January 2017 Update on Emergency Referral System

In Barangay Goaw, trauma cases ranked 7^th in the morbidity cases in 2014. From 2013-2015, 5 cases of labor and delivery, 41 cases of trauma and 5 medical emergencies with 2 mortalities were documented in Liloy Integrated Health District Hospital; none of which was recorded in the BHS.

Below are the objectives, implementation and results of the health plan:

Specific Objective # 1

To increase the knowledge and skills of the Barangay Health Workers (BHWs) and members of the Barangay Emergency Response Team (BHERT), youth and housewives

            Previous Strategies Done

ü  Health promotion on ‘Health Emergency Guidelines’ among BHWs and BHERT. This is a focused group discussion attended by the BHW and BHERT last October 2014 emphasizing their roles in emergency management. Distribution of pamphlets regarding health emergency was also done.

ü  “Vital Signs Taking: Kaalaman Para sa Kalawasan”. A lecture demonstration on proper assessment of pulse rate, respiratory rate, temperature and blood pressure with basic interpretation of results was conducted among BHWs and BHERT last April 2015.

ü  “Maayong Lawas Magsugod sa Balay”. Engagement of the family/mothers in health emergency preparation, which includes emergency resources and practices was conducted on April 2015. This was done through distribution of promotional materials from the Local Rural Health Unit ans Philippine Red Cross about medical emergencies and first aid management

ü  “First Aid Drill for Kids”. Lecture demonstration and return demonstration about basic splinting, bandaging techniques and first aid management was done in Goaw Elementary School last October 2015.

ü  “FIRST AID TRAINING: Alamin at Gawin Para sa Kaligtasan Natin”. In coordination with Philippine Red Cross Dipolog Chapter, the organized Barangay Health Emergency Response Team (BHERT) and Barangay Health Workers (BHWs) already underwent training on First Aid last October 2014.

ü  “FIRST AID AND BLS TRAINING”. To prevent knowledge decay, a refresher course was done last September 27, 2016, where Basic Life Support (BLS) and basic first aid measures of common cases in the barangay were discussed. In addition, the Local Disaster Risk Reduction and Management Council (LDRRMC) allocated financial support for yearly First Aid and BLS trainings among responders of each barangay in the municipality.

Future Plans

o   Re-evaluation of the knowledge and skills will be done on the succeeding exposures.

o   “Maayong Lawas Magsugod sa Balay” will be done again with pre-test and post-test to be answered by mothers or heads of  household.

o   Coordination with the Local Disaster Risk Reduction and Management Council (LDRRMC) for the re-training and refresher course.

Specific Objective # 2

To increase the resources available in the barangay for health emergency management according to DOH protocol

            Previous Strategies Done

ü  Acquisition of health resources through Health Facility Enhancement Program (HFEP). Up to date, all resources acquired and turned-over to the BHS are fully functional and being used in the activities of the BHS. Three (3) first aid kits, 2 weighing scales, and 1 height measuring equipment were acquired through this program.

Current Strategies Done

ü  Emergency Tricycle (EmT). It is intended to be the primary mode of transportation for trauma, obstetric and medical emergencies. This is a project proposed to the Local Government Unit (LGU) in solving two of the problems of the community when accidents and emergencies occur—distance to the RHU/hospital and availability of transportation. The EmT was patterned from the motorcycle ambulance advocated by the Federal Ministry of Health of Nigeria for their Maternal and Child Care and was then modified by the Municipal Engineer in a way that can withstand rough terrain and narrow roads common in the community.

Results

·      As of December 2016, 3 obstetrical cases were responded using the EmT.

Future Plans:

o   Continuous monitoring of the utilization of the EmT.

Specific Objective # 3

To increase the knowledge of the BHWs and BHERT on proper documentation and referral system.

Previous Strategies Done

ü  Creation of a referral document and recording system

ü  Lecture discussion among BHWs and BHERT about most common cases of the barangay and the need for referral according to DOH protocol

Current Strategies Done

ü  Evaluation of responded and referred emergency cases. Equipped with knowledge and skills, the BHERT responds to the emergency cases in the barangay and provides proper documentation and referral to the next level of care. Headed by the barangay’s chairman on health, monthly monitoring of the recorded cases is done.

Results

·       As of the month of December 2016, 33 cases in the barangay were properly recorded, responded and referred to the Rural Health Unit, District Hospital and Animal Bite Center.  

Future Plans

o   Monthly monitoring and reporting will be continued on the succeeding exposures. 

o   Creation of flow chart for common cases of the barangay.

o   Focused group discussion with the BHWs and BHERT members will be conducted for problems with the referral system and for evaluation of the referral system.

Conclusion

The strategies employed targeted 3 aspects: knowledge and skills, resources as well as documentation system. The coordination with government and non-government organizations paved way for availability of supplies and equipment. Also, with the Emergency Tricycle (EmT), the problem on distance and lack of transportation for emergency cases were overcome.