Special Project For The Mothers and Babies of Candoni

Introduction
In 2007, Candoni's maternal death rate was 5.69 per 1,000 live births, making Candoni among the municipalities in the Negros Occidental province that have high maternal mortality rates. The leading causes of maternal death in 2007 were post-partum bleeding and complications of pregnancy-induced hypertension. Candoni is a poor municipality (4th class) situated in the Tabla Valley at the South part of Negros Occidental. It is surrounded by Cauayan, Ilog, Hinobaan and Sipalay. It has a Main Health Center and barangay health station in every 9 barangays within the municipality.


Maternal Mortality and Infant Mortality are among the leading problems of the municipality, thus, when I was deployed as doctor to the barrio in November 2007, I made it a personal goal to reduce maternal mortality and infant mortality rates by half.


What has been done:

To address the maternality mortality rate problem, I decided to ask help from the community and make them realize that the only solution is to enable to community to support the health programs of the government. One program is the facility-based delivery policy of theDepartment of Health . Years ago, to address the lack of supply against the high demand for doctors in the rural areas who would tend to birthing mothers, theDepartment of Health decided to train traditional birth attendants (hilots) to handle deliveries whether in the home or in birthing centers. The objective was to reduce maternal mortality due to complications surrounding the birthing process.

Unfortunately, despite this effort, the maternal mortality rate in the Philippines was relatively high. Thus, in the early 2006, the Department of Health changed perspective. This time, all deliveries must be handled only by skilled birth attendants, such as doctors, nurses and licensed midwives, and only in a well-equipped birthing facility. No more home deliveries or deliveries attended by hilots. The role of the hilot has been demoted only to assisting the doctor or nurse or midwife and the mother before, during and after delivery.
This is where the tricky part comes in. How do we get the mothers to deliver in the Main Health Center? Many of these pregnant women reside in far-flung areas. Many of these pregnant women also have been used to having their babies delivered in their homes out of habit and convenience.

Meeting the Hilots:
In order to solicit support from the community, in the summer of 2008, I gathered all the trained and untrained hilots of Candoni and discussed with them the new policy of theDepartment of Health together with the village chiefs. I was able to gather their support and all of them pledged to support the new policy of the Department of Health.

At the same time, in order to complement the demand for facility based deliveries, I was able to lobby with the local government unit to start the renovation of the Mainhealth center which is equipped with a Delivery Room. Through the efforts of incumbent mayor Cicero Borromeo, the renovated Main health center , which is equipped with a Delivery Room, Labor Room and Observation Ward (along with an emergency room, TB DOTS laboratory, mini-conference room and public health office), was blessed and opened on September 15, 2008.

Thus, by the end of 2008, we were able to reduce maternal mortality rate from 5.6 per 1000 live births in 2007 to 0 per 1,000 live births. We have also increased our facility-based delivery rate from a meager 24% in 2007 to 74% in 2008.

More to be done:
Unfortunately, there is still more to be done and while many mothers are now opting to have their babies delivered at the Main health center, there are still a number of mothers, particularly indigent mothers, who would prefer to have their babies delivered at home for reasons such as: economics (they cannot afford to spend for transportation and some medical supplies) and in my personal opinion lack of motivation.

If not addressed, these mothers who still prefer to have their babies delivered at home, who still prefer not to seek prenatal consultation, and who still prefer not to have their babies immunized, this group of individuals can be the source of an outbreak of preventable diseases.

A mechanism must be in placed therefore that would motivate the mothers to seek prenatal consultation, deliver their babies at home and ensure that their children are fully immunized.

The Proposal:
To motivate the mothers and even the fathers, I have proposed to start a special project: The Buntis Baby Bag.

The Buntis Baby Bag is a package containing the following items:

"White Bag"
disposable baby diaper
newborn clothes
loin cloths
safety pin
Multivitamin drops for baby*
free Newborn Screening Kit*
Canned goods for the family
ready-to-eat noodle packs (siblings)

"Green Bag"
baby clothes
multivitamin drops*
slippers
1 kilo of rice*
ready-to-eat noodle packs
canned goods for the family


The White Bag will be given to a mother who:
1. has had at least 4 prenatal visits as reflected in her prenatal card
2. has her baby delivered at the main health center of Candoni, Negros Occidental only.
3. has made one post-natal visit at the barangay health center within the first month after she delivered her baby.

The Green Bag will be given to a mother:
1. whose child has completed his or her immunization shots (last shot = Measles vaccine).
2. whose child has made a well-baby visit at the Main Health Center or at the barangay health center before the child has reached 1 year old.

The Green Bag will be given regardless whether the child was born at home or in a facility. The White Bag and the Green Bag will be given to the mother regardless of the number of times the motheris pregnant.


Estimated cost of the Bags:
"White Bag"
disposable baby diaper (3 pieces x P9/piece = 27 pesos)
newborn clothes (2 pieces x P30/piece = 60 pesos)
loin cloths (2 pieces x 200/piece = 400 pesos)
safety pin (2 pieces x 12/piece = 24 pesos)
Multivitamin drops for baby* (100 pesos/bottle)
free Newborn Screening Kit* (600 pesos/kit)
Canned goods for the family (3 cans x P20/can = 60 pesos)
ready-to-eat noodle packs (siblings) (7 pieces x P6/piece = 42 pesos)
TOTAL estimated cost per bag = 1,313.00 pesos
*Newborn Screening Kits and Multivitamin drops for baby can be provided by LGU as counterpart from the existing Municipal health office budget or from Early Childhood Care and Development Grant Fund.


"Green Bag"
baby clothes (2 pieces x 100/piece = 200 pesos)
multivitamin drops* (130/bottle)
1 kilo of rice* (P35/kilo)
ready-to-eat noodle packs (7 pieces x P6/piece = 42 pesos)
canned goods for the family (7 cans x P20/can = 140 pesos)
baby toys (1 piece x P100/piece = 100 pesos)
TOTAL estimated cost per bag= 647.00 pesos
*Multivitamin drops and 1 kilo of rice can be provided for by the LGU as its counterpart from the existing Municipal health Office budget or from Early Childhood Care and Development Grant Fund.

Target population:
1 delivery per day x 30 days a month x 12 months a year = 360 deliveries

(est)25,000 population x 2.7% (target) = 675 target children

Which means for the White Bags: 360 x 1,313pesos/bag = 472,680 pesos for the year
For the Green Bags: 675 x 647pesos/bag = 436,725 pesos for the year.
TOTAL: 909,405.00 pesos

With this huge amount, the municipality cannot shoulder the entire value of the bags. However, the municipality can provide the free Newborn Screening Kits, Multivitamin Drops and 1 kilo of rice.

For the White Bags: NBS (600 pesos) + MVdrops (100 pesos) = 700 pesos
700 pesos x 360 deliveries = 252,000 pesos

For the Green Bags: 1 Kilo of rice (35 pesos) + MVdrops (130 pesos) = 165 pesos
165 pesos x 675 target children = 111,375 pesos.
TOTAL LGU counterpart = 363,375.00 pesos
REMAINING AMOUNT TO RAISE = 909,405.00 - 363,375.00 = 546,030.00 pesos
{itemized: Multivitamin drops: (100 pesos x 360)+(130 pesos x 675) = (36,000 + 87,750) = 123,750 pesos}
{itemized: Newborn Screening Kits: 600 pesos x 360 = 216,000 pesos.}
{itemized: 1 Kilo of rice: 35 pesos x 675 target children = 23,625 pesos, 675 kilos divided by 50 kilos = 13.5 sacks of rice}

Need To Raise:
In order to fill up my White and Green Bags, I have decided to ask help from all generous patrons and philanthropists out there. Through this blog, I am therefore asking any individual, organization or community who wish to help me fill up these bags. Instead of giving money, contributions of any of the listed items will be very much appreciated. Baby diapers, clothes, toys (for less than a year old), even multivitamin drops for babies, or anything you would wish to add to our White and Green Bags, will help the poor mothers and their babies in the almost-forgotten poor municipality of Candoni.

Our goal is to make the mothers visit their doctors more frequently through more regular prenatal visits. Our goal is to convince the mothers to have their babies delivered at the birthing facility attended by skilled workers. Our goal is to motivate the mothers to have their babies immunized. The ultimate goal is to prevent mothers from dying. The ultimate goal is to prevent babies from dying before they reach their first year of life.

Many of these poor mothers are left with no options thus they resort to what is convenient to them. By rewarding them with goodies due to good health seeking behavior, we inculcate in them a more desirable health seeking behavior. By improving their health seeking behavior, the facility-based delivery of the government will be more effective.

If anyone is interested, I would be willing to make a presentation with regards to the situation in Candoni and how I believe this Baby Buntis Bags will be helpful not only to the program of the government but to the mothers and their babies as well.

Take note: these bags are NOT DOLE-OUTS. For a mother to receive a bag, she has to make effort to make at least 4 prenatal visits, to make effort to have her child deliver at the health facility, and to make effort to bring her child to the barangay health station for their scheduled immunization.

Bags will not be tagged with names and pictures of any politician in order to avoid partisanship. Instead, bags will be tagged with the title of the Project and the Logo of the Municipality of Candoni only.

If anyone is interested to know how they can contribute, please send me a note or an email or a comment and leave me with your contact details (contact details will be made confidential) and I can send you more information on how to send in your donations. Remember, I will not accept at any time cash donations. We would prefer the items already listed. Second-hand items are acceptable. In fact, I personally encourage anyone donating their old toys, old loin cloths, etc. instead of really purchasing new ones. Canned goods and ready-to-eat noodles can be substituted with other grocery items. These grocery items can help the family during the time the mother or father had to skip work in order to attend to their kid's immunization or his wife's delivery.

I am making an appeal to anyone there who has extra to give away. I am willing to personally pick up these items at any place you would want me to pick up. At the same time, I am also willing to make links with other interested groups, whether small or big organizations, who are willing to help me fill up my bags.

On my end, I will be lobbying this to the municipality to convince them to provide their own counterpart.

I am hopeful that many will consider the many indigent people in Candoni, through this very simple project for the mothers and their kids.