LINKAGES Project to curb Hypertension and diabetes: Leveraging Intervention,

Networking Knowledge-driven Advocacies, Game-changing Expanded Services to

curb Hypertension and Diabetes to Pilot Barangays in Basey

An Innovation Project presented to the

Public Management Development Program
Development Academy of the Philippines

Ayap, Shiela Ann L.

Municipal Health Officer
Municipal Government of Basey

June 10, 2024

i
 COPYRIGHT STATEMENT

This paper is an official document of the Development Academy of the Philippines.

Reproduction and distribution of the paper or parts thereof is prohibited except with
permission from the copyright owners - the author, Development Academy of the
Philippines, and the author's LGU.

The author and publisher make no representation or warranties with respect to the
accuracy, applicability, fitness, or completeness of the contents of this publication. The
information contained in this report is strictly for educational purposes.

Proper acknowledgement and citation should be accorded to information obtained

from this material.

ii
 TABLE OF CONTENT

CHAPTER 1.......................................................................................................................1
CHAPTER 2.......................................................................................................................5
2.1 Project Objectives....................................................................................................5
2.2 Project Component..................................................................................................6
CHAPTER 3.......................................................................................................................8
CHAPTER 4.....................................................................................................................11
CHAPTER 6.....................................................................................................................13
MY PMDP-LGEMC JOURNEY....................................................................................16
REFERENCE...................................................................................................................18
GLOSSARY OF TERMS................................................................................................19
ANNEXES.........................................................................................................................20
BIOGRAPHICAL SKETCH..........................................................................................22

LIST OF ACRONYMS

iii
AO Administrative Order
DOH Department of Health
DTTB Doctor to the Barrio
Phil PEN Philippine Package for Essential Non-Communicable Diseases
Intervention
POPCOM Commission on Population
LGEMC Local Government Executive and Managers Class
LGU Local Government Unit
MHO Municipal Health Office
NCD Noncommunicable Disease
NGO Nongovernment Organization

iv
 EXECUTIVE SUMMARY

The COVID19 pandemic affected Basey heavily, causing disruptions in its

existing programs. Almost of the health programs became non-functional affecting health
deliverables, thus there was adversities in addressing health issues in the municipality.
Among the common health issues are hypertension and diabetes in the community yet
neglected.
The Department of Health (DOH) recognizes hypertension and diabetes as critical
health issues that contribute significantly to the mortality and morbidity rate in the
Philippines, affecting the lives of many Filipinos. According to POCOM report,
“Philippine population’s health challenged by highest mortality rate in 63 years; Covid-
19, heart attacks, strokes, hypertension, diabetes mellitus are greatest contributors to
elevated number of deaths since post-worldwar2.” (cpd.gov.ph)
NCD also imposes economic burden due to its costly management. According to
DOH AO 2012-0029, “currently, the main focus of clinical health care for NCDs in the
Philippines is hospital-centered acute care. Patients with NCDs usually seek treatment at
the hospitals when cardiovascular disease, cancer, diabetes and chronic respiratory
disease have reached the point of acute events or long-term complications. This is a very
expensive approach that will not contribute to a significant reduction of the NCD burden.
It also denies people the health benefits of taking care of their conditions at an early stage.
A strategic objective in the fight against the NCD epidemic is the early detection and care
using cost-effective and sustainable health-care interventions that are integrated in the
primary health care facilities such as barangay health stations, rural health units,
community health centers and the like. DOH considered NCD as top priority health
program.” In response, DOH included screening of risk factors to NCDs for individuals
aged 20 years old above as one of the performance indicators in the LGU scorecard in
2019 until now. This is to encourage LGUs to take actions in their health services to
combat NCDs such hypertension and diabetes.
To tackle the rising incidence of hypertension and diabetes, the scholar is
dedicated to establish a robust coordination mechanism from the grassroot to higher
facility that will address this health issues targeting the interconnected linkages of
prevention and control hypertension and diabetes through the LINKAGES PROJECT to
curb hypertension and diabetes: Leveraging Intervention through Networking,
Knowledge-driven Advocacies, and Game-changing expanded services.
The goal of this project is enhancing the availability and accessibility of NCD
program services in the community. The services will be brought down to the community,
especially screening of risk factors exposures leading to the likelihood of developing
hypertension and diabetes for individuals aged 20 and above using the PhilPEN protocol
endorsed by the Department of Health adopted from World Health Organization. PhilPEN
tool also provide individuals to know their risk of developing hypertension and diabetes
and provides preventive information that guide individuals in making informed decisions
on their health.
Basey has 51 barangays and launching this project to all barangays is not feasible,
hence, project will commence in the Poblacion catchment, which comprises seven
component barangays. It will flinch on July 2024 and will run continuously until all 51
barangays are included. Engagement with local leaders remains indispensable to allocate
funds as their counterpart ensuring sustainability of this project.
The project cost estimate is 1,000,000 PHP for the procurement of screening
logistics, medications, and hypertension and diabetes booklet production.

v
 CHAPTER 1
BACKGROUND AND CONTENT

To address the nation’s biggest killers, the Department of Health (DOH) aimed to
improve the detection of risk factors that link to the development of noncommunicable
diseases (NCDs) such as prevention and control of hypertension and diabetes in the
country. One of the priority programs, projects and activities of DOH is to reduce the
morbidity, mortality and disability rates due to noncommunicable diseases. Since 2019,
DOH included in the LGU health scorecard among the performance indicators, is the
percentage of adults 20 years old and above who were risk assessed using the PhilPEN
protocol. The continued inclusion of this performance indicator up to the present in the
LGU health scorecard serves as a mechanism for LGUs to embark on measures and
instigate necessary reforms against NCDs.

Philippines Package of Essential Noncommunicable Disease (PhilPEN)

Intervention is a tool to assess the presence and absence of common risk factors that
exposed among adults 20 years old to increase likelihood of developing NCDs. It is
integrated management for prevention, early treatment and control of hypertension and
diabete. It also estimates the level of risks of individuals for a fatal and non-fatal
cardiovascular event in 10 years. Stated in the background and rationale of the DOH
administrative order No. 2012-0029, PhiLPEN was adapted by DOH from the World
Health Organization in consideration of the country’s commitment to a 2% yearly
reduction in mortality due to NCDs and to contribute to the global reduction of 25% by
2025.

1
Figure 1. LGU scorecard on Health 2019. Figure 2. LGU scorecard on Health 2020

Figure 3. LGU scorecard on Health 2021. Figure 4. LGU scorecard on Health 2022

DOH. Scorecard Regional Summary. https://ro8.doh.gov.ph/lgu-scorecard-regional-summary/

2
 Seen in figures 1- 4, circled with red is the result of Basey scorecard on health
performance level from 2019 to 2022 of the indicator percentage of adults 20 years old
above risk assessed using the PhilPEN protocol. In 2019, the performance level indicated
by red color which means performance result is below from the national target of 15%.
There was no data available for two consecutive years 2020-202 with shades of grey,
while at that time the country was succumb to COVID19 pandemic. In 2022, the
performance level again is color red with 1.01% performance result, against the national
target of 8%. These data suggest that the performance indicator to address NCDs was not
even close to the national target set from 2019 to 2022.

Based on the health scorecard of the municipality, there is apparent deficiencies in

health services specifically related in addressing noncommunicable diseases. This may
relate to constraint health services that is confined only at the Municipal Health Office
(MHO). Individuals with high-risk exposure to developed chronic diseases at the
community are not detected early thus not being abetted for early management, awareness
and education until such time it developed into severe conditions that require specialized
care that entails expensive treatment.

One of the challenges on the health information of the MHO is poor record-
keeping. Poor data management is one of the biggest hurdles to demonstrate the real
picture of hypertension and diabetes cases in the municipality. There is nonexistence of
health record or lacks individual treatment record of patients. Patients who seek multiple
consultations everyday always considered as new patient. Thus, patients’ history
especially individuals with hypertension and diabetes are not monitored.

There is lacking adoption to health ordinances that supports NCD program

implementation. Although there are existing health regulations such as antismoking, it is
not strictly enforced. Local leaders tend to neglect embarking on measures to combat
hypertensions and diabetes at their jurisdictions as they perceive health issues are solely
the responsibilities of the health sectors. They depend profoundly on health services
offered at the MHO; hence they don’t include procurement of medicines and essential
logistics as their major thrust to support their constituents living with NCDs. The budget
allocated for medicine is only four million with a considerable portion allocated on the
procurement of maintenance medications for hypertension and diabetes. However, stock
3
is easily depleted due to many patients requesting at the MHO, thus, cannot cater to
supply barangay health stations.

Moreover, health information and promotions of NCDs is not organized and

conducted. There is difficulty in solidifying system and practices especially that staff are
accustomed to being idle to acquiring new knowledge and skills and are resistant to
change. At times, staff themselves are propagating misinformation on their view about the
pathologies of these chronic diseases, that leads to gap in the accuracy and reliability of
health information being conveyed to the public. Barangay Health Workers lack even the
basic skills and knowledge (BP taking, Normal BP…) in performing their mandated tasks
as barangay health promotion officers. This underlines the critical need for training
among healthcare providers to obtain correct and credible health information in
strengthening health information and education dissemination in the public.

There are numerous factors linked to hypertension and diabetes and the
management varies depending on the underlying factors and the most effective and cost-
effective is prevention measures. Failure to intervene and attend to these factors leading
to these conditions will results in the continued escalation of these chronic diseases
causing a ripple effect on the economic burden that the municipality will have to bear in
addition to the serious impact of premature deaths and debilitating complications.

4
 CHAPTER 2
PROJECT DESIGN

2.1 Project Objectives

The acronym of the project is “LINKAGES” which is an Elaboration of

Leveraging Intervention through Networking, Knowledge-driven Advocacy, Game-
changing Expanded Services to implement strategies of decreasing hypertension and
diabetes to pilot barangays. It is a broad- based strategy that seeks to tackle the link
factors on the rising prevalence of hypertension and diabetes to pilot barangays in the
Municipality of Basey.

The main purpose of the project is to expand health services for noncommunicable
disease to the grassroot focusing on screening on the risk factors using the PhilPEN
assessment tool. It also aims to establish effective system of coordination to meet the
needs of the community related to NCDs. This includes guidelines and procedures for
the processes required to be undertaken for those with high risk factors and those already
with hypertension and diabetes to avail NCD services.

Any starting project is always difficult. There are no smooth waters at the initial
period in a project particularly if it is centered on behavior modification. It is always very
easy for people to resist and or to hesitate before they adopt any new practice. Trying to
persuade people to change old habit will always be greeted with a lot of resistance. In this
case, it is crucial to have the backing of the community. To assist the community in
establishing their network such health support clubs as platform for sharing experiences,
accessing valuable information regarding their health that promote better self-care
practices.

One of the chief dilemma in embarking projects is the lack of resources and is
always the constant issue especially if stakeholders do not consider it their top priority.
Therefore, effective management on resources such as efficient budget and logistic
tracking, and viable strategies such exploring grant opportunities, consort with
nongovernment organizations and employing PhilHealth Konsulta packages should be

5
considered during the operation of the project. This will aid supplement budget
constraints ultimately leads to the successful execution of the project.
2.2 Project Component

The LINKGAGE Project was not previously part in the health services of the
Municipality of Basey. Moreover, there was barely active existing programs which were
concerned with noncommunicable diseases such as hypertension and diabetes during the
previous years. This transformation toward the scaled introduction of explicit projects and
programs indicates a rising appreciation of the importance of preventive and anticipatory
health measures on smaller scales. Heralding these new efforts, there is a progressive
social practices orientation towards improving health status and fulfilling the related
needs individuals living with hypertension and diabetes in the community. With these
measures, there is an evident focus on addressing concerns revolving around the health of
the public with an unprecedented importance on public health enlightenment.

The LINKAGE project deliverables comprise a number of wide-ranging strategies

that can help accomplish the specific goals and targets set. These include aggressive
community health outreach activities bringing services of NCDs to the barangays aimed
at screening target population on risk factors to developing hypertension and diabetes,
educating and involving members of the public, organizing hands-on training for
healthcare practitioners with respect to NCDs management, targeted awareness
campaigns to keep people informed about a healthy lifestyle, introducing mobile clinics
as part of health care access initiatives, carrying out comprehensive data collection and
analysis for monitoring purposes and decision-making, as well as partnerships with local
organizations to ensure better coordination.

To synthesize this project, it should be noted that through this multi-dimensional

approach the project aims to effectively addressing non-communicable diseases. These
are the steps that will not only enhance availability and accessibility of health services but
also ensure that individuals are self-determining in their choices regarding health matters
hence they will be able to manage their conditions appropriately. Ultimately therefore,
this project is aiming at making significant improvements in the overall health status of
the community by implementing an intervention strategy tailored specifically to its needs.

6
 The conversation with the Municipal Planning Development Officer, on behalf of
the Municipal Mayor as my institutional partner , highlights the need to bring focus on
patients with high blood pressure and diabetes by extending services to the barangays. It
is essential to strengthen the noncommunicable disease system because these persons
often rely on the financial support from the LGU to cover their medical expenses. By

Addressing this pressing health problem in multifaceted way, the initiative does
more than seek to solve problems of financial burden in the LGU but also tries to prevent
the growing incidences of these diseases meaningfully. Varied approaches of intervention
tailored at various geographical points are all aimed at the constituents’ health and well-
being.

7
 CHAPTER 3
PROJECT IMPLEMENTATION

This chapter identifies the basic requirements for the LINKAGES project, such as
the total budgetary needs of the program. Beginning in July 2024, this project will be
implemented and it will start with pilot barangays at Poblacion Catchment.

The project duration spans up to six months starting from July of the year 2024
right up to December 2024. The total required project funding for the implementation of
LINKAGES Project in pilot barangays (Poblacion Catchment) in Basey, Samar is one
million pesos (PHP 1,000,000).

Potential fund source will be provided by the LGU while additional funding can
be sourced from barangay health funds, community initiatives such as fundraising for the
project, partnership with Non-Government Organizations (NGOs) that shares common
goal, and lastly utilization of PhilHealth Konsulta package through out the operation of
the project.

3.2 Project Implementation plan

Table 1. List of Activities and Components under the Programmatic Approach

No Activities Duration Cost Description
. Requirement
1. Master listing for Database 2 weeks 10,000 PHP Sustaining the master
list of the database so
as to obtain all the
hypertension and
diabetes cases health
related in the health
facility and
community
2. Passing of Health Ordinances 1 month 1,000 PHP Formulation and
enactment of health
ordinances to
contribute to
measures necessary
in addressing
Hypertension and
Diabetes in Basey
Samar
3. Training of Health Care 2 weeks 200,000 PHP Organizing

8
 Workers awareness and
education campaigns
to improve firstly and
secondly condition
among healthcare
workers through skill
development training
4. Health Information and continuing 70,000 PHP Educational and
Education promotional
initiatives for disease
prevention and care
involving
hypertension,
diabetes and
practices in the
community
5. Meeting with Stakeholders in 1 week 5,000 PHP Approaching the
Pilot Barangays Punong Barangay,
other elected
barangay officials
and influential people
of the seven pilots
councils to explain
the project to them
and to seek their
cooperation in the
project
implementation.
6. Expanded Services: Risk Continuing 400,000 PHP Fix post or modified
Factors Assessments and post for screening of
Community Services Risk factors at the
Barangay level
7. Creation of Hypertension and 1 month 100,000 PHP Platform for patients
Diabetes Club receiving
comprehensive care
(drug and nod-drug
interventions
strategies)
8. Setting up Community Health - 200,000 Improving access to
Medication Initiative essential medications
in the management of
hypertension and
diabetes at the
Barangay Health
Station

9
 Table 2. List of Activities Align with the Corresponding timeline
Task Activities July August September October November December
No.
1. Master
listing for
Database
2. Passing of
Health
Ordinances
3. Training of
Health Care
Workers
4. Health
Information
and
Education
5. Meeting with
Stakeholders
in Pilot
Barangays
6. Expanded
Services:
Risk Factors
Assessments
and
Community
Services
7. Creation of
Hypertension
and Diabetes
Club
8. Setting up
Community
Health
Medication
Initiative

10
 CHAPTER 4
PROJECT MONITORING AND EVALUATION

It is crucial to have a robust monitoring and evaluation plan for the LINKAGE
Project to track progress, monitor outcomes and measure achievement of results and
targets.

Table 3. Outline of the Monitoring and Evaluation Plan

Activity Output
Baseline 1. Do a comprehensive baseline to get the initial status of key indicators
Assessment for non-communicable diseases in the target communities.
2. Get baseline data on disease prevalence, health seeking behaviors,
knowledge levels and existing health infrastructure.

Monitoring 1. Collect and analyze data on project activities, outputs and outcomes
using the indicators.
2. Use data collection tools such as surveys, interviews, focus group
discussions and health facility records.
3. Track against targets, milestones and timelines to ensure project is on
track to achieve goals.

Evaluation 1. Develop an evaluation framework with clear objectives, evaluation

questions and criteria for project effectiveness.
2. Determine data collection methods, sampling technique and analysis
approach for project impact.
3. Identify team members involved in the evaluation process.

Data Analysis 1. Analyze monitoring data to measure progress, track trends and
and Reporting evaluate project interventions.
2. Produce regular reports with key findings, challenges, lessons learned
and recommendations for improvement.
3. Use data visualization tools to present findings in a simple language
for stakeholders.

Stakeholders 1. Get feedback from stakeholders including community members,

Feedbacking project beneficiaries, government officials and partner organizations.
2. Have stakeholder consultations and feedback sessions to ensure
transparency, accountability and participation in the monitoring and
evaluation process.

Review and 1. Review monitoring and evaluation findings regularly to assess project
Adaptation performance and identify areas for adaptation or course correction.
2. Use evaluation results to inform decision making, improve program
strategies and optimize resource allocation for better project
outcomes.

Impact 1. In the context of impact assessment interviewing to assess the

Evaluation sustainable changes that the project may have brought about in the
fight against hypertension and diabetes, and the promotion of better

11
 health services to the community.

Lessons 1. Capturing successes, accomplishments, and potential problem areas

Learned and observed during project implementation process to use in planning
Best Practices and design of subsequent phases of a project and improve
management and efficiency of existing project plans.

CHAPTER 6

12
 PROJECT ORGANIZATION AND MANAGEMENT

Table 4. Roles and Responsibilities of Key Actors

Project Team Member Roles and Responsibilities
Local Executive Officer 1. Approve the innovation project and its
components
2. Approved changes in policies or
allocation of budget towards NCD
prevention interventions that can sustain
project outcomes
3. Support the LINKAGES project by
allocating resources, giving the green
light to project activities, and fostering
collaboration between different
agencies.
4. Engaging with stakeholders like the
Project Team, barangay officials, and
community organizations to make sure
the project aligns with the
municipality's priorities.

Project Manager 1. Responsible for coordination, planning

and execution of the whole project
2. Responsible for budgeting, financial
statements presentation & resources
allocation for the project
Plan projects, develop goals, align with team
members and monitor progress, ensure that the
project objectives are met
Program Coordinator 1. Oversee particular project components
ensuring timely accomplishment
2. Implement project activities, managing
resources; engaging stakeholders and
supporting achievement of project
milestones

Monitoring and Evaluation Officer 1. In charge of monitoring project

progress, assessing performance, and
reporting outcomes
Design a monitoring framework for the project;
assess its impact on various areas; highlight
what need to be changed or improved- then
report back.
Health Education Program Officer 1. Manage information dissemination
about the project as well as
stakeholders’ involvement
2. Develop media plans for informing
people about projects. Involve
stakeholders in your projects as much
possible. Communicate any changes

13
 within our work to ensure visibility of
these programs.

Field Coordinators 1. Oversees on-site operations while

linking up with other community
partners to ensure that the projects
aligns with local settings
Take charge of operations within the boundaries,
such as coordinating logistics and other services
relevant to this program. They oversee the
smooth running of on-ground modules in
partnership with local communities.
Rep Hypertension and Diabetes Club 1. Represent club members and speak for
those with hypertension and diabetes.
Representative
2. Organize support group meetings,
health education forums and create
awareness in the community through
campaigns about these two diseases.
3. Help in identifying people who are at
risk; encourage healthy living among
everyone while at the same time taking
care of their health status
4. Work with Project Team to see to it that
what the club does relates well with
other health promotion activities meant
for controlling these conditions that
may be within the project area
5. Evaluate how effective interventions
have been so far by giving suggestions
on more personalized ways through
which members’ needs can be met
during care provision thus leading them
towards seeking better treatment options
henceforth
6. Act as advocates of good health
searching behavior change
communication messages among people
living around where this association
exists so that they can fully support
each other in taking drugs regularly as
prescribed by doctors until complete
recovery is achieved

Punong Barangay (barangay captain) 1. Be the local government

representative and leader of all
decisions making body in barangay
2. Guide and assist in project activity
implementation in the barangays.
3. Support the mobilization of
communities for projects initiatives.
4. Partner with the Project Team to
ensure project goals relate to barangay
priorities.

14
 5. Track project milestones, troubleshoot
problems, and support project
sustainability.

Strict utilization of barangay resources and

facilities in support of the implementation of
projects.
Barangay Health Worker 1. Provide immediate care and support
as frontline healthcare workers and
community health advocates.
2. Participate in health screenings, health
education programs, and health
promotion activities.
3. Recognize health needs and problems
in the community; Deliver primary
health services.
4. Partner with the Project Team in order
to integrate project interventions with
on-going health programs.
5. Data collection, monitoring and
evaluation support for health related
project outcome

15
 MY PMDP-LGEMC JOURNEY

When I first arrived in Basey as Doctor to the Barrio (DTTB), I came with the end
in mind. “After my contract, what will I contribute in this place that will make a
difference?

I seized the opportunity to be the Municipal Health Officer (MHO) in the Local
Government of Basey, but there may come a time I will leave the area to be with my
family in Cagayan Valley for good. By that time, I hope to exit meaningful and leave
impactful legacy in this place.

Being head of a department is a privilege. But no matter how much you strive to be
a great leader, there always come a time when exhaustion sets in, and you just consider
giving up.

In public health, interventions extend beyond individuals to the population. Heads

in health sectors must possess broad knowledge, encompassing both clinical expertise and
non-clinical management skills. In today's volatile, uncertain, complex, ambiguous
(VUCA)world, mere intelligence is insufficient rather it involves strategic thinking to
surmount challenges that require solutions beyond technical measures alone.

As neophyte in government service, I am still groping in the dark about the overall
operations of the LGU. Assuming the role as MHO, felt akin to receiving the Municipal
Health Office resembling a blank canvas. It is up to us how we create a beautiful
masterpiece. We can’t be able to produce an exceptional masterpiece from the MHO if I,
myself as their leader unsure of what steps to take and have limitations in my knowledge
of the overall operation or system of the LGU.

Then I found LGEMC that serves as my significant guide in my journey as an

MHO. My passion for service reawakened. Despite the short duration of this program for
only three months, this brief period ignites a fire within me to tirelessly serve the
community. There is a purpose why I entered this training course, and it is not for my
own benefit but for the community.

16
 I hope that all leaders go through LGEMC, especially elected officials and
decision-makers who bear significant responsibilities in the government. It is highly
recommended for them to undergo this training as it plays a pivotal role in molding the
character of a leader and a manager to excel in the demands of a challenging government
position. It provides a platform to explore the identity of the scholar who she/he is as a
leader.

The LGEMC is an instrument for me to better understand and recognize myself to

become an adaptive leader. Being a leader requires more than just intelligence; it
necessitates adaptive strategies to navigate mandated task in the government especially
when decentralization be fully implemented.

The best take away is that, I discovered a sense of belongingness with my

LGEMC Batch- Bugsay. A safe place where I can authentically express myself. We likely
came together as a batch due to our shared ambitions despite our diverse backgrounds.
It’s a space where we exchanged knowledge and experiences from our unique
municipalities. I have gained valuable insights from them which is essential for enhancing
my knowledge in my administrative tasks as an MHO, particularly I am relatively new
and my batchmates are seasoned professionals in their respective fields.
Moreover, the LGEMC faculty staff provides exceptional support, fosters growth
and development as a leader.

17
 REFERENCE

“POPCOM: PHL population’s health challenged by highest mortality rate in 63 years;

Covid-19, heart attacks, strokes, hypertension, diabetes mellitus are greatest
contributors to elevated number of deaths since post-WW2. “
https://cpd.gov.ph/popcom-phl-populations-health-challenged-by-highest-
mortality-rate-in-63-years-covid-19-heart-attacks-strokes-hypertension-diabetes-
mellitus-are-greatest-contributors-to-elevated-number/

DOH. (2012). DOH Administrative Order No. 2012-29

DOH. Scorecard Regional Summary. https://ro8.doh.gov.ph/lgu-scorecard-regional-

summary/

18
 GLOSSARY OF TERMS

The definitions below are excerpted from the DOH Administrative Order No.
2012-0029 on the implementing guidelines on the institutionalization of PhilPEN on the
integrated management of hypertension and diabetes.

Diabetes mellitus - A group of metabolic disorders characterized by high blood sugar

levels, i.e. a fasting plasma glucose concentration above 7.0 mmol/l (126 mg/di) or a
postprandial (approximately hours after a main meal) plasma glucose concentration above
11.0 mmol// (200mg/l) on two separate occasions.

Hypertension- Blood pressure reading of 130/80 mm Hg or higher.

Phil PEN Protocol on the Integrated Management of Hypertension and Diabetes-

The Philippine Package of Essential Noncommunicable Disease Interventions Protocol on
the Integrated Management of Hypertension and Diabetes adopted from the WHO PEN
and adopted for country use.

Protocol on the Integrated Management of Hypertension and Diabetes- The first

clinical protocol developed under WHO PEN that makes use of the total risk approach
using hypertension, diabetes and tobacco use as the entry points. It specifically involves
the use of the WHO/ISH risk prediction charts to determine the risk of developing a
cardiovascular event, i.e. heart attack or stroke over a ten period and management
guidelines for risk reduction appropriate referral, regular follow-up, core set of
technologies and essential medicines.

Risk Factor Assessment- The key process of evaluating individuals for the presence or
absence of common risk factors that expose them to increased likelihood of developing
NCDs.

Risk Screening- The presumptive identification of unrecognized disease or the presence

intermediate risk factors by the application of test and procedures which can be applied
rapidly.

Risk Stratification-Estimating the level of risks of individuals for a fatal or non-fatal

cardiovascular event in 10 years.

19
 ANNEXES

Figure 5. Problem Tree

Figure 6. Objective Tree

20
 Table 5. Project Logical Framework

Table 6. Project Implementation Plan

21
22
 BIOGRAPHICAL SKETCH

I completed elementary and high school in Balbalan, Kalinga, my hometown.

Pursued a Bachelor of Nursing at the University of the Cordillera in Baguio City. After
passing the nursing board exam, I applied for a job order position at our Rural Health
Unit (RHU) in my hometown for three months. However, the monthly salary of 4,000
PHP was not sufficient, so I had to leave. But it was this time, my passion for public
service ignited. It was challenge to find a stable job back then as a nurse, so I decided
pursuing medicine at Cagayan State University in Carig Sur, Tuguegarao City.

When I enrolled medicine, I am a single mom to one-year-old daughter. I

experienced difficulties of balancing my studies and raising a child with limited financial
resources. This experience may have been a significant factor in shaping my character
and making me resilient in my current job.

During my medical clerkship, it was a blessing that DOH offered a scholarship,

the DTTB program, which community return service commitment for two years. I seized
opportunity, as it aligns with my dream after graduation, I will return and serve to my
hometown in Kalinga. In March 2019, I passed the PLE and immediately started my
return service in Basey, Samar, Region VIII. Though I didn’t end up in Kalinga as
originally planned, I firmly held onto the belief that service is not selective. The important
thing is the dedication to serve others especially the underserved communities.

I completed a Master's in Public Health at UP Manila as part of the compulsory

continuing education of the DTTB program. Currently, I am undergoing Practice-Based
Residency Training in Family and Community Medicine at EVMC, Tacloban City. While
I may not have received prestigious awards in my academic or career journey, the
proudest recognition I received is the COVID-19 Hero award from DOH-CHD Region
VIII for volunteering at the Philippine Lung Center in Manila for 3 months during the
surge of COVID-19 cases in the city.

I have a deep love for public health service despite its challenges. My immense
passion in public service led me to sacrifice my own well-being. Being separated from
my husband and daughter in Cagayan, with my son in Basey, is perhaps the true
testament to my commitment to public service and in the field of health. Hence, I actively
seeking trainings and skills development opportunities that align with my commitment to
public service to further enhance my abilities to serve effectively and be of benefit to the
Philippine government and its people, even at the grassroots level.

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