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Philippine's Response to AIDS

Chief, Health Division. Health and Nutrition Center, DepEd. Country Report. Philippine's Response to AIDS. by . MARIA CORAZON C. DUMLAO, MD, MPH. Government. Population. Capital . : Manila. : 84.7 M (2004). Population. : President. Head of State. : 115 M (2015). System .

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Philippine's Response to AIDS

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  1. Chief, Health Division Health and Nutrition Center, DepEd Country Report Philippine's Response to AIDS by MARIA CORAZON C. DUMLAO, MD, MPH

  2. Government Population Capital : Manila : 84.7 M (2004) Population : President Head of State : 115 M (2015) System : Presidential : 37% below 15 y/o Urban Population : 48% Average Size of Households : 5.0 Health Situation : Males - 67 Life Expectancy : Females - 72 Infant Mortality Rate : 29 / 1000 Economy Education Geography Crude Death Rate Currency : Peso (P) : 18,730,682 : 5.8 / 1000 Student Population : P1,100,654 B : 300,080 sq. km GNP Land Area No. of Schools : 60,439 Maternal Mortality : 172 / 100,000 GDP : P1,104,255 B No. of Teachers No. of Islands : 7,107 : 451,134 Women pregnant / year : 2.4 M Total Exports : $ 2.849 B Mountains : Sierra Madre Literacy Rate : 95.6 OB complications/ Hospitalization : 360,000 Total Imports : $ 2.867 B Lakes : Laguna & 58 others Teacher-Student Ratio : 1:41 Unsafe abortions : 400,000 4th Leading cause of Maternal Mortality : Induced Abortion

  3. Philippine's Response to AIDS Educational System • Free and compulsary – Elementary (6 years) • Free Secondary Education (4 years) • Department of Education • Responsible for the management of basic educ. (elementary & secondary levels) • Commission on Higher Education • Tertiary level • Technical Education and Skills Development Authority (TESDA) • Post-Secondary Vocational and Tech.

  4. Philippine's Response to AIDS School Population – SY 2003 – 2004 - DepEd A. Pupils / Students

  5. Philippine's Response to AIDS B. Teachers and Non-Teaching Personnel

  6. Philippine's Response to AIDS Ten Leading Cause of Morbidity 2002 Number Rate per 100,000 Rate 866,411 700,105 632,930 502,718 279,992 126,489 52,957 50,869 35,306 23,287 1134.8 917.0 829.0 658.5 366.7 165.7 69.4 66.6 46.2 30.5 • Diarrheal disease • Bronchitis • Pneumonias • Influenza • Hypertension • TB Respiratory • Disease of the heart • Malaria • Chichen Pox • Measles

  7. Philippine's Response to AIDS Ten Leading Cause of Mortality 1998 Number Causes Rate 55,830 41,380 33,709 32,090 29,874 28,041 14,228 8,819 7,516 7,453 76.3 11.7 46.1 43.9 40.8 38.3 19.5 12.1 10.3 10.2 • Disease of the heart • Disease of the vascular system • Pneumonia • Malignant neoplasms • Accidents • Tuberculosis (all forms) • Chronic obstructive pulmonary diseases and allied conditions • Diabetes Mellitus • Other diseases of respiratory system • Nephritis, Nephrotic • Syndrome and Nephrosis

  8. Philippine's Response to AIDS Health Expenditures • Health Budget US$ 186M (1.5% of total US$ 1.22B) • 70.4% Personal Health care Delivery • 14.1% Public Health Programs • Share of Health Expenditure (WHO standard 5%) 1998 - 3.3% to 2001 - 3.1%

  9. Philippine's Response to AIDS HIV/AIDS Budget • 2003 US$ 300,000 0.16% of the Dept. of Health budget 0.025% total general appropriation (GA) • Majority of responses externally sourced • US$ 8.5M needed every year for strategic activities of the Third Medium Term Plan

  10. Philippine's Response to AIDS Health Care Delivery System • Decentralized since 1992 (Local Gov’t. Code)  Health Care devolved to LGU’s • 1,708 hospitals • 640 government • 1068 private • 2,045 Rural Health Units (RHUs) • 13,096 Barangay (village) health stations

  11. Philippine's Response to AIDS AIDS Registry – (Institutionalized since 1987)As of November 2003 • 1953 - HIV + • 630 - AIDS • 256 - Deaths • 6000 estimates

  12. Philippine's Response to AIDS RELEVANT INFORMATION FROM AIDS REGISTRY • Predominant Sexual Transmission • Male to Female ratio of 1:6 to 1 • 62% males • Peak age for female (20-29 years) • Peak age for males (30-39 years) • 32% of total infected are overseas workers: 39% are seafarers

  13. Philippine's Response to AIDS • STI reports  mainly come from social hygiene clinics (SHC) 1993 – 1999  35,500 of STI cases reported

  14. Philippine's Response to AIDS 3rd YAFS – Young Adult Fertility and Sexuality (YAFS 3) – study by UPPI (University of the Philippines Population Institute) • Show that young adults have liberal attitudes on sexuality and sexual practices

  15. Philippine's Response to AIDS Knowledge Survey Among Pupils(DepEd) 10 - item knowledge test National Average of 5.3 All below passing average of 75%

  16. School Nurse Teachers 14% 10% Friends 4% Doctor Others 19% 2% Sisters/Bros. 2% T.V. Parents 17% 13% Newspapers Radio 8% 8% Sources of Information on AIDS/HIV: Elementary Level

  17. Philippine's Response to AIDS Knowledge Survey Among H.S. Students(DepEd) • 15 item test • national average is 9.07 • all below ideal passing average of 75% or 11 correct answers

  18. School Nurse Teachers 7% 20% Doctor 19% Friends 3% Parents Others 1% 10% Sisters/Bros. 2% T.V. Radio 17% 10% Newspapers 12% Sources of Information on HIV/AIDS: Secondary Level

  19. Current low prevalence may be influenced in the future by the following factors : TRENDS FOR THE FUTURE • Increased mobility of some population groups • A fast growing young population • Persisting knowledge gaps in all groups studied • Low condom use • Needles/syringes sharing • High STI prevalence and high antimicrobial resistance • Lack of available low cost ARV • Inadequate government support for other therapeutic agents • High economic impact of AIDS

  20. Philippine's Response to AIDS The Philippine Government Responding to HIV / AIDS • Creation of Philippine AIDS Prevention and Control Act in 1998 (Republic Act 8504) • The law provides a clear basis for policies and plans to address the problem of HIV/AIDS

  21. Lead agency in the fight against HIV/AIDS • It coordinates and oversees various programs and activities dedicated to the prevention and control of HIV/AIDS in the Philippines

  22. PNAC Network • The Council itself, with 26 members as defined by law. • The Secretariat of the Council, staffed primarily by officials and personnel of the DOH • The organizations with representation in the Council, which include 13 government agencies, 2 leagues of local governments, 2 committees of Congress, 2 medical and professional organization, and 7 NGOs, including one for people with HIV/AIDS.

  23. PNAC Network • Cooperating projects assisted by donors of financed by government. • Self-financed organizations working in fields related to HIV/AIDS. • Voluntarily organized local AIDS councils. • Local governments undertaking HIV/AIDS activities.

  24. PNACThe Dynamic structure 2000 • Organizational contraction • Role expansion • 4 committees • Scientific Committee • Committee on Advocacy • Committee on Education • Committee on Local Responses

  25. Scientific Committee • Capacity Building of PNAC on Ethical Guidelines for HIV/AIDS • Establishment/Institutionalization of STI surveillance and Behavioral surveillance systems in the designated local areas of integration. • Research and Economic valuation on STI/HIV/AIDS interventions

  26. Scientific Committee • Evaluation Research on Program interventions • Dissemination Fora on HIV/AIDS situation/programs/issues • Collection and Compilation/Publication of the Philippine HIV/AIDS social/bio-medical research • Further research on data gaps

  27. Committee on Advocacy • A network of organizations,institutions and individuals is regularly interacting in support of the priorities and targets of PNAC • Major Media organizations assume responsibility for educating and informing their audiences about HIV/AIDS • The main organized churches and religions in the country accept their respective responsibility for educating and informing their members about HIV/AIDS prevention

  28. Advocacy Activities • World AIDS DAY/Awareness related events • Candlelight Commemoration • Formation of a Critical Core of the Most Aware focused advocacy • Executives/Legislators/Leaders • Health Workers • Employers • Educators • Religious • Civil Society/Vulnerable groups

  29. Advocacy Activities • Media • Capacity Building of Local media on HIV/AIDS in the Local Areas of Integration • Regular Press Briefers/Releases on STI/HIV/AIDS and Development • Establishment of Local/Sub national networks for the Tri-Media • Production of new communication tools and materials for STI/HIV/AIDS

  30. Committee on Education • Public and Private tertiary and secondary formal education programs include adequate information on HIV/AIDS in the curriculum training materials including textbooks, teacher training courses • Capability building for STI management,VCT and care and support at the different levels of the LGUs to ensure the continuum and quality of care

  31. Committee on Education • Capability building for Institutions/Organizations in providing focused STI/HIV/AIDS education • Groups at Most Risk • Institutions • Education (teachers/parents) • Workplace • Special Settings

  32. Committee on Education • Training of Social Workers and Counselors in other related institutions on HIV/AIDS • Capacity building of legal and para-legal personnel on HIV/AIDS rights and ethics

  33. Committee on Education • Instituting HIV/AIDS education in the school curricula • DepEd • CHED • TESDA • Training for STI care/ VCT in the Local Heath Settings • Training for HIV/AIDS Core Teams in the City/Provincial Hospitals and Selected Private Hospitals

  34. Committee on Local Responses • At least 60% of the local government jurisdictions are associated with an active sub-national coordinating mechanism for HIV/AIDS Prevention

  35. Lagging: HIV+ AIDS Deaths Mainstreamed Basic Health Services OIs ARVs Counseling Community -based care Home Care Work and Welfare Pallative Care Services Policy Structure Co-incidental: STIs Condom Use Behavioral Indicators Social Hygiene Clinic Services Voluntary Counseling and Testing Services STI and Behavioral Surveillance Focused IEC activities Policy Structure Leading: Dempgraphics HDIs Institutional HIV/AIDS Education Programs Workplace HIV/AIDS Programs NGO/CBO-Civil Society Intervention/Investment Private Sector Investments in HIV/AIDS Policy Structure Indicators for Local Reponses

  36. The Phases of Local Responses

  37. 2000 – 2004 Medium Term Plan • Five Focus Strategies • Improve care and support for people with HIV/AIDS through enhanced hospital-based services, promoting community-based care and support for PWHAs, private sector involvement in counseling and treatment services and increased access to voluntary counseling and treatment.

  38. 2000 – 2004 Medium Term Plan • Address the specific needs of people in prostitution by increasing access to acceptable and effective STI services for sex workers and their clients, strengthening the capacity of peer educators to influence behavioral change, and intensifying condom social marketing.

  39. 2000 – 2004 Medium Term Plan • Empower the youth sector with correct knowledge and information on reproductive health, sexuality and HIV/AIDS; initiate youth-friendly RH services and peer counseling; and assist young people living with STI/HIV/AIDS.

  40. 2000 – 2004 Medium Term Plan • Provide protection to migrant workers from mandatory HIV antibody testing by pushing for strict compliance to provisions of RA 8504 on testing and confidentiality. • Increase awareness on HIV/AIDS in the workplace by improving awareness of workers, medical personnel and union members on HIV/AIDS, rights and development issues.

  41. Vulnerable Groups PIPS (500,000 - 1M) IDUs - 400-500Thou 15,000* MSMs Youth (15-24) 15.7M or 20% Clients (1-2M) Migrant Workers 7.6M Institutions DepEd CHED TESDA Special Groups AFP/PNP/Prisons Workplace In Country 31M PNAC Plan for 2002-2004prevention focus (15 - 49) 51% of 80M

  42. Department of Education SCHOOL-BASED AIDS EDUCATION PROJECT

  43. RA 8504 Mandates DepEd to integrate AIDS Prevention Concepts One priority thrust for EFA 2015

  44. Philippine's Response to AIDS OBJECTIVES: Goal: To develop matured and responsible studentry imbued with desirable health values which can assist them in making rational decisions that can lead to satisfying, productive, and quality life.

  45. Philippine's Response to AIDS OBJECTIVES: • Create awareness on the local and global situation on AIDS • Inculcate desirable health behavior • Provide pre-and in-service training of teachers and other school officials

  46. Philippine's Response to AIDS OBJECTIVES: Strengthen parent and community involvement Initiate research studies Institutionalize AIDS prevention education

  47. Philippine's Response to AIDS COMPONENTS: IEC Co-curricular and Ancillary Services HRD Parent Education & Community Outreach Monitoring, Research & Evaluation

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