This proposal form part of the alternative budget on health presented before the Committee on Appropriations during the civil society presentation on the alternative budget.

1. Health Promotion andHealth Promotion and
Integrative HealthIntegrative Health
Care Sub-clusterCare Sub-cluster
Proposal for FY 2014Proposal for FY 2014
Alternative Budget Initiative (ABI) Health Cluster

2. Health Promotion and IntegrativeHealth Promotion and Integrative
Health Care Sub-clusterHealth Care Sub-cluster
Health promotion is the processHealth promotion is the process
of enabling people to increaseof enabling people to increase
control over their health and itscontrol over their health and its
determinants, and therebydeterminants, and thereby
improve their healthimprove their health
Ottawa Charter 1986

3. Health Promotion and IntegrativeHealth Promotion and Integrative
Health Care Sub-clusterHealth Care Sub-cluster
Integrative Health Care is awareness,Integrative Health Care is awareness,
a consciousness of viewing health as aa consciousness of viewing health as a
state of total well-being resultingstate of total well-being resulting
from the interplay of socio-economic,from the interplay of socio-economic,
political and spiritual aspects of life.political and spiritual aspects of life.
Basic to this consciousness is theBasic to this consciousness is the
understanding that health is aunderstanding that health is a
fundamental human right andfundamental human right and
responsibility of the individual and,responsibility of the individual and,
collectively, of the community.collectively, of the community.

4.  This PIM consciousness adheres to the integration ofThis PIM consciousness adheres to the integration of
different systems of medicine based on empirical anddifferent systems of medicine based on empirical and
scientific knowledge, rooted in the culture of the people.scientific knowledge, rooted in the culture of the people.
Such an integrated system addresses the health problems inSuch an integrated system addresses the health problems in
the community through promotive, preventive, curative andthe community through promotive, preventive, curative and
rehabilitative services, which are accessible, affordable,rehabilitative services, which are accessible, affordable,
available, effective and acceptable to the people.available, effective and acceptable to the people.
 PIM, as an evolving consciousness, emphasizes the direct,PIM, as an evolving consciousness, emphasizes the direct,
responsible and sustained participation of people in theresponsible and sustained participation of people in the
development of their alternative health care systems, andevelopment of their alternative health care systems, an
indicator of the fulfillment of their aspiration for self-indicator of the fulfillment of their aspiration for self-
determination.determination.
 Uses primary healthcare approach as a strategy (Alma-AtaUses primary healthcare approach as a strategy (Alma-Ata
Declaration)Declaration)
Influenced by INAM…Influenced by INAM…

5. Primary Healthcare ApproachPrimary Healthcare Approach
Essential health care based on practical,Essential health care based on practical,
scientifically sound and socially acceptable methodsscientifically sound and socially acceptable methods
and technology made universally accessible toand technology made universally accessible to
individuals and families in the community throughindividuals and families in the community through
their full participation and at a cost that thetheir full participation and at a cost that the
community and country can afford to maintain atcommunity and country can afford to maintain at
every stage of their development in the spirit of self-every stage of their development in the spirit of self-
reliance and self-determination. – Alma-atareliance and self-determination. – Alma-ata
DeclarationDeclaration

6. Primary care andPrimary care and
Primary HealthcarePrimary Healthcare
Primary Care, the shorter term, describes aPrimary Care, the shorter term, describes a
narrower concept of "family doctor-type" servicesnarrower concept of "family doctor-type" services
delivered to individuals. Primary Health Care is adelivered to individuals. Primary Health Care is a
broader term which derives from core principlesbroader term which derives from core principles
articulated by the World Health Organization andarticulated by the World Health Organization and
which describes an approach to health policy andwhich describes an approach to health policy and
service provision that includes both servicesservice provision that includes both services
delivered to individuals (Primary Care services) anddelivered to individuals (Primary Care services) and
population-level "public health-type" functions.population-level "public health-type" functions.
http://www.ncbi.nlm.nih.gov/pubmed/17120883

7. SITUATIONER/CONDITIONSITUATIONER/CONDITION
We are in a situation where the Philippine government’sWe are in a situation where the Philippine government’s
policy including its budget is greatly skewed towardspolicy including its budget is greatly skewed towards
the curative and conventional approaches of medicinethe curative and conventional approaches of medicine
and it has been happening for years now.and it has been happening for years now.
 More budget towards infrastructure/hospital/medicine-based kindsMore budget towards infrastructure/hospital/medicine-based kinds
of good and servicesof good and services
 No clear support for the traditional and alternative healthcareNo clear support for the traditional and alternative healthcare
Let’s review the current government’s policies onLet’s review the current government’s policies on
health…health…

8. Healthy population
Population at risk
Population with sickness
Sick that need hospitalization
but have no access to
hospital care
Sick and
hospitalized

9. Percentage of DOH BudgetPercentage of DOH Budget
Support for NCD’s and NCHPSupport for NCD’s and NCHP
YEAR NON-COM
%
(fr DOH
budget)
TOTAL
NCDPC
%
(NON COM
fr NCDPC
budget)
TOTAL
NCHP
%
(fr DOH
budget
TOTAL
DOH
2014
(Proposed)
677,891,00
0
0.85%
7,542,423,0
00
8.99%
165,227,00
0
0.21%
80,171,300,
000
2013 70,764,000 0.14%
6,736,124,0
00
1.05%
162,479,00
0
0.32%
50,442,
299,000
2012 68,766,000 0.16%
6,267,343,0
00
1.10%
153,230,00
0
0.36%
42,155,963,
000
2011 35,849,000 0.11%
5,342,956,0
00
0.67%
153,978,00
0
0.48%
31,828,616,
000
2010 35,849,000 0.14%
4,779,139,0
00
0.75%
172,322,00
0
0.70%
24,649,765,
000
2009 26,377,000 0.11%
4,509,107,0
00
0.58%
167,200,00
0
0.71%
23,666,655,
000

10. Budget of the NCHPBudget of the NCHP
Year PS MOOE CO Total
2011 14,618,000 139,360,000 153,978,000
2012 13,870,000 139,360,000 153,230,000
2013 17,952,000 144,527,000 162,249,000
2014
(NEP)
16,794,000 148,433,000 165,227,000

11. AQUINO HEALTH AGENDA (AHA)AQUINO HEALTH AGENDA (AHA)
The Universal Healthcare under Aquino AdminThe Universal Healthcare under Aquino Admin
Primary Health CarePrimary Health Care
Health Sector ReformHealth Sector Reform
Integrated Referral SystemIntegrated Referral System
National Health Insurance ProgramNational Health Insurance Program
(PhilHealth)(PhilHealth)

12. UHC for government is…UHC for government is…
Not a one-size-fits-all concept nor does coverageNot a one-size-fits-all concept nor does coverage
for all people necessarily mean coverage forfor all people necessarily mean coverage for
everything.everything.
Maintain coverage in three critical areas: who isMaintain coverage in three critical areas: who is
covered from pooled funds, what services arecovered from pooled funds, what services are
covered, and how much of the cost is covered.covered, and how much of the cost is covered.
Within this broad framework, we, the policyWithin this broad framework, we, the policy
makers, will have to decide how and how muchmakers, will have to decide how and how much
of the funds have to be raised and administered.of the funds have to be raised and administered.

13. UHC for government is…UHC for government is…
Improving the implementation of the NationalImproving the implementation of the National
Health Insurance Program by means of reforms inHealth Insurance Program by means of reforms in
PhilHealth’s operationsPhilHealth’s operations
Includes the enhancement of informationIncludes the enhancement of information
dissemination activities, streamlining processes todissemination activities, streamlining processes to
facilitate enrollment and other transactions forfacilitate enrollment and other transactions for
members, and mobilizing our burgeoning reservesmembers, and mobilizing our burgeoning reserves
to reduce out of pocket expenditures of itsto reduce out of pocket expenditures of its
members which may range from 60-90% of totalmembers which may range from 60-90% of total
hospital costs, depending on the disease incurred.hospital costs, depending on the disease incurred.

14. Furthermore UHC means…Furthermore UHC means…
Enhancing government healthEnhancing government health
facilities such as hospitals, ruralfacilities such as hospitals, rural
health units, health centers, andhealth units, health centers, and
placing able health workers toplacing able health workers to
operate these facilities, andoperate these facilities, and
stocking them with quality andstocking them with quality and
affordable medicinesaffordable medicines

15. StrategiesStrategies
 Public-private partnership to expand, upgrade, andPublic-private partnership to expand, upgrade, and
modernize our 25 major medical centers to the tune ofmodernize our 25 major medical centers to the tune of
several billion pesosseveral billion pesos
 United Nations European Commission for Europe (UNECE)United Nations European Commission for Europe (UNECE)
through its International PPP Center of Excellence just recentlythrough its International PPP Center of Excellence just recently
selected the Philippines to be the Specialist Center for PPP inselected the Philippines to be the Specialist Center for PPP in
HealthHealth
 Work closely with the other national governmentWork closely with the other national government
agencies, local governments, civil society and foreignagencies, local governments, civil society and foreign
development organization and the private sectordevelopment organization and the private sector

16. The three strategic thrusts:The three strategic thrusts:
Financial Risk Protection throughFinancial Risk Protection through
expansion in National Health Insuranceexpansion in National Health Insurance
Program enrollment and benefitProgram enrollment and benefit
deliverydelivery
Improved access to modern hospitalsImproved access to modern hospitals
and health facilitiesand health facilities
Attainment of health related MDGsAttainment of health related MDGs

17. Investing in KalusuganInvesting in Kalusugan
PangkalahatanPangkalahatan
pursuant to the Social Contract provisionspursuant to the Social Contract provisions
Investing in our people, reducingInvesting in our people, reducing
poverty and building nationalpoverty and building national
competitivenesscompetitiveness
Advancing and protecting public healthAdvancing and protecting public health
Building of capacities and creation ofBuilding of capacities and creation of
opportunities among the pooropportunities among the poor
Increasing social protectionIncreasing social protection

18. ISSUES AND CHALLENGESISSUES AND CHALLENGES
 People as patients ONLY not as partners in developing andPeople as patients ONLY not as partners in developing and
implementing healthcareimplementing healthcare
 Infrastructure and doctor-based; Skewed primarily toInfrastructure and doctor-based; Skewed primarily to
curative care rather than preventioncurative care rather than prevention
 Universal Healthcare equals universal coverageUniversal Healthcare equals universal coverage
 It does not extend to the underlying determinants ofIt does not extend to the underlying determinants of
health: food and nutrition, housing, access to safe &health: food and nutrition, housing, access to safe &
potable water & adequate sanitation, safe & healthypotable water & adequate sanitation, safe & healthy
working conditions, healthy environment, education &working conditions, healthy environment, education &
participation.participation.

19. ISSUES AND CHALLENGESISSUES AND CHALLENGES
 Devolution of our Healthcare SystemDevolution of our Healthcare System
 Fragmented Health FinancingFragmented Health Financing
 Mindset of DOH and LGU officialsMindset of DOH and LGU officials
 Supply-driven rather than needs-driven in procuringSupply-driven rather than needs-driven in procuring
medicines, vaccines, equipmentmedicines, vaccines, equipment
 Power dynamics between doctors and otherPower dynamics between doctors and other
conventional health practitioners and traditionalconventional health practitioners and traditional
health / holistic medicine practitionershealth / holistic medicine practitioners

20. NEEDSNEEDS
Since we are in a developing country with aSince we are in a developing country with a
limited resource, then we logically need morelimited resource, then we logically need more
interventions towards preventive and promotiveinterventions towards preventive and promotive
healthcare.healthcare.
We need affordable health goods and servicesWe need affordable health goods and services
such that there would be wide-range of optionssuch that there would be wide-range of options
especially to those who have less economicallyespecially to those who have less economically
(e.g. traditional, alternative healing modalities).(e.g. traditional, alternative healing modalities).

21. JUSTIFICATIONSJUSTIFICATIONS
To clarify, preventive measures not toTo clarify, preventive measures not to
get sick and not just controlling theget sick and not just controlling the
spread of diseases (e.g. Tips on How tospread of diseases (e.g. Tips on How to
Control Dengue by mosquito nets, etc.Control Dengue by mosquito nets, etc.
but rather focus more on properbut rather focus more on proper
nutrition like eating Malunggay andnutrition like eating Malunggay and
Camote Tops to strengthen resistanceCamote Tops to strengthen resistance
vs Dengue and other diseases).vs Dengue and other diseases).

22. VisionVision
Have a healthy citizenry for aHave a healthy citizenry for a
productive and fulfilling life!productive and fulfilling life!

23. ““We want a healthcare system , which is designed,We want a healthcare system , which is designed,
planned, implemented and evaluated by theplanned, implemented and evaluated by the
people/community members.”people/community members.”
People as principal actor, owner, participants andPeople as principal actor, owner, participants and
beneficiary.beneficiary.
Significantly reduced out-of-pocket expenses forSignificantly reduced out-of-pocket expenses for
healthcare.healthcare.
With this, what do we want ourWith this, what do we want our
healthcare system to become?healthcare system to become?

24. ““The people have the right and dutyThe people have the right and duty
to participate individually andto participate individually and
collectively in the planning andcollectively in the planning and
implementation of their healthcare.”implementation of their healthcare.”
It is the responsibility of the individual and,It is the responsibility of the individual and,
collectively, of the community.”collectively, of the community.”
Alma-ata Declaration during the International Conference on Primary
Healthcare at USSR, September 6-12, 1978

25. GOALGOAL
 For people to be at the heart of the healthcare system inFor people to be at the heart of the healthcare system in
terms of taking control and as informedterms of taking control and as informed
participants/beneficiary of the system.participants/beneficiary of the system.
 Access to affordable and quality healthcare for all.Access to affordable and quality healthcare for all.
 QualityQuality would mean:would mean:
 Wide range of choices of evidence-based, safe healthcareWide range of choices of evidence-based, safe healthcare
modalities / integration of different systems of medicinemodalities / integration of different systems of medicine
 Rooted in the culture of the peopleRooted in the culture of the people
 Preventive, promotive, curative and rehabilitative medicalPreventive, promotive, curative and rehabilitative medical
products and servicesproducts and services

26. The People’sThe People’s
Healthcare SystemHealthcare System
A Human Rights Based ApproachA Human Rights Based Approach
to Universal Health Careto Universal Health Care
through community-managed health plans
(CMHPs)

28. Health Promotion and Integrative Health CareHealth Promotion and Integrative Health Care
Sub-cluster: RecommendationsSub-cluster: Recommendations
1)1) Increase the support for Community HealthIncrease the support for Community Health
Team or CHTsTeam or CHTs
a.a. Provide training for interpersonal counseling andProvide training for interpersonal counseling and
community health education (preventing and curing basiccommunity health education (preventing and curing basic
illnesses using food , natural cures and home remedies)illnesses using food , natural cures and home remedies)
b.b. Provide additional allowance/incentive for personnel in theProvide additional allowance/incentive for personnel in the
CHT doing health promotion activitiesCHT doing health promotion activities
c.c. Accredit barangay health workers who will be doing healthAccredit barangay health workers who will be doing health
promotion activities.promotion activities.
d.d. Capacitate and employ additional health professionals toCapacitate and employ additional health professionals to
do health promotion at the community level (e.g. nurses)do health promotion at the community level (e.g. nurses)

29. Health Promotion and Integrative HealthHealth Promotion and Integrative Health
Care Sub-cluster: RecommendationsCare Sub-cluster: Recommendations
2)2) Provide specific funding for health promotionProvide specific funding for health promotion
activities (policy development to inform LGUs, andactivities (policy development to inform LGUs, and
provide training for better health education) thatprovide training for better health education) that
responds to NCDs (specifically diabetes,responds to NCDs (specifically diabetes,
hypertension, and cancers)hypertension, and cancers)
3)3) Provide a specific budget item for the convergenceProvide a specific budget item for the convergence
of stakeholders/inter-agency on health promotion-of stakeholders/inter-agency on health promotion-
related initiatives (health and non-health actors).related initiatives (health and non-health actors).
4)4) On the PITAHC budget, provide additional fundingOn the PITAHC budget, provide additional funding
for the standardization of herbal medicinefor the standardization of herbal medicine
preparations, improvement of awarenesspreparations, improvement of awareness
campaigns, and research and development.campaigns, and research and development.

30. Recommended Budget (DOH NCHP)Recommended Budget (DOH NCHP)
Program 2013 2014 (DOH proposed) 2014 (ABI Proposed)
Tobacco and
Alcohol Control
221 Million
Physical activities
and Exercise
58 Million
Healthy Eating
Options
44 Million
Exclusive
Breastfeeding
61 Million
Support to CHTs 7 Million
Support to
Various NCD
Programs
100 Million
Support to HP
Convergence
No suggestion pa
Total

31. Recommended Budget (PITAHC)Recommended Budget (PITAHC)
Program 2013 2014 (DOH
proposed)
2014 (ABI
Proposed)
Tobacco and Alcohol
Control
Physical activities
and Exercise
Total

32. Possible Sources of Additional FundsPossible Sources of Additional Funds
SinTax (provision on the attainment of MDGsSinTax (provision on the attainment of MDGs
and health awareness campaigns)and health awareness campaigns)
PDAFPDAF
Others (President’s Social Fund and other lumpOthers (President’s Social Fund and other lump
sums)sums)

33. Health Promotion and IntegrativeHealth Promotion and Integrative
Health Care Sub-clusterHealth Care Sub-cluster
Members:Members:
Fatima Cabanag (KAMAO/SENTRO)Fatima Cabanag (KAMAO/SENTRO)
Aida Ishikawa (Concern Inc.)Aida Ishikawa (Concern Inc.)
Mercy Cepe (Health Integrated Development and Services)Mercy Cepe (Health Integrated Development and Services)
Zella Pescadero (Philippine Nurses Association)Zella Pescadero (Philippine Nurses Association)
Marilyn Chaguile (SBSB)Marilyn Chaguile (SBSB)
Roger Broal (Earth Saver’s Movement)Roger Broal (Earth Saver’s Movement)
Jofti Villena (Sarilaya)Jofti Villena (Sarilaya)
Ronnel Lim (Healthcare without Harm)Ronnel Lim (Healthcare without Harm)
Elen Pedrosa (Alternative Health Foundation)Elen Pedrosa (Alternative Health Foundation)
Ralph Emerson Degollacion (HealthJustice)Ralph Emerson Degollacion (HealthJustice)

34. MARAMINGMARAMING
SALAMAT PO!SALAMAT PO!