The Philippine Healthcare
o 2020-2021 - almost 4.85 billion dollars
Delivery System
Healthcare delivery system
 Is the totality of societal services and activities
designed to protect or to restore the health of
individuals, families, groups, and communities
WORLD HEALTH ORGANIZATION (WHO)
 MILLENNIUM DEVELOPMENT GOALS
 SUSTAINABLE DEVELOPMENT GOALS
PHILIPPINE DEPARTMENT OF HEALTH
 MISSION - VISION
 HISTORICAL BACKGROUND
 LOCAL HEALTH SYSTEM & DEVOLUTION OF HEALTH
SERVICES
 CLASSIFICATIONS OF HEALTH FACILITIES (DOH AO –
0012A)
 PHILIPPINE HEALTH AGENDA
UNIVERSAL HEALTH CARE (UHC)
 LEGAL BASIS
 BACKGROUND AND RATIONALE, OBJECTIVES AND
THRUSTS
World Health Organization
 To promote health, keep the world safe and serve
the vulnerable
 It acts as an adviser on the health issues but cannot
impose policies on governments
 Its three main strands of work
o Aiming for universal health coverage in every
country
o Preventing and responding to acute
emergencies
o Promoting health and wellbeing for all
 What doesn't it do?
o WHO is not the world's doctor
o It doesn't provide treatment or conduct
surveillance on illness
o The information it collates and publishes is only
as good as the data it receives
 How is it funded?
o WHO has 194 member states - every country
except Liechtenstein
o Paid for via 2 routes
 Assessed contributions
 voluntary contributions
 WHO's budgets spans every 2 years
o Up 9% from the previous 2 year period
 WHO is dependent on the reports made and sent to
them
 Specialized organization of the United Nations
responsible for public health
 Attainment of by all people of the highest possible
level of health
 Helping countries make the air you breathe safer
 Promoting healthy diet to prevent diabetes, cancer,
and heart disease
 Helping monitor how the children are growing and
know what to do if they're not growing as expected
 Recommending vaccinations to keep the family
healthy and helping countries survey how many
people get the immunizations they need
 Keeping your food safe to eat and your water safe
to drink
 Ensuring availability of safe, modern contraceptives
for everyone
 Increasing seatbelt and helmet to use to save lives on
roads
Eight Millennium Development Goals
 189 UN member states have agreed to try to
achieve by 2015
 September 2000
 Combat poverty, hunger, disease, illiteracy,
environmental segregation, and discrimination against
women
 Eradicate extreme poverty and hunger
 Achieve universal primary education
 Promote gender equality and empower women
 Reduce child mortality
 Improve maternal health
o Reduce by three quarters the maternal
mortality ratio
o Achieve universal access to reproductive
health
 Combat HIV/AIDS, MALARIA and other disease
 Ensure environmental sustainability
 Develop a global partnership for development
 EMDs have been superseded by the SDGs (17
integrated goals, broader, deeper and far more
ambitious in scope)
 Progress made but gaps remain
 HIV, tuberculosis and malaria targets, halting and
reversing global epidemic were met.
 Child mortality decreased by 53%.
 Deaths related to pregnancy and childbirth (maternal
mortality) fell by more than 40%.
 The target for drinking water was met, with 91% of
the global population using an improved drinking water
source, compared to 76% in 1990.
 Between 1990 and 2015, the global prevalence of
underweight among children aged less than 5 declined
from 25% to 14%.
 September 2015, more than 150 leader gathered in
UN headquarters to adapt the new post 2015
development agenda
17 Sustainable Development Goals ( 169 targets)
 Seek to build what is in the MDGs and complete what
they did no achieved
 Providing focus and assistance to the least developed
countries and other countries in special occasions
 Aim to tackle emerging challenges including the
growing impact of noncommunicable diseases
(diabetes and heart disease) and the changing social
and environmental determinants affect health
(increasing urbanization, pollution, and climate change)
 To ensure health, lives, and promote wellbeing for all
at all ages
 No Poverty
o End Poverty in all its forms everywhere
o Economic growth must be inclusive to provide
sustainable jobs and promote equality.
o Donate what you don’t use. 836 million people live in
extreme poverty
 Zero Hunger
o End Hunger, achieve food security and improved
nutrition and promote sustainable agriculture
 Good Health and Well-Being
o Ensure healthy lives and promote well-being for all at
all ages
 Quality Education
o Ensure inclusive and equitable quality education and
promote lifelong learning opportunities for all
 Gender Equality
o Achieve gender equality and empower all women and
girls
 Clean water and sanitation
o Ensure availability and sustainable management of
water and sanitation for all
 Affordable and Clean Energy
o Ensure access to affordable, reliable, sustainable, and
modern energy for all.
 Decent Work and Economic Growth
o Promote sustained, inclusive, and sustainable
economic growth, full and productive employment
and decent work for all.
 Industry, Innovation and Infrastructure
o Build resilient infrastructure, promote inclusive and
sustainable industrialization and foster innovation
 Reduced inequalities
o Reduced inequality within and among countries
 Sustainable cities and communities
o Make cities and human settlements inclusive, safe,
resilient and sustainable
 Responsible consumption and production
o Ensure sustainable consumption and production
patterns
 Climate action
o Take urgent action to combat climate change and its
impacts
 Life below water
o Conserve and sustainably use the oceans, seas, and
marine resources for sustainable development
 Life on land
o Protect, restore and promote sustainable use of
terrestrial ecosystems, sustainably manage forests,
combat desertification, and halt and reverse land
degradation and halt biodiversity loss
 Peace and Justice, and Strong Institutions
o Promote peaceful and inclusive societies for
sustainable development, provide access to justice
for all and build effective, accountable and inclusive
institutions at all levels
 Partnerships for the Goals
o Strengthen the means of implementation and
revitalize the global partnership for sustainable
development
 Invent, innovate and campaign
4 principles of SDG
 Universality
o First and most important, these goals apply to
every nation … and every sector. Cities,
businesses, schools, organizations, all are
challenged to act.
 Integration
o Second, it is recognized that the goals are all
interconnected, in a system. We cannot aim to
achieve just one goal. We must achieve them
all.
  Leave no one behind
 Participation
 Transformation
o And finally, it is widely recognized that
achieving these goals involves making very big,
fundamental changes in how we live on Earth.
 Social progress
 Economic Development
 Climate and Environment
 The 2030 Agenda for Sustainable Development, adopted by
all United Nations Member States in 2015, provides a shared
blueprint for peace and prosperity for people and the
planet, now and into the future. At its heart are the 17
Sustainable Development Goals (SDGs), which are an urgent
call for action by all countries - developed and developing - in
a global partnership.
 They recognize that ending poverty and other deprivations
must go together with strategies that improve health and
education, reduce inequality, and spur economic growth – all
while tackling climate change and working to preserve our
oceans and forests.
 UN Department of Economic and Social Affairs
 Broad ownership of the SDG's must translate into a strong
commitment by all stakeholders to implement the Global
Goals.
Philippine Department of Health
 Least prioritized department of the country
 Aims accessible, equitable, quality health services for
all filipinos with special focus on the poor,
marginalized, and the vulnerable population groups
Mission & Vision
 MISSION
 To lead the country in the development of a
productive, resilient, equitable and people-centered
health system
 VISION
 Filipinos are among the healthiest people in Southeast
Asia by 2022, and Asia by 2040
12 Legacies of the DOH for 2022
 A benchmark or indicator that we already attained Universal
healthcare in our country
 Battle cry in the essence that everyone should be involved
 Universal Health Insurance Coverage for ALL Filipinos
o All filipinos are covered by the national health
insurance program
 Blood Adequacy
o We have attained blood donations at least 1% of the
total population
o Type ng bayan - blood typing event
 Zero Unmet Need for Family Planning
o Universal access to reproductive health services
 HIV AIDS Reversed
o Decreasing trend of HIV AIDS
 Access to Health Services for all
o Deploy 1 health worker per barangay
 Zero Open Defecation
o All filipinos have access to sanitary toilet facilities
 Expenditure on Health Increased
o Government as well as private sectors investing in
health
 Reduce Out of Pocket Expenditures for Health
o Ensure health insurance coverage
 Ensuring Good Data for Decision Making
 Reducing Malnutrition
o Rise against hunger
o Provide supplemental meals for pregnant women in a
nutritionally at risk community
 Community Based Drug Rehabilitation Program in all
Communities
o Community is involved in rehabilitating in drug
dependence and also preventing drug addiction and
drug abuse
 Quality Management Systems in all Government Hospitals
o Filipinos that go to the hospitals are valued and cared
for.
Historical Background
 1991
o A major devolution of national government
services.
o first wave of health sector reform (Local
Government Code of 1991).
 The code revolved basic services for
agriculture extension, forest
management, health services,
barangay or township roads, and social
welfare to local government units
 1992
o Devolved the management and delivery of
health services from the National Department
of Health to locally elected provincial, city and
municipal governments.
 1992-1997
o A breakdown in management systems:
✓ levels of government
 ✓ declining utilization particularly in the
hospital sector
✓ poor staff morale
✓ decline in maintenance of infrastructure
✓ under financing of operational costs of
services.
Local Health System
 Republic Act 7160
o under this law, all structures, personnel and
budgetary allocations from the provincial
health level down to the barangays were
developed to the local government units to
facilitate health service delivery.
Devolution of Health Services
 RA 7160 or commonly known as the Local
Government Code. The code aims to: transform local
government units into self-reliant communities and
active partners in the attainment of national goals
through a more responsive and accountable local
government structure instituted through a system of
decentralization.
o 79 provinces
o 113 cities
o 1496 municipalities
o 41 943 barangays
Classification of Health Facilities (DOH AO - 0012A)
 According to Ownership (Government & Private)
 Government
o Funded and supported by the government
o NMMC, JR Borja general Hospital, camp
evangelista hospital
 Private
o Funded or supported by a group of people,
mostly doctors or healthcare related
professionals or businessmen, who decided to
build their own hospitals
o Polymedic Medical group: polymedic plaza
(kauswagan), polymedic general hospital
(velez), polymedic hospital (tagoloan), Capitol
University Medical Center, Maria Reyna,
Cagayan de Oro Medical Center, Madonna and
Child hospital
 According to Scope of Services (General and Specialty)
 General
o Provide various services for various numbers
of disease conditions or illnesses
o Have medical services for specific systemic
conditions
o Provide emergency services
o Out-patient services
o ancillary services: pharmacy, radiology etc
 Specialty
o Specific cases
o Limited services
o Focused
o Specialized services
o Madonna (before) only cater pregnant women
o Specific age group
 According to Function and Capacity
o General Hospital (level 1, level 2 and level 3)
o Level 1
 Limited services
 Emergency or Operating room
o Level 2
 More advanced services
 More specialty units (NICU)
 Advanced diagnostics and exams
o Level 3
 More variety of services offered
 Cancer unit
 Training hospital
 Cater affiliations for different courses
o Specialty Hospitals
o Offer specific procedures
o Trauma Capability of Hospitals
o Provide emergent care and response to
trauma cases
Classification of other Health Facilities
 Category A: Primary Care Facility
 Birthing homes, infirmary
 Limited services
 Normal delivery, newborn care
 Category B: Custodial Care Facility
 Has a custody for long term services
 Drug abuse patients, psychiatric concerns, nursing
home
 Category C: Diagnostic / Therapeutic Facility
 Offers services specifically for exams or diagnostics
exams
 Lab centers, drug testing centers, clinical laboratories
 Category D: Specialized Out-Patient Delivery Facility
 Patient just goes there and go home after the care
or procedure is done
 Dialysis patient, stem-cell facility
 Philippine Health Agenda
A- Advance quality, health promotion and primary care
C- Cover all Filipinos against health-related financial risk
H- Harness the power of strategic HRH development
I- Invest in eHealth and data for decision-making
E- Enforce standards, accountability and transparency
V- Value all clients & patients, especial y the poor,
marginalized, & vulnerable
E- Elicit multi-sectoral and multi-stakeholder support for
health
 PHA 2016-2022 we will achieve a health system with
values of equity, quality, efficiency, transparency,
accountability, sustainability, resilience towards lahat para sa
kalusugan tungo sa kalusugan para sa lahat
 Financial risk protection through expansion in enrollment and
 Improved access to quality hospitals and health care
 Attainment of health-related Millennium Development Goals
Universal Health Care (UHC)
Legal Basis
Background and Rationale, Objectives and Thrusts
 Universal health care lowers health care costs
for an economy.
 The government controls the price of medication and
medical services through negotiation and regulation.
 It eliminates the administrative costs of dealing with
different private health insurers
 Referred as Kalusugan Pangkalahatan (KP), is the
“provision to every Filipino of the highest possible
quality of health care that
 Is accessible, efficient, equitably distributed,
adequately funded, fairly financed, and appropriately
used by an informed and empowered public”
 Bill into law (Republic Act No. 11223) that
automatically enrolls all Filipino citizens in the National
Health Insurance Program and prescribes
complementary reforms in the health system.
 That all people and communities can use the
promotive, preventive, curative, rehabilitative and
palliative health services they need, of sufficient
quality to be effective, while also ensuring that the
use of these services does not expose the user to
financial hardship.
Providing :
o adequate resources
o Health human resources
o Health facilities
o Health financing
Objectives
 Improve the health of the community
 Educate members on how to access timely, quality,
affordable health services without selling or losing
property or assets
 Improve provider cost recovery and financial planning
ability
 Create link between providers and community
To attain UHC, three strategic thrusts are to be pursued,
namely:
benefit delivery of the National Health Insurance Program
(NHIP);
facilities; and
(MDGs).
Financial Risk Protection
 Protection from the financial impacts of health care
is attained by making any Filipino eligible to enroll, to
know their entitlements and responsibilities, to avail
of health services, and to be reimbursed by
PhilHealth with regards to health care expenditures.
o PhilHealth Operations are to redirected
towards enhancing national and regional health
insurance system
o NHIP enrollment shall be rapidly expanded to
improve population coverage
o The availment of outpatient and inpatient
services shall be intensively promoted
o The use of information technology shall be
maximized to speed up philhealth claims
processing
Improved Access to Quality Hospitals and Health Care
Facilities
 Financial efforts shall be provided to allow immediate
rehabilitation and construction of critical health
facilities. In addition to that, treatment packs for
hypertension and diabetes shall be obtained and
distributed to RHUs.
 The DOH licensure and PhilHealth accreditation for
hospitals and health facilities shall be streamlined and
unified.
 Achieved in a number of approaches
o Quality of government owned and operated
hospitals and health facilities is to be upgraded
to accommodate larger capacity to attend to
all types of emergencies and to handle non-
communicable disease
o The health facility enhancement program
(HFEP) provide hands to improve facility for
preparedness for trauma or other
emergencies
 Aim: upgrade to 20% of TOH hospitals,
46% provincial hospitals, 46% district
hospitals, 51% rural health unit
Attainment of Health-related MDGs
 Further efforts and additional resources are to be
applied on public health programs to reduce maternal
and child mortality, morbidity and mortality from
Tuberculosis and Malaria, and incidence of HIV/AIDS.
Localities shall be prepared for the emerging disease
trends, as well as the prevention and control of
non-communicable diseases.
o Organization of community health teams in
each priority population areas is one way to
achieve health related MDGs
 CHTs are a group of volunteers who
will educate families in their health
needs, provide health education and
facilitate communication with other
health providers
 Another effort will be the provision of necessary
services using the life cycle approach. These
services include family planning, ante-natal care,
delivery in health facilities, newborn care.
o DOH
o DepEd
o DSWD
o DILG
UHC Act in the Philippines: A new dawn for health care
 It is a time for celebration in the Philippines. President
Rodrigo Duterte has just signed a Universal Health
Care (UHC) Bill into law (Republic Act No. 11223) that
automatically enrolls all Filipino citizens in the National
Health Insurance Program and prescribes
complementary reforms in the health system.
UHC is a political choice
 In the Philippines, like elsewhere, universal health
coverage is foremost a political choice. The UHC Act
embodies this choice, and was carried by a broad
coalition of parliamentarians across the political
spectrum.
Senator Ejercito - Chair of the Health Committee
 “During our visits to hospitals in different provinces,
my own eyes have seen the deplorable state of our
countrymen – in hot and cramped wards, enduring
the lack of government support. It is sad that our
fellow citizens who, rather than be healed, are
worried about being infected with the illness of
another patient.”
Senator Angara - Chair of the Ways and Means Committee
 “The majority of Filipinos only consult a doctor when
their illnesses are already at their worst because of
the lack of government support to the health
department.”
Why now?
 Parliamentarians and health stakeholders have made
concerted efforts to pass a UHC bill for the past
two years, but in reality, the Philippines has
experienced a 50-year process of health reform,
under different names. The UHC Act is the
culmination of decades of progress, and two years
of dedicated political and technical work.
Developing and refining the bill
 WHO’s global drive for UHC came at an opportune
time to advocate and inform the consultation and
drafting process of the Bill in the Senate during the
second half of 2017. By that time the Bill had
already passed the House of Representatives. In
order to get it passed through the upper house, the
Bill needed technical refinement to ensure that it
was comprehensive, practical and feasible, and
would eventually achieve universal health coverage.
 The Act will mean all Filipinos get the health care
they need, when they need it, without suffering
financial hardship as a result. Although there is much
work to be done to implement the UHC Act, it takes
a critical step towards achieving health for all in the
Philippines. It is a new dawn for health care and real
progress towards achieving UHC.