The National Health Situation - Copy

8/11/2019 The National Health Situation - Copy

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THE NATIONAL HEALTH SITUATION


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Philippine Scenario

In the past 20 years some infectiousdegenerative diseases are on the rise.

Many Filipinos are still living in remote

and hard to reach areas where it isdifficult to deliver the health services

they need

The scarcity of doctors, nurses andmidwives add to the poor health delivery

system to the poor


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The Philippines is an archipelago of 7,107

islandswith a total land area, including

inland bodies of water, of approximately300,000 square kilometers (116,000 square

miles).

Located in the Pacific Ring of Fire and isexposed to almost the full array of natural

hazards (earthquakes, typhoons,

landslides, floods, etc.) Highest number of disasters

per country in 2009


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Demographic profile

Philippinesis one of the most populous

country in the world.

2000population was 75.3 million

Projected to increase to 82,636,689 in 2004

Aug 2007: 88.57M

Projected 2010 population: 94.01M2.04% annual growth rate (2000-2007)

PRESENT: July 27, 2014 = 100,000,000


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THE NATIONAL HELATH SITUATION

- High population density transmission ofinfectious and communicable diseases.

- Greater need for social services such as:decent housing education

transportation health services

communication


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- High level of stress in congested areas leads

to:

disintegration of moral values and social

institutions

contributes to the incidence of a number ofhealth problems, including mental health

problems.


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Countrys population very young

39%- of the total population in 1994 wasestimated to be in the 0 - 14 age group.

Only 5% were 60 years old and above.

Dependency ratio79/100 (0 - 14 years & 60 y/o and above)

dependent

15 - 59 y/oproductive age group


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About 249 people for every square kilometer of

Philippine territory.

Metro Manilahas the highest population density(16,051)

CARhas the lowest (75)


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High density population densityfacilitates

the _______________of __________ and

______________ ____________________.

There is a greater need for social services:

________ ______, _________, ________,

________, and ______ ________.


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LIFE EXPECTANCY

1999

68.671.28for females

66.03for males Up from 61.6 years in 1980


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Health profileBirth and deaths

Crude Birth Rate (CBR) in 1997 was 28.4 per 1000population

Crude Death Rate (CDR) 6.1 per 1000 population.

The rate of natural increase in the countryspopulation for the same year was 22.3 (28.4minus 6.1) for every 1000 population


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- Rural women have more children than urbanwomen.

- Uneducated women also have more children

than those who are with college education.- Those in the 25-29 age group have the

highest fertility rate (national demographic

and health survey, 1999)


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- In 1995, infant mortality rate (IMR) was 48.9 per

1000 live births, which is within the WHO global

goal for IMR of less than 50/1000 live births.

- Under-five mortality rate or deaths of children

below five years old in the same year was 67/1000

live births.


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- Infant mortality rate is one of the most sensitive

indicators of health status of a country or

community.

Results from:1. poor maternal conditions

2. unhealthy environment

3. inadequate health care delivery system


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Last update: January 11, 2007

leading causes of infant mortality in 2003 were:

1. Other perinatal conditions

2. Pneumonia

3. Bacterial sepsis of newborn

4. Congenital malformation of the heart5. Diarrhea and gastroenteritis of presumed

infectious origin.


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Infant mortality

6. congenital pneumonia

7. other congenital malformation

8. respiratory distress of newborn 9. neonatal aspiration syndromes

10. disorders related to short gestation and

low birth weight.


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Causes of morbidity & mortality

2003causes of mortality among Filipinos

1. diseases of the heart

2. diseases of the vascular system

3. malignant neoplasm

4. accidents

5. pneumonias

6. TB, all forms

7. symptoms, signs and abnormal clinical, laboratory

findings, NEC 8. chronic lower respiratory system diseases -

obstructive & pulmonary diseases

9. diabetes mellitus

10. certain conditions originating in the perinatal period


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Leading causes of morbidity

1. diseases of the heart

2. diseases of the vascular system

3. pneumonias

4. cancer 5. accidents

6. TB

7. COPD

8. DIABETES mellitus 9. diseases of the respiratory system

10. nephritis/ nephrotic syndrome & nephrosis


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Most of the top ten leading causes of

morbidity are non-communicable

disease These include heart problem, HPN,

accidents and malignant neoplasms


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Maternal mortalitymajor indicator of a

womans health status

defined by WHO as the death of a woman

while pregnant or within 42 days of

termination of pregnancy from any cause

related to, or aggravated by the pregnancy or

its management, but not from accidental orincidental causes.


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Leading causes of maternal mortality in 2003

1. Postpartum hemorrhage

2. Eclampsia

3. Retained placenta

4. Uterine atony

5. Placenta previa


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THE NATIOAL HEALTH SITUATION

Analysis of womens poor health and maternal

mortality should consider the overall social,

cultural, and economic environment. (poor, loweducational status, multipara, anemic)


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AIDSmajor public health problem, (urban

areas)

- increase in STDs (syphilis, & gonorrhea due

to unhampered prostitution in the

country.

- prostitution has always been identified as a

consequence of poverty.


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TUBERCULOSIS

- Number one cause of mortality about 50 years ago

continue to be a major killer of Filipinos.

LEPROSY

-MDT (multi-drug therapy) 1.7/10,000 (1995)


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*MOSQUITO*

- malaria

- filariasis- dengue fever


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Political system

first automated election last 10 May 2010

The country is made up of political local

government units of provinces, cities,

municipalities and barangays (villages).Local Government Code of 1991


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POLITICAL INFLUENCES ON HEALTH

- politics affects health

- health policies emanate from congress, the

executive department (DOH)- policies that affect health = health care delivery

system and the practice of nursing in the Philippines


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Economy

69 million Filipinos

(80% of population) struggle to survive on

Php 96 (1.3 Euro) or less a day

46 million Filipinos go hungry every day (i.e.,

unable to meet minimum nutritional needs)


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- health budget is the most concrete

expression of the governmentspolitical will.

- health spending has always beeninadequate.


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WAGES

Wages are not enough to sustain a decent life.

June 2008:Living Wage -------------------------------P 911.00 (16Euros)(NCR, family of 6 according to the Natl Wages andProductivity Commission)

Daily Minimum Wage---------------- P 382.00 (6.7 Euros)(NCR, including COLA)

NOT ENOUGH--------P 529.00 (9.3 Euros)Prices of basic goods are rising faster than wages.


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While the rich are getting richer

Net worth of 10 richest Filipinos:

US$12.4 billion or 10B Euro (2006)

Equivalent to the combined annual income of

poorest 9,600,000 families (approximately 49

million Filipinos)(Ibon Databank 2007)


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No. 2 Exporter of Doctors

68% of Filipino doctors work overseas, next to

India. (Mejia, WHO 1975) Health Human ResourceS

200 hospitals have closed down within the pasttwo yearsno more doctors and nurses

800 hospitals have partially closed (with one totwo wards closed)lack of doctors and nurses

Nurse to patient ratios in provincial and district

hospitals now 1: 40 to 1: 60Loss of highly skilled nurses in all hospitals acrossthe country(Galvez-Tan, 2009)


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Doctor, doctor where are you?

According to the Regional Coordinator of

Pinoy MD Program Dr. Genelyn Herrera, at

least 18 towns in Eastern Visayas have no

doctors.

This means that around 720,000 people in the

region have no access to basic medical

services.


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Dr. Melchor Rey Santos, president of the

Philippine Medical Association (PMA), reported that of the 35,000 doctors in the

PMA roster, 6,000 are now working

abroad. Another 4,000 have opted to retrain and

shift to the nursing profession, in

preparation for an overseas job as anurse.


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Health Education

Decreasing passing rate in the national nursing

licensure examinations

1970s - 80s: 80%-90%1991: below 61%

2001-2003: 44%-48%

2004: 55.9%

2005: 49.7%2006: 41%


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THE ANTIONAL HELATH SITUATION

Laws that affect the delivery of health services

1. Local government code

2. National health insurance Act

3. Professional practice acts of the different

professions


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ISSUES AND CONCERNS

Some of the major factors affecting

the countrys he lth st tus re s

follows:

inappropriate health delivery system

inadequate regulatory mechanisms

and

poor health care financing


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THE HEALTH CARE

DELIVERY SYSTEM


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Health System

Interrelatedsystem in which acountry organizes available

resources for the

maintenanceand

improvementof the health

of its citizens andcommunities.


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THE HEALTH CARE DELIVERY SYSTEM

- is the totality of all policies, infrastructures,

facilities, equipment, products, human resources,

and concerns of all people


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This approach has influenced many

countries including the Philippines.

Its innovativeness is indicated by the call forparticipatory development management since

community members are expected to take an

active role in managing their own healthrequirements, instead of depending on the

government.

PHC also gives importance to the participationof various sectors of government and the

private sector in local health activities.


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- preventive health care = concern of

the government -owned healthcenters

- curative care = provided byhospitals, both government and

private


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The DOH is the principal agency in

health in the Philippines.


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HISTORICAL BACKGROUND

For over 40 yrs after post war independence, the

Phil. Health Care systemwas administered by a

central agency based in Manila Centralcontrol agencyprovided all the

resources, policy direction, technical and

administrative supervision to all health facilities

nationwide.


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Milestone in Health Care Delivery System

RA 1082 - RHU Act

RA 1891 - Strengthen Health Services

PD 568 - Restructuring HCDS

RA 7160 - LGU Code


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DEPARTMENT OF HEALTH

- national governments biggest health care provider

- used to have control and supervision over allbarangay health stations, rural health units and

hundreds of hospitals throughout the country


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- Bureau of local health development

- local health systems development

- health care financing programs

- quality improvement programs

- intersectoral (public-private)

coordination and local projects


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Three divisions of Health Care Delivery System

1. Government

2. Mixed Sectors3. Private Sectors


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Major players

1. PUBLIC SECTOR

Largely financed through a tax-based budgeting

system at both the national and local levels

Where health care is generally given for free at thepoint of service

National and local government agencies

DOHnational levelmandated as the lead agencyin health.


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2. PRIVATE SECTOR

Largely market-oriented and where health

care is paid for through user fees at the point

of service.


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PRIVATE SECTORS1. Socialized Medicine- funded by general taxation,

emphasis on prevention2. Compulsory Health insurance- law requires people to

subscribe to health insurance plan, usually governmentsponsored; covers only curative and rehabilitative

medicine; preventive services provided by governmentagencies

3. Voluntary Health insurance- government only encouragespeople to subscribe to health insurance

4. Free Enterprise- people have to take care of their medicalneeds.


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3. MIXED SECTORS

PTS- Philippine Tuberculosis society PCS- Philippine Cancer Society

PNRC- Philippine National Red Cross

PMHA- Philippine Mental Health

Association

PHA- Philippine Heart Association

d l ti


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devolution

Refers to the act by which the

national government confers power and authority upon

the various local government units

to perform specific functions andresponsibilities,

including the provision and deliveryof basic health services.


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DEVOLUTION OF HEALTH SERVICES


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DEVOLUTION OF HEALTH SERVICES

- RA 7160

= local government code- the code aims to:

transform local government units into self-reliantcommunities and

active partners in the attainment of national goals

through a more responsive and accountable localgovernment structure instituted

through a system of decentralization.


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I li i f D l i PHC


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Implications of Devolution on PHC

Lack of understanding and appreciation bylocal chief executives of health services of

PHC as an innovative strategy.

The government launched the MinimumBasic Needs (MBN) approach as the

management technology for supporting the

Social Reform Agenda to improve the qualityof the poorest of the poor.

The


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Self-Reliant, Healthy Filipino

NGO/PS

LGU

DOH

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TheHealth

Sector


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Provincial and district hospitalsunder

the provincial government City/ municipal government

manages the health centers/ rural

units and barangay health stationsin every province, city or

municipality


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- provincial, district and municipal hospitals

provincial governments

- rural health units (RHUs) and barangay healthstations (BHSs) municipal governments


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provincial level

> governor (chair)

> provincial health officer (vice chair)> chairman of the Committee on

Health of the sangguniang panlalawigan

> DOH representative

City and Municipal level


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City and Municipal level

- > mayor (chair)

> municipal health officer (vice

chair)

> chair of the committee on healthof the sangguniang bayan

> DOH representative and NGO

representative

LEVELS OF HEALTH CARE & REFERRAL


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SYSTEMN ATIONAL HEALTH

SERVICES

REGIONAL HEALTHSERVICES & TRAINING

CENTERS

PROVINCIAL/ CITY HEALTHSERVICES

PROVINCIAL/ CITY HOSPITALS

EMERGENCY/ DISTRICT

HOSPITALS

RURAL HEALTH UNIT

COMMUNITY HOSPITALS & HEALTH CENTERS

PRIVATE PRACTITIONERS/ PUERICULTURE CENTERS

BARANGAY HEALTH STATIONS

1 P i L l f C


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1. Primary Level of Care

It is health care provided by center physicians, public health nurse,

rural midwives, barangay health

workers, traditional healers and othersat the barangay health stations andrural health units.

First contact between the communitymembers and the other levels of healthfacility


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According to Increasing Complexity According to the Type of


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g g p yof the Services Provided

g ypService

Type Service Type Example

Primary Health Promotion, PreventiveCare, Continuing Care forcommon health problems,attention to psychological

and social care, referrals

HealthPromotionand illnessPrevention

InformationDissemination

Secondary Surgery, Medical services bySpecialists

Diagnosis andTreatment

Screening

Tertiary Advanced, specialized,diagnostic, therapeutic &rehabilitative care

Rehabilitation PT/OT

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bl


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Public sector

GOAL OF DOHimplementation of health

sector reforms through the Health Sector

Reform Agenda (HSRA):

Areas to be reformed 1. local health systems

2. hospital systems 3. public health programs

4. health financing

5. health regulation

Framework for the


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Framework for the

implementation of the hsra

FOURmula ONE for health

The National Objectives for Health

l f h l h


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Fourmula one for health

Intends to implement critical interventions as

a single package backed by effective

management infrastructure and financing

arrangements thru a sectorwide approach. This is directed towards ensuring accessible

and affordable quality health care, especially

for the more disadvantaged and vulnerablesectors of the population.

It has 4 ELEMENTS = Go Go FIRES

Memory aid = go go fires


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Memory aid go go fires Good Governanceto enhance health

system performance at the national and locallevels.

Key players for this element include:

A. Philippine Health Insurance Corporation(PHIC), through the National HealthInsurance Ptogram (NHIP).

B. DOH through sector-wide policy support.

HEALTH FINANCINGto foster greater,better, and sustained investments in health.

HEALTH REGULATIONto ensure the quality

and affordability of health goods and


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The Health Sector

Department of Health

Vision: Leader and staunch advocate and model inpromoting Health for ALL in the Philippines

Mission: Guarantee equitable, sustainable, and quality

health for all Filipinos, specially the poor and shalllead the quest for excellence in health

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NATIONAL OBJECTIVES FOR HEALTH


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Mission:

Ensure accessibility and quality of health

care to improve the quality of life of all

Filipinos, especially the poor



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Principles

universal access to basic health services must be

ensured.

the health and nutrition of vulnerable groups must

be prioritized.



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The epidemiologic shift from infectiousto degenerative diseases must be

managed.

The performance of the health sector

must be enhanced.



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GOALS AND OBJECTIVES

1. Improve the general health status ofthe population

- reduce infant mortality rate

- reduce child mortality rate

- reduce maternal mortality rate

- reduce total fertility rate

- increase the life expectancy and the

quality of life years



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a. Reduce morbidity, mortality, disability

and complications from the followingdiseases and disorders

- pneumonias and acute respiratory

infections

- diarrheas and other food and water

borne diseases like typhoid, cholera, and

hepatitis A



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b. Eliminate the certain diseases as public healthproblems

- Schistosomiasis

- malaria

- filariasis- leprosy

- rabies



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c. Eradicate poliomyelitis

- vaccine-preventable diseases: measles,tetanus, diptheria, and pertussis

- Vitamin A deficiency

- Iodine deficiency disorders



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d. Promote healthy lifestyle and emotionalhealth

- promote healthy diet and nutrition

- promote physical activity and fitness

- promote personal hygiene

- Prevent smoking and substance abuse- Prevent violent and risk-taking behaviors

- - promote mental health and less stressful life



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f. Promote the health and nutrition of

families and special populations(vulnerable group)

- neonatal and infant health

- health of indigenous peoples- children's health

- adolescent and youth health

- adult health- women's health

NATIOANAL OBJECTIVES FOR HEALTH


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- health of older persons

- health of overseas Filipino workers

- health of differently-abled persons

- health of the rural poor

- health of the urban poor

2. Ensure Quality Service delivery


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2. Ensure Quality Service delivery

a. Strengthen national and local health systems toensure better service delivery.

b. Pursue public health and hospital reforms

c. Reduce the cost and ensure the quality ofessential drugs.

d. Institute health regulatory reformsto ensurequality and safety of health goods and services.

e. Strengthen health governance andmanagement support systems.

3. improve support system for the vulnerable


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3. improve support system for the vulnerable

and marginalized groups

Institute safety nets for the vulnerable &marginalized groups

4. implement proper resource management. Expand the coverage of social health

insurance.

Mobilize more resources for health.

Improve efficiency in the allocation,

production, and utilization of resources for

health.



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5. Promote environmental health and

sustainable development

- healthy homes

- healthy workplace and establishments- healthy schools

- healthy communities, towns and cities


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Definition of Primary Health Care (PHC):

World Health Organization (WHO)

defines PHC as

essential care made universally

accessible to individuals and families in thecommunity by means acceptable to them

through their full participation and at a cost

that the community and country can afford atevery stage of development.

Background:


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Background:

Primary Health Care (PHC) was declaredduring the First International Conference on

Primary Health Care held in Alma Ata, Russia on

September 6-12, 1978 by the World HealthOrganization (WHO).

- The goal was Health for All by the Year 2000.

This was adopted by the in the Philippines through

Letter of Instruction 949 signed by PresidentMarcos on October 19, 1979 and has an underlying

theme of Health in the Hands of the People by

2020.


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Primary Health Care (PHC) as anapproach to delivery of health

care services

Elements/Components of PHC


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1. Health Education

2. Control of communicable disease3. Expanded Program on immunization (EPI)

4. Locally Endemic Disease Treatment

5. Environmental sanitation5. MCH and Family Planning

6. Essential Drugs & herbal plants Provision

7. Nutrition and Adequate Food Provision

8. Treatment of Locally Emergency cases

Provision of Medical Care


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Four Cornerstones

or Pillars in PHC

1. Active community participation

2. Intra and inter-sectoral linkages

3. Use of appropriate technology

4. Support mechanism made available


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SGD


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SGD

What are the priority programs of the DOH?

List down the objective/s and activities of

each program.

SUBMISSION: Sec. A: Jun 3 @ 8 am

Sec. B: Jun 4 @ 8 am

SGD


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SGD Discuss the FOURmula ONE for Health(F1)over-all goals,

objectives

Discuss the four components of F1as to:

A. Strategies

B. Activities

C. Govt structure implementing the activities

D. Available DOH program in the implementation of activities

SUBMISSION: Sec. B: Jun 4 @ 8 am


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FOURmula ONE FOR HEALTH

FOURmula ONE


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FOURmula ONE

implementation framework for health

sector reform



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GOALS

Better health outcomes

More responsive health systems

Equitable health care financing



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FOUR THRUSTS

1. Financing (increased, better and sustained)

2. Regulation (assured quality and

affordability)

3. Service Delivery (ensured access and

availability)

4. Governance (improved performance)



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STRATEGIC GUIDEPOSTS1. Building upon gains and lessons from major

reform initiatives

2. Focus on critical interventions to be implementedas a single package

3. Sector wide management of FOURMULA ONE

implementation

4. NHP as the primary instrument



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CONSTRAINTS1. Restricted government health budgets

- inflexible allocation across categories- allocation among programs not linked toperformance

2. Difficulty in managing a highly decentralizedsystem

- steering various stakeholders (i.e. - local systems,private markets)

- managing health finances from multiple sources



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OPPORTUNITIES1. Deeper understanding of and increasing leverage

of the NHIP over health system performance.

2. Inroads in health reforms in at least 30 provinces

resulting in improvements in health outcomes and

providing invaluable lessons.



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3. Growing support for HSRA implementationfrom partners - government agencies,external.

4. Deeper understanding of reformimplementation requirements.

5. Revitalized support from national leadership.



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CRITICAL COMPONENTS TO JUMP STARTfourmulaoneIMPLEMENTATION

Identifying critical components

- sufficient groundwork and buy-in- triggers a chain reaction to spur other FOURmula

ONE interventions

- produces tangible results

- generates public support



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FINANCING

GOAL

Secure increased, better and sustained

investments in health to improve health

outcomes especially of the poor.

FOURmula ONE.FINANCING


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FOURmula ONE.FINANCING

Rationalization of sources of health financing* out of pocket

- shift of OOP to outpatient care (e.g. check-up,

consultation, etc.)* Local government

- focus subsidy on preventive and promotive health

services

FOURmula ONEFINANCING


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Local health financing reforms Earmarking funds and prioritizing health services

- social marketing advocacy to LGUs, NGO & privatesector to earmark funds for priority health

programs.



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- identify tools for prioritizing health

services (e.g. segmentation and targetingthe poor)



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*Management/coordination of LGU health fund- integrate national and local investment plan

- cost-sharing arrangements among LGUs

- national and local coordination of funds (e.g.

counterparting arrangements)- Rapid estimation of local health accounts



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NATIONAL HEALTH FINANCING REFORMS1.Public finance management system

2.Institutionalization of revenue-enhancement

measures

*full retention of income

*asset management



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3. Development of efficient and equitableallocation mechanics.

-priority health programs

-geographic

-income

-population groups



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4. Performance based-budgeting system-develop models for hospitals, public health and

regulatory agencies

-reform financial management and procurementsystem

-develop / implement performance audit and

review system



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IMPROVEMENT OF THE NHIP1. Increase membership and collections

2. Enhance benefit package

3. Improve utilization of reimbursements

4. Enhance systems for regulation and

governance

FOURmula ONEREGULATION


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REGULATION

GOAL

Assure access to quality and affordable health

products, devices, facilities and services especially

those used by the poor.



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STRATEGIES

1. Harmonizing & streamlining of systems,processes for licensing & accreditation andcertification

2. Developing a seal of approval3. Pursuing cost recovery with income retention for

health regulatory agencies & other revenuegenerating mechanisms

4. Ensuring access of the poor to essential healthproducts



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COMPONENTSPrograms include:

1. one-stop shop

2. Philhealth-sentrong sigla seal

3. Unified seal of approval

4. Botika ng barangay / pharma 50

FOURmula ONESERVICE DELIVERY


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SERVICE DELIVERY

GOAL

Improve accessibility and availability of basic

and essential health care for all, especially

the poor.



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COMPONENTS

1. Public health development plan

a. disease-free zonemopping-up leprosy

b. Intensified disease programs - TB, HIV/AIDSemerging infections

c. Improving reproductive health outcomesMMR, IMR, U5MR, TFR, CPR



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d. Intensified promotion of healthy lifestyleDM, HPN, CVD, breast and cervical cancer,

anti smoking, safe water, sanitation, among

others



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2. Health facilities development plan- critical upgrading of facilities through fund pool

- rationalizing services in DOH-retained, local

government & private facilities inside the 16 sites- Integrating wellness services in hospitals



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3. Establishment of National Health PromotionFoundation

4. Disaster preparedness and response system

5. Disease surveillance and networking system

6. Intensification of health promotion



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STRATEGIES1. Making available basic and essential health

service packages by designated providers in

strategic locations

2. Assuring the quality of both basic and

specialized health services



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3. Intensifying current efforts to reduce publichealth threats

4. Diseasefree zones

a. Filariasisendemic mapping with STH and

Schistosomiasis programs, disability

prevention



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b. Leprosyquality diagnosis & casemanagement

c. Rabiesfunctional animal bite treatment

centers, responsible pet ownership



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d. Malariacommunity participation in vectorcontrol elimination & surveillance activities.

Malaria benefit package Insecticide Treated

Nets (ITN), rapid diagnostic test.



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e. Schistosomiasisintensify surveillance of humancases and the snail vector

5. Intensifies disease prevention and control

a. emerging infectious diseasesavian influenzatask force at all levels, preparedness & responseplan for pandemic influenza, philhealth benefitpackage


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6. Improving reproductive health outcomes

a. Public-private partnership on women health

b. Pre-pregnancy package

c. Contraceptive delivery & logistic MIS

d. Standard days method as NFP

e. Paradigm shifthigh-risk pregnancies to

ALL PREGNANCIES ARE AT RISK



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f. mother and child book

g. infant and young children feeding program



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7. Intensified promotion of healthy lifestylea. tobacco management team at various levels

b. smoking cessation clinics

c. community-based NCD prevention and control

programd. intensified promotion of healthy lifestyleDM, HPN,CVD, breast & cervical cancer, anti-smoking, safe water,sanitation among others.

e. strengthen national HL campaign

FOURmula ONEGOVERNANCE


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Sectoral development approach for health

1. To strengthen government leadership in implementing a

sector program where development partners cooperate

and contribute accordingly

- effective donor and LGU coordination towardsfinancing a sector program

- harmonizing procedures among donors and national

government



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Health human resource masterplan1. To maintain a national HHR masterplan in support

of national & local health systems

- HHR information system

- competency-based recruitment & selection

systems

- training and development need analysis



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- Performance management system- Career development and management

- Advocacy plan



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Developing a localized health humanresource strategy

1. Health professional development and careertrack

2. Identifying and providing venue for postingof vacancies

3. Actively promoting LGU vacancies

4. Support for developing local HR strategy



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Establishment of 4-in-1 convergence sites

1. Health investment planning

2. Developing appropriate governance and

mechanisms, i.e., ILHZ convergence sites

3. Helping mobilizing extra-budgetary resources for

health at the local level



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4. Improving procurement, devolving regulatoryfunctions, linking, local regulatory policies with

health programs and financing

5. Nationalizing the health delivery network, provision

of basic health services

6. Monitoring & evaluation, i.e., LGU score card



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Philippine health information system

1. establishment, operationalization, & use of health

portal and development of Philippine health

information infrastructure

- harmonization of info systems

- human resource info system

- vital registries, health statistics



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Philippine health information system1. establishment, operationalization, and use

of health portal and development of

philippine helath information infrastructure2. Development of manual of operations

FOURmulaGOVERNANCE


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DOH procurement and logisticsmanagement system

1. Inventory system, supply chain mechanism

2. Efficient storage

3. Database of goods / supplies (standardspecifications)

4. Procurement systems

- pooling- monitoring

- feedback mechanism



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- Disease surveillance- health accounts

- health regulations

- health facilities



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5. Database of supplies with performancemonitoring

6. Standardization of specifications and

documents7. Implementation of ethical practices

framework


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THE NATIONAL OBJECTIVES ON

HEALTH

NATIONAL OBJECTIVES


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NATIONAL OBJECTIVES FOR HEALTH 2005 TO 2010

-Provides the road map for stakeholders in health andhealth-related sectors to intensify and harmonize

their efforts to attain its time-honored vision ofhealth for all Filipinos and continue its avowedmission to ensure accessibility and quality of life ofall Filipinos, especially the poor.

NATIONAL OBJECTIVES


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It provides concrete handle that would guide

policy makers, program managers, local

government executives, developmentpartners, civil society and the communities

in making crucial decisions for health.

NATIONAL OBJECTIVES


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OBJECTIVES OF THE HEALTH SECTOR

1. Improve the general health status of the

population

2. Reduce morbidity and mortality from certain

diseases

3. Eliminate certain diseases as public helath

problems

4. Promote healthy lifestyle and environmentalhealth

NATIONAL OBJECTIVES


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5. Protect vulnerable groups with special health andnutrition needs

6. Strengthen national and local health systems to ensurebetter health service delivery

7. Pursue public health and hospital reforms8. Reduce the cost and ensure quality esssential drugs

9. Institute health regulatory reforms to ensure qualityand safety of helath goods and services

NATIONAL OBJECTIVES


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10. Expand the coverage of social healthinsurance

11. Mobilize efficiency in the allocation,

production and utilization of resources forhealth

Primary health care


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As a strategy PHC


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BACKGROUND:

P i H lth C (PHC) d l d


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Primary Health Care (PHC) was declared

during the First International Conference onPrimary Health Care

-held in Alma Ata, Russia

-on September 6-12, 1978 by the World HealthOrganization (WHO).-The goal was Health for All by the Year 2000. This

was adopted by the in the Philippines through Letter

of Instruction 949 signed by President Marcos onOctober 19, 1979 and has an underlying theme of

Health in the Hands of the People by 2020.

This approach has influenced many

countries including the Philippines


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countries including the Philippines.

Its innovativeness is indicated by the call for

participatory development management since

community members are expected to take an

active role in managing their own healthrequirements, instead of depending on the

government.

PHC also gives importance to the participation

of various sectors of government and theprivate sector in local health activities.

Problems/IssuesThe implementation of PHC has not been spared from


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problems and difficulties.

Lack of political will of the top leadership of the DOH for the

continued implementation of PHC.

Passage of BHWs Incentives Act which violated the principle ofvolunteerism and could be a tool for politicking by local

executives since the volunteer workers could beholden to them

instead of the community.

The transfer of responsibility of PHC to local executives underdevolution is not easy. PHC could not be fully achieved if the

bureaucracy itself is not empowered.


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The National Health Situation - Copy

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Transcript of The National Health Situation - Copy