The Visayas Primary Healthcare Services, Inc. (VPHCS) implemented a project on COVID-19 response with the support of the United States Agency for International Development (USAID) ReachHealth Project from August 10, 2020 to January 31, 2021. The ReachHealth Project is on ongoing project since 2018 and is administered by the RTI International.

The VPHCS implemented project provided technical assistance to the local government units (LGUs) of Bogo City, San Remigio, Medellin, and Tabuelan, Cebu in order to delay and contain the transmission of COVID-19; and mitigate the effects of the pandemic in their localities.

This objective was achieved by the  implementation of various capacity-building activities for Barangay Health Emergency Response Teams (BHERTs), barangay health workers (BHWs), barangay nutrition scholars (BNS), youth leaders and port personnel and other activities to support community-based COVID-19 response efforts.

Trainings for BHERTs

A series of trainings for the BHERTs of the four project areas were conducted.  The trainings concerned the roles and functions of the BHERTs in COVID-19 response, risk communication and community engagement (RCCE), infection prevention and control (IPC) protocols, water, sanitation and hygiene (WASH), gender-based violence (GBV), and adolescent concerns.  Handouts on the topics were also given to the participants.

A total of 344 BHERTS members from 60 barangays attended the trainings which were conducted on September 3, 9, 11, 14, 15, 16, 17, 21, 22, 24, 25, and October 16, 19, 2020. The number of BHERTs members ranged from four to seven members in each barangay, and were composed of BHWs, BNS, barangay captains, barangay councilors, and barangay tanods.  There were also nurses and midwives in some of the trainings.

Trainings for BHWs and BNS

Trainings on IPC, GBV, and WASH were also conducted for BHWs and BNS. The trainings were conducted on October 20 and  22, 2020.  There were 41 participants in San Remigio, 42 in Bogo City, 51 in Tabuelan, and 28 in Medellin, for a total of 162 participants.

Trainings for members of the PCG and port personnel

Trainings on IPC and RCCE were conducted for members of the Philippine Coast Guard (PCG) and port personnel assigned in the ports of the four LGUs.  The training for the personnel in Polambato Port in Bogo City was conducted on October 26, 2020, in Hagnaya Port on November 19, 2020, Kawit Port on November 20, 2020,  and in Tabuelan Port on December 3, 2020.   A total of 12 PCG members and 52 port personnel attended the trainings.

In all the trainings for the BHERTs, BHWs, BNS and port personnel, the participants shared their experiences that they had always been practicing the basic health protocols on IPC such as wearing their face masks and handwashing and social distancing.  They also said that people in their LGUs have also been complying with these and other quarantine protocols.

Training handouts on the five topics were reproduced by the project team and distributed to all the participants.  Resource persons included the VPHCS staff.

Trainings for youth leaders

Trainings for youth leaders on hygiene and hygiene promotion were conducted in Tabuelan on November 5, 2020, Bogo City on November 6, 2020, San Remigio on November 6, 2020, and Medellin on November 17, 2020.

A total of 74 youth leaders attended the four trainings, coming from the following organizations, namely: different Sangguniang Kabataan (SK) Chapters of the barangays, the Kabatan-onan Kontra Druga at Terorismo (KKDAT), Students Supreme Government Councils,  Tau Gamma Phi (TGP), Pag-asa Youth Association of the Philippines,  Youth for Christ (YFC), Poblacion Youth Association (PUYA), Tabuelan Youth Catholic Organization (TYCO), Olivo, Tabuelan Youth Catholic Organization (OYCO), Fourth Club Federation, Parish Youth Coordinating Council (PYCC), and Pre-professional Youth Acting Program (PPYAP)

Information dissemination on adolescent gender-based violence and BIDA Solusyon on COVID-19

The project also disseminated information on adolescent gender-based violence.  A total of 120 flyers, 180 tarpaulins and 630 pamphlets of “Approach to Adolescent Victims of Physical and Sexual Abuse” taken from the Adolescent Job Aid Manual of the World Health Organization were reproduced and disseminated to the four LGUs last January 28 and 29, 2021. They are to be used by the Municipal Health Officers (MHOs), nurses, midwives and BHWs as guides in dealing with adolescent victims of physical and sexual abuse.

The project also disseminated information, education and communication materials on COVID-19.  The BIDA Solusyon on COVID-19 infographics of the Department of Health (DOH) were used in the printing of 2,200 flyers, 180 tarpaulins and 95 fans which were then distributed to the 60 barangays covered in the project through their BHERTs, youth groups and port personnel during their post-training monitoring gatherings on January 7, 8, 14, and 15, 2021.

Posting of the BIDA Solusyons on COVID-19 infographics and video clips was also done by the VPHCS project team in its facebook page, Visayas Primary. They were then shared to the facebook pages of the four LGUs, namely:  LGU-San Remigio, Tabuelan RHU Cares, Bogo City Health Office, and SK Medellin, which were then posted.  This occurred on January 20, 2021.

Installation of handwashing facilities

The project also installed handwashing facilities in public places in the four project areas as part of the efforts to contain the transmission of the virus.

In San Remigio, the facilities were installed in the bus terminal in the Poblacion,  Cebu Technological University in  Barangay Tambongon, municipal fish port in Barangay Hagnaya, bus terminal in Hagnaya Port, Lapyahan Public Beach in the Poblacion, the temporary treatment and monitoring facility (TTMF) in  Barangay Tambongon, satellite public market in Barangay Hagnaya, and the San Remigio Mental Health and Psychosocial Support Center.

In Medellin, two were installed in the public market in the Poblacion, and one in the municipal hall.  Three lavatories are installed in the birthing unit, RHU, and Animal Bite Center in the RHU.  In Tabuelan, one facility was installed in the public market in Poblacion and another one in the Tabuelan Port.

In Bogo City, they were installed in the City Health Office, bus terminal in the Bogo City Hall Road, two in the public market in Barangay Cantecson, and one in Polambato Port.

The installation was done by the Oasis Development and Construction in Bogo City. It was completed in November 2020. Turnover ceremonies to the respective LGUs were held on October 23, 2020 for San Remigio, November 12, 2020 for Bogo City, November 13, 2020 for Tabuelan, and November 23, 2020 for Medellin.

Hygiene kits consisting of two gallons of liquid soap, one dispenser and two packs of paper towels for each handwashing facility were also distributed to the administrators of the areas where they were installed to be used by the public.

Contingency planning workshops on COVID-19

The project also assisted the four LGUs in contingency planning on COVID-19 which drafted contingency plans that embodied the successes, gains and lessons learned by the LGUs in the management of the COVID-19 pandemic as well as the needs and resources that still have to be addressed.

The contingency planning workshop on COVID-19 was held in Medellin on January 7, 2021, in San Remigio on January 8, 2021, in Tabuelan on January 14, 2021, and in Bogo City on January 15, 2021.

There were 22 participants from 14 agencies in Medellin, 19 participants from 17 agencies in San Remigio, 13 participants from 8 agencies in Tabuelan, and 26 participants from 12 agencies in Bogo City, or a total of 80 participants coming from 23 different agencies in the four workshops.

Resource persons who facilitated the workshops included four personnel from the Cebu Provincial Disaster Risk Reduction and Management Office (PDRRMO), namely, Neil Angelo R. Sanchez, Rhee S. Telen, Jr. and Emily N. Lagrimas, and Josephine Aves.

Post-training monitoring workshops

A series of post-training monitoring workshops were held for BHERTs who were trained on October 23, 2020 to January 15, 2021.  A total of 336 BHERTs members participated in the workshops.  The participants in all the workshops were comprised of BHWs, BNS, barangay captains, councilors and tanods.

A monitoring tool of the RTI International which was translated to Cebuano by the VPHCS project team was used to assess how well they had been performing their roles and functions as BHERTs, such as identification and monitoring of close contacts of positive COVID-19 cases, how many contacts they had met or talked with and if they had problems in such monitoring.  They also answered questions on the other health services rendered in the barangay health centers as most of them were BHWs and BNS.  The answers discussed during the workshops were presented in plenary sessions.

Generally, their answers reported that each barangay has one BHERTs with an average number of six to eight members.  All of the BHERTs said that they know their roles. With close contacts in home quarantine, they monitored them once or twice a day using the Signs and Symptoms Log forms. They also used the Contact Line List Form to identify the close contacts. After the 14 days quarantine of the close contacts and locally stranded individuals (LSIs) who did not have any signs and symptoms, the BHERT reported them immediately to the barangay captain. If the close contacts or LSIs showed COVID-19 symptoms, they reported it immediately to the barangay captain and MHO.

The BHERTs also did home visits of the close contacts and they ensured to observe the health protocols. The BHERTs also used short message service (SMS) and social media to deliver vital information about the virus and how the community can battle against it together. Face to face discussion was also done but rarely and while observing COVID-19 minimum health standards.

They also performed the essential services stated in the monitoring form, including tuberculosis treatment services, weighing of children, giving of medicines to the elderly, deworming of children, family planning, giving of hypertensive  medications,  and reminding mothers to have their children immunized.

On the other hand,  four post-training monitoring gatherings for the youth leaders were conducted through focus group discussions.  A total of 51 youth leaders from the four LGUs attended the focus group discussions held in January 2021.

They evaluated how the youth leaders had practiced personal, home, food, respiratory, laundry, menstrual, and oral hygiene, evaluated how they had applied their knowledge on sanitation in their everyday life and evaluated how well they had promoted hygiene promotion in their communities.

The youth leaders also expressed that they played a role in the control of the COVID-19 pandemic.  They practiced the health protocols such as social distancing, and wearing face masks. They also practiced personal hygiene, handwashing, and cleanliness in their homes and communities.

Post-training monitoring gatherings for members of the PCG and port personnel were also conducted in January 2021 with a total of 20 participants.

The activity evaluated how the port personnel had been ensuring the practice of infection prevention and control in the ports and in relating with passengers that went to the ports.  The participants said that being frontliners working in the ports, they were very strict in ensuring that passengers practiced the health protocols. There was also a limit of the number of passengers who can board the vessels to ensure that there was social distancing inside the vessel.

Distribution of BIDA kits

The project also distributed 1,800 BIDA hygiene kits to the four LGUs.  Each kit consisted of two bottles of shampoo, 1 sachet of  liquid dishwashing soap, 8 sachets of powder detergent soap, 7 sachets of shampoo, 3 pieces of washable face mask, 1 piece of condom for males, 1 pack of sanitary napkin for females,  and 1 piece of pamphlet on family planning.

In conclusion, the USAID ReachHealth Project on COVID-19 response reaped tremendous gains in terms of increased awareness and capacity of the residents in the four LGUs on COVID-19 response.