ANNUAL

OPERATIONAL
PLAN 2024
SOLANO, NUEVA VIZCAYA

INTRODUCTION:
 The Municipal Annual Operational Plan and the Local Investment Plan for Health serve
as vehicle for implementing and consolidating support for health reforms to achieve health
sector goals of better health outcomes, more responsive health system, and equitable health
care financing through DOH-LGU partnership representing all interests, activities, investments
of stakeholders for health.

With the use of the Field Health Service Information System (FHSIS) and LGU
scorecard as a tool to look into the performance indicators and the external and internal
benchmarks and identify the accomplishments, gaps and deficiencies, we have outlined the
Municipal Annual Operational Plan (AOP) of Solano, Nueva Vizcaya.

Section I: PLAN DEVELOPMENT

During policy development, program planning and implementation and budget

transparency, engagement of the different concerned agencies is not neglected. Programs were
also monitored by the team more frequently and the result of the attempts to enforce
accountability and update constituents of progress of programs were presented. The Local
Chief Executive, Municipal Health Officer, Public Health Nurse, Rural Health Midwives and the
Local Finance Committee of the municipality composes the Core LIPH Planning team in the
local development and annual investment plan.

During annual budget preparation, a thorough deliberation with all the concerned
offices/departments and interested citizens is undertaken. The preparation of the budget has
been open to the public through private sector representation in order to make decisions
participative and democratic. This is also in keeping with government thrust for transparency
and accountability in the budget-making process. Non-government organizations, other sector
associations and general public have also taken their part in the budget process.

Section II: Health Situation of the Municipality

DEMOGRAPHIC PROFILE
1. DESCRIPTION, TOPOGRAPHY & DEMOGRAPHIC INFORMATION
Solano, officially the Municipality of Solano, is a 1st class municipality in the province of
Nueva Vizcaya, Philippines. It is politically subdivided into twenty-two (22) barangays,
composed of six (6) urban and sixteen (16) rural barangays.

The municipal center of Solano is situated at approximately 16° 31' North, 121° 11' East,
in the island of Luzon. Elevation at these coordinates is estimated at 260.5 meters or 854.4 feet
above mean sea level.

The municipality has a land area of 139.80 square kilometers or 53.98 square miles
which constitutes 2.90% of Nueva Vizcaya's total area. Its population as determined by the
2020 Census was 65,287. This represented 13.12% of the total population of Nueva Vizcaya
province, or 1.77% of the overall population of the Cagayan Valley region.

2. MEDICAL HEALTH FACILITIES AND HEALTH PERSONNEL

Due to rapid urbanization of the municipality and its growing population, the demand for
greater access to quality health care services also increases.
From a building at the old municipal compound, the Rural health Unit was transferred to
a limited space at the left side of the new municipal building. The limited space was a constraint
for hiring additional personnel, office expansion and acquisition of new equipment, thus the
need for a construction of a separate Rural Health Unit building.
 The new Rural Health Unit with Laboratory and Lying-in Clinic was built at the back of
the new municipal building and it started its operation on August 8, 2011. Its expanded services
include dental services, laboratory services, management of animal bite patients and attending
to normal spontaneous deliveries.
The Solano Rural Health Unit with Laboratory and Lying-in Clinic is a primary health care
facility accredited as provider of PCB Package, TB-DOTS Package, MCP Plus Package (MCP
+Newborn Screening Package) and Animal Bite Treatment Package by Philhealth.
All the twenty-two barangays of the municipality have facilities. Eleven (11) of which are
classified as Barangay Health Stations (single structure exclusive for health services) and the
rest as Barangay Health Centers. These facilities are being manned by Rural Health Midwives
(RHM), Nurses Deployment Program (NDP) and RHMPP under DOH-HRH deployment
program and Community Health Volunteers such as barangay health workers and barangay
nutrition scholars.
As of today, the Municipal Health Office has one (1) doctor, one (1) dentist, four (4)
nurses, nine (9) midwives, two (2) medical technologists, two (2) sanitary inspectors, one (1)
pharmacist, one (1) nutrition officer, two (2) drivers, one (1) administrative aide, two (2) utility
workers, four (4) contractual midwives, two (2) contractual nurses, four (4) contractual nursing
attendant, one (1) contractual medical technologist, one (1) contractual laboratory aide, one (1)
contractual administrative aide, one (1) contractual driver and one (1) contractual security guard
for total of twenty-six (26) plantilla positions and fifteen (15) contractual health personnel.

3. HEALTH DATA ANALYSIS

VITAL HEALTH INDICES FOR THE LAST THREE YEARS (2019-2021)

Table 1. TOTAL LIVE BIRTHS AND FAMILY PLANNING CURRENT USERS
FOR THE LAST THREE (3) YEARS

YEAR TOTAL LIVE BIRTHS TOTAL FP CURRENT

USERS
2019 816
2020 417
2021 907

This table above shows the number of live births in the Municipality for the last three
years. The data shows that there is a decrease in live births of 399 in 2020 and increases by
490 livebirths in 2021.

Table 2. CRUDE BIRTH RATE (CBR) AND CRUDE DEATH RATE (CDR)
FOR THE LAST THREE (3) YEARS

YEAR CBR CDR

2019 13% 4.67%
2020 6.56% 4.54%
2021 14.07% 6.11%

Crude Birth Rate (CBR) refers to the total live births per 1,000 mid-year population. It is
the simplest and most commonly used index of fertility. The computed average Crude Birth Rate
(CBR) from 2019 to 2021 is 11.21%. This means that there were 11 to 12 live births registered
per 1,000 populations per year from the said period.
 Crude Death Rate (CDR) is a rough measure of mortality. It refers to the number of
deaths per 1,000. The CDR of the municipality was computed at an average of 5.11% from
2019 to 2021. This means that were six (6) deaths for every 1,000 populations during the said
period.

Table 3. UNDER-5 MORTALITY RATE FOR THE PAST 3 YEARS

Year 2019 2020 2021

Total live births 816 417 907
Number of Under-Five deaths 5 9 8
Under Five Mortality rate per 1000LB 6.12% 21.58% 8.82%

The table shows that there is a constant increase of under-five mortality rate from 2019
to 2020 except in 2021 that shows a slight decrease of mortality rate. The highest mortality rate
was recorded in 2020 which is 21.6% deaths per 1000 live births.

Table 4. TOP 10 CAUSES OF DEATH IN ALL AGES FROM 2019 TO 2021

2019 LEADING CAUSES OF 2020 LEADING CAUSES OF 2021 LEADING CAUSES OF

MORTALITY MORTALITY MORTALITY

1. CVD/HCVD/CHF/ 65 1. CVD/HCVD/ 63 1. COVID19 Positive 140

CAD/Stroke CHF/CAD/ HPN
2. Pneumonia All Types 48 2. Malnutrition/Diabetes 32 2. CVD/HCVD/ 86
Mellitus CHF/CAD/ HPN

3. Myocardial Infraction 32 3. Pneumonia All Types 28 3. Senile Debility 16

4. Cancer All Types 26 4. Cancer All Types 26 4. Myocardial Infraction 11

5. Pulmonary 12 5. Myocardial Infraction 20 5. Community Acquired 9

Tuberculosis Pneumonia/Respiratory
Failure

6. Sepsis 9 6. Senility 13 6. Cancer All Types 7

7. Senile Asthenia 8 7. Heart Disease 12 7. Cardiac Arrest 6

8. Acute 8. Acute Renal Failure/ 8. Intracerebral

Malnutrition/Diabetes Kidney Failure/ Kidney Bleeding/Acute Renal
Mellitus 7 Disease/ Pulmonary 8 Failure 5
Tuberculosis

9. Chronic Obstructive
Pulmonary Disease/
Senile Disability/ 6 9. Asthma 4 9. Malnutrition 3
Bronchial Asthma/ Acute
Renal Failure

10. Strangulation/ 4 10. Vehicular Accident 3 10. Diabetes Mellitus 2

Vehicular Accident
 The above table shows that the top leading causes of Death in the Municipality is heart
diseases and in 2021 which the COVID-19 pandemic hits worldwide many deaths were reported
due to this virus.
The following factors that may have contributed to the increased mortality rate are:
unhealthy diet/lifestyle, poor sanitation and hygiene,
financial constraint,
poor and/or delayed health seeking behavior for medical treatment,
uncontrolled high blood pressure,
tobacco smoking and alcohol intake;

Failure to address the indicated factors or causes may lead to increased mortality.

Table 5. MATERNAL MORTALITY RATE (MMR) FROM 2019 TO 2021

Year 2019 2020 2021

Total live births 816 1042 907
Number of deaths 0 0 1
Maternal Mortality Rate per 0% 0% 1.10%
100,000LB

Table 5 shows that there is no maternal death from 2019 to 2020 but with one (1)
maternal death in 2021.
The main factor or reason identified which contributed to the maternal death is refusal to
seek prenatal care and delayed consultation for complicated labor because of religious belief of
the pregnant women and family.
Failure to address the causes or factors may lead to increased maternal mortality rate
which may result to malnutrition, morbidity and even death of the child.

Table 6.TEN LEADING CAUSES OF MORBIDITY FROM 2019-2021

2019 LEADING CAUSES OF 2020 LEADING CAUSES OF 2021 LEADING CAUSES OF

MORBIDITY MORBIDITY MORBIDITY

1.AURI/ARI/RTI 14,463 1.AURI/ARI/RTI 7,004 1.AURI/ARI/RTI 11,070

2.DERMATOLOGIC 2,003 2.Hypertension 1,548 2.COVID-19 3,458

CONDITION

3.FEVER/HEADACHE 1,911 3.Wound 1,076 3. Acute Gastroenteritis 577

4.Urinary Tract Infection 1,672 4. Urinary Tract 1,020 4.Hypertension 447

Infection

5.Hypertension 1,059 5. Musculoskeletal 626 5.Fever/Headache 430

Disorder

6. Asthma/Bronchial 917 6. DERMATOLOGIC 457 6. Wound 371

Asthma CONDITION

7. Wound 902 7.Bronchitis 327 7. Urinary Tract Infection 306

8. Acute Bronchitis 791 8. Furuncle/ Carbuncle 272 8. DERMATOLOGIC 219

CONDITION
9. Musculoskeletal Disorder 634 9. Vertigo 262 9.Toothache 144

10.Acute Gastroenteritis 611 10. Vaginosa 254 10. Upper Respiratory 83

Tract Infection

The above table shows that Upper Respiratory Tract Infection is consistently the leading
cause of morbidity for the year 2019-2021. The factors or causes that may have contributed to
the high morbidity rate and persistent leading causes of morbidity are the following:
lack of patient’s awareness on prevention of diseases,
Incomplete or no immunization,
Unhealthy diet & lifestyle, poor sanitation and hygiene,
Low percentage of households with access to safe water,
Poor or delayed health seeking behavior of patients,
Not practicing of proper body mechanics,
Financial constraint.

Table 7. MORBIDITY RATE FOR 2019-2021

YEAR 2019 2020 2021
Number of 16,300 30,108 17,653
consultations
Morbidity rate (ARI, 22.36% 26.9% 17.17%
Pneumonia, AGE,
Bronchitis)

The table shows that the highest morbidity rate was seen in 2020 which is 26.9% and
rapidly decreasing in 2021. Rapid decrease of morbidity cases in 2021 is maybe due to home
management by patients/guardians, interrupted supply of medicines, afraid of COVID-19 swab
testing.

HEALTH OUTCOME INDICATORS

Table 8. FACILITY BASED DELIVERIES 2019-2021

YEAR TOTAL TOTAL FACILITY BASED PERCENTAGE

DELIVERIES DELIVERIES
2019 816 816 100%
2020 417 414 99.28%
2021 907 904 99.66%

The table above shows that all deliveries for 2019 are facility-based deliveries. In 2020
and 2021, there were three (3) home deliveries reported.
Despite the campaign of the Municipal Health Office encouraging delivery in health
facility, there’s still some who prefer to deliver at home maybe due to:
Inadequate awareness on possible risks or complications of home delivery,
Financial constraint,
Patient resides far from the birthing facility,
Religious belief,
Reliance to hilot/non health practitioner,
Delayed decision to go to the birthing facility,
Fear of COVID-19/or do not want to undergo COVID-19 testing
 Table 9. DELIVERIES ATTENDED BY SKILLED BIRTH ATTENDANTS (SBA)
2019-2021

YEAR TOTAL TOTAL PERCENTAGE

DELIVERIES SBA
2019 816 816 100%
2020 417 414 99.28%
2021 907 904 99.66%

The above table shows that in 2019 all deliveries were 100% attended by skilled birth
attendant (doctors, nurse, midwife) and in 2020 and 2021, there were 99.47% which indicates
that there are deliveries attended by traditional birth attendants or hilots. The reasons for
incidence of deliveries not attended by skilled birth attendants includes:
Presence of traditional birth attendants (hilot) who still attend deliveries,
Lack of awareness on possible complications of home delivery,
Financial constraints,
Delayed decision to go to the health facility;
If not resolves, this may lead to more maternal and neonatal death due to complications.

Table 10. NUMBER OF TEENAGE PREGNANT TRACKED FOR 2019-2021

YEAR TOTAL PREGNANT AGES 10-19Y/O
2019 133
2020 152
2021 123

This table shows that 2022 noted the highest number of teenage pregnancies tracked is
152 while the lowest number of teenage pregnancies is tracked in 2021 which is 123.

Teenage pregnancy is due to the following:

Out of school youth
Poor parents’ supervision and guidance
Insufficient knowledge on the risk of teenage pregnancy
Sexual abuse
Failure to address the indicated factors or reasons may result to teenage pregnancy.

Table 11. CONTRACEPTIVE PREVALENCE RATE FOR 2019-2021

YEAR TOTAL ELIG. TOTAL CURRENT PERCENTAGE

POPULATION TARGET USERS
2019 62,742
2020 63,544
2021 64,458
The table shows that the highest percentage of current users is 32 in 2018 & 2020. The
latest 4 years municipal accomplishment has exceeded the DOH target for 2020 which is 28%.
This is due to continues supplies of FP commodities from the DOH, close monitoring and follow-
up to current users and conduct of IEC to target couples.
Table 12. FULLY IMMUNIZED CHILD (FIC) FOR 2019-2021

YEAR ACTUAL TOTAL FIC PERCENTAGE

TARGET
 2019 1,290 985 76.35%
2020 1,340 988 73.73%
2021 1,360 959 70.51%

The table above shows the comparison of accomplishment for 3 years. It shows that
there is a decreasing number of Fully Immunized child due to poor-seeking behavior of
guardians/parents. People may have been reluctant to seek health care because of fear of
transmission of COVID-19 and may have experience challenges reaching services due to
lockdown measures and transportation disruptions.

Table 13. NEWBORN SCREENING FOR 2019-2021

YEAR TOTAL LIVEBIRTHS TOTAL NBS DONE PERCENTAGE

2019 816 816 100%
2020 417 417 100%
2021 907 907 100%

The table above shows that the all livebirths from 2019 to 2021 were tested with
newborn screening test. This implicates that there is an increase awareness on the importance
of newborn screening among mothers.

Table 14. NUMBER OF HOUSEHOLDS WITH SANITARY TOILET FACILITIES

FOR 2019-2021

YEAR TOTAL HHS WITH SANITARY PERCENTAGE

HOUSEHOLDS(HHS) TOILET
2019 16,643 15, 194 91.29%
2020 15,655 15,356 96.77%
2021 15,868 15,409 97.11%

The table shows that the lowest accomplishment is 91.29% in 2020 & 2021 while the
highest accomplishment is 97.11% in 2021. There is a significant increase in the number of
households with sanitary toilet facilities because there is increase awareness of the constituents
regarding used of sanitary toilets and presence of barangay ordinance and policies on
environmental sanitation.
Failure to address the indicated issues can lead to unsanitary environment, increase of
waterborne diseases, infectious diseases and diseases transmitted by fecal-oral route.

Table 15. NUMBER OF HOUSEHOLDS WITH ACCESS TO

SAFE WATER FOR 2019-2021

YEAR TOTAL HHs with Access to PERCENTAGE

HOUSEHOLDS(HHs) safe water
2019 16,643 16,643 100%
2020 15,655 15,598 99.63%
2021 15,868 15,792 99.52%

The table above shows that there is a decrease of households with access to safe water
from 2019-2021. From 100% in 2019, it decreases to 99.52% in 2021.This decrease percentage
may attributable to the following reasons:
Insufficiency of developed potable water source in some urban barangays,
No regular cleaning of water systems,
Water Bacteriology test is not regularly conducted.
 No ordinance of water sources protection.

Failure to address the above issue may lead to the persistent or increased incidence of
waterborne diseases.

TABLE 16. TB CASE DETECTION FOR 2019-2021

YEAR TARGET ACCOMPLISHMENT CDR

2019 347 229 66%
2020 352 160 45.45%
2021 357 107 29.97%

The above table shows that the Case Detection Rate is constantly decreasing to 36.06%
from 2019 to 2021.The low Case Detection Rate may be attributed to the following reasons:
Lack of awareness on early detection of tuberculosis by the patients,
Financial constraints,
Delayed decision to go to the health facility;

Table 17. COMPARISON OF OPT OF PRE-SCHOOL CHILDREN

CY 2020-2022
WEIGHT FOR AGE

YEAR
NUTRITIONAL STATUS
2020 2021 2022
No. % No. % No. %
Severely Wasted 4 0.09 5 0.11 4 0.10
Wasted 43 0.98 43 0.97 32 0.77
Normal 4,293 98.44 4,312 97.95 4,081 98.01
Overweight 21 0.48 42 0.95 47 1.13
Total # of Pre-school 4,361 - 4,402 - 4,164 -
Children
Total # of Pre-school 4,361 100 4,402 100 4,164 100
Children Weighed
Total SUW/UW 47 1.07 48 1.09 36 0.86

Table 18. COMPARISON OF OPT OF PRE-SCHOOL CHILDREN

CY 2020-2022
WEIGHT FOR LENGTH/HEIGHT 0-59months

YEAR
NUTRITIONAL STATUS 2020 2021 2022
No. % No. % No. %
Severely Wasted 13 0.29 5 0.11 10 0.24
Wasted 25 0.57 33 0.74 15 0.36
Normal 4,279 98.11 4,301 97.70 4,091 98.25
Overweight 26 0.59 31 0.70 25 0.60
Obese 18 0.41 32 0.72 23 0.55
Total # of Pre-school 4,361 - 4,402 - 4,164 -
Children
Total # of Pre-school 4,361 100 4,402 100 4,164 100
Children Weighed
 Total Severely Wasted/ 38 0.87 38 0.86 25 0.60
Wasted

Table 19. COMPARISON OF OPT OF PRE-SCHOOL CHILDREN

CY 2020-2022
LENGTH/HEIGHT FOR AGE 0-59 months

YEAR
NUTRITIONAL STATUS
2020 2021 2022
No. % No. % No. %
Severely Stunted 16 0.36 13 0.29 5 0.12
Stunted 72 1.62 86 1.95 72 1.73
Normal 4,186 95.98 4,221 95.88 4,011 96.33
Tall 87 1.99 62 1.40 76 1.83
Total # of Pre-school 4,361 - 4,402 - 4,164 -
Children
Total # of Pre-school 4,361 100 4,402 100 4,164 100
Children Weighed
Total SST/ST 88 2.01 99 2.24 77 1.85

Prevalence of malnutrition is always a perennial problem in our municipality but with the
multisectoral efforts done, there was a significant decrease in the number of malnutrition cases
among preschoolers as reflected in Table 19 wherein 36 (0.87 %) children were reported as
underweight and severely underweight based on 2022 Operation Timbang (OPT) reports of
Barangay Nutrition Scholars compared to 47 (1.07%) and 48 (1.08%) cases of underweight
children in 2020 and 2021 OPT results.

Section III: Local Priorities/Major Thrusts of the Local Investment Plan

for Health

A. LEADERSHIP AND GOVERNANCE

Objective: To strengthen leadership, management capacities and support mechanism.

Identified Priority Health Contributing Factors Strategies

Problems
1. Poor sustainability  Agenda on health  Lobby with the
of municipal and projects, programs, & barangay council to
barangay health activities comes last accommodate agenda
board under the other topics on health projects &
during the brgy programs at least
council meeting quarterly
 Some health
personnel are not
present during the
brgy sessions
2. Poor performance in  Lack of administrative  Lobby for additional
LGU scorecard manpower fund and logistics
 Lack of funds and allocation
logistics  Request for additional
 Lack of technical manpower with
 knowledge on the administrative
formulation of health functions
policies

B. HEALTH FINANCING

Objective: To increase LGU investment for health.

Identified Priority Health Contributing Factors Strategies

Problems
1. Poor compliance for  No functional EMR  Institutionalization of
Philhealth EMR
reimbursements  Enrollment on the
Ekonsulta
2. Low barangay  Least priority  Review barangay
allocation budget for budget for health
health  Lobby with
Brgy.Council during
budget review on
health allocation

C. HEALTH WORKFORE

Objective: To strengthen health workforce and development.

Identified Priority Health Contributing Factors Strategies

Problems
1. Insufficient RHU  No approved OSSP  Creation of plantilla
personnel both  PS limitation position
medical and  Hiring of contract of
administrative service (COS) health
care professionals
2. Outdated trainings  Insufficient funding for  Conduct of trainings,
of health care human resource seminars, orientation
workers activities including & make use of e-
training and staff learning platform
development (DOH academy)

D. HEALTH INFORMATION SYSTEM

Objective: To establish and maintenance of knowledge management/data/information

systems and functionality of management system

Identified Priority Health Contributing Factors Strategies

Problems
 1. Weak internet signal  Minimal cell site in  Procurement of Wifi
some barangays booster
 Only one internet  Additional internet
service provider service provider
2. Lack of training on  No trainings  Attend training on
electronic system for conducted on EMR
health electronic system for
health

E. MEDICAL PRODUCTS, VACCINES AND TECHNOLOGY

Objective: To ensure availability of essential medicines and vaccines.

Identified Priority Health Contributing Factors Strategies

Problems
1. Out of stock mental  Increase number of  Submission of
drugs psychological masterlist on mental
disturbed clients; high health patient at the
cost of medicines DOH
2. Some vaccines are  Low FIC  Timely provision of
not available vaccines

F. SERVICE DELIVERY/HEALTH OUTCOME

Objective: To provide quality health services according to clients’ needs.

Identified Priority Health Contributing Factors Strategies

Problems
1. Increase number of  Increasing and  Strengthen IEC on
teenage pregnancies uncontrolled access of adolescent
children to social media reproductive health;
platforms pregnancy tracking
 Establishment of
KADA/Teen centers
2. Presence of home  Distant referral facility  Encourage
deliveries  Lack of finances for enrollment to
hospitalization Philhealth
 Lack of enforcement of  Strict enforcement of
Facility-based delivery ordinance of FBD
(FBD) ordinance
3. High incidence of  Unavailability of DOH  Allocation of
mortality due to NCD medicine allocation for sufficient funds for
and increasing NCD especially diabetes procurement of NCD
number of (injectable logistics from various
uncontrolled Insulin) levels of government
hypertensions,
diabetes and other
NCD cases
4. Low case TB  Passive case finding  Intensify IEC on TB
detection rate  TB stigma  Conduct TB caravan
 5. Presence of  Less priority of the  Monitoring of
unsanitary/ open pit households household
toilets  Only LGU provides  Ensure 100%
budget/equipment for the household with
construction sanitary toilets

6. Presence of potable  Incapacity of some  Intensify IEC on the

water system household to put up implication of having
(protected water potable water service due potable water system
source) of all to high budgetary
barangays requirements
7. Not all children are  Incidence of migration/out-  Intensify IEC on the
fully immunized migration importance of
 Negative attitude of vaccination (RA
patients, re: vaccination of 10152)
children

G. HEALTH FACILITY/ENHANCEMENT PROGRAM

Objective: To upgrade the status of health care delivery system and sustain equity in
providing quality health services.

Identified Priority Health Contributing Factors Strategies

Problems
1. Inadequate health  Inadequate funds to  Improvement of
facilities and establish complete existing health
personnel in the Barangay Health facilities
barangay Station (BHS)  Creation of items/filling
 PS limitation up of vacant positions

Section IV. Monitoring and Evaluation

Monitoring and evaluation are vital in the planning process because it through these
activities that plan is being re-evaluated, re-assess, re-modified if necessary. This is also
essential in order to evaluate if objectives and goals set in the plans are met and to validate if
strategies are cost-effective and efficient. Monitoring and evaluation are done through the
following:

1. Quarterly meeting to discuss matters regarding their delivery of services and to solve
issues that may have come along our way.

2. Mid-Year Assessment to look into the how far have we gone with the program and
how much more effort do we need to achieve the desired outcome.

3. Year-end Assessment Program- to take stock of where the program is at the end of
the implementation year and ss a prelude to the annual program planning exercises for
Solano undergoing evaluation.