Second National Communications Contraceptive Prevalence Rate 28% 28% 60% TB Case Detection Rate 67% 65% 70% 89/100,000 94/100,000 92/100,000 90% 91% 85% TB Case Notification Rate TB Cure Rate Anoth er adaptation mechanism gathered was the development of a provincial strategic communication plan where technical assistance will be directed at expanding private-public sector partnerships in health service delivery. Inclusions will be in the enhancement of LGU use of interpersonal communication groups, mass media, traditional media and emerging communication technologies to convey messages for behavior change. Evaluation and sustainability of quality local health promotion and communication initiatives will also be done. Towards population management in consideration of future climate change impacts, a strengthening of the LGU response to Contraceptive Self Reliance (CSR) through the implementation of their CSR Plans. This technical assistance will focus on interventions that will ensure safety nets for the poor, availability of whole range of Family Planning services, and increasing private sector alternatives for FP services. Jagna and Tagbilaran ILHZs, low performers on FP indicators, will be the priority areas to receive specific TAs on CSR implementation. It was noted that of those diseases prevalent in Bohol, Schistosomiasis has figured relatively high. As early as 1989, studies noted that the continuous wet weather33 was a reason for the increase (7 new snail breeding sites discovered) in the number of cases. While it is not considered an epidemic, it is endemic in the island. Adaptation mechanisms couched in recommendations were already being suggested in a review of the disease in 2004: the development of strategies on environmental sanitation and snail control/eradication in the thrust of the Schistosomiasis control program. Other policy related concerns should be formulated subject to the results of further research activities such as on (a) chemotherapy; (b) drug delivery schemes; (c) diagnosis; (d) search for a safe, economical and effective chemical(s) for vector control; and (e) prophylaxis and vaccine production for protection against infection for disease modulation or reduction of pathology.34 Schistosomiasis vaccines as an adaptation to the disease are being discussed by clinicians as a possible response to the growing resistance to praziquantrel, the mainstay drug of choice for the treatment; also to the problem of re-infection even after completion of treatment. It will need an improved understanding of the immune response to the schistosome infection, both in animal models and in humans. Yasuraoka, K Et.al., Schistosomiasis on Bohol Island, Philippines, with special emphasis on the successful discovery of new habitats of the vector snail, Oncomelania quadrasi, and area-wide mollusciciding. Japan J. Exp Med 1989 Aug;59(4):149-55. 33 34 Blas BL Et.Al., The Schistosomisais problem in the Philippines: A review. Parasitology International. 2004 Jun;53(2):12734.Avaialble from http://www.ncbi.nlm.nih.gov/pubmed/15081944?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel. Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=5&log$=relatedreviews&logdbfrom=pubmed 24