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PIMAM SSM March 2021TACLOBAN CITY (Leo Christian V. Lauzon) - On March 16-19, 2021, a joint team from DOH and CPRMCI conducted the very first Philippine Integrated Management on Acute Malnutrition (PIMAM) Supportive Supervision and Mentoring (SSM) in Oras and Borongan City, Eastern Samar.  This Supportive Supervision and Mentoring Pilot Visit in selected areas in Eastern Samar will serve as basis towards improving the PIMAM Supportive Supervision Manual for supervisors/mentors to assist implementers in reinforcing their skills and knowledge, mentoring, coaching, motivating, and identifying implementation issues and other learning gaps for purposes of ensuring efficient and effective service delivery of PIMAM.

The Philippine Integrated Management on Acute Malnutrition advocacy workshops and SAM training started in 2016. More than 200 health professionals completed a Training of Trainers Course in priority provinces identified by DOH. A Guide Book on Mentoring PIMAM Courses was developed in 2017 to serve as a guide for newly trained SAM (Severe Acute Malnutrition) trainers to ensure that the SAM training course is effectively rolled out to health workers at all levels from hospitals up to communities.

Bottleneck Analysis (BNA) Validation and Action Planning Workshop in April 2019, three main bottlenecks were identified: (1) ineffective supply chain for therapeutic and anthropometric supplies, (2) poor demand for SAM management services linked to poor community mobilization and (3) limited supervision and lack of reporting/monitoring systems. Upon review of the provincial action plans of the 17 provinces, the lack of PIMAM and SAM training for health workers and other community workers was a stand-out issue. The need for the conduct of training courses, refresher courses and supportive supervision were some of the interventions included in the plans.

The visit consists of visiting the In-patient Therapeutic Care (ITC) at the Eastern Samar Provincial Hospital and two selected Outpatient Therapeutic Care (OTCs) located in RHU Oras and CHO 2 Borongan. The PIMAM SSM Team is composed of Dr. Milagros Salvacion Bolito (DOH), Ms. Felicita Borata (DOH), Ms. Sallie Jabinal (PNAO), and Mr. Leo Christian Lauzon (CPRMCI). During these visits, the Team goes to the ITC/OTC facility, warehouse and storage areas to check the availability of supplies, does record review, and conducts SSM session with the PIMAM trained health worker.

Supportive Supervision and Mentoring deviates from the prevailing norm of fault finding and blame in the work of the PIMAM trained health worker. Rather, it focuses on identifying challenges in the PIMAM implementation and facilitating the identification of solutions which can be done with the support of the SSM Team and PHO. Common challenges faced by the PIMAM trained health worker is the need to do the rollout of PIMAM training to fellow health workers so that they could also be capacitated to manage SAM patients, availability of supplies (i.e. RUTF, Vitamin A, and Amoxicillin), proper storage and warehousing, and sustaining the two way referral mechanism in order to avoid lost-to-follow SAM cases.

The SSM Team also interviews the parent/caretaker of the child with SAM. After the interview and site visits, the team facilitated a feedback session to OTC (In charge of OTC and concerned staff). A feedback session was done together with Dr. Marilou Tejero, the Municipal Health Officer of RHU Oras and Dr. Patricia Bernadette Apita, the City Health Officer of CHO 2 Borongan. The collated data were analyzed and presented all findings, results from the checklist and preparing a feedback reports.

Borongan City Administrator Atty. Celestino Cabato also met the SSM Team to personally receive the feedback of the SSM in CHO 2 Borongan. He scheduled a meeting with Mayor Jose Ivan Dayan Agda the following day together with Dr. Apita and the new CNAO designate to act on the feedback given by the Team. The visit is capped with the Exit Conference with Dr. Marian Epefania Isiderio, the Provincial Health Officer of Eastern Samar where the Team presented the results of the SSM Visit and provided recommendations in addressing the challenges in PIMAM implementation in the province. The PIMAM SSM is being implemented by CPRM Consultants, Inc. in partnership with the Department of Health with funding support from UNICEF. #