A NEW BREED OF DORA EXPLORERS…
AGSB MBAH 10-B
Entrepreneurship NU-12 (1/12)
Category: Government Services
By: sherwinisms
DORA as most of us know, is that eight-year old Spanish girl who, while sporting her backpack, embarks on a new trip every episode in order to find something or help somebody while teaching the viewers a few Spanish words and phrases on the side. DORA’s backpack provides whatever DORA needs to complete her quests.
It is in this context that the Direct Obstetric Roving Attendant (DORA) Explorer Program is being conceptualized. The program aims to capacitate health service providers, particularly Rural Health Midwives in Geographically Isolated and Disadvantaged Area (GIDA) municipalities to be able to render timely, quality health services especially Maternal and Child Health services to pregnant mothers in far-flung, isolated, island barangays and/or municipalities.
The fragmentation of the health care delivery system in the country, brought about by the process of decentralization with the implementation of the Local Government Code in 1991, resulted to the deterioration of primary health care services mostly in poor rural municipalities especially in GIDA’s. Local interface became a major hindering factor in delivering comprehensive primary health care services in these communities.
In 1999, the Department of Health (DOH) launched the Health Sector Reform Agenda (HSRA) in response to the post devolution health issues encountered. The identification of GIDAs was an approach to support the implementation of the Local Health Systems Reform in these remote, isolated and disadvantaged communities. But until now, already under the Kalusugang Pangkalahatan (KP)approach under President Aquino’s term, no clear policies and programs are being identified and implemented specifically for GIDAs. If at all, being carried out in GIDAs are approaches no different from those rolled-out in ordinary poor rural communities, only they are labeled “for GIDAs”.
Characterized generally by a lack of health facilities with low logistical support resulting to poor access and delivery of quality health services, an increase in Maternal and Infant mortalities were noted in GIDA municipalities which account for 7.5% of municipalities in the country and if not addressed drastically will hinder the country from reaching its Millennium Development Goal (MDG) target particularly on reducing the Maternal Deaths to 52 by year 2015.
The DORA Explorer Program will provide Basic Emergency Obstetric and Newborn Care (BEmONC) training for all midwives in GIDA municipalities to increase their capacities in responding to Maternal and Newborn cases whileproviding them with “backpacks” fully equipped with irreplaceable medical equipment and supplies necessary for facilitating home deliveries. The program thus promotes home deliveries by Skilled Birth Attendants rather than Facility Based Deliveries, which have proven to be very difficult to implement in GIDA municipalities. Each GIDA municipality will have to be zoned properly with each zone having its assigned midwife. Barangay Health Workers (BHWs) and/or Community Health Teams maybe tapped to do the mapping of pregnant women andtogether with the local Barangay Leaders arrange the transfers of a midwife to be able to answer on time to any deliveries within their areas. Special arrangements may also be made with PhilHealth for the accreditation of these midwives to have their Maternal and Newborn Care services rendered for free to PhilHealth member families. Most if not all of these mothers cannot access these services, if at all available, thus we bring the services to them.
GIDA municipalities were identified for the simple reason that they are very difficult areas and their needs more than the ordinary, and would thus have to be assessed separately. Special policies and more targeted programswould have to be formulated for these areas if the government is indeed serious in solving their problems, health or otherwise. 3
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