ZFF/DOH: Model PPP

The Zuellig Family Foundation (ZFF), in partnership with the Department of Health (DOH), just held the First National Colloquium of the Health Leadership and Governance Program or HLGP.  My personal journey with HLGP started in 2008 when I was appointed chairman of ZFF and, in turn, I appointed Ernesto Garilao as its president.

Ernie developed the Health Change Model (HCM) which is founded on the conviction that health is a right for all people and that the poor must have equitable access to basic health services. What is unique about the HCM approach is that it is anchored on health leadership and governance. The attainment of health outcomes was predicated on the leader’s recognition of his purpose as a public leader, and the recognition that better health outcomes is the result of the leader’s passion and deliberate acts of leadership.

Since the ZFF vision is to improve the health outcomes of the poor, then our mission became capacitating local chief executives (mayors) so that they can make their local health systems equitable since the poor go primarily to public health facilities.

We have been piloting the HCM through ZFF’s own Community Health Partnership for the Poor (CHPP) program since 2009. At present we have 72 fourth and fifth class municipalities under our pilot program.

The pilot health teams went through a two-year, training cum practicum intervention, using bridging leadership as the leadership approach and the World Health Organization’s (WHO) six building blocks of health. ZFF also provided coaching and technical assistance, as well as built birthing clinics and maternal halfway homes. The focus was on improving maternal health, because in 2009, the Philippines was lagging behind its Millennium Development Goal for Maternal Mortality Ratio (MMR). Moreover, maternal health is a sentinel indicator on the quality of the local health system.

In 2012, after three to four years of piloting HCM in 29 municipalities from cohorts one to three, we observed dramatic improvements in the local health systems and health outcomes. 

Specifically, MMR went down from 177 (37 deaths) to 44 (nine deaths) deaths per 100,000 livebirths and infant mortality rates went down from 4.9 (101 deaths) to 4.1 (85 deaths) deaths per 1,000 livebirths.

In 2015, we commissioned an impact evaluation study of the first 29 pilot LGUs. The study concluded that there is a positive connection between the health-related decisions of the mayor, or what we call acts of leadership, to the improvements in the health systems. These eventually made a difference in reducing inequities in the health system, especially in access to health services of the poor. The study concluded the program should be replicated or scaled-up.

In 2013, we were asked by then Health Secretary Dr. Enrique Ona to replicate our approach in the DOH, and we signed a three-year partnership with the department from May 2013 to May 2016. The same agreement has since been extended by then Health Secretary Janette Loreto-Garin until November 2017.

Personally, I am pleased to inform what ZFF has accomplished: 

• Reached a total of 543 municipalities, 20 cities, and 32 provinces; of these 375 municipalities, eight cities, and one province have already completed the program

• Engaged 12 regional academic partners, and trained more than 200 faculty members of these academic partners

• Trained more than 600 DOH officers and staff from 16 regional offices.

We were gratified by the kind words of Secretary Garin in her speech:

“You (ZFF) have opened the minds of the people (local chief executives) that health is not just about infrastructure and equipment… (Through HCM we learned that) as bridging leaders, we start with ourselves by owning the challenge… Ownership has been created, commitment has been enhanced.”

“We have seen the (HCM as the) perfect formula in making things work in enhancing (the health of) our people.”  

ZFF would also like to express our gratitude for the support and guidance of the former Secretaries (Drs.) Enrique Ona, Esperanza Cabral (ZFF trustee) and Manuel Dayrit (ZFF trustee). We assure incoming Secretary Paulyn Ubial our continued support.

We take great pride in the ZFF-DOH partnership which is a successful model of public-private partnership (PPP).    

I want to thank the ZFF staff’s professional commitment and dedication. Lastly, I would like to thank and honor our president Ernie Garilao, whose wisdom and leadership made it happen.

In photo (from left) DOH Secretary Paulyn Ubial, former DOH Secretaries Janette Garin, Enrique Ona, Esperanza Cabral (also ZFF trustee), Health Leadership and Governance Excellence awardee Davao DOH regional director Abdullah Dumama Jr., ZFF trustee David Zuellig, the author and ZFF president Ernesto Garilao.