Across the Philippines, health leaders long struggled with gaps in civil registration and vital statistics (CRVS). Too often, deaths were recorded with vague or meaningless causes; “He stopped breathing” was one example noted by the Department of Health (DOH). As Assistant Secretary Maylene Beltran explained on data quality: “The problems that we faced were…the vagueness of information given during death registration.” Without accurate cause-of-death data, it was impossible to design policies that could prevent the next avoidable deaths. 

The Philippine Statistics Authority (PSA) pointed out that basic services like vaccination programs faltered because officials lacked clear numbers on births and deaths. “Without data, they cannot plan. And when they cannot plan, they cannot serve. They cannot provide basic services, goods to their constituents,” said Guillermo Lipio Jr., PSA Caraga’s Officer in Charge. These systemic data issues trickled down to the community level where local governments lacked the tools to plan vaccination programs effectively, and families paid the price through outbreaks of measles and other preventable diseases. 

In 2019, an increase in measles cases in Caraga Region and in 2023, an increase in pertussis (whooping cough) deaths in the Philippines, were identified largely through both CRVS and health surveillance systems (Philippines Integrated Disease Surveillance and Response System and the Field Health Services Information System). The measles cases and deaths prompted the DOH in Caraga to investigate further, and health officials found that vaccine coverage rates were disproportionately lower in geographically isolated areas.

Initial assumptions pointed to vaccine hesitancy, but local research conducted by health officials showed otherwise. Supported by the Data for Health Initiative and the DOH’s Health Policy Development and Planning Bureau, a team led by Dinnes Garcia, a senior health program officer in Caraga, studied the vaccine supply chain. Their findings were decisive: “We came to realize that if a Barangay Health Station (BHS) has electricity, cold chain equipment, a refrigerator to be exact, they tend to have higher vaccine coverage,” Garcia explained. Where vaccines were stored on site, mothers could access services even beyond the fixed schedule, and health workers could run additional sessions when demand spiked. The constraint was not the demand; it was the system. “We discovered that mothers are not that hesitant about our vaccines. In fact, they have high trust and high confidence in the vaccines that the Department of Health gives out.”

Instead, the barriers were structural. “One is the cost of travel. Secondly is the distance from their residence to the nearest health center that offers vaccination,” said Garcia. “In some areas, especially areas that do not have refrigerators or cold chain equipment, vaccination is only done once a month.” For families who missed that one day, the result was another month’s delay or an expensive trip to a distant Rural Health Unit (RHU). 

With support from the Bloomberg Philanthropies Data for Health Initiative, Caraga’s Data to Policy (D2P) team translated those findings into two options: 

• Status quo: continue point-to-point delivery from larger health facilities (Rural Health Units) to each local health care facilities (Barangay Health Stations), with limited, irregular sessions and high out-of-pocket burdens for families. 

• Satellite Vaccination Hubs: upgrade select local primary care facilities (Barangay Health Stations) into catchment “hubs” with refrigerators, backup generators, supplies, and training, increasing the frequency and reliability of services for surrounding stations. 

 

Armed with granular, local data that quantified both the human toll of pertussis and measles outbreaks and the cost-effectiveness of different vaccine delivery models, the team briefed the mayor, the municipal health officer, and other local government units. They presented cost scenarios and expected coverage outcomes under each policy option. Decision-makers endorsed the Satellite Vaccination Hubs approach because it promised fewer outbreaks, less strain on staff, and better protection for children and other at-risk groups. 

Within four months, the policy recommendation was adopted with the launch of a pilot at BHS Mahapag (Agusan del Sur), establishing it as a satellite hub serving five nearby Barangay Health Stations. While operational gains have increased immunization frequency from once a month to once or twice a week, the bigger success is the understanding and adoption of the principle that better data leads to better policy, and better policy leads to healthier lives.