AOP 2024 Narrative

ANNUAL OPERATION PLAN 2024
EXECUTIVE SUMMARY
I. PLAN DEVELOPMENT
The Annual Operational Plan for Health (AOP) is an important tool for guiding the
allocation of resources towards improving the health of the local population. The AOP
for the province is developed through an orientation/workshop during the Program
Implementation Review. Every barangay is assessed according to their needs by their
respective assigned Midwife and HRH (Human Resources for Health). The results of
these assessments are then consolidated by the municipality through LGU Needs
Investments reports. The development of the AOP also involves Interlocal Health Zone
Meetings and Consultative Meetings with other stakeholders.
Plan Management
The Camiguin Provincial Health System is headed by the Provincial Governor with
the Sangguniang Panlalawigan as the policy-making body. Overseeing the general
operations of the system is the Provincial Health Officer II, who is currently handling the
operations of the Field Health Services and supervises the Catarman District Hospital.
The province has one ILHZ which comprises the five municipalities and the two
hospitals. Overseeing the operation and control of an ILHZ is a management committee
headed by the Provincial Health Officer with the support of the PHO Technical Staff and
PDOHO through its DMOs.
The Provincial/district hospitals, RHUs, and BHSs are the program/project

implementers with the hospital, RHU, and BHS staff at the forefront.
Structures for Plan Implementation
The Local Investment Plan for Health (LIPH) of the province shall be implemented
through the collective efforts of the provincial government and its municipalities with
assistance and collaboration from DOH-ROX.
The Provincial Health Board (PHB) shall oversee the implementation of the AOP.
The Provincial Health Board composition is as follows:
Presiding Chairman: Provincial Governor

Vice Chair: Provincial Health Officer II
Members: Sangguniang Panlalawigan: Committee on Health

PDOHO
Private organization/NGO Representative
Representative/s of Municipalities of PWHS
Municipal Mayors
Municipal Health Officers
Chief of Hospitals
Provincial Finance Committee
Provincial Planning and Development Officer
The PHB shall have the following roles and responsibilities:

 Formulate policies and guidelines for AOP implementation at the LGU
level.
 Approve the Annual Operation Plan
 Ensure the counterpart funds are appropriated in the Annual Budget.
 Recommend systems and processes for better coordination and
implementation of local health service delivery.
 Hold meetings every month to assess the progress of implementation.
The Team shall be supported by Technical Working Groups to review and

recommend solutions to key policies and operational issues presented by the
PHO. The TWG on AOP operations is to be composed of the Provincial Health
Office, Provincial Planning Development Office, Provincial Finance Committee,
PDOHO, PhilHealth Representative, Municipal Health Officers, and NGO/Private
Sector Representative.
The TWG on LIPH Operations will have the following functions:

 Responsible for the operations of the three–year AOP.
 Maintenance of the existing management structure.
 Recommend to the local health board strategies to ensure the smooth
implementation of the plan.
 Review health-related proposals.
 Ensure that the AOP activities support the National Objectives for Health
(NOH), Sustainable Development Goals (SDG), and the Philippine Health
Agenda and,
 Assess the outcomes of the programs identified in the AOP to the needs
of the local constituents through the conduct of regular monitoring and
review of the plan implementation.
The Technical Working Group (TWG) on AOP Financing shall be composed of

the Provincial Planning Development Office, Provincial Health Office, Provincial
Budget Office, Provincial Treasurer, and Provincial Accountant.

The TWG on AOP Financing shall:

 Ensure the sustained financing of key interventions identified in the AOP.
 Integrate operational plans in the local development plans and annual
investment programs of the province and the component cities and
municipalities.
 Facilitate policy and procedural dialogue to discuss key issues and
problems affecting the implementation.
 Review financial management systems, guidelines, and procedures for the
efficient and effective management of AOP resources including reforms to
strengthen procurement, logistics, and warehousing.
 Submit periodic physical and financial accomplishment reports to the
members of the PHB, PICT, and the DOH-ROX.
Financial Management
Grant funds from external sources shall be held in trust to the provincial
government through the office of the Provincial Treasurer. A separate subsidiary ledger
will be handled by an assigned accountant to handle the funds for this particular project.
A Fund Management Information System (FMIS) will be strengthened or developed to
be signed by authorized officials to approve cheques, withdraw and deposit money,
liquidate funds, and other finance-related procedures and activities.
The Expenditures Tracking System will be installed to keep track of the flow of
transactions, and the cash flow and also ensure that funds are properly appropriated,
documented, and early processing of purchases by the end users.
Grant funds shall be disbursed at the provincial level. Municipalities requesting

components of the AOP charged against the sub-allotted funds shall submit the
necessary documents and justification to the province. Upon acceptance, the AOP
Coordinator, which is the Provincial Health Officer II, initiates the acquisition process as
the proponent.
In the case of procurement of equipment and construction materials, the

Government Procurement Service follows Republic Act No. 9184, improving the
operation of the procurement service. Fund allocation will be released every quarter
based on the annual investment program. All expenditures and disbursements are
subject to the existing pertinent accounting and auditing rules, regulations, and policies.
Fund control and monitoring will likewise be handled by the assigned accountant.
II. HEALTH SITUATION OF THE PROVINCE

II-A. HEALTH NEEDS
A. VITAL HEALTH INDICES
A.1 CBR, CDR, IMR, MMR

A total of 1,143 live births were reported and recorded in 2022 with a Crude
Birth Rate (CBR) of 12/1000 population. The figure shows an increase in Crude
Birth Rate (CBR) by 0.36/1000 population from 11.64/1000 population recorded
in 2021.
Table 1 – YEARLY TREND IN VITAL HEALTH STATISTICS RATE

Camiguin 2018-2022
YEAR CBR CDR IMR UFMR MMR
2018 15.01 5.98 14.61 16.8 0.73
2019 14.62 6.24 7.42 8.91 0.00
2020 13.97 5.58 12.31 13.85 0.00
2021 11.64 4.0 4.61 18.45 0.92
2022 12 8.34 6.12 22.75 174.98
Source of Data: PHO Accomplishment Report 2022
Figure 1 - YEARLY TREND IN VITAL HEALTH STATISTICS RATE

CAMIGUIN
200
180
160
140
120
100
80
60
40
20
0
2018 2019 2020 2021 2022
CBR CDR IMR UFMR MMR
There is an increase in Crude Death Rate from 4.0 in 2021 to 8.34 this
year. The data showed that the leading causes of death were lifestyle-related
diseases (e.g., Heart Disease, Hypertension, Cancer, Diabetes Mellitus) with
cardiac death/arrest/arrhythmia being the number one cause of mortality.

Figure 2. Infant Mortality; Neonatal Death Rate; Under-Five

Mortality
25
20
15
10
0
2016 2017 2018 2019 2020 2021 2022
Infant Mortality Rate Neonatal Death Rate Under-Five Mortality Rate
Infant Mortality Rate
The infant mortality rate (IMR) of the province reflects an increase of

1.51/1000LB compared to 2021. There were 8 infant deaths reflecting an Infant
Mortality Rate of 6.12/1000 live births, compared to 2021 with 4.61/1000 live births.
Intensified advocacy, diligent information and education dissemination, focused among
men and women of reproductive age group specifically in the financially challenged
group, done to address the continued presence of a high percentage of Infant Mortality
in the province, has shown a slight negative result as noted in the increase of IMR.
Despite this, the unified and intensified effort of the health sector to focus on some of
the hindering factors like poor referral, low health-seeking behavior, and negative
attitude of pregnant mothers towards early prenatal check-ups should be sustained to
ensure progressive and positive results in the next coming years. Data on prenatal
check-ups reflects that among 1,073 eligible pregnant women only 571 (53.22%) have
undergone quality prenatal care. This implies the importance of health promotion as far
as the Maternal and Child Health program is concerned. Quality prenatal and neonatal
intensive care should be enthusiastically pursued and focused by health personnel.
On the other hand, one should also consider that the actual number of pregnant
women in 2021 was about 40.7% smaller than the eligible population and thus the
actual percentage of quality prenatal check-ups was bigger than the data.
However, complacency is unacceptable in health personnel, instead one should

always be vigilant and proactive to address the problem more effectively.
Maternal Mortality Rate

Though the province consistently has zero maternal deaths since 2010, there
was a dramatic turnout in year 2012 where 0.55 MMR was recorded, then year 2013
came with no recorded maternal death which was sustained in 2014. Unfortunately, in
2015, two (2) maternal deaths were recorded. Acute Blood Loss secondary to Ruptured
Ectopic Pregnancy and Cardiopulmonary Arrest secondary to Hypertensive Vascular
Disease were the cause of maternal death. Year 2016 had one maternal death, while in
2017 with no death. Unfortunately, 2018 had one recorded maternal death which is due
to Status Asthmaticus. We have zero maternal death for last 2 years however by 2021,
we have 1 maternal death due to Hypovolemic Shock Secondary to Acute Blood Loss
Secondary to Uterine Atony. In 2022, we have 2 maternal death due to Intra-abdominal
Infection and Uterine Atony (postpartum).
Table 2: Leading Causes of Mortality

Camiguin 2022
5 YEAR
AVERAGE 2022
NO
CAUSES 2017-2021
.
NUMBE
RATE NUMBER RATE
R
1 Cardiac Death/Arrest/Arrythmia 0 0.00 104 1.11

2 Acute Respiratory Failure 0 0.00 44 0.47
3 Pneumonia 500 6.53 38 0.41
4 Cerebrovascular Disease 37 0.48 37 0.39
5 Chronic Renal Disease 129 1.68 25 0.27
Chronic Vascular Hypertensive Disease 479 6.25 21 0.27
6 Natural Cause of Death 0 0.00 22 0.23
7 Cancer All Forms 231 3.02 21 0.22
Diabetes Mellitus 70 0.91 21 0.22
Septicemia/Sepsis 95 1.24 21 0.22
8 Congestive Heart Failure 95 1.24 19 0.20
Coronary Artery Disease/Myocardial Infection 282 3.68 19 0.20
9 Hypovolemic Shock 0 0.00 11 0.12
Hepatic Encephalopathy 12 0.16 11 0.12
Mortality: Leading Causes
There was a change in the trend of mortality for this year, one hundred four
deaths were due to Cardiac Death/Arrest/arrhythmia. Acute Respiratory Failure came in
second leading cause as it contributes 44 or 0.47/1000. Pneumonia, Myocardial
Infarction, Renal Disease, Cancer all forms, and Sepsis were again in the top ten
leading causes of death.
The causes of mortality drifted to non-communicable diseases which can be

attributed to lifestyle diseases. This further indicates the need to raise people’s
consciousness of healthy lifestyle habits that can prevent and control risk factors in
developing such illnesses. Furthermore, there is a need to invest in healthy lifestyle
promotion and advocacy. On the other hand, communicable diseases such as
Pneumonia which is infectious yet preventable have a notable number of cases. These
calls for thorough scrutiny of the implementation of the program down to the barangay
level which may mean the provision of refresher courses for all health personnel who

are tasked to undertake this program. Additionally, capacitating the community

volunteer health worker on prompt referrals could go a long way.
5 YEAR AVERAGE
2022
NO. 2017-2021
CAUSES Table 3: Leading Causes of Morbidity
Province of NUMBER
Camiguin 2022
RATE NUMBER RATE
ACUTE RESPIRATORY INFECTION/UPPER
1 7012 915.66 1588 169.35/10,000 pop.
RESPIRATORY TRACT INFECTION
2 WOUNDS (all form) 1577 205.89 1164 124.13/10,000 pop.
3 HYPERTENSION 1905 248.72 662 70.60/10,000 pop.
4 PNEUMONIA 1376 179.73 595 63.45/10,000 pop.
5 URINARY TRACT INFECTION 941 122.85 549 58.55/10,000 pop.
6 DENTAL PROBLEM 89 11.67 146 15.57/10,000 pop.

7 ANIMAL BITE 0 0.00 121 12.90/10,000 pop.
8 BRONCHIAL ASTHMA 307 40.06 119 12.69 /10,000 pop.
9 BRONCHITIS 1045 136.48 106 11.30/10,000 pop.
10 ALLERGY (all forms) 286 37.40 104 11.09/10,000 pop.
AGE with MILD DEHYDRATION 240 31.34 104 11.09/10,000 pop.
Morbidity: Leading Causes
Seven out of ten leading causes of morbidity are infectious diseases. For the past
five years trend, infectious diseases like acute respiratory infection, pneumonia, wounds
in all forms, urinary tract infection, and bronchitis have been leading causes of illness in
the province.
The data reflects those infectious diseases still pose a problem. This calls for
municipal LGU support in the purchase of antibiotics as the counterpart to the
province’s allocation. The Provincial Health Office and the CHD- Northern Mindanao
can only support and augment in terms of medicine procurement and luckily the
PhilHealth Per Family Patient Rate greatly helps in allocating funds to improve out-
patient services in all Rural Health Units.
There seems to be a need to focus more closely on the increasing number of

hypertensive patients in the province. Master listing of hypertensive was done in all rural
health units for follow-up and counseling purposes. It is a constant endeavor of health
personnel to motivate people to adopt and maintain a healthy lifestyle through
counseling and lifestyle intervention programs in health facilities, schools, workplaces,
and communities. Through its health promotion component, the health sector is geared
towards institutionalizing and implementing the Healthy Lifestyle Program and
establishing a hypertensive club in every municipality.
B. ATTAINING BETTER HEALTH OUTCOMES

B.1 SUSTAINABLE DEVELOPMENT GOALS 2 -ZERO HUNGER
The malnutrition rate of the province is decreasing in trend for last five years with
a slight increase in the recent year. Currently, malnutrition rate of the province is 5%
based on Operation Timbang Plus 2023. It’s a positive achievement as the national

benchmark is <5 for 2022.Out of the 6,216 children 0-59 months old weighed, there
were 60 children who are severely underweight and were 257 underweight. All fifty-
eight (60) severely underweight children were given supplementary feeding under the
Nutrition program of the province. While underweight children of Catarman, Guinsiliban,
Sagay and Mambajao were fed under MLGU funds. All (60) severely underweight
preschool enrolled under Egg Feeding Program were rehabilitated, while out of the
(257) underweight and pre-school children given supplementary feeding, there were two
hundred two (202) children rehabilitated, representing 75% rehabilitation. Underweight
refers to being underweight-for-age based on the World Health Organization- Child
Growth Standards (WHO-CGS) cutting off points. It is an indicator of acute malnutrition.
Figure 3: PERCENT DISTRIBUTION OF NUTRITION

WEIGHT FOR AGE STATUS BY CATEGORY 2021
0.97 1.95
4.13
Normal
Underweight
Severely Underweight
Overweight
92.95
Source: OPT+ 2023 1st round
Figure 4: PERCENT DISTRIBUTION OF WASTED CHILDREN BY CATEGORY 2023

(Weight for Length/Height Status)
0 1.8 1.1
3
Normal
Wasted
Severely Wasted
Overweight
Obese
92
Figure 5: PERCENT DISTRIBUTION OF STUNTED CHILDREN BY CATEGORY 2023

(Length/Height-for-age Indicator)
2.94 3.19
8.12

Normal
Stunted
Severely Stunted
Tall
85.75
The magnitude and severity of stunting are considered “low” in the province,
according to the Anthropometric Survey of Food and Nutrition Research Institute in
2013. Stunting is being under height-for-age based on WHO-CGS and is an indicator of
chronic malnutrition.
For the last five years, the province has been implementing the new WHO- CGS
guidelines which mandates the use of additional two indicators aside from Weight-for-
age. That is, the province provided refresher courses on WHO-CGS among volunteers
particularly the Barangay Nutrition Scholars since they are the ones tasked to do the
weighing and height measurement of preschool children.
Based on the data gathered as baseline, five hundred five (505) of children,
which is 8.12% of the eligible population are stunted, one hundred eighty-three (183)
2.94 % are severely stunted, one hundred ninety-eight (198) 3.2% are tall using the
length/height-for-age indicator. Consequently, one hundred twenty-nine (129) 2.08%
children are wasted, forty-three (43) .61% are severely wasted, one hundred fifty-one
(151) .94 % are overweight and ninety-six (96) 1.54% are obese using the weight-for-
length indicator. Further, the magnitude of wasting in the province is “low” according to
the latest data gathered through Operation Timbang Plus.
Contributing factors to the decrease in malnutrition rate of the province are;

supervised feeding program, better nutrition practices at home by mothers and others
caregivers who are able to attend nutrition education classes such as PABASA sa mga
Nanay and Caregivers Classes, and Purok household classes too, parents who develop
positive health seeking behavior are those well-informed parents, collaboration with
Provincial Veterinary Office, who provides the fresh milk from the Camiguin Dairy Farm,
as well as other agencies such as Department of Social Welfare and Development and
Department of Agriculture and lastly the active involvement of parents and other
caregivers in the parenting roles and responsibilities towards their children.
B.2 SUSTAINABLE DEVELOPMENT GOAL 3 – GOOD HEALTH AND

WELL BEING
B.2.1 FAMILY HEALTH CLUSTER

NATIONAL IMMUNIZATION PROGRAM
The over-all objective of the program is to reduce morbidity and mortality among
children against the most common vaccine - preventable diseases. The pandemic
brought by the covid-19 virus pose a great challenge against public health sector’s
preparedness against such magnitude of problem. Because of the threat of contracting
the virus and to mitigate the impact of transmission, various health programs were put
at halt because of the lockdown impose by both the national and local authorities.
This is the main reason why our number of children fully immunized decreased
drastically in the year 2020 with a service delivery gap of 25.77% as compared to 2019
and a gap of 36.10% in 2021 comparing to the national benchmark of 95% based on the
eligible population.
Slowly we have gained our fight against covid-19 virus and our partners in the
public health started already to implement face to face routine immunization despite the
ongoing threat of covid-19 virus.
Figure 6. Trend of Children Fully Immunized

95
85
75
65
55
45
Source:35FHSIS PHO Accomplishment of Fully Immunized Child
25
On
15 the other hand, pregnant mothers who received at least two doses of tetanus
toxoid in 52022 are 11.54% which is 1.73% lower than in 2021 which registered 13.27%.
Pregnant women given TT2 plus were listed at 17.33% which is higher by 4.06% than in
CATARMAN GUINSILIBAN MAHINOG MAMBAJAO SAGAY CAMIGUIN NATIONAL
2020. Women who are on their first pregnancy will receive two doses of tetanus toxoid
2019 83.47 85.64 65.83 69.91 88.48 75.6 95
vaccines while the next dose will be given on the next succeeding pregnancy. Although
2020 57.97 42.02 45.05 42.88 69.55 49.83 95
the data showed that we are lagging against the national benchmark, however, there
2021 56.13 40.91 43.54 61.06 82.13 58.9
were no reported cases of neonatal tetanus or pregnant women to have 95
cases of
tetanus.
Figure 7: Pregnant women given TT2 & TT2 plus
90
80 80
80
70
60
52.09
50
40
31.06 29.18
30 27.35 26.17
24.83
20 18.37 ANNUAL OPERATION PLAN 2024
14.81 14.83 13.27
7.58 8.85
10
0
Catarman Guinsiliban Mahinog Mambajao Sagay Camiguin National
TT2 TT2 + Series3
Source: FHSIS Accomplishment of Pregnant women given TT2 & TT2 plus, 2022
Effective implementation of this program depends on serious observance and

prompt reporting of Adverse Events Following Immunization (AEFI), the timely supplies
and logistics by the LGU’s and furthermore strict compliance and commitment of RHU
personnel to cold chain, correct immunization technique and keeping track of all
defaulters. Although we recognized that reaching the national target of 95% is
impossible because of the big difference between the national benchmark and actual
number of livebirths, we are still adamant with our effort to prevent our children from
getting disease which are vaccine preventable.
BREASTFEEDING PROGRAM
For newborn initiated with breastfeeding within 1 hour after birth, the
accomplishment of the province this year is 100% (799) based on the eligible population
of 1,854. Further, 731 infants, 39.43% are exclusively breastfed until six months.
Furthermore, 879 infants, 47.41% were introduced to complementary feeding with
continued breastfeeding. Strengthening of breastfeeding program thru adherence to EO
51 (Milk Code), that includes developing a monitoring plan for Mother-Baby Friendly
Hospital Initiatives (MBFHI) establishing breastfeeding areas, capability-building and
intensifying IEC should be materialized in order to have an excellent or green
accomplishment.
In terms of infants exclusively breastfed, the percentage of infants exclusively

breastfed up to 6 months in 2021 is 1404 (57%) with eligible population of 2,462 as the
denominator. There was an increase of 5% from 52% (1332) in 2020.
Figure 8. Infants Exclusively Breastfeed until 6th months

Camiguin Prov. 57
Catarman
Municipalities
40
Sagay 74
Guinsiliban 41
Mahinog 56
Mambajao
62
0 10 20 30 40 50 60 70 80
Source: PHO Accomplishment of Infants exclusively breastfeed until 6th months, 2018
It is desire of the province that all below 6 months old infants should be
exclusively breast feed as stipulated in E.O. 51- MILK CODE and Infant and Young
Child Feeding program. The accreditation of Camiguin General Hospital as Mother-baby
Friendly Hospital Initiative (MBFHI) and the ongoing preparation of Catarman District
Hospital (CDH) to be accredited MBFHI, manifest our desire and advocacy of fully
implementing the 10 steps to successful breastfeeding in the hospital. The revitalization
of Lactating Brigade in the hospital helps pregnant women in preparation of nursing
their newborns and educate them on the importance of exclusive breastfeeding below
6th months old. We also encourage all Rural Health Midwives, BNS and mother leaders
to conduct bench conference, household class, Pabasa sa Nutrisyon and have Infant
and Young Child (IYCF) counselling in every barangay.
INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS
IMCI is the key strategy in improving child health. This strategy combines
improved management of childhood illness with aspects of nutrition, immunization, and
other important factors influencing child health, including maternal health. The
objectives of this strategy are to reduce death and the frequency and severity of illness
and disability, and to contribute to improved growth and development. The core IMCI
intervention is integrated case management of the 5 most important causes of
childhood deaths, such as acute respiratory infections (ARI), diarrhea, measles,
malaria, and malnutrition.
Based on the Field Health Services Information System (FHSIS) data (hospitals
not included), the province had 21 cases of pneumonia for 0-59 age group, where 100%
were given treatment per IMCI protocol

Figure 9: PNUEMONIA CASES SEEN & TREATED
25
SEEN TREATED
20 21 21
15
15 15
10
5
4 4
2 2
0
Catarman Guinsiliban
0 0 Mahinog Mambajao 0Sagay0 Camiguin
Source of Data: PHO Annual Accomplishment, IMCI Accomplishment- 2021
This year we had a total of 12 cases of diarrhea compared to 9 cases registered

in 2020, with 7 given Oral Rehydration Solution and 5 given ORS/ORT and zinc
supplement. An increase of accomplishment in zinc supplements was attributed to an
increased allocation of budget for this. Zinc supplementation was based on A.O. 2007-
0045 “Zinc Supplementation and Reformulated Oral Rehydration Salt in the
management of Diarrhea among Children”, which was passed by the DOH as zinc
supplementation is recommended by the WHO and UNICEF as an adjunct to the use of
newly formulated ORS. It was proven in the studies that 10-20 mg of zinc for 14 days
reduced the number of episodes of diarrhea within 2-3 months after the
supplementation regimen.
Despite the advent of the IMCI computerized training tool, this did not hinder the
midwives from assessing under-five children effectively using IMCI protocol because of
their vast experience. The augmentation of a younger breed of nurses and Doctors to
the Barrio (DTTB) through the DOH HRH program helps the community health care
workers in their preventive therapy thus reducing under-five morbidity and preventing
death caused by diarrheal diseases.
Figure 10: Diarrheal Cases Seen Given ORT, ORS and Zinc supplement

5
6 7
12
0
5 0
0
1
4 0
1
3
3 5
8
0
2 0
0
1
1 2
3
0 2 4 6 8 10 12 14
ORT W/ZINC ORS SEEN

Source: PHO Annual Accomplishment 2021. Diarrheal Cases Seen Given ORT, ORS and Zinc supplement
IMPROVED MATERNAL HEALTH OUTCOMES
1. MNCHN Core Package of Services
ADMINISTRATIVE ORDER 2008-0029 “Implementing Health Reforms for

Rapid Reduction of Maternal and Newborn Mortality”. This is an articulation of the
following: the current state of health of women and children, the Philippine commitment
to improving the state of health of women and children, the DOH commitment to
implement health reforms to improve the health system’s efficiency, the current focus on
mothers and newborns and the transition to a broader frame of women’s health and
child survival using the Maternal Newborn and Child Health and Nutrition (MNCHN)
Strategy. This A.O. wants to achieve the number 5 MDG Target which is to Improve
Maternal Health and MNCHN Strategy – intermediate results are every pregnancy is
wanted, planned, and supported, every pregnancy is adequately managed, every
delivery is facility-based and managed by a skilled health professional, every mother
and newborn pair secures proper postpartum and postnatal care with smooth transitions
to the women health care package for the mother and child survival package for the
newborn.
For 2022, the province's accomplishment in four antenatal care reaches 53.22%
(571) based on the total number of deliveries of 1154 with a 26.78% service utilization
gap compared to the national benchmark of 80%. Antenatal care with at least four visits
is an important strategy to determine the risk factors associated with pregnancy, it is
also a key to preventing maternal death, and improving pregnancy by determining the
health status of the mother and baby.

Figure 11: QUALITY PRENATAL CARE
Camiguin 50.64
Sagay 96.61
Mambajao 47.31
Mahinog 37.95
Guinsiliban 19.05
Catarman 41.27
0 20 40 60 80 100 120
Figure 11: Source of Data, PHO Annual Accomplishment, 2021 based on eligible population
On the other hand, accomplishment in women with 2 postpartum visits as of this

year is 97.14% (1,121) with a total delivery of 1,154. This data reflects that many of the
women who delivered were visited by the health workers within 7 days of delivery. This
approach was to make sure that the mother and her baby were healthy and that no
complications occurred after delivery. This is also one of the effective strategies to
prevent maternal issues and death.
Figure 12: WOMEN WITH 2 POSTPARTUM VISITS
102
100
100
98
98 98
96 97 97
94
92
90
90
88
86
84
Catarman Guinsiliban Mahinog Mambajao Sagay Camiguin
Source of Data, PHO Annual Accomplishment, 2021: PP women with at least 2 Postpartum Visit
Furthermore, deliveries are mostly done by skilled birth attendants contributing

99.74% (1,022). Midwives 14.12%, physicians 85.01%, public health nurses at 0.61%
and we have a delivery at home assisted by her husband at 0.26%. Pregnancy tracking
and religious visits of the scheduled prenatal check-ups is an important undertaking to
all deliveries are assisted by skilled health personnel.

Figure 13: ATTENDANCE AT BIRTH
0.91
22.64
76.36
MD RHM PHN
Source of Data: PHO Annual Accomplishment 2021: Attendance at Birth
Facility-based deliveries are deliveries in clinics, barangay health stations, rural

health units, lying-ins, birthing clinics, hospitals, and Department of Health licensed
ambulances however the template for reporting provided by the Field Health Services
and Information System categorized the health facilities into public and private only.
Public health facilities are facilities operated and owned by the national government and
local units while the rest are under the private category.
Of the total deliveries, 1,151, or 99.74% were delivered in the public health
facilities while 155 or 13.43% in the private. The high accomplishment is attributed to
the increased awareness of the expectant mother on the importance of delivering in the
health facilities and the decreased burden of financial stress/problems with PHIC
coverage, Medical Assistance Program, increased number of health stations funded by
HFEP, and other financial support extended to indigent patients.
FIGURE 14: PLACE OF DELIVERY
11.73
88.18
Public Private
Source of Data: PHO Annual Accomplishment 2021: Place of Delivery

2. Women’s Health Package
1. Modern Family Planning
The Continuing Current Users of Modern Family Planning Methods in 2022 are 6,418
with Contraceptive Prevalence Rate (CPR) of 29.59% with a service utilization gap of
0.41% against the national target of 30%. A total of 57 New Acceptors, 385 Other
Acceptors, and drop out of 321. With this, among the Artificial Modern FP methods.
Pills-COC still ranks first with 2,699 current users, followed by BTL with 1,059 current
users, close in third is IUD-INTERVAL with 736 users, Injectables placed 4 th with 686,
5th is condom with 242, followed by condom at 6 th with 242, and lastly Implants with a
total of 153 current users. On the other hand, the Natural Modern FP methods such as
NFP-LAM had 760, NFP-SDM 81, NFP- STM 1, and NFP-CM, and BBT at 0 current
users.
A.2.2 INFECTIOUS DISEASE CLUSTER
NATIONAL TUBERCULOSIS CONTROL PROGRAM (NTP)
The burden of Tuberculosis is still a health threat in the province. The prevention
and control of TB lies on the passive case detection of new cases and successful
treatment of those affected. These measures reduce disease transmission and
minimize the physiological and socio-economic impact of TB to the patient, his family
and community.
Per province’s report in 2022 (table below), Camiguin has achieved the 90% Cure
Rate and 90% Treatment Success Rate which achieve the National Target of 90%. But
despite of this, the province still needs to increase the Case Detection Rate because we
only detected 36% which is 54% lower to the National Target of 90%.
Figure 15. Indicators of NTP per Municipality, 2022
120%
100%
80%
60%
40%
20%
0%
Mambajao Mahinog Guinsiliban Sagay Catarman CAMIGUIN
Cure Rate Treatment Success Rate Case Detection Rate

The main factor that contributes to the low Case Detection Rate is poor heath
seeking behavior. People are afraid to seek consultation because they are afraid to
undergo antigen test for COVI-19.
To reach the national target of 90% case detection rate, we plan to visit barangays
with no or low TB case, as well as the barangays with the greatest number of TB cases
to conduct Information Education Campaign and mass sputum collection and
examination. This activity also aims to reduce stigma about the disease. We also plan to
conduct intensified case finding in partnership with Philippine Business for Social
Progress by offering free chest x-ray in the community.
Also, the Provincial Health Office together with the 5 DOTS facilities are preparing
for the full implementation of iDOTS in the province.
NATIONAL AIDS/STI PREVENTION AND CONTROL PROGRAM (NASPCP)
Camiguin as an Island Province is rich with natural wonders that endears to local
and foreign tourists alike, thus making the province fast becoming one of the prime
tourist destinations of the country in the whole world. This is also the dream of which our
local leaders are aiming to provide better income and increase livelihood to the
Camiguinons. With the expected increase tourist influx in the province, Prevention and
Control of HIV in the province is a priority program of the Provincial Government of
Camiguin through the Provincial Health Office. Monitoring and Advocacy is done to
create awareness and responsibility especially in our youths.
As of December 2022, there are already 34 cumulative HIV cases reported in the
province, 3 of them were diagnosed in the year 2021. Fortunately, there was no positive
HIV case in 2022. Cases that were found reactive in the province were assisted and
referred to NMMC Treatment Hub for initiation of treatment. For STI, the province only
had a total of 37 reported cases as reported from Social Hygiene Clinic. Free medicines
and free laboratory work ups are provided free for suspected cases. Social Hygiene
Clinic was also established located at the Camiguin General Hospital. Now that we
already have the facility, we look forward to catch and treat more STI cases in the
province.
Figure 16. STI Cases by Municipality, 2022
40
35
30
25
20
15
10
5
0
Mambajao Mahinog Guinsiliban Sagay Catarman CAMIGUIN
Sexually Transmitted Infection

The National AIDS/STI Prevention and Control Program has collaborated with
National Tuberculosis Control Program. The two programs collaborated to provide
services to those with TB and HIV co-infection. Key activities include provider-initiated
HIV counselling and testing (PICT) for TB patients and screening for TB among people
living with HIV/AIDS.
RABIES PREVENTION AND CONTROL PROGRAM
Table 4. Animal Bite Cases

INDICATOR 2018 2019 2020 2021 2022
ANIMAL BITE CASES 880 1043 955 804 1237
HUMAN RABIES DEATH 0 0 0 0 0
COMPLETION RATE 94% 96% 95% 96% 96%

In Camiguin, the goal is to sustain the province to its Rabies-Free Zone status
since 2012 after the official declaration of the Department of Health and Department of
Agriculture-Bureau of Animal Industry during the World Rabies Day celebration in
Makati City remains a big challenge to us.
Fortunately, for the last fifteen (15) years there had been No Human Rabies
Death noted in the province. Though, animal bite cases had an erratic trend, increasing
this year and decreasing the next year, this would indicate consciousness to seek
consultation. The percentage of treatment completion rate as noted for the last five (5)
years reached the national target of 95%. This may be attributed for our continuous
advocacy on the importance of completing vaccination regimen, regular allocation of
anti-rabies vaccine by the Department of Health and the strong LGU support that
provide enough funds for the Rabies Control Program and maintenance of our Animal
Bite Treatment Center.
DENGUE
Epidemiological data shows changes in the seasonal nature of dengue and continued
high prevalence from 2007 until present, spreading to the whole island, leading to
outbreak proportions, and causing disruption of economic and social activities.
Figure 17. DENGUE CASES IN CAMIGUIN

250
200
150
100
50
0
Mambajao Mahinog Guinsiliban Sagay Catarman
The increase cases of Dengue could be linked to environmental factors, including

climate changes and poor waste management and reconstruction work increasing
mosquito breeding sites in the island as well as increased population movement.
Under the ambit of “reducing the disease burden”, it was concluded that there is
sufficient evidence on the reduction of dengue hemorrhagic fever case fatality rates
through application of standardized clinical management practices to warrant an
acceleration of capacity building and training in this field. Trained health personnel will
then help reduce case fatality rate of Dengue. In addition to delivery of patient care in
government health facilities, there is large but not quantified proportion of patients in the
province who receive treatment at home or from private providers. Hence, better
understanding of disease recognition and initial care in the home and of treatment
seeking behavior and quality of care in the informal as well as the formal health care
systems were also deemed essential. Tools and approaches developed within the
Integrated Management of Childhood Illness framework, wherein all health personnel
were trained, improved quality of care in the home can be applied to dengue.
The Provincial Health office of Camiguin focuses of health education as essential

for the control of diseases such as Dengue, ensuring that community members
understand the mechanisms of infection and the key behaviors or activities that need to
be addressed to prevent the transmission, reduce severe disease and avoid fatalities.
Aksyon Barangay Kontra Dengue (ABKD) was being promoted and sustained in the
province as effective strategy to sustain efforts to fight Dengue. In Camiguin, health
education for dengue control is provided in all Barangay Council with the Teachers and
Barangay Health Workers. The 4’s strategy in the prevention of Dengue is always the
emphasis of the campaign. However, this endeavor was challenged by some factors
like availability and provision of new educational or IEC materials, fund to sustain the
campaign and community participation. Community involvement in the prevention and
control of dengue is essential, but this should be coupled with health education. If health
promotion and education is poorly resourced and not regularly done, the lessons on
prevention do not result in action.
MALARIA CONTROL PROGRAM

The province is able to sustain zero case of Malaria. Though it is not endemic in
the island, preventive measures through vector surveillance are done in coordination
with the Department of Health, Center for Health and Development X. The province thru
the support of the provincial government aims to be declared as Malaria free province in
the next few years.

FOOD-BORNE AND WATER-BORNE DISEASES

Though food borne and water borne diseases were not among the leading causes
of mortality and morbidity in the province, the provincial government invest on
maintaining the water and sanitation in the province at its optimum level. Still the
province faces the threat of emerging communicable diseases and chronic conditions -
all are linked to environmental issues. These include disease conditions that arise due
to unsafe water and food, poor environmental sanitation and hygiene, pollution and
global warming. This is much so during epidemics and disaster events by which the
province has crafted a plan to combat possible occurrence of food borne and water
borne diseases.
LEPROSY CONTROL PROGRAM

Much effort still has to be done to eradicate the stigma of the disease and there is
a need to intensify patient education to increase awareness of the disease. Advocacy
will be pursued to help inform the community about the disease that it can be treated
and that medication is provided free by the government.
FILARIASIS
Though Filariasis is not endemic in the province, its goal is to sustain zero
prevalence by conducting vector control through surveillance with the technical
assistance from Center for Health and Development-Northern Mindanao.
SCHISTOSOMIASIS
Like Filariasis and Malaria, the province is so fortunate that Schistosomiasis is not
endemic in the area. But still its goal is to sustain zero prevalence through regular
conduct of vector surveillance and vector control with the help from Center for Health
and Development-Northern Mindanao technical staff.
EMERGING AND RE-EMERGING INFECTION PREVENTION AND

CONTROL SERVICES (AVIAN INFLUENZA, SARS, ETC)
Since Camiguin has a Roro terminal and an airport in the municipality of
Mambajao connecting Cebu and Bohol, and to mainland Mindanao thru Mahinog and
Guinsiliban, the Province could still be considered at risk because of its prime location
as part of the central nautical highway routes. A Task Force composed of government
agencies and Civil Society Organization has already been organized to manage and
control emerging and re-emerging cases. Regular updates and coordination between
agencies were being made to ensure safety of the residents and to prevent/control the
spread of EREID cases. Furthermore, the Provincial Veterinary Office in coordination
with the Bureau of Quarantines strictly monitored all animals in every port of entry and
exit in the province.
A.2.3 NON-INFECTIOUS DISEASE CLUSTER
LIFESTYLE-RELATED DISEASES
Lifestyle-related diseases have continued to be in the Top Ten causes of

Mortality in the province, as presented in Table 13. Thus, more efforts to identify
possible viable interventions to address this problem, as we all know that this issue is
associated with smoking, alcohol intake, drug abuse, physical inactivity, and other
unhealthy diets and lifestyles. There is a need to advocate for more ways and strategies
to raise awareness to manage such problems. Diabetes and Hypertension clubs
throughout the five municipalities are one of the tools to greatly help in increasing
awareness. Furthermore, the club will be the extension of PHO and RHU not only in
raising awareness but also in other innovative activities to inspire in promoting health to
achieve optimum care and health through health-seeking behavior among these groups.
RENAL DISEASE CONTROL PROGRAM

Kidney month was celebrated every June in each year, to highlight the activity of
simultaneous water drinking was conducted to different elementary and high school
students in the public and private schools. The regular activity that we implemented in
the province was the Dipstick urine screening conducted in both public and private
schools from June to July every year, but only grade one pupils were screened due to
the limited supply of our urine test strips.
The total number of positive patients through laboratory tests province-wide, were
given treatment at their respective RHUs. During the School-Based Immunization
campaign, Dipstick urine screening was also done on 9 and 10-year-old pupils. Those
found positive were also referred to the hospital for a confirmatory test in the laboratory
and the positive after the test were given treatment. Advocacy was done to grade one
pupils before doing the urine screening giving more emphasis on the 11 ways of
preventing Kidney disease. In the community, we conducted advocacy during the
PABASA/IYCF/ Purok Household classes by the RHU staff, NDPs, and RHMPPs. In the
leading causes of morbidity, Urinary Tract Infection rank no. 8 and in mortality rank no,
6 in the province. These results were presented during their classes so that they would
be aware that kidney problem is increasing and the ways of preventing this disease
were emphasized.
NEWBORN SCREENING PROGRAM
RA 9288, an Act promulgating a comprehensive policy and a national system for

ensuring new born screening using the expanded newborn screening filter cards with 28
metabolic disorders. It is an essential, preventive public health program which aims to
identify early new born at high risk for endocrine, genetic metabolic and hematologic
disorders to prevent or reduce disability or serious diseases. The province
accomplished 99.39% in 2018. Province got the lowest unsatisfactory samples of new
born screening which is 0.7% entire region. Hopefully in 2020 the lying in and hospital
will follow the policy of no new born infants discharge without new born screening. In the
province we have one positive case of Congenital Hypothyroidism in the municipality of
Sagay, confirmatory test was conducted at NMMC.
A.2.4. ENVIRONMENTAL HEALTH AND SAFETY SETTING DIVISION
Every year there is an increase in population and household by barangay,

municipality, and province as per NEDA advisory based on birth rate during the year.
For the year 2022, there are 21,326 households in the province, and 17,489 or
82.01% of households with access to basic safe water supply are distributed by level.

For Level III 16,297 households or 93.18%, for Level II 1,104 households, or 6.31% and
for Level I-88 households, or 0.5% and there are still 3,837 households, or 27.9%%
without access to safe access to safe water supply or they are getting drinking water
from doubtful sources.
However, under the new indicator of the Field Health Services Information
System (FHSIS), the households using safely managed drinking water services in the
province have only reached 12,103 households or 56.75% still passed the performance
rating under the FHSIS benchmark of 60%. Hence, the accomplishment passed the
benchmark of FHSIS, it still falls under the green color code of the external benchmark
for the LGU scorecard. Thus, the total number of water sources in the province is 70
sources, distributed to 3 levels, for Level 3 -62 sources, Level II-3 sources, and Level I -
5 sources respectively. The water service providers are the following: 1. Camiguin
Integrated Water Service Cooperative (CIWASCO) 2. Mambajao Water District, 3.
Barangay Water Works Sanitation Association (BWWSA) and Water Refilling Station
(WRS).
In order to increase the percentage of households using safely managed drinking

water services, the Provincial Health Office in cooperation with the 5 Municipal Health
Offices and all Water Service Providers advise them to conduct regular water sources
inspection for any possible contamination as well as monthly Bacteriological
Examination for E-coli detection and regular chlorination to all sample found positive as
well as to all doubtful water sources to ensure safe and potable water supply in the
province and to prevent the spread of water and foodborne diseases. For the year 2022,
the Environmental Health and Safety Setting Division of the Center for Health
Development-Northern Mindanao and the local government unit of Camiguin plan to
achieve household using safely managed drinking water services by 75%.
TABLE 5. STATUS OF WATER SUPPLY SOURCES

HH with Access to Basic Safe Water Supply
HHs using Safely
Projected Managed
AREA No. Of Drinking-water
Level 1 Level 2 Level 3 Services
HHS Total %
No. % No. % No. % No. %

17,48 82.0 0.5 1,10 17,48 82.0 12,10 56.7
CAMIGUIN
21,326 9 1 88 0 4 6.31 9 1 3 5
During the Pandemic time, the Department of Health noted that the number of
barangays to be recognized and declared as Zero Open Defecation (ZOD) free status
are very few or none of the barangays accepted for ZOD declaration due to health
situation in the country.
For the same year 2020, the Department of Health introduces the Philippine
Approach to Sustainable Sanitation (PHATSS) in support to the Community Led Total
Sanitation (CLTS) strategy encouraging all Non-ZOD Free status barangays to be
recognized and declared based on the statistical data of the household with toilet in the
community.
However, to all barangays who were recognized and declared as Zero Open
Defecation (ZOD) free status for the previous years are advised to level up their status
from Grade I to Grade II to those barangays having 100% household with sanitary toilet.
Out of 58 barangays in the province, 51 of which were recognized as, declared and

certified by the Department of Health as Zero Open Defecation Free Status so with the
Municipality of Mambajao as of December 31, 2021 and the province already achieved
88%.
TABLE 6. STATUS OF EXCRETA DISPOSAL FACILITY
HH With Basic Sanitation Facility HHs Using

Pour/Flush Toilet Connected To: Safely
Project
Ventillated Managed
ed No. Community
AREA Improved Sanitation
Of Septic Tank Sewer/Sewe
Total % Pit Latrina Service
HHS rage System
(Vip)
No
No. % % No. % No. %
.
66.0
21,326 17,385 81.52 17,279 99.39 0 0.00 106 0.61 14,081
CAMIGUIN 3

HHs Using Safely HHs With Satifactory
Projecte HHs With Complete
Managed Sanitation Solid Waste
AREA d No. Of Sanitation Facilities
Service Management
HHS
No. % No. % No. %
CAMIGUIN 21,326 14,081 66.03 14,359 67.85 14,359 67.85

Total No. Of Industrial Establishment Total No. Of No. Of Barangay Certified of
AREA Industrial with Sanitary Permit Barangays ZOD Area
Establishment No. % No. %
CAMIGUIN 64 64 100 58 51 87.9
A.2.5 SUPPORT PROGRAMS
ADOLESCENT HEALTH DEVELOPMENT PROGRAM
The Adolescent Health Development Program targets primarily adolescents aged

10-19 years old. To complement the roles of the Council for the Welfare of Children
which serves to protect the rights of children under 18 years old and preventing
pregnancies before the age of 20. Philippines is the third highest teenage pregnancy
rate in the ASEAN, but it is only in the Philippines when rates actually increased.
Camiguin has an erratic trend based on the number of teenage pregnancies in the
province. To address the needs of the adolescent and youth population, the Provincial
Government of Camiguin supported the priority projects and programs of Department of
Health focused on adolescents and youth. A school-based Teen Centers were
constructed in Mambajao NHS and Sagay NHS. Last year, series of activities and
training were conducted for the adolescents as we slowly embracing the new normal
such as:
 Five batches of U4U Facilitators Training for five municipalities

 Peer Educators Training for Potential Adolescent Counselors by DOH and
POPCOM in Coordination with PSWDO and PHO.

 Conducted the Youth Summit to selected Junior and Senior High School
students in the province. The U4U trail activities and an advocacy forum on
common teenage issues faced by our teenagers like Teenage Pregnancy,
Smoking,Drug Abuse, HIV/AIDS, Bullying and Mental Health/Depression were
conducted during the said event in coordination with PSWDO and PHO.
Figure 18. Number of Teenage Pregnancy
No. of Teenage Pregnancy

160
139
140
120 113
103
100
No. Teenage Pregnancy
80
60 54
40
20
0
2019 2020 2021 2022
CHILD INJURY PREVENTION AND MANAGEMENT
All Rural Health units has not implemented the accidents and injuries prevention
and management. Yet this intervention was integrated as part and parcel in other health
programs. The intension of the province is to give emphasis on this concern, yet due to
lack of manpower, this initiative was anchored to all health program especially on
maternal and child health program. As far as hospitals are concerned, both Camiguin
General Hospital and Catarman District Hospital have not yet established a trauma
section. Hopefully this year, with the health facility enhancement program, and this
could be coupled with training on management of accidents/injuries and trauma.
A.2.6. EMERGENCY AND DISASTER PREPAREDNESS

III. HEALTH SERVICE DELIVERY
III A-1. Health Care Facilities and their Geographical Distribution
Table 9. List of Hospital and their respective Location and Level

Hospital Location Level
1. Camiguin General Hospital Lakas, Poblacion Mambajao Level 1
2. Catarman District Hospital Poblacion Catarman Infirmary
Table 10. Health Facilities and Services Rendered

Facility Total Materni DOTS Social Mother- With Rendering PhilHealt
No. ty Accredit Hygiene Baby Breastfee Maternity h
Lying- ed Friendly ding without Accredite
In/MCP Hospital Policy Breastfee d
Implement and ding
ed Implemen Policy
ted
RHU 5 4 4 0 NA 4 0 5
Gov’t 2 1 2 2 0 2
Hosptal
Private 1 NA 1 0 1
Lying-in
III A-2. Service Utilization

BED OCCUPANCY RATIO
Occupancy rate is an indicator of in-patient utilization of the facilities. The DOH

acceptable standard for occupancy rate is 85%.
Table 11. In-patient Utilization

Facility SERVICES UTILIZED
MEDICAL SURGICAL OBSTETRICS- PEDIATRICS
GYNECOLOGY
Camiguin 1578 575 1409 413
General Hospital
Catarman District 319 0 162 742
Hospital
Table 12. Payment Classification by Type of Patients

Facility Pay Patient PhilHealth Indigent Total
Camiguin General 131 3228 46 3615
Hospital

Catarman District 0 626 597 1223

Hospital
Table 13. Field Personnel to Population Ratio

Health Personnel Number Ratio to Standard Ratio
Population/Household
MHO/DTTB 6 1:20,000
LGU Nurse/PHN 7 1:20,000
LGU Midwives/RHM 13 1:5,000
Dentists 1
Dental Aide 3
Medical Technologists 2
Rural Sanitary 5
Inspectors
Active CVHW’s 591
DMO’s 2
NDP’s 58
PHA 7
RHMPP’s 11
PT 1
Pharmacist 1
GAPS- SERVICE DELIVERY
SDGOAL 2: END HUNGER, ACHIEVE FOOD SECURITY AND IMPROVED

NUTRITION AND PROMOTE SUSTAINABLE AGRICULTURE
High National target as compared to actual number of children in the province.

Some DOH-recommended micronutrient supplementation supplies are not readily
available at the local level. Insufficient MLGU funding support for Micronutrient
Supplementation Health promotion activities not sufficient to support the implementation
of nutrition program
SDGOAL 3: ENSURE HEALTHY LIVES AND PROMOTE WELL-BEING FOR ALL

AT ALL AGES
REDUCTION OF CHILD MORTALITY

1. High national target as compared to number of children in the province.
2. Training & updates for new hired personnel on IMCI & EINC.
3. Strengthened catch-up immunization for missed and defaulter on routine
immunization for children under 5 years old
4. Still in the process of accreditation for MBFHI.
5. MNCHN ordinance still for adoption in some municipalities.
IMPROVEMENT OF MATERNAL HEALTH OUTCOMES

1. There are mothers who still prefer home delivery
2. Increase teen-age pregnancy
3. Most of pregnant women have their prenatal check-up on the 2nd or last
trimester of pregnancy
4. PHO has no data on the unmet needs of the province as to municipal/barangay
distribution.
5. MNCHN ordinance still for adoption of the 3 municipalities
6. Increase the numbers of new acceptors for modern family planning method.
DENTAL SERVICE
1. Lack of dental manpower specially dentist to implement dental health programs
2. Not fully functional dental units in RHUs and Hospitals
COMBAT HIV, AIDS, MALARIA, NTP AND OTHER DISEASES

HIV/AIDS PREVENTION AND CONTROL PROGRAM
1. Inadequate/lack of information of key affected population
2. Poor health seeking behavior due to social stigma
TB PREVENTION AND CONTROL PROGRAM

1. All microscopist are contractual
2. Poor health seeking behavior due to social stigma
3. Low Case Detection Rate
PREVENTION AND CONTROL OF LIFESTYLE-RELATED NON-COMMUNICABLE

DISEASES
1. Lack of IEC materials on promoting good nutrition with healthy diet, physical activity
and other healthy lifestyle activities.
2. Insufficient funds to support the implementation of activities on non- communicable
programs.
3. Insufficient funds to support drugs and medicine for the members of the club to all
municipalities.
4. Lack of legal local legislations.
Health Services for Elderly and Indigent Senior Citizen
1. Some Senior citizens did not submit for vaccination especially the 4P’s for fear,
personal reasons and belief.
Health Services for Mentally-Challenged Clients
1. Some mentally ill patients still roaming in the street

2. Lack of Legal Legislations
Health Services for Adolescent and Youth

1. Most of the Grade 1 and 7 parents of the enrollees refused immunize their children
due to the Dengvaxia issue.
2. Some teachers or school administrators were quite hesitant to support the activity
because of the Dengvaxia issue.
REDCOP
1. Inadequate budget allocation for REDCOP in the province and no budget

allocation in the five Municipalities
2. Health Personnel are not trained in Urine Screening
Accidents and Injuries Prevention and Management
1. Lack of Information campaign.

2. No implementation in the municipal level
3. No RHU personnel coordinator
ELIMINATION AND CONTROL OF INFECTIOUS DISEASES
RABIES PREVENTION AND CONTROL PROGRAM

1. Presence of defaulters due to financial constraints
2. Lack of Implementation of Provincial/Municipal Ordinance and also on the
Responsible Pet Ownership.
3. Trained CGH Nurses on animal bite management cannot focus in ABTC because of
lack of manpower so they have to duty to patients wards on shifting schedules.
NATIONAL LEPROSY CONTROL PROGRAM
1. Inability of patient to seek consultation due to stigma

2. Some health care providers are not yet trained on the new MOP
DENGUE PREVENTION AND CONTROL PROGRAM
1. Irregular activities of Barangay Dengue Task Force

2. Some of the LGU fail to formulate IRR for full implementation of Dengue Prevention
and Control Ordinance
SDGOAL 4: ENSURE ACCESS TO WATER AND SANITATION FOR ALL
1. Irregular Monitoring of Drinking Water Quality for E-coli and Coliform Count.
2. Absence of Water Microbiological Equipment for Water Analysis.

3. Absence of Local Drinking Water Quality Monitoring Committee Organization in the
Municipality/Barangay.
4. Some LGU's lack of support to purchase toilet bowls (sitting type).
5. Some of the household without toilets depends on Government dole outs.
6. Some of the household did not practice the waste segregation techniques at home.
SDGOAL 5: TAKE URGENT ACTION TO COMBAT CLIMATE CHANGE AND ITS

IMPACT
DISASTER AND EMERGENCY PREPAREDNESS AND RESPONSE

1. Personal Protective Equipment (PPE), medicines, equipment, and other logistics
not available at all times
2. Lack of training on Nutrition in Emergencies and Mental Health Psychosocial
Support.
3. Lack of manpower/heath personnel during emergencies and disasters.
4. Lack of training for the personnel handling the program.
5. Lack of funds for the needed training for the province.
SURVEILLANCE AND EPIDEMIC MANAGEMENT SYSTEM

1. Lack of computer equipment to sustain the reporting system including internet
connection.
B. SITUATIONAL GAPS ANALYSIS
A. GAPS IN HEALTH FINANCING_ ________________________________________
Health financing is how financial resources are being generated, allocated and
used in health systems. It refers to the function of a health system concerned with the
mobilization, accumulation and allocation of money to cover the health needs. Despite
of the critical budgeting of the Local Government unit on health care services, problems
and gaps are inevitable.
The Province of Camiguin has been greatly affected by the health crisis brought
by the COVID19 pandemic. Despite of the limited resources of the province, the
provincial government is working so hard to implement mitigating measures and tailored
plans and responses to recover from the crisis and ensure financial risk protection to
those Camiguingnons who are financially incapacitated and challenged.
The SERBISYONG PPR PROJECT, a Social Services Program of the Provincial

Government of Camiguin, could extend medical, educational, transportation and burial
assistance to the people of Camiguin. Part of the Serbisyong PPR project, a five million
pesos (Php 5,000,000.00) were allocated for drugs/medicines and cash assistance to
patients need MRI, mammogram, chemotherapy and 2d echo procedures outside the
island province.
The two hospitals, Camiguin General Hospital and Catarman District Hospital
fully implemented the No Balance Billing but several gaps were identified in the
implementation such as delayed procurement of drugs/medicines and other logistics.
Financially incapacitated and challenged patients availed the Point of Care, Medical
Assistance for Indigents Patients (MAIP) Program from Department of Health,
Department of Social Welfare and Development, Philippine Charity Sweepstakes Office
through the establishment of a Functional Malasakit Center in Camiguin General
Hospital. The province also received financial assistance from our political leaders and
legislators namely: Congressman Jurdin Jesus M. Romualdo, Senator Christopher
“Bong” Go, Senator Ronald Dela Rosa and Senator Sonny Angara.
As the Province of Camiguin is in the preparatory phase for the forthcoming

implementation of Universal Health Care, our main goal is to institutionalize as well as
implement KonSulTa package of PhilHealth to among our Rural Health Units and
Provincial Hospital as primary care providers in collaboration with our core referral
hospital, Camiguin General Hospital. The major gap are as follows: current information
system, poor internet connection, manpower and software to be used in the electronic
medical record. May this undertaking helps reduce the financial burden of our patients
and entice the people to have a positive health seeking behavior in the future and seek
early consultation when they experience symptoms of a perceived disease.
Health allocation among LGUs still falls short of the National Benchmark of 20%.
Allocation on health, municipalities averages 6-10% only. Though at the provincial level
budget is 24% much higher compared to municipalities but still not be able to hit the
national target because the national target for province level increases from 22% to
25% as indicated in the LGU Scorecard.
TABLE 14. Status of Appropriations, Allotments and Obligations for Health Services (Provincial Health Office,
Camiguin General Hospital and Catarman District Hospital) I, Provice of Camiguin, 2019, 2020 & 2021.
OBJECT OF EXPENDITURE ACTUAL 2019 ACTUAL 2020 ACTUAL 2021
PS 73,527,479.41 80,315,266.13 77,234,382.37
PHO 7,892,489.16 8,743,688.68 7,413,413.13
CGH 56,173,022.25 62,270,449.07 60,193,168.59
CDH 9,461,968.00 9,301,128.38 9,627,800.65
MOOE 32,324,384.41 31,952,021.14 79,540,103.56
Traveling Expenses - Local 1,401,189.24 907,459.63 951,794.37
Training Expenses 27,994.15 - 18,591.00
Office Supplies Expenses 920,853.19 1,547,390.63 2,450,641.26
Accountable Forms Expenses 100,845.00 81,045.00 69,300.00
Food Supplies Expenses 2,906,721.07 3,700,761.69 6,654,531.77
Drugs and Medicines Expenses 3,017,765.04 5,532,582.69 16,622,688.93
Medical, Dental and Laboratory Supplies
12,841,638.60 9,961,222.77
Expenses 34,996,259.18
Fuel, Oil and Lubricants Expenses 1,220,671.62 947,979.75 1,694,790.17
Other Supplies and Materials Expenses 1,044,279.66 2,096,276.05 5,539,834.60
Water Expenses 31,976.00 31,033.25 324,635.60
Electricity Expenses 6,532,929.29 5,874,504.51 7,095,455.36
Postage and Courier Services 15,060.00 16,352.00 17,778.00
Internet Subscription Expenses 12,990.00 15,559.16 376,809.60
Taxes, Duties and Licenses 17,140.00 16,430.00 38,870.00
Fidelity Bond Premiums 10,800.00 14,475.00 23,573.01

Membership Dues and Contributions to
18,689.00 14,100.00
Organizations 13,329.00
Telephone Expenses 15,710.91 65,477.00 112,438.72
Repairs and Maintenance - Machinery and
240,659.14
Equipment - 147,499.00
Repairs and Maintenance - Transportation
350,691.34 309,667.90 290,037.25
Equipment
Subscription Expenses 51,405.00 49,046.00 46,956.00
Representation Expenses - 121,320.00 1,407,400.00
Other Maintenance and Operating Expenses 1,544,376.16 650,109.11 646,119.74
Barangay Health Workers 140,000.00 147,000.00 147,000.00
PhilHealth Premiums (included in Non-Office) 1,000,000.000 1,000,000.00 1,000,000.00
CAPITAL OUTLAY (PHO, CGH & CDH) - 1,718,600.00 6,525,000.00
NON-OFFICE 8,923,779.14 31,099,584.42 10,023,665.19
20% DF - 975,000.00 1,999,999
GRAND TOTAL 115,915,642.96 147,207,471.69 176,470,150.12
The Health Care Funds for 3 years in the province of Camiguin comprises of the
following, PHO, CGH and CDH. It was observed that 2020 and 2021 capital outlay
increased immensely compared to 2019 because this is the year wherein the COVID19
was at its peak and the province was equipping our hospitals for our response. The
table also shows that total budget allocated every year is increasing from year 2019 to
2021. The Provincial Government allocated and spent an enormous amount for year
2021 for the laboratory and reagents supplies and drugs and medicines expense as we
were hit by COVID19 Delta variant. The percentage to its total appropriations is 24.07
%, meaning it did not reach the national benchmark target of 25% and is therefore has
the yellow color in the LGU scorecard. Percentage of total health budget allocated is
93.54%. However, only 65.83% of the total allocation was disbursed.
B. GAPS IN HEALTH REGULATION________________________________________
Status of enforcement and compliance to national and local health laws, local
policies implemented and those that are in the pipelines.
All 5 Rural Health Units are PhilHealth Accredited with the exclusion of
Guinsiliban which only has a PCB Accreditation. The Unit is on the process of
accreditation for MCP, and TB-DOTs. All of the RHUs provided regular supply of
essential medicines and family health commodities through DOH Compack as well as
provided from the Provincial Government.
The Catarman District Hospital and Camiguin General Hospital are all PhilHealth
Accredited and certified as Mother-Baby Friendly Hospital Initiative. All facilities are also
active in the implementation of Newborn Screening through RA 9288 or the NBS Act of
2004. A total of 1,269 or 100 % NBS coverage were performed in which 990 or 78%
were from Camiguin General Hospital, 74 or 5.8% from Catarman District hospital, 183
or 14.4% from Marydel Birthing Home and only 22 or 1.73% from the Municipalities.
There were 1260 NBS screened under inborn category which means they were
PhilHealth members and 9 were considered out-born but still be able to avail Newborn
Screening because the Provincial Health Office procured 50 filter cards distributed to
hospitals and RHUs for augmentation in case there are cases that the mother has no
PhilHealth membership.
The implementation of the Voluntary Blood Donation services in the province is
far better than the years have passed. The five municipalities were now active in
conducting bloodletting activities and our blood donors in the province is slowly
increasing but still not enough to cover the total number of blood bags needed in a year.
The province cannot conduct bloodletting activity anytime without the technical support
from a license blood collecting unit which is Northern Mindanao Medical Center-
Bloodletting team since Camiguin General Hospital has no license to collect and to test
the blood due to inadequate number of Medical Technologists in the hospital.
The province has been declared Rabies-free since 2012. There were a total of
804 bite cases in 2021, in which 100% were given Post Exposure Treatment and 96 %
Completion Rate. An increasing annual budget was allocated for the program by the
provincial government while a separate budget was also allocated for the vaccination of
dogs thru the Provincial Veterinary Office.
A Provincial Ordinance on Safe Motherhood was approved last October 29, 2013
and only three municipalities were able to adopt and implement the ordinance namely,
Mambajao, Catarman and Sagay. The Approval and adoption of the ordinance paved
the way for the successful implementation of Facility Based Delivery and Skilled Birth
attendant in the municipalities and the entire province.
However, there are still gaps that were identified. The province has not yet
passed any local ordinance supporting the implementation of the national guidelines on
“DISPOSAL OF DEAD PERSONS” as manifested in Section III of the IRR Chapter XXI
of PD 856, otherwise known as Code of Sanitation of the Philippines.
SMOKE-FREE CAMPAIGN
The Province of Camiguin has passed a Provincial Local Ordinance declaring

Camiguin as a Smoke Free Province. Though all five Municipalities has also passed
their own local ordinance, only two Municipal Local Government Units namely
Mambajao and Guinsiliban has actively implemented the ordinance. The said
Government Units was also a Red Orchid Awardee.
Compliance of Health Care facilities to DOH Licensing and Philhealth Accreditation

Requirements
- 1 out of 5 RHU is not accredited yet with TB DOTS.
- 1 out of 5 RHU is not accredited with MCP.
C. GAPS IN HEALTH GOVERNANCE
"Health Governance" refers to policy agenda setting processes, implementation

and accountability within the health sector. It includes the management and

administration of policies and resources in health, including processes for health

systems strengthening. In the province of Camiguin, good governance is being
implemented at all times with the strong leadership of our beloved Governor Hon.
Xavier Jesus D. Romualdo and also through the coordination and support of the
different Local Chief Executives province wide.
Through its’ implementation, there are still gaps that are being encountered. One
of which is that there is no regular attendance of the LCEs during the ILHZ Board
meetings. Another gap is the irregular financial pooling in which all resources are being
grouped together for the purpose of maximizing advantage and or minimizing the risks
of the beneficiaries. The Province of Camiguin has one ILHZ composed of the five
municipalities and the two hospitals.
As for the Disaster Risk Reduction Management in Health, the Province has an
updated plan as well as the five municipalities namely, Catarman and Guinsiliban.
Mambajao, Sagay and Mahinog is on the process of crafting their own DRRM-H plan.
An annual refresher course and training are also provided not only the health personnel
but also to our officials, students and responders in the municipal and barangay level.
The Provincial Government has centralized procurement management system for

all offices and hospitals under its supervision. All hospitals under the management of
PLGU submit purchase request based on the approved annual health plan and
recommendation of the Therapeutic Committee of each hospitals. The BIDS and
Awards Committee (BAC) conducts bidding for the province. Other hospital needs may
use other alternative methods of procurement if needed like small-value procurement.
Once the stocks are available the Provincial Health Services Office will notify the end
users.
D. GAPS IN HUMAN RESOURCE FOR HEALTH
Table 15. Health Personnel Distributions by their Geographical location in 2021
Municipalities/ Popula Barang BHS Main House Medical Dent PHN RHM RSIs
ay Health Doctor ist
Cities tion Centers holds
Catarman 16,989 14 7 1 3,681 1 1 4 1

Guinsiliban 5887 7 3 1 1,579 1 1 2 1

Mahinog 14,104 13 3 1 3,076 1 1 3 1

Mambajao 40,294 15 12 1 8,781 2 1 2 3 1
Sagay 12880 9 5 1 2,912 1 2 2 1
TOTAL 90,153 58 30 5 20,029 6 1 7 14 5
For hiring of personnel, the provincial government slowly to create new items-in
addition to existing regular positions because of lack of funds and the constant
personnel services limitations. Only Mambajao has its own dentist, the rest of the
municipality has none because of no applicants and no available plantilla position. Of
the five Municipal Health Officers, 2 are DTTB namely Mahinog, and Guinsiliban. There
are five Rural Sanitation Inspectors, however, only Sagay has a permanent RSI
position, the rest are all designate RSI.
Table 16. Current Health Personnel Distribution by their Technical

Skills/Training/Orientation
DOTS FPCBT Family Basic MCH EPI Nutrition Environment

Family Planning Compre al Sanitation
Planning Level II
Level I
Doctors 100% 100% 100% 0 100 100 100% 100%
% %
PHNs 82% 80% 80% 40% 60% 80% 100% n/a
Midwives/RHMs 100% 100% 35% 42.9% 35.7 100 100% n/a
% %
Rural Sanitation n/a n/a n/a n/a n/a n/a n/a 73%
Inspectors
Health personnel are also given orientation on other health programs such as;
Rabies, Leprosy, Healthy Lifestyle, Mental Health, Health Emergency Management
System, Newborn Screening, Anti-Smoking, Vector Borne Diseases, Dental Services,
Child Injury Prevention Program and others.
As to competent professional health providers for the provincial level, there are
only 9 programs coordinators that will work on 47 different health programs: 2 are
regular nurses, 1 contractual nurse, 1 dentist, 1 midwife, 1 contractual nurse designate
as sanitation inspector. The provincial health department has no HEPO on board, no
Provincial Health Officer I and still needs additional nurses to work the different health
programs of the government.

Capacity Development of health personnel is limited by inadequate budget of

LGUs particularly in the hospital services in addition to overlapping of activities both
regional and provincial levels.
E. GAPS IN HEALTH INFORMATION
Field Health Services and Information System
Health Information data of the Provincial Health Office is managed through the
electronic Field Health Services Information System (eFHSIS), of which the software
are already available in all five (5) municipalities of the province. Weekly notifiable
diseases are reported weekly by 5 Municipal Epidemiology and Surveillance Units
(MESUs) and 2 hospital Disease Reporting Units (DRUs) through PIDSR.
Through the system health data are easily collected from RHUs/CHOs, reported,
managed, generated. The reports are analyzed for monitoring/management purposes,
and are important for decision making, planning and fund sourcing which are evidence-
based. Analysis of the data/reports of the barangay /RHU/CHO levels should be done
before submission to the Provincial Health Office. Inadequate action could be instituted
in their levels.
For FHSIs, almost all of the RHUs/CHOs in the province are almost always on
time in the submission of reports quarterly and annually. The challenges in the
operation are some municipalities have no internet connection though they reported to
other means but it’s not sustained. Secondly, some encoders are casuals while two are
nurses. The province has to lobby to LGUs to utilize the program installed and provide
computer to other programs. The provincial health office will enhance manpower to the
existing health information team. As of the present, Health Information System has
significantly improved in terms of adopting the new technology in generating the data
and in the dissemination of information. However, there are some gaps as to the
utilization of the new software used in the Field Health Services and Information System
(eFHIS). Electronic FHSIS is not fully implemented due to software/technical problems.
Manual submission was done and yet, the submission is not strictly followed. Hence,
there is a need for the province to level up by adapting innovative technology service
provider available in the market to address the said problem.
For IT IS (Integrated Tuberculosis Information System), the province has

implemented this since its conception. The first phase of implementation faced a lot of
challenges such as internet connections, encoders and equipment itself. Fortunately in
2015, Department of Health through PBSP, a project associate was deployed in the
province which helps in the full implementation of the program up to the present. Timely
and accurate submission of NTP reports thru the online system reporting was already
observed together with the five Rural Health Units.
The province still has to establish a Percent of health facilities with paperless
electronic medical record and regularly submit data
F. GAPS IN ACCESS TO LOW-COST QUALITY DRUGS________________________

Until now, this problem still exists in that some medicines are not available at all
times due to delay of the delivery of the regularly purchased of medicines through the
“General fund”. Most of the Municipalities has inadequate budget for medicines and
commodities.
G. GAPS IN EQUIPMENT____________________________________________
The province aims to be able to provide quality health care services through up-
to date, and accurate equipment in both the two hospitals and the five Rural Health
Units. Several of the equipment given by the Department of Health has been used
effectively and has proved to be valuable in achieving our goals. Despite the care given
to such equipment, with constant use, most of them need to be replaced with up-to-date
tools.
H. GAPS IN HEALTH FACILITY ENHANCEMENT

PROGRAM_____________________
Camiguin General Hospital is a Level 1 Hospital and is the only core referral
hospital in the province. The Goal of the province of Camiguin is to upgrade the facility
into a Level 2 hospital as this will be beneficial for the community since Camiguin is an
island province. As for Catarman District Hospital, upgrading the said facility into a level
1 from its Infirmary status to increased capacity and its health services that cater
emergency cases and provide basic health services for the Guinsacat population.
The province has 58 barangays but only 47 of them have Barangay Health
Stations in which some are also dilapidated. Thus, upgrading and rehabilitation of BHS
of the following barangays Poblacion,, Naasag, Anito, Yumbing, Magting, Agoho,
Benhaan and Sorosoro of Mambajao, Barangay Benoni and Hubangon of Mahinog,
Liong, Cantaan, and Butay of Guinsiliban, Catibac, Mainit and Panghiawan of
Catarman, Bacnit and Balite of Sagay is a valuable intervention to answer several gaps
in the health services of these said barangays. It is also proposed that Construction of a
BHS in the barangays of Baylao, Bug-ong and Tagdo of Mambajao, San Isidro,
Poblacion and Pontod of Mahinog, Alangilan, Poblacion and Bugang of Sagay and
Alga, Lawigan and LAwigan of Catarman to cater for the needs of the people.
I. GAPS IN SURVEILLANCE UNITS, PRESENCE AND UTILIZATION REPORTS
There is close collaboration and coordination with the disease Surveillance Officer
of the hospitals and the Rural Health Units. During conduct of surveillance and larva
survey, the municipal disease surveillance officer was also supported by the rural
sanitary inspectors from the municipality and the province. There is also a feed backing
mechanism to the Provincial and Municipal Health Officer being implemented. Despite
of the lacking computer equipment to the RHU level, still we managed to report weekly
on our notifiable cases in the province. But in order to sustain in prompt submission of
report computer equipment is really needed including the internet connection.
J. GAPS IN EMERGENCY PREPAREDNESS, DISASTER RISK MITIGATION

AND MANAGEMENT AND DISASTER RESPONSE PLAN, AND CLIMATE
CHANGE ADAPTATION

The Provincial Health Office already adapted and implemented Disaster Risk
Reduction Management- Health Plan since 2021.The five municipalities also crafted
their own DRRM-H Plan after the Provincial crafting workshop conducted by DOH-CHD
NM. Presently the five Municipalities already have their DRMM-H plan.
The Province thru its Camiguin General Hospital has active and capable HEMS
which provides training for BLS/First AID for the province as well as the five
Municipalities. Unfortunately, the HEMS members are all nurses from the hospital which
leads to inadequate number of staff in the hospital once there was training being
conducted. It is also being observed that in the event of emergencies and disasters, the
HEMS members will not be able to respond since their first and primary duty is the
hospital. Thus, a creation of a Provincial HEMs core group is being proposed which will
become the primary responders for the province.
K. GAPS IN UNIVERSAL HEALTH CARE INTEGRATION________________________

Universal Health Care is a health strategy to address the health concerns of the
country. It is an integrated and comprehensive approach to ensure that all Filipinos are
health literate, provided with healthy living conditions, and protected from hazards and
risks that could affect their health. The province of Camiguin opted to adapt the
mandate and has now started to integrate into Universal Health Care. The province
envisioned a province-wide health service delivery to better improve the health status of
Camiguingnons. Through UHC, it will enrich the health seeking behavior of our
community. At present the province is at 81% for level I mode of verifications, 32% for
Level II and 5% respectively for Level III. Formulation of necessary ordinances and
executive orders are still needed to comply. And hiring of personnel to work on the
province-wide health service delivery and creation of the Management Support Unit.
L. GAPS IN MENTAL HEALTH

PROGRAM____________________________________
Health Services for Mentally-Challenged Clients
Mental, neurological, and substance use (MNS) disorders are widespread,

contributing significantly to the global burden of disease and disability. In the province,
there is a deficiency of both legislations and infrastructure aimed at formalizing the care
of mentally ill patients, resulting in some individuals still wandering the streets. A plan to
create a half-way house is being made to temporarily cater for patients in need of urgent
confinement.
There is also hesitancy among healthcare providers in the local health facilities
as being the first line of contact of the service users, and this widens the gap more in
their diagnosis and management. The figures below represent the count of health
personnel trained under the Mental Health Gap Program, highlighting the shortage of
personnel in certain municipalities, with some having undergone their training several
years ago. With empowered healthcare providers in the community setting, the mental
health aspect of public health can be penetrated more and can accommodate greater
coverage among undiagnosed service users.
Table 17. Number of Mentally Ill cases per municipality as of June 2023

Epilepsy/S Mental
Developmental Drug Use Behavioral Alcohol Use
Municipality Schizophrenia eizures Psychosis Depression Dementia Bipolar ADHD Retardation Total
Disorder Disorder Disorder Disorder
Disorder Severe
Mambajao 96 8 8 0 0 0 0 0 0 11 2 2 127
Mahinog 0 2 45 0 0 3 6 0 5 0 0 0 61
Catarman 0 1 77 30 2 1 1 1 1 0 0 0 114
Guinsiliban 0 7 30 2 0 5 0 0 0 0 0 0 44
Sagay 0 18 56 0 0 0 2 0 0 0 0 0 76
Total 96 36 216 32 2 9 9 1 6 11 2 2 422
Table 18. Mentally Ill patients on-going treatment per Municipality

Mambajao Mahinog Guinsiliban Sagay Catarman
71 30 28 76 114
Total 319
Table 19. Number of trained personnel for mhGAP

Mambajao Mahinog Guinsiliban Sagay Catarman Province
Doctor 1 0 0 1 1 1
Nurse 3 0 0 1 1 0
Midwife 1 0 0 0 0 0
Total 5 0 0 2 2 0
V. Overall Health Strategy and Proposed Specific Interventions
A. Provincial Vision, Mission, Goals
Vision:
Camiguin a prime tourist destination with sustainable socio-economic growth and
effective management of all resources while preserving the dignity and high
moral values of the populace
Mission
To improve the general well-being of Camiguingnons through people and
community centered development, small island ecosystem management and area
development zones management
Objectives:
General Goal
The ultimate goal is to improve the quality of life of the people through the
provision of sufficient employment opportunities by harnessing the resource
potentials of the province particularly its tourism industry.

Development Objectives
General objective:
To attain a well-balanced, environmentally harmonious and sustainable eco-

tourism development coupled with agri-industrialization.
Specific objectives:
1. To improve and expand access to basic services such as health, education,

housing, transportation, communication, power, water, sports and recreation
facilities;
2. To increase family income by improving the productivity in the agri-tourism industry

sector;
3. To rehabilitate, maintain and preserve natural environment and reduce vulnerability to

natural disasters;
4. To promote a regulated level of urbanization in all municipalities of the province;
5. To enhance the capability of the province and municipalities along land use planning
and environmental management with the support of PDC and SP to ensure proper
utilization of land, water and other physical resources in the province.
B. PHO Vision, Mission, Goals
Vision:
In 2025, Camiguingnons is the healthiest among the provinces of Region X.
Mission:
To improve health outcomes through the prevention of illnesses, promotion of

healthy lifestyles and to consistently improve the health care system by focusing
on access, equity, efficiency, quality as well as sustainability through
accountable, effective, and responsive service delivery.
Goals:
1. Reduce the incidence of communicable and non-communicable diseases.

2. Prioritize interventions that will address health needs and health inequities
among the underprivileged, Senior Citizens, Persons with disabilities.
3. 100% implementation of the No Balance Billing Policy.
4. Strengthen two-way referral system.
5. Strengthen the Inter-Local Health Zones.
6. Continuous upgrading of health facilities.

7. Continuous quality service improvement.
8. Improve Information and Data Reporting System that generates timely,
accurate and reliable data on health.
9. Strengthen partnership with the GOS and NGOs
10. Enhance community participation.
C. Socio-economic and Political Factors
The Province of Camiguin is guided by the battle cry of the new Provincial Governor,
“Progress never stops”. The present administration believes in the essence of
solidarity and unity for the continuity of progress.
I. LOCAL PRIORITIES/MAJOR THRUSTS OF THE LIPH
In our effort to provide quality health care services to all and to fulfill our mandate
in leaving no one behind even if we are still in the health crisis today, the Local
Government Unit has strongly implemented all health programs in the province as well
as its Local priorities. Our local priorities are aligned with the 10 point Development
agenda of the Provincial Governor as well as the health situation of our community.
Foremost in our priorities is to affect behavioral change in our schoolchildren for them
to develop positive health seeking behaviors as they grow to become into a healthy and
empowered Camiguingnon. Thus, Essential Health Care Program (EHCP) is
particularly sustained. This program is a coordinative endeavour between Provincial,
Municipal and Barangay LGUs as well as the Department of Education and its parents-
teachers association.
Another priority program is the Adolescent Health Care Program with its focus on
decreasing the number of Teenage Pregnancies as well as protecting their mental
health, likewise protecting them from drugs, sexually transmitted infections, alcoholism
and smoking.
Controlling and Preventing the spread of Sexually Transmitted Infection

specifically Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency
Syndrome (AIDS) is also one of the local priorities of the province. Our aim is to
increase awareness on the disease, decrease the number of high risk individuals who
are unaware of the importance of condom use on prevention and who are also unaware
of their status, as well as decrease the number of Person Living with HIV (PLHIV) who
are not on anti retro-viral therapy (ARV). Anent to this is the establishment of a satellite
treatment hub in the province to cater to the needs of our PLHIV such as accessibility
and availability of services.
The province has been consistent on its desire to protect and nourish the mental
status of its populace. Thus, our Mental Health Program has been sustainably
implemented for more than ten (10) years. Though despite such long years of

execution, there are still a lot of room for improvement. Passage of an Ordinance
supporting this ventures as well as creation of a team that can provide counselling as
well as psycho social services are the things that will be prioritized this year.
Preparing the Province from the effect of Climate Change, one of our local priority is
Environmental Sanitation particularly envisioning the province to be declared as Zero
Open Defecation Free Province.Likewise, improvement of our Provincial Waste
Disposal Facility is also prioritized.
To progressively realize our intention to be part of Universal Health Care Integration
Sites of Region 10. Para sa serbisyong sapat, tamang oras, kabuoang kalusugan para
sa lahat, as our health system implemented the Universal Health Care Act or Republic
Act No. 11223
In alignment of the Vision-Mission of the province to become a prime tourist

destination, improvement of our health care system particularly with our provincial
hospital, Catarman District Hospital from Infirmary to Level 1 status is our top priority.
As Camiguin General Hospital became the newly reintegrated DOH-Retained Hospital,
they’re making extra effort to make their facility to be well equipped and highly capable
Level II facility as our core referral hospital in the island province. The Northern
Mindanao Medical Center, a Level III hospital still our apex hospital for our patients
navigation and referral system.
Lastly, the province has started to integrate Universal Health Care. UHC is
considered as the main thrust for health. The province envisioned a province-wide
health service delivery to better improve the health status of Camiguingnons. Through
UHC, it will also enhance the health seeking behavior of our community.
IV. MONITORING AND EVALUATION (M & E)
In order to regularly assess and measure the performance of the implementation

of the programs in the entire province and to determine the achievements of each RHU
in terms of the six (6) building blocks of the Philippine Health Agenda program
interventions and activities. The personnel of the Provincial Health Office -Technical
staff and the Provincial Planning Development Office will be conducting a regular
monitoring of the implementation of the Local Investment Plan for Health (LIPH).
The outcome of the regular assessment activities will be reported by the

Provincial Health Officer to the Provincial Governor, and also to the Provincial Health
Board which convenes monthly.
Being evidence-based, the Monitoring and Evaluation System shall utilize the
indicators of the following reports to assess the success of program implementation:
FHSIS, LGU Scorecard, Annual Accomplishment Reports, PIDSR, OPCR and the new
implementation of quarterly submission of Local Project Monitoring and Evaluation
(LPME) and Physical and Progress Monitoring Report by the Provincial Government.

AOP 2024 Narrative

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ANNUAL OPERATION PLAN 2024

The Provincial/district hospitals, RHUs, and BHSs are the program/project

Structures for Plan Implementation

Presiding Chairman: Provincial Governor

ANNUAL OPERATION PLAN 1

The PHB shall have the following roles and responsibilities:

The Team shall be supported by Technical Working Groups to review and

The TWG on LIPH Operations will have the following functions:

The Technical Working Group (TWG) on AOP Financing shall be composed of

ANNUAL OPERATION PLAN 2

The TWG on AOP Financing shall:

Grant funds shall be disbursed at the provincial level. Municipalities requesting

In the case of procurement of equipment and construction materials, the

II. HEALTH SITUATION OF THE PROVINCE

ANNUAL OPERATION PLAN 3

Table 1 – YEARLY TREND IN VITAL HEALTH STATISTICS RATE

Figure 1 - YEARLY TREND IN VITAL HEALTH STATISTICS RATE

CBR CDR IMR UFMR MMR

ANNUAL OPERATION PLAN 4

Figure 2. Infant Mortality; Neonatal Death Rate; Under-Five

Infant Mortality Rate Neonatal Death Rate Under-Five Mortality Rate

Source of Data: PHO Accomplishment Report 2022

Infant Mortality Rate

The infant mortality rate (IMR) of the province reflects an increase of

However, complacency is unacceptable in health personnel, instead one should

Maternal Mortality Rate

ANNUAL OPERATION PLAN 5

Table 2: Leading Causes of Mortality

1 Cardiac Death/Arrest/Arrythmia 0 0.00 104 1.11

Mortality: Leading Causes

The causes of mortality drifted to non-communicable diseases which can be

ANNUAL OPERATION PLAN 6

are tasked to undertake this program. Additionally, capacitating the community

5 URINARY TRACT INFECTION 941 122.85 549 58.55/10,000 pop.

6 DENTAL PROBLEM 89 11.67 146 15.57/10,000 pop.

Morbidity: Leading Causes

There seems to be a need to focus more closely on the increasing number of

B. ATTAINING BETTER HEALTH OUTCOMES

ANNUAL OPERATION PLAN 7

Figure 3: PERCENT DISTRIBUTION OF NUTRITION

Figure 4: PERCENT DISTRIBUTION OF WASTED CHILDREN BY CATEGORY 2023

Figure 5: PERCENT DISTRIBUTION OF STUNTED CHILDREN BY CATEGORY 2023

ANNUAL OPERATION PLAN 8

ANNUAL OPERATION PLAN 2024

Source: OPT+ 2023 1st round

Contributing factors to the decrease in malnutrition rate of the province are;

B.2 SUSTAINABLE DEVELOPMENT GOAL 3 – GOOD HEALTH AND

B.2.1 FAMILY HEALTH CLUSTER

ANNUAL OPERATION PLAN 9

NATIONAL IMMUNIZATION PROGRAM

Figure 6. Trend of Children Fully Immunized

Figure 7: Pregnant women given TT2 & TT2 plus

Effective implementation of this program depends on serious observance and

In terms of infants exclusively breastfed, the percentage of infants exclusively

Figure 8. Infants Exclusively Breastfeed until 6th months

ANNUAL OPERATION PLAN 11

INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS

ANNUAL OPERATION PLAN 12

Figure 9: PNUEMONIA CASES SEEN & TREATED

Source of Data: PHO Annual Accomplishment, IMCI Accomplishment- 2021

This year we had a total of 12 cases of diarrhea compared to 9 cases registered

ANNUAL OPERATION PLAN 13

ORT W/ZINC ORS SEEN

IMPROVED MATERNAL HEALTH OUTCOMES