Philippines – Enhanced and Rapid Improvement of Community Health (EnRICH)
Empowering Communities to Proactively Face Health Issues
ACDI/VOCA implemented this activity in the Maguindanao and Tawi-Tawi regions of the Philippines. Tawi-Tawi, the southernmost province in the Philippines, is a remote group of over 300 islands, which was gripped by poverty and underdevelopment. The province is part of the Autonomous Region of Muslim Mindanao (ARMM), which is 90 percent Muslim and administratively independent of the predominantly Catholic nation. This unique political situation had been the backdrop for generations of violence between the Philippine government and Muslim separatist forces. Unrest, underdevelopment and the sprawling geography had combined to choke Tawi-Tawi’s population off from the modernization and prosperity spreading throughout much of Southeast Asia. Maguindanao had similarly suffered from the conflict in the region, and its difficult geographic location made stability and development an even greater challenge.
In response to the increasingly dire situation in Tawi-Tawi, ACDI/VOCA began the USAID-funded Enhanced and Rapid Improvement of Community Health (EnRICH) project in September 2002, which ended in February 2007. The project empowered communities to face health issues proactively, giving them the tools and knowledge to be effective.
The first major initiative of the EnRICH project was to promote reproductive health, specifically the overall health of women of reproductive age and children under five, with a particular emphasis on family planning. An important goal was to raise the rate of contraception use, which had been 25 percent below the national average. This discrepancy was largely due to the fact that women in the ARMM region had considered themselves bound by religious restrictions that disallow contraceptive use. The success of the EnRICH project hinged on the participation and support of the community which was led by a handful of Muslim religious leaders. A cornerstone of the EnRICH program was the organization of a discussion entitled “Mussawarah on Responsible Parenthood: The Islamic Perspective,” during which religious leaders unanimously agreed to issue a fatwa, or legal statement, in support of family planning. With the support of the local religious leaders who showed a willingness to modernize to improve livelihoods in their communities, ACDI/VOCA worked successfully to raise consciousness about family planning throughout the community.
Another program goal was tackling tuberculosis, a disease that is highly prevalent in the region. The program focused on TB prevention and treatment, with an emphasis on children under 5 and women between the ages of 15 and 45. ACDI/VOCA staff in Tawi-Tawi and Maguindanao disseminated education to prevent this disease and trained health workers in best practices for treatment.
In addition to its efforts to revitalize and modernize health care practices, ACDI/VOCA took strides to revamp the health care infrastructure in the region. The repair and operation of a floating clinic that had become inoperable after years of insufficient funding was the centerpiece of this effort. The refurbished clinic’s rehabilitation is complete, and the Provincial Health Office of Tawi-Tawi has used it to take doctors and medical staff to patients on remote regions who otherwise would lack access to health care. They often served more than 1,000 individuals on a single outing.
Training volunteer health workers to educate and empower the people was also a component under the EnRICH program. To make educational programs available to all residents of Tawi-Tawi’s 300 islands and some regions of Maguindanao, ACDI/VOCA implemented the innovative Distance Education Program through a local radio station. The program targeted five municipalities in Tawi-Tawi and three in Maguindanao, educating health workers on family planning and maternal and child health issues. The health workers met in a classroom in their community and listened to the educational program together. The one-hour educational program aired once every week for six months.
Additionally, ACDI/VOCA organized Healthy Family Coalitions. These now registered organizations were previously informal groups of citizens and healthcare practitioners working on issues related to healthy families. Now since registered, these groups applied for small grants from the EnRICH project that provided them with funds to implement small, feasible activities in their communities. A favorite activity was the creation of local health clinics.
With new education initiatives and updated infrastructure, EnRICH changed the way health care is delivered in Tawi-Tawi. Age-old practices yielded to modern ones, and the program enabled citizens to take control of their health, allowing them to contribute toward developing a prosperous and peaceful home in the turbulent region.
For more information contact Angelina Tracy at atracy@acdivoca.org.