One of the Philippine national health goals is to reduce and eliminate maternal death and children under 5 mortality. In order to reach this goal, the municipality of Alcantara created Project SuSAN, an incentive based program for pregnant women. There are three main goals of project SuSAN: enroll all mothers to PhilHealth, pregnancy tracking and immunizations, and the graduation incentive program.
The first objective is enrolling all pregnant mothers in PhilHealth. In 2014, before the project started, there were no pregnant mothers enrolled in PhilHealth. Not being enrolled in the national health insurance is a major financial risk to the mother and her family. What would happen if the birth resulted in complications for her or her baby? Who would pay for those medical costs? Enrollment in PhilHealth provides at least one payer towards those scenarios and helps protect the family from paying the full amount of that medical care. They also started the baby banks, a way for the mothers to save money for their PhilHealth. When mothers would come to the clinic, they would deposit money into a bank, instead of spending it on other items. This helps them with long term financial planning and helps ensure they have the money to pay for PhilHealth next year. Now there are many women who are enrolled in PhilHealth.
The second goal is pregnancy tracking and immunizations. There is a map in the rural health clinic that has every pregnancy known by clinic. This information is relayed first by the barangay health workers, volunteers in the community who are like peer to peer counselors. They encourage the women to make healthy choices and serve as the eyes of the midwives/nurses over the community. The midwives track this information so that they know who needs services.
One of the interesting challenges in rural Philippines is around having skilled birth attendants. Women in rural areas have high access and acceptance of the traditional “hilot”, a birth attendant who is not medically trained. This challenge has been addressed two-fold: 1. The local government unit doctor and staff have partnered with the hilots to give them incentives for bringing their pregnant women to birth in the healthcare facility instead of at home. The local government unit also provides free PhilHealth for the hilots. 2. Hilots that are caught attending a home birth are fined; 500 pesos for the first offense, 1000 for the second offense and 1500 with possible prison time for the third offense.
The best part about Project SuSAN is the Graduation Incentive Program. Mothers who complete at least 4 prenatal visits, deliver in an any health care facility attended by a skilled health professional, complete 2 postnatal visits and have their child fully immunized are eligible for graduation. They are awarded at the Alcantara flag ceremony and given a T-Shirt, which advertises the program to others in the community.
Project SuSAN has made a major impact on the community and it is Nadia’s job to evaluate its effectiveness. Dr. Jobin has impacted the lives of many women in Alcantara through innovative programing, direct patient care and making the health care delivery system more efficient. Great job Dr. Jobin!