FEATURE | Dr. Honorata Catibog – Bringing Healthcare to Grassroots Level

For the tenacious Dr. Catibog advocacy is no lip service

As Dr. Honorata Catibog, director of DOH’s Family Health Office, fondly recall the times she has spent as Municipal Health Officer and Provincial Board Member -- combing the remotest barrios of her native Western Samar -- one can’t help but grasp that her advocacy is not one that is compulsory of her office but is borne out of years of experience accompanied with the tireless dedication to bring healthcare to those hardest to reach. Her tenacity is easily noticeable in the personal anecdotes she readily shared during our brief afternoon interview: looking back at this one time when she had sea ambulances custom made to service several island municipalities under her jurisdiction, then as provincial board member of Western Samar. Such that Dr. Catibog’s remark about understanding the “difficulties of bringing healthcare to people at grassroots level” and importance of public policies in ensuring its success is certainly no lip service.

It is no secret that the success of any health reform lie not only in the merits and benefits of the program but equally relies on a sound and robust political strategy that shall guarantee its effective and timely implementation across a wide constituency. Dr. Catibog is one of the instrumental forces in championing maternal and infant health, having headed the Task Force for Rapid Reduction of Maternal and Neonatal Mortality. The task force was responsible for institutionalization and strengthening the implementation of the Maternal, Neonatal and Child Health and Nutrition (MNCHN) Strategy.

The MNCHN Strategy is formalized under the AO No. 2008-2009 otherwise known as Implementing Health Reforms for the Rapid Reduction of Maternal and Neonatal Mortality. This Order applies the Fourmula One for Health (F1) approach instituted by then Health Secretary Francisco Duque III for the implementation of an integrated Maternal, Neonatal and Child Health and Nutrition (MNCHN) Strategy. This overarching strategy guides the development, implementation and evaluation of various programs aimed at women, mothers and children, with the ultimate goal of rapidly reducing maternal and neonatal mortality in the country. This goal is to be achieved through the provision and use of integrated MNCHN services, which refers to a package of services for women, mothers and children that cover known appropriate clinical case management services and cost-effective public health measures which are provided by the health system to reduce the risks of and prevent direct causes of maternal and neonatal deaths. 

Enclosed within this strategy are provisions to guide the engagement, assistance and empowerment of LGUs and other partners in providing an integrated package of services for mothers, babies and children. This includes organizing training sessions and capacitybuilding workshops for community health workers enabling them to respond to the evolving needs of their clients from prenatal to intrapartum and postpartum/postnatal care and interventions. Dr. Catibog further emphasizes that this integration reflects the paradigm shift cognizant that health workers and providers should be able to address and manage complications that may arise at any of the stages in a woman’s pregnancy. For instance, midwives, at the LGU level, shall be trained not only in evidence-based safe delivery practices but also trained in essential newborn care (ENC).

In continuing efforts to rapidly reduce the number of newborn death in the Philippines, the DOH issued an administrative order to implement the ENC protocol last December 1, 2009. The AO 2009-0025, the whole hierarchy of the DOH and its attached agencies, public and private providers of health care and development partners implementing the Maternal, Newborn and Child Health and Nutrition Strategy and all health practitioners of maternal and newborn care were enjoined to adopt the policies and protocol on Essential Newborn Care. ENC was likewise incorporated into the Basic Emergency Obstetric and Newborn Care (BEmONC) Training. Unang Yakap is the social marketing campaign that was launched to spread the call to action to implement the Essential Newborn Care protocol. At advanced implementation sites, as the ENC scale-up program evolved into the Essential Intrapartum and Newborn Care protocol, Unang Yakap likewise became Unang Yakap 4&5. 

Asked of what else is needed to further the aims in achieving the goals of MDGs 4 & 5, Dr. Catibog responds, “[I am hoping] that we can bring EINC implementation down to the barangay level with barangay health workers being equipped to carry out EINC protocol even at barangay health stations or perhaps even at home.” She quickly qualifies, “while the gold standard is facility-based, we should consider fallback options for areas where health facilities are not yet available…with the EINC protocol, we ensure the life of the mother and baby even when the mothers are forced to give birth at home.”

In her closing remarks to the 1^st MNCHN EINC Advocacy Forum held last July 13-15 at Century Park Hotel in Manila, Director Catibog underlines the crucial partnership of the public and private sectors as a significant step to achieving the country’s commitment to Millennium Development Goals 4 and 5: “With the birth of this new partnership with the private sector, we can successfully prevent the needless death of mothers and newborns in the country,” further adding that the private sector’s involvement is the yet largely untapped area ensuring that safe and essential intrapartum and newborn care is given to as many Filipino mothers and newborns as possible.