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Is the Curriculum Responsive to the Needs of the Community?

Revisiting The POGS Residency Training Curriculum:. Is the Curriculum Responsive to the Needs of the Community?. Revisit the POGS Residency Training Curriculum. 1.Is it responsive to the MDGs?

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Is the Curriculum Responsive to the Needs of the Community?

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  1. Revisiting The POGS Residency Training Curriculum: Is the Curriculum Responsive to the Needs of the Community?

  2. Revisit the POGS Residency Training Curriculum 1.Is it responsive to the MDGs? 2. How active is community participation? 3.Identify Health problems and solutions 4. What is the difference in Curriculum implementation between the community based and hospital based both private and government? 5. What are the difficulties encountered in the Residency Training Program? What are the needs of assessment kindly identify the weakness and strengths?

  3. Acknowledgement: Sources • The PBOG handbooks, 1996, 2006 • Brokenshire WomanCenter files • Files from Women Deliver Conference, September 2010 4. August 2009 issue of the POGS Neswletter 5. Southern Philippines Medical Center 2010 Statistics 6. The worldwide web

  4. 1. POGS Training Curriculum - clinical, individual patients 2. Community defined Premises 4. CREED- relevance of curriculum 3. Women with priority health problems

  5. Health Systems Building Blocks Governance Structures Health Services Human Resources for Health Regulatory Mechanisms Health Information Systems Health Care Financing WHO

  6. Most maternal deaths occur during labor, delivery and the immediate post-partum period Percent of maternal deaths in developing countries 0-1 day 2-7 days 8-14 days 15-21 days 22-30 days 31-42 days Day of maternal death after delivery Source: X. F. Li et al., International Joumal of Gynecology & Obstetrics 54 (1996): 1-10 Women Deliver Philippines, Crowne Plaza, September 15-17, 2010

  7. Attendant at delivery NDHS 2008

  8. Health Systems Building Blocks Governance Structures Health Services Human Resources for Health Regulatory Mechanisms Health Information Systems Health Care Financing WHO

  9. The progress made on MMR, 1993-2006 (Source: NSO) Sources: 1993 NDS, 1998 NDHS, 2006 FPS

  10. Saving Filipino Women’s Lives • Core heath-sector strategies for reduction of maternal mortality: • 1. Comprehensive reproductive healthcare, including family planning. • 2. Skilled care for all pregnant women by a qualified midwife, nurse, or doctor during pregnancy and childbirth. • 3. Emergency care for all women and infants with life-threatening complications.

  11. WOMEN’S HEALTH THE ROAD TO WOMEN’S HEALTH PBOG handbook, 2006 MDGs, 2000 PBOG handbook,1996 Beijing, 1995 ICPD, Cairo, 1994 Safe Motherhood, Nairobi, 1987 CEDAW, 1979 Alma Ata Conference, 1977 Human Rights, 1948

  12. Increasing female education, improving gender equality, and strengthening empowerment for making decisions about seeking care are essential elements of strategies to reduce maternal mortality. WHO, 2007

  13. Integration of Non-Clinical Subjects • Primary Care (Level 1) • First year of Training • Involvement and Provision • of Public Health Services • STD • Immunization • Women’s Advocacy, • Domestic Violence and • Counselling • Breastfeeding and • Lactation Management • Family Planning • (Natural and Artificial) • Women and Children • Protection Unit (Observational Capacity) • Health Education: • Mothers’ Classes • Introduction to Medical • ethics • Reproductive Health • Concept and Advocacy • Tertiary Care • (Level III and IV) • Third and Fourth Year • of Training • Treatment and Diagnosis of Gender Based Violence • Familiarity with common Ethical Issues in Ob-Gyn • Optional Rotations: • Pedagogy • Community Development • Reproductive Health NGO Immersion • Secondary Care • (Level II) • Second Year of Training • Psychosocial/ Study Tour Immersion PBOG handbook, 2006

  14. Saving Filipino Women’s Lives • Core heath-sector strategies for reduction of maternal mortality: • 1. Comprehensive reproductive healthcare, including family planning. • 2. Skilled care for all pregnant women by a qualified midwife, nurse, or doctor during pregnancy and childbirth. • 3. Emergency care for all women and infants with life-threatening complications.

  15. MMR in POGS Accredited Hospitals Capito, POGS Newsletter August 2009

  16. Southern Philippines Medical Center, Davao City 2010 Data 36,315 out patients 30,950 admissions 13,644 deliveries 18 residents MMR-248/100,000 livebirths with permission

  17. Resident Duty Hours excessive service demands long work hours Fatigue, sleep deprivation Physician error, depression, anger, lack of compassion Harmful to patients, exploitative of residents Annals of Internal Medicine, 1995

  18. Obstetrics and Gynecology “ …increasingly economically unforgiving environment, where fiscal pressures challenge core missions.” Ethics: an essential dimension of soliciting philanthropic gifts from donors, Chervenak, et al, AJOG December 2010

  19. “The biggest enemy of women’s health and rights is political indifference” Jill Sheffield President of Women Deliver, 2010

  20. Maternal Mortality for 181 countries: 1980-2008: A Systematic Analysis of Progress towards MDG 5 Maternal deaths- 1980- 526,300 2008- 342,900 Global MMR- 1980- 422 2008- 251 23 countries on track to achieve MDG 5 The Lancet, April 12, 2010

  21. Recommendations 1. Deeper integration of Gender and Reproductive Health to the curriculum, backed by continuous exposure or experiences of working with NGOs, LGUs, midwives, community organizations • Professionalism • Gender, social, and cultural sensitivity • Community orientation • Ethics

  22. Recommendations 2. Value Integration efforts in the accreditation of programs, with due consideration of varied program/institution philosophy, vision and mission. 3. Extract data from the POGS Annual Statistics, make meaningful analysis, and utilize them to: • Identify hospitals with the highest MMR and study causes and areas where interventions can have impact • Seek funding support for operations research and trainings

  23. Recommendations • 4. For POGS accredited hospitals to study their own data on • Service and education components of the program • 4.1Impact of resident duty hours • 4.2 Maternal Mortality ratio and morbidity rates • Utilize data to : • 4.3 Advocate for policy changes , administrative support • 4.4 Seek funding support for operations • research and trainings • 4.5 Seek funding for services

  24. Good day! Mabuhay!

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