4.2.b Identification of Lands and Sites for Socialized Housing: 1.

Gawad Kalinga (Tubodville Housing Project)

The City of Toledo acquired a 3 hectare lot along Barangay Tubod which has been developed as reseetlement site for the poorest among the poor dwellers within the city. The program is in partnership with Gawad Kalinga who sourced out funds from other sources for its development. A. No. of Housing Units: 28 units completed 40 units under construction 92 for construction B. Type of Building : Duplex, Row House (6 units/row) C. No. of Beneficiaries : 160 D. Future Projects: Riprapping Works and Improvement of Roads 2. Toledo Socialized Housing Project A. Landowner : National Housing Authority B. Total Area : 114,562 square meters (11.45 has.) C. Land Use Classification : Residential D. Density : 78 units E. Housing Units: Type Single Detached 1 Single Detached 2 Duplex 1 Duplex 2 Row House Floor Area 26 sq.m. 32 sq.m. 26 sq.m. 26 sq.m. 26 sq.m. total F. Site Characteristics/Conditions: Topography Existing Utilities Water : : : Deepwell is available on-site, but the Local Water District is willing to supply Water to the project Gently Rolling No. of Units 267 74 446 21 87 895

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Power Drainage Access R.O.W

: : :

Primary

power

lines

supplied

by

the

local electric cooperative Drainage outfall shall be through the Road-right-of way With acquired road-right-of way The site is a partially developed residential subdivision. It is accessible to almost all forms of economic, social, health and educational centers and institutions. It is strategically located and is very suitable for housing. Technical Aspects: Land Use Saleable Residential Non-saleable Roads/Circulation Easements Community Facilities Parks & Playgrounds Total No. of Saleable Lots/Units: Residential : 895 House & Lot Packages No. of Units Socialized Economic Residential Lot Sizes: Minimum Maximum Modal Average : 40 square meters : 192 square meters : 60 square meters : 78.49 square meters 554 341 % 62% 38% 45,075 29,910 2,033 2,126 11,006 114,562 39.35% 26.11% 1.77% 1.86% 9.61% 100% Area(sq.m) 69,487 % 60.65% Other Characteristics:

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3. DASMASSICO SOCIALIZED HOUSING DEVELOPMENT PROGRAM R.A. 7279 otherwise known as the Urban Development and Housing Act mandates that Local Government Units uplift the conditions of the underprivileged and homeless citizens. The City of Toledo passed Resolution No. 2006-47 authorizing the City Mayor to sell a parcel of land located at DASMASSICO, Barangay DAS, Toledo City to its occupants as part of the on-site housing development program of the city. The area is owned by the city government with Tax Declaration No. 2007-149016 and as per recommendation by the City Appraisal Committee, the city will square meter along the main road or highway. The dispose the area on a stripping method in which the reference value is P700.00 per beneficiaries shall pay to the City of Toledo on cash or installment basis without interest the corresponding area occupied for a specified number of years. There are about were awarded Board. eighty-nine (89) beneficiaries belonging to the Lower DAS (DASMASSICO) Homeowners Association and all of which a Certificate of Lot Entitlement by the Toledo Housing

4. Fishermans Village - Mainggit

A. Area : 21,404 sq.m B. Location : Salvage Zone, Barangay Mainggit ( Sto. Nio) C. No. of Households: 32 D. Facilities : Comfort Room - 1 , Basketball Court - 1 E. Water System : Shallow well - 2 F. Livelihood : Fishing 5. Blasab Gala Homes Subdivision (PAG-IBIG ASSISTED PROJECT) Location Owner/Developer Land Area No. of Lots Amenities : Barangay Poog, Toledo City : Blasab Realty & Development Corp. : 4.4 has : 281 lots @ P100/sq.mtr/lot :

a) Entrance Gate with guard house b) Concrete main road & secondary road with curb & gutter

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c) Underground storm drainage system d) Centralized reservoir e) Complete electrical facilities f) Landscaped parks & playground g) Perimeter fence h) Systematic solid waste disposal i) j) Multi-purpose clubhouse Street lighting facilities water distribution system with elevated water

k) Basketball court/tennis court A privately-operated housing project that is open to all PAG-IBIG members. 6. Lingap Para sa Mahihirap (Matab-ang Housing Project) The city with the assistance of former Congressman Antonio P. Yapha of the 3rd Congressional District of Cebu endorsed the Matab-ang Proper Homeowners Association Barangay Matab-ang as the possible recipient of the President Estradas Lingap para sa Mahihirap Program. With the program, the city purchased a 2000 sq.m. lot for the intended beneficiaries. There are about 15 benficiaries of the program. Table 4.31 SUMMARY OF EXISTING SOCIALIZED HOUSING PROJECTS Housing Project 1.Tubodville Gawad Kalinga 2. Toledo Housing Village 3. DASMASSICO Socialized Housing Project 4. BLASAB 5. Fishermens Village 6. Lingap Para sa Mahihirap Total National/ DENR Toledo City Govt. Landowner Toledo City Govt. NHA Toledo City Govt. Private Sector Location Tubod Luray II DAS Poog Sto. Nino Matabang Area 3 has 11 has 5,000 sq.m 4.4 has 2.14 has 2,000 sq.m 21.24 has No. of Units 160 895 89 281 35 15 1475 units Status of Development Housing construction ongoing Underdevelop On site On-going Documentation On-Process On-going

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Housing Needs Housing needs in Toledo City consists of housing backlogs and the new housing needs due to population growth . With the reopening of Carmen Copper Corporation formerly known as the Atlas Mining and Development Corporation and the expansion of Global Power Business Corporation and the establishment of industrial zone in Toledo City, its is expected that the housing needs of the city would tremendously increase during the planning period. a. New Housing Units The total need for housing is computed by summing up the housing backlog and the need for the new housing units due to population growth. Basic Data Assumptions Population in year 2000 (NSO) Annual growth rate Household size Household/dwelling unit (Doubled-up) Displaced units Landless/informal settlers Housing Stock 1990 (NSO) Housing Stock 2000 141,174 1.66 % 5.3 1.01 2033 26,564

Population Projection (Reference is NSO 2000 Census) Planning Base Year (2000) Population Growth Rate (1.66%/Year) 141,174 Household Average Size (5.3) 26,771 Housing Stock 26,564 Period 1 Start End (2006) (2008) Period 2 End (2011) Period 3 End (2015)

155,289

161,044

169,198

180,715

29,402

30,386

31,924

34,097

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New units Due to Backlog Housing backlog is defined as the number of dwelling units needed at the beginning of planning period, due to double up housing units and homeless household Table 4.32 Housing Backlogs(Assuming of 10% increase towards 2015) TOTAL ANNUAL PROGRAM PERIOD Doubled-Up Household 251 25 10 years Displaced* 60 6 10 years Landless/Informal Settlers** 558 59 10 years TOTAL 869 90 Double Up Household (Assuming 10% increase through CY 2015) Displaced Families are those living in danger areas and those with court orders Landless/Informal Settlers are those households living in private and government lots without offer to sell from the landowner, living in lots with court litigation, renters, etc listed in TUPC New Units Needed Due to Population Growth The number of new dwelling units required for the future depends on the projected size of population increase and the subsequent formation of households arising from the population increase. Table 4.33.a New units due to population growth with an average Population Growth rate at 1.66% per year Planning Period Total Units Annual Units 2006-2008 1,464 488 2009-2011 1,538 513 2012-2015 2,173 543 TOTAL 5,175 1544

Summary of Shelter Needs Table 4.33.b New Housing Units Needed Due to Population Growth and Backlog Planning Period Total Units Annual Units 2006-2008 1734 173 2009-2011 1,808 181 2012-2015 2533 451 City of Toledo Comprehensive Land Use Plan (CLUP) Page 167

total
B. Shelter Plan

6075

608

Vision: A Livable City that provides Toledanos decent and affordable dwelling places with a peaceful environment. Mission: Objectives: 1. To strengthen the existing Toledo Housing Board. 2. To minimize squatting and control squatting syndicates 3. To provide opportunities of the urban sector to be partners in development 4. To generate funds to finance housing needs 5. To sustain housing program of the city Strategies and Approaches: Toledo City has developed and established support mechanism to address housing development problems and to effectively implement the program. The following strategies are to be carried- out. 1. Establishment of Toledo City Local Housing Board The City Government of Toledo has been very active in pursuing the city housing development program, especially socialized housing. The Toledo Housing Board was created and re-organized through Executive Order No.012005 to tackle issues and problems affecting the following committees: housing needs, squatting problems and residential land development plan and this is sub-divided into to promote the quality of life by empowering the community through holistic development.

COMMITTEE

FUNCTIONS

a. Beneficiary Selection Committee

Maintain and update lists of the homeless squatters and potential beneficiaries of the housing projects Prepare lists of households qualified for the housing projects and relocation; and Conduct census and tagging operations for relocation purposes Develop and recommend anti-squatting measures, file appropriate cases, work for the Page 168

City of Toledo Comprehensive Land Use Plan (CLUP)

b. Anti-Squatting Relocation Resettlement Committee

and

c. Livelihood Development Committee

demolition of illegal structures/houses in accordance with law; Coordinate with the PNP and other law enforcement agencies to prevent squatting, eject and demolish professional squatters. Establish criteria and guidelines for the disposal and/or possible rouse of dismantled materials Provide the necessary logistics for relocation Plan and cause the implementation of the appropriate livelihood projects in the project site Coordinate and facilitate the conduct of appropriate skills training and entrepreneurship development Establish policies and guidelines on relocation in conformity with RA 7279 Establish in-house policies on relocation procedures, occupancy rules and house and lot repayments. Disseminate policies and guidelines on the governments housing program to all concerned parties and maintain an information center. Undertake the necessary social services preparation for prospective relocates; Provide post-relocation services to relocates to facilitate their adjustments in the new area housing site; Provide social services such as food for relocates during relocation Plan and provide the necessary social, sanitation, health and education services for relocates Conduct inventory of lands and develop land banking for the housing program of the city. Facilitate acquisition/titling of lots for the city Design site development plans for government housing projects Design houses and infrastructure system such as water, roads, drainage and electrical lines to project beneficiaries; and Supervise the construction and installation of infrastructure systems

d. Policy Regulation and Community Relations Committee

e. Social Services Committee

- Continuation f. Lot Aquistion Appraisal and Valuation Committee

g. Infrastructure Committee

&

Development

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2. Financing Scheme Program

Toledo City through the Toledo City Housing Board shall implement various housing program with the partnership of various housing agencies, private sector and in-house budgeting. Government lots which are no longer feasible for other purpose shall be declared as socialized housing project. The Community Mortagage Program (CMP) The Community Mortgage Program is a financing scheme which enables slum dwellers and residents of blighted areas, or areas of priority to own the lot they occupy where owners are willing to sell, re-block their structures and introduce facilities or utilities like water, electricity, drainage and sewerage through community mortgage. Housing agency such as the National Socilaized Housing Finance Corporation formerly the National Home Mortgage and Finance Corporation shall be the primary partner of this program.

Gawad Kalinga Partnership The City of Toledo has forged partnership with Gawad Kalinga for the establishment of resettlement site. The city purchased the lot where Gawad Kalinga provides housing infrastructure development. Landbanking/Swapping The city has acquired some land properties from Atlas Mining which will be reserved for future housing needs. Some public land in the foreshore area which is already filled up with informal settlers will be converted as Fishermens Village pursuant to RA 8550. Tie Up with National Government Agencies and Financial Institutions The National Housing Authority acquired a 10 hectare lot at Barangay Luray II which is intended for socialized housing. Other national government housing agencies such Home Guaranty Corporation, the Home Development Mutual Fund, GSIS Pabahay Program .

4.3 Health
The Philippine Health Care System is comprised mainly of government, private and non-government and peoples organization. Like most LGUs, the devolved City Health Office ( CHO ) takes the responsibility of uplifting the

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quality of life of Toledanos by improving health and human resources through education finances and moral values. The Toledo City Health Department have since focused on improving the coverage and access of the urban poor to basic health services towards the reduction of infant mortality rate and maternal mortality rate as well as the improvement of the nutritional status for children. In addition, the City Health Office implemented the following program: 1) Environmental Sanitation 2) Maternal and Child Health Care (MCH) 3) National Tuberculosis Program (NTP) 4) Control of Diarrhea Diseases ( CDD) 5) Cardiovasuclar Diseases Prevention & Control System 6) Expanded Program on Immunization 7) National Leprosy Control Program (NLCP) 8) Control of Acute Respiratory Infection ( CARI) 9) Dental Health Services 10) Laboratory Health Services 11) Phil. Cancer Control Program 12) Nutrition Program 13) Primary Eye Care 14) Rabies Prevention & Control Program 15) Sexually Transmitted Diseases Prevention & Control Program 16) Underfive Clinic

Vision:
A community of organized people promoting health and

sanitation, with greater emphasis in the prevention of communicable and noncommunicable diseases, leading to an improved quality of life among the local people, regardless of creed, political affliation and status in the society.

Mission:
The lead agency in the City of Toledo duly responsible in the active promotion of health in the implementation of its various programs,

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empowering the community to be self-reliant and agent in the effective delivery of basic health services especially among those in the lower socioeconomic status in the community.

4.3.a Fertility Indices

From the period 2003 to 2006, there were an estimated 20 livebirths per 1,000 population.

a.1.

Crude Birth Rate (CBR) Table 4.34 Fertility and Mortality Rate Year 2003-2006

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Crude Birth Rate Year Populatio n

Death No. Rate No . Rate

Mortality

Infant Mortality (Below 1 Year Old) No . Rate

Young Child Mortality (1-4 Years Old) No . Rate

Maternal Mortality

No .

Rat e

200 0 200 1 200 2 200 3 200 4 200 5 200 6

141,174 143,489.25 145,842.47 148,919.47 152,031 155,173 158,263 3,077 3,112 3,142 3,090 20/1000 20/1000 20/1000 20/1000 85 622 700 686 .5/1000 4/1000 5/1000 4/1000 33 28 8 12 .221 .184/1000 .51/1000 .075/1000 57 45 26 24 .382/1000 .3/1000 .171/1000 .151/1000

Source: Office of City Civil Registrar, Toledo City, 2006

Table 4.35 shows

that

Barangay

Poblacion

registered

the

highest

number of livebirths from the year 2003 to 2006 with an approximate rate of 30-25% of the total registered livebirth population of a given year.

Table 4.35 Livebirths by Sex, and By Barangay Years 2003-2006

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2003 Barangay
Male Awihao Bagakay Bato Biga Bulongan Bunga Cabitoonan CalongCalong Cambang-ug Campo 8 Canlumampao Cantabaco Capt. Claudio Carmen Daang Lungsod DAS Dumlog Ibo Ilihan Landahan Loay Luray II Juan Climaco Gen. Climaco Matab-ang Media-Once Pangamihan Poblacion Poog PutingBato Sagay Sam-ang Sangi Sto. Nio Subayon Talavera Tungkay Tubod TO T A L 30 6 45 33 27 16 35 1 33 33 21 75 28 24 9 105 40 29 7 18 8 29 25 60 60 54 8 458 61 6 4 11 83 8 9 61 1 15 1576 Female 32 15 46 39 25 28 17 22 7 32 20 87 32 22 4 128 27 31 7 14 7 26 31 32 61 39 8 453 48 1 8 12 86 15 13 30 3 20 1528

2004
Male 22 18 58 41 22 40 27 2 36 28 31 66 49 29 8 115 41 60 9 11 9 51 45 75 67 56 15 316 39 5 9 18 97 14 6 63 5 23 1626 Femal e 6 4 31 17 8 19 8 0 0 12 14 41 24 16 7 62 14 16 1 11 11 17 19 32 35 30 9 185 26 2 3 7 76 10 3 22 3 13 814

2005
Mal e 25 12 59 25 22 35 27 3 32 30 26 71 50 33 6 100 35 18 9 14 12 35 45 63 49 71 15 356 65 10 9 18 71 12 11 47 1 25 154 7 Femal e 28 6 35 27 21 31 28 1 39 25 33 68 33 26 10 112 28 42 12 11 8 19 39 49 54 53 13 313 47 7 13 23 49 10 12 47 2 30 1404

2006
Mal e 17 4 33 16 8 29 18 6 22 22 13 45 22 23 6 61 21 19 5 13 5 18 26 23 42 27 3 232 33 3 4 9 43 12 3 34 4 15 939 Femal e 21 3 40 24 8 21 14 6 20 22 17 43 25 23 6 59 23 20 12 7 1 14 16 23 41 40 6 192 36 3 5 7 43 7 4 34 2 12 900

Source: Office of the City Civil Registrar, Toledo City, 2006

4.3.b Mortality Indicators

From the year 2003-2006 the following barangays recorded the highest number of deaths, as follows: 1) Barangay Poblacion, 2) Barangay DAS and

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3) Barangay Bato. Barangay Poblacion and Barangay DAS , all of which are considered to be densely populated barangays of the city.

TABLE 4.36
Barangay Awihao Bagakay Bato Biga Bulongan Bunga Cabitoonan Calong-calong Cambang-ug Campo 8 Canlumampao Cantabaco Capt. Claudio Carmen Daanglungsod DAS Dumlog Ibo Ilihan Landahan Lo-ay Luray II Magdugo Malubog Matab-ang Media- Once Pangamihan Poblacion Poog Puting-Bato Sagay Sam-ang Sangi Sto. Nio Subayon Talavera Tubod Tungkay Total M 14 2 18 0 15 7 10 5 6 3 13 9 8 5 6 40 11 11 10 3 0 11 10 9 16 19 2 44 8 3 4 7 6 4 1 12 8 0 360 2003 F 8 2 21 1 6 4 7 6 6 2 5 11 9 4 1 35 8 9 7 3 0 11 10 19 19 11 0 45 11 4 6 5 4 4 4 14 8 0 330 Both 22 4 39 1 21 11 17 11 12 5 18 20 17 9 7 75 19 20 17 6 0 22 20 28 35 30 2 89 19 7 10 12 10 8 5 26 16 0 690 M 8 4 26 1 13 4 8 4 10 1 4 7 8 5 7 37 12 8 3 5 2 16 13 6 13 12 0 36 10 1 6 5 16 7 2 16 5 0 341 2004 F 7 3 14 2 8 8 8 6 4 2 8 9 8 6 5 27 7 2 6 3 1 9 8 11 8 10 0 31 13 2 3 5 5 3 0 8 7 0 267 Both 15 7 40 3 21 12 16 10 14 3 12 16 16 11 12 64 19 10 9 8 3 25 21 17 21 22 0 67 23 3 9 10 21 10 2 24 12 0 608 M 19 2 16 5 8 7 15 0 8 4 10 18 5 5 5 31 10 9 6 2 1 15 13 14 18 18 1 55 15 6 5 7 10 11 0 11 9 1 395 2005 F 9 1 17 0 6 7 15 4 9 2 6 8 7 4 1 28 8 6 10 6 0 11 6 5 11 15 3 33 9 3 6 5 8 3 2 12 6 1 293 Both 28 3 33 5 14 14 30 4 17 6 16 26 12 9 6 59 18 15 16 8 1 26 19 19 29 33 4 88 24 9 11 12 18 14 2 23 15 2 688 M 13 3 15 10 8 8 15 1 5 1 7 19 8 8 10 45 10 9 12 11 0 12 10 13 14 14 3 45 15 1 2 9 18 5 5 25 8 0 417 2006 F 12 3 16 4 8 5 11 6 4 0 6 22 6 10 4 33 11 6 11 4 1 17 12 12 13 16 3 47 18 4 8 5 14 3 2 11 4 0 372 Both 25 6 31 14 16 13 26 7 9 1 13 41 14 18 14 78 21 15 23 15 1 29 22 25 27 30 6 92 33 5 10 14 32 8 7 36 12 0 799

Source: City Health Office, Toledo City 2006

c.1

Maternal Mortality Rate (MMR)

Maternal mortality is the number of women who die as a result of child bearing in a given year per one thousand (1,000) births in a given year. Maternal deaths are those caused by

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complications of pregnancy and childbirth. The table below shows that we have a rare or very low case of maternal mortality rate for the following reasons: a. Our doctors , nurses and midwives are skilled enough to handle deliveries Our hilots in the different barangays have undergone extensive trainings on the basic delivery stability procedures so much so that in case they meet a difficult delivery, they will refer it to the nearest health center or hospital.

b.

TABLE 4.37 Deaths Among Women in Pregnancy, Labor and Puerperium 2003-2006 Age Number of Deaths Pregnancy 25 28 1 1 Causes Labor Pueperium Post Partum Ecclampsia Bleeding Loss Post Partum Hemorrhage Pregnant Uterine, Full Tem, Multiparity, Hypertensive Crisis

39

Source: City Health Office, Toledo City, 2006

4.3 c Causes of Mortality and Morbidity

The ten leading causes of mortality have remained the same since 2002 up to 2006. Most of the leading causes includes among others, vascular diseases, heart disease, hypertension, cancer, peptic ulcer and TB pulmonary

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infections. Of the leading causes, heart disease consistently top the list followed by pneumonia and vascular disease.

TABLE 4.38 Ten Leading Causes of Mortality for the Last Five (5) Years Year 2002 to 2006
Year 2002
Causes Heart Disease Pneumonias Vascular Diseases Hypertension Cancer (All Forms) Peptic Ulcer PTB (All Forms) Bronchial Asthma Diabetes Mellitus Diarrheas Myocardial Infarction Congestive Heart Failure Bleeding Peptic Ulcer Kidney Failure No. of Deaths 144 112 87 83 59 24 21 % Mortality 21.23 16.51 12.83 12.24 8.7 3.53 3.09

Year 2003
No. of Deaths 241 64 42 20 45 25 12 % Mortality 35.13 9.32 6.12 2.91 6.55 3.64 1.74

Year 2004
No. of Deaths 84 82 63 25 21 16 % Mortality 13.81 13.48 10.36 4.11 3.45 2.63

Year 2005
No. of Deaths Deaths 105 137 56 55 21 % Mortality 15.26 19.91 8.13 7.99 3.05

Year 2006
No. of Deaths Deaths 85 75 180 50 38 % Mortality 14.09 12.43 29.85 8.29 6.3

17

1.91

54

7.87

21

3.45

24

3.48

30

4.97

13 -

2.5 -

19 12 -

2.76 1.74 -

36 69

5.92 11.34

28 -

4.06 -

9 -

1.49 -

127

18.45

19 9

3.15 1.49

The Philippine Health Care System is comprised mainly of government, private and non-government and peoples organization. Like most LGUs, the devolved City Health Office ( CHO ) takes the responsibility of uplifting the quality of life of Toledanos by improving health and human resources through education finances and moral values. The Toledo City Health

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Department have since focused on improving the coverage and access of the urban poor to basic health services towards the reduction of infant mortality rate and maternal mortality rate as well as the improvement of the nutritional status for children. In addition, the City Health Office implemented the following program: 1) Environmental Sanitation 2) Maternal and Child Health Care (MCH) 3) National Tuberculosis Program (NTP) 4) Control of Diarrhea Diseases ( CDD) 5) Control of Vascular Diseases ( CVD) 6) Nutrition 7) National Leprosy Control Program (NLCP) 8) Control of Acute Respiratory Infection ( CARI) 9) Dental Health Services 10) Laboratory Health Services 11) Phil. Cancer Control Program 12) Nutrition Program 13) Primary Eye Care 14) Rabies Prevention & Control Program 15) Sexually Transmitted Diseases Prevention & Control Program

Table 4.39 Livebirths by Sex, and By Barangay Years 2003-2006 2003 Barangay
Male Female Male Female Male Female Male Femal

2004

2005

2006

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e Awihao Bagakay Bato Biga Bulongan Bunga Cabitoonan CalongCalong Cambang-ug Campo 8 Canlumamapao Cantabaco Capt. Claudio Carmen Daang Lungsod DAS Dumlog Ibo Ilihan Landahan Loay Luray II Juan Climaco Gen. Climaco Matab-ang Media-Once Pangamihan Poblacion Poog PutingBato Sagay Sam-ang Sangi Sto. Nio Subayon Talavera Tungkay Tubod TO T A L 30 6 45 33 27 16 35 1 33 33 21 75 28 24 9 105 40 29 7 18 8 29 25 60 60 54 8 458 61 6 4 11 83 8 9 61 1 15 1576 32 15 46 39 25 28 17 22 7 32 20 87 32 22 4 128 27 31 7 14 7 26 31 32 61 39 8 453 48 1 8 12 86 15 13 30 3 20 1528 22 18 58 41 22 40 27 2 36 28 31 66 49 29 8 115 41 60 9 11 9 51 45 75 67 56 15 316 39 5 9 18 97 14 6 63 5 23 1626 6 4 31 17 8 19 8 0 0 12 14 41 24 16 7 62 14 16 1 11 11 17 19 32 35 30 9 185 26 2 3 7 76 10 3 22 3 13 814 25 12 59 25 22 35 27 3 32 30 26 71 50 33 6 100 35 18 9 14 12 35 45 63 49 71 15 356 65 10 9 18 71 12 11 47 1 25 1547 28 6 35 27 21 31 28 1 39 25 33 68 33 26 10 112 28 42 12 11 8 19 39 49 54 53 13 313 47 7 13 23 49 10 12 47 2 30 1404 17 4 33 16 8 29 18 6 22 22 13 45 22 23 6 61 21 19 5 13 5 18 26 23 42 27 3 232 33 3 4 9 43 12 3 34 4 15 939 21 3 40 24 8 21 14 6 20 22 17 43 25 23 6 59 23 20 12 7 1 14 16 23 41 40 6 192 36 3 5 7 43 7 4 34 2 12 900

Source: Office of the City Civil Registrar, Toledo City, 2006

4.3 d Rate of Malnutrition

Quite a number of children were affected by malnutrition. Table shows the Nutritional Status of Children (0-72 months) from Operation Timbang results from 2003-2006. 4.40

Barangay

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Data also shows the top ten (10) barangays with the highest incidence of 2nd and 3rd degree of malnourished children. Survey shows that among the primary causes of malnutrition are poverty, unemployment, ignorance of mothers and laziness of parents. However, a decrease in the prevalence rate of 2nd and 3rd degree malnourished children were noted in the succeeding years (2004 to 2006). This is the result fo the coordinated efforts of the City Health personnel, the City Nutrition Committee headed by the City Mayor, the Barangay Nutrition Scholars and the Barangay Nutrition Committee together with the NGOs.

Table 4.40 Number of Malnourished Children by Barangay City of Toledo, Year 2003
Barangay Population Number and Percentage of Malnourished Children

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1st Degree
Number %

2nd Degree
Number %

3RD Degree
Number %

Total
Number %

Awihao Bagakay Bato Biga Bulongan Bunga Cabitoonan CalongCalong Cambang-ug Camp 8 Canlumampao Cantabaco Capt. Claudio Carmen Daanlungosd DAS Dumlog Ibo Ilihan Landahan Loay Luray II Juan Climaco Gen. Climaco Matab-ang Media-Once Pangamihan Poblacion Poog Putingbato Sagay Sam-ang Sangi Sto. Nio Subayon Talavera Tungkay Tubod TOTAL

3713 1497 6635 2396 2322 2685 3512 1174 3585 1498 3026 5948 4103 2774 2997 19803 2802 2935 2962 1511 1013 3799 4478 5641 7042 5603 1620 13464 5143 1426 1300 1630 3730 4473 893 5162 1536 2432 148263

68 72 55 47 18 24 44 28 35 15 84 118 13 51 64 281 88 53 68 35 63 25 168 91 66 23 89 633 145 8 20 9 17 17 2 22 28 2 2689

11.8 24 6.38 9.87 5.8 4.5 6.9 11.5 5.47 5.43 15 10.5 1.59 6.2 12.7 55.9 16.5 9.36 16.5 11.5 31 3.5 18.7 8.06 5.7 2.05 27.4 23.5 14 2.8 7.6 2.76 2.2 1.89 1.1 2.1 9.12 0.41 10.56

8 10 7 12 6 5 0 1 11 2 16 11 6 13 12 41 26 7 6 7 11 12 8 21 34 5 20 13 4 4 4 2 2 19 3 9 9 9 396

1.3 3.3 0.78 2.5 1.9 0.93 0 0.4 1.72 0.72 2.86 0.98 0.73 2.89 2.39 8.16 4.88 1.23 1.45 2.3 5.4 1.48 0.89 1.86 2.96 0.44 6.1 0.48 0.38 1.4 1.5 0.61 0.26 2.1 1.6 0.8 2.9 1.8 1.55

1 1 2 0 0 0 1 0 0 0 0 5 0 0 0 2 1 1 2 1 3 1 3 4 8 2 5 1 5 2 0 2 0 5 1 1 0 0 64

1.01 1.3 0.22 0 0 0 0.15 0 0 0 0 0.446 0 0 0 0.05 0.18 0.17 0.48 0.33 1.47 0.14 0.33 0.35 0.69 0.17 1.5 0.03 0.48 0.7 0 0.61 0 0.5 0.5 0.09 0 0 0.25

77 83 64 59 24 29 45 29 46 17 100 134 19 64 76 324 115 61 76 43 77 38 179 116 118 30 114 647 154 14 24 13 19 41 6 32 37 11 149

13.3 5.5 7.17 12.3 7.79 5.4 7 11.9 7.19 6.15 17.9 11.9 2.3 14.2 15.1 8.25 21.6 10.3 12.8 14.2 37.9 5.38 19.9 10.28 9.4 2.6 35.1 24 14.9 4.9 9.2 3.9 2.5 4.5 3.3 3.1 12 2.2 12.3

Source: City Health Department, Toledo City, 2006

Number and Percentage of Malnourished Children Per Barangay 2004 BARANGAY BNL No. Awihao Bagakay 44 70 % 6.9 11 No. 2 13 VL % 0.3 4.9 Total No. 46 83 % 7.2 15.9 16 55 BNL No. % 2.4 20.6 No. 2 9 2005 VL % 0.3 3.3 Total No. 18 64 % 2.7 24 13 17 BNL No. % 1.9 6.2 No. 2 8 2006 VL % 0.3 2.9 Total No. 15 25 % 2.2 9.1

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Bato Biga Bulongan Bunga Cabitoonan CalongCalong Cambang-ug Camp 8 Canlumampao Cantabaco Capt. Claudio Carmen Daanlungsod DAS Dumlog Ibo Ilihan Landahan Loay Luray II Juan Climaco Gen. Climaco Matab-ang Media Once Pangamihan Poblacion Poog Putingbato Sagay Sam-ang Sangi Sto. Nio Subayon Talavera Tungkay Tubod TOTAL

52 41 55 18 34 29 8 15 17 10 17 31 25 81 72 41 26 31 18 43 30 184 31 62 42 88 29 18 20 29 43 40 32 43 23 28 152 0

4.4 9.6 13 3.7 13 14 1.3 5.6 2.9 0.9 2.3 6.2 4.6 2.3 14 7.8 4.9 12 10 6.3 3.7 18 2.5 6.2 15 3.6 3.17 7 8.6 10 6.4 5 20 5.4 8.4 6.4 5.78

6 0 1 3 0 3 0 4 2 4 0 7 8 9 10 5 9 4 1 6 3 7 2 2 9 4 5 11 0 1 7 5 4 4 2 4 16 7 0 0.2 0.6 0 1.4 0 1.5 0.3 0.4 0 1.4 1.5 0.3 2 0.9 1.7 1.4 0.6 0.9 0.4 0.7 0.2 0.2 3.1 0.2 0.5 4.3 0 0.3 1 0.6 2.5 0.5 0.7 0.9 0.63

58 41 56 21 34 32 8 19 19 14 17 38 33 90 82 46 35 35 19 49 33 191 33 64 51 92 34 29 20 30 50 45 36 47 25 32 168 7

4.9 9.6 13.2 4.32 13 15.4 1.3 7.1 3.24 1.27 2.3 7.6 6.1 2.55 16 8.7 6.6 13.4 10.6 7.2 4.07 18.7 2.65 6.4 18.1 3.76 3.67 11.3 8.6 10.3 7.4 5.6 22.5 5.9 9.13 7.3 6.41

42 24 13 7 4 46 14 49 30 11 42 24 20 79 85 15 20 19 33 27 65 159 48 25 75 61 59 39 13 12 36 24 11 16 24 6 134 8

3.5 5.6 3.1 1.8 0.6 22 2.1 18.3 5.6 1 5.7 4.8 3.7 2.2 17 2.8 3.7 7 18.3 4 8.1 15.8 3.8 2.5 3.8 2.5 6.4 15 5.6 4.1 5.3 3 7.2 1.7 8.6 1.4 5.1

12 1 1 1 2 1 3 0 2 1 6 4 6 6 16 4 1 3 2 6 9 15 3 1 12 5 9 10 6 0 3 3 1 2 2 1 17 1

1 0.2 0.2 0.2 0.3 0.4 0.5 0 0.4 0.1 0.8 0.8 1.1 0.2 1.2 0.8 0.2 1.1 1.1 0.9 1.1 1.4 0.2 0.1 4.1 0.2 1 0.8 2.6 0 0.4 0.4 0.7 0.2 0.7 0.2 0.64

54 25 14 8 6 47 17 49 32 12 48 28 26 85 101 19 21 22 35 33 74 174 51 26 87 66 68 49 19 12 39 27 12 18 26 7 151 9

4.5 5.8 3.3 2 0.9 22 2.6 18 6 1.1 6.5 5.6 4.8 2.4 18 3.6 3.9 8.1 19 4.9 9.2 17 4 2.6 7.9 2.7 7.4 16 8.2 4.1 5.7 3.4 7.9 1.9 9.3 1.6 5.7

42 17 9 9 10 31 14 19 21 3 12 26 9 26 56 7 29 20 3 18 12 80 8 20 64 45 3 55 8 11 16 32 10 11 30 15 83 1

3.5 3.9 2.1 1.8 1.5 15 2.1 7 3.8 0.3 1.6 5.1 1.7 0.7 11 1.3 5.3 7.3 1.6 2.6 1.4 7.8 0.6 1.9 22 1.8 0.3 21 3.4 3.7 2.3 3.9 6.1 1.2 11 3.4 3.09

10 0 1 1 2 3 4 2 1 3 0 5 4 6 3 3 1 3 2 4 5 9 3 4 10 4 3 7 0 0 2 4 3 3 1 1 12 7

0.8 0 0.2 0.2 0.3 1.4 0.6 0.7 0.2 0.3 0 0.9 0.7 0.2 0.6 0.6 0.2 10 1.1 0.6 0.6 0.9 0.2 0.4 3.4 0.2 0.3 2.7 0 0 0.3 0.5 1.8 0.3 0.4 0.2 0.47

52 17 10 10 12 34 18 21 22 6 12 31 13 32 59 10 30 23 5 22 17 89 11 24 74 49 6 62 8 11 18 36 13 14 31 16 95 8

4.3 3.9 2.3 2 1.8 16 2.7 7.7 4 0.6 1.6 6 2.4 0.9 12 1.9 5.5 17 2.7 3.2 2 8.7 0.8 2.3 25 2 0.6 24 3.4 3.7 2.6 4.4 7.9 1.5 11 3.6 3.6

Source: City Health Department, Toledo City 2006 BNL - Below Normal Level VL Very Low

Ten (10) Barangays with High Incidence of Malnutrition Year 2003 Moderate Severe 3 Total 44

1. DAS City of Toledo Comprehensive Land Use Plan (CLUP)

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2. 3. 4. 5. 6. 7. 8. 9. 10.

Matab-ang Dumlog Pangamihan Sto. Nio Canlumampao Carmen Poblacion Daanlungsod Biga

34 26 20 19 16 13 13 12 12

8 1 5 5 0 0 1 0 0

42 27 25 24 16 13 14 12 12

End of the year, number or rehabilitated malnourished children : Severe manlnoursihed children Moderate malnourished children 40 120

Year 2004 VL BNL 184 93 70 9 10 2 19 6 1 0 55 51 72 62 42 52 56 51 81 82 64 61 58 191 97 91 90 Total

1. Malubog 2. Poblacion 3. Bagakay 4. DAS 5. Dumlog 6. Media-Once 7. Pangamihan 8. Bato 9. Bulongan 10. Biga

7 4 21

Year 2005 VL BNL 85 75 59 Total 91 84 68

1. Dumlog 2. Malubog 3. Poog City of Toledo Comprehensive Land Use Plan (CLUP)

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4. DAS 5. Poblacion 6. Bato 7. Putingbato 8. Luray II 9. Canlumampao 10. Ilihan

5 6 12 10 6 2 1 Year 2006 VL

63 57 42 49 27 30 69

68 63 54 49 33 32 30

BNL 9 10 7 3 10 4 11 6 5 1

Total 89 74 62 59 52 36 32 32 31 30

1. Malubog 2. Pangamihan 3. PutingBato 4. Dumlog 5. Bato 6. Sto. Nio 7. Canlumampao 8. DAS 9. Carmen 10. Ilihan

80 64 55 56 42 32 21 26 26 29

Toledo City Nutrition Services/Programs: I. Home,

School of and Community Food Production establishment involves of fruit the and

distribution

seeds/seedlings/cuttings,

vegetable gardens and distribution of poultry, livestock and fingerlings in coordination with the Department of Agriculture.

II. Micronutrient Supplementation involves the provision of Vitamin A, Iron

supplements to preschool children.

III. Food Fortification is a program that encourages the people to use

iodized salt and availability of fortified foods (Sangkap Pinoy Products).

IV. Food

Assistance

conducts

supplemental

feeding

to

malnourished

children, both preschoolers and schoolers.

V. Nutrition Information, Education and Communication conducts nutrition

education classes, advocacy meeting, integration of nutrition in the school curriculum and promotion of breast feeding.

VI. Livelihood Assistance involves the giving of assistance to family with

malnourished coordination children with lead like animal dispersal, cottage of industry in and agencies Department Agriculture

Veterinary Services.

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VII. Implementing the Malunggay Planting in every household of Toledo City VIII. Essential Maternal/Child Health Services involves the provision of dental
services to preschoolers, AP with dental treatment, full immunization of children (9-11 mos.), infant breastfeeding the until 4 in of months, the family planning and deworming services.

IX. Water

and

Sanitation proper

involves

campaign availability

households toilet,

concerning

garbage

disposal,

sanitary

proper drainage and potable water.

X. Adopt a Child a program undertaken by the city government where the

city provides the needs of malnourished children with food, clothing and others.

XI. Organizaing the Barangay Nutrition Committee implements the nutrition

program in the respective barangays.

XII. Nutrition Month Celebration which is observed every month of July. In

accordance with Presidential Decree No. 1569, the City of Toledo forty-five has (45) Barangay Nutrition Scholars who are barangay based

volunteers responsible for the delivery of nutrition services and other related activities such as community health, backyard food production, environmental sanitation, culture, mental feeding and family planning to the barangay.

4.3 e Health Resources, Facilities and Services a. City Health

Access to health facilities in Toledo City is sufficient. The city is divided into five (5) health districts that provides promotive, preventive and curative health care. Despite the apparent improvement in the availability of health centers, the City of Toledo still experiences a problem affecting the shortage of government health personnel. Population per health worker ratio at the local level is not at par with DOH standards so that the city relies on the services of Barangay Health Service workers to augment its health force. Aside from health physicians, nurses and midwives, the city government also utilizes the services of dentist, medical technologists, sanitary inspectors, nutritionist or dietitians sputum canvassers. Table 4.41 shows the different health districts and the allocation of health personnel including the services rendered in each district. The services

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include laboratory

medical/dental, maternal/child health services. Information drive on

environmental the prevention

health of

and

sexually

transmitted diseases, its causes and treatment including family planning services is also offered by the health personnel. Majority of the barangays in the city have a barangay health station with only thirteen (13) still in need of the facility which are the following: 1) Barangay Calong-Calong 2) Barangay Cambang-ug 3) Barangay Canlumampao 4) Barangay Capt. Claudio 5) Barangay Carmen 6) Barangay Daan Lungsod 7) Barangay Landahan 8) Barangay Lo-ay 9) Barangay Pangamihan 10) Barangay Sam-ang 11) Barangay Subayon 12) Barangay Tubod 13) Barangay Tungkay

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Table 4.41 Medical Health Facilities, Personnel and Services Year 2003-2006 Medical Personnel (Number) Dist. I Health Facility Poblacion Sangi Luray II Ibo Cabitoonan Awihao Bato Areas Served (Barangay)
Poblacion Sangi Luray II Ibo Cabitoonan Awihao Bato
Health Officer Public Health Nurse Health Midwives Dentists Medical Technogists Nursing Attendant Dental Aide Sanitary Inspectors Services Rendered Barangay Without BHS Daanlungsod Ilihan

Medical/ Dental Maternal/Child Health Environmental Health Laboratory Services

II

none

Medical/Dental Maternal/Child Health Environmental Health

Bulongan Sam-ang Tubod Sagay Landahan Subayon

III

Matab-ang Sto. Nio Dumlog Carmen Talavera

Matab-ang Sto. Nio Dumlog Carmen Talavera

none

none

Medical/Dental Maternal/Child Health Environmental Health

Canlumampao Calong-Calong Capt. Claudio Putting-Bato

Source: City Health Office, Toledo City, 2006

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Table 4.41 Medical Health Facilities, Personnel and Services Year 2003-2006 Medical Personnel (Number) Dist. IV Health Facility Magdugo Gen. Climaco Media Once Bunga Poog DAS Cantabaco Areas Served (Barangay)
Magdugo Cambang-ug Media Once Bunga Poog
Health Officer Public Health Nurse Health Midwives Dentists Medical Technogists Nursing Attendant Dental Aide Sanitary Inspectors Services Rendered Barangay Without BHS Biga Bagakay Pangamihan Cambang-ug

None

none

None

None

Medical/ Dental Maternal/Child Health Environmental Health Laboratory Services

DAS Cantabaco

none

Medical/Dental Maternal/Child Health Environmental Health

Lo-ay Tungkay Camp 8

Source:City Health Office,Toledo City , 2006

Remarks: For Barangays withouts BHS -Medical, Dental and other health Barangay Multipurpose Center and Day Care Center. services are held either at the Barangay Hall,

Schedule of Barangay Clinics: Along the Coastal Barangays 3 to 4 times a month Far-Flung Barangays - Once a month depending on the availability of a 4-wheel vehicle

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Health Manpower
Despite the improvement in the availability of health facilities, City of Toledo still experiences a severe shortage of government health personnel. Population per health worker ratio at the local level is far off from the DOH standards even as it is noted that 2006 figures are already far better than the previous years. With the addition of more health programs, it is still far from the average expectation particularly because majority of the health workers (e.g. nurses and midwives) are hired on a casual basis, hence their services are subject to termination by the government anytime. Aside from health physicians, nurses and midwives, the government also utilizes the services of dentist, medical technologists, sanitary inspectors, nutritionist or dietitians, sputum canvassers and a number of barangay health workers. Data below shows the present set up of manpower by district with a number of vacancies that needs to be filled up to attain the quality of service the City Health is expected to give. TABLE 4.42 Number of Health Personnel Assigned by District Personnel CGDH I CGADH I Medico-Legal Officer Medical Officers Dentists Public Health Nurse Midwives Nursing Attendants Dental Aides Sanitary Inspectors District I 1 1 1 1 1 1 2 4 1 3 District II 1 1 3 1 vacant 2 1 2 District III vacant 1 3 3 1 2 District IV 1 1 1 1 vacant 2 3 2 2 1 1 vacant 1 6 15 4 11 District V vacant 1 vacant Total 1 1 1 3 5 2

Med. Technologists 2 BNS 10 10 10 Source: City Health Department, Toledo City

10

46

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Health Problems and Concerns

Rapid urbanization had some ill effects to the health condition of the citys populace. The rapidly increasing population of the city which is due mainly to migration, with unemployment-poverty, had consequently resulted in the proliferation of squatters making it difficult for the LGU to cope up with responsibility of providing the basic health and welfare services to the populace. Indeed, the health sub sector must address the problems of the infant, child and maternal mortality, morbidity rates. There will be also a need for government to determine the possible causes of the possibility to increase in morbidity and the means to arrest them. The failure of pregnant mothers to submit themselves for pre-natal care due to ignorance, illiteracy and lack of awareness may contribute to the incidence of infant and maternal death. This underlines the necessity to strengthen the promotion of safe motherhood. A wider coverage of pre-natal care to pregnant mothers as well as post natal care had been extended by our health personnel emphasizing on the preventive measures and identification of the risk factors. The accessibility of one place is also brought to consideration, especially the far-flung barangays. New roads had been opened recently but not all. Some are accessible by vehicles while some are not. One has to go by foot. Transportation is also a problem. At present, the City Health Department has only two (2) vehicles which are already or almost unserviceable and could not be used in the mountainous barangays. To go by foot is time consuming and risky especially in transporting sick people in the mountainous barangay.

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Projects/Programs/SWOT MATRIX
PROJECTS/PROGRAMS
Expanded Program on Immunization

STRENGTHS/POTENTIALS
> Children will be protected for the 7 immunizable diseases.

WEAKNESSESS
> lack of manpower for flung barangays. > irregular clinic schedule no vehicle.

OPPORTUNITIES
> Disease free city > Healthy children

THREATS/CONSTRAINTS
> Medical supplies like syringe/ needles are not given free from the regional office. > Local purchasing of medical supplies

RECOMMENDATIONS
> request LGU for allocation of medical supplies.

Family Planning Program

> All couples are responsible parents. > All couples are aware of the diff. F. P. method. > Easy access of F.P. at the health facility. > Less incidence of waterborne diseases especially among children.

> Impedicious use of F.P. supplies esp. to teenagers. Religious conflict.

> No more free F.P. supplies from the region. > No budget for F.P. supplies.

> Request LGU for allocation of F.P. supplies. > Motivate mothers to use the natural method.

Environmental Sanitation water sealed toilet construction.

> poverty > no water supply for flung barangays

> clean & healthy environmental surroundings > NGO assisted project.

> negative attitude of the household. > scarse water supply > occurrence of epidemic of water borne diseases.

> motivate community or the importance of clean environment > coordinate with the Local Brgy. Officials on the project.

Construction of Barangay Health Stations in Brgys. without Health Facility.

> All residence of the barangay will have access to medical care.

> Brgy. Officials negative attitude.

> Easy access to have health care. > Can have early consultation & treatment for ill patients.

> no brgy. Budget for the construction of BNS. > no electric & water supply

> Make a representation with the SP/Mayor for allocation.

S - Describe the impact of the projects to the proponent and to the community and stakeholders W - Describe its negative impact to the environment, proponent, community ant to other stakeholders O - List down all the possible opportunities on the proposed projects T - List down all the possible constraints or threats or issues that impedes the success of the projects

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WORK AND FINANCIAL PLAN

BUDGET PER TARGET PLAN STRATEGIES 1. TECHNICAL > Capability Building on Diff. Health Program by Diff. Health Personnel Medical Officers, nurses, midwives & sanitary insp. > BNS training and convention > Traditional Hilots (Training/Refresher course) > PURCHASE OF Medical equipments & Instrumnents Dental equipments & Instruments P 200 T P 220 T P 250 T P 250 T P 250 T P 1.17 M LGU CHD P 12 T P 120 T P 10 T P 20 T P 120 T P 20 T P 130 T P 15 T P 25 T P 130 T P 25 T P 135 T P 15 T P 30 T P 140 T P 30 T P 140 T P 15 T P 30 T P 150 T P 35 T P 150 T P 35 T P 150 T P 18 T P 262 T P 1.2 M P 73 T LGU LGU LGU CHD CHD CHD P 100 T P 120 T P 140 T P 160 T P 180 T P 200 T P 200 T P 220 T P 220 T P 250 T P 1.79 M LGU CHD YR. 1 YR. 2 YR. 3 YR. 4 YR. 5 YR. 6 YR. 7 YR. 8 YR. 9 YR. 10 TOTAL SOURCE OF FUNDS IMPLEMENTING AGENCY

P 150 T

P 300 T P 100 T

P 300 T P 150 T P 150 T P 150 T P 200 T

P 750 T P 750 T

LGU LGU CHD

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Development Needs: Issues/Problems/Causes & Effects

ISSUES AND PROBLEMS
MCH .1% maternal death

POSSIBLE CAUSES
> 10% of hilots are unstrained > lack of midwives > distance to Health Facilities > Lack of knowledge on the early signs & symptoms of complications.

EFFECTS

HOW TO SOLVE IT
> conduct training & refresher course to hilots especially on 3 CLEANS ( CLEAN Surface, CLEAN Hands, CLEAN Cords) > provide a regular & quality prenatal care > request for additional midwives > upgrade the health facilities

> Increase incidence of maternal complications

CONTROL OF DIARRHEAL DISEASES (CDD) > Diarrhea is one of the 10 leading causes of morbidity & mortality among children.

> Improper disposal of waste & garbage. > poor environmental sanitation. > unsafe drinking water > late consultation & treatment > no water sealed toilets. > incomplete immunization > lack of knowledge on the prevention & control of the disease.

> increase incidence of diarrheal cases w/c will lead to dehydration & eventually to death.

> proper disposal of waste/garbage. > intensify IEC on environmental sanitation. > provision of potable water supply > construction of water sealed toilet. > seek early consultation/treatment. > urge mothers to bring their children for immunization > promote homecare & management on diarrheal cases. > breastfeeding promotion.

CONTROL ON ACUTE RESP. INF. > Pneumonia as one of the 10 leading causes of mortality/morbidity among children & adults. > lack of knowledge on the prevention & control of pneumonia. > late consultation/treatment. > lack or inadequate supply of medicine in the health facilities. > increase incidence of pneumonia cases w/c will eventually worsened and will lead to death. > provide proper home care management. > seek early consultation/treatment on all respiratory infections. > advice mothers to watch for early danger signs of pneumonia. > request for appropriation of medicines.

EXPANDED PROG. ON IMMUNIZATION > 10% of the targetted children are not fully immunized children (FIC). > lack of awareness to mothers on our immunization program/schedule. > fear of side effect esp. pain. > laziness of parents to visit the health centers. > lack of manpower. > irregular sched. Of immunization esp. to far flung brgys. Because of lack of transportation (4 - wheeled). > increase mortality among infants/ children caused by the 7 childhood immunizable diseases. > active masterlisting of infants/children. > Follow-up of defaulters. > Health Education to mothers. > Request for transpo to far flung barangays. > request for additonal manpower.

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ISSUES AND PROBLEMS

NUTRITION > 3.1% of preschoolers are below normal (BNL) and very low below normal (BNVL)

POSSIBLE CAUSES
> poverty - food not always in their home. > unemployment > laziness of parents to look for livelihood.

EFFECTS
> increase morbidity/mortality to malnourished children.

HOW TO SOLVE IT
> provide jobs/livelihood to poor families > food supplementation to BNL & BNVL children (on a continous basis). > provision of budget for food (with supplementation). > TAP NGO's for assistance ex. Adopt A Barangay > encourage backyard gardening.

NATIONAL TUBERCULOSIS PROG. (NTP) > T.B. is one of the leading causes of mortality among adults. > late consultation/treatment on T.B. symptomaties. > non compliance to the T.B. regimen > unhealthy life style > poor nutrition > poverty RABIES PREVENTION AND CONTROL > increase dog bites cases > still have unimmunized dogs. > irresponsible pet owner > lack of inadequate supply of human anti rabies vaccines. > human rabies is 100% fatal > conduct seminar on responsible pet pet e ownership (by the veterinary office). > seek early consultation/treatment. > provision of human anti rabies vaccine to indigent patients. > immunization of dogs. > penalty to dog owners for the unvaccinated or stray dogs. > increase mortality (TB) among the adult population. > Sputum Exam to all T.B. symptomaties. > initiate early treatment & case holding to T.B. patients. > DOTS by health personnel & BNS > 100% cured after treatment.

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4.3 e Health Resources, Facilities and Services Development Objectives

Under the health sub-sector, one basic objective is being set which is also consistent with the Regional development objective, viz: 1. To improve the health status of the city residents through the provision of maximum partnership access with to qualified and efficient health care services in LGUs, national government and non-government

organization by the succeeding years.

Proposed Development Strategies/Programs

1) Strict implementation on the preventive and promotive health care through the different health programs of DOH: MCH Immunization /Pre and Post Natal Care Medical Services - Infectious and Non Infectious NTP Leprosy CVD Family Planning Nutrition CARS CDD Dental Services Environmental Services Laboratory Services 2) Improvement/Rehabilitation of all facilities and supplies, i.e. health centers, equipment and medicines in all barangays. 3) Provide adequate health services and facilities to all the barangays in the city by construction of barangay health stations to different barangays and provision of dependable/durable vehicle for transportation. 4) Initiative steps to acquire ACMDC hospital to be utilized as a district hospital. 5) Conduct of massive and continued IEC campaign on health programs ensuring a wide coverage of beneficiaries. 6) Upgrade from 25 hospital beds to 100 bed capacity with corresponding increase in personnel.

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7) Filling up of the vacant position of health personnel to ensure sufficient service.

8) Institutionalized

health

services

through

community

involvement/community based health programs. 9) Construction of new Barangay Health Centers/Stations with priority on those barangays where health centers are practically the Barangay Multi-Purpose Hall . 10) Provision of garbage trucks to support/facilitate in programs on proper waste disposal and cleanliness programs. 11) Provision of adequate potable water supply to all barangays. 12) Develop active partnership between the LGU and the NGOs in the management and implementation of health care services; 13) Conduct active diseases monitoring/surveillance system to monitor health indices regularly in all barangays; 14) Establishment of Botica sa Barangay projects to provide residents immediate access to common affordable medications.

Policy Recommendation
1. Provide medical/health insurance to low income families. 2. Procure a mobile medical and dental clinic. 3. Institutionalize and improved the conduct of the Minimum Basic Needs ( MBN) survey to provide for its optimization as a tool for health sector planning. 4. Institute City Health Information and Management Information System for central data banking on health programs and activities. 5. Provide the rights of every citizen to avail of every health services available. 6. Policy recommending every citizen to notify for any communicable and non-communicable disease present which would endanger the health status of the people. 7. Policy recommending every citizen in the barangay to submit for immunization necessary to maintain health. 8. Policy recommending that all pre-schooler should be fully immunized before entering school proper with complete health records. 9. Policy recommending every citizen the right for a clean environment, to avoid nuisance in any form.

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10. Policy recommending that all pregnant women in the 1st Semester
onwards to have their pre and post natal check-up with complete records. 11. The right of every citizen to be treated and admitted in the hospital should the situation arise without any discrimination. 12. The right of every citizen to complain to any maltreatment by any health official but will not endanger the department.

b.

Hospital
The city has one (1) hospital with a 25-bed capacity focusing mostly provision of curative health care. Complicated cases are referred to the

on

the

private hospitals in nearby Cebu City. On the other hand, there are eight private clinics in the city which are located in Barangays Poblacion, DAS and Sangi. For the year 2006, there were 3,705 hospital admissions (excluding newborn) with an average length of hospitalization/patient of three (3) days. The average number numbered 14,201. of in-patients/day is twenty six (26) and the total number of patients transferred to other hospitals numbered 290. Total number of out-patients

TABLE 4.43 General Medical Consultation and Hospitalization Rate Year 2003-2006 Year 2003 2004 2005 2006 Population 150,045 153,691 157,329 160,845 (January October) T O T A L
Source: Toledo City Hospital, 2006 The Year 2003 recorded the consultation and hospitalization with highest number of general medical 119 general medical consultations

General Medical Consultation Rate Number Rate 17,957 15,031 14,021 10,645 57,654 119.67 97.8 89.1 66.18 372.75

Hospitalization Rate Number Rate 4,808 4,009 3,705 3,421 15,943 32.04 26.08 23.54 21.26 102.92

and 32 hospitalizations, respectively, for every 1,000 population .

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Table 4.44 Hospital Facility, Personnel and Services Hospital Facility No. of Beds
Medica l Officer Toledo City Hospital 25 5 Medical Nurse 6 Nursing Attendant

Medical Personnel (Number)

Pharmacist s 1 Radiologis t 1 Rad. Tech Services Rendered Pediatrics Medicine Minor Surgery Obstetrics Out-Patient Services

Source: Toledo City Hospital, 2006 Hospital Sevices and Personnel: A. Administrative Services 1 Administrative Officer II 1 Storekeeper II/Supply Officer 1 Adm. Aide VI / Records Clerk 1 Adm. Aide III 1 Adm. Aide 1 Medical Services 1 Chief of Hospital 1 Medical Officer V 3 Medical Officer IV C. Medical Ancillary Services 1 Medical Technician/Radiologic Technician 1 Pharmacist 1 Pharmacy Aide 1 Adm. Aide/Laboratory Aide D. Nursing Services 1 5 3 5 E. Supervising Nurse Regular Staff Nurses Midwives Nursing Aides

B.

Dietary Services 1 Dietitian 2 Cooks 4 Adm. Aide/Food Service Work

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Hospital Facilities/Equipments: A. Emergency Room/Out-Patient Department o o o o o o o o o o o o B. 1 Suturing Table 3 Stretchers 3 Wheel Chairs ( 1-Pediatric) 2 Oxygen Tanks with gauge 1 Suction Machine 1 Gooseneck Lamp 1 Adult Ambubag 1 Pedia Ambubag 1 Nebulizer 1 Sphygmanometer/Stethoscope Suturing sets/Surgical Instruments 2 Ambulances

Pediatric/Male & Female Medical Ward o 32 Hospital Beds/Bedside Tables

C.

Delivery Room/OB Ward o o o o o o o o o o 2 Delivery Tables 1 Suction Machine 1 Gooseneck Lamp 1 Adult Ambubag 1 Pedia Ambubag 2 Oxygen Tank with Gauge 1 D & C Set 10 Hospital Beds/Bedside Tables 1 Stretcher 1 2Hp Aircon

D.

Clinical Laboratory o 1 Hematology Analyzer with Printer o 1 Clinical Chemistry o 1 Microscope o 1 Centrifuge o 1 Oven o 1 2Hp Aircon o 1 Refrigerator o Radiology o o o o o 1 X-Ray Machine with all accessories 1 Developing Tank 1 Double Negastoscope X-Ray Cassettes Gonadal Shields

E.

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o o o F.

Film Hanger 1 Pair Lead Gloves 1 1Hp Aircon

Dietary o o o o o 4 Gas Stoves 1 Refrigerator 1 Blender 1 Food Cart Various cooking utensils

Development Plan of the Toledo City Hospital 1. Determination of Existing Need Existing Problems in the City Hospital
The primary problem of the City Hospital is the lack of funding that is necessary in order to improve the delivery of services. The annual rise in population is parallel to the rise of health and hospital care expenses. The current

budget of the hospital is P15,039,633.50 which covers expenditures for personnel services and maintenance and operating expenditures. In the 2007 budget, the amount of P 3,800,000.00 is earmarked for the purchase of medicines , fluids, medical, dental and laboratory supplies which is approximately twenty-five percent (25%) of the total budget. About 62% is set aside for personnel services of regular employees which includes salaries and wages, hazard pay, ACA-PERA, overtime and night premiums. However, as of 2006, the actual income of the city hospital was only P2,298,140.42. even for basic hospital services. Apparently, the paradox lies on the fact that much is spent for personnel services with so little income realized to answer Another problem is the need for additional equipment to address the basic requirements that are consistent with the present technology. Hiring of employees based on the padrino system invites less efficient personnel into the bureaucracy and impair the quality of the service.

2. Projected/Future Needs
In order for the hospital to increase its income-generating capacity and provide better service, there is a need to improve its facilities and the service which may include among others the following: 1) Procurement of medical equipment the quality of

2) Enhancement Training of medical personnel and adapt

screening of medical personnel applicants

rigorous

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3) Renovation of

Hospital Building with the provision of

private rooms

4) Increase in budget allocation for medicines and other medical supplies 5) Increase bed-capacity

3. Goals and Objectives 1) Provide equipment, supplies and materials for the deliver of optimal care
to the patient.

2) Utilize all necessary discipline

and understand the pathophysiology of available.

diseases and various methods of treatment

3) Provide care, support, understanding and companionship to the patient

and family throughout the course of illness including the occurrence of death.

4. Policy Recommendations 1) Policy recommending the employment of the best qualified person
especially in vacant of the charges. 3) Policy recommending that procurement of medicines, medical bid price. Strengthen the prequalification of the bidders. supplies and equipment should be of good quality and not merely the lowest medical positions and strengthen the composition Personnel Selection Board.

2) Policy recommending an Increase of ten percent (10%) of all hospital

5. Strategy
1) Operate the hospital like the manner it is operated by private hospitals. 2) Privatization of the City Hospital in accordance with existing laws and regulations.

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CAUSES OF CONSULTATION & HOSPITALIZATION JANUARY DECEMBER 2003 OUT- PATIENT 1. Urinary Tract Infection 2. Diarrheal Diseases 3. Bronchopneumonia 4. Hypertension 5. Dengue Hemorrhagic Fever 6. Acute Gastritis 7. Bronchial Asthma 8. Measles 9. Typhoid Fever 10. Pulmonary Tuberculosis IN PATIENT 1. Diarrheal Diseases 2. Deliveries 3. Acute Gastritis 4. Dengue Fever 5. Measles 6. Bronchopneumonia 7. Urinary Tract Infection 8. Hypertension 9. Bronchial Asthma 10. Typhoid Fever 11. Acute Pneumonia

1,833 1,490 1,131 989 647 446 390 206 170 107 1,067 844 308 313 273 245 216 221 98 52 52

CAUSES OF CONSULTATION & HOSPITALIZATION JANUARY DECEMBER 2004 OUT- PATIENT 1. Diarrheal Disease 2. Bronchopneumonia 3. Urinary Tract Infection 4. Essential Hypertension 5. Acute Gastritis 6. Upper Respiratory Tract Infection 7. Dengue Fever 8. Bronchial Asthma 9. Enteric Fever 10. Pulmonary Tuberculosis IN PATIENT 1. Diarrheal Diseases 2. Deliveries 3. Acute Gastritis 4. Urinary Tract Infection 5. Essential Hypertension 6. Bronchopneumonia 1,639 971 902 763 540 417 368 205 123 92 1,282 560 341 254 189 154

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7. 8. 9. 10.

Acute Pneumonia Enteric Fever Dengue Fever SVI

117 98 74 65

CAUSES OF CONSULTATION & HOSPITALIZATION JANUARY DECEMBER 2005 OUT- PATIENT 1. Diarrheal Disease 2. Urinary Tract Infection 3. Upper Respiratory Tract Infection 4. Essential Hypertension 5. Dengue Fever 6. Bronchopneumonia 7. Acute Gastritis 8. Acute Pneumonia 9. Respiratory Tract Infection 10. Systematic Viral Infection IN PATIENT 1. Diarrheal Diseases 2. Deliveries 3. Urinary Tract Infection 4. Acute Gastritis 5. Dengue Fever 6. Bronchopneumonia 7. Essential Hypertension 8. Acute Pneumonia 9. Systematic Viral Infection 10. Upper Respiratory Tract Infection 1,818 946 555 499 487 467 405 293 209 163 1,492 535 278 263 204 175 157 150 78 62

CAUSES OF CONSULTATION & HOSPITALIZATION JANUARY OCTOBER 2006 OUT- PATIENT 1. Diarrheal Disease 2. Urinary Tract Infection 3. Upper Respiratory Tract Infection 4. Essential Hypertension 5. Wound 6. Acute Pneumonia 7. Acute Gastritis 8. Bronchopneumonia 9. Peptic Ulcer Disease 10. Acute Bronchitis IN PATIENT 1. Diarrheal Diseases 2. Deliveries 3. Urinary Tract Infection 4. Acute Pneumonia 5. Bronchopneumonia 6. Acute Gastritis 7. Essential Hypertension 1,644 763 506 477 435 387 315 308 210 198 1,419 437 299 224 196 178 139

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8. 9. 10.

PUD Systematic Viral Infection Upper Respiratory Tract Infection

113 109 103

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4.4

Solid Waste Management and Disposal

Toledo City has developed a ten-year Integrated Solid Waste Waste Management in compliance activities such as with the

Ecological Solid Waste Regulation (

DA 2001-34)

and

captures

specific

segregration, re-use,

recycling, composting, collection and transport of waste and Figure 4.03 ISWM Framework

establishment of MRF as well as disposal sites. This 10-year plan will become the framework for subsequent actions and decisions in addressing Solid Waste Management of the city.

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TOLEDO ISWM FRAMEWORK

MANDATORY SEGREGATION AT SOURCE SEGREGATED COLLECGTION WASTE PROCESSING & DIVERSION EC O PA KW STE R A D ISPO L SA

PUBLIC MARKET BIODEGREDABLE RESIDENTIAL RECYCLABLE INSTITUTION PARKS / COMPLEX RESIDUAL SLAUGHTERHOUSE SLF MRF CITY /BRGY COMPOSTING RESIDUALS

SPECIAL WASTE

SPECIAL WASTE

SLF SEPTIC TA K N

O ERS TH

Relative Solid Waste Generation of Toledo City

Service Center

General Store

Recreation Center

Residential

Food Establishment

Public Market

Institution

Slaughter House

3.50 3.00 2.50 4.4 a. Solid Waste Generation2.00 1.50 1.00 A 7-day waste characterization was made and the results revealed information that served as basis for the 100.50 year ISWM plan. The characterization not only allowed one to assess the different categories of the solid waste generated Industry
but provided information as to who and where it was generated.

Special Waste

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Figure 4.04 Relative Solid Waste Generations

Figure 4.4 shows the relative distribution of the waste generation according to source per unit. For example, the Public Market Sector generates about 3.04 kg/day per stall while the residential sector household. However, the residential sector generated mostly of the solid generates due about to the 1.9/kg/day number per of waste mainly

households. Large number of households are at the coastal barangays of Poblacion, Bato and Matab-ang. Inland households are located in barangays DAS and Poog.

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