MHO/ CHO Guide For
Training, Deployment and
Mobilization of Community
Health Teams (CHTs)
Preparing for CHT Mobilization
at the Municipal/City Level
The Municipal Health Officer/City Health Officer
will play a vital role in the Training,
Deployment and Mobilization of Community
Health Teams (CHTs) in his/her Local
Government Unit (LGU). All of the following
activities will have to be immediately
initiated and implemented by the MHO/CHO
prior to the undertaking of the training of the
CHT Management Group and Partners at the
municipal level.
Preparing for CHT Mobilization
at the Municipal/City Level
A.
B.
C.
D.
E.
Assessing the Local Health Situation
Securing Local Support
Organizing, Managing and Sustaining CHTs
Securing the list of NHTS-PR Families
Determining CHT Partner Requirements and
Matching with Families
F. Preparing the List of Health Providers
G. Preparing for the Municipal Level Training of
CHT Partners
Preparing for CHT Mobilization
at the Municipal/City Level
A.
B.
C.
D.
E.
Assessing the Local Health Situation
Securing Local Support
Organizing, Managing and Sustaining CHTs
Securing the list of NHTS-PR Families
Determining CHT Partner Requirements and
Matching with Families
F. Preparing the List of Health Providers
G. Preparing for the Municipal Level Training of
CHT Partners
Assessing the Local Health Situation
WHY?
• To know what to prepare for in terms of what health
risk assessments (HRAs), health use plans (HUPs)
that CHTs will need when CHTs are deployed
• To know which types of providers will need to be
oriented in terms of possible patient load (Section F,
Instructions on Preparing the List of Providers, Page
32)
• To prepare a briefer or health situationer for
presentation to the LCE in order to generate support
for CHT deployment (Section B, Securing Local
Support at the Municipal or City Level, Page 14)
Assessing the Local Health Situation
WHAT?
• top causes of morbidity and mortality;
• number of maternal, infant and under-5
deaths; and
• top three causes of maternal, infant and
under-5 deaths.
The proposed source of information is the FHSIS
from 2009 to 2010. MHO/CHO and the PHN
will fill up the following tables:
TABLE 2. MUNICIPAL/CITY HEALTH DATA ON MATERNAL,
INFANT AND UNDER-FIVE DEATHS, 2008-2010
Municipality/City:_________________________________________________
Province: ________________________________________________________
Date Accomplished: _______________________________________________
Name, Signature and Designation of Person who prepared the table: ____________________
(1)
(2)
(3)
(4)
Health Indicator
Source of
2008
2009
Data
Number of Maternal
Deaths
Top (3) Causes of Death
1.
1.1
1.2
1.3
2. Number of Infant Deaths
Top (3) Causes of Death
2.1
2.2
2.3
3. Number of Under-five
Deaths
Top (3) Causes of Death
3.1
3.2
3.3
FHSIS
Reports
(5)
2010
(6)
Remarks
TABLE 3. MUNICIPAL/CITY HEALTH DATA ON THE
TOP 10 CAUSES OF MORBIDITY, 2008-2010.
Municipality/City:_________________________________________________
Province: ________________________________________________________
Date Accomplished: _______________________________________________
Name, Signature and Designation of Person who prepared the table:
________________________________________________________________
(1)
(2)
(3)
(4)
(5)
Health
Source of Data
2008
2009
2010
Indicator
Top Ten
FHSIS Reports 1.
1.
1.
Causes of
2.
2.
2.
Morbidity
3.
3.
3.
4.
4.
4.
5.
5.
5.
6.
7.
8.
9.
10.
6.
7.
8.
9.
10.
6.
7.
8.
9.
10.
(6)
Remarks
TABLE 4. MUNICIPAL/CITY HEALTH DATA ON THE
TOP 10 CAUSES OF MORTALITY, 2008-2010.
Municipality/City:_________________________________________________
Province: ________________________________________________________
Date Accomplished: _______________________________________________
Name, Signature and Designation of Person who prepared the table:
________________________________________________________________
(1)
(2)
(3)
(4)
(5)
Health
Source of Data
2008
2009
2010
Indicator
Top Ten
FHSIS Reports 1.
1.
1.
Causes of
2.
2.
2.
Mortality
3.
3.
3.
4.
4.
4.
5.
5.
5.
6.
7.
8.
9.
10.
6.
7.
8.
9.
10.
6.
7.
8.
9.
10.
(6)
Remarks
Assessing the Local Health Situation
• Secure from the PHO (c/o Ms. Aurora Doria) the
cleaned data (2010)on the 5 MDG indicators of
the LGU:
– Contraceptive Prevalence Rate (CPR)
– Fully Immunized Children (FIC)
– Facility-Based attendance by skilled birth attendants
– Vitamin A supplementation
– Case Detection Rate (CDR) and Cure Rate (CR) for TB
Assessing the Local Health Situation
 The data will be inculcated in the Letter to the
Community Health Team (CHT) Partner.
 The Local Health Situation can be used as
baseline data to determine improvements in
the local health programs, especially in FPMNCHN and TB programs, that can be
attributed to the CHT activities.
 It can also be used by the MHO/CHO to
convince the LCE on the importance of the
CHTs as part of the health delivery system in
the LGU.
NEXT
•
•
•
•
•
•
•
•
•
•
•
LETTER TO THE COMMUNITY HEALTH TEAM PARTNER
(TO BE MODIFIED BY THE P/M/CHO)
Dear CHT Partner,
The families assigned under your care have long endured the risk of dying from
causes that can be prevented simply by knowing how to go about getting the
medical services they need.
[Insert here the number of maternal, infant and under-five child deaths in the
province/city/municipality. Discuss barriers to health care use and factors
contributing to maternal and child deaths (e.g., financing, physical access to
health providers and health-seeking behaviour of families, information on
available health providers.) Refer to Section A of Preparing for CHT
Organization, Training & Deployment: Guide for MHOs/CHOs.]
Now you have a chance to help these families break these barriers to accessing
health services. As their CHT Partner, your role is to directly communicate with
underserved families --especially those covered by PantawidPamilya --to give
them the information they need to recognize their health risks, plan for their
health, and access the medical services they need. You serve as their link to the
local health system - introducing them to the wide array of services it offers,
giving them real options in health care and enabling them to make informed
decisions about their health.
Preparing for CHT Mobilization
at the Municipal/City Level
A.
B.
C.
D.
E.
Assessing the Local Health Situation
Securing Local Support
Organizing, Managing and Sustaining CHTs
Securing the list of NHTS-PR Families
Determining CHT Partner Requirements and
Matching with Families
F. Preparing the List of Health Providers
G. Preparing for the Municipal Level Training of
CHT Partners
Securing Local Support
1. MHO/Health
CHO will
convey to Assistance
the LCE and other
Navigational
concerned local agencies on the importance of the
CHT,
its navigation
•Giving specifically
families the information
they needfunction,
to maximizein
opportunities
to use
health
services
improving
the
health
status
of poor families; and
what the LGU can do to support their mobilization
•Assisting
families in recognizing health risks and
or
deployment.
managing
risks through
a. The such
MHO/CHO
canhealth
citeplans
the enabling
statutes/policies on CHT mobilization:
•Linking
health providers
- DILGfamilies
MemotoCircular
2011-145and health
emergency
contacts
- Joint Memorandum
Circular No. 2011-0073
(DOH, DSWD, DILG, DepED)
•Guiding families in using their Philhealth benefits
Securing Local Support
1. The MHO/CHO will conduct advocacy
meetings with the SB and the LIGA to gain
support for KP-CHT and request for a
resolution of support and possible funding
for the sustainability of the project, at least
up to 2016.
2. The MHO or CHO is responsible for ensuring
that resources are available to support and
sustain CHT activities in the municipality/
city.
TABLE 5. INVENTORY OF AVAILABLE RESOURCES
FOR THE LGU TO SUPPORT AND SUSTAIN CHT
CHT activity or
Type of Resources (1)
component
needed (2)
Example 1: TA for Training CHT TOT,
the CHT trainors at the
municipal level
LGU level – prototype
training materials and
resource persons.
Source
(3)
DOH –
CHD
Amount/
Data of
Quantity
Access Requirements (5)
availability
(4)
(6)
Good for Letter of request from the
October 15
15
MHO/ CHO to the CHD; follow
trainors
up calls to CHD
Example 2: MNCHN
Grants Money
CHT training
DOH –
and deployment CHD
or TEV support
for CHT
members
PhP
10,000
Example 3: Local Health
budget under MOOE:
MNCHN training fund
CHT training
PhP
50,000
LGU
budget
for
health
Submission of Fund Utilization
Report (FUR) to CHD,
including accomplishment of
Annex C (Template for CHT) in
the DOH Department Order
2011 - 0219
Program of work approved by
the Mayor
As soon as
the FUR is
accepted
As soon as
the program
of work is
approved
Preparing for CHT Mobilization
at the Municipal/City Level
A.
B.
C.
D.
E.
Assessing the Local Health Situation
Securing Local Support
Organizing, Managing and Sustaining CHTs
Securing the list of NHTS-PR Families
Determining CHT Partner Requirements and
Matching with Families
F. Preparing the List of Health Providers
G. Preparing for the Municipal Level Training of
CHT Partners
Organizing, Managing & Sustaining CHTs
MHOs/CHO should ensure the mobilization of CHTs.
RHU - MHO, PHN, RNheals
BHS - RHM
Organizing, Managing & Sustaining CHTs
The CHT Management Group:
1. Punong Barangay – Chairman
2. Rural Health Midwife – Co-chairman
3. Brgy. Chairman on Health – Member
4. Brgy. Nutrition Scholar – Member
5. Others –Purok leaders, etc.- Member
The RHM is not only the co-chairman but also the
frontline service provider in the BHS as well as
the one responsible for collecting, recording and
reporting the FHSIS data.
Preparing for CHT Mobilization
at the Municipal/City Level
A.
B.
C.
D.
E.
Assessing the Local Health Situation
Securing Local Support
Organizing, Managing and Sustaining CHTs
Securing the list of NHTS-PR Families
Determining CHT Partner Requirements and
Matching with Families
F. Preparing the List of Health Providers
G. Preparing for the Municipal Level Training of
CHT Partners
Securing the List of NHTS-PR households
MHO requests
NHTS list from
PHO
MHO
disaggregates
NHTS list by
barangay
MHO
distributes
barangay level
lists to RHMs
for CHTs
Securing the List of NHTS-PR households
The list should be secured as early as possible to
facilitate the identification of the families to
be served by the CHTs in every barangay.
The MHO/CHO should exert effort to get the list
in whatever way possible and wherever the
list is available.
Preparing for CHT Mobilization
at the Municipal/City Level
A.
B.
C.
D.
E.
Assessing the Local Health Situation
Securing Local Support
Organizing, Managing and Sustaining CHTs
Securing the list of NHTS-PR Families
Determining CHT Partner Requirements and
Matching with Families
F. Preparing the List of Health Providers
G. Preparing for the Municipal Level Training of
CHT Partners
Determining CHT volunteer requirements
and matching with families
• How many CHT volunteers are needed?
- Necessary adjustments based on characteristics
of barangay and number of NHTS-PR families
• Who are available for the tasks?
- Mostly active BHWs who will be screened prior
to training. Additional volunteers will have to be
recruited if necessary
• Who are matched to families?
TABLE 6. NUMBER OF REQUIRED CHT
VOLUNTEERS PER BARANGAY
Barangay
Number of Volunteers Characteri Recommen
No. of
No. of
NHTS
needed
stic of
ded
available additional
Households
Barangay
adjusted
CHT
volunteers
number of volunteers
to be
CHT
recruited
volunteers
Ambonao
189
10
High
4
17
None
density
poblacion
Ambuetel
100
5
Difficult
10
14
None
terrain
Lawaan
300
15
long travel
30
15
15
time
Santa
400
20
With
8
12
none
Elena
celphone
network
Riovista
300
15
Has 4Ps
6
5
1
assembly
Determining CHT volunteer requirements
and matching with families
Characteristic of Barangay
1. Barangays with high population density such
as poblacion areas – CHT partner can walk to
the residence or less tha 30 minutes ride: 1 is
to 50 families
2. Barangays with difficult terrain, with minimal
available transportation, long time travel snf
high cost of travel- more tha an hour ride
just to reach 1 family: 1 is to 10
Determining CHT volunteer requirements
and matching with families
Characteristic of Barangay
3. Barangays with available communications
(cellphones and radios) : 1 is to 50 families
4. Barangays with other venues to for
monitoring the families like 4Ps assemblies: 1
is to 50
TABLE 7. ADJUSTED NUMBER CHT
VOLUNTEERS PER BARANGAY
Barangay
Number of Volunteers Characteri Recommen
No. of
No. of
NHTS
needed
stic of
ded
available additional
Households
Barangay
adjusted
CHT
volunteers
number of volunteers
to be
CHT
recruited
volunteers
Ambonao
189
10
High
4
10
None
density
poblacion
Ambuetel
100
5
Difficult
10
30
20
terrain
Lawaan
300
15
long travel
30
15
15
time
Santa
400
20
With
8
12
none
Elena
celphone
network
Riovista
300
15
Has 4Ps
6
5
1
assembly
Determining CHT volunteer requirements
and matching with families
Number of Available CHT Volunteers
The MHO, PHN and assigned Rural Health Midwife in a
barangay will have to evaluate the possible BHWs
who will be trained as CHT Partners:
a. Educational attainment – based on local BHW
Registry (if no registry, just survey BHWs)
b. Dedication to work – based on RHMs evaluation
c. Age – capacity to perform required tasks
* Not all the BHWs will be selected/trained except in
barangays where their number is inadequate.
TABLE 8. LIST OF CHT VOLUNTEERS PER
BARANGAY (SCREENED)
Barangay
assignment
Ambonao
Names of CHT volunteers
Address of CHT volunteer
Ablaza, Norma
Baron, Jennifer
Dela Cruz, Erlinda
Guzman, Rogel
.....
.....
Purok 6, Sta. Elena
10 Rizal St., Poblacion
Mabini St., Poblacion
25 Calle Real, Poblacion
.....
.....
Total
17
Ambuetel
Badoy, Nene
Caluhib, Princess
Dela Paz, Christina
.....
.....
Total
Sitio 8, Purok 7, San Jose
Sitio 9, Purok 8, San Jose
Sitio 7, Purok 9, San Jose
.....
.....
14
Determining CHT volunteer requirements
and matching with families
Number of Available CHT Volunteers
If the recommended adjusted number of CHT
volunteers exceeds the number of available CHT
volunteers, the MHO, PHN and assigned Rural Health
Midwife of the barangay should recruit additional
CHT Partners. (Section C, Criteria for Recruiting Additional
CHT Partners, Page 26)
The total recommended adjusted number of CHT
volunteers is the number of future CHT Partners to
be trained at the municipal level.
TABLE 9. ADJUSTED NUMBER CHT
VOLUNTEERS PER BARANGAY
Barangay
Number of Volunteers Characteri Recommen
No. of
No. of
NHTS
needed
stic of
ded
available additional
Households
Barangay
adjusted
CHT
volunteers
number of volunteers
to be
CHT
recruited
volunteers
Ambonao
189
10
High
4
17
None
density
poblacion
Ambuetel
100
5
Difficult
10
14
None
terrain
Lawaan
300
15
long travel
30
15
15
time
Santa
400
20
With
8
12
none
Elena
celphone
network
Riovista
300
15
Has 4Ps
6
5
1
assembly
Determining CHT volunteer requirements
and matching with families
Matching CHT Partners to NHTS families
The MHO, with the supervising midwives, should be
responsible for matching CHT Partners to NHTS
families, and make the necessary assignments and
adjustments to ensure that the navigational
functions of the CHTs are utilized properly. (Section C,
Allocation of Available CHT Partners to Families, Page 27)
Preparing for CHT Mobilization
at the Municipal/City Level
A.
B.
C.
D.
E.
Assessing the Local Health Situation
Securing Local Support
Organizing, Managing and Sustaining CHTs
Securing the list of NHTS-PR Families
Determining CHT Partner Requirements and
Matching with Families
F. Preparing the List of Health Providers
G. Preparing for the Municipal Level Training of
CHT Partners
Preparing the list of Providers
Accessible to NHTS households
This list is important because it will form part of the
Family Health Guide, the CHT Guidebook and in
filling up the Health Plans (Forms 2A to 2G)
– All available public and private health facilities and
individual providers
– Services offered, professional fees, room and
board rates and cost of treatment for selected
conditions; their address, phone number and
other contact details; operating hours; and the
type of their PhilHealth accreditation.
Health Service Providers
• Hospitals -- e.g. medical centers, regional
hospitals, LGU hospitals, DOH hospitals
• Lying-in clinics
• Outpatient clinics -- e.g. RHUs, private doctor
clinics or private practising midwives.
• Outpatient laboratory and ancillary services
e.g. laboratory units, imaging centers, dialysis
units
TABLE 10. TEMPLATE FOR THE LIST OF HEALTH
PROVIDERS
LIST OF HEALTH PROVIDERS
MUNICIPALITY/MAIN HEALTH CENTER OF ______________ (specify name of municipality/city)
Health Provider
Address/Contact
Information/
Operating Hours
Type of
Facility
Hospital
1.
2.
3.
Lying-in
Outpatient clinic
Outpatient laboratory and ancillary services
PhilHealth
Accreditatio
n
Service Offered/ Schedule/ Rates
Pregnanc
y,
delivery,
postpartu
m
Newbo
rn
FP
Child
care
Chroni Others
c
(1)
cough
Other
s (2)
Preparing the list of Emergency
Health Contacts
This list is important because it will form part of the
Family Health Guide, the CHT Guidebook and in
filling up the Health Plans (Forms 2A to 2E)
– Create a list of emergency health contacts; names,
address, contact number or radio frequency,
including services for transportation to and from
the health facilities.
TABLE 11. SUGGESTED TEMPLATE FOR REGISTRY OF
EMERGENCY HEALTH SERVICE PROVIDERS
Province:
Eastern Samar
Municipality:
San Julian
Emergency need
.
.
Name of Contact
A.
Linda Garcia
(Midwife)
A.
A.
Medical assistance (e.g.,
feeding, emergency care,
medication administra-tion,
ambula-tion, emer-gency
delivery, suturing, etc.)
Transport to health facility
Referral to higher level
facility
Date of Preparation / Update:
Mobile/Landline/
Radio frequency
0917-4567920
October 2011
Address
.
Service cost
No. 25 Rosal St., San
Julian
(Non-working
hours/days)
P600.00 per delivery
(weekends & holidays)
Area covered
San Julian
municipality
Other services: Free
Melinda Santos
(PHN)
0932-2347890
2373 Dahlia St.,
Campidhan, San Julian
Free
San Julian
municipality
Coun. Eric Soler
(for municipal
ambulance)
0918-8752340
No.2 Bougainvillea St.,
San Julian (Nonworking hours/days)
Any point in Samar
and Leyte
June Abesia
(head, tricycle
drivers’ group)
0922-8364660
Pagbabangnan, San
Julian (near St. Clare
Chapel)
Ambulance driver:
P100.00/day
Ambulance use: Free
Gasoline use: replace as
needed
Tricycle fare for 1st 5 km
– P10.00; add P2.00 for
every km thereafter
Dr. Cherry
Santillan
(MHO)
0915-4485290
055-4567892
No. 14 Sampaguita St.,
San Julian
(Non-working
hours/days)
None
San Julian
municipality
Dr. Mark Sales
(PHO)
0922-8376779
055-7658903
125 Campana St.,
Bunacan, San Julian
(Non-working
hours/days)
None
Eastern Samar
San Julian, Dolores,
Taft
Preparing for CHT Mobilization
at the Municipal/City Level
A.
B.
C.
D.
E.
Assessing the Local Health Situation
Securing Local Support
Organizing, Managing and Sustaining CHTs
Securing the list of NHTS-PR Families
Determining CHT Partner Requirements and
Matching with Families
F. Preparing the List of Health Providers
G. Preparing for the Municipal Level Training of
CHT Partners
Preparing for the Municipal Level
Training of CHTs
1.
2.
3.
4.
5.
6.
Determine the training team
Determine trainees’ current capacities
Prepare the FAQ CHT
Prepare the CHT training design
Secure funding for CHT training
Conduct of a separate training-orientation
material for CHT management
7. Organize all CHT training materials and conduct
a dry-run for the CHT training
TABLE 12. TRAINERS’ PROFILE INFORMATION
Name of
Trainor
Age
Educational
Attainment
Current
Designation
Office
Address
Contact No. /
Cell Phone /
Landline
Date Trained
as a CHT
Trainer
Dr. Chito
Mendoza
40
MMD;
Masters in
Public
Health
PHO
Albay PHO,
Athena
Street,
Legaspi
City
09273837547
September
30, 2011
TABLE 13. PROFILE
Name
of
Trainee
Age
Address
OF TRAINEES
Educationa No. of Religion Current
l
Families
PhilHealt
Attainment Covered
h
(if a
member?
trainee is
a BHW)
Maria
del
Barrio
41
1230
Industria
Street,
Pababag
Island, Tawi
Tawi
Grade 5
40
Current/
Previous
Work
Experience
Preferred
Language
for the
training
BHW for
10 years
Visayan
Yes or
No
Muslim
No
(English,
Tagalog,
Visayan or
Others)
THANKS!!!