THE PHILIPPINE HEALTH CARE DELIVERY SYSTEM.pptx

THE PHILIPPINE
HEALTH CARE
DELIVERY SYSTEM
By: ROMMEL LUIS C. ISRAEL III

MAJOR
PLAYERS
2
Public health nursing in the Philippines. (2007). Manila]
National League Of Philippine Government Nurses.

MAJOR PLAYERS
COMPOSED OF 2 SECTORS:
1. PUBLIC SECTOR
- largely financed through a tax-based budgeting system at both
national and local levels and where health care is generally given
free at the point of service
2. PRIVATE SECTOR
- for profit and non-profit providers
- largely market –oriented
- health care is paid through user fees at the point of service
3

THE DEPARTMENT OF
HEALTH
• Mandated as the lead
agency in health
• It has a field office in every
region and maintains
specialty hospitals regional
hospitals and medical
centers
Public health nursing in the Philippines. (2007). Manila] National League Of
Philippine Government Nurses. 4
This Photo by Unknown author is licensed under CC BY.

THE DEPARTMENT OF
HEALTH
• It also maintains provincial
health teams made up of
DOH representatives to the
local health boards and
personnel involved in
communicable disease
control, especially for Malaria
and Schistosomiasis

THE DEPARTMENT OF
HEALTH
• Other national agencies
providing health care
services such as the
Philippine General Hospital
are also part of this sector

DEVOLUTION OF HEALTH
SEERVICES
LOCAL HEALTH SYSTEM
• Run by LGUs (Local Government
Units)
PROVINCIAL DISTRICT
HOSPITALS
• Under the provincial government
HEALTH CENTERS/RURAL
HEALTH
UNITS/BARANGAY
HEALTH STATIONS
• Managed by the City/Municipal
Government
This Photo by Unknown author is licensed under CC BY-ND.

LOCAL HEALTH BOARD
•In every province, city or municipality
•Chaired by the local chief executive
•Functions mainly to serve as advisory body
to the local executive and the sanggunian or
local legislative council on health-related
matters
This Photo by Unknown author is licensed under CC BY-NC-ND.

THE PRIVATE SECTOR
• Includes For-Profit and Non-Profit health providers
• Providing health services in clinics and hospitals, health
insurance, manufacture of medicines, vaccines, medical
supplies, equipment and other health and nutrition
products, research and development, human resource
development and other health-related services

ROLES AND FUNCTIONS OF THE
DEPARTMENT OF HEALTH
Leadership in health
Enabler and Capacity Builder
Administrator of Specific Services
10
This Photo by Unknown author is licensed under
CC BY.

LEADERSHIP IN HEALTH
DOH serves as the national policy and
regulatory institution
- from which LGUs, NGOs, and other
members of the health sector involved in
social welfare and development will
anchor their thrust and directions for
health

LEADERSHIP IN HEALTH
DOH provides
leadership in the
formulation, monitoring
and evaluation of
national health policies,
plans and programs.
- shall spearhead
sectoral planning and
policy formulation and
assessment at the
national and regional
levels

LEADERSHIP IN
HEALTH
• DOH serves as advocate in the
adoption of health policies,
plans and programs, to
address national and sectoral
concerns
Public health nursing in the Philippines. (2007). Manila] National
League Of Philippine Government Nurses. 13
This Photo by Unknown author is licensed under CC BY-SA-NC.

ENABLER AND CAPACITY
BUILDER
• Innovate new strategies in health
- to improve the effectiveness of
health programs
- to initiate public health discussion on
health issues and undertaking
- to disseminate policy research
outputs to ensure informed public
participation in policy decision-
making

ENABLER AND CAPACITY BUILDER
Exercise oversight
functions and monitoring
and evaluation of national
health plans, programs
and policies
Ensure the highest
achievable standards of
quality health care, health
promotion and health
protection
15
CC BY.
CC BY-SA.

ADMISITRATOR OF SPECIFIC SERVICES
MANAGES THE FOLLOWING:
Selected National Health Facilities
and Hospitals with modern and
advanced facilities that shall serve
as national referral centers (I.e.
special hospitals)
Selected health facilities at sub-
national levels that are referral
centers for local health systems
(tertiary and special hospitals,
reference laboratories, training
centers, centers for health
promotion, centers for disease
control and prevention, regulatory
offices, etc.)

ADMINISTRATOR OF
SPECIFIC SERVICES
• Administer direct services for emergent health concerns that require new complicated
technologies that it deems necessary for public welfare
- Administer special components of specific programs like
Tuberculosis, schistosomiasis, HIV-AIDS, in as much as it
will benefit and affect large segments of the population.

ADMINISTRATOR OF
SPECIFIC SERVICES
• Administer health emergency response services, including referral and networking system
for trauma, injuries, and catastrophic events, in cases of epidemic and other widespread
public danger, upon the direction of the President and upon consultation with concerned
LGU.
This Photo by Unknown author is licensed under CC BY-NC-ND.

VISION-MISSION OF THE DEPARTMENT OF HEALTH
VISION
Filipinos are among
the healthiest
people in Southeast
Asia by 2022, and
Asia by 2040

VISION-MISSION OF THE DEPARTMENT OF HEALTH
MISSION
To lead the country in
the development of a
productive, resilient,
equitable and people-
centered health system

HOW WILL
THE
GOVERNMENT
REALIZE THE
VISION OF THE
DOH?
By producing the best
health systems for the
country through seeking
all ways to establish:
• Performance standards for
health human resources
• Health Facilities and institutions
• Health products and health
services

GOAL:
HEALTH
SECTOR
REFORM
AGENDA
(HSRA)
Health Sector
Reform
- the overriding
goal of the DOH

THE HSR
SUPPORT
MECHANISM
Sound
organizational
development
Strong policies,
systems,
and procedures
Capable human
resources
Adequate
financial
resources

RATIONALE
FOR HSR
CURRENT
SITUATION:
Slowing down in the reduction of the Infant Mortality
Rate (IMR) and the Maternal Mortality Rate (MMR)
Persistence of large variations in health status
across population groups and geographic areas
High burden from infectious diseases
Rising burden from chronic and degenerative
diseases
Unattended emerging health risks from
environmental and work-related factors
Burden of disease is heaviest on the poor

RATIONALE
FOR HSR
REASONS
FOR THE
CURRENT
SITUATION:
Inappropriate health delivery system as
shown by an inefficient and poorly targeted
hospital system, ineffective mechanism for
providing public health programs on top of
health human resources maldistribution
Inadequate regulatory mechanism for health
services resulting to poor quality of health
care, high cost of privately provided health
services, high cost of drugs and presence of
low quality of drugs in the market.
Poor health care financing and innefficient
sourcing or generation of funds for health
care

RATIONALE
FOR HSR
IMPLICATION
OF THE
CURRENT
SITUATION
There is poor coverage of
public health and primary
care services
There is inequitable access
(physical and financial) to
personal health care services
There is low quality and high
cost of both public and
personal health care

FRAMEWORK FOR
THE HSRA
IMPLEMENTATION:
FOURmula ONE For
Health
GOALS OF
FOURmula ONE For
Health
• Better health outcomes
• More responsive health
systems
• Equitable health care
financing

FOURmula
ONE For
Health
•Health Financing
•Health Regulation
•Health Service
Delivery
•Good governance
4 ELEMENTS

FOURmula
ONE For
Health:
HEALTH
FINANCING
The goal is to foster greater, better,
and sustained investment in health
The Philippine Health Insurance
Corporation (PHIC) through the
National Health Insurance Program
(NHIP) and the DOH through sector-
wide policy support will lead this
component jointly.

FOURmula
ONE For
Health:
HEALTH
REGULATION
• The goal is to ensure the quality and
affordability of health goods and services
Public health nursing in the Philippines. (2007). Manila] National League Of Philippine
Government Nurses. 30

FOURmula
ONE For
Health:
HEALTH
SERVICE
DELIVERY
• The goal is to ensure and improve the
accessibility and availability of basic
and essential health care in both public
and private facilities and services

FOURmula
ONE For
Health:
GOOD
GOVERNANCE
• The goal is to enhance health system
performance at the national and local
levels

MILLENNIUM DECELOPMENT GOALS
Millennium Development Goals | Philippine Statistics Authority (psa.gov.ph) 33
In September 2000:
Member states of the United
Nations (UN) gathered at
the Millennium Summit to
affirm commitments towards
reducing poverty and the
worst forms of human
deprivation.
The Summit adopted the
UN Millennium Declaration
which embodies specific
targets and milestones in
eliminating extreme poverty
worldwide.

MILLENNIUM DECELOPMENT GOALS
Millennium Development Goals | Philippine Statistics
Authority (psa.gov.ph) 34

HEALTH AND SUSTAINABLE DEVELOPMENT
GOAL
Health is a reliable indicator of the SDG progress as the
social, economic, and environmental determinants of health
are broad, involve many sectors, and cross-link with these
sectoral outcomes.
In addition to being an outcome, health is also a contributor
to achieving sustainable development.
35

THE SUSTAINABLE DEVELOPMENT
GOAL
The 17 Sustainable Development Goals - SDGs -
Philippines (neda.gov.ph)
36

GOAL
37

GOAL
38

FROM: SDGs and the PDP - SDGs - Philippines
(neda.gov.ph)
39

Updated Philippine Development Plan 2017-2022 -
Philippine Development Plan (neda.gov.ph)
40

THE 17 SUSTAINABLE DEVELOPMENT
GOALS
41

GOALS
42

GOALS
43

THE LOCAL
HEALTH
SYSTEM:
HISTORICAL
BACKGROUND
• For over 40 years after Post War
independence, the Philippine Health Care
System was administered by a central agency
based in Manila which provided the singular
sources of resources, policy direction,
technical and administrative supervision to all
health facilities nationwide.

THE LOCAL
HEALTH
SYSTEM:
HISTORICAL
BACKGROUND
RA 7160
• Local Government Code passed in
1991
• All structures, personnel, and
budgetary allocations from the
provincial health down to the
barangays were devolved to the
LGU to facilitate health service
delivery
• Local Government Executives are
responsible to operate local health
services

THE LOCAL
HEALTH
SYSTEM:
HISTORICAL
BACKGROUND
RA 7160
• Emerging of the new
centers of authority for
health: provincial, city,
municipal governments,
including an autonomous
regional government and
a metropolitan authority.

THE LOCAL
HEALTH
SYSTEM:
HISTORICAL
BACKGROUND
RA 7160
• PROVINCIAL GOVERNMENT operates the hospital
system (provincial and district hospitals)
• CITY OR MUNICIPAL GOVERNMENTS operate the
health centers, rural health units, and barangay health
stations

THE LOCAL
HEALTH
SYSTEM:
OBJECTIVES
1. Establish Local Health System for effective
and efficient delivery of health care services
2. Upgrade the health care management and
service capabilities of local health facilities
3. Promote inter-LGU linkages and cost-
sharing schemes including local health care
financing systems for better utilization of
local health resources
4. Foster participation of the private sector,
NGOs and communities in local system
development
5. Ensure the quality of the local health service
delivery at the local level

PRIMARY
HEAKTH
CARE AS AN
APPROACH
TO THE
DELIVERY OF
HEALTH CARE
SERVICES
According to the World Health Organization:
PHC is essential health care made universally
accessible to individuals and families in the
community by means acceptable to them through
their full participation and at a cost that the
community and country can afford at every stage
of development.

PRIMARY HEAKTH CARE AS AN APPROACH
TO THE DELIVERY OF HEALTH CARE
SERVICES
• Declared during the First International Conference on Primary
Health Care held in Alma Ata, USSR on September 6-12, 1978 by
the W.H.O.
• The Goal was Health for All By Year 2000
• Adopted in the Philippines through the Letter of Instruction 949
signed by President Ferdinand Marcos on October 19, 1979
- Underlying theme: Health in the Hands of the People by
2020
51

PRIMARY HEAKTH CARE AS AN APPROACH
TO THE DELIVERY OF HEALTH CARE
SERVICES
WHO stated 3 Components of PHC:
1. integrated health services to meet people’s health needs
throughout their lives
2. addressing the broader determinants of health through
multisectoral policy and action
3. empowering individuals, families and communities to take
charge of their own health.
World Health Organization. (2022). Primary health care. Who.int; World Health Organization: WHO. https://www.who.int/health-topics/primary-health-
care#tab=tab_1
52

ELEMENTS/COMPONENTS OF PHC
1. Environmental Sanitation (adequate supply of safe water and good waste disposal)
2. Control of communicable diseases
3. Immunization
4. Health Education
5. Maternal and Child Health and Family Planning
6. Adequate Food and proper nutrition
7. Provision of medical care and emergency treatment
8. Treatment of locally endemic diseases
9. provision of essential drugs
53

PRIMARY HEAKTH CARE:
4 CORNERSTONES/
PILLARS
54

LEVELS OF PHC WORKERS
1. VILLAGE OR BARANGAY HEALTH WORKERS
- trained community health workers or health auxillary
volunteer or a traditional birth attendant or a healer
2. INTERMEDIATE LEVEL HEALTH WORKERS
- Medical Practitioners or their assistants
- Public Health Nurse, Rural Sanitary Inspectors and
midwives
55

RURAL
HEALTH UNIT
An intermediate health facility
Located in a town or poblacion
RHU Team: Physician, Dentist,
Public Health Nurse, Midwife,
Sanitarian, and other health
workers

LEVELS OF
HEALTH
CARE AND
REFERRAL
SYSTEM
Primary Level of
Care
Secondary Level
of Care
Tertiary Level of
Care

PRIMARY
LEVEL OF
CARE
Devolved to the cities and the
municipalities
Health care is provided by the
center physicians, public health
nurses, rural health
midwives, barangay health
workers, traditional healers and
others at the BHS and RHUs
The first contact between the
community members and the other
levels of health facility

SECONDARY
LEVEL OF
CARE
Secondary care is given by
physicians with basic health
training
Usually in health facilities
either privately owned or
government operated such
as infirmaries, municipal and
district hospitals, and Out-
Patient Departments of
provincial hospitals
Serves as a referral center
for the primary health
facilities
Capable of performing minor
surgeries and perform some
simple laboratory
examinations

TERTIARY
LEVEL OF
CARE
Complicated cases and intensive care requires
tertiary care and all these can be provided by the
tertiary care facility
The referral center for the secondary care facilities
Tertiary care is rendered by specialists in health
facilities including medical centers, as well as regional
and provincial hospitals, and specialized hospitals
such as the Philippine Health Center

61

DOH WEB LINKS
DOH HOSPITALS
DOH Hospitals | Department of Health website
ATTACHED AGENCIES
DOH Attached Agencies | Department of Health website
LOCATION MAP
DOH Location Map | Department of Health website
UNIVERSAL HEALTH CARE AND ITS AIM
Universal Health Care | Department of Health website (doh.gov.ph)
66

DOH WEB LINKS
MILLENIAL DEVELOPMENT GOALS (SDG)
Things You Want To Know About MDG | Philippine Statistics
Authority (psa.gov.ph)
SUSTAINABLE DEVELOPMENT GOALS (SDG)
The 17 Sustainable Development Goals - SDGs - Philippines
(neda.gov.ph)
67

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