Organization of Public

Health Care Delivery

System
Philippine Health Care System

 Is a complex set of organizations interacting to provide an array of

health services.(Dizon, 1977)
Philippine Health Care System

The Department of Health is responsible for developing:

 health policies and programs
 regulation
 performance monitoring
 standards for public and private sectors
 provision of specialized and tertiary level care.
Philippine Health Care System

The Department of Health regional offices(ROs) assist in LGUs are the

implementing agencies in provinces, cities and municipalities, and link
national programs to Local Government Units.
Philippine Health Care System

 Health Service Delivery has evolved into dual delivery systems of

public and private provision, covering the entire range of
interventions with varying degrees of emphasis at different health
care levels.

 Public services are mostly used by the poor and near-poor,

including isolated and deprived communities.
 Private services are used by approx. 30% of the populationthat can
afford fee-for-service payments.
Philippine Health Care System

 The service package that is supported by the government is

outlined by the Philippine Health Insurance Commission(PhilHealth).

 However, services covered are not comprehensive. Co-payments

are high and reimbursement procedures are difficult.
Health Agenda
Health Agenda

 President Rodrigo Duterte has recently released the Philippine

Health Agenda for 2016-2022

 “All for Health towards Health for All”

“All for Health towards Health for All”

 Aspires financial protection

 Better health outcomes

 Responsiveness for all Filipinos

 “All for Health towards Health for All”
In order to attain health-related sustainable development goals, the ACHIEVE
strategy is followed:
 A – advanced 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 and patients, especially the poor. Marginalized and
vulnerable
 E – Elicit multi-sectoral and multi-stakeholder support for health
“All for Health towards Health for All”

With the Philippine Health Agenda 2016-2022, we will all ACHIEVE a

health system. With the values of Equity, Quality, Efficiency,
Transparency, Accountability, Sustainability, Resilience towards “Lahat
Para sa Kalusugan Para sa Lahat”.
Department of Health(DOH)
Department of Health(DOH)

 holds the over-all technical authority on health as it is a national

health policy-maker and regulatory institution.
 provider of special tertiary health care services and technical
assistance to health providers and stakeholders.
Department of Health(DOH)

Roles:

1. Leadership in Health
2. Enabler and capacity builder
3. Administrator of specific services
Department of Health(DOH)

Vision:
 Health as a right. Health for all Filipinos by the year 2000 and Health in the
hands of people by the year 2020.

Mission
 The mission of the DOH, in partnership with the people to ensure equality,
quality and access to health care by making services available, by
arousing community awareness, by mobilizing resources, by promoting the
means to better health.
Philippine Health Insurance
Commission(PhilHealth)
PhilHealth
 Created in 1995 to implement universal health coverage in the
Philippines.
 Government owned, government-controlled(GOCC).
 Under DOH.
PhilHealth
 Stated goal is to ensure a sustainable national health insurance program for
all.
 Claimed to have achieved “universal” coverage at 86% of the population,
although the 2008 National Demographic Health Survey showed that only
38% of respondents were aware of at least one household member being
enrolled in PhilHealth.
Mandate and Functions

 In 2010 & 2015, reform efforts were outlined to make

decentralization and health insurance work more effectively,
including an expanded government subsidy for the enrolment of
the poor, the creation of local health service delivery/planning units
to reduce fragmentation, and a stronger DOH role in regulation.

 Shifting from Fee-for-service to case rate payment scheme and

IHCP Portal System is established to provide a link between
accredited institutional health care providers and PhilHealth
through online connections.
PhilHealth Membershi Categories

 Formal
 Indigents/ “Philhealth sa masa”
 Sponsored – via LGUs
 Lifetime(non-paying members)
 Senior Citizens(RA 10645)
 Informal Economy(OFWs)
Non-government Public Health
Organizations
Inter-Organizational Efforts in Public
Health
The Global Fund to Fight AIDS,
Tuberculosis and Malaria

 An international financing institution that invests the world’s money

to save lives.
Joint United Nations Programme on
HIV/AIDS (UNAIDS)

 Innovative partnership leading and inspiring the world in achieving

universalaccess to HIV prevention, treatment, care and support
World Bank

 A vital source of financial and technical assistance to developing countries

around the world to fight poverty, including making investments in health.
World HealthOrganization(WHO)

 The directing and coordinating authority for health within the United
Nations system.
 Providing leadership on global health matters.
 Helps in shaping the health research agenda.