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ARMM Programs
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Population, Health and Nutrition Efforts in ARMM
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Private Sector Mobilization for Family Planning (PRISM)
Enhanced and Rapid Improvement of Community Health (EnRICH)
The Public Information Project - Family Planning (TSAP)
Well Family Midwife Clinic Partnership Foundation, Inc. (WFPI)
LEAD (Local Enhancement and Development) for Health
THE CHALLENGE
Health indicators in the Autonomous Region of Muslim Mindanao (ARMM) are way below national averages. Vitamin A deficiency is most severe in this conflict-torn area at 44.5% compared to the national average of 85.6% (2002 Maternal and Child Health Survey, Philippine National Statistics Office). The region also has the lowest immunization coverage (24% vs. 65.2% national), the highest infant mortality rate (55 infant deaths per 1,000 live births), and the lowest contraceptive use (16.2% versus 48.8% national).
What makes the low health indicators doubly alarming is that ARMM is also faced with the highest poverty rate in the country. Its 2.4 million populace is growing by 3.86% with most families having an average household size of 6.13 - again, the highest nationwide.
These extreme health, poverty and population growth figures are complicated by decades-long political conflicts making ARMM a major challenge for USAID assistance.
Innovative USAID Programs in ARMM
While USAID's population, health and nutrition program are implemented nationwide, especially-tailored strategies have been developed to address nuances and conditions unique to Mindanao and particularly, ARMM.
To date, 21 local government units (LGUs) in ARMM are increasing service coverage for vitamin A, immunization and tetanus toxoid and family planning especially to their constituents in far-flung communities. USAID has made available voluntary sterilization services in public hospitals. The Sentrong Sigla Movement (Quality Assurance in Public Health Service Delivery) has certified 500 public health facilities in Mindanao that meet basic standards for quality health services. Private clinics like the FriendlyCare Foundation and Well-Family Midwife Clinics provide affordable and quality family planning services to lower and lower-middle income families. Muslim midwives in the frontline of health care have, in fact, been celebrated as "agents of health and peace."
Child survival is given priority particularly in the delivery of Vitamin A capsules and immunization to children between the ages of one and five, and in the management of illnesses like pneumonia and diarrhea. Up-to-date and comprehensive information on the current capacity of the health care system in ARMM is being gathered. To keep HIV/AIDS in the country low and slow, four of the eight sentinel surveillance sites are maintained in high-risk areas in Mindanao.
All these are done through close partnerships, making family planning and health a responsibility of USAID, the local government and the community. Religious leaders like the ulama (men) and alima (women) are tapped. "Fatwas" or religious edicts encouraging Muslims to use family planning have been issued by Muftis (head ulama).
Fiestas are organized to motivate families to practice family planning and adopt proper health-seeking behaviors in languages and forms they are familiar with. Mothers and children pitch in to form "peer advocacy" groups. Theatre and indigenous communication forms are maximized to bring home messages on infectious diseases.
It is in Mindanao that USAID practices what a Filipino Mayor, Pedro Acharan, Jr., sees as a maxim for health interventions, "Health providers should not just be givers, and the community, recipients. Health care should be owned by the communities."
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