A CITIZEN PARTICIPATORY AUDIT...5. DepEd Order No. 56, series of 2009, dated June 4, 2009, “Immediate Construction of Water and Hand Washing Facilities in All Schools for the Prevention

Republic of the Philippines COMMISSION ON AUDIT

Department of Education Division of Cagayan de Oro

Cagayan de Oro City

A CITIZEN PARTICIPATORY AUDIT


Department of Education Division of Cagayan de Oro

Cagayan de Oro City

IMPLEMENTATION OF WATER, SANITATION AND HYGIENE (WASH) IN PUBLIC SCHOOLS

A CITIZEN PARTICIPATORY AUDIT

TABLE OF CONTENTS

AUDIT IN BRIEF i ABBREVIATIONS AND ACRONYMS …………………………………………………………………. ii LETTER……………………………………………………………………………………………………………. iii

1.0 BACKGROUND …………………………………………………………………………………….. 1 2.0 AUDIT FOCUS ……………………………………………………………………………………….. 4 3.0 AUDIT OBJECTIVES ………………………………………………………………………………. 7 4.0 AUDIT CRITERIA …………………………………………………………………………………… 8 5.0 AUDIT SCOPE AND METHODOLOGY …………………………………………………………. 10 6.0 AUDIT PERIOD …………………………………………………………………………………………. 13 7.0 AUDIT TEAMS COMPOSITION …………………………………………………………………. 14 8.0 AUDIT RESULTS …………………………………………………………………………………….. 16

8.1 AUDIT OBSERVATIONS 8.2 AUDIT RECOMMENDATIONS FOR MANAGEMENT’S ACTION

8.3 MANAGEMENT'S COMMENTS 8.4 AUDIT TEAM’S EVALUATION AND REJOINDER

9.0 ACKNOWLEGEMENT …………………………………………………………………………. 69

APPENDICES:

APPENDIX 1: MAPS OF PUBLIC SCHOOLS: Appendix 1.1 Bulua Central School …………………………………………………….. 70

Appendix 1.2 City Central School ……………………………………………………….. 71 Appendix 1.3 Gusa Elementary School………………………………………………… 72 Appendix 1.4 Camaman-an Elementary School ………………………………….. 73 Appendix 1.5 Macabalan Elementary School ………………………………………. 74

APPENDIX 2: RESULTS OF SURVEY: Appendix 2.1 Students of BuluaCentral School…………………………………… 75

Appendix 2.2 Teachers of Bulua Central School………………………………….. 85 Appendix 2.3 Students of City Central School……………………………………… 94 Appendix 2.4 Teachers of City Central School……………………………………… 104 Appendix 2.5 Students of Camaman-an Elementay School…………………… 114 Appendix 2.6 Teachers of Camaman-an Elementary School………………… 124 Appendix 2.7 Students of Macabalan High School………………………………. 132 Appendix 2.8 Teachers of Macabalan High School……………………………….. 143 Appendix 2.9 Students of Gusa Elementary School…………………………….. 153 Appendix 2.10 Teachers of Gusa Elementary School…………………………… 163

APPENDIX 3: SURVEY QUESTIONNAIRES:

Appendix 3.1 Survey Questionnaires for Students………………………………… 171 Appendix 3.2 Survey Questionnaires for Teachers ………………………………. 177


Commonwealth Avenue, Quezon City

National Government Sector

Cluster 5 – Education and Employment

March 22, 2017

Dr. ELENA M. BORCILLO, Ph. D, CESO V

Schools Division Superintendent

Division of Cagayan de Oro City

Department of Education

Cagayan de Oro City

Dear Dr. Borcillo:

Pursuant to Section 2, Article IX-D of the Philippine Constitution of the Philippines

and Section 43 of the Government Auditing Code of the Philippines (Presidential Decree No.

1445), Audit Teams were created under Commission on Audit (COA) Office Order No. 2016-

001 dated January 30, 2016 to conduct a performance audit on the Water, Sanitation and

Hygiene (WASH) Project of the Department of Education (DepEd) implemented by five Public

Elementary Schools of the DepEd in COA Regional Office No. X, Cagayan de Oro City from

February 1 to May 31, 2016.

For this undertaking, we adopted the Citizens’ Participatory Audit technique in line

with the COA’s response to the call of the President of the Philippines for increased

transparency and citizens participation in government and invoking COA’s authority granted

by the 1987 Constitution “to define the scope of its audit and examination and establish the

techniques and methods required thereof”.

The audit observations and recommendations were discussed with the DepEd Schools

Divisions Superintendent (SDS), Officials of the Division of Cagayan de Oro City, School

Principals and Teachers in an exit conference conducted on April 5, 2016. Their

responses/comments were incorporated in the report where appropriate. The details of the audit

are contained in this Audit Report.

We wish to express our thanks to the SDS, School Principals and Teachers of the five

schools in Cagayan de Oro City for their cooperation and support extended to the Teams during

the audit. Likewise, we will appreciate receiving feedback on the status of implementation of

our audit recommendations within 30 days from receipt hereof.

Very truly yours,

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CITIZEN PARTICIPATORY AUDIT Water, Sanitation and Hygiene (WASH)

4. Audit Criteria: The standards/benchmarks used as basis for the evaluation and validation of the implementation of WASH programs in public schools include: 1. Implementing Rules and Regulations of Chapter VI-School Sanitation and Health Services of

the Code on Sanitation of the Philippines (P.D. 856) 2. DOH Administrative Order No. 2007-0007 dated January 3, 2007 - “Guidelines in the

Implementation of Oral Health Program for Public Health Services” 3. DepEd’s Universal Medical/Dental Check-Up Program dated March 30, 2005 4. DepEd Memorandum No. 277 s. 2009 dated June 18, 2009 - “Strengthening the Expanded

Universal Medical and Dental Check-Up in Schools” 5. DepEd Order No. 56, series of 2009, dated June 4, 2009, “Immediate Construction of Water

and Hand Washing Facilities in All Schools for the Prevention of the Influenza A (H1N1)”. 6. DepEd Order No. 66, series of 2009, dated June 23, 2009 - Addendum to DepED Order No.

56, series of 2009 identifies the three designs of lavatory counters. 7. DepEd Order No. 65, series of 2009, dated June 2, 2009 “Implementation of Essential Health

Care Program (EHCP) for the School Children”. 8. DepEd Order No. 61, series of 2011 dated August 5, 2011 “Use of the Monitoring Tool for

Essential Health Care Program”. 9. DBM-DepEd-DPWH Joint Circular 2013-1, dated February 18, 2013 10. DepEd Order No.45, series of 2015 - Eligible Activities and Expenditures include among

others the provision of personal hygiene, first aide, deworming, medicine.

5. Audit Methodology: The audit team conducted the evaluation of implementation of WASH programs in public schools adopting the following audit methodologies:

1. Gather, review and understand the following documents and reports 2. Conduct interview with the concerned officials of DepEd Division Offices, School Principals

and School Health Personnel, Students, Officials of LGUs, concerned officials of DOH, and other concerned officers and individuals

3. Select a sample of class of Grade 6 –Students and Teachers in five (5) public schools that will be subjected for survey.

4. Administer the Survey Questionnaires to selected respondents: Grade 6 Students and Teachers.

5. Validate the availability of hygiene materials such as soap, tooth brush, tooth brush holders and fluoride tooth paste for students of selected Grade 6 sections stored inside their classrooms

6. Conduct ocular inspection of water and sanitation facilities in selected five (5) public schools: (a) CY 2013 DepEd Implemented /Constructed Water Tanks and Hand Washing Facilities; (b) CY 2014 DPWH Implemented/Constructed Toilets and Hand Washing Facilities; (c) Toilets and Hand washing Facilities built inside the classrooms of selected Grade-6 Students

7. Data processing and analysis 8. Preparation of Audit Observation Memoranda based on audit results 9. Issuance of Audit Observation Memoranda. 10. Conduct of Exit Conference with concerned officials of DepEd Division of Cagayan De Oro

City and selected 5 public schools

11. Preparation , finalization and submission of Audit Report for review of Director-in-Charge

6. Audit Period: The audit shall be completed within three (3) months, broken down into two (2) months for audit planning and field work and one (1) month for report writing.

7. Audit Team Composition: Commission on Audit Civil Society Organizations

2. Audit Focus:

Adopts the Citizens Participatory Audit (CPA)

Approach to evaluate implementation of

WASH programs in five (5) selected public

Schools located in Cagayan de Oro City:

Bulua Central School

City Central School

Gusa Elementary School

Camaman-an Elementary School

Macabalan Elementary School

3. Audit Objectives:

1. Validate the purpose/functions and physical existence/conditions of the water and sanitation facilities.

2. Determine if there are adequate separate toilets. 3. Determine if there are toilets designed and

provided for persons with disabilities. 4. Determine/validate whether the implementation

of DepEd’s WASH Programs are effective and efficient.

5. Validate whether concerned officials of the leading agencies: DepEd, DPWH, LGU responsible for safeguarding sanitation in schools have become more proactive in implementing and monitoring sanitation policies in the public schools.

6. Ascertain that hand washing facilities projects of DPWH are properly turned-over to and accepted by concerned School Principals and concerned DepEd Officials.

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ABBREVIATIONS AND ACRONYMS

ANSA-EAP Affiliated Network for Social Accountability in East Asia and the Pacific

BEFF Basic Educational Facilities Fund

BOHC Basic Oral Health Care

COA Commission on Audit

COWD Cagayan de Oro Water District

CPA Citizens Participatory Audit

CSO Civil Society Organization

DepEd Department of Education

DOH Department of Health

DPWH Department of Public Works and Highways

EHCP Essential Health Care Program

FIT Fit for School

LGU Local Government Unit

MOOE Maintenance and Other Operating Expenses

PNSWD Philippine National Standards for Drinking Water

PTA Parents Teachers Association

PWD Persons With Disability

SBRMS School Based Repair and Maintenance Scheme

UMDC Universal Medical and Dental Check-up

UNICEF United Nations Children's Fund

WASH Water, Sanitation and Hygiene

WATSAN Water and Sanitation

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1.0 BACKGROUND

After family homes, schools are considered as important places for children where they spend long hours learning. Schools become risky of hygiene-related diseases causing harm to children, if water is inadequate or have inferior quality, if water and sanitation (WATSAN) facilities are inadequate or badly maintained and if children in schools lack oral health care and hygiene education and training.

To respond to water, sanitation and hygiene (WASH) in public schools, the Philippine Government has developed several WASH programs and policies through the years and identified the Department of Education (DepEd), Department of Health (DOH) and Department of Public Works and Highways (DPWH) as the three leading government agencies responsible for the implementation of the following school WASH policies, programs, activities and projects:

DOH, in line with its function, promotes the preservation of the health of the people and raises the health standards in schools through the issuance of the Implementing Rules and Regulations (IRR) of Chapter VI - School Sanitation and Health Services of the Code on Sanitation of the Philippines (PD No. 856) approved on April 28, 1998. It specifies the rules and regulations on school sanitation and health services, sanitary facilities requirements which include: toilet room requirement for pupils/students, water supply, care and maintenance of facilities.

In 2007, the DOH formulated the Guidelines in the Implementation of Oral Health Program for Public Health Services (AO 2007-0007). The program aims to reduce the prevalence rate of dental caries to 85 percent and periodontal disease by to 60 percent by the end of 2016. The program seeks to achieve these objectives by providing preventive, curative, and

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promotive dental health care to Filipinos through a lifecycle approach. This approach provides a continuum of quality care by establishing a package of essential basic oral health care (BOHC) for every lifecycle stage, starting from infancy to old age.

DepEd’s Universal Medical/Dental Check-Up Program dated March 30,

2005 intends to address two objectives: (1) Highlight the importance of good health among young children in school: To provide each child with a medical/dental record from Grade 1 onwards; (2) Advocate the need for parental participation in establishing good health among young children in school: The importance of health to good schooling.

DepEd Memorandum No. 277 series of 2009 dated June 18, 2009, known as

“Strengthening the Expanded Universal Medical and Dental Check-Up in Schools,” implements E-UMDC to underscore the need to promote good health and nutrition among pupils/students.

DepEd Order No. 56, series of 2009 dated June 4, 2009 was issued for “Immediate Construction of Water and Hand Washing Facilities in All Schools for the Prevention of the Influenza A (H1N1)”. All schools, regional and division offices are required to: (a) assess the availability of water sources at school level and ensure availability of running water and soap in schools; and (b) construct common hand washing facilities in schools to be sourced from Maintenance and Other Operating Expenses (MOOE) or School Based Repair and Maintenance Scheme (SBRMS) funds or from any available local funds.

DepEd Order No. 66, series of 2009 dated June 23, 2009 - Addendum to

DepEd Order No. 56, series of 2009 identifies the three designs of lavatory counters to wit: (a) Standard Hand Washing Counter with 10 units of faucets; (b) Type II-Hand Washing Counter with 5 units of faucets; (b) Type III-Hand Washing Counter for schools without existing running water.

DepEd Order No. 65, series of 2009 dated June 2, 2009 provides the guidelines for the “Implementation of Essential Health Care Program (EHCP) for the School Children”. The program aims to improve the health of school children and improve their academic performance through combining the three evidence–based preventive interventions, namely:

(a) Daily handwashing with soap; (b) Daily tooth brushing with fluoride toothpaste; and (c) Bi-annual deworming.

Regional Directors and School Division Superintendents of DepEd are advised to link with Local Government Units (LGUs) and jointly participate in the planning while the regional/division health and nutrition personnel and Adopt – A-School Program (ASP) coordinators are tasked to monitor the program and orient school principals and teachers for proper

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supervision/implementation of the daily handwashing with soap and tooth brushing with fluoride toothpaste. Moreover, Parent Teachers Associations (PTAs) are encouraged to establish handwashing / tooth brushing facilities, toothbrush holders and other improvements of the schools.

DepEd Order No. 61, series of 2011 dated August 5, 2011 prescribes the

“Use of the Monitoring Tool for Essential Health Care Program”. The DepEd together with United Nations Children’s Fund (UNICEF) and Fit For School (FIT) have developed EHCP Monitoring and Evaluation System to strengthen the school based management EHCP and assess properly the program coverage by utilizing a Monitoring Form with an Action Plan and On-line Monitoring System (OMS) as the necessary tools.

DepEd Order No. 94 series of 2011 dated November 29, 2011 provides the

“Guidelines on the Implementation of the Basic Educational Facilities Funds (BEFF)”. The DepEd Order includes, among others, the guidelines on the implementation of water and sanitation facilities to be funded under the DepEd BEFF. It indicates the standard designs available for toilets and hand washing facilities, considerations in constructing water facilities and sewage disposals of schools.

DBM-DepEd-DPWH Joint Circular No. 2013-1 dated February 18, 2013

prescribes the guidelines relative to the Implementation of the Special Provision (SP) No. 4 of the DPWH for the Basic Educational Facilities of the DepEd.

DepEd Order No. 24, series of 2015 covers the “Guidelines on the

Implementation of Bottom-Up-Budgeting (BUB) projects” which includes, among others, the construction of water and sanitation (WatSan) facilities of Fiscal Year (FY) 2014.

DepEd Order No. 45, series of 2015, “Guidelines on School Based

Management (SBM) Grants for FY 2014,” identifies Eligible Activities and Expenditures including, among others, the provisions of personal hygiene, first aide, deworming and medicine.

DepEd Order No. 87, series of 2015, “Approved School Building Projects under Calendar Years (CY) 2014 and 2015 Basic Educational Facilities Fund (BEFF)”, lists down the following construction projects under CY 2014 and 2015 BEFF which will be implemented by the DPWH:

a. BEFF 2014 construction of new classrooms with water and sanitation

facilities; b. BEFF 2015 construction of new classrooms with water and sanitation

facilities; c. BEFF 2015 construction of technical and vocational workshop buildings

for senior high schools.

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2.0 AUDIT FOCUS

The Citizens Participatory Audit (CPA) was the audit technique adopted and covered evaluation of implementation of WASH programs in five selected public schools located in Cagayan de Oro City, namely:

Bulua Central School City Central School Gusa Elementary School Camaman-an Elementary School Macabalan Elementary School

The water and sanitation facilities constructed in the five selected public schools under the DepEd Division of Cagayan de Oro City include:

Bulua Central School: Overhead steel water tank type I and Hand washing counter, 10 faucets

City Central School:

Overhead Steel water tank type 1 Camaman-an Elementary School:

Overhead Steel water tank type 1

Macabalan Elementary School:


Gusa Elementary School:


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The audit specifically focuses on evaluating the following:

Availability of water and sanitation facilities:

- Separate toilets for boys and girls - Separate toilets for students and teachers/non-teaching personnel - Provision of sanitation facilities accessible to persons with disability

(PWD)

Availability of supply of safe water: - Adequate/Regular supply of water and clean water for handwashing,

cleansing and toilet flushing - Submission of water samples to DOH accredited - laboratories for drinking water analysis

Utilization of the following CY 2013 DepEd implemented/ constructed water and sanitation facilities:

SCHOOL WATSAN FACILITY

Bulua Central School Overhead steel water tank type I and Hand washing counter, 10 faucets

City Central School Overhead Steel water tank type 1

Gusa Elementary School Overhead Steel water tank type 1

Camaman-An Elementary School Overhead Steel water tank type 1

Macabalan Elementary School Overhead Steel water tank type 1

Utilization of the following CY 2014 DPWH implemented / constructed

water and sanitation facilities:


Bulua Central School T-3 three seater (1B-1G-1PWD) with Handwashing Facilities and Septic Vault

City Central School Two (2) Units of T-3 three seater (1B-1G-1PWD) with Handwashing Facilities and Septic Vault

Gusa Elementary School T-3 three seater (1B-1G-1PWD) with Handwashing Facilities and Septic Vault

Camaman-An Elementary School

T-3 three seater (1B-1G-1PWD) with Handwashing Facilities and Septic Vault

Sustainability and Maintenance of water and sanitation facilities

- Repair and maintenance of water and sanitation facilities - Proper and regular maintenance of toilets and hand washing facilities

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Standards

- Hygiene education and training for students

Information dissemination

- Implementation of DepEd’s EHCP - Implementation of Oral / Dental Health Care Program of DepEd

Budget allocation for needed supplies and services

- Soap, tooth brush and fluoride toothpaste - Dental medicines and supplies - Janitorial services

Performance by Division Offices and Schools over the implementation and monitoring of DepEd’s WASH programs and projects as well as compliance to sanitation policies

Support provided by LGUs relative to DepED’s Sanitation Programs and Projects

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3.0 AUDIT OBJECTIVES

The CPA on DepEd’s implementation of WASH Programs has the following objectives:

1. To validate the purpose/function and physical existence/conditions of the

water and sanitation facilities constructed within the five selected public schools in Cagayan de Oro City;

2. To determine if there are adequate separate toilets for boys and girls; for

students and teachers/non-teaching personnel;

3. To determine if there are toilets designed and provided for persons with disabilities;

4. To determine/validate whether the programs implementation is effective

and efficient to guarantee:

Adequate, sufficient, clean, suitable facilities for the students Adequate and safe water supply Adequate supply of soap , tooth brush and fluoride tooth paste Proper Hygiene training and practices

- Tooth brushing - Hand washing

Oral/ Dental Health Care Services

5. To validate whether concerned officials of the leading agencies, such as: DepEd, DPWH, and LGU, which are responsible for safeguarding sanitation in schools, have become more pro-active in implementing and monitoring sanitation policies in the public schools; and

6. To ascertain that hand washing facility projects of DPWH are properly

turned-over to and accepted by concerned School Principals and concerned DepEd Officials.

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4.0 AUDIT CRITERIA

The guidelines, rules and regulations used as standards for the evaluation and validation of the implementation of WASH Programs in public schools include the following:

1. Implementing Rules and Regulations of Chapter VI-School Sanitation and Health Services of the Code on Sanitation of the Philippines (P.D. 856)

2. DOH Administrative Order No. 2007-0007 dated January 3, 2007:

“Guidelines in the Implementation of Oral Health Program for Public Health Services”

3. DepEd’s Universal Medical/Dental Check-Up Program dated March 30,

2015

4. DepEd Memorandum No. 277, series of 2009, dated June 18, 2009: “Strengthening the Expanded Universal Medical and Dental Check-Up in Schools”

5. DepEd Order No. 56, series of 2009, dated June 4, 2009: “Immediate

Construction of Water and Hand Washing Facilities in All Schools for the Prevention of the Influenza A (H1N1)”

6. DepEd Order No. 66, series of 2009, dated June 23, 2009: Addendum to

DepED Order No. 56, series of 2009

7. DepEd Order No. 65, series of 2009, dated June 2, 2009: “Implementation of Essential Health Care Program (EHCP) for the School Children”

8. DepEd Order No. 61, series of 2011, dated August 5, 2011: “Use of the

Monitoring Tool for Essential Health Care Program”

9. DBM-DepED-DPWH Joint Circular 2013-1 dated February 18, 2013: Guidelines relative to the Implementation of the Special Provision (SP) No. 4 on the Provisions of DPWH for the Basic Educational Facilities of the DepEd

10. DepEd Order No. 45, series of 2015: “Guidelines on School Based

Management (SBM) Grants for FY 2014”

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5.0 AUDIT SCOPE AND METHODOLOGY

The Audit Teams identified their audit scope and adopted their audit methodologies, as follows:

1. Understanding the WASH Program through gathering and understanding of

rules, regulations, standards, policies and necessary reports related to WASH, such as:

Philippine Government’s programs, standards and policies related to WASH

Status Report of Constructed Water and Sanitation Facilities (DPWH Implemented) prepared by DepEd Division Physical Facility Coordinator and Engineer

Status Report of Water Tanks and Hand Washing Facilities (DepEd Implemented) prepared by DepEd Division Physical Facility Coordinator and Engineer

Report on School’s Operating Budget

DepEd Division’s Budget and Financial Accountability Report

List of laboratories accredited by DOH for Drinking Water Analysis

2. Identifying and selecting the WASH Program recipients;

3. Inviting, selecting and engaging CSOs interested to participate as partners of COA;

4. Conducting Exploratory Meeting and Capacity Building Workshop

participated by COA and partner CSOs for agreements on:

Focus audit area

Methodology (use of sampling, survey questions and citizens report cards)

Audit Plan (planning, execution and communication and reporting)

Audit Program (audit objectives, procedures, timelines and tasking)

Survey Plan o Survey questionnaires (SQ) and citizens report cards (CRC)

formulated and simulated/tested o Sampling method adopted and selection of sample schools and

respondents

5. Performing field work to administer SQs and CRCs:

Groupings of enumerators (COA and CSO members)

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Briefing concerned DepEd officials/personnel conducted by Audit Teams

Administering the Survey Questionnaires to selected respondents:

School Respondents

Grade - 6 students

Grade - 6 Teachers

Bulua Central School 137 13

City Central School 251 13

Gusa Elementary School 107 7

Camaman-An Elementary School 96 9

Macabalan Elementary School 89 7

Total 644 49

Validating the availability of hygiene materials such as soap, tooth brush, tooth brush holders and fluoride tooth paste for students of selected Grade 6 sections inside their classrooms:

SCHOOL Selected Class/Section

Bulua Central School Grade 6- Section Osmeña Grade 6 – Section Garcia Grade 6- Section Roxas

City Central School

Grade 6- Section Virgo Grade 6 – Section Pegasus Grade 6- Section Nebula Grade 6- Section Cassiopeia Grade 6 – Section Sun

Gusa Elementary School Grade 6- Section Venus Grade 6 – Section Jupiter Grade 6- Section Sun

Camaman-An Elementary School Grade 6- Section Jade Grade 6 – Section Emerald

Macabalan Elementary School Grade 6- Section Mars Grade 6 – Section Saturn

Conducting ocular inspection of water and sanitation facilities in five (5) selected public schools: o CY 2013 DepEd Implemented /Constructed Water Tanks and Hand

Washing Facilities:


Bulua Central School Overhead steel water tank type I and Hand washing counter, 10 faucets

City Central School Overhead Steel water tank type 1

Gusa Elementary School Overhead Steel water tank type 1

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Camaman-An Elementary School Overhead Steel water tank type 1

Macabalan Elementary School Overhead Steel water tank type 1

o CY 2014 DPWH Implemented/Constructed Toilets and Hand

Washing Facilities


Bulua Central School T-3 three seater (1B-1G-1PWD) with Handwashing Facilities and Septic Vault

City Central School Two (2) Units of T-3 three seater (1B-1G-1PWD) with Handwashing Facilities and Septic Vault

Gusa Elementary School T-3 three seater (1B-1G-1PWD) with Handwashing Facilities and Septic Vault

Camaman-An Elementary School T-3 three seater (1B-1G-1PWD) with Handwashing Facilities and Septic Vault

o Toilets and Hand washing Facilities built inside the classrooms of

selected Grade-6 Students

Conducting interviews of selected officials of DepEd, DOH and LGUs, and some students on implementation of WASH Program;

Data processing and analysis: o Data encoding and tabulating answers obtained from survey of

students and teachers o Analyzing tabulated answers of SQs and CRCs o Documenting and summarizing survey results

6. Communicating audit results

Preparation of the Audit Observation Memoranda

Issuance of Audit Observation Memoranda to concerned officials of DepEd Division of Cagayan de Oro and five (5) selected public schools

Conduct of Exit Conference with concerned officials of DepEd Division of Cagayan De Oro City and five (5) selected public schools

Evaluation of Management’s comments and preparation of Audit Team’s Rejoinder

Preparation of Audit Report and its transmittal to DepEd officials.

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6.0 AUDIT PERIOD

The CPA was conducted from February to May 2016, broken down into two months for audit planning and field work and one month for report writing.

7.0 AUDIT TEAM COMPOSITION

There were four Audit Teams constituted to conduct the CPA. These are composed of the following:

Name and Office/Organization Designation / CPA Audit Assignment

A. Commission on Audit

Olivia C. Flores State Auditor IV/OIC, Regional Supervising Auditor COA-DEPED 10 /CHED 10

Team Supervisor for the four Audit Teams and Team Leader - Gusa Elementary School

Jocelyn Z. Yanilla State Auditor III-Audit Team Leader COA-Division of Misamis Oriental/ Cagayan de Oro

Team Leader, Camaman-an Elementary School and Macabalan Elementary School

Teresa A. Cabegin State Auditor II –Audit Team Member (ATM) COA-DEPED 10/ CHED 10

Team Leader, Bulua Central School

Lovely Melchita C. Macario State Auditor I -ATM COA-Division of Misamis Oriental/ Cagayan de Oro

Team Leader, City Central School

B. Civil Society Organizations A4 Mindanao Alliance Noel G. Butad Jeffrey Alia

Team Members , Gusa Elementary School

Ab2cd Inc. Harriet Villaroya Myra Quilab

Team Members, Gusa Elementary School

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Name and Office/Organization Designation / CPA Audit Assignment

XU KKP-SIO Nestor Banuag

Team Member - Bulua Central School

GoBugohanon Inc. Loremie Davis Angelita Davis Generosa Maghanoy

Team Members - Bulua Central School

Group Foundation Cristina W. Gamos Luzviminda E. Banaynal Rebecca T. Pastrano

Team Members - Macabalan Elementary School

Gusa Empowered Women in Action Bernadette P. Sarraga Margie R. Ognir Jovy O. Nabua

Team Members - Camaman-an Elementary School

Philcared Inc. Marivic de los Santos El Cisco Jun B. Ramos Maryjoy Dacu Sonia J. Chang

Team Members - City Central School

The CPA Teams composed of four (4) COA Auditors and eighteen (18) representatives from different Civil Society Organizations (CSO).

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8.0 AUDIT RESULTS : OBSERVATIONS, RECOMMENDATIONS, MANAGEMENT’S COMMENTS, AUDIT TEAM’S EVALUATION AND REJOINDER

1. The Implementing Rules and Regulations (IRR) of Schools’ Sanitation and Health Services of the Code on Sanitation of the Philippines (PD No. 856) have not been strictly enforced in the schools while implementation of DepEd’s Essential Health Care Program (EHCP) remains weak and has been devoid of budgetary support resulting in the following inadequacies/deficiencies:

a. Gender disaggregated toilets are inadequate.

b. There are no professional cleaners due to economic reasons requiring the

schools to utilize the labor of students to clean toilets and handwashing facilities.

c. Schools’ water system was declared potable or safe to drink even without

regular water examination by the DOH accredited water laboratory for drinking water analysis.

d. Budget allocation is insufficient for hygiene materials such as soap, tooth

brush and fluoride toothpaste.

e. The toothbrushes of students were not properly labelled and covered while the heads of the brushes stored in the holders were not exposed to the air allowing molds to grow within the covers and brushes.

f. The toothbrushes stored inside the classroom were not used by students;

instead, these brushes were stored for display only in the classroom.

g. The toothbrushes of students inside the plastic keeper were kept inside the teacher’s drawer to avoid interchange due to three shifting of classes. The toothbrushes are apparently unused and new in appearance.

h. The water and sanitation facilities inside the three classrooms selected for

inspection were badly maintained, not well ventilated and restricted for limited use.

i. There is lack of accessible or disabled friendly toilets depriving students of a

healthy physical school environment thereby affecting their health and ability to learn.

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Aiming towards improving the health of school children to all public schools, DepEd incorporated the Essential Health Care Program (EHCP) into the regular school activities. The program focuses on three interventions, to wit: (1) daily handwashing with soap; (2) daily tooth brushing with fluoride toothpaste; and (3) biannual deworming that greatly limit the occurrence and transmission of diseases and ailments among students.

With the support from LGUs, parents and non-government organizations, DepEd

commits to properly implement the EHCP to ensure that these interventions are correctly practiced by students and become lifelong healthy habits.

DepEd’s counterpart in terms of sanitation services is the DOH, Philippine’s

National Government Agency responsible to implement policies on basic sanitation, promotes the preservation of the health of the people and raises the health standards in schools through the issuance of the IRR of Chapter VI-School Sanitation and Health Services of the Code on Sanitation of the Philippines (PD No. 856).

Some of the pertinent rules and regulations on Water and Sanitation (WatSan)

Requirements stated in the IRR on School Sanitation and Health Services are summarized as follows:

1) Section 6.1.15 states that “Pupils shall be provided with toilet rooms

separate for each sex. The number of fixtures shall be as follows: Male Toilet:

Number of Male Pupils

Toilet Bowl Urinal Lavatory

Below 50 1 1 1

50 to 100 2 1 2

For each additional 100 males : one (1) toilet bowl, one (1) urinal, one (1) lavatory

Female Toilet:

Number of Male Pupils

Toilet Bowl Lavatory

Below 30 1 1

30 to 100 2 2

One (1) toiler bowl for each additional females

One (1) lavatory for each additional 100 females

2) Section 6.1.14 states that “Employees shall be provided with locker rooms

and toilet rooms separate for each sex”. The toilet requirements are:

Number of Persons


Female Male Female Male

1-29 1 1 1 1

Page | 16

Number of Persons


30-49 2 1 1 2 2

50-99 2 2 2 3 3

100 up One (1) fixture unit for each additional 50 employees

3) Section 6.1.13 d. Natural Ventilation: window space shall be at least 25

percent of the floor area of toilet room; Section 1.13.e. Mechanical Ventilation: Use of exhaust fun

4) Section 6.1.12 Toilet facilities shall be easily accessible to persons with disability.

5) Section 6.2.2 requires the maintenance of hand washing facilities and specifically provides the following:

6.2.2.a. An adequate supply of water and soap shall be provided at all

times. 6.2.2.c. The lavatory shall be maintained in good and clean condition.

6) Section 6.8.1 provides that it shall be the responsibility of the School

Administrator to assign custodial workers to manage housekeeping activities of the school and its premises.

7) Section 6.3 specifically provides the following rules and regulation on Water Supply:

6.3.1. The water supply shall be adequate and potable whether from public or from a private water supply system. The quality of water used shall be in accordance with the provisions of Chapter II – “Water Supply” of the Code of Sanitation of the Philippines and the Philippine National Standards for Drinking Water.

6.3.2 It shall be the duty of the school authorities to submit water samples for examination by a DOH accredited water laboratory. Frequent monitoring of water system shall also be done by the school administrator.

On February 2016, surveys on the implementation of the WASH Programs and inspection of WATSAN facilities built inside the classrooms were conducted by the Audit Teams in five public schools in Cagayan de Oro City, namely:

Bulua Central School; Camaman-an Elementary School; Macabalan Elementary School; City Central School; and Gusa Elementary School.

Page | 17

Results obtained through inspection and survey from selected Grade 6- Students and Teachers of the five public schools were carefully analyzed and evaluated by the Audit Teams noting the following inadequacies that adversely affect the health of the students and their ability to learn:

a. Results of Survey on the Implementation of DepEd’s WASH programs:

a.1. Gender disaggregated toilets are inadequate.

Survey results disclosed that 49 percent of the 644 Grade 6 students responded that there are no separate toilets for boys and girls in their schools. While survey conducted on 49 Grade 6 teachers disclosed that 63 percent responded that no dedicated or separate toilets are provided for male and female school personnel as shown in table below:

Are there separate toilets for boys and girls?

YES NO I DON'T KNOW

NO ANSWER

RESPONDENT

Bulua Central School 50% 48% 1% 1% 137 Grade-6 Students


19% 71% 10% 0% 96 Grade-6 Students


14% 80% 6% 0% 89 Grade-6 Students

City Central School 63% 32% 3% 2% 215 Grade-6 Students

Gusa Elementary School 16% 39% 6% 39% 107 Grade-6 Students

Total 39% 49% 5% 7% 644 Grade-6 Students

Is there a dedicated toilet for male and female school personnel?

YES NO I DON'T KNOW

NO ANSWER

RESPONDENT

Bulua Central School 38% 54% 0% 8% 13 Grade-6 Teachers

Camaman-an Elementary School 0% 89% 0% 11% 9 Grade-6 Teachers

Macabalan Elementary School 29% 71% 0% 0% 7 Grade-6 Teachers

City Central School 38% 38% 0% 24% 13 Grade-6 Teachers

Gusa Elementary School 38% 54% 0% 8% 7 Grade-6 Teachers

Total 30% 59% 0% 12% 49 Grade-6 Teachers

Page | 18

Moreover, survey further disclosed that majority of the students and teachers responded that there are no separate toilets for students and teachers in their schools, as shown in table below:

Are there separate

toilets for students/pupils and

teachers/school staff?

YES NO I DON'T KNOW

NO ANSWER

RESPONDENT



8% 69% 21% 2% 96 Grade-6 Students

Are there separate toilets for

students/pupils and teachers/school staff?

YES NO I DON'T KNOW

NO ANSWER

RESPONDENT


17% 54% 29% 0% 89 Grade-6 Students

City Central School 61% 31% 6% 2% 215 Grade-6 Students





0% 89% 0% 11% 9 Grade-6 Teachers



City Central School 46% 31% 0% 23% 13 Grade-6 Teachers



Ocular inspection conducted by the Audit Teams confirmed that majority of the toilet bowls in the five public schools are for common use and therefore being shared by both sexes of students and teachers. This set up does not follow the requirement of separate toilet rooms for students and employees for each sex, pursuant to Sections 6.1.14 and 6.1.15 of the IRR of PD 856 which requires the following separate toilet requirement for students and employees of schools:

Section 6.1.15: Pupils shall be provided with toilet rooms separate for each sex. The number of fixtures shall be as follows:

Male Toilet:

Number of Male Pupils Toilet Bowl Urinal Lavatory

Below 50 1 1 1

50 to 100 2 1 2

For each additional 100 males : one(1) toilet bowl, one(1) urinal, one(1) lavatory

Page | 19

Female Toilet:

Number of Male Pupils Toilet Bowl Lavatory

Below 30 1 1

30 to 100 2 2

One (1) toilet bowl for each additional females

One (1) lavatory for each additional 100 females

Section 6.1.14: Employees shall be provided with locker rooms and toilet rooms separate for each sex. The toilet requirement:

Number of Persons


Female Male Female Male

1-29 1 1 1 1

30-49 2 1 1 2 2

50-99 2 2 2 3 3

100 up One (1) fixture unit for each additional 50 employees

It was learned per interview from teachers that the communal toilet inside every classroom was built with the financial assistance given from Parents-Teachers Associations (PTA), and other donor organizations.

Majority of female respondents are more comfortable with separate toilets both for perceived safety and privacy reasons.

Failure to provide gender disaggregated toilets can be inconvenient for boys. Most of girls are likewise inconvenienced especially during their menstrual period where privacy is necessary. Also, bullying, intimidation and sometimes sexual harassment occur to girls unless separate toilets for girls and boys are provided.

We recommended the following for Management’s appropriate actions:

1. Revisit the IRR on School Sanitation and Health Services of the Code on Sanitation of the Philippines (PD No. 856) and comply with the policies stipulated therein. Adhere to the standard on Toilet Bowl to Pupil Ratio in the IRR of 1:49 males and 1:29 females. Moreover, employees of school must be provided with their own toilet rooms separate for each sex and following a toilet bowl to employee ratio of 1:49 for males and 1:29 for females.

2. Promote Gender Water and Sanitation Facilities by providing more separate

toilets and hand washing facilities for students and teachers.

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3. Encourage those who are interested to help the schools through “Adopt a School Program” and prioritize the gender water and sanitation facilities.

Management provided the following comments:

The Management of DepEd Division of Cagayan de Oro City acknowledged the observations and remained focused and determined in envisioning to meet the guidelines set by the DOH through its IRR on School Sanitation and Health Services of the Code on Sanitation of the Philippine.

Audit Teams’ Rejoinder

As soon as children enter the school grounds, their safety and security is one of the School Administration’s priorities. This safe learning environment must be maintained by a range of strategies designed to prevent harassment and bullying and promote positive relationships. Hence, the Audit Teams encouraged the DepEd to maintain a safe learning environment for students including teachers and non-teaching personnel by providing secured and safe school facilities such as separate toilets for female and male.

a.2. There are no professional cleaners due to economic reasons driving the four

public schools to utilize the labor of students to clean toilets and hand washing facilities.

Sections 6.2.2.c and 6.8.1 in the IRR, Chapter VI of PD No. 856 stipulate the requirements for maintenance of sanitation facilities in schools. This should guide the school administrators who are given the responsibility to make sure that sanitation facilities are maintained in good condition and assign professional cleaners or janitors to maintain the cleanliness of toilets and hand washing facilities on a daily basis.

However, results of surveys obtained from 555 Grade 6 students in four public schools disclosed that majority or 51 percent answered that Pupils are in charge of cleaning the toilets in schools on a daily basis as shown in tables below:

How regular

is the cleaning of the toilets?

ONCE A WEEK

EVERYDAY TWICE

A WEEK I DON'T KNOW

NO ANSWER

INVALID RESPONDENT


4% 90% 3% 1% 1% 1% 137 Grade-6

Students


7% 86% 1% 6% 0% 0% 96 Grade-6 Students

Page | 21

How regular is the

cleaning of the toilets?

ONCE A WEEK

EVERYDAY TWICE

A WEEK I DON'T KNOW

NO ANSWER

INVALID RESPONDENT

City Central School

4% 74% 3% 18% 1% 0% 215 Grade-6

Students

Gusa Central School

3% 16% 19% 63% 0% 0% 107 Grade-6

Students

Total 4% 69% 6% 20% 1% 0% 555 Grade-6

Students

Who cleans the toilets?

HIRED PEOPLE

SCHOOL VOLUNTEERS

PUPILS I DON’T KNOW

OTHERS NO

ANSWER RESPONDENT


1% 1% 96% 1% - 1% 137 Grade-6

Students


7% 2% 81% 10% - 0% 96 Grade-6

Students

City Central School

52% 6% 23% 15% - 4% 215 Grade-6

Students

Gusa Central School

3% 7% 23% 56%

9% 1%

107 Grade-6 Students

Total 22% 4% 51% 19% 2% 2% 555 Grade-6

Students

While majority of students in City Central School answered that there are hired people cleaning their toilets, interview result of the Audit Teams with some students disclosed that cleaning of toilets constructed inside the classrooms are being done by the respective students (for classrooms having their own toilets).

Maintaining the school’s water and sanitation facilities clean and in good condition should be a top priority due to health, safety and psychological effect it has on students and teachers.

It is imperative to protect the best interest of the school children at all times. Student’s cleaning participation should never be a “child labor”. Students should participate equally in cleaning in safe areas (e.g. inside classroom and corridors) where there is proper supervision by teachers and lesser risk of exposure to microorganisms that are commonly found in toilets.

Page | 22


1. Include the cost of repairs and maintenance of school facilities as an essential part of the schools’ annual plans and budget. Therefore DepEd should provide sufficient budget to finance and make the EHCP and other School’s Sanitation Programs sustainable.

2. For School administration, ensure efficient manpower through employing

janitorial services from professional cleaners or janitors for the up-keep and sanitation of school facilities so that students can practice effectively good hygiene.

3. For Teachers, (a) train and allow students to participate equally in cleaning

safe areas in the school (e.g. inside classroom and corridors) where there is proper teacher’s supervision; and (b) teach the students the proper use of WATSAN facilities while employing professional cleaners/janitors to keep the facilities always clean and in good condition.

Management provided the following Comments:

The School Principal of Camaman-an Elementary School explained that the hiring of professional cleaners was discouraged so that pupils can learn to clean the toilets inside their classrooms. Further, no budget was allocated for janitorial services.

During the exit conference with concerned officials of DepEd Division of Cagayan De Oro City, management explained that with limited budget for School’s Maintenance and Other Operating Expenses, no funds are available for janitorial services to clean toilets inside the classrooms. Management further explained that the cleaning of toilets by students is being allowed provided there is proper supervision by teachers.

Audit Team’s Rejoinder:

Care should be taken that students are not exploited. Allowing Grade-6 students to clean the toilets may teach the students the true value of labor and promote character building. However, cleaning school facilities especially toilets and handwashing counters without proper precaution expose the students to danger resulting from accidents caused by slippery wet toilet floors; and illness caused by microorganism such molds and bacteria underneath sinks, outside toilet bowls and floor drains.

Moreover, allowing students to clean the facilities may have a negative impact on the quality of cleaning because they are not skilled to combat the said dangers associated with an unclean toilets and/or hand washing counters.

Page | 23

Hence, to ensure that WATSAN facilities are properly maintained at the same time students are protected, it is necessary to have professional cleaners or janitors to keep the WATSAN facilities always clean and in good condition.

a.3. School’s water system was declared potable or safe to drink by selected students and teachers in three public schools, namely: (1) Bulua Central School; (2) Camaman-an Elementary School; and (3) Gusa Elementary School even without regular water examination by DOH accredited water laboratory for drinking water analysis.

Section 6.3 of the IRR of Chapter VI of PD No. 856 specifically states that:

6.3.1. The water supply shall be adequate and potable whether from

public or from a private water supply system. The quality of water used shall be in accordance with the provisions of Chapter II – “Water Supply” of the Code of Sanitation of the Philippines and the Philippine National Standards for Drinking Water.

6.3.2 It shall be the duty of the school authorities to submit water

samples for examination by a DOH accredited water laboratory. Frequent monitoring of water system shall also be done by the school administrator.

Survey results disclosed that majority of students and teachers of three public schools declared that their school’s water system is potable or safe to drink. They further responded that they are very satisfied with the water’s potability as shown in tables below:

Is the water in your school potable/safe to drink?

YES NO I DON'T KNOW

NO ANSWER

Respondent


Camaman-an Elementary School 31% 11% 58% 0% 96 Grade-6 Students



Is the water in your school potable/safe to drink?

YES NO I DON'T KNOW

NO ANSWER

Respondent


Camaman-an Elementary School 55% 33% 12% 0% 9 Grade-6 Teachers



Page | 24

How satisfied are

you with the portability/

drinkability of water in your

school?

NOT SATISFIED

MODERATELY SATISFIED

VERY SATISFIED

NO ANSWER

Respondent

Bulua Central School 6% 24% 69% 1% 137 Grade-6

Students


16% 74% 10% 0% 96 Grade-6

Students


25% 25% 25% 25% 107 Grade-6

Students

Total 15% 38% 38% 8% 340 Grade-6

Students

How satisfied are you with the portability/

drinkability of water in your

school?

NOT SATISFIED

MODERATELY SATISFIED

VERY SATISFIED

NO ANSWER

Respondent







One way of improving the water, sanitation and hygiene conditions is by providing the schools with safe drinking water. However, it is alarming to note from survey results that majority of students and teachers in the three schools: (1) Bulua Central School, (2) Camaman-an Elementary School and (3) Gusa Elementary School have considered their water system potable or safe to drink, even without the regular water examination for possible fecal coliform contamination by DOH accredited laboratories as listed in next page.

Page | 25

Further survey results disclosed that 84 percent to 86 percent and 100 percent of the students and teachers respectively responded that the tap water is the water that supplies the WATSAN facilities inside their classrooms as shown in tables in next page:

Bulua Central School:

If water is available

inside your

school, what is

the source?

TAP WATER/

MAIN WATER SUPPLY

WATER DISPENSER

DEEPWELL PUMP

MANUAL PUMP

WATERWELL

RAIN WATER

NO ANSWER

Respondent

85% 28% 1% 1% 1% 1% 2% 137 Grade-6

Students

100% 0% 0% 0% 0% 0% 0%

96 Grade-6 Students

Camaman-an Elementary School:

If water is available

inside your

school, what is

the source?

TAP WATER/

MAIN WATER SUPPLY

WATER DISPENSE

R

DEEP WELL PUMP

MANUAL PUMP

WATER WELL

RAIN WATER

NO ANSWER

Respondent

84% 11% 4% 0% 0% 1% 0% 13 Grade-6 Teachers

100% 0% 0% 0% 0% 0% 0%

9 Grade-6 Teachers

Page | 26

Gusa Elementary School If water is available

inside your

school, what is

the source?

TAP WATER/

MAIN WATER SUPPLY

WATER DISPENSE

R

DEEP WELL PUMP

MANUAL PUMP

WATER WELL

RAIN WATER

NO ANSWER

Respondent

86% 39% 2% 2% 28% 56% 1% 107 Grade-6

students

100% 0% 0% 0% 0% 0% 0% 7 Grade 6- teachers

The supply of tap water comes from the local water district and distributed through indoor plumbing. During rainy season, the risk of water contamination is higher as pipes usually get submerged in flood waters. If water pipes leaked, contaminants can easily seep into the pipes and caused contamination of the water. Contaminants such as fecal coliform contaminating the water could cause diarrhea, typhoid fever or amoebiasis and worst even death to infected human being.

Safe water supply and sanitation can significantly affect the health and well-being of school children. Sections 6.3.1 and 6.3.2 of the IRR of Chapter VI of PD No. 856 specifically state that water supply shall be adequate and potable whether from public or from a private water supply system and that it is the responsibility of the school authorities to submit water samples for examination by a DOH accredited water laboratory and at the same time frequent monitoring of water system shall be done by the school administrator.

It is imperative that safety in schools must be the top-of-mind of Teachers, Parents and Students. On the other hand, DepEd officials, health personnel and school principals must fully exercise their duties and responsibilities to keep both students and teachers safe.


1. Strictly require the school administration to submit regularly water samples for examination by a DOH accredited water laboratory and at the same time frequent monitoring of water system shall be done by the School Principal.

2. For DepEd Division Office through its Health Personnel (doctors, nurses, etc.),

assist and monitor the schools in their regular examination of school’s water system.


The School Principal of Bulua Central School informed that Cagayan De Oro City Water District (COWD) has certified the water supply in the school potable and safe for drinking and domestic purposes based on the standard limit set by Philippine

Page | 27

National Standards for Drinking Water (PNSDW) and water analysis conducted by COWD laboratory on February 9, 2016.

Audit Team’s Evaluation and Rejoinder:

Although the COWD has certified that the supply of water in Bulua Central School is potable and safe to drink, COWD laboratory is not accredited by DOH Regional Office to examine water samples for notability. As provided for under Section 6.3.2 of the IRR of Chapter VI of PD 856, it shall be the duty of the school authorities to submit water samples for examination by a DOH accredited water laboratory.

The DOH accredited laboratories include: PHO Water Analysis Laboratory; The First Analytical Services and Technical Cooperative; DOST-Regional Standards and Testing Laboratories; RIO Verde Consortium Inc.; Microbiology Research Laboratory; Northern Mindanao Medical Centre; AJ H20 Micro Lab.

Moreover, a program of frequent monitoring of water system should be done by the school administrator. According to the Philippine National Standards for Drinking Water 2007, the minimum frequency of sampling for Drinking Water Supply Systems for Microbiological Examination is as follows:

Source and Mode of Supply

Population Served Minimum Frequency of Sampling

Level I 90-150 Once in three months

Level II 600 Once in two months

Level III less than 5,000 1 sample monthly

5,000-100,000 1 sample per 5,000 population

More than 100,000

20 samples and additional one sample per 10,000 population monthly

Water Vending Machines (product water)

1 sample monthly

The Audit Teams encourage concerned officials of DepEd and Schools to ensure that students, teachers and non-teaching personnel have access to safe, free drinking water throughout the school environment and provide them a healthy alternative to sugar-sweetened beverages before, during, and after school.

a.4. Budget allocated by DepEd is insufficient for hygiene materials comprising of soap, toothbrush and fluoride toothpaste at P25.00 per child covering the entire school year; while the LGUs being one of the leading partners of DepEd in the proper implementation of schools’ sanitation programs failed to support the EHCP needed to improve the hygiene behavior and health of school children.

Page | 28

In 2009, DepED has initiated the EHCP aimed at improving the health of the students in public schools. Through this project, soap, toothbrush, tooth paste with fluoride will be provided for the conduct of daily hand washing and daily tooth brushing by all students in the elementary public schools. Guidelines in the implementation of the ECHP for school children are provided under DepEd Order No. 65, series of 2009. School principals are advised to establish a strong link and rapport with Local Government Units (LGU) and other stakeholders to provide proactive support for the EHCP while School Health Personnel are tasked to monitor and give feedback to teachers and to the principal on the status of implementation and make suggestions for improvement.

The LGUs, being one of the leading partners of DepEd in the proper implementation of school’s health and sanitation programs, failed to support the EHCP needed to improve the hygiene behavior and health of school children. In fact, majority of the students and teachers responded to the survey that school administration, parents, school volunteers and teachers have been at the forefront of providing soap, toothbrush and toothpaste needed for the daily personal hygiene activities of the school children as shown in tables below:

Have you received

the following?

SOAP TOOTHBRUSH TOOTHPASTE DID NOT RECEIVE

NO ANSWER

RESPONDENT

Bulua Central School 82% 92% 83% 1% 1%


Camaman-an Elementary School 27% 28% 19% 57% 0%

96 Grade-6 Students

City Central School 12% 6% 5% 84% 4%


Macabalan Elementary School 3% 3% 40% 57% 0%

89 Grade-6 Students


32% 46% 53% 15% 15%


Did your Students received

the following:

SOAP TOOTHBRUSH TOOTHPASTE DID NOT RECEIVE

NO ANSWER

RESPONDENT

Bulua Central School 100% 62% 85% 0% 0%


Camaman-an Elementary School 22% 11% 22% 77% 0%

96 Grade-6 Students

City Central School 0% 0% 0% 85% 15%



43% 28% 57% 14% 0% 89 Grade-6 Students


100% 62% 85% 0% 0%


Page | 29

From what source?

School Adminis-tration

Parents School

Volunteers Donations Government Teacher

I Don’t know

Others No

answer Respondents


43% 26% 11% 9% 14% 0% 18% 2% 2% 137Student

s

8% 54% 31% 15% 8% 23% 0% 0% 0% 13Teachers

Camaman-an

Elementary School

5% 23% 2% 4% 6% 0% 53% 1% 0% 96 Students

0% 11% 11% 0% 11% 0% 0% 0% 0% 9 Teachers

Macabalan Elementary

School

6% 3% 6% 9% 1% 0% 20% 0% 0% 89 Students

14% 28% 0% 28% 0% 0% 0% 0% 0% 7 Teachers

City Central School

6% 4% 1% 1% 4% 0% 36% 1% 48% 215

Students

0% 0% 0% 8%

0% 0% 0% 0% 92%

13 Teachers?

Gusa Elementary

School

73% 31% 37% 18% 50% 23% 15% 18% 2% 107 students

8% 54% 31% 15% 8% 23% 0% 0% 0% 7 teachers

In Bulua Central School, Camaman-an Elementary School and Gusa Elementary School, majority of students and teachers responded that they received soap, toothbrush and toothpaste from school administration, parents, school volunteers and teachers; however, we noted during inspection that hand washing counters built inside and outside the classrooms lack soap while most of students share fluoride toothpastes.

Interview with the teachers confirmed that their school has not been provided with financial assistance and other support from their respective LGU in undertaking the ECHP. However, it is worthy to note that Parents, School Volunteers and Teachers have been quick to respond to the assistance requested by the school administration for donation of hygiene materials needed for their students’ daily personal hygiene activities.

Random interview with students in City Central School and Macabalan Elementary School who were not chosen as respondents confirmed that they did not receive any soap, toothbrush or toothpaste coursed through the school. Their own personal hygiene kits, if any, were provided by their parents.

Because sanitation and hygiene practices have serious impact on child’s health and well-being, the intervention of providing hygiene materials for student beneficiaries comprising of preschoolers and Grades 1 to 6, must have sufficient budget to make the EHCP sustainable. However, we noted that for school year (SY) 2015-2016, DepEd allocated a very limited budget for hygiene material comprising of soap, toothbrush and fluoride toothpaste at P25.00 per child. With this limited budget and lack of support from LGU, the supply of hygiene materials will not be sufficient enough to cover for the daily personal hygiene activities of school children for the entire school year, preventing these students to practice effectively good hygiene.

Page | 30


1. For DepEd, to consider the EHCP as one of the top priorities to be allocated with sufficient budget to cover for the hygiene materials of school children needed to sustain the program and for each child to practice effectively good hygiene.

2. For the school administration, to improve linkage and encourage partnership with Local Government Units, Private Sectors and Non-Government Organizations, to ensure financial support; community involvement and promote/advocate school health on local, national and global level.


The Management of DepEd Division of Cagayan de Oro informed that a total of 4,066 school based feeding program received EHCP materials. Moreover Grade 1 pupils are recipient of Colgate Bright Smile Bright Future. Distribution of health materials are prioritized to pupils in lower grade levels because these pupils need more attention and are vulnerable to diseases.

Moreover the Management assured that they will find adequate funding to include all grade levels as beneficiaries of the EHCP materials.


In response to inadequate funding, the public schools are faced with great challenges in sustaining DepEd’s EHCP which started in year 2009.

Where hygiene materials are scarce, the success of EHCP in schools cannot be effectively achieved. School Health Personnel and Teachers cannot credibly convey the importance of handwashing and tooth brushing if there is no soap, fluoride toothpaste and toothbrush for students to use failing to develop the good hygiene behavior/practices.

The Audit Team hopes for the joint efforts of leading government agencies (DepEd, DBM, DOH and LGUs), parents and private organizations to help sustain the EHCP through adequate funding assistance that will provide for hygiene materials needed to be distributed to thousands of students in the public schools.

b. Results of the Ocular Inspection on Storing and Keeping of Toothbrushes of Students inside their Classrooms

How to store toothbrush can affect the oral health of students. If toothbrush is overrun with germs such as bacteria and mold due to improper storage, students may get infected causing them illness.

Page | 31

During our inspection we noted the following deficiencies in the respective schools:

BULUA CENTRAL SCHOOL

The toothbrushes of students under Grade 6 Sections Garcia and Roxas were

not properly labeled while some do not have covers.

This condition is prone to swapping or mixing up of brushes. When toothbrushes swapping occur, contaminated brushes with bacteria can be transmitted to students that cause illness.

The covers of toothbrushes belong to students under Section Osmeña don’t

have holes for air to circulate, allowing molds to grow within the covers and brushes. Moreover, the toothbrushes stored in holder of Grade 6 - Garcia were not exposed to air promoting growth of molds and bacteria.

Page | 32

CAMAMAN-AN ELEMENTARY SCHOOL

The students under Grade 6 Section Jade have only six toothbrushes and these do not belong to the students. No toothpaste nor toothpaste dispenser were found inside the classroom.

The toothbrushes stored in holder of Grade 6 Section Emerald, although

complete with toothbrush holder, do not belong to the class. These were brushes left behind by the previous students of the school and these were for display only.

GUSA ELEMENTARY SCHOOL

There was no cabinet or washstand for the toiletries, inside the room. However,

the teacher made their own design for the toothbrushes keeper but it showed that they are still unused as there are several users of the room (due to three

Page | 33

shifting of classrooms); instead, the items were kept in the teacher’s drawer. Each toothbrush was in the position marked/labelled for each student.

Toothbrushes of students were not properly displayed

No group tooth brushing done inside the classroom due to:

a) Shifting of classes – 3 shifts or sections use the room (shifting: 1st shift 6am to 9am, 2nd shift is 10am to 2pm and 3rd shift 2pm to 6 pm)

b) Time constraints: only four (4) class hours in every session which is insufficient time for other activities.

Because one of the main purposes of toothbrush is to remove bacteria from the mouth, it is important to keep the toothbrush sanitary and free from bacteria. The EHCP aims to improve the health of students through behavioral change. The role of teachers is vital to the success of the EHCP, because they are important instrument in bringing about the change.


1. Strictly advise the teachers to carry out their role as effective hygiene promoters and empower students to take leadership roles and responsibility so that hygiene will be practiced correctly;

2. Store toothbrush upright (bristles up, handle down) after use to allow water to drain from bristles easier and all the water and particles can dry out;

3. Provide toothbrush with cover having small holes and toothbrush holders for good ventilation, allowing air to circulate to prevent molds;

4. Properly design toothbrush holders so that other toothbrushes do not touch each other to prevent cross contamination;

5. Properly label each tooth brush and space of the holder with student’s names, to avoid swapping of toothbrushes among students; and

6. Always keep the toothbrushes and holder clean.

Page | 34


Management of DepEd Division of Cagayan de Oro acknowledged the findings and considered it as an eye-opener for them to intensify its monitoring of tooth brushing drills and ocular inspection of EHCP materials inside the classrooms.

The school administration of Bulua Central School assured that the recommendations will be given due importance by the teachers to correct the deficiencies noted by the Audit Teams.


Teachers play vital roles in the lives of the students in their classrooms. Teachers are best known for the role of educating the students that are placed in their care. Beyond that, the Audit Team believes that teachers serve many other roles in the classroom such as nurturing the health of students. The teachers are also responsible for the behavior of students in the classrooms and their actions towards hygiene care will have a positive or negative effect on students because student often mimic teacher’s action.

Because teacher’s proper supervision can bring changes in hygiene behavior and reduce hygiene-related diseases among students, the Audit Teams encourage the concerned health personnel of DepEd to re-orient the School Principals and Teachers on the proper supervision/implementation of the tooth brushing with fluoride toothpaste as well as the proper storage of tooth brushes of students. Daily tooth brushing with fluoride toothpaste is one of the interventions covered by DepEd’s Essential Health Care Program, the role of teachers is vital to the success of the program, hence, all concerned must ensure that this intervention is correctly practiced.

c. Results of Ocular Inspection of the WATSAN facilities built inside the classrooms by Parents, Teachers and other Private Donors

Favorable conditions are necessary for effective implementation of sanitation and hygiene programs in schools. Cleaning and maintenance of WATSAN facilities is imperative because a badly maintained toilet and hand washing facility often cause serious health risk. However, ocular inspection of WATSAN facilities built inside the classrooms disclosed unfavorable conditions:


Toilet used by students of class Section Garcia does not guarantee privacy and

safety because of holes in the door. In addition, pests such as rats, cockroaches and flies are not being prevented from entering inside the toilet because of the

Page | 35

openings in toilet wall and door. The presence of these pests in the toilet is not only a nuisance but could also spread diseases.

The toilet used by students belonging to class Section - Osmeña had a bad odor. Bad odor may be caused by molds and bacteria that breed together on floor drains and outside toilet bowls which can affect the health of students. It is also sad to note that students belong to class Section - Osmeña were limited/ restricted to access the toilet for their use. To deny the students the basic human need to eliminate body waste thru bowel movement can cause significant physical, emotional and psychological damage to students. Ignoring the urge to move bowel can result in serious discomfort and shame to the child.

The Class Adviser of Grade 6 Section Osmeña explained that the toilet has been

clogged for three days prior to the inspection conducted by the Audit Team. The poster with signage on the door served as caution to the students not to use the toilet due to clogged toilet bowl.

Cooking wares and pots must not be stored in the toilet for sanitary reasons;

however, the toilet of Class Section Roxas was also used as storage of rice cookers and other food containers which might fall off and hurt the students.

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The handwashing counters of Class Section - Garcia had a lot of stuff, such as rice containers, plastic containers, empty plastic coca-cola bottle, etc. crowding all over the counter and making no room for proper hygienic activities of students.

CAMAMAN-AN ELEMENTARY SCHOOL

Toilet used by students of Grade 6 class Jade does not guarantee privacy and safety because the door has no lock. In addition, the toilet has no window cover or grills for protection. There is also no provision for light and water and the toilet bowl is shared by boys and girls and even for the teacher. The toilet is so unclean and no maintenance at all.

The toilet used by students belonging to class Emerald is also very dirty. There’s faucet available but no water. The students fetched water outside for flushing the toilet bowl.

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GUSA ELEMENTARY SCHOOL:

The toilets built inside the three classrooms selected for inspection were badly maintained, not well ventilated and restricted for limited use which may cause serious health risk

There were no handwashing counters inside the classroom.

All the toilets inspected lack proper ventilation promoting growth of molds. Molds can cause many upper respiratory ailments, and can cause asthma attacks. Since many diseases are airborne, poor ventilation will allow these airborne diseases to build up, and cause illness. If school’s WATSAN facilities are badly maintained and used, then these become a health risk where diseases can be transmitted. Teachers can function as role models and greatly influence students’ hygiene behavior. Therefore, it is important that teachers implement behavioral changes on hygiene and lead the students on proper maintenance and use of facilities.


1. As role models for behavioral changes concerning hygiene, Teachers must ensure and keep WATSAN facilities always clean and properly maintained to reduce incidence of diseases.

2. Advise the School Principal and Teachers never to deny school children their basic human need such as access to defecate in toilets. Employ administrative sanctions to those school personnel responsible of depriving any child access to toilets.

3. The school administration must immediately employ appropriate repairs

and improvements of the toilets by:

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Covering all openings of the toilet to prevent pests such as rats, cockroaches and flies to get inside;

Fixing the toilet door to the safety and privacy of students’ and teachers; and

Providing proper ventilation of toilets pursuant to Section 6.1.13 d and e of IRR, PD No. 856 which provides as follows: Section 6. 1.13 d. Natural Ventilation: window space shall be at least 25% of the floor area of toilet room; and Section 6.1.13.e. Mechanical Ventilation: Use of exhaust fun.

4. Allocate enough funds to cover for repairs and maintenance of schools’

WATSAN facilities. For example, there must be funds to cover for the labor cost of professional cleaners who will be tasked to clean the WATSAN facilities.

5. Mobilize support from LGUs, parents and non-government organizations to

achieve and maintain a healthy physical school environment.


The School Administration of Camaman-an Elementary School admitted that the classrooms have not been in good condition and that repair has not been made due to lack of budget to fund repair expenses. The School Administration of Bulua Central School informed that attention of concerned advisers of the Grade 6 sections subjected to inspection concerning deficiencies noted in sanitation facilities inside the classrooms. Likewise, corresponding actions have been made to address such deficiencies. Moreover, the concerned advisers admitted that one toilet has been used as storage for the cooking wares instead of storing it within the classroom area to provide wider space for pupils.

Moving forward, Management of DepEd Division of Cagayan de Oro City committed to improve the sanitation facilities in schools.

Audit Team’s Rejoinder

Potable water and sanitation facilities in schools provide a healthy physical learning environment benefiting student’s learning and health. However, the mere provision of sanitation facilities does not make them sustainable or produce the desired impact. It is the use of these sanitation facilities and the related appropriate

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hygiene behaviors of teachers and students that provide health benefits. Teachers being the second parents in school have the responsibility to protect the students from any physical, emotional and psychological harm. It is for this reason that Teachers must train students the correct hygiene practices and the proper use and maintenance of sanitation facilities to prevent water and sanitation-related diseases as well as promote healthy behavior.

d. There is lack of accessible toilets for persons with disabilities (PWD).

Section.1.12 of the IRR of PD No. 856 provides that toilet facilities shall be easily accessible to persons with disability. During our evaluation of WATSAN facilities, it was noted that only one toilet located several meters away from the school buildings for each of the four schools. The said toilet was constructed by the DPWH in year 2014, but school administration locked the toilet because it was found to be defective preventing students with disabilities to use the facility for their basic human needs. In Macabalan Elementary School, there are no toilets accessible for disabled students and teachers.

The special needs of students with disabilities must be taken into consideration in facility design and construction. The needs of these students are often neglected and excluded from basic school facilities. The lack of accessible or disabled-friendly toilets in schools may deter these students from attending schools because the school did not provide them with services to address their special needs (e.g. special grips guiding system, wider toilet doors and proper lighting system)

We recommended the following for Management’s action:

1. Consider the special needs of students with disabilities by adapting the following: For students having poor vision, install special grips and proper lightning

system in the toilets.

For students with crutches or wheelchairs, a wider toilet door is needed.

2. Add more disabled-friendly WATSAN facilities and encourage disabled children to enroll and attend school.

Management provided the following comments: Management acknowledged the observations and is determined to meet the guidelines set by the DOH through its issuance of the IRR of School Sanitation and Health Services of the Philippines.

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The Audit Teams hope that DepEd includes all essential elements to support the

PWD students. Students with disabilities enroll in schools and gain new experiences

and way of life. In understanding their needs, the schools must provide toilets for

their special needs such as but not limited to provisions for grab bars inside the

toilets to increase safe accessibility and mobility. It must also be spacious so that

students on wheelchair can use toilets easily. Thus, PWD students can be provided

with hygienic and safe sanitary experience within the school.

2. The oral health care program in public schools remains weak which is attributed to

lack of oral/dental medicines and supplies and shortage of dentist to check the oral health needs as well as improve the oral health conditions of public school learners in Cagayan de Oro City contrary to the DepEd and DOH guidelines and policies to promote quality oral health care. These conditions likewise pose detrimental effects with oral disease continuous to be a serious health problem among Filipino school children affecting their school performance.

According to the DOH, the oral health status of Filipino children is alarming. The 2006 National Oral Health Survey (NOHS) revealed that 97.1 percent of six year old children suffer from tooth decay. More than four out of every five children of this subgroup manifested symptoms of dentinogenic infection. In addition, 78.4 percent of twelve-year-old children suffer from dental caries and 49.7 percent of the same age group manifested symptoms of dentinogenic infections. Filipinos bear the burden of gum diseases early in their childhood. According to NOHS, 74 percent of twelve-year-old children suffer from gingivitis. If not treated early, these children become susceptible to irreversible periodontal disease as they enter adolescence and approach adulthood.

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DOH further informed that poor oral health poses detrimental effects on school performance. In fact, children who suffer from poor oral health are 12 times more likely to have restricted-activity days. In the Philippines, toothache is a common ailment among schoolchildren, and is the primary cause of absenteeism from school. Indeed, dental and oral diseases is an epidemic, placing a heavy burden on Filipino schoolchildren.

To respond to oral health and hygiene in public schools, the Philippine Government has developed several oral health guidelines through the years which include as follows:

a. In 2007, the DOH formulated the Guidelines in the Implementation of Oral Health

Program for Public Health Services (AO 2007-0007). The program aims to reduce the prevalence rate of dental caries to 85 percent and periodontal disease to 60 percent by the end of 2016. The program seeks to achieve these objectives by providing preventive, curative, and promotive dental health care to Filipinos through a lifecycle approach. This approach provides a continuum of quality care by establishing a package of essential basic oral health care (BOHC) for every lifecycle stage, starting from infancy to old age.

The basic package of essential oral health services/care for every lifecycle group to be provided either in health facilities, schools or at home is shown in Table 1:

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Table 1:

LIFECYCLE TYPES OF SERVICE

(Basic Oral Health Care Package)

Mother(Pregnant Women)

Oral Examination Oral Prophylaxis (scaling) Permanent fillings Gum treatment Health instruction

Neonatal and Infants under 1 year old

Dental check-up as soon as the first tooth erupts

Health instructions on infant oral health care and advise on exclusive breastfeeding

Children 12-71 months old

Dental check-up as soon as the first tooth appears and every 6 months thereafter

Supervised tooth brushing drills Oral Urgent Treatment (OUT) Application of Atraumatic Restorative

Treatment (ART)

School Children (6-12 years old)

Oral Examination Supervising tooth brushing drills Topical fluoride therapy Pits and Fissure Sealant Application Oral Prophylaxis Permanent Fillings

Adolescent and Youth (10-24 years old)

Oral Examination Health promotion and education on oral

hygiene, and adverse effect on consumption of sweets and sugary beverages, tobacco and alcohol

Other Adults (25-59 years old)

Oral Examination Emergency dental treatment Health instruction and advice Referrals

Older Person (60 years old and above)

Oral Examination Extraction of unsavable tooth Gum treatment Relief of Pain Health instruction and advice

b. Sections 11.1.1 and 11.2.1 of the IRR of Chapter VI-School Sanitation and Health

Services of the Code on Sanitation of the Philippines provides that:

Section 11.1.1 Teaching and Non-teaching personnel of the school shall undergo annual physical, medical and dental check-up

Section 11.2.1 All pupils/students enrolled in the school shall undergo physical, medical and dental examination annually

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c. DepEd’s Universal Medical/Dental Check-Up Program dated March 30,2005

intends to address two obj

Documents

A CITIZEN PARTICIPATORY AUDIT...5. DepEd Order No. 56, series of 2009, dated June 4, 2009, “Immediate Construction of Water and Hand Washing Facilities in All Schools for the Prevention