Accessing mainstream health in the Philippines

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Two municipalities in the Philippines are showing how local government can work with people with disabilities to bring about big changes in inclusive health. This article tells the story of these two municipalities: San Jose de Buenavista and Ilocos del Sur.

San Jose de Buenavista: Working with persons with disabilities

In the coastal municipality of San Jose de Buenavista, Philippines, government leaders are working with persons with disabilities, families, communities, and external disability non-governmental organisations (NGOs), including CBM, to ensure communities own their Community Based Rehabilitation (CBR) programmes.

The Local Government Unit (LGU) has taken comprehensive action, in partnership with persons with disabilities and their representative organisations, to include persons with disabilities in a whole range of public services, including those in the field of health. To do this, it established a local committee on disability affairs which links the Municipal Development Council, a disabled persons organisation (DPO), family groups, health professionals and the business sector. Persons with disabilities and their families feed into the planning.

This model, in which Disabled Persons Organisations work in partnership with the local government, with CBM as a partner is becoming a blueprint for policy and decision makers at local level. The model is now being replicated with around 300 LGUs taking CBR as a formal strategy combined with local legislation.

Within a seven-year period, the LGU in San Jose de Buenavista, under Mayor Rony Molina, has established a wide range of health services. These include:

  • Installing a ramp, low vision strips and “shorelines” for cane users at the Municipal Health Office and village health centres.
  • Ensuring all people with disabilities are included in all local health initiatives, from regular vaccinations and development check-ups to maternal health initiatives, dental care and eye and ear screenings.
  • Keeping health promotion and prevention materials visually friendly (simple illustrations, clear written messages).
  • Providing health insurance coverage for the poorest families with members who have a disability.
  • Including disability concerns in the local Disaster Risk Reduction Management (DRRM) programme.
  • Including women with disabilities in gender and development programmes, including those relating to reproductive health.
  • Providing access to low-cost, high-quality prosthetic and orthotic services.
  • Ilocos del Sur: Systemic action to ensure accessibility

At Cervantes LGU, in the mountainous area of Ilocos del Sur, there has also been systematic action to ensure health services are accessible to persons with disabilities. Mayor Benjamin Maggay is convinced that CBR is one of the best strategies to attain its development objectives, and a good entry point for including its entire population in its development aspirations. Mayor Maggay commented: “If I won’t act for persons with disabilities, it’s as if I’m discarding them as my constituents. Under the law, we all have the same rights to be respected. For survival, we have the same stomachs that need food. Therefore, I must deliver the services that the person with disability needs on an equal footing with other persons.”

The Cervantes LGU’s stated mission is: ”Everyone in the community has access to the community’s services. Everyone contributes to local development.” One of the municipality’s main aims is to provide quality, basic services to all “Cervantenians” with a special focus on marginalised groups. One of the actions to support this agenda was training provided by the CBM-CBR Coordinating Office to local doctors and health workers. This training enabled 960 people with disabilities to be identified in the municipality and more are expected to be identified in the future. The training and identification process took place through existing activities and field visits, making use of village health workers, midwives, municipal doctor and others. This meant maximum impact could be achieved for minimal additional cost.

Other inclusive health services and training that have been implemented are:

  • Home visits for people with disabilities who cannot get to clinics, conducted by a specially trained doctor.
  • Financial assistance for people with disabilities who need to be referred to hospitals.
  • Repair of water systems in the different barangays according to the accessibility concerns voiced by people with disability. This means they can have water close to their homes, which is especially important during natural disasters.
  • Training for the municipality on including people with disabilities in Disaster Risk Reduction Management (DRRM) programmes.
  • Distribution of assistive devices in partnership with the provincial government of Ilocos Sur, the Latter Day Saints and the networks of CBM-CBR-CO.

In order to replicate the programme, Mayor Maggay is committed to sharing the lessons learned from the programme with other mayors and LGU leaders. So far, he is having some success in sharing these lessons and encouraging other mayors to consider CBR as a model, he stated “Many have other priorities and are not interested, but I have already convinced three municipalities to replicate the programme”.