Global Presence

The Philippines Local Enhancement and Development for Health (LEAD) Project is a three-year project funded by the US Agency for International Development (USAID) assisting local governments to improve delivery and financing of family planning, tuberculosis (TB) treatment, HIV/AIDS surveillance, and Vitamin A and maternal and child health services. Since 1990, MSH has implemented six projects in the Phillipines-LEAD is its largest. LEAD also has ambitious goals to assist in the following areas: reducing total fertility, increasing use of modern method contraceptives, improving TB treatment success rates, and maintaining low HIV/AIDS seroprevalence rates.

LEAD's main clients, local government units (LGUs), took on a key role in health service delivery in 1993 when the Philippines accomplished a radical devolution of health services. Under this new alignment of responsibilities, over 1,600 LGUs-representing provinces, cities, and municipalities-assumed responsibility for the delivery of most health services. LEAD will work with up to 530 local governments, representing up to 40% of the total population. To provide integrated technical assistance to local governments, LEAD is partnering with the Department of Health (DOH), the Population Commission, and the Philippines Health Insurance Corporation (PhilHealth).

Under LEAD, MSH is helping LGUs to strengthen their financial, managerial, and technical capacity to provide family planning and selected health services, while improving the policy and legislative framework at both national and local levels to finance and support these programs. MSH has introduced some innovative approaches to work with local chief executives and local legislatures, along with local and national health personnel. Upon USAID approval, MSH plans to administer performance-based grants to most of the participating LGUs. These grants will provide incentives for LGUs to improve their performance in delivering and financing the specific health services.

One of LEAD's priority areas will be to work in selected provinces of Mindanao, particularly in the Autonomous Region of Muslim Mindanao, which has poorer health indicators than many other regions. LEAD will also focus on assuring sustainable results through collaboration between public and private providers, as well as partnering with PhilHealth to achieve universal coverage by social health insurance, with a strong emphasis on serving the indigent population. As more Filipinos enroll in the social health insurance plan, they will be able to access outpatient services for family planning, Tuberculosis direct observation treatment short-course ( TB DOTS) and other basic health services.

The LEAD Project has adopted specific principles that will assist it to achieve rapid startup and large-scale operations. By working closely with stakeholders at all levels, adapting-rather than developing-tools and techniques, using local subcontracts,and using the most cost-effective methods of providing technical assistance.

As LEAD works to improve national and local level policies to facilitate efficient delivery of quality family planning and selected health services, it will work with LGUs to find alternative modes of financing contraceptives to reduce the Philippines' reliance on donated contraceptive commodities that USAID is phasing out over a seven-year period.

MSH is working on LEAD with ARD Inc., Save the Children, JHPIEGO, Harvard School of Public Health, Manoff Associates, the Center for Economic Policy Research (CEPR), and Technical Assistance, Inc., plus a large number of small local subcontractors and consultants.