Vision
"A Center for Excellence Committed to Health Systems Development to Attain Health for All.”

Mission
Build health workers capabilities to better influence local governance for health, stir the entire health system toward the promotion of health and well being of its constituents and provide quality, efficient, equitable and accessible health care through a strong multi-sectoral collaborative and coordinative strategy.

REGIONAL PROFILE

1. Land Area and Political Subdivision

Region 10 occupies an area 17,274.77 square kilometers subdivided into five (5) provinces: Bukidnon, Camiguin, Lanao del Norte, Misamis Occidental and Misamis Oriental and eight (8) cities: Cagayan de Oro, Gingoog, Iligan, Oroquieta, Ozamiz, Tangub and Malaybalay. Cagayan de Oro, which is the provincial capital of Misamis Oriental also serves as the Regional Center.

The region has a total of 85 municipalities and 2,020 barangays with a total household of 702,904.

2. Demographic Profile

2.1 Population, Density and Growth

The region`s total population is estimated at 2,738,329 as of the latest census (May 1, 2000). There is an increase of 10.64% or 264,313 inhabitants compared to actual census of 1995. This constituted 3.63% of the national total, ranking 12th among the regions.

In 2005, the projected population is 3,896,546 or 1,158,217 inhabitants compared to 2000 survey. The increase in population where attributed to the transfer of Lanao del Norte and Iligan City to this region.

The population growth rate of the region is 2.08, which is higher than the national growth rate of 2.02. The provinces, which registered high growth rates, were Misamis Oriental (2.47) and Bukidnon (2.46). Among the cities, Gingoog (3.41) and Malaybalay (2.09). The rest of the provinces and cities registered only at one percent growth annually.

The population of the provinces accounted for 61.38% of the population while that of cities constituted 38.62%. Bukidnon is the most populous province, constituting 21.71% (845,886) of the total population followed by Misamis Oriental 16.93% (659,506): Lanao del Norte 13.06% (508,925); Misamis Occidental 7.61% (296,511) and Camiguin, the smallest province with 2.07% (80,852).

The most populous city is Cagayan de Oro with 13.17% (513,065) followed by Iligan 7.84% (305,678); Valencia 4.43% (172,570); Malaybalay 3.68% (143,458); Ozamiz 3.15% (122,775); Gingoog 3.25% (126,826); Oroquieta 1.67% (65,147) and Tangub 1.42% (55,347).

With a higher growth rate in population, crude population density increased by 13% from 157 persons per square kilometer in 1990 to 177 in 1995 and 194 persons per square kilometer in 2000 an increased by 9.03% over the period of five (5) years. Likewise in 2005 Region 10 has a population density of 226 with an increase of 15.98% for five (5) year period.

Being the regions capital city, Cagayan de Oro registered the most number of persons per square kilometer at 1,242.This could be attributed to the fast growth of region 10 as an industrial center and the development of the Cagayan-Iligan Corridor (CIC) areas and also the establishment of the International Airport located at Laguindingan, Misamis Oriental.

2.2 Age, Sex, Structure and Dependency Ratio

Northern Mindanao (Region 10) has a predominantly young population with 51.27% of the latest population survey, belonging to 19 years and below age group while only 3.2% were aged 65 years and over.

Men outnumbered women by only 3.96% indicating that males comprise 51.98% of the total population and females 48.02%.

The dependency ratio per 100 workers of 15-64 age group was 76.90%, an increased by 5.74 compared to 1995, which was 72.78%.

3. Demographic Profile

3.1 Births

There were 95,819 registered births with a Crude Birth Rate (CBR) of 24.59 per 1,000 population. An increase by 6.27 % was noted compared to 2004, which was 23.14 per 1,000 population. Likewise, compared to five (5) year average an increase trend of 10.27% per 1,000 population was also noted. Among the provinces, Bukidnon, Lanao del Norte, Camiguin and Misamis Oriental posted the highest Crude Birth Rate of 28.27, 20.54, 19.52 and 18.96, respectively. While, Misamis Occidental had a CBR of 14.72 per 1,000 population the lowest among the provinces. Almost all of the provinces revealed a decreasing trend compared to 2004 and the 5-year average, except for Bukidnon, which showed an increase of 5.09% for the period of one year.

Among the cities, Valencia has the highest CBR of 53.84% per 1,000 population followed by Iligan (33.23); Cagayan de Oro (27.42); Malaybalay (19.74); Ozamiz (18.32); Gingoog (18.29); Tangub (17.96); Iligan (19.05) and Oroquieta the lowest with a CBR of 16.92 per 1,000 population.

Iligan and Valencia noted a significant increase in CBR by 41.05 and 74.44% respectively. While Cagayan de Oro showed a slight decrease by only 0.25% compared to 2004. However Gingoog, Malaybalay, Oroquieta, Ozamiz and Tangub revealed a decreasing trend by 4.45%, 2.98%, 9.35%, 15.80% and 15.80% respectively compared to 2004.

Of the registered births, 71.48% (68,490) were delivered at homes; 24.56% (23,532) at government and private clinics; 3.95% (3,789) at other places. Out of the 95,819 registered births 49.03% (46,979) were attended by trained health personnel while 41.36% (39,630) were attended by trained hilots 9.61% (9,204) were attended by untrained hilots and others.

Of the total livebirths, 51.65% (49,478) were males and 48.35 (46,341) females. This shows that there were more males born in 2004 than females. With regards to weight at births 88,278 (92.13%) were born with a weight of more than 2,500 grams, 6,193 (6.46%) with less than 2,500 grams, while 1,348 (1.41%) were registered under unknown.

On Natality reports, out of 95,819 livebirths 67.28% (64,469) mothers had a normal pregnancy, while 31.03% (29,732) were at risk and 1.68% (1,610) belongs to others, which indicate that mothers had not been properly assessed.

The increased in Crude Birth rate (CBR) was attributed to the slowly phasing down of contraceptives, like pills and DMPH, no more supply of condom for the whole year of 2005, delayed and inadequate supplies of contraceptive from the Central Office and irregular monitoring at all levels on Family Planning Program. This increase was also justified in the reduction of Contraceptive Prevalence Rate by 2.37%.

On the other hand, the increased in CBR can be explained on the improved registration of births by the Local Civil Registry, as part of their campaign on improving birth registration, especially on the hard to reach areas where the Indigenous people settle down. In addition, all health workers including Hilots and Traditional Birth Attendant were enjoined to assist in the registration of births.

3.2 Deaths

A total of 15,600 deaths were registered in 2005 representing a Crude Death Rate (CDR) of 4.00 per 1,000 populations. An increase by 2.82% was noted on the Crude Death Rate (CDR) compared to a period of one (1) year from 3.89 in 2004 to 4.00 in 2005. However, a decreasing trend of 3.46% was noted compared to the 5-year period.

Among the provinces, Camiguin has the highest CDR of 6.04 per 1,000 population followed by Misamis Occidental (4.28), Misamis Oriental (3.37), Lanao del Norte (2.61), and the lowest Bukidnon (2.38).

Among the cities, Ozamiz has the highest of 7.54 per 1,000 population followed by Oroquieta (6.89); Cagayan de Oro (6.65); Tangub (5.08); Iligan (4.93); Malaybalay (4.92); Gingoog (4.35); and Valencia registered the lowest CDR of 2.63.

Of the 15,600 deaths, 7.31% (700) were infant deaths, of which 0.93% (145) were caused by Pneumonia and Diarrhea 0.26% (40).

A decrease in the Crude Death Rate (CDR) in most of the provinces and cities was noted compared to 2004, except for Misamis Occidental, Iligan, Gingoog, Oroquieta and Ozamiz, which shows an increasing trend by 6.54%, 12.98%, 5.75%, 1.16% and 6.37% respectively.

3.3 Infant Deaths

There were 700 registered infant deaths in 2005 representing an Infant Mortality Rate (IMR) of 7.31 per 1,000 livebirths. Lanao del Norte posted the highest Infant Mortality Rate (IMR) of 32.32, higher than the regional average of 8.12 per 1,000 livebirths. This is attributed to an accurate reporting system wherein most of the cases found are due to teenage pregnancies and unwed mothers in the locality.

Among the cities, Tangub registered the highest IMR of 23.14 per 1,000 livebirths, followed by Ozamiz (20.01); Oroquieta (16.33); Cagayan de Oro (11.66); Iligan (10.63); Malaybalay (9.53). Gingoog and Valencia have an IMR below the regional average, of 6.03 and 0.22 per 1000 livebirths, respectively.

A decreased of 12.56% was noted on the IMR of 2005 (7.31) compared to 2004 with 8.12 per 1,000 livebirths. Likewise, a declining trend was also noted from 9.27 per 1,000 livebirths in 2000 to 7.31 or 23.41% reduction for the past five (5) years.

The continuous capability building of service providers, increase awareness of mothers on child care, especially on the integrated management of childhood illnesses, the promotion and advocacy/IEC on the maternal and Child Care as well as the joint effort of the LGUs, CHD-NM and donor agencies, such as the Management of Sciences for Health (MSH), UNICEF, WHSM-PC, USAID-LPP, and the improvement of two way referral system among RHUs/BHS and hospital, contributed so much on the reduction of the Infant Mortality Rate (IMR) in the region.

3.4 Maternal Deaths

The total registered Maternal Deaths in 2005 were 64 with Maternal Mortality (MMR) of 0.67 per 1,000 livebirths. A significant decreased by 25% was noted for a period of one (1) year from 0.90 in 2004 to 0.64 per 1,000 livebirths in 2005. A decreasing trend was noted by 10.66% compared to the past five (5) years. The increase in number of maternal death was noted in Misamis Oriental with 8 deaths in 2005, while only three (3) deaths in 2004.

Although there was an increase of maternal deaths in some provinces/cities but this does not shows that Comprehensive Maternal and Child Health Care Program was not well implemented at all levels. Records shows that there is still an increase awareness on the part of the mothers on the program, as well as the linkages with the GOs, NGOs, the full support of the LGUs, the technical and financial support provided by the Center for Health Development, Northern Mindanao (CHD-NM), the training of the functional literacy program, quality assurance, the training of service providers on OB-complications and the regular Maternal Mortality review in all provinces/cities region wide, support of foreign assistance from UNICEF, UHNP (Cagayan de Oro) and WHSM-PC have a greater impact on the implementation of the program.

Bukidnon registered the highest Maternal Death (17) with an MMR of 0.71 per 1,000 livebirths followed by Lanao del Norte (8) 5.07 and Misamis Oriental (8) .64. Camiguin and Misamis Occidental have zero (0) maternal death in 2005, however in 2004 Camiguin have one (1) registered maternal death with .61 MMR.

Among the cities, Cagayan de Oro has a Maternal Mortality Rate (MMR) of (1.00%) with fourteen (14) deaths followed by Malaybalay (1.41%) with 4 deaths. Three (3) cities have registered three (3) deaths namely: Iligan, Gingoog and Valencia, while Tangub had only two (2) maternal deaths and Ozamiz had zero (0) deaths.

3.5 Morbidity, Leading Causes

Communicable disease except for Hypertension, Skin Disease, Wounds all forms and Urinary Tract Infection (UTI) continues to be the major health problems in the region.

Upper Respiratory Tract Infection leads the ten leading causes of Morbidity. A marked increased by 98.89% was noted compared to 2004. Bronchitis, Acute Respiratory Infection, Pneumonia and Influenza ranking second, third, fourth and fifth respectively, with a rate of 1,246.57; 1,197.03; 915.43 and 693.72 per 100,000 populations.

Diarrhea, and Hypertension the same ranked 6th and 7th, exhibited a decreasing trend of 23.56% and 9.22% respectively. Urinary Tract Infection occupies the same no 8th with a rate of 306.99 per 100,000 populations. While TB, which occupies the 10th ranking were no longer on the list of the leading causes of morbidity. Skin Problem/Disease maintained its 9th ranked however with an increased of 6.71% while Wounds all forms now ranked 10th with a rate of 180.44, wherein for the past five years were not among the list of the ten leading causes of morbidity.

3.6 Mortality, Leading Causes

Disease Circulatory System, Pneumonia and Malignancy occupied the same ranked 1st, 2nd and 3rd respectively. Disease of the Circulatory System and Malignancy showed an increasing trend of 5.98% and 5.09%, while Pneumonia exhibited a declining trend of 8.45% compared to the five-year average.

TB rose it`s ranked from 5th to 4th, however, it has a declining trend compared to five-year average of 14.35%.

Other causes of mortality such as Accidents/violence and Diabetes Mellitus showed also an increasing trend compared to the five-year average by 61.57% and 35% while Peptic Ulcer decreased by 6.07%.

3.7 Infant Mortality, Leading Causes

Non-communicable dominated the leading causes of Infant Mortality wherein only two (3) were communicable diseases namely: Pneumonia and Diarrhea.

Five (5) of the Leading Causes of Infant Mortality showed a remarkable downward trends such as Pneumonia (20.53%); Congenital Anomalies (22.22%); Prematurity (25.92); Sepsis Neonatorum (15.38%) and Malnutrition (36.36%) over the five-year period. Four (4) diseases namely: Septicemia (.61%); Respiratory Distress Syndrome (.53%); Diarrhea (0.42%) and Malnutrition (36.36%) exhibited an increasing trend of 36.36%.

Pneumonia still topped as the number one killer disease, although it has recorded a very significant decreased. This is an indication that the delivery of quality health services especially the maternal and child care programs are well implemented at all levels, management by trained service providers and availability of CARI medicines, and IEC at all levels have great impact on the reduction pneumonia deaths.

3.8 Maternal Mortality, Leading Causes

The pattern of the causes of maternal deaths for the past five years had not change. Postpartum Hemorrhage was still on the lead with a rate of (0.30) per 1,000 livebirths followed by Placenta Retention (.06), Hypertension in Pregnancy (.06), Toxemia in Pregnancy (.06), Atony of Uterus (.04), Ectopic Pregancy (.02), Other complication in Pregnancy (.02), Incomplete Abortion, Postpartum Sepsis, Puerperal Sepsis, Amniotic Fluid Embolism both with same rate of (.01).

For the past five years, all of the causes of maternal deaths exhibited a downward trend except for Postpartum Hemorrhage, Other Complication in Pregnancy, Pre-eclampsia and Puerperal Sepsis, which showed an increasing trend of 6.89%; 220%; 40%; and 100% respectively.

The decrease was attributed to the early referral of high-risk cases, accessibility to health facilities that can manage obstetrical complication and unavailability of transportation for referral especially in far-flung and hard to reach areas.

3.9 Neonatal Tetanus

Lanao del Norte registered three (3) Tetanus deaths in 2005.

3.10 Hospital Statistics

A. Occupancy Rate

The three (3) Retained Hospitals, Northern Mindanao Medical Center, Mayor Hilarion Ramiro Regional Training and Teaching Hospital and Amai Pakpak Medical Center registered an occupancy rate of 107.78%, 90.79% and 113.39%, respectively. Amai Pakpak Medical Center has no data in occupancy rate for the year 2004.

NMMC, MHARSTTH and Amai Pakpak Medical Center had a total admission of 20,641, 11,166 and 9,317. An increase of 6.70%, and 120% respectively compared to 2004, reflecting a 5.49%, 5.03% and 1.96% death respectively out of the total admission excluding Newborn.

Among the district hospitals, Initao District Hospital registered the highest occupancy rate of 404% followed by Maramag District Hospital 106.21%, Gingoog District Hospital 58%, Talisayan District Hospital 57% and Calamba District Hospital 40%. Five district hospitals have an occupancy rate, which ranges from 40% to 133%. Kapatagan and Kolambogan District Hospitals registered the lowest with 14.74% and 10.41% respectively.

B. Hospital Consultations, Leading Causes

The ten leading causes of consultations in all government hospitals is almost the same with the private hospitals wherein five (5) where caused by non-communicable disease while the five (5) were non-communicable disease (Table 10b and 10c.)

C. Hospital Discharges, Leading Causes

Of the leading causes of discharges both admitted in the government and private hospitals, six (6) were caused by Communicable disease namely: Gastroenteritis/Diarrhea (21,807); Pneumonia (7,845); Bronchitis (2,252); ARI (1,983); Typhoid (1,070) and Dengue Fever (464) the rest were non-communicable in nature. As noted, most cases were admitted in the private hospitals.

D. Hospital Mortality, Leading Causes

Of the total leading causes of deaths in both government and private hospitals, two (2) were caused by communicable wherein Pneumonia ranked 3rd among the leading causes with 13.68% against the total leading causes of hospital deaths and PTB 3.78%.

E. Hospital In-patients, Discharge and Referral System

A total of 41,003 patients were admitted excluding newborn in three (3) retained hospitals in 2004 of which 20,641 were admitted in NMMC, 11,166 MHARSTTH and 9,196 in Amai Pakpak Medical Center with an average length of hospitalization of 5 days per patients.

There were 28,025 patients for non Phi-Health or charity patients of which 15,158 were in Northern Mindanao Medical Center, 6,210 in Mayor Hilarion Ramiro, Sr., Regional Teaching and Training Hospital and 6,657 in Amai Pakpak Medical Center, of the total non-PhilHealth patients only 1,649 were paying patients, wherein 972 were in NMMC and 677 in APMC, while in MHARSTTH all were charity patients.

For Phil-Health members admitted, there were 5,407 Indigent patients, 7,916 members and dependent and only 597 were paying patients. Out of the total Indigent patients admitted 2,734 were in NMMC, 2,844 in MHARSTTH and 436 in APMC.

Of the total patients admitted in three (3) Retained Hospitals, 25,920 were recovered/improved of which 19,275 were in NMMC, 10,525 MHARSTTH and 7,783 in APMC. There were 276 patients transferred, 233 absconded, 16 unimproved, 1,267 in the home against medical advice and 1,827 patients died.

In terms of referral, out of the total admissions 125 (.30%) were referrals from RHUs, 1,153 (2.81%) from hospitals/centers and 625 (1.52%) from other health facilities.

F. Hospital Manpower

With regards to hospital manpower, NMMC has a total of 433 personnel of which 68 where resident physicians, 28 medical specialist (consultants) 6 DOH National poll, 129 ancillary, 2 dentist, 1 Chief nurse, 28 nurse supervisors, 80 staff nurse, 1 midwife, 35 Aide and 123 Administrative Nurse.

4.0 Environmental Indices

4.1 Water Supply

Of the 733,501 households in the region, 2005 data showed that 88.99% or 652,718 household have access to safe and potable water supply. There was a slight decrease of 0.49% accomplishment from 89.48% in 2004 to 88.99% in 2005.

Out of the total households, 21.03% (154,283) were in Level I type, 26.48%(194,206) Level II, 41.48% (304,229) Level III and 11.01% (80,783) household with doubtful sources.

Among the provinces Misamis Oriental still registered the highest coverage of household with access to safe water supply 97.94% (119,989). Misamis Occidental now ranked 2nd with 92.61%( 52,950), followed by Bukidnon 89.12% (140,506), Camiguin 87.87% (14,209) and Lanao del Norte with 58.14% (55,800). There was a decrease of 4.14% due to non- submission of reports from some municipalities of Lanao del Norte. The provision of safe and potable water supply is the Local Government Units full responsibility.

For the cities, almost all attained more than 90% coverage of households provided with safe water supply, except for Gingoog 89.17% (20,562) and Iligan City 89.38% (55,577), with a significant decrease by 10.11% and 10.32% respectively compared to 2004.

4.2 Sanitary Toilet

On toilet facilities, out of the 733,501 households, 71.28% (522,841) have sanitary toilets; 7.64% (56,068) have unsanitary toilets and 20.38% (149,483) without toilets.

There was an increase of accomplishment by 6.38% of household with sanitary toilet and 12.68% of household without toilet as compared to 2004 but a decrease of 20% for unsanitary toilet.

Almost all provinces registered an increasing trend of accomplishment of which Bukidnon is the highest, from 27.90% in 2004 to 64.72% in 2005 with an increase of 131.97%. Lanao del Norte had a decreasing accomplishment of 10.60 % compared in 2004.

Among the cities, Oroquieta still registered the highest coverage of household with sanitary toilet and Valencia ranked 2nd with 92.53% Cagayan de Oro and Malaybalay have more than 80% coverage, while Ozamiz, Iligan and Tangub fall below the 80% accomplishment. Gingoog got the lowest with only 67.85%. Provision of toilet facilities in every household is still on the low priority list of the LGUs.

4.3 Sanitary Garbage Disposal

Out of the 733,501 households, 56.44% (414,030) households have sanitary garbage disposal, while 43.56% (319,471) have no proper garbage disposal. Based on the data we can safely conclude that they disposed their garbage anywhere.

4.4 Complete Basic Sanitation Facilities

With regards to Complete Basic Sanitation Facilities wherein households have available potable water, toilet facility, blind drainage and compost pit, data showed that there were 54.15% (397,167) households complied the requirements, while the remaining percentage of households either have one or two of these basic facilities.

4.5 Food Sanitation

There were 84.58% (32,945) out of 38,951 food establishment issued with Sanitary Permit, while 82.96% (49,094) out of 59,180 food handlers were given Health Certificates by the Rural Health Units in their respective municipalities of the region.

5.0 Nutrition

Malnutrition is still a health problem in Northern Mindanao. In 2005, of the 544,277 preschool children weighed, 73,894 or 13.59% are registered to be Below Normal Very Low (BNVL) and Below Normal Low (BNL). Out of 544,277 preschool children weighed, 9,106 (1.67%) are Below Normal Very Low (BNVL), 64,843 (11.91%) are Below Normal Low (BNL), 459,975 (84.51%) are Normal and 10,353 (1.9%) are Above Normal (AN). 2004 reporting on weighing standards uses the International Reference Standards (PRS).

6.0 Health Resources

a. Health Facilities

The health care delivery system of the region which is linked by an improved referral system is composed of 30 government hospitals with 1,715 beds; 74 private hospitals with 2,557 beds and an aggregate bed capacity of 4,272 for both government and private hospitals a total bed population ratio of one bed for every 912 population.

A total of 94 Main Health Centers with a population ratio of (1:41,452) and 940 Barangay Health Stations (1:4,145) were under direct supervision of the Local Government Units.

b. Health Manpower

In terms of manpower, Center for Health Development, Northern Mindanao has a total number of 1,111 retained personnel of which 148 are in the CHD Office, 433 NMMC, 240 MHARSTTH, 145 Amai Pakpak Medical Center, 67 DOH-Reps, 32 Malaria, 25 Schistosomiasis, 7 Traveling Skin Clinic and 3 STD, and 11 Quarantine.

For the devolved health personnel (LGUs) a total of 1,697 personnel in different categories manning the Rural Health Units and Barangay Health Stations in the provinces and cities, regionwide. Of the total personnel 111 (1:35,104) were doctors; 209 (1:18,644) nurses; 984 (1:3,960) midwives; 153 (1:25,468) RSI; 73 (1:53,377) Dentist; 13 (1:299,734) Nutritionist; 95 (1:41,016) Medical Technologist and 59 (1:66,043) Dental Aide. Likewise, a total of 12,060 (1:323) Active Barangay Health Workers; 3,203 (1:1,217) Trained Birth Attendant and 86 (1:45,309) Non-Technical personnel for the support services.

c. Health Budget

Center for Health Development, Northern Mindanao operated a budget of P98,668,000.00 for the year 2005. The total obligations incurred during the year including Personal Services (PS) and Maintenance and Other Operating Expenses (MOOE) amounted to P97,445,000.00 of which P71,233,000.00 is for the personal services and (P26,212,000.00) for the Maintenance and Other Operating Expenses (MOOE).

Of the total budget appropriated, (P890,338.84) was used to purchased drugs and medicines, medical, dental and laboratory supplies and P400,000.00 was used for grants and subsidies to LGUs. And also we spent P938,385.18 for training of our devolved health personnel.