by
MARIA CORAZON C. DUMLAO, MD, MPH
Chief, Health Division
Health and Nutrition Center, DepEd
1
Health Situation
Economy
Life
Expectancy: Peso (P)
Currency
: P1,100,654 B
GNP
GDP Mortality: Rate
P1,104,255 B
Infant
Total Exports : $ 2.849 B
Total Imports
: $ 2.867 B
Crude
Death Rate
Education
Maternal
Mortality : 18,730,682
Student
Population
No.
of Schools
: 60,439
Women
pregnant / year
No. of Teachers
: 451,134
OB complications/
Hospitalization
Literacy
Rate
: 95.6
Teacher-Student Ratio
: 1:41
: Males
- 67
: Females - 72
: 29 / 1000Government
Capital
: Manila
: 5.8 / 1000 Head of State : President
System
: 172 / 100,000
: 2.4 M
: 360,000
Population
Unsafe abortions
Population
: 400,000
4th Leading cause of Maternal Mortality
: Induced Abortion
Geography
Land Area
No. of Islands
Mountains
Lakes
: 300,080 sq. km
: 7,107
: Sierra Madre
: Laguna & 58 others
: Presidential
: 84.7 M (2004)
: 115 M (2015)
: 37% below 15 y/o
Urban Population : 48%
Average Size of Households : 5.0
2
Educational System
Free and compulsary – Elementary (6 years)
Free Secondary Education (4 years)
Department of Education
Responsible for the management of basic
educ. (elementary & secondary levels)
Commission on Higher Education
Tertiary level
Technical Education and Skills
Development Authority (TESDA)
Post-Secondary Vocational and Tech.
3
School Population – SY 2003 – 2004 - DepEd
A. Pupils / Students
LEVEL
NO. OF
SCHOOLS
ENROLLMENT
ELEMENTARY
41,267
12,964,475
SECONDARY
7,893
6,034,882
48,160
18,999,357
TOTAL
4
B. Teachers and Non-Teaching Personnel
LEVEL
Teachers
NonTeaching Personnel
ELEMENTARY
337,082
16,699
SECONDARY
119,235
10,901
TOTAL
456,317
27,600
5
Ten Leading Cause of Morbidity 2002
Rate per 100,000
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Diarrheal disease
Bronchitis
Pneumonias
Influenza
Hypertension
TB Respiratory
Disease of the heart
Malaria
Chichen Pox
Measles
Number
866,411
700,105
632,930
502,718
279,992
126,489
52,957
50,869
35,306
23,287
Rate
1134.8
917.0
829.0
658.5
366.7
165.7
69.4
66.6
46.2
30.5
6
Ten Leading Cause of Mortality 1998
Causes
1.
2.
3.
4.
5.
6.
7.
Disease of the heart
Disease of the vascular system
Pneumonia
Malignant neoplasms
Accidents
Tuberculosis (all forms)
Chronic obstructive pulmonary
diseases and allied conditions
8. Diabetes Mellitus
9. Other diseases of respiratory
system
10. Nephritis, Nephrotic
Syndrome and Nephrosis
Number
Rate
55,830
41,380
33,709
32,090
29,874
28,041
76.3
11.7
46.1
43.9
40.8
38.3
14,228
8,819
19.5
12.1
7,516
10.3
7,453
10.2
7
Health Expenditures
 Health Budget US$ 186M (1.5% of total
US$ 1.22B)
– 70.4% Personal Health care Delivery
– 14.1% Public Health Programs
 Share of Health Expenditure (WHO
standard 5%)
1998 - 3.3% to 2001 - 3.1%
8
HIV/AIDS Budget
 2003 US$ 300,000
0.16% of the Dept. of Health budget
0.025% total general appropriation (GA)
 Majority of responses externally sourced
 US$ 8.5M needed every year for strategic
activities of the Third Medium Term Plan
9
Health Care Delivery System
 Decentralized since 1992 (Local Gov’t.
Code)  Health Care devolved to LGU’s
– 1,708 hospitals
 640 government
 1068 private
– 2,045 Rural Health Units (RHUs)
– 13,096 Barangay (village) health stations
10
AIDS Registry – (Institutionalized since
1987)
As of November 2003
–
–
–
–
1953 - HIV +
630 - AIDS
256 - Deaths
6000 estimates
11
12
13
RELEVANT INFORMATION
FROM AIDS REGISTRY
 Predominant Sexual Transmission
 Male to Female ratio of 1:6 to 1
 62% males
 Peak age for female (20-29 years)
 Peak age for males (30-39 years)
 32% of total infected are overseas workers:
39% are seafarers
14

STI reports  mainly come from social
hygiene clinics (SHC)
1993 – 1999  35,500 of STI cases
reported
15
3rd YAFS – Young Adult Fertility and
Sexuality
(YAFS 3) – study by UPPI (University of the
Philippines Population Institute)
Show that young adults have
liberal attitudes on sexuality and
sexual practices
16
Knowledge Survey Among Pupils
(DepEd)
10 - item knowledge test
National Average of 5.3
All below passing average of 75%
17
School Nurse
10%
Teachers
14%
Friends
4%
Others
Doctor
19%
2%
Sisters/Bros.
2%
T.V.
17%
Parents
13%
Radio
8%
Newspapers
8%
Sources of Information on AIDS/HIV:
Elementary Level
18
Knowledge Survey Among H.S. Students
(DepEd)
• 15 item test
• national average is 9.07
• all below ideal passing average of 75% or 11
correct answers
19
Doctor
19%
School Nurse
7%
Teachers
20%
Friends
3%
Parents
10%
Others
1%
Sisters/Bros.
2%
Radio
10%
Newspapers
12%
T.V.
17%
Sources of Information on HIV/AIDS:
Secondary Level
20
TRENDS FOR THE FUTURE
Current low prevalence may be influenced in the
future by the following factors :
Increased mobility of some population groups
A fast growing young population
Persisting knowledge gaps in all groups studied
Low condom use
Needles/syringes sharing
High STI prevalence and high antimicrobial
resistance
Lack of available low cost ARV
Inadequate government support for other
therapeutic agents
High economic impact of AIDS
21
The Philippine Government
Responding to HIV / AIDS
 Creation of Philippine AIDS Prevention and
Control Act in 1998 (Republic Act 8504)
– The law provides a clear basis for policies
and plans to address the problem of
HIV/AIDS
22
• Lead agency in the fight
against HIV/AIDS
• It
coordinates
oversees
and
various
programs and activities
dedicated
to
the
prevention and control
of
HIV/AIDS
in
the
Philippines
23
PNAC Network
– The Council itself, with 26 members as
defined by law.
– The Secretariat of the Council, staffed
primarily by officials and personnel of the
DOH
– The organizations with representation in the
Council, which include 13 government
agencies, 2 leagues of local governments, 2
committees of Congress, 2 medical and
professional organization, and 7 NGOs,
including one for people with HIV/AIDS.
24
PNAC Network
– Cooperating projects assisted by donors
of financed by government.
– Self-financed organizations working in
fields related to HIV/AIDS.
– Voluntarily organized local AIDS councils.
– Local governments undertaking HIV/AIDS
activities.
25
PNAC
The Dynamic structure
2000
 Organizational contraction
 Role expansion
 4 committees
 Scientific Committee
 Committee on Advocacy
 Committee on Education
 Committee on Local Responses
26
Scientific Committee
 Capacity Building of PNAC on Ethical
Guidelines for HIV/AIDS
 Establishment/Institutionalization of STI
surveillance and Behavioral surveillance
systems in the designated local areas of
integration.
 Research and Economic valuation on
STI/HIV/AIDS interventions
27
Scientific Committee
 Evaluation Research on Program
interventions
 Dissemination Fora on HIV/AIDS
situation/programs/issues
 Collection and Compilation/Publication
of the Philippine HIV/AIDS social/biomedical research
 Further research on data gaps
28
Committee on Advocacy
 A network of organizations,institutions and
individuals is regularly interacting in support of the
priorities and targets of PNAC
 Major Media organizations assume responsibility for
educating and informing their audiences about
HIV/AIDS
 The main organized churches and religions in the
country accept their respective responsibility for
educating and informing their members about
HIV/AIDS prevention
29
Advocacy Activities
 World AIDS DAY/Awareness related events
 Candlelight Commemoration
 Formation of a Critical Core of the Most
Aware focused advocacy
–
–
–
–
–
–
Executives/Legislators/Leaders
Health Workers
Employers
Educators
Religious
Civil Society/Vulnerable groups
30
Advocacy Activities
 Media
– Capacity Building of Local media on
HIV/AIDS in the Local Areas of Integration
– Regular Press Briefers/Releases on
STI/HIV/AIDS and Development
– Establishment of Local/Sub national
networks for the Tri-Media
– Production of new communication tools and
materials for STI/HIV/AIDS
31
Committee on Education
 Public and Private tertiary and secondary
formal education programs include adequate
information on HIV/AIDS in the curriculum
training materials including textbooks, teacher
training courses
 Capability building for STI management,VCT
and care and support at the different levels of
the LGUs to ensure the continuum and quality
of care
32
Committee on Education
 Capability building for
Institutions/Organizations in providing
focused STI/HIV/AIDS education
– Groups at Most Risk
– Institutions
 Education (teachers/parents)
 Workplace
 Special Settings
33
Committee on Education
 Training of Social Workers and
Counselors in other related institutions
on HIV/AIDS
 Capacity building of legal and para-legal
personnel on HIV/AIDS rights and ethics
34
Committee on Education
 Instituting HIV/AIDS education in the school
curricula
 DepEd
 CHED
 TESDA
 Training for STI care/ VCT in the Local Heath Settings
 Training for HIV/AIDS Core Teams in the City/Provincial
Hospitals and Selected Private Hospitals
35
Committee on Local Responses
 At least 60% of the local government
jurisdictions are associated with an
active sub-national coordinating
mechanism for HIV/AIDS Prevention
36
Indicators for Local Reponses
Lagging:
HIV+
AIDS
Deaths
Basic Health
Services
OIs
ARVs
Mainstreamed
Coincidental:
STIs
Condom
Use
Counseling
Community based care
Work and
Welfare
Pallative Care
Services
Policy
Structure
STI
and
Behavioral
Focused
IEC
activities
Policy
Structure
Private Sector
Investments in
HIV/AIDS
Policy
Structure
Home Care
Social
Hygiene
Clinic
Services
Voluntary
Counseling and
Testing
Services
Surveillance
Behavioral
Indicators
Leading:
Dempgraphi
cs
HDIs
Institutional
HIV/AIDS
Education
Programs
Workplace
HIV/AIDS
Programs
NGO/CBOCivil Society
Intervention/I
nvestment
37
The Phases of Local Responses
10 ASEP Sites
8 PNAC – TFG
Sites
11/22 Cities
Local Areas of
Integration
8 New
PNAC-UNAIDS
PAF Sites
***Baguio
Angeles
Pasay
Quezon City
Cebu
Iloilo
Gen San
Davao
Zamboanga
***Cagayan de Oro
Laoag
San Fernando
Urdaneta
Dagupan
Batangas
Naga
Butuan
Dipolog
Candon
Gapan
Cabanatuan
Palayan
Munoz
San Jose
Cauayan
Santiago
Baliwag
Sustain
Strengthen
**Bauang
Tarlac
**San Fernando
**San Pablo
Lucena
**Gumaca
**Legaspi
**Tabaco
**Sorsogon
**Matnog
Tacloban
Maasin
Calbayog
Catarman
Catbalogan
**Ormoc
**Lapulapu
**Mandaue
Danao
***Tagbilaran
Dumaguete
Build
Scale-Up
38
2000 – 2004 Medium Term Plan
Five Focus Strategies
Improve care and support for people with
HIV/AIDS through enhanced hospital-based
services, promoting community-based care
and support
for PWHAs,
private
sector
involvement in counseling and treatment
services and increased access to voluntary
counseling and treatment.
39
2000 – 2004 Medium Term Plan
Address
the
specific
needs
of
people
in
prostitution by increasing access to acceptable
and effective STI services for sex workers and
their clients, strengthening the capacity of peer
educators to influence behavioral change, and
intensifying condom social marketing.
40
2000 – 2004 Medium Term Plan
Empower
the
youth
sector
with
correct
knowledge and information on reproductive
health, sexuality and HIV/AIDS; initiate youthfriendly RH services and peer counseling; and
assist young people living with STI/HIV/AIDS.
41
2000 – 2004 Medium Term Plan
Provide protection to migrant workers from
mandatory HIV antibody testing by pushing for
strict compliance to provisions of RA 8504 on
testing and confidentiality.
Increase
awareness
on
HIV/AIDS
in
the
workplace by improving awareness of workers,
medical personnel and union members on
HIV/AIDS, rights and development issues.
42
43
PNAC Plan for 2002-2004
prevention focus (15 - 49) 51% of 80M
 Vulnerable Groups
– PIPS (500,000 - 1M)
– IDUs - 400-500Thou
– 15,000*
– MSMs
– Youth (15-24)
– 15.7M or 20%
– Clients (1-2M)
– Migrant Workers 7.6M
 Institutions
–
–
–
–
DepEd
CHED
TESDA
Special Groups
 AFP/PNP/Prisons
– Workplace
 In Country 31M
44
Department of Education
45
RA 8504
Mandates DepEd to
integrate AIDS
Prevention Concepts
One priority thrust for EFA 2015
46
OBJECTIVES:
Goal: To develop matured and responsible
studentry imbued with desirable
health values which can assist them
in making rational decisions that can
lead to satisfying, productive, and
quality life.
47
OBJECTIVES:
Create awareness on the local and global
situation on AIDS
Inculcate desirable health behavior
Provide pre-and in-service training of
teachers and other school officials
48
OBJECTIVES:
Strengthen parent and community
involvement
Initiate research studies
Institutionalize
education
AIDS
prevention
49
COMPONENTS:
IEC
Co-curricular and Ancillary Services
HRD
Parent Education & Community Outreach
Monitoring, Research & Evaluation
50
Component # 1 - IEC
Development
of
Modules
for
Integration in Science and Health and
Makabayan (sp. Social Studies)
Production of AIDS Sourcebook
Information campaign in schools

students, teachers, parents
51
Component # 2 - Co-Curricular Activities
Campus Journalism

Inclusion of HIV/AIDS
Prevention in school papers
Scouting
Health Services
Student Organizations/Clubs
Guidance and Counselling
52
Component # 3 - HRD
Training of Secondary School Nurses as
Trainors on Life Skills
Training of Teacher Coordinators and
School Health Personnel on Adolescent/
Reproductive Health
Orientation of Sch. Admins. on the Proj.
Training of Teachers on Teaching
Strategies for HIV/AIDS Education
53
Component # 4 - Parent Education
Training of Parents on
Effective
Parenting
Information
dissemination
during
PTCA assemblies
Monitoring of children’s behavior in
coordination with School Guidance
Counsellor
54
Component # 5 - MRE

Conduct
monitoring
surveys,
and
periodic
evaluative
studies
55
FUTURE PLANS
Printing of Modules, Training Manual &
Source Book
Capability Building
MRE
 KAP
Linkages
- UNICEF, WHO, SEAMEO &
ADB, GOs & NGOs, UNESCO
Focusing Resources for Effective School
Health (FRESH) Education on HIV/AIDS
Prevention
56
Not One of Us is as Good
or as
Strong as All of Us
Nobody’s Perfect –
But a Team Can Be
Preventive Education Works
57
Maraming Salamat Po!
58