A Guide for the Establishment of a

Barangay Health Management Council

An Initiative to Strengthen the Health System and Improve
Services at the Barangay Level through Better Health
Leadership, Management, and Governance

Arthur B. Lagos MD
Lynette P. Adorio-Arce MD
 A Guide for the Establishment of a Barangay Health Management Council

This report is made possible by the generous support of the American people through the US
Agency for International Development (USAID), under the terms of cooperative agreement
number AID-OAA-A-11-00021. The contents are the responsibility of Management Sciences for
Health and do not necessarily reflect the views of USAID or the United States Government.

About SIAPS

The goal of the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program
is to ensure the availability of quality pharmaceutical products and effective pharmaceutical
services to achieve desired health outcomes. Toward this end, the SIAPS result areas include
improving governance, building capacity for pharmaceutical management and services,
addressing information needed for decision-making in the pharmaceutical sector, strengthening
financing strategies and mechanisms to improve access to medicines, and increasing quality
pharmaceutical services.

Recommended Citation

This report may be reproduced if credit is given to SIAPS. Please use the following citation.

Lagos AB, Adorio-Arce LP. 2017. A Guide for the Establishment of a Barangay Health
Management Council: An Initiative to Strengthen the Health System and Improve Services at the
Barangay Level through Better Health Leadership, Management, and Governance. Submitted to
the US Agency for International Development by the Systems for Improved Access to
Pharmaceuticals and Services (SIAPS) Program. Arlington, VA: Management Sciences for
Health.

Key Words

Health systems strengthening; community (barangay) level; leadership, management and

governance; health services

Systems for Improved Access to Pharmaceuticals and Services

Pharmaceuticals and Health Technologies Group
Management Sciences for Health
4301 North Fairfax Drive, Suite 400
Arlington, VA 22203 USA
Telephone: 703.524.6575
Fax: 703.524.7898
E-mail: [email protected]
Website: www.siapsprogram.org
 CONTENTS

Acronyms ........................................................................................................................................ ii
Preface............................................................................................................................................ iii
Acknowledgments.......................................................................................................................... iv
Introduction ..................................................................................................................................... 1
Establishing the BHMC .................................................................................................................. 2
Pre-establishment Phase (Preparatory Phase) ............................................................................. 2
Establishment Phase .................................................................................................................... 4
Operationalizing the BHMC ........................................................................................................... 6
Creating the BHMC Work Plan .................................................................................................. 6
Implementing the Work Plan ...................................................................................................... 7
Monitoring and evaluation of BHMC establishment and performance .......................................... 9
Strategies to institutionalize and sustain the BHMC .................................................................... 10
Annex A. BHMC Indicators for TB Case Finding and treatment Outcomes ............................... 11
Annex B. Indicators for Maternal Health and Nutrition programs for BHMC use ...................... 15
Annex C. Indicators for monitoring BHMCs at district/city level................................................ 16
References ..................................................................................................................................... 17

i
 ACRONYMS

AP antepartum
BHMC Barangay Health Management Council
BOC barangay operations center
CXR chest x-ray
DHO district health officer
DSSM direct sputum smear microscopy
EPTB extra pulmonary tuberculosis
FBD facility-based delivery
GX GeneXpert
HC health center
IPT isoniazid preventive therapy
LGU local government unit
NGO nongovernmental organization
NSP new smear positive
NTP national TB control program
PMDT programmatic management of drug-resistant TB
SIAPS Systems for Improved Access to Pharmaceuticals and Services
Sm (+) smear positive
Sm (-) smear negative
SUW severely underweight
TAF treatment after failure
TB tuberculosis
TBDC TB diagnostic committee
Tx treatment
USAID US Agency for International Development
UW underweight

ii
 PREFACE

The concept of a Barangay Health Management Council (BHMC) was developed by a working
group comprising technical advisors from the US Agency for International Development
(USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS)
Program and health staff from the Quezon City Health Department in late 2011. The BHMC
initiative aims to strengthen the delivery of services under the national tuberculosis (TB) control
program (NTP) in poor urban communities. Through the BHMC, the community can effectively
lead, manage, and govern the NTP.

This document was developed as a quick reference for those who plan to establish BHMCs. The
contents of this guide are based on the insights and experiences of the people involved in the
implementation of the BHMC initiative in Quezon City from 2012 to 2016. It was developed
through workshops and discussions with Quezon City health staff and barangay officials working
in BHMCs as core team members.

Described here are the practical steps for establishing, operationalizing, and sustaining a BHMC.
Details of specific processes (e.g., planning, monitoring) are beyond the scope of this guide.
Sample indicators used in the BHMC workshops are included to guide readers.

While this guide is based on the experiences in Quezon City, it can be easily adapted for use in
other cities and municipalities in the Philippines.

Arthur B. Lagos MD
Lynette P. Adorio-Arce MD
SIAPS/Philippines
Quezon City, Philippines
2017

iii
 ACKNOWLEDGMENTS

For their support for the establishment and institutionalization of BHMCs in Quezon City: Hon.
Mayor Herbert M. Bautista, Hon. Vice Mayor Ma. Josefina G. Belmonte, Hon. Jessica C. Daza
MD, Hon. Eufemio Lagumbay, and Dr. Verdades P. Linga.

For their role in the pilot implementation of the BHMC in Barangay Payatas: Annie Inumerable
MD, Ms. Rose Dadulo, Kgd. Zaldy Inzon, Elmira Dizon MD, Melchor Gabagat MD, and Leticia
M. de Guzman MD.

For their contributions to the preparation of this document: PB Elmer C. Maturan MD, Kgd. Ma.
Felisa Llaneza, PB Allan P. Franza, Karen Gemma A. See MD, Ma. Lucila Ganotan MD, Leticia
de Guzman MD, and Elmira Dizon MD.

iv
 INTRODUCTION

The devolution of health services to local government units (LGUs) through the Local
Government Code of 1991 brought new challenges to LGUs and barangays in the management
and delivery of public health services. With devolution, the LGUs became responsible for the
general control and supervision of health personnel and facilities; the operation and maintenance
of local health facilities; the delivery of health services; and regulatory functions, such as
formulation and enforcement of ordinances related to health, nutrition, sanitation, and all other
public health-related matters.

The BHMC is a collaborative effort of the Quezon City Health Department and the USAID-
funded SIAPS Program in the Philippines, implemented by Management Sciences for Health.
The BHMC was created to strengthen the delivery of health services, particularly the TB control
program in poor urban communities.

The intent was to strengthen the health system as it works at the community (barangay) level
where patients and health services meet. A strong health system at the barangay level will
improve the quality and delivery of TB control program services and help reduce the burden of
TB in the community in the long term. The system strengthening approach for the TB program
will also benefit other health programs.

The concept uses a team approach to health leadership, management, and governance that
promotes broad stakeholder participation in setting shared health priorities and objectives. The
team comprises representatives from the community’s health services, barangay officials, and
other stakeholders.

The effective engagement, strong commitment, and cooperation of barangay officials and
community stakeholders are critical to the success of BHMCs. The creation of shared objectives
and priorities as articulated in a BHMC’s work plan manifests stakeholders’ commitment and
desire to work together to improve the TB situation in their community. Barangay-level planning
and decision making for TB control is done by the BHMC and is guided by evidence from
barangay data.

The BHMC model supports the NTP’s strategy to localize the implementation of the NTP as
stated in the Philippines Plan of Action to Control TB (PhilPACT 2010–2016) and in the
recently crafted Philippine Strategic TB Elimination Plan (PhilSTEP-1 2017–2022). The
experiences in Quezon City have demonstrated the BHMC’s potential to address service delivery
problems for TB and other health programs.

1
 ESTABLISHING THE BHMC

Pre-establishment Phase (Preparatory Phase)

The purpose of this phase is to formalize and increase the involvement of local barangay
officials, particularly the Punong Barangay and the Kagawad for Health in the NTP, as well as
other community actors who have a stake in the demand, delivery, and management of health
services in the community.

The main objective is to improve the awareness and understanding of barangay officials and
other stakeholders of the TB problem in the community. With a better understanding of the TB
situation, they can make better decisions and take positive actions that will contribute to address
the problem. This activity will also benefit health workers and program managers by giving them
a better understanding of the TB problem in the community.

Review the TB Situation in the Barangay

1. Review the TB situation and the TB control program’s performance in the barangay, or
cluster of barangays, served by the community’s public health centers (HCs). The HC staff,
led by the HC medical officer with the support of the district health officer (DHO) and
supervisors, should organize activities for the program review.

2. Ensure the involvement of barangay health workers, community health volunteers,

community-based organizations, patients, and others affected by the disease in this activity to
get varied perspectives.

3. Focus the review on the results of case studies and treatment outcomes based on routine TB
program indicators. Identify the factors that positively or negatively influence the program’s
results. Include epidemiologic, social, political, and economic factors in the analysis to better
understand the context of the community’s problems and health needs.

4. Analyze the TB program performance in terms of the health system building blocks,
including community leadership and governance, human resources, financing, medical
products and technologies, service delivery, and information management. Understanding the
systemic problems will play an important role in the effective and sustainable delivery of
TB/health control services.

5. Prepare a report to be shared and discussed with barangay officials and other interested
individuals or groups. Discussions are an effective way of sharing findings and should
include suggestions or ideas on what barangay officials and stakeholders can do to help
address the problems.

6. Discuss the findings in a way that lay people will understand. Remember that the objective is
to ensure that stakeholders, particularly barangay officials, gain a better understanding of the
TB situation and problems in the delivery of effective TB control services. Therefore, make
an effort to keep the findings simple and easy to understand.

2
 Establishing the BHMC

Engage Barangay Officials

1. Organize one or more meetings to engage barangay officials. The HC medical officer, the
Barangay Operations Center (BOC) coordinator, and the DHO should initiate the
engagement, particularly the Punong Barangay and the Kagawad for Health. If this is an area
with a cluster of barangays, ensure that all Punong Barangaya and Kagawads for Health in
the cluster area are able to attend.

2. The objectives of the meeting should be to inform stakeholders of the TB situation and to get
their support for the BHMC initiative.

3. Work with the barangay secretary to organize the meeting, prepare an agenda, and invite
participants. Barangay officials are busy, and it may take several attempts to schedule and
hold a meeting.

4. Prepare the meeting agenda with a focus on the key meeting objectives. Do not overload the
agenda.

5. During the meeting, give a concise account of the review findings. Highlight the main issues
in the TB situation. This is also the time to introduce the concept of the BHMC as a key
intervention in which barangay officials and other community members can participate by
leading and managing health services.

6. Communicate messages in a friendly, conversational manner and encourage participation.

Engage barangay officials and other participants to enhance their involvement in the TB
problem.

7. Distribute handouts to help participants remember key messages. Make the handouts
attractive and easy to read. Provide the handouts to stakeholders who could not attend the
meeting.

8. Follow the agenda and schedule. Take notes, and write minutes after the meeting.

9. More than one round of meetings and discussions or informal conversations with barangay
officials, stakeholders, and advocates may be needed to achieve the objectives. Be patient
and follow through.

Tip #1. A better way of engaging community partners…

• Inform the partners of the TB situation by talking to barangay officials and partners.
• Barangay officials and other partners are busy, so make the meetings short and productive.
• It may take several meetings and informal discussions to achieve the objectives.
• Be patient and persistent.

3
 A Guide for the Establishment of a Barangay Health Management Council

Secure Barangay Officials’ Commitment to Support the TB program

At this stage, it is important to secure the support and active participation of barangay officials in
in the management of the TB program and other health services. While there are many instances
in which TB is not a priority for barangay officials, the medical officer and other health workers
and advocates can find ways to convince them to prioritize TB control.

Establishment Phase

Organize the BHMC Core Team and Secretariat

CORE TEAM
Chair: Punong Barangay
Co-chairs: Kagawad for Health and Medical Officer III
Members (7): Representatives from GO, NGO, private sector, CHW,
TB Task Force, religious sector, and schools (private/public)

Community
NGOs, Health Community organizations
Barangay GOs/
private center health (e.g., senior
Council schools
providers staff volunteers citizens,
PWDs)

Figure 1. Structure of a single barangay BHMC

CORE TEAM
Chair: Punong Barangay or Kagawad, Committee Chair on Health
(as chosen by the barangay cluster)
Co-chair: Medical Officer
Members: Representatives from GO, NGO, private sector, CHW, TB Task
Force, religious sector, schools (private/public), Punong barangays in the
cluster, and Kagawads for Health of all barangays in the cluster

Community
NGOs/ Community organizations
Health Barangay GOs/
private health (e.g., senior
center staff Council schools
sector volunteers citizens,
PWDs)

Figure 2. Structure of a barangay cluster BHMC

1. The Punong Barangay, Kagawad for Health, and medical officer should meet to organize the
BHMC core team and the secretariat based on the provisions of the city ordinance. The
Punong Barangay should be the chair and the Kagawad for Health and the medical officer
should be co-chairs. Figures 1 and 2 show the structure for both types of BHMCs.

4
 Establishing the BHMC

2. The rest of the core team should comprise a representative each from stakeholder group, such
as a government organization that is active in the barangay, a community-based non-
governmental organization (NGO), the private sector, a community health workers’
organization, a TB task force, religious organizations, and public and/or private schools.

3. The secretariat should comprise the barangay secretary, health center nurse, and health center
midwife. It should be responsible for the documentation of all activities to be conducted by
the BHMC, coordination of meetings, preparation of reports, and dissemination of such as
approved by the core team.

4. The city health officer, DHOs, and district supervisors should serve as technical advisors to
the BHMC. The city health staff and the BHMC core team can ask for technical advice or
assistance from external partners when needed.

5. The barangay, or barangays in the cluster BHMC, should create their respective barangay
resolutions, which will serve as their expression of commitment to support the creation of the
BHMC and the implementation of its planned activities.

Tip #2. A better way of unifying…

• Ensure that stakeholders have shared goals and objectives for the BHMC.
• Ensure that individual barangays in the cluster pass a resolution supporting the BHMC.
• Share commitments and achievements with BHMC members and partners.

BHMC Member Orientation

1. Orient the core team members and secretariat on the content of the BHMC ordinance and
implementing rules and regulations, particularly the purpose and function of the BHMC.
Emphasize the roles and functions of the BHMC core team and other members and the rules
and procedures within the BHMC.

2. Orient the BHMC core team on the concepts and practices of team leadership, management,
and governance for health at the community level. This is important because it will provide
the BHMC with a new paradigm for leadership, management, and governance in which
teamwork, cooperation, transparency, equity, and accountability are emphasized. The
orientation should be carried out by DHOs, district supervisors, and medical officers.

3. The secretariat should be oriented on the management and use of information to ensure that
relevant reports and accurate information are generated and provided to the BHMC core team
and stakeholders in a timely manner. The secretariat should also ensure that achievements,
lessons learned, and problems are shared with the community.

Tip #3. A new way of moving forward…

• Having a BHMC means working as a team for leadership, management, and governance.
• Success can be achieved when teamwork and cooperation enable the community to face
challenges and overcome obstacles to better health.

5
 OPERATIONALIZING THE BHMC

Creating the BHMC Work Plan

A work plan is needed to ensure that a BHMC can implement activities in a rational and focused
manner. The work plan provides a direction for the BHMC by describing the objectives and
activities to be implemented within a specific period of time. It unifies BHMC members and
helps them work together. The work plan is one of the bases for measuring a BHMC’s
performance and achievements.

Planning is a joint undertaking by core team members, key stakeholders, and advisers. Ideally, an
initial work plan is for a 12-month time frame. This provides adequate time to implement
activities and achieve short-term tangible results. Achieving results is important to understand a
BHMC’s potential to overcome problems and challenges when members work together.

Preparing for the Planning Workshop

1. Planning can be carried out through well-structured activities (workshops) held in suitable
facilities in the community, such as barangay or HC meeting rooms. However, an on-site
planning workshop is ideal to ensure continuous participation by core team members,
particularly during the early stages of the BHMC. The BHMC core team and secretariat will
organize the planning activity with the support of DHOs and technical advisors.

2. Prepare the schedule and program of activities for the planning workshop. Ensure that
adequate time is allocated for discussions and decision making. Invite participants well in
advance of the event. Secure the resources and logistics that will be required for the activity
and prepare all planning materials. Idea cards and easel sheets can be used to help guide the
discussion.

3. The BHMC secretariat should prepare all relevant data sets, information, and reports,
including the results of the TB program review, at least two weeks prior to the planning
session (annex A). The technical advisors, HC medical officers, and other technical staff
should start the analysis and interpretation of available data and information prior to the
planning workshop.

4. Document the planning session activities and products and store those documents for future
use.

Conducting the Planning Activities

1. The entire BHMC core team must participate in the planning session with key stakeholders.
If needed, resource personnel and facilitators can be invited to join the planning activity. At
the initial stages, it is suggested that BHMC technical advisors facilitate the discussions and
provide guidance during the workshops.

6
 Operationalizing the BHMC

2. Conduct the sessions in a welcoming atmosphere and encourage all core team members to
participate. Follow the agenda and schedule so that everyone will be focused on the session’s
activities. Assign leadership roles to barangay officials during the planning session.

3. Manage the discussion so that everyone will be focused on the topic and encourage everyone
to participate. Good time management is important, as is flexibility. In addition, ensure that
barangay officials participate in all discussions and group activities.

4. During discussions, technical terms (e.g., “program indicators”) should be simplified and
explained to ensure that non-technical participants, particularly barangay officials, can
understand the discussions.

5. Start with an analysis of the situation using the results of the TB program review, followed
by the identification, prioritization, and analysis of the problems and their root causes.
Identify priority problems and challenges and develop objectives and activities that are
focused on those priorities.

6. The plan should focus on the next 12 months so that short-term results can be demonstrated
to provide a sense of accomplishment and encouragement at the end of the year. Longer-term
plans can be made based on the needs and the situation.

7. Planners should create the monitoring and evaluation plan based on the finished set of
activities and expected results.

8. Share a copy of the approved work plan and budget with all BHMC members, key partners,
and stakeholders to promote transparency among stakeholders in the community.

Implementing the Work Plan

1. The BHMC core team is responsible for implementing the work plan, including securing the
budget and funds and mobilizing resources, including people, tools and equipment,
diagnostic supplies, medicines, office supplies, transportation, and money. These resources
are usually available in the community through residents and other partners and stakeholders
in the barangay.

2. Align community stakeholders and inspire them to support the plan activities. These
stakeholders can include other government entities, the business sector, faith-based
organizations, and schools.

Monitor Work Plan Implementation

1. The BHMC core team, DHOs, supervisors, and BOC coordinators should monitor the
implementation of BHMC plans and activities to ensure that they are aligned with the
objectives and timeframe. The information gathered from monitoring will inform BHMCs of
progress in plan implementation and achievement of results.

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 A Guide for the Establishment of a Barangay Health Management Council

2. Findings should be analyzed by core team members and advisors to extract lessons learned,
identify problems, and formulate solutions. This information will also feed into the
evaluation process.

Evaluation of Results of Plan Implementation

1. At the end of the implementation, DHOs should help the BHMC core team evaluate the
results of its activities. Information gathering and analysis and reporting of the results should
be led by DHOs and medical officers.

2. The BHMC secretariat and DHOs should ensure that the evaluation results are reported to the
BHMC core team, key stakeholders, and decision makers at the community, district, and city
levels. The evaluation results can be used to guide the following year’s planning.

8
 MONITORING AND EVALUATION OF BHMC ESTABLISHMENT AND
PERFORMANCE

1. DHOs, with the support of the city BOC district coordinators, are tasked with monitoring the
performance of BHMCs in their respective districts. Monitoring the performance of BHMCs
gives DHOs the opportunity to measure and understand implementation problems and
provide technical support to the implementers.

2. DHOs should create and implement a district-level BHMC monitoring and evaluation plan
and budget. This will track the performance of an established BHMC based on its planned
objectives and accomplishments, as well as the progress of the scale-up in districts. Annex C
shows the list of indicators that DHOs can use to monitor and evaluate BHMCs. DHOs may
solicit support from technical partners to implement monitoring and evaluation activities.

3. DHOs should conduct meetings to discuss and share findings from monitoring activities. It is
important to highlight the positive aspects of the implementation. In addition, the lessons
learned during the process should be documented. DHOs should help the BHMC core team
analyze and address identified problems. Part of the monitoring process is to follow up on the
results of the interventions.

4. DHOs should provide a report of the monitoring results and feedback to the BHMC core
team and community stakeholders. The report should be submitted to the city health officer
and shared with major stakeholders.

5. DHOs should implement evaluation activities by the end of the year with support from
technical partners. They should share the evaluation results with the BHMC and community
stakeholders. The evaluation report should be submitted to the city health officer, and shared
with the BHMC, partners, and major stakeholders.

9
 STRATEGIES TO INSTITUTIONALIZE AND SUSTAIN THE BHMC

Having shown the potential of a BHMC to improve the delivery of TB control services, it is
important to sustain the gains that have been made. It is worthwhile to institutionalize the
existence of BHMCs in the public health and primary care landscape to enable health program
managers and providers to continue making use of this mechanism to improve health in the
community.

1. Pass a local (city) ordinance that supports the establishment and implementation of BHMCs
to institutionalize the initiative. In the absence of a city-level ordinance, a barangay-level
resolution is a good starting point for institutionalization. Advocacy and support for the
policy development and approval process is recommended to achieve a barangay resolution
or city ordinance.

2. Ensure that regular BHMC meetings are held to discuss progress in the implementation of
activities, emerging problems and challenges, and ways to address these. Hold annual work
planning and team building sessions to help sustain stakeholders’ commitment to and interest
in the BHMC and its activities.

3. Discussions or forums to share BHMC successes with other people or organizations within
and outside the community, district, or city can help enhance community spirit, sustain
commitment, and improve camaraderie among the BHMC and other barangays. They can
also inspire new stakeholders to participate.

4. Collaborate with new and existing partners to address gaps and shortcomings for continuous
improvement in BHMC performance. Adapt initiatives that were effective for other BHMCs.

5. Conduct continuous and innovative learning activities to update the knowledge and skills of
the BHMC core team, community health workers, and other partners in the community. This
will help stakeholders improve their capacity to adapt to changing situations and respond
effectively to new challenges.

6. Acknowledge good performers, supporters, and partners to inspire them to continue their
work and sustain their commitment to their BHMC and community.

Tip #4 Ways to sustain BHMCs…

• Institutionalize BHMCs through an ordinance
• Inspire continuous performance of BHMCs
• Mobilize new stakeholders and partners
• Continue to build BHMC capacity
• Institutionalize effective initiatives
• Acknowledge good performance
• Share successes

10
 ANNEX A. BHMC INDICATORS FOR TB CASE FINDING AND TREATMENT
OUTCOMES

The following indicators are based on the NTP’s routine reporting requirements. They were
expanded to allow a more detailed analysis of program results during planning workshops and
program reviews but are not required for reporting to the NTP.

Case Finding 1
Baseline
Year 1 Year 2 Year 3
Indicators year
no. % no. % no. % no. %
Population
Pres. TB cases identified
Pres. TB cases with DSSM
Pres. TB cases with two specimens for DSSM
Smear positive cases detected (Pos. Rate)
Smear negative cases
 Smear (-) Pres. TB Cases
 Smear (-) Pres. TB Cases with CXR
 Smear (-) PTB diagnosed clinically by HC
 Smear (-) PTB diagnosed through TBDC
EPTB
Number EPTB detected
Total TB cases
 Total Sm (+) PTB
 Total Sm (-) PTB
 Total EPTB
 Total TB all forms
PMDT
Number of new cases screened for PMDT
Number of retreatment cases screened for PMDT
Number of patients referred for Xpert testing
Number of patients referred for GX testing
 GX-MTB + cases
 GX-MTB + with Rif resistance
 GX-MTB + Rif resistance not detected
 GX-MTB + with Rif resistance indeterminate
 GX-MTB not detected

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 A Guide for the Establishment of a Barangay Health Management Council

Case Finding and Case Holding Indicators for TB in Children 1

Indicator Baseline year Year 1 Year 2 Year 3
TB infection no. % no. % no. % no. %
1. No. children with TB infection
2. No. children with TB infection with IPT
3. % children with TB infection given IPT
4. IPT success rate
TB disease no. % no. % no. % no. %
1. No. children with active TB (all forms)
2. No. children active TB with treatment
3. % children TB with treatment
4. Success rate for pediatric TB

Adult TB Treatment Outcome 1

Baseline year Year 1 Year 2 Year 3
Indicators no. % no. % no. % no. %
NSP cases put on treatment
Cured
Tx completed
Died
Failure
Lost to follow up/default
Trans-out
Total
Treatment success

Treatment Outcome 2
Baseline year Year 1 Year 2 Year 3
Indicators no. % no. % no. % no. %
Relapse cases put on treatment
Cured
Tx completed
Died
Failure
Lost to follow up/default
Trans-out
Total
Treatment success

12
 Annex A. BHMC Indicators for TB Case Finding and treatment Outcomes

Treatment Outcome 3
Baseline year Year 1 Year 2 Year 3
Indicators no. % no. % no. % no. %
TAF cases put on treatment
Cured
Tx completed
Died
Failure
Lost to follow up/default
Trans-out
Total
Treatment success

Treatment Outcome 4
Baseline year Year 1 Year 2 Year 3
Indicators no. % no. % no. % no. %
New Sm (-) cases on treatment
Cured
Tx completed
Died
Failure
Lost to follow up/default
Trans-out
Total
Treatment success

Treatment Outcome 5
Baseline year Year 1 Year 2 Year 3
Indicators no. % no. % no. % no. %
TAF Sm (-) cases on treatment
Cured
Tx completed
Died
Failure
Lost to follow up/default
Trans-out
Total
Treatment success

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 A Guide for the Establishment of a Barangay Health Management Council

Treatment Outcome 6
Baseline year Year 1 Year 2 Year 3
Indicators no. % no. % no. % no. %
EPTB cases on treatment
Cured
Tx completed
Died
Failure
Lost to follow up/default
Trans-out
Total
Treatment success

14
 ANNEX B. INDICATORS FOR MATERNAL HEALTH AND NUTRITION PROGRAMS
FOR BHMC USE

The indicators below are for the Maternal Health and Nutrition programs and were used to fill
information gaps about the programs’ performance. These are not routine indicators and were
used solely for the BHMC planning workshops.

Maternal Health Indicators

• Number of AP with four visits
• Percent change in the number of AP with four visits
• Number of attendees in Buntis Congress
• % change in number of attendees in Buntis Congress
• Number of FBDs
• Percent change in FBDs

Nutrition Program Indicators

• Number of participants in feeding program
• % change in number of participants in feeding program by facility (HC, NGOs)
• HC rehab success rate for SUW
• HC rehab success rate for UW
• NGO rehab success rate for SUW
• NGO rehab success rate for UW

15
 ANNEX C. INDICATORS FOR MONITORING BHMCS AT DISTRICT/CITY LEVEL

The set of indicators below is used at the district and/or city level for monitoring the scale up and
functionality of new and existing BHMCs. The previous sets of program indicators are also used
at the district level to monitor and evaluate BHMC performance.

Number of functional BHMCs in the district

Indicator No. Evidence
1. Number of functional BHMCs in the 1.1 Document showing organizational structure and
district list of roles and functions of members
1.2 Existence of functional secretariat
2. Percent of BHMCs established
based on district target

Functionality of BHMCs
Indicator Y/N Evidence
1. Core team organized 1.1 Organizational meeting held (minutes) with list of
members
1.2 Document showing organizational structure and list
of roles and functions of members
1.3 Existence of secretariat
2. BHMC is functional 2.1 Minutes of meetings signed by secretariat
2.2 Periodic reports of activities
2.3 Existence of BHMC work plan
3. Work plan is implemented 3.1 Activity reports describing activities and results
3.2 Monitoring reports from DHO
3.3 Evaluation results
4. Monitoring is performed 4.1 Monitoring reports from BHMC and DHO
5. Annual evaluation performed 5.1 Evaluation reports

16
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