Balilihan 2004 - LGRC DILG 10

BALILIHAN, BOHOL
“PUROK POWER” FOR PRIMARY
HEALTH CARE
Balilihan Countryside
Action Program

“PUROK POWER” FOR PRIMARY HEALTH CARE
Balilihan Countryside Action Program
Copyright © 2004 Philippines-Canada Local Government Support Program
(LGSP)
The Philippines-Canada Local Government Support Program encourages the
use, translation, adaptation and copying of this material for non-commercial
use, with appropriate credit given to LGSP.
Although reasonable care has been taken in the preparation of this book,
neither the publisher and/or contributor and/or editor can accept any liability
for any consequence arising from the use thereof or from any information
contained herein.
Printed and bound in Manila, Philippines
Published by:
Philippines-Canada Local Government Support Program
Unit 1507 Jollibee Plaza
Emerald Ave., Pasig City
1600 Philippines
Tel. Nos. (632) 637-3511 to 13
www.lgsp.org.ph
This project was undertaken with the financial support of the Government of
Canada provided through the Canadian International Development Agency
(CIDA).

CONTENTS
Summary
About Balilihan, Bohol’s Countryside Action Program (CAP)
Project History
Project Description
Project Results
Replicating Countryside Action Program (CAP)
Key Implementation Steps
Reference Matrix On Replicating Countryside Action Program
Lessons And Insights In Replicating The Project
Annexes
1
3
5
5
7
8
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10
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Summary
Under the local governance system, puroks are sub-units of the barangay, which
is the basic political unit of the government. Traditionally, however, puroks are
no more than loose geographical groupings of households within the barangays,
with little political or social function.
In Balilihan, Bohol, the lowly “purok” has been transformed into a powerful tool for
community mobilization and action, particularly
in the area of primary health care.
In 1998, then newly-elected Mayor Edgar Chatto
saw the potential of harnessing puroks as a main
force for the delivery of primary health care
services. Mayor Chatto launched the Balilihan
Countryside Action Program (CAP) with the aim
of mobilizing and organizing local government,
rural health units, health personnel and local
residents towards the more effective delivery of
basic services.
“PUROK POWER”
FOR PRIMARY
HEALTH CARE
Balilihan Countryside
Action Program
Balilihan, Bohol
The program had two core strategies:
1) capacity building at the municipal and barangay levels through training, to strengthen
such structures as the Municipal Development Council, the Municipal Council, the
Barangay Development Council, and
2) mobilizing and organizing households into puroks or health zones that would then
identify problems and needs, formulate actions and undertake programs at the purok
level.
Today, a total of 186 puroks have been established in the 31 barangays of Balilihan, with
1,302 sectoral volunteers organized and acting as a semi-autonomous extensions of the
local government. Some 50% of the population actively participates in purok activities,
including livelihood projects, health care services, feeding programs, vegetable and
herbal gardens. Various infrastructure projects have been undertaken, accessed by the
puroks themselves from the national line agencies through the support of the municipal
government. Most importantly, Balilihan has been able to meet 95% of its health and
nutrition targets.
In 1997, the municipal government of Balilihan approved an ordinance institutionalizing
the purok system in every barangay, thus ensuring its sustainability.
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Balilihan’s success has not gone unnoticed. In 1994, Balilihan won the Health and
Management Information System (HAMIS) Gold Medal awarded by the Department of
Health. The German Agency for Technical Cooperation (GTZ) recognized Balilihan as having
the most Outstanding Health Care Management Program in.
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Bantay sa Kahusay Ug Kalinaw (BKK): Oroquieta City, Misamis Occidental
ABOUT THE PROJECT
Project History: Turning Failure into Success
The idea of mobilizing puroks was
not new to Balilihan. The Rural Purok
Initiative, a strategy of the Department
of Health for rural health care was first
launched in 1983. The initiative did
not take off, however, mainly due to the
compartmentalized view and system for
delivering health care at the time and
the lack of support from the national and
local government. With the devolution
of health services, the time became ripe
for reviving the project.
The Purok system under the Baliliha’s CAP has been attracting
When Mayor Edgar Chatto assumed many visitors (e.g. healthworkers) for possible replication in their
office in 1988, he built on the beginnings
respective areas/LGUs
of the Rural Purok Initiative and drew in
other sectors to carry out a more holistic mode to development; he also gave it a new name -
the Countryside Action Program. One of the components of the Countryside Action program
was the Primary Health Care through Purok.
The primary health care component had 4 objectives:
1. Raise health consciousness among residents
2. Organize teams of purok-level volunteers that can assist the municipal health workers in
maximizing health services at the purok level
3. Encourage the design and implementation of purok-level livelihood projects
4. Mobilize human and material resources for networking with national agencies and NGOs
for the implementation of community-based health programs
Project Description: Power at the Purok Level
Capacity Building from the municipal to barangay level
The CAP framework departed from the usual top-down approach. The Mayor begun the
program by launching a series of capability-building programs. Among the first trained
were the municipal government officials and employees, the members of the Municipal
Development Council and local legislators. The Association of Barangay Chairs and the
Barangay Development Councils as well as other barangay officials also held their own
seminars on barangay administration, planning and project management.
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Residents also participated in training focused on sectoral concerns and technology
transfer.
Armed with new skills and attitudes, the municipal and barangay personnel were ready
to engage the municipality as partners in development. CAP was launched with its purok
system, giving spirit to empowerment through community organizing, mobilization and
human resource development.
Setting up the Purok Kiosks as Activity Centers
The target population of CAP was the 14, 527 residents in the 31 barangays of Balilihan.
These people were mostly marginal farmers of rice, corn and other staples. Each of the 31
barangays was divided into six (6) puroks composed of 10-25 households, resulting in a total
of 186 puroks of the entire municipality.
The main feature of the program that mobilized the community to participate was the
construction of cluster houses or Kiosks made up of indigenous materials. The Kiosk has
the features of a typical home and served as model for the members. Each Kiosk had the
following: 1) Meeting / teaching area; 2) Kitchen; 3) Water sealed toilet; 4) Seed house;
5) Compost pit / pile; 6) Herbal garden; and 7) Vegetable garden.
Constructing the kiosks in every purok became the starting point for the mobilization of the
community. With the kiosks constructed, they served as community centers for the conduct
of meetings and health activities such as immunization drives, operation Timbang (weighing
children to check for malnutrition), mass feeding, first aid treatment and training. These health
activities and the presence of a structure built by their own hands, in turn made it easier for
the community to move beyond health concerns to other community problems, such as
livelihood and income generation and cooperative formation. The kiosks made it easier for
people to congregate, and encouraged discussions on identifying problems and needs of the
community and how best to address them.
Each activity center or Kiosk has installed a system whereby residents take part in monitoring
their health conditions and addressing their conditions through problem-solving activities
with the purok leaders. Community members of each purok have set up systems for managing
and implementing activities. Among the systems put in place:
• Complete record of meetings
• Health data boards
• Household profiles
• Organizational charts
Purok leaders also coordinate with the Barangay and municipal health workers for health
campaigns, and with the barangay and municipal government for other activities. Puroks also
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Bantay sa Kahusay Ug Kalinaw (BKK): Oroquieta City, Misamis Occidental
network with national line agencies
for specific projects identified by the
puroks.
Project Results: A Kiosk in Every
Purok, Power in Every Community
1. Meeting Health and Livelihood
Needs
Today, each of the 186 puroks has
initiated an income-generating activity
for its members. In addition, puroks Barangay officials outside Bohol Province in a visit to one of the
also undertake other projects, such as
Kiosks under Balilihan’s CAP
vegetable and herbal gardens, compost
pits, seedhouses, water-sealed toilets. As a result of the livelihood projects, a 50% increase
in agricultural production was noted after 7 years of implementation.
This enabled the community to meet 95% of its health and nutrition targets. Various
infrastructure projects were undertaken by provincial and national government agencies.
2. Creating a New Social Institution
With its established puroks and currently 1,302 sectoral volunteers, the puroks now act
as semi-autonomous extensions of the government. With these purok-level organizations,
nearly 1 out of every six adult Balilihanhon is a sectoral volunteer. Each purok has an incomegenerating
project to complement the municipal government and other agencies budgets.
The Purok, then, has become a new social institution. During local elections, a candidate’s
performance in his/her respective purok became an important criterion for voters. It also
enhanced socialization because each Kiosk became a social hall.
In the Balilihan country action program, what was initially an attempt to provide basic health
services in the community itself, became a means to support and organize several community
goals:
• Making natural medicines available (through herbal gardens)
• Better general hygiene thereby preventing and reducing the prevalence of disease
• Livelihood activities so that families can increase their income and meet their basic
needs
• More productive and sustainable agricultural practices
• Specific mechanisms to ensure peace and order in the community
• Better waste management through composting initiatives
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REPLICATING THE PROJECT
Due to its success, Balilihan’s purok system has been replicated at the provincial level
when Mayor Chatto was elected vice-governor of Bohol. It is also being replicated by other
municipalities in and outside the province.
Key Implementation Steps
The following are the key implementation steps identified in implementing a similar
project.
1. Conceptualize, Get LGU approval
Create a Management Team that would develop a project proposal and push for the issuance
of an executive order or SB Resolution for the implementation of the project.
2. Capacity Building
Develop a capacity building program, in consultation with key sectors in the municipality/
city and barangay and municipal/city officials.
Among the training/capacity building that needs to be included in the program are:
Table 1. Municipal and Barangay Training
Municipal Level
• Reorientation on MDC functions, duties and
responsibilities
• Human resource development
• Effective local legislation
• Integrated evaluation and planning
Purok/Barangay Level
• Organizing of purok health zones or districts
• ABC strengthening
• Barangay administration (systems and
procedures)
• Reorganization of BDCs
• Training for barangay sectoral committees
(technology transfer for agriculture, health,
environmental protection, infrastructure,
education, livelihood)
• Project planning and evaluation
• Leadership training
• Primary health care
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Bantay sa Kahusay Ug Kalinaw (BKK): Oroquieta City, Misamis Occidental
3. Cluster barangays as district/ health
zones, assign district/health center
per zone
Begin the process of organizing
barangays into health zones, as well
as organizing puroks within each
barangay.
4. Construct Purok Kiosks as a first
step to mobilizing community
participation
Mobilize the community to participate
in the start-up activity of Building a
Kiosk in each Purok. This includes
organizing the community around the
following activities:
National line agencies like the Dept. of Education utilizing the
kiosk in delivering services like non-formal education, illiteracy
eradication, sanitation, etc.
• identifying strategic sites for the purok kiosk
• acquiring the lot (through donation or other means)
• kiosk construction
5. Mobilize and sustain community participation and project ownership
This includes holding regular meetings, electing purok leaders, holding regular capacity
building seminars, identifying health activities and other projects that the community would
like to pursue
6. Establish monitoring and evaluation system
Establish as system for monitoring and evaluation progress of the purok through annual
purok and barangay evaluations.
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Implementation Step Timeframe Budget*/Resources
Needed
1. Conceptualize, get LGU approval/Creation of the
Program in the LGU
1.1 Project Proposal/Program Outline
1.2 EO Order/SB Resolution
1.3 Creation of a Management team
2. Capacity building
Town level
2.1 Strengthening of the MDC for strong inter-agency
cooperation(seminar/training workshop)
2.2 Human Resource Devt Training
2.3 Effective local legislation (training for developed
responsive legislation)
2.4 Integrated evaluation and planning
District/health zone level
3. Cluster barangays as district/health zones for
convenient delivery of services and coordination
amongst units
Assign district/ health center per zone
1 month
1 day
1-3 days
1-3 days
3 days
2 days
1 day
1 week
15,000
25,000
45-47,000
5,000
60,000-70,000
Barangay level
- Strengthening of the ABC to enhance barangay linkages
- Barangay Administration Training
- Organization of Secretaries, Treasurers Federation
- Establishment of Barangay offices
- Reorganization of Barangay Development Council
- Training of Barangay sectoral committees
Purok level
- Purok Chairmen,Secretaries, Treasurers & Barangay
Health Workers Leadership Training
- Purok Health Care Workers
- Training on Primary Health Care
- Training for sectoral committees
4.Construct Purok kiosks or Activity Centers
5. Mobilize and sustain community participation and
project ownership
1 month
1-3 days
3 days
1 month
1 week
3 days per sector
(total of 21 days)
3-5 days
3 days
1 month
(identification to
construction)
Once a month
60,000- 65,000
100,000
50,000- 60,000
(bayanihan)
6. Establish monitoring and evaluation system Through
annual purok
an Barangay
evaluations
*Note:Budget/funds are sourced from the Local funds/LGU operations budget
12

Bantay sa Kahusay Ug Kalinaw (BKK): Oroquieta City, Misamis Occidental
Lessons and Insights in Replicating the Project
As Balilihan’s experience shows, the purok initiative can be a powerful tool for community
mobilization and is well suited for low income communities with scarce health and other
resources. The following elements need to be put in place in replicating Purok Power.
1. LGU assistance, strong leadership and commitment in capacity building of the
community
2. Engaging the community and encouraging the spirit of self help and empowerment
through building of purok kiosks mobilizing the community’s resources
3. Ensuring ownership and sustainability of project by helping the communities identify
their needs and projects, contribute their own labor and resources, and participate in
making major decisions.
4. Human resources, time and effort as the key inputs, not money.
5. Determining financial resources needed on a case to case basis by starting with minimal
resources and building investment over time.
6. Using incentives to secure peoples participation such as awards for most outstanding
purok with the following criteria:
7. Presence of health board – a color coded billboard using indicators that reflects the
health status of the community.
8. Ensuring that the purok centers act as information centers to keep the community
informed about the progress of their projects and activities.
9. Publishing gains of the puroks to keep spirit up at the community level and attract
investors.
10. Enacting a local ordinance to institutionalize the program.
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14

ANNEXES
“PUROK POWER” FOR PRIMARY HEALTH CARE
COUNTRYSIDE ACTION PROGRAM
Balilihan, Bohol

“Making Crime Prevention Everybody’s Business”
Annex A: Sample Ordinance Institutionalizing the Purok System
in the Balilihan Countryside Action Program: Delivery of Primary
Health Care through Purok
• Sample Ordinance with information on:
• Vision/Mission Statement of Balilihan, Bohol
• Institutionalization requirements
• Policy statement
• Composition of Officers
Republic of the Philippines
PROVINCE OF BOHOL
MUNICIPALITY OF BALILIHAN
Office of the Sanggunianag Bayan
ORDINANCE NO. 97-07
AN ORDINANCE INSTITUTIONALIZING THE PUROK SYSTEM IN THE BALILIHAN
COUNTRYSIDE ACTION PROGRAM IN EVERY BARANGAY WITHIN THE
MUNICIPALITY
(SPONSORED BY HON. AMBROSIO L. BAYUD)
BE IT ENACTED by the Sangguniang Bayan of Balilihan, Bohol in session assembled that:
Section 1. – This ordinance is called the “Purok System) Ordinance of the Municipality
of Balilihan, Bohol.
Section 11. – Policy Statement – It is the policy of the municipality of Balilihan,
Bohol to adopt the Countryside Action Program (CAP), a holistic approach to the delivery
of basic services to the constituents and a feed back mechanism with man as the focus of
development. CAP is implemented through the purok system in which all inhabitants shall
be members of a purok.
Section 111. – Vision-Mission Statement of Balilihan CAP.
Vision – a self-reliant community that has achieved a sustainable level of Physical,
Social, Economic, Cultural Environmental, Moral and Spiritual Development in an Atmosphere
of Peace.
Mission – to efficiently and effectively deliver the basic services with man as the
focus of development through the strengthening of the Local Government Bureaucracy and
Peoples Participation and Empowerment.
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Bantay sa Kahusay Ug Kalinaw (BKK): Oroquieta City, Misamis Occidental
Section 1V. – Institutionalizing of Purok in Every Barangay. The Purok serves as the
smallest unit of government in the municipality.
a) There shall be 6 (six) institutionalized purok in every barangay.
b) The barangay officials headed by the barangay catain shall divide the barangay
into six areas called puroks considering the number of households which are
situated in the purok’s jurisdiction.
c) All households situated within the defined area shall be registered as the members
of the particular purok expect Barangay Kagawads or Sectoral Officers & their
families who are assigned in another purok during their term of office.
d) Each purok shall have a “kiosk” where all members of the purok hold their monthly
meeting, and they are required to put up the following basic requirements:
1) Purok records and charts to include the minutes of the purok secretary,
BHW’s records and purok treasurer’s records.
2) Spot map
3) Purok kitchen
4) Purok comfort room
5) Vegetable garden
6) Herbal garden
7) Compost pit/pile
8) Purok label
9) Fence
Section V. – Composition of Officers. Every purok shall have the following officers:
1) Purok Chairman
2) Purok Secretary
3) Purok Treasurer
4) Sectoral Volunteers – (7)
a) Health – Volunteers Health Worker
b) Peace and Order – Barangay Tanod
c) Agriculture
d) Education
e) Livelihood and Environmental Protection
f) Youth
5) Others – like the Auditor and PRO.
All the purok officers, except the Purok Chairman who is the elected Barangay Kagawad
assigned to the particular purok, are chosen by the purok members from among themselves.
They function as volunteers in their respective areas of concern.
Section V1. – All officers and members shall meet once a month in their purok and
submit reports to the barangay captain and to the agencies concerned.
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Section V11. – Penal Clause. Any person who violates the provisions in this ordinance
shall be punished by:
a) Non-issuance of a purok clearance for whatever legal purpose it may serve, such
as a prerequisite for the issuance of a barangay clearance.
b) He is not entitled to any benefits, or privileged derived from the purok.
c) Fine of One Thousand Pesos (P1,000.00).
Section V111. – Any previous ordinance whose provisions are inconsistent with the
provisions in the ordinance shall be repealed or modified accordingly.
Section IX. – This ordinance shall take effect upon its approval.
APPROVED: NOVEMBER 12, 1997
A F F I R M A T I V E
(SGD) ESTEBAN L. CHATTO
SB Member
(SGD) AMBROSIO L. BAYUD
SB Member
(SGD) LORENZO L. BALIONG
SB Member
(SGD) AGAPITO R. GEANGAN
SB Member – ABC
(SGD) CONRADO M. IBARRA
SB Member
(SGD) LUIS S. VARQUEZ
SB Member
(SGD) RUPERTO H. BAQUERO
SB Member
(SGD) LORELIE T. CHATTO
SB Member – SK
NEGATIVE
NONE
CERTIFIED CORRECT:
(SGD) SALVIO JEROME M. MADANGUIT
SB Member, Presiding
ATTESTED:
(SGD) EXPECTACION M. QUIRONA
Clerk III
Acting Secretary
APPROVED:
(SGD) ELADIO I. CHATTO, SR.
Municipal Mayor
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Annex B: Sample Purok Membership Form
Purok membership form with information on:
• Name
• Age, place of birth, status
• Family members living in the area and members of the Purok
Bantay sa Kahusay Ug Kalinaw (BKK): Oroquieta City, Misamis Occidental
This is a requirement for those availing services under the Countryside Action Program (CAP).
One has to be a bonafide member of the Purok to avail the services available in the Kiosk.
(activity center).
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Annex C: Sample Purok Clearance (CAP in operation)
Purok Clearance
1. A certification stating that the person applying for Purok membership is a person with
good moral character and a law abiding citizen of the community.
2. This is a requirement in applying for Purok membership
Republic of the Philippines
PROVINCE OF BOHOL
MUNICIPALITY OF BALILIHAN
Barangay Del Carmen Weste
PUROK 1- TALONG
PUROK CLEARANCE
TO WHOM IT MAY CONCERN :
THIS IS TO CERTIFY that ________________________________________, a bonifide
resident of Barangay Del Carmen Weste, Balilihan, Bohol and a member of PUROK 1 –
TALONG of this Barangay is “cleared from all money and property accountabilities of the
Purok”.
This certifies further, that he/she is a person with good moral character and a lawabiding
citizen of the community.
This certification is issued to MR/MRS/MISS ____________________________ for
whatever legal purpose that this may serve.
Given this __________ th day of ___________________, 200 _____ at Purok 1 –
Talong, Barangay Del Carmen Weste, Balilihan, Bohol, Philippines.
RADIGUNDA H. GUMALO
Purok Chairman
ATTESTED :
AGAPITO R. GEANGAN
Barangay Captain
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