with various forms of erosion caused by natural calamities such as flood, tidal
waves – even quarrying is also considered to cause unclassified erosion.
This situation prompted the infrastructure sector to propose continuous construction of
shore protection facilities within the affected areas. River control shall also be
constructed to prevent the occurrence of floods in the production areas and to secure
lives, food and properties.
Others:
There are 15 municipal buildings, 11 public markets, 25 public cemeteries
and 1 memorial park in Davao del Sur. Five towns; Digos, Santa Maria, Malalag, Santa
Cruz and Sulop have more than 1 cemetery. Some people bury them under their own
private lot, which are not allowed under the Sanitation Code. Others have permit to have
their own private burial place like religious groups / order.
9
CHAPTER IV – INCOME INDICATORS / SITUATION
Local Governance Income: The total income generated by the provincial government,
based on local tax collection for the 1994-1996 period, amounted to P344.58 million. By
sources of fund 97.6% or P336.18 million was generated from the general funds which
include tax revenue, taxes on goods and services, other taxes, internal revenue allotment
(IRA), fines and penalties and government business operation like terminal fees, rentals,
interests on bank deposits.
Based on this income, the provincial government is classified as first class province, as of
May 1997. On the municipal level, there are two 1st class municipalities, two 2nd class,
six 3rd class, three 4th class, one 5th class, and one 4th class city, an improvement from the
previous income classification. (Table 6)
Internal Revenue Allotment: The IRA of municipality or province depends upon the
land area and the population. In 2002, the province received an IRA of P403.447 million,
a 24.96% increase from 2001 IRA received. Digos and Malita got the biggest IRA due to
bigger land area and the bigger population followed by Jose Abad Santos, while on the
tail end, Padada and Sarangani. There is a remarkable increase of IRA in all
municipalities. But, this is not enough to cover the cost of devolution especially on
salary increase of health personnel as well as monetary benefits, allowance and per
diems.
Table 6. INTERNAL REVENUE ALLOTMENT
Davao del Sur, 2001 & 2002
City/Municipality
CLASS
Province of Davao del Sur
1st Class
Bansalan
2nd Class
Don Marcelino
3rd Class
Hagonoy
3rd Class
Jose Abad Santos
2nd Class
Kiblawan
4th Class
Magsaysay
3rd Class
Malalag
3rd Class
Malita
1st Class
Matanao
3rd Class
Padada
4th Class
Sta. Cruz
1st Class
Sta. Maria
3rd Class
5th
Sarangani
Class
th
Sulop
4 Class
Total Municipalities
Digos City
4th Class
TOTAL LGU
10
2001
302,753,561.00
33,082,340.00
34,082,760.00
24,584,160.00
43,963,900.00
33,928,550.00
32,414,000.00
33,964,000.00
42,428,320.00
30,924,000.00
18,027,450.00
40,615,620.00
30,084,020.00
19,994,280.00
20,911,120.00
439,004,520.00
207,362,434.00
949,120,515.00
2002
403,447,688.00
38,467,786.00
34,432,555.00
33,284,892.00
55,738,148.00
41,350,978.00
38,214,555.00
30,738,090.00
85,819,436.00
38,726,155.00
22,711,076.00
50,941,007.00
35,761,726.00
20,245,096.00
26,995,789.00
553,427,289.00
207,362,434.00
1,164,237,411.00
Labor and Employment: The current definitions of employment include any kind of
work that generates income. A fully employed person is one who has worked more than
65 days in the last quarter while a partially employed person is someone who has worked
less than 65 days. The underemployment rate includes fully and partially employed
person who wants additional work. There is a tendency to focus attention only on
unemployment figures when the large ranks of underemployment are also important. In
times of crisis, the under employment are the first to lose their temporary jobs since they
have the least specific skills.
Roughly, 56.1 percent of the population belongs to 15-64 years old bracket, ages
considered to be economically productive. Based on 1998 data, the number of employed
has reached 500,000 (92.5%) and unemployment of 7.5%. But, the under visible
employment is 18.3%.
Two thirds of the population derives their income from non-agricultural sources, like
industry and service sectors. Most of the poor people are dependent on salaries. While
one third are mainly from agricultural sectors. But still, most people seek employment
overseas due to lack of available jobs and competition is high among job applicants.
Poverty: The issue of poverty must be analyzed in the context of social inequity. One
often hears that in this country, the rich get richer and poor get poorer. Looking at the
country’s income distribution can substantiate such a claim.
Based on the 1994 Family Income and Expenditures Survey, the richest 20% (9th and 10th
income decile) account for 51.9% of the total family income. The bottom 30% (1st, 2nd
and 3rd income decile), or the other hand, only contributes 8.8% to total family income.
This means that the income of the ruling elite are so high that they comprise more than
half of the country’s total family income. Indeed, such social inequity remains hidden in
government claims that only a few Filipinos are poor, since poverty is being defined
along the lines of questionable standards. Poverty incidence is based on a daily poverty
threshold of P146.05 for a family of six. With their low poverty line, the government
does not consider the poor, the family subsistence on P33.48 per meal and P47.04 for
other basic necessities.
In 1988, the government removed several basic needs in the estimation of poverty
threshold, thus resulting in a lower figure. In the same year the government stopped
using the daily cost of living as a measure of estimating how much a family needs to live
decently. In the process, the government redefined poverty from a level of decent living
to subsistence.
Poverty incidence is still high in Davao del Sur, based in NSO, HES 1991 & 1994
Survey. With almost half of the rural household having an annual per capita income of
less than P7,350 a month. This amount is the minimum required satisfying daily
nutritional requirement (2000 calories) and other basic needs. Remarkably, in urban
areas, poverty incidence declines more than 60%.
The causes of poverty had been traced to unemployment and under employment, brought
about by disparity between available jobs and the number of job seeker, especially
migrant workers from other regions. Moreover, people’s income had not been able to
cope with the escalating cost of basic goods.
11
CHAPTER V -DEMOGRAPHIC CHARACTERISTICS
Population, Size, Growth, Density and Distribution. Based on the 2005 census, Davao
del Sur has a total population of 860,862 an addition of 102,061 people against the 2000
population. The annual growth rate is 2.48. The population of the province is the largest
among cities and provinces of Region XI, or 14.52% of the Region. Among the 15
municipalities/city, Digos has the largest population with 106,565 and a growth rate of
3.20. Padada and Sarangani have the smallest population but ranks 9th and 2nd
respectively in terms of growth rate. Malita and Jose Abad Santos have the highest
growth rate of 3.60 while Magsaysay has a lowest growth rate at 0.56. Most of the
municipalities have an increase growth rates.
Table 7. 2000 Actual Count and 2005 Projected Population, by Municipality
Davao del Sur
Municipality
2000
2005
Growth
Rate
Increase/
1995-2000
2000-2005
Population
Population
Decrease
Bansalan
51781
58,746
1.16
1.24
Inc
Digos
125,171
142,007
3.2
3.51
Inc
Hagonoy
43,871
49,772
0.98
1.07
Inc
Magsaysay
43,172
48,979
0.56
0.6
Inc
Matanao
46,916
53,226
1.52
1.66
Inc
Sta. Cruz
67,317
76,371
2.6
2.82
Inc
Padada
24,112
27,355
1.5
1.61
Inc
Kiblawan
41,275
46,827
2.6
2.75
Inc
Sulop
27,340
31,017
1.02
1.11
Inc
Malalag
33,334
37,818
1.62
1.76
Inc
Sta. Maria
45,571
51,700
1.68
1.81
Inc
Malita
100,000
113,450
3.6
3.96
Inc
Don Marcelino
33,403
37,896
2.2
2.36
Inc
Jose Abad Santos
57,147
64,833
3.6
3.89
Inc
Sarangani
18,391
20,865
2.0
2.16
Inc
TOTAL
758,801
860,862
2.47
2.48
Inc
Davao del Sur has a population density of 202 persons per square kilometers. Magsaysay
is the most densely populated area at 600 persons /sq. km. While, Jose Abad Santos is the
least populated area with 72 people occupying per square kilometer of land.
Table 8. Population Density by Municipality, 2005 Davao del Sur:
Municipality
Bansalan
Digos
Hagonoy
Magsaysay
Matanao
Sta. Cruz
Padada
Kiblawan
Sulop
Malalag
Sta. Maria
Malita
Don Marcelino
Jose Abad Santos
Sarangani
TOTAL
2005 Population
54,369
131,431
46,065
45,331
49,262
70,683
25,318
43,339
28,707
35,001
47,850
105,001
35,073
60,005
19,311
796,749
Area (Sq. Km.)
200.47
317.96
132.19
75.56
173.75
334.74
45.38
182.52
160.87
187.16
167.83
564.02
449.10
835.98
106.48
3934.01
12
Population Density
271.21
413.35
348.48
599.93
283.52
211.16
557.91
237.45
178.44
187.01
285.10
186.17
78.10
71.78
181.36
202.53
Age-Sex Distribution: Taken as a whole, the province’s population is still relatively
young, with almost half of the population aged under 20 (See Table below). Ages 0-9
years old comprise only 28.1% and 10 years old and above constitute 71.9% of the
population. More males than female are living in the province. The population aged
above 65 years is slowly increasing from 2.9 in 1970 to 3.7 in 1985. This can affect the
dependency ratio.
Table 9. Age & Sex Distribution:2005
AGE GROUP
Under 1
1-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80 & above
MALE
10,243
45,188
58,846
57,654
46,942
38,602
33,870
29,908
27,560
23,774
18,942
14 ,238
10,293
8,738
5,922
4,167
2,394
2,257
FEMALE
10,063
43,661
56,585
53,463
44,973
36,549
31,840
28,735
25,816
22,012
17,531
13,096
9,571
8,250
5,661
4,135
2,477
2,417
Davao del Sur
432,036
428,826
13
BOTH SEXES
20,307
88,848
115,431
113,116
91,915
75,150
65,710
58,644
53,375
45,786
36,473
27,334
19,864
16,988
11,583
8,302
4,871
4,674
860,862
Urban-Rural Population: The movement from rural to urban areas (Population
Movement) is well documented, although the extent of their shift may have been
exaggerated. While almost half of population was reported to living in “urban” areas
during the last national census of 2000 the definition of “urban” is actually loose.
Apparently, in the Philippines, a municipality is considered “urban” if it has facilities
from all economic sectors: industrial, agricultural and service. Thus a small town can
still be predominantly agricultural but because it has one factor, it may be classified as
urban.
It is clear, however, that rural-urban migration is taking place because of limited
economic opportunities in rural areas. The government speed toward growth corridors”
and also attracts rural migrants.
One other population movement – much less documented is that of migrants from
lowland areas going to the uplands. Upland areas are defined as those with more than
18% slope.
The large scale of upland migration has resulted in an environmental impact. Together
with deforestation, upland migration hastened soil erosion and soil loss. Traditional
shifting cultivates (kaingin) were displaced and forced upward to areas where land was
even more scarce. These kaingineros often went into kaingin of despair shortening the
rest periods between the cultivation.
Table 10.
Urban-Rural Population by Sex and by Municipality, Davao del Sur, 2005
Total
Munici
Pality
Bansalan
Digos
Hagonoy
Magsaysay
Matanao
Sta. Cruz
Padada
Kiblawan
Sulop
Malalag
Sta. Maria
Malita
Don Mar.
J.A.Santos
Sarangani
TOTAL
Urban
M
F
Both
Sexes
M
F
29485
71273
24981
24583
26714
38331
13729
23502
15567
18981
25948
56941
19020
32540
10472
432067
29261
70734
24791
24396
26522
38040
13626
23325
15450
18837
25752
56509
18876
32293
10393
428795
58746
142007
49772
48979
53236
76371
27355
46827
31017
37818
51700
113450
37896
64833
20865
860862
22114
53455
18735
18437
20039
28748
10297
17627
11676
14236
19461
43706
14265
24405
7854
326955
21946
53050
18594
18297
19888
28530
10219
17493
11587
14128
19314
42382
14157
24220
7795
321600
Rural
Both
Sexes
M
F
44060
7371
7315
106505 17818
17684
37329
6245
6198
36734
6146
6099
39927
6680
6629
57278
9583
9510
20516
3432
3407
35120
5876
5831
23263
3892
3862
28364
4745
4709
38775
6487
6438
85088 14235
14217
28422
4755
1719
48625
8135
8073
15649
2618
2598
648555 108018 104289
Both
Sexes
14686
35502
12443
12245
13309
19093
6839
11707
7754
9454
12925
28362
9474
16208
5216
212307
Age Dependency Ratio. The population of the population age (0-14) and 65 and above
to the economically productive age (15-64) years old is 75 dependents in 2000 census.
This implies that a great proportion of the province’s income is used to provide the basic
needs of the dependents. This is expected, as life expectancy increases, there will be
more geriatric dependents.
Only Hagonoy has a lower dependency ratio of 51 while the rest has more than 65
dependency ratios.
14
Household Number and Size. The total number of household is 148,512 in 2005 with
an average size of 5.36. An increase of 11.6% in the total number of households was
recorded. Padada and Bansalan have the least household size of 5.99 while Sarangani,
Don Marcelino and Jose Abad Santos have 5.1 average household size.
Table 11. Population Density by Municipality, Davao del Sur:
Municipality
Bansalan
Digos
Hagonoy
Magsaysay
Matanao
Sta. Cruz
Padada
Kiblawan
Sulop
Malalag
Sta. Maria
Malita
Don Marcelino
Jose Abad Santos
Sarangani
TOTAL
2005 Population
58,746
142,007
49,772
48,979
53,226
76,371
27,355
46,827
31,017
37,818
51,700
113,450
37,896
64,833
20,865
860,862
Household Number
9,062
21,789
9,262
9,306
9,167
12,871
5,202
6,751
5,816
7,433
10,032
19,853
7,032
11,164
3,772
148,512
House hold Size
5.99
6.03
4.97
4.87
5.37
5.49
4.87
6.41
4.93
4.71
4.77
5.28
4.99
5.37
5.12
5.36
Religion: Religious affiliation is an important consideration when planning health
programs. The 1995 census does show that there are more Protestants now as well as
Iglesia Ni Cristo and an emerging group of Born Again Christians. The actual number of
Born Again Christians may be larger since many will still consider themselves Roman
Catholics or Protestant.
Based on the 1995 NSO data, Davao del Sur has 70% of Filipino are nominally Roman
Catholic with another 25% belonging to Protestant Groups. There are numerous
indigenous groups with varying degrees of integration with Muslims and Christian
neighbors in the face of internal colonization for other Filipino “Christians” groups, there
has been a reassertion of ethnic identity and pride among Muslims and indigenous
people.
Languages: Filipinos often uses the term “dialect” to refer to the different languages in
the country. It is important to clarify that Ilocano, Cebuano, Tagalog are languages not
dialects. The differences between Ilocano and Cebuano, for example are sharp enough to
have them classified as separate languages. A dialect is a distinction made within a
language. These languages belong to the Indonesian (Malayan-Polynesian) family.
The people of Davao del Sur speak 48 languages excluding foreigners who speak their
language like Chinese, English, Hindi/Indian, Indonesian, Italian, Japanese and others.
Statistics in 1990, shows that 69.4 percent of the population speak Cebuano, followed by
Tagakaulo (8.1%), Blaans (6.7%), Manobo (6.4%) and Bagobo (2.4%). Health
information and education / communication campaign remains hampered by the number
of languages. That’s why the health promotion and advocacy should also focus in 23%
of this population or use these languages to enhance coverage of health programs and
projects.
Indigenous People. There are more than 30 indigenous groups found all over the
province. But, in the local survey conducted by the National Commission on Indigenous
People, the number went to 383,864, comprising 51% of the total population.
In Davao del Sur, there are a total of 15,127 households within 104 barangay of Davao
del Sur that belong to indigenous people. These ethnic tribes are Bagobo, Tagacaulo,
Blaan, Klagan, Manobo that are scattered in their ancestral domain of Davao del Sur.
There are no data available for Don Marcelino, Padada, Sarangani and Sulop.
15
In 1991, they comprise 24.8% of the provincial population or over 156,143 people. They
are distinct people with culture, political structure economic system and spiritual beliefs
different from that of the predominant Filipino majority. They trace their ancestral origin
to the land on which they live and their culture are rooted in their land. They are
conscious of their identity as distinct people independent of the colonized, Westernized
and predominant Filipino people.
Table 12. Indigenous People
2005, Davao del Sur
Municipality
Indigenous People Tribe
Number
Bansalan
Digos
Hagonoy
Magsaysay
Matanao
Sta. Cruz
Padada
Kiblawan
Sulop
Malalag
Sta. Maria
Malita
Don Mar.
J.A. Santos
Sarangani
TOTAL
Bagobo
Bagobo-Klagan-Mandaya-Igorot
Klagan-Blaan
Blaan – Bagobo – Igorot
Blaan – Bagobo – Klagan-Manobo-Tagakaulo
Bagobo – Tagakaulo – Blaan
Blaan – Igorot
Blaan
Blaan – Tagakaulo – Klagan- Manobo
Tagakaulo – Blaan
Tagakaulo
Tagakaulo – Blaan – Manobo
Manobo – Blaan
Manobo – Blaan – Mandaya
Blaan – Manobo
9,317
49,797
4,387
25,900
11,726
26,908
723
16,510
820
13,333
36,440
89,968
30,062
51,425
16,548
383,864
% Pop. In
Service Area
Classified as
IPs
18%
40%
10%
60%
25%
40%
3%
40%
3%
40%
80%
90%
90%
90%
90%
51%
Non-Government Organization: There are 42 non-government organizations in Davao
del Sur. Most of these organizations from different sectoral groups and cooperative,
civic and health organization.
16
CHAPTER VI
=
SOCIAL/RESOURCE MOBILIZATION/
INFORMATION RESOURCES
Broadcast and Print Media: Today, television recorded the fastest growth of all mass
communication media. But, radio remains the most accessible broadcast medium in the
province. In 1994, two out of 10 Filipinos are exposed to radio. Radio is more popular
in the rural areas compared to television. Out of 11 televisions operating in the country,
people in the province view only 5 channels. The reasons that most channels have no
clear reception due to mountainous terrain. Some channels are in VHF (very high
frequency) level and no relay station in Davao City.
There are also 3 cable television operators in the province with more than 2,000
subscribers. As to cable television/Dream TV or community antenna television, which
are located in Digos, Malita and Bansalan with all good signals in areas distant from
transmittal or in areas where mountains, tall building or other obstruction impede signal
reception.
There are 370 commercial radio stations operating in the country, there is 1 FM and 1
AM radio station all within Davao del Sur, though coverage’s all limited. Commercial
radio station, both AM & FM based in Davao City can also be heard in Digos due to
higher frequency.
Education. In Davao del Sur, there are 125,259 elementary enrollees; 39,183 high school
students and 7,751 students in tertiary education. Tertiary education includes college,
vocational and 2-year courses. This supports the NDS survey on out-of-school youth.
Worth note taking, 98.1 % of elementary pupils are enrolled in public school; almost
three-fourths of high school students are in public schools but in tertiary level 81.8%
percent of students are in private schools.
There are enough teachers for both elementary and secondary schools in both public and
private schools satisfying the ratio of 40 students per teacher, except in 3 town (don
Marcelino, Malita and Sarangani). As to the number of classrooms, there are enough
classrooms in elementary both public and private, but not in secondary levels wherein the
ratio is 1:58, which far from the standard of 1:40. There are great disparities between
elementary and secondary in participation (98.3 % vs., 14.34 %) almost opposites drop
out rate (.0.2 % vs. 78%, completion rate (52.8% vs. 91.1 %), transition rate and retention
rate. Significantly, elementary cohort survival rate is 52 %. This means that only 52
pupils have reached Grade Vi among the Grade I pupil who were enrolled in Grade I, five
years ago. While secondary education has a cohort survival rate of 91>7 %. The reasons
for these are inaccessible school, far from home, peace and order problem, responsible
/task to take care of younger brothers/sisters, child labor to augment family income.
Discourage because teachers were always absent, late and lack of motivation.
As to tertiary education the enrollment represents only those who enroll in college within
the province. Quite, understandably almost two-thirds of these students are taking
agricultural, business and teaching courses. No data is available to those who are
studying outside Davao Sur.
Non-formal education was implemented in the province. Most of this education is geared
toward income generating activities like dressmaking, bag making, slipper making, wood
lamination and radio, electronics courses, practical electronics and live stock raising.
There are also 20 public and 25 private preschools. Other program /project undertaken
under non-formal education are basic literacy education, functional literacy and
continuing education.





Number of Primary Schools:
Number of Elementary Schools:
Number of Secondary Schools:
Number of Vocational Schools:
Number of Colleges:
Private : 0
Private: 15
Private: 28
Private: 3
Private: 8
17
Public:
Public:
Public:
Public:
Public:
=
=
=
=
=
72
300
41
0
2
Literacy Rate: Davao del Sur’s basic literacy rate from 1994 to 1996 are 91.2%, 9184% and 92.8% respectively per report from the DECS, Division of Davao del Sur.
Gleaning the rates of increase yearly for 3 years, DECS target of increasing Literacy Rate
by 2 percent annually had been minimally achieved. In 2005, basic literacy rate is
95.12% and functional literacy rate of 79.23 %. As of 2000, Bansalan has the highest
literacy rate with 99% while Don Marcelino has a literacy rate of 67%.
18
CHAPTER VII -GENERAL HEALTH MATTERS (HEALTH STATUS)
Births: In 2005, a total of 17,965 births were recorded in Davao del Sur. The crude
birth rate was placed at 20.93 per 1,000 population, the lowest in Region XI. This means
that every 40 minutes, 1 baby is born or every 2 hours, 3 babies are born. But most births
are not reported or registered.
Of these births, most deliveries (80%) were home deliveries and 20 percent were
delivered at health facility, either public or private. Moreover, trained personnel
including trained “hilots” (traditional birth attendants) attended 83.35 percent and about
12.63 percent are still being delivered by untrained hilots/persons. Remarkably, half of
those pregnancies are at risk, 38 percent are normal and rest are unknown, (can’t
determine if at risk or normal type of pregnancy) these unknown have no prenatal care.
Table 13. Birth Attendance by Skilled and Non-skilled Health workers
BIRTH ATTENDANTS
Skilled Health Workers
Unskilled Health Workers
Total
NUMBER
6,225
11,740
17,965
PERCENT
35%
65%
100%
Illness: The health problems of Davao del Sur have essentially remained for the past ten
years, changing only in their ranks, a rigodon of killer diseases. The leading causes of
morbidity are mainly communicable in nature, both preventable and curable. Still,
respiratory and gastro-intestinal infections lead. Significant increases have been reported
for the incidence of acute respiratory infections (ARI), pneumonias, diarrheas, unknown
fever, dengue, wounds, urinary tract infection, hypertension, bronchitis and pulmonary
tuberculosis but at the same time a reduction of malaria was noted.
But this morbidity figures are limited to notifiable diseases and chromic ailments are not
well reported. Health Department’s National Health survey gives more useful
information on common illnesses with some limitations. These limitations are 1) only
chromic cases can be extracted 2) it is dependent on self-reported condition based on
their recall of a diagnosis by a doctor. Despite these limitations, the reported illnesses
give us clues to the magnitude of health problems. Note, that there are gender
deficiencies in the rates. More men reported having tuberculosis, hypertension, peptic
and gastric ulcer. Women, on the other hand, reported more on diabetes, heart diseases,
cancer, anemia and goiter. The rates for rheumatism / arthritis are almost the same for
both sexes.
Table 14. Trend of Morbidity Rate
 Trend of Specific Morbidity Rate in 2000 - 2005
2000
3485.7
2001
4017.04
2002
4372.7
2003
2873.94
19
2004
1685.4
2005
2930.6
Table 15. Ten Leading Causes of Illnesses
 Causes of Morbidity (Rate/100,000 Pop.)
Causes
1
2
3
4
5
6
7
8
9
10
ARI
Bronchitis
Unknown Fever
Pneumonias
Wounds
Diarrheas
UTI
Hypertensions
Dengue Fever
PTB
2005
Number
6932
1754
1641
1527
855
828
827
777
579
411
Rate
807.85
204.34
191.17
177.84
99.6
96.46
96.34
90.52
67.45
47.88
1999-2004 Average
Number
Rate
10658
1336.25
4567
572.59
553
69.33
1708
214.14
10
1.25
2192
274.82
50
6.26
878
110.08
183
22.94
254
31.84
Mortality: The death statistics tends to be more extensive than those for morbidity.
Table 5.4 gives a disturbing picture of the leading causes of death in the province based
on the reported deaths. The diseases listed as top causes are also found in morbidity.
The leading causes are mainly communicable. While communicable diseases accounts
for only 25 percent total of deaths, these deaths should still be considered as needless
since the disease are both preventable and curable.
The RHIS made a distinction between the diseases of the heart and diseases of the
vascular system but it is not being done internationally but rather should be lumped as
cardiovascular disease. It should be noted that while cardiovascular are associated with
industrialized countries, increases can also occur, not necessarily as a sign of
development. For instance, the relationship between poverty, stress and hypertension is
becoming well established.
As for cancers, the leading type is lung cancer and can be attributed to wide spread of
tobacco use. While the number of cigarette smokers is dropping in developed countries,
partly because of strict controls on advertising and better health education, tobacco use is
on the rise in developing countries, where government generally do not impose
restrictions on advertising.
The figures also show some significant changes between 2000 and 2005, notably the
decline in deaths from pneumonias, diarrheal, avitaminosis and nutritional deficiencies
and measles. Remarkably, unknown cases of death still remain number one. The reasons
of this unknown cause are deaths without medical attendance, medico legal cases
unattended or not seen, and circumstances or previous history were unknown. Men
generally have a higher death rate for most diseases. The ranking also differs. Chronic
liver diseases and cirrhosis probably associated with alcohol use constitute a major death
among male but not among female.
Table 16. Crude Death Rate
 Trend of Crude Death Rate in 2000 - 2005
2000
2001
2002
1.94
2.14
2.37
20
2003
2.49
2004
1.94
2005
2.94
Table 17. Ten Leading Causes of Mortality
 Causes of Mortality (Rate/1,000 Pop.) total deaths = 2,532
Causes
2005
1999- 2004 Average
Number
Rate
Number
Rate
1 Heart Disease
810
94.36
157
19.68
2 Cancer, All forms
228
26.56
119
14.91
3 Hypertensive dis.
174
20.27
126
15.79
4 Accidents, All Causes
136
15.84
126
15.79
5 PTB
106
12.34
115
14.41
6 Kidney Disease
105
12.23
57
7.14
7 CVA
94
10.95
57
7.14
8 Assault
89
10.36
121
15.17
9 Diabetes Mellitus
82
9.55
33
4.13
10 Severe Anemia
44
5.12
42
5.26
21
CHAPTER VIII -
MATERNAL AND CHILD HEALTH
Maternal Death: When a woman while pregnant or within 42 days of termination of
pregnancy, irrespective of the duration and the site of the pregnancy, from any cause
related or aggravate to or by the pregnancy or its management, but not from accidental or
incidental causes is maternal death. The main causes of maternal mortality are still postpartum hemorrhage, uterine rupture, placental retention and cerebral anoxia (?). Which
are usually delivered at home by untrained/unrecognized persons. They are all
preventable through proper prenatal care; birth spacing and health education so that
mothers and their relatives could identify the risk factors early enough.
Table 18. Maternal Mortality Rate
 Trend of Maternal Mortality Rate in 2000-2005
2000
2001
2002
2003
0.6
0.4
0.31
0.37
2004
0.54
2005
1.56
Table 19. Maternal Mortality; Main Cause
 Causes of Maternal Mortality (Rate/1,000 LB.)
Causes
1
2
3
Post Partum Hmmhge.
Placenta Retention
Eclampsia
2005
Number
13
8
7
Rate
0.72
0.44
0.38
Child Survival: The process of seeking a health state at birth and in the early months
and years of life suggest a positive definition of child survival. Increases in a survival
ratio in children is better than measuring the decrease in infant and child mortality rate.
Survival rate is the inverted mortality rate. The infant survival rate in 2005 in Davao del
Sur is 6.51 per 1,000 livebirths. This means that 189 out of 200 children will reach age
one and 190 of children age 1 will reach 4 years old. Sad to note, more than third of
these infant deaths occur within the first week after birth, due to condition related to
congenital defects and difficult delivery. The rest of these deaths are mainly caused by
infectious diseases and malnutrition.
The first year of life is the most difficult to handle, but challenges continues throughout
childhood. The toddler years from age 1 to 4 still accounts for 43 deaths in 2005. Again,
the leading causes are preventable and curable for the most part. Respiratory &
infections/disease, malnutrition, cancer form the bulk of disease that claim children’s
deaths. Accident, become a more important cause of death as the child grows older.
Significantly, cancer adds to these deaths. These killers should not be looked as separate
entities for many of them interrelate forming a virus web.
Table 20. Infant Mortality
 Trend of Infant Mortality Rate in 2000 - 2005
2000
2001
2002
2003
5.23
3.94
5.76
6.63
22
2004
6.1
2005
6.51
Table 21. Ten Leading Causes of Infant Mortality
 Causes of Infant Mortality (Rate/1,000 Pop.) Total Deaths = 126
Causes
2005
1999-2004 Average
Number
Rate
Number
Rate
1 Pneumonias
18
1.00
17
0.71
2 Prematurity
12
0.67
7
0.29
3 Sepsis
10
0.56
4
0.16
4 Heart disease
10
0.56
5
0.2
5 Severe Anemia
7
0.39
3
0.12
6 Asphyxia Neo
5
0.28
2
0.08
7 Meningitis
5
0.28
0
0
8 Acute Abdomen
4
0.22
0
0
9 Diarrheas
4
0.22
3
0.12
10 Accidents, All Causes
3
0.17
0
0
Table 22. Child Mortality ( 1- 4 years old)
 Trend of Child Mortality Rate in 2000-2005
2000
0
2001
0.4
2002
0.6
2003
0.63
2004
0.38
2005
1.39
Table 23. Ten Leading Causes of Child Mortality
 Causes of Child Mortality (Rate/1,000 Pop.) Total Deaths = 43
Causes
2005
1999-2004 Average
Number
Rate
Number
Rate
1 Diarrheas
7
7.87
0
0
2 Pneumonias
7
7.87
1
1.21
3 Severe Anemia
5
5.62
1
1.21
4 Heart Disease
4
4.5
1
1.21
5 Accidents, All Causes
4
4.5
2
2.42
6 Hydrocephalus
3
3.37
1
1.21
7 Cancer, All Forms
2
2.25
1
1.21
8 Meningitis
2
2.25
0
0
9 Sepsis
2
2.25
0
0
10 Asphyxia
1
1.12
0
0
Child Nutrition: Operation Timbang in 2005 shows a different picture. Only
undernutrition can be determine. Stunting (inadequate height for age) and wasting
(inadequate weight for height) are not determined. Based on the 1989/90 survey, the
percentage of stunted 7-10 years old children increased over 1987 level, reflecting
survivors of the last economic crisis and emphasizing the need to look at long term
impact of economic recession.
Sharp gender differences exist for nutritional status, indicating that women are
disadvantage from an early age. Women’s nutritional needs are often perceived as being
lower than men’s when in fact their physical activities are as strenuous while certain
physiological states (menstruation, pregnancy, lactation) require added nutrition.
23
Table 23. NUTRITIONAL STATUS
 Nutritional Status of Children Weighed – Year 2005
CLASSIFICATION BY
WEIGHT STATUS
Severely Underweight
Moderately Underweight
Mildly Underweight
Normal
Overweight
NUMBER
PERCENT
933
6,938
27,106
85,872
3,792
0.74
5.5
28.16
68.8
3.04
Table 24. Undernourished Children
 % 2nd & 3rd degree Undernourished Children in 2005
YEAR
2000
2001
2002
2003
2004
2005
NUMBER
8023
8545
9000
8634
7,853
7,871
24
PERCENT
6.71
7.29
7.36
7.09
6.44
6.31
CHAPTER IX
-
HEALTH FACILITIES AND HUMAN
RESOURCES
Rural Health Units and Barangay Health Stations: The importance of rural health
units (RHUs) and barangay health stations (BHSs) is clear and significant for low-income
families. These are considered primary level health facilities where the poor go to these
units for preventive, promotive and curative aspect of health especially maternal and
child health programs.
As of 2005, the number of RHUs & BHSs is 155, but in some areas, there are no rural
health midwives (RHM), only public health nurses (PHNs) who could covered the areas
during immunization and prenatal clinics. This is because of RHMs under the (PHDP)
public health development program) were terminated when the program ended. In Jose
Abad Santos, where most of the PHDP midwives were assigned, no new midwives were
permanently hired, only on contractual basis. Some barangay health stations are manned
by casual RHM who has temporary or casual status of appointment that are political
appointee. This implies that there is certain period of time in a year that these BHS are
not manned, and there is no continuity as to rest of program or projects being undertaken.
The ratio of RHU/BHS to population is 1:3874. If the standard ratio of 1:5,000
population is to be followed, only the city of Digos is below the standard ratio. The 14
municipalities are within the standard ratio. Significantly, in Don Marcelino, item or
plantilla for midwives were created to increase population in hard-to-reach areas or far
flung barangays.
All these figures for health facilities are just that numbers. They indicate availability but
not necessarily functional status or their accessibility. The lack of equipment and staff
also facing in some RHUs/BHS. Another drawback is the construction/location of RHU
besides or in front the hospital /clinic or RHU is located within the hospital
.
Table 25. Number of Main Health Centers (MHCs), Barangay Health Stations (BHSs) &
Private Clinics Per Municipality
Municipality
2002
2003
2004
2005
M* B*
P*
M* B*
P*
M* B*
P*
M* B*
P*
Bansalan
1
14
6
1
14
6
1
14
6
1
14
6
Digos
2
19
3
2
20
3
2
20
3
1
20
3
Don Marcelino
1
8
1
10
1
10
1
10
Hagonoy
1
10
3
1
10
3
1
10
3
1
10
3
Jose A. Santos
1
15
1
5
1
5
1
5
Kiblawan
1
10
1
1
8
1
1
8
1
1
8
1
Magsaysay
1
11
2
1
9
2
1
9
2
1
9
2
Malalag
1
7
4
1
7
4
1
7
4
1
7
4
Malita
1
20
2
1
14
2
1
14
2
1
14
2
Matanao
1
11
1
1
9
1
1
9
1
1
9
1
Padada
1
4
3
1
4
3
1
4
3
1
4
3
Santa Cruz
1
13
2
1
12
2
1
12
2
1
12
2
Santa Maria
1
10
2
1
7
2
1
7
2
1
7
2
Sarangani
1
5
1
4
1
4
1
4
Sulop
1
7
2
1
7
2
1
7
2
1
7
2
Davao del Sur
16 164
31
16 140
31
16 140
31
15 140
31
 M = Main Health Centers
 B = Barangay Health Stations
 P = Private Clinics
Hospitals: This institution is integral to the delivery of services whose function is to
provide health care to the population where the sick or injured persons are given medical
and surgical interventions. It also provides preventive care as well as health promotion
and disease prevention and is also considered as “center of wellness”. Ideally, medical
research and training are also undertaken in hospitals.
In 2005, the province has a total of 44 hospitals, of which 38 hospitals are classified as
primary and 6 as secondary but no tertiary hospitals. Private hospitals numbering to 37
(84%) comprise the bulk of hospital systems while public hospitals comprise only 16%.
25
This implies that the hospital system is largely dependent on the private sectors especially
the middle class and upper classes (with Medicare). Contrary to popular misconception,
government hospitals are also heavily utilized by high-income group due to medical
specialists / experts presence in this institution. This figures excludes a lying-in clinic
that only caters to normal birth deliveries. Table (7.0) shows that at present, the hospital
to population ratio is 1:16,024 while the bed to population is 1:529. (Proliferation of
Medicare Clinics/Hospitals is also subject to abusive claims of hospitals). There is also
maldistribution of hospitals in the province. More hospitals can be found in Digos,
though most towns have at least, 1 hospital in their area. There are no private hospitals in
Don Marcelino, Magsaysay, Jose Abad Santos and Sarangani. Notably, the seriously ill
patients of Sarangani are usually referred to General Santos City due to distance and
availability of diagnostic procedures, facilities and equipment. Hospital Admissions:
Most of the admissions in these facilities are normal deliveries.
Now, all public hospitals in the province were devolved to the provincial government.
Budget constraints and financial difficulties of maintaining hospital operations besieged
the local government. As the cost of maintaining hospitals escalate, the price of
medication and hospitalization also rise. With these constraints, these hospitals are
encouraged to embark in cost cutting measures and cost recovery programs. Hospital
services can only be availed of with fees. Even, charity cases have to hand in cash
“donations”. Moreover, laboratory and radiologic examination fees have increased that
become inaccessible and unaffordable to the poor. Just like any other commodity, money
becomes a prerequisite in getting medical attention in the hospital.
Only 39 hospitals were accredited as of 2005, of the total 32 are primary; 7 are secondary
and 2 are tertiary.
Table 26. HOSPITALS BY SERVICE CATEGORY
 Distribution of Hospitals by Service Category (Public and Private) Yr. - 2005
FACILITIES / SERVICES
TOTAL NUMBER
a. Primary hospitals (10-bed capacity)
32
b. Secondary hospitals (25-50 bed cap.)
7
c. Tertiary hospitals (75-bed capacity)
2
d. In-Patients served during the year
53,257
e. Out Patients served during the year
71,964
Health Manpower: The existing government health workers by category with
corresponding ratios. Though, most municipalities are within the standard ratios, still
others have not increased nor filled up positions for Medical Technologists, Rural Health
Midwives which are needed especially the worsening hospital condition of
inadequate/lack of hospital staff and equipment. Though field workers are essential to
augment the maldistribution of health facility, social inequities in municipalities ensured.
Also list of health worker volunteers that are frontliners in their respective areas, which
are helping health staff, served people of their health rights. Most of them maybe BHW,
BNS or TBAs or hilot. The true sense of volunteerism endangers the role of health
volunteers. They are now receiving monetary remuneration from barangay, municipal or
provincial, which is prone to political maneuvers or became a political issue especially
during election.
Concentration of health professionals, particularly those who are well trained in the cities
and urban areas. The health care of people in many rural areas is left to the paramedical
personnel. The health manpower production and management problem can be traced to
two very important causes. First, is the lack of clear policies on health manpower
development and coherent health manpower planning. Second is the tremendous
economic difficulty the country is facing.
 Emigration to other countries exacerbates the maldistribution problem, with
deteriorating peace and order situation in the rural areas and little opportunity for
professional growth and material improvement; it provides the graduates a better
chance to improve their lot.
26
 Economic difficulties have forced government and private sector to implement cost
containment measures. The government has cut its health budget drastically and
frozen hiring of personnel.
 Total absence of sensible policy on health manpower. The only policy is freedom of
movement. The health professionals have so much freedom and privileges without
corresponding or with so little responsibility toward the community and its members.
Table 27. Health Human Resources
Distribution of Health Human Resource (HHR) in public health by municipality.
Municipality
Bansalan
Digos
Don Mar.
Hagonoy
JAS
Kiblawan
Magsaysay
Malalag
Malita
Matanao
Padada
Santa Cruz
Sta. Maria
Sarangani
Sulop
PHO
Davao del Sur
FIELD HEALTH SERVICES & HOSPITAL SERVICES
PERMANENT HEALTH PERSONNEL Yr. 2002
MD
Dentist
PHN
RHM
Med.Tech.
1
1
3
15
1
1
2
5
22
1
1
1
2
12
1
1
3
12
1
1
1
2
16
1
2
10
1
1
2
13
1
1
2
8
1
2
1
3
24
1
2
12
1
1
2
7
1
1
1
3
17
1
1
1
2
14
1
1
5
1
1
2
8
1
2
6
18
15
42
195
7
 Ratio of HHR to Population (per category of service provider)
Population Yr. 2005
=
860,862
MDs
=
1: 47,826
RHMs
=
Dentists
=
1: 57,390
MedTech
=
PHNs
=
1: 20,497
S Is
=
27
SI
3
4
1
2
2
1
2
2
3
2
2
3
2
2
2
3
35
1:4,415
1:122,980
1:24,596
CHAPTER X
-
HEALTH FINANCING
Sources of Health Expenditures: An intercase study shows that in 1991, health
expenditures in the Philippines amounted to about P23.5 trillion. The 53.3% comes from
private sources, mainly out of the pocket (meaning household funds). The rest came
from public sector and mainly from the health department.
In 1988 and1991 FIES figures shows that 1.7 – 1.8% of family income are allotted or
spent for medical care. A report from the World Health Organization gives slightly
different figure from the ones above but the pattern is similar. We use there WHO
figures for purposes of comparing the Philippines with other countries especially in terms
of the public-private risk.
Health Financing Schemes: Many Filipinos know how disastrous it is to have a major
illness in the family. Years of savings are easily wiped out, even for middle-income
families.
The importance of health financing comes with other figures from the National Health
Survey , showing that it is the lower income groups that will use health-financing
schemes, if it is available. Note, however, that among the poorest, usage of health
financing (when available) is very low, suggesting that there maybe problems in
awareness of the benefits and the ways in which these benefits can be used.
Government Expenditure on Health. We have seen that health expenditures in the
Philippines came equally between public (government) and private (out-of-pocket,
private health insurance) sources. It is not a bad mix when compared to other Asian
countries – even in socialist China, government expenditures now account for only about
60 percent of expenditures. The problem of course is not just the percentages but the
funds that are available from government. Thus, while Thailand’s governmental
accounts for only one fifth of total health expenditures, the amount in absolute terms is
still longer than that spent by the Philippine government.
The government’s medical insurance program, Philippine Health Insurance Corporation
(PHIC), covers the government and private employees, pensioners, and OCW or overseas
contractual workers. MEDICARE PROGRAM II was launched in 1983 to extend
coverage, to include the self-employed. In 1995, Congress passed a National Health
Insurance Law which will take over Medicare functions. It is not clear how the national
insurance scheme can be sustained and how it can overcome problems including fraud
from doctors and hospitals that have plagued Medicare.
As a country becomes more economically developed, government may have more money
to put into health. Capitalist Singapore and Japan for example, pour in large amounts of
money into the public health system.
A problem for countries like the Philippines is that much of the national government
budget continues to be allocated for debt servicing. Debt servicing continues to consume
more than a third of the national government budget.
As of the end of 1994, the Philippines had a total foreign debt of US $38 billion, an
amount that is expected to increase farther in 2005, especially because of the revaluation
of the Japanese Yen (i.e., even if the amount is the same, the cost in terms of US dollars
and the Philippine Peso increases).
Debt servicing is not just a matter of paying off foreign debts. The government also
borrows money locally (to pay off the foreign creditors). Much of debt servicing goes to
these local debts as well.
28
Local Government realation with People’s Organizations, Non-government
Organizations and the Private Sector.
1. Disaster Response Center, Inc. (DIRECT). Objectives of the organization
include the following:
a.
b.
c.
d.
e.
f.
g.
h.
i.
Facilitate and extend immediate relief assistance such as food, clothing,
shelter, medicines/medical services and other basic needs.
Conduct symposia, for a and other informational activities to educate and
raise peoples’ awareness and understanding on disaster-related issues and
problems and enhance their active participation and support;
Document, disseminate and project disaster incidence to draw public
support;
Assist and facilitate disaster victims and vulnerable sectors in setting up
socio-economic projects;
Organize beneficiaries in their respective communities for effective masspreparedness and self-reliance.
Organize disaster committees and peoples’ disaster council in disasterprone areas and peoples’ organizations and initiate in the formation of
support groups and volunteers from the less vulnerable sectors;
Launch comprehensive staff development program to equip and upgrade
knowledge and skills in line with disaster and development work;
General material, financial, technical and moral support locally and
internationally for the disaster victims and vulnerable sectors; and,
Establish and strengthen network, linkages and coordination with other
NGOs and government agencies, peoples’ organizations, groups and
individuals.
2. Oblates of the Divine Mother 01230-6-4 Missionary of Mindanao, Philippines,
Inc. (ODM). Its major areas of concern include the upliftment of spiritual and
physical aspects of a person. Present scope of operation is towards the delivery of
basic services livelihood projects and in the development of local enterprise for
the benefit of the people in the province.
3. United Womens’s Multi-Purpose Cooperative. Its major areas of concern are the
upliftment of economic and social aspects of the people in the province. The
organization’s objectives include:
a.
b.
c.
d.
To encourage thriftiness and savings mobilization among members for
capital formation.
To generate funds in order to grant loans for productive and providential
purposes to its members;
To provide goods and services and other requirements of the members;
and,
To promote the cooperative as a way of life for improving the social and
economic well-being of the people.
29
A SUMMARY OF THE OVERALL HEALTH INITIATIVES OF THE PROVINCIAL
HEALTH BOARD FOR THE PROVINCE
The Provincial Health Board – Province of Davao del Sur, made possible
the issuance of the following resolutions / requests / indorsements / solicitation of
pleges, to wit: (note: 2005 PHB Resolutions)
1. Resolution to support the release of the 1998 Health Development
Program from DOH in the amount of P90,000.00
2. Resolution to support the negotiated purchase for all hospital equipment
repairs to the Hospital Management Services (HMS), Department of
Health, Davao City.
3. Requested for additional appropriation in the amount of P2,430,000.00 to
be incorporated in the Supplemental Budget No. 4 of 1999.
4. Resolution to support enactment of the Anti-Smoking Law of the National
Government and the same to be indorsed to the Sangguniang
Panlalawigan for adoption.
5. Resolution requesting for the issuance of an Executive Order from the
Office of the Provincial Governor creating the task force on Salt Iodization
Program.
6. Resolution supporting the creation of the Anti-Rabies council of the
province.
7. Resolution strongly supporting the launching of Garantisadong Pambata
on April 16, 1999.
8. Resolution strongly supporting the TB program by requiring all
storekeepers, sales boys/ladies, all market vendors, all engaged in the
sale of food stuffs to undergo urinalysis, sputum and stool exams, as
requirements for the issuance of their permits/licenses to do the job.
9. Hon. Carlito Giducos, Sangguniang Panlalawigan – Chairman, Committee
on Health, pledged an amount of P10,000.00 per municipality under the
2nd Congressional District with a sum total of P80,000.00 to be taken from
his 1999 PDF to serve as a seed capital for BHWs in the purchase of
Iodized Salt.
Likewise, Hon. Esther Molina pledged an amount of P5,000.00 per
municipality under the 1st Congressional District with a sum total of
P25,000.00 to be taken from the 1999 PDF.
10. Resolution strongly supporting the PHIC Indigent Program.
11. Resolution for the grant of Honorarium to Dr. Oscar Grajeda, for services
rendered as visiting Pathologist.
12. Resolution strongly supporting the splitting of the position of full time to
part time Medical Specialist to add to the number of consultants in OBGyne, Pedia and Surgery.
30
13. Resolution addressed to the Finance/Appropriation Committee that a
workable, functional and realistic maintenance budget shall be given to
the Provincial Health Office.
14. Requested Hon. Carlito Giducos, Chairman Committee on Health, for the
allocation of P10,000.00 intended for the procurement of additional
Sanitation Toilet Bowls for the municipality of Sulop.
15. Resolution requesting the grant of monthly honorarium to three (3) visiting
Pedia Consultants in the amount of P3,000.00 each.
16. Requested LBAC to formulate guidelines relative to incomplete, late,
wrong deliveries/wrong supporting documents and without approval of the
Food and Drug Regulation Inspector.
17. Resolution requesting for the creation of District Health Board through the
issuance of an Executive Order.
18. Resolution requesting for appropriate budgetary allocation for loyalty
benefits of all devolved personnel.
19. Proposal for the upgrading of Cook I to Cook II as well as Radiation
Technician II to Radiation Technician III.
20. Indorsement to the office of the Governor requesting for appropriation the
amount intended for the registration/issuance and the construction of the
shed parking area for the ERAP Mobile Clinic.
31
G O A LS :

Reduce incidence of communicable diseases, especially ARI, PTB,
Leprosy, Malaria and Schistosomiasis

Strengthen preventive health activities, especially in relation to noncommunicable diseases, such as CVD and Cancer.

Improve operational performance of health resources.

Strengthen linkage with the municipal, district and provincial hospital, as
well as with the NGOs and PO’s.
32
CANCER CONTROL PROGRAM
Cancer is the result of uncontrolled growth of cells in the body. It is a
lifestyle disease and the third leading cause of death in Davao del Sur.
Major goal of the Cancer Control Program is to reduce morbidity and
mortality rate. Late detection and referral are the factors in most cancer deaths.
The major activities of this program are Pap Smear Test among women 25-55
years old, Breast examination for women 30 – 60 years old and advocacy/IEC
campaign.
For year 2005, Pap Smear collection was 7.26%. Pap smear collection is
expected to increase by 5% for the succeeding years. For 2007 – 10.89%, 2008
– 14.5%, and 2009 – 18.15%. Breast Examined in 2005 was 17.17%. It is also
expected to increase by 5% in the following years. For 2007 – 25.75%, 2008 –
34.33% and 2009 – 42.91%.
To meet the goal of the program there is a need to increase coverage of
Pap smear collection and Breast Examination for early detection with adequate
logistics, strengthen information and advocacy campaigns and improve
knowledge, skills and attitudes of health care providers.
33
EXPANDED PROGRAM on IMMUNIZATION
WHEN THE Expanded Program on Immunization (EPI) was first carried
out in the Phillipines in the 1980’s, it covered six vaccine-preventable diseases
that include tuberculosis, diphtheria, pertussis, tetanus, poliomyelitis and
measles. Hepatitis B immunization was later incorporated into the program.
However, the monitoring of fully immunized children (FIC) in the country includes
only those immunization. One dose of BCG, thru consecutive dose of DPT
vaccine, three doses of OPV and one dose of measles vaccine. Hepatitis B
immunization is not yet included in the monitoring of FIC.
FIC coverage has decreased from 90% in 2004 and 89% in 2005. The
municipality with the highest coverage of FIC in Don Marcelino (105%) followed
by Malalag (101%) while the lowest FIC coverage was reported in Malita (76%).
The coverage of more than two doses of tetanus toxoid (TT2+) among
pregnant women in Davao del Sur in 2005 is 57%. The highest percentage of
coverage are Jose Abad Santos (65%) and Sarangani (65%) followed by
Matanao (62%), the lowest coverage are Malita and Kiblawan (50%).
Hepatitis B coverage, Padada got the highest which is 64%, Sulop (51%),
and the lowest is Malita (15%).
There were no cases of Diptheria, Pertussis, Neonatal Tetanus, Measles,
and Polio in Davao del Sur in 2005.
34
CONTROL DIARRHEAL DISEASES
Diarrhea is a clinical syndrome of diverse etiology that kills primarily due
to dehydration. The disease is transmitted from person to person through unsafe
food and water supply and poor hygienic practices.
The main danger of diarrhea, especially among infants and children, is
death due to dehydration and malnutrition. Large amounts of water and salt are
lost during episodes of Diarrhea. The best treatment for diarrhea is Oral
Rehydration Therapy and continued feeding. Around 90% or more of Diarrhea
cases can be successfully treated with this alone.
For the past years, there was significant declined of mortality and
morbidity among all ages. This could be attributed to massive information
campaign on the prevention and control of the disease and sufficient supply of
medicines and logistics.
But recently, a dramatic increase of morbidity and mortality were noted,
not only among all ages but among children as well. Of the total 885 cases
reported in 2005, 50% of which are children, 10 have already resulted to death,
which makes diarrhea as the number 1 killer of children. It also ranked 3 rd on the
morbidity chart for all ages. For this reason, the Provincial Health Office of Davao
del Sur is aiming of reducing mortality and morbidity due to Diarrhea by the end
of 2010.
35
FILARIASIS CONTROL PROGRAM
FILARIASIS is
a
parasitic
infection
transmitted
by
a
mosquito
WUCHERERIA BANCROFTI and BRUGIA MALAYI are the two species that
exists in the Philippines. Mosquito vectors of these parasites includes Aedes,
anopheles and Mansonia.
The infection starts when larvae is transmitted and carried into the blood
through mosquito bites. These larvae will then mature and produce million of
microfilaria where these maybe sucked by another mosquito and transmit to
another human. And the cycle begins again.
The microfilaria live for two (2) years in the body, causing periodic filarial
fever attacks and other manifestations. Although not a killer disease, filariasis is
considered the second leading cause of permanent, long term disability. More
affected are the males and the working age group due to work exposure in the
field.
In 1995, WHO included filariasis as one of eradicable diseases, thus the
shift from control to elimination. In 2000, Mass treatment among endemic
provinces was launched and in 2003, Davao del Sur is included in the program.
The program is for 5 consecutive years covering the entire population excluding
children ages 2 years and below, pregnant and lactating women and the
terminally ill patients.
In 2005, the province have recorded a 52% treatment coverage and
targeted an accomplishment of 80% treatment coverage by the end of 2008.
36
LEPROSY CONTROL PROGRAM
Leprosy is a chronic infectious disease caused by Mycobacterium Leprae
an acid fast-rod shaped bacillus that may infect skin, peripheral nerves, mucosa
of the upper respiratory tract and eye.
Its incubation period ranges from 3 – 15 years. It is acquired through
prolonged exposure and only small proportion of population is affected.
Its diagnosis is commonly based on clinical sign and symptom and rare
instances is there a need to use laboratory and other investigation to confirm
diagnosis of leprosy.
In provincial level the prevalence rate is 0.47 per 10,000 population. This
is the rate at which the level of leprosy is considered eliminated as public health
problem. The case detection rate is 2.67 per 100,000 population which also
continued to decreased.
37
RENAL DISEASE CONTROL PROGRAM (ReDCoP)
Nephrites, nephritic syndrome and nephrosis can be sign of infectious,
systemic condition autoimmune and chronic or degenerative disease affecting
the kidney. They can be hereditary or acquired and maybe secondary to other
leading cause of death manifesting end-stage renal disease (ESRD).
Study shows that around
9,,500 filipinos developed fatal disease of
kidney yearly. Nephrites, nephritic syndrome and nephrosis accounted for 87
registered deaths in 2005. This translates to a death rate of 10.13 per 100,000
population, ranked number 9 in the cause of death in the province. A significant
proportion of ESRD is secondary to the top leading cause of chronic illness in the
country.
In short deaths from renal causes are the consequences of prolonged or
uncontrolled assert of infectious or metabolic agents in the kidneys and are
regarded as degenerative.
On
the
preventive
side,
healthy
lifestyle
promotion
to
control
degenerativwe disease has been set into motion. Heightened awareness on the
ill effects of tobacco smoking, environmental pollutants and abuse of drugs and
medicines fall in the control of renal disease. Success in this effort is expected to
eventually lead to reduction of ESRD.
38
NUTRITION PROGRAM
Malnutrition is considered as world’s number 1 killer as indicated in the
UNICEF 1998 “State of World’s Children Report” which claimed more than half of
all child deaths worldwide.
The problem remains a challenge in the Philippines and is directly or
indirectly responsible for around 60 percent of deaths among children under five
years old. Only 68 percent of children 0-5 years old normal in weight- for- age
using the NCHS/WHO standards (1998 NDHS, FNRI). On the other hand, based
on the 2003 National Nutrition survey, 27.6 percent of the same ages are
underweight and 30 percent are stunted. Low birth babies were about 13 percent
(2003 NDHS). The prevalence rate in Davao Region for malnutrition CY 2005 13
percent among 0-71 months old preschool children. The province of Davao del
Sur has a 16.4% prevalence rate for malnutrition (combined BNVL & BNL).
The government addresses malnutrition through the Philippine Plan of
Action for Nutrition or PPAN. The PPAN is the country’s guide for action for
nutrition improvement to help national government agencies, local government
units,
non-government
organizations,
academic
institutions,
business
corporations, and international organizations align their actions accordingly. Its
ultimate goal is improved quality of life for Filipinos through better nutrition and
improved health and productivity. Various programs that will contribute to
improving food and nutrient intakes, and reduction and prevention of the
incidence and duration of infections will be implemented to achieve the nutritional
goals.
There is a need for program interventions to focus efforts during the age o
to 1 year, a critical period when under-nutrition struck very high. As to anemia,
there was a prevalence rate 0f 66% in the national level. However, no data can
be presented at the local level since not all children have there hemoglobin taken
due to limited supplies. This holds true among pregnant women and therefore,
nutritionally-at-risk and were at risk of delivering low birth weight infants, thereby,
contributing to the problem raised about the high prevalence of undernutrition
among young children.
39
DAVAO DEL SUR PROVINCIAL HOSPITAL LABORATORY
The Davao del Sur Provincial Hospital Laboratory is categorized and
licensed as a tertiary laboratory by the Bureau of health Services and Facilities.
The laboratory is manned by individuals working behind the scenes to provide
the clinical data upon which the diagnostic, monitoring and treatment of the
clinicians are based. These are the medical technologist who are under the
technical and administrative function of a pathologist who is hired in a
consultancy basis.
The laboratory personnel worked on an 8- hour the clock duty and a
minimum of 5 duties in a day shift will suffice. The bulk of patients cattered for the
day, 2 duties in the afternoon and in the night duty.
As in other areas of health care, changes are occurring the system and
will continue to undergo medical restructuring as more complicated technology
emerge. Replacement of instrumentation for the last several years has
progressed towards automation. And as to facilitate efficiency in service, it is
rather a must that improvement be made of the system.
OBJECTIVE: To have a laboratory that will compliment all the necessary
test required by the clinicians in their diagnosis and treatment.
SPECIFIC OBJECTIVE:
1.
To train resident physician on clinical and anatomic pathology
to head and assume the technical and administrative
supervision and control of the activities in the laboratory.
2.
To hire additional/upgrade Med. Techs. To manage the
increasing regulatory, safety and accreditation requirements.
3.
To
train/upgrade
performances
staff
renewed
skills
job
to
improved
satisfaction
quality
and
of
updating
diagnostic procedures.
4.
To upgrade instrument for ease operation and immediate
results.
5.
To increase income and provide immediate services.
40
DSPH LAB.
MANPOWER COMPONENT:
PROPOSAL (ITEMS)
Visiting Pathologist (1)
Pathologist (1)
Medical Technologist II (1)
Medical Technologist III (1)
Lab. Aide (2)
Med. Tech. II (3)
Nursing Aide Item (Med.Tech) (1)
Med. Tech I (3)
JOB Order (Med.Tech) (3)
Lab Tech./Lab Aide (2)
Lab. Aide (Non-Med.Tech.) (1)
Lab. Secretary (1)
41
SCHISTOSOMIASIS
Schistosomiasis is a parasitic disease caused by a blood fluke known as
Schistosoma Japonicum. It is transmitted through an intermediary host, a tiny fresh water
snail identified as Omcomelania Hupensis Quadrasi where the cercaria (infective) stage
comes out. It will penetrate the skin of the host, enter the blood circulation, then to the
liver, and finally in the intestines.
The endemic areas in the Philippines are distributed in 12 regions; affecting 28
provinces including Davao del Sur. Digos City has 3 endemic barangays, namely: Matti,
Colorado, and Igpit with a total endemic population of 4,145. Endemic areas of Hagonoy
are located in barangays Balutakay, Kibuaya, Sacub, San Isidro, and Sinayawan with
5,320 endemic populations.
All attempts were made to implement early diagnosis and prompt treatment
through the Primary Health Care approach in endemic areas using Praziquantel 600 mg
tablets.
The construction and utilization of sanitary toilets in the endemic barangays is
also an effective measure in controlling the disease. 85% of the households were using
sanitary toilets as of December 2005.
Out of the 11 snail sites surveyed, 4 were negative for Schistosoma Japonicum.
Snail control through Environmental Management Modification such as clearing of
drainage and water clogged areas were done in collaboration with the community in areas
where eradication of snails (Omcomelania Quadrasi) is possible.
Continuous IEC activities were implemented to sustain the community’s level of
awareness. Small group lectures and social preparation were undertaken prior to the
conduct of Case Finding to ensure support and active participation of the community.
It is also noteworthy to mention that the municipal mayors of Digos City and
Hagonoy give their all-out support to the program. Effective coordination between the
CHD, PHO, the City Health Office of Digos, the Hagonoy RHU and concerned
barangays is the key factor in lowering down the prevalence rate. Eventually, these
concerted effort, and pooling of resources would achieve the goal of eliminating
Schistosomiasis as a public health problem in Davao del Sur.
42
SOIL TRANSMITTED HELMINTHIASES
Soil Transmitted Helminthiases (STH) or worm infection caused by Ascaris
lumbricoides, Trichuris trichiura, and Hookworms are among the most widespread of all
chronic human infections. They remain a public health problem having the widest
distribution and the highest prevalence rate.
Intestinal helminthes affects the most vulnerable sector of the society – the
children aged 1-12 years old causing decreased physical activity and poor performance in
school. Intervention must be focused on them.
Chemotherapy is a safe and efficient intervention with immediate results visible
to affected clients as it reduces worm burden, worm transmission and chance of reinfection. Thus, treatment of at least 85% of all 1-12 year old children through regular
mass deworming should be done within a 3 year period.
The water and sanitation component serves as the cornerstone in reducing
diseases especially those related to intestinal parasitism.
The adequacy of water is important as its accessibility. It has been stressed that
basic hygiene measures, especially handwashing should not be compromised by lack of
water. Sufficient water should be made available at all times for drinking, personal
hygiene, food preparation, cleaning and laundry.
Promotion of sanitary toilets construction must be continued. Low cost sanitation
technology should be encouraged.
Behavioral change is central to the control of intestinal parasitism. The greatest
culprits in the transmission of worms are the human beings. Worms are transmitted
through poor personal hygiene such as neglecting to wash fruits and vegetables properly,
eating with dirty hands, or not wearing slippers. Those behaviors that reduce the risk of
infections should be reinforced and encouraged to enhance compliance.
Achieved objectives means achieved goal! Reduction of mortality and morbidity
due to STH infection will be evident after the 4 year period.
43
ENVIRONMENTAL SANITATION
The top 10 leading causes of morbidity in Davao del Sur are related to poor
environmental health conditions. Diarrhea, which ranked 3rd, is a disease that has
remained in the top 10 leading of morbidity for the past years. The prevalence of this
disease is clearly linked with environmental conditions.
Household with access to safe drinking water have increased from 80% in 2003 to
83.64% in 2005. After a 4 year period, the province is hopeful that 90% of the
households will have an increase access to safe drinking water supply sources.
Coupled with access to safe drinking water is the issue of access to sanitary toilet
facilities. The percentage of population with access to sanitation facilities has increased
from 60% in 2003 to 64.65% in 2005. More efforts will be exerted so that after a 4 year
period, 80% of the households in the entire province will have access (construction and
utilization) to sanitary toilet facilities.
Food-borne diseases are usually caused by infectious organisms like viruses,
bacteria and parasites, and often manifest as diarrhea. These diseases are transmitted from
person to person by means of soiled hands and food contaminated by human waste
through the oral-fecal route. The incidence of food-borne diseases peaks during rainy
season and is usually high in areas where sanitation and hygiene are poor. In this regard,
the province moved that all food establishments, including food handlers, should comply
with the minimum sanitation standards to ensure greater access of safe food sources.
The Ecological Solid Waste Management Act of 2004 prescribes the exclusive
use of sanitary landfill by 2007 to address the generated municipal solid wastes.
However, the necessary waste management infrastructure has to be put in place to
drastically modify current unsafe and unsanitary practices.
The means of solid waste collection and disposal by households in the province
includes individual burning, municipal garbage collection system, open dumping,
burying, and composting. The most effective means seen is waste minimization.
Hopefully, 75% of the households will practice waste segregation at home.
Health care wastes are classified as hazardous wastes. No landfill facilities for
hazardous wastes are available in the province. As a result, health care waste generators
store their wastes or dispose them either partially treated or untreated. The province aims
to educate and convince health care waste generators to dispose only their wastes through
approved means. 75% of them are targeted to comply after the 4 year period.
The road to change maybe too winding and the process maybe too tiring, but the
Environmental Sanitation Division will stand on its commitment of improving the
environmental health condition of Davao del Sur.
44
SENTRONG SIGLA
The quality of health services in the Philippines varies markedly in the different
parts of the country depending on various factors such as leadership, training, experience,
available resources and networks. There are various efforts in defining safety standards,
clinical practice standards, and health care delivery systems standards to organize these
into an integrated plan in order to create the envisioned impact and lasting benefit to the
citizens.
In 1998, the DOH formulated a five-year strategic plan on Quality Assurance
program with two major strategies: a) certification or recognition of public health facility
using DOH criteria, and b) capability building to install knowledge, attitude and skills in
the same public health facilities on continuous quality improvement.
Sentrong Sigla (Centers of Vitality) is the certification component of the QAP of
the DOH. It is instituted to ensure uniformity and consistency of quality standards for all
health facilities and services. It focused on the accreditation/certification of primary
health care units.
Sentrong Sigla certification will continue to consist of granting SS seals and other
incentives to out-patient health facilities that meet quality standards which currently
consist of total systems criteria (input, process, and output indicators) that emphasize
integrated public health services and basic facility system. Sentrong Sigla certification
includes self assessment by the health facilities and provision of technical assistance and
packages to assist the facilities meet the quality standards.
Technical assistance would be separate from the formal assessment and
certification to ensure that the certification process remains objective.
At present, the province of Davao del Sur has six RHU’s (Digos, Bansalan,
Padada, Kiblawan, Hagonoy, Sta. Maria) with Phase II level I certification. 100% of the 4
RHU’s ( Sta. Cruz, Sulop, Malalag, Malita) which was granted Phase I level I SS seal
before would be the target to be elevated to Phase II level I certification. 60% of the
remaining 5 RHU’s (Matanao, Magsaysay, JAS, Don Marcelino, Sarangani) without
accreditation would successfully meet the basic certification.
The province of Davao del Sur, after a 4 year period, hopes to improve the quality
of outpatient health care and of public services being offered by her 12 SS Phase II level I
certified RHU’s.
45
CARDIOVASCULAR DISEASE PROGRAM
Cardiovascular diseases (CVD) can develop at anytime throughout the individual
life cycle. Congenital Heart disease (CHDs) and malformations can be present at birth,
Rheumatic fever (RF) and Rheumatic Heart Disease (RHD) may set-in during childhood
and adolescence. Arterios clerotic changes in blood vessels may start developing in early
childhood and progress to Hypertension (HPN), coronary artery disease (CAD) or
Ischemic Heart Disease (IHD) which may result into Myocardial Infaction (MI) or heart
attack. Cerebrovascular accident (CVA) or stroke may happen in uncontrolled
hypertension, especially among the elderly.
The development of CVD is multifarious. Some are acquired and some are
inherited. Others are due to environmental causes. Still others are due to cross reactions
with infectious agents like the case RF and RHD. Among the most predominant risk
factors in the development of CVDs are smoking, physical inactivity and obesity.
Lifestyle modification is necessary to prevent and control the development of CVDs.
The Provincial Cardiovascular disease Program aims to reduce mortality rate from
37.62% (2005) to 33.82% by year 2010 for heart disease. Hypertension related mortality
to reduce from 20.27% (2005) to 18.75% by 2010. Reduction of morbidity cases is also
one of the objectives. Most of all, prevention of risk factors such as diabetes mellitus,
obesity, hypertension, smoking place one of the objectives need to be attended. Early
detection of diabetes and hypertension will be given importance by regular BP screening
and FBS screening. Increase number of LGUs to have anti-smoking ordinance in all
public places and increase number of LGUs to adopt physical activity fitness and
promotion of Healthy Lifestyle is aim to be 100% by year 2010.
Efforts will be from all LGUs and other NGOs province wide to obtain these
objectives.
46