Health Care Delivery System

Ivan N. Tanodra, M.D. RPh

Objectives

To know the structure of health care delivery system in the Philippines To define primary health care To know the levels of health care To be aware of the different agencies that deliver health care

Philippine Healthcare Delivery System

Public sector
- financed through a tax-based budgeting system at both national & local levels - health care is delivered free at the point of service

Private sector
- profit & non-profit providers

- market-oriented, health care is paid

through user fees at point of service

PUBLIC SECTOR
NATIONAL LOCAL

PGH

DOH
PROVINCIAL GOVERNMENT

LOCAL GOVERNMENT UNITS

CITY/MUNICIPAL GOVERNMENT HEALTH CENTER/ RURAL HEALTH UNITS (RHU) BARANGGAY HEALTH STATIONS (BHS)

PROVINCIAL/DISTRICT HOSPITALS

Primary Health Care

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 the country can afford at every stage of development

Primary Health Care

Declared during the First International Conference on Primary Health Care in Alma Ata, USSR on Sept 6-12, 1978 by WHO Goal Health for All by the Year 2000

Primary Health Care

Adopted in the Philippines through Letter of Instruction 949 signed by President Marcos on Oct 19, 1979 Theme Health in the Hands of the People by 2020

Elements/Components of Primary Health Care

Environmental Sanitation (adequate supply of safe water & good waste disposal) Control of Communicable Diseases Health Education Maternal & Child Health and Family Planning

Elements/Components of Primary Health Care

Adequate Food and Proper Nutrition Provision of Medical Care and Emergency Treatment Treatment of Locally Endemic Diseases Provision of Essential Drugs

Strategies of Primary Health Care

Reorientation/reorganization of the national health care system with the establishment of functional support system Effective preparation and enabling process for health actions at all levels

Strategies of Primary Health Care

Mobilization of the people to know their communities and identifying their basic health needs with the end in view of providing solutions leading to self reliance and self determination

Strategies of Primary Health Care

Development & utilization of appropriate technology focusing on local indigenous resources available in and acceptable to the community Organization of communities arising from their expressed needs which they have decided to address and that this is continually evolving in pursuit of their development

Strategies of Primary Health Care

Increase opportunities for community participation in local level planning, management, monitoring and evaluation within the context of regional and national objectives Development of intrasectoral linkages with other government and private agencies

Strategies of Primary Health Care

Emphasizing partnership so that the health workers and the community leaders/members view each other as partners rather than merely provider and receiver of health care respectively

Four Pillars of PHC

Active community participation Intra and inter-sectoral linkages Use of appropriate technology Support mechanism made available

Types of PHC Workers

Vary in different communities depending upon: 1. Availability of health manpower resources 2. Local health needs and problems 3. Political and financial feasibility

Types of PHC Workers

Village or Baranggay health workers

- trained community health workers, traditional birth attendants, health auxiliary volunteer, healer

Intermediate level health workers

- general medical practitioners, public health nurses, rural sanitary inspectors, midwives

Levels of Health Care and Referral System

Primary level of Care Secondary level of Care Tertiary level of Care

Levels of Health Care and Referral System

Primary level of Care

- devolved to the cities / municipalities - provided by center physicians, public health nurses, rural health midwives, baranggay health workers - first contact between the community members and other levels of health facility

Levels of Health Care and Referral System

Secondary level of Care

- given by physicians with basic health training - either privately owned/government operated (infirmaries, municipal/district/provincial hospital, OPD) - referral center for the primary health facilities

Levels of Health Care and Referral System

Secondary level of Care

- capable of performing minor surgeries and some simple laboratory examination

Levels of Health Care and Referral System

Tertiary level of Care

- rendered by specialists in health facilities including medical centers, regional and provincial hospitals, specialized hospitals - referral center for the secondary care facilities - complicated cases/intensive care

National/Regional Medical Centers And Training Hospitals

Rural Health Unit, Community Hospitals Emergency/District Hospitals

Provincial/City Hospital Baranggay Health Stations

Sentrong Sigla

1998- DOH embarked Quality Assurance Program in providing quality health services 1999- renamed Sentrong Sigla or Centers of Vitality Movement (SSM) Goal: Quality healthcare services and facilities SS Phase 1

Sentrong Sigla

2001 concern for quality health care into the entire health sector SS Phase 2

Guiding Principles of Sentrong Sigla

Recognition for achieving good quality shall be the main incentive in SS Certification Quality improvement is an unending process, promote the continuing drive for ever improving quality by providing higher quality standards

Guiding Principles of Sentrong Sigla

Focus shall be on core health programs that have proven to be most benificial to the people such as child health, maternal care and family planning, prevention & control of infectious diseases

Guiding Principles of Sentrong Sigla

Quality improvement is a partnership that empowers all stakeholders, and is based on trust and transparency All quality standards and methods shall be openly shared and discussed to ensure clear understanding and strong commitment by all concerned

Guiding Principles for Sentrong Sigla

DOH shall give purposive technical assistance to targeted health facilities to help them achieve quality improvement particularly in the underserved and marginalized areas Assessment for certification shall involve other stakeholders in order to provide objectivity and varying perspective in the process

Thank you!