The provincial government of Bataan is a good example of how leadership and governance play a vital role in the effective implementation of health programs.
The USAID defined health system governance as governance undertaken with the objective to protect and promote the health of the people. It is composed of elements such as “(1.) setting strategic direction and objectives; (2.) making policies, laws, rules, regulations, or decisions, and raising and deploying resources to accomplish the strategic goals and objectives; and (3.) overseeing and making sure that the strategic goals and objectives are accomplished.”
The World Health Organization (WHO), on the other hand, explained that governance is about “ensuring that a strategic policy framework exists and is combined with effective oversight, coalition-building, regulation, attention to system-design and accountability.”
Michael Angelo Baluyot, nurse epidemiologist of the Bataan Provincial Health Office (PHO), said that their governor spearheaded their health programs and ensured these were cascaded down to the municipal and barangay levels.
Speaking on behalf of Bataan Governor Albert Garcia during the Health for Juan and Juana Forum, Mr. Baluyot said that the governor personally reached out to local chief executives, municipal health officers, and heads of various government offices to secure their commitment to and support for the provincial government’s tobacco control program.
Smoking inside enclosed public places in Bataan, including public vehicles, and other enclosed areas, was strictly prohibited. Selling of cigarettes to and by minors, and in certain places frequented by minors like the vicinity of schools, was likewise prohibited. There was also a province-wide ban on advertising, promotion and sponsorship of tobacco products. Information, education, and communication materials, such as posters and tarpaulins, were developed and placed in strategic public places to promote awareness of the ill effects of smoking.
Smoking cessation counseling sessions were conducted in different municipalities and barangays, which were attended by smokers in the province — including some key officials and police personnel from the municipalities. To monitor tobacco control program compliance, the provincial government relied on citizens’ text messages on alleged violators, which were then relayed to the concerned mayors for appropriate action.
As a result of the Bataan provincial government’s tobacco control program, seven of its local government units (LGUs), three government hospitals, and 20 government offices won a total of 30 awards in the 2017 Red Orchid Awards of the Department of Health (DoH). “This year, Bataan is aiming to win 40 Red Orchid Awards,” Mr. Baluyot said. The annual Red Orchid Awards are conferred by the DoH to recognize cities, municipalities, government offices, and health facilities that are strictly enforcing tobacco control measures. Its panel of judges is composed of representatives from the DoH, the WHO, the Civil Service Commission, the Philippine Ambulatory Pediatric Association, and the Framework Convention on Tobacco Control Alliance Philippines.
Another health program of the Bataan PHO is Malusog na Kawani, Healthy Lifestyle ang Susi, which aims to identify provincial government employees with hypertension and type 2 diabetes and who manage their conditions through medications and a healthy lifestyle.
The PHO provides free blood pressure measurement and fasting blood sugar (FBS) tests once a month. All employees diagnosed with hypertension and diabetes are entered into a registry for monitoring, provided with maintenance medications on a monthly basis, and enrolled in a health club organized by the PHO. They undertake healthy lifestyle changes, which include eating a healthy diet, increased physical activities such as dance class and running, smoking cessation counseling for smokers, and reduction of alcohol intake. These employees are also asked to have regular follow-ups and re-evaluation by the PHO physician.
Indeed, leadership and governance are important building blocks of a health system and crucial in the attainment of Universal Healthcare.
Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines (PHAP). Medicine Cabinet is a weekly PHAP column that aims to promote awareness on public health and health care-related issues. PHAP and its member companies represent the research-based pharmaceutical and health care industry.