War On Drugs: Public Health Perspective.

Transcription

1 War On Drugs: Public Health Perspective. (CDR,Res) MA.VILMA V. DIEZ, MD, MHA, PHSAE, MNSA, CESO IV Director III, Office for Special Concerns Dangerous Drug Abuse Prevention and Treatment Program

2 Introduction As of 9/22/2016: 712,730 surrenderers 1.8M - 3M dug users: 0.6-1% (18-30k) will be inpatient 99% (2.9M) will be out-patient (CBRP) 92% NCR Barangays affected 44 DATRCs: 15 DOH,>5.5k beds; 29 NGOs, >1.7k beds Total = 7-10K beds

3 DOH Residential DATRCs in the PHIL. LUZON NCR: BICUTAN, TAGUIG CITY ** Ilocos Region:. DAGUPAN, PANGASINAN Cagayan Valley: ILAGAN, ISABELA Central Luzon: PILAR, BATAAN Calabarzon: TAGAYTAY** Mimaropa CAR: Bicol: SAN FERNANDO, CAM. SUR** MALINAO, ALBAY** VISAYAS Western Visayas:. POTOTAN, ILOILO** Cebu: ARGAO, CEBU /. MANDAUE CITY Eastern Visayas: DULAG, LEYTE NIR MINDANAO Northern Mindanao:CAG. DE ORO Davao: DAVAO CARAGA:SURIGAO CITY Zamboanga: SOCCSKSARGEN: ARMM:

4 GAPS for 99% (2.9M) outpatient: CBRP tru BADAC for 1% (30K) inpatient: lack 20K beds Priority policy recommendations: court order for surrenderers? - Monitoring CBRP & After Care - Land ownership of DOH DATRCs - Halfway house in LGUs, DATRCs/region - For Mega TRCs: 100 beds/team, better manage - SDN (continuum of care) /LGU or ILHZ

5 Immediate Responses 1.) DOH thru ROs & DATRCs: - NCR trained MDs/district, - Reg.1 devised good algorithm, - Reg.5 very good inter-agency collaboration - DATRCs doubled, tripled their capacity We meet RDs & DATRC Chiefs once/month to report responses, plans, needs

6 2.) Inter-Agency Convergence

7 3.) Standard guidelines on voluntary surrenderers of drug users & dependents

8 4. Distribution of Manual

9 4. Temporary DATRCs in Military Camps Luzon: Fort Magsaysay, Nueva Ecija Visayas: Camp Gen.Macario Peralta Jr., Jamindan, Capiz Camp Rajah Sikatuna, Carmen, Bohol Mindanao: Saranggani

10 5. ADVOCACY What to do with surrenderers?

11 6. Harmonization/Standardization of: Trainings, Algorithms, Forms, Halfway houses, Standard Treatment Program for Mega TRC; Policy Recommendations

12 Activities Every Tues.: TWG meet for establishment of Mega DATRC Every Wed.: inter agency convergence meet 1st wk of the month: 2 days meet with ROs & TRCs; 1 st wk Oct: IEC Materials Development; Museum contents 4th wk Oct: Develop Info System; 1 st wk Nov: Train 1 MO/DATRC in Meth & alcohol detox 2 nd wk Nov.: Strategic Planning 3 rd wk Nov.: Review Standard lay out of DATRCs 1 st wk Dec.: Plan to institutionalize DDAPTP

13 Plans Goal: Prevalence of drug abuse & its healthrelated effects are further reduced. Mission: Lead in the implementation of a unified & rational health response in the fight against drug abuse, through a more effective drug abuse prevention, treatment & rehabilitation.

14 What we want to achieve: 1. More effective leadership & governance for drug abuse prevention, treatment & rehabilitation; 2. Provision of comprehensive, integrated health care services in TRCs & community-based settings; 3. Implementation of strategies for health promotion & drug abuse prevention; 4. Strengthened information systems & evidence based research.

15 Abstain We need to take an eye to the real target! Tx, Rehab, After-care, & other ancillary support services At Risk Population Functional in family, School or work & community

16 3 Strategies Strategy 1 DOH With Private With LGUs Strategy 2 PhilHealth Establishment of additional facilities to improve accessibility in areas without DATRCs & provide wider coverage of service for clients with severe substance use disorders 4 DATRCs in regions without rehab facilities 4 temporary Mega DATRCs in military camps Halfway House to decongest regional DATRCs with outpatient & after care services PhilHealth coverage to lessen burden of facilities & reduce out of pocket expense. Patients can avail of variety of evidenced-based tx programs not offered by government. structured 2-mos. or 45 days program (required by IRR of RA 9165) for P40,000 tru PhilHealth (for 20,000 patients, it will cost the government P800M/year

17 Strategy 3 Activate ADACs & Mobilize LGU Health Units Mobilize Stakehold ers Incorporate Drug Abuse Intervention in PHC Program - encourage participation of all sectors at the community to provide early interventions & advocacies that will prevent progression of drug user to drug dependent. Institutionalize DDAPTP in the community. -Capacity building of ADACs & LGU Health Center staff on: a) Community mobilization & networking b) Knowledge on addiction & tx c) Mapping & referral system for service providers d) Screening & assessment of clients e) Data management & monitoring of clients -81 Provinces, initial 50 LGU paramedics to be trained x 3 days (81 provincesx50 x3dxp1,800/day = P21,870,000.00) -Provision of Com-based manuals & IECs (81 provinces x 50 staffxp1,000 cost of manuals & IECs = P4,050,000) -Travel & other incidental expenses of resource persons (P1,000,000) -Total Cost to prepare communities = about P26,920,000 Faith-Based & Private Organizations at the community knowledgeable in providing behavioural modification & value formation initiatives. Advocacy can be charged from LGU IRA (Sec.51, RA 9165)

18 How can we assist LGUs? Through our Regional Offices: Technical assistance on: - training of personnel - establishment of DATRCs ( 1 / region) - establishment of halfway house in areas near DATRCs - admission to DOH DATRCs - Community Based Rehab Program (CBRP) Policies/guidelines/standards - Permit to Construct, License to Operate - Algorithms (guidelines), Training Manuals, MOP - Lay out, Staffing standards, Costing - New Issuances e.g EO, MOA, DDB

19 100 Beds: P 248,194, hectares Master Site Development Plan = P158,263,200 Land Development = P10,800,000 Medical Equipment & Furnitures = P79,131,600 Dormitory Admin Bldng Multipurpose Covered Court Visitor Staff Building Motorpool Laundry Building Kiosk/Canteen Solar lighting Entrance Powerhouse Hydrotherapy Landscape Sewage Treatment plant

20 Halfway House: 50 beds satellite of DATRC Dormitory = P 8,424, Multi-purpose Covered Court/Hall = P 9.9 M Total: P18,324, Operationa annual cost: P 10 M

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22 ACHIEVE! ` Salamat po