Activating the Inter-Local Health Zone (ILHZ) to Deliver Community-Based Drug Rehabilitation and Mental Health Services

The project focused on the implementation of CBDR, an approach for helping low- to moderate-risk people who use drugs (PWUD) access treatment in the community. The Dangerous Drugs Board (DDB) issued Regulation No. 7 in 2016, which consolidated and updated the policies and procedures in managing PWUD who surrender to authorities. Consequently, PWUD screened as low- to moderate-risk could enroll in a CBDR program instead of being admitted to a rehabilitation facility. The municipality of Tolosa in Leyte Province improved its screening of PWUD and trained personnel of rural health units (RHUs) as facilitators who provide screening, brief intervention, and referral to treatment. The Tolosa local government unit (LGU) developed and proposed the establishment of a one-stop-shop facility (Lamrag Center) that will provide CBDR services to the component municipalities of Leyte Gulf and Golden Harvest ILHZs. The proposal included a CBDR network design that includes provincial and Department of Health (DOH) facilities operating in the area. It aimed to demonstrate networked primary care service provision in the context of Republic Act (RA) No. 11223, otherwise known as the Universal Health Care (UHC) Act. The Lamrag Center proposal eventually evolved into the proposed implementation of CBDR through the ILHZ modality. The documentation of the CBDR through Leyte ILHZs aimed to derive learnings from a network-type primary care service provision and, if shown to be a GPPI, to replicate the model in other areas. Additionally, the experience and practices in the ILHZ mode of delivering health services can be applied in designing a health care provider network (HCPN) or a primary care provider network (PCPN), as envisioned in the UHC Act. CBDR delivered through the Leyte ILHZ is an innovative model of service delivery through a network of health facilities. However, the proposed model is still in its preparatory and infancy phase. Nevertheless, the documentation yielded a number of recommendations to accelerate the growth of the intervention into a mature model. These recommendations include increasing buy-in for adopting an integrated CBMH-CBDR implementation mechanism through a network of ILHZs using heightened advocacy and groundwork among the local chief executives and the provincial health officer (PHO) of Leyte. The documentation also highlighted the importance of bundling the CBDR program with other primary care services, particularly CBMH, and implementing them through the ILHZ modality. This is based on the premise that the PWUD belongs to families, hence providing all the primary care services, including CBMH-CBDR, in specified ILHZ events. Furthermore, the documentation emphasized the need to increase the capacity of the ILHZs to provide CBDR services, including training and technical assistance, and to establish a monitoring and evaluation system to track the progress and outcomes of the intervention. The implementation of CBDR through the Leyte ILHZ has the potential to improve the health outcomes of PWUD and their families, particularly in the context of the UHC Act. The model can also be replicated in other areas, providing a scalable and sustainable solution to address the growing need for community-based drug rehabilitation services.