chd1_chapterii_health care delivery system

8/3/2019 CHD1_chapterII_health Care Delivery System

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THEPHILIPPINE

CHAPTER II

HEALTH CARE

DELIVERYSYSTEM


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HEALTH CARE SYSTEM

Is the totality of service offeredby all health disciplines.

system was to provide care to illand injured.


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MAJOR PLAYERS:

PUBLIC SECTORWhich is largely finance through

both national and local levels.And were Health care is generally

given free at the point of service.


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Consist:

National and Local government agenciesproviding health services. It also contains

prov nc a ea eams ma e up orepresentatives to the local health boardsand personnel.


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PRIVATE SECTORLargely market oriented

and where Health care ispaid through user fees at

the point of service.


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Consists:

For profit and non-profit health providers. Itincludes providing health services in clinics andhos itals health insurance manufacture of

medicine, vaccine, medical supplies, equipmentand other health and nutrition products, researchand development, human resource development

and other health related services.


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stor ca

Backgroundof DOH


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Pre-spanish and spanish periods

Traditional health care practices specially theused of herbs and rituals for healing were widelypracticed during this period.

JUNE 23,1898- the DPWEH was created byvirtue of a decree signed by president EmilioAguinaldo.

SEPTEMBER 29,1898- With the primaryobjective of protecting the health of Americansoldiers Gen. Orders No.15 established theboard of health for city of Manila.


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JUNE 1,1901- Board of health for the Philippine

Islands was crated through Act No. 157.Thisfunctioned as the local health board of Manila.

OCT.26,1905- The insular board of health

proved to be inefficient operationally so it wasabolished and was replaced by the Bureau ofhealth under the Department of Interior through

.

1912- Act No. 2156 known as Fajardo Act,consolidated the municipalities into sanitarydivision and established as the Health Fund for

travel and salaries


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1915- Act No.2468 transformed the Bureau of

health into a commissioned service called ThePhilippine Health Service.

AUG.2,1916- The passage of the Jones Lawalso known as the Philippine Autonomy Act,filipino struggle for Philippine Independencefrom the American rule.

- .Reorganization Act. Of 1932, reverted back thePhilippine service into Bureau of Health, andcombined the Bureau of public welfare.


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PHILIPPINE COMMONWEALTH AND

JAPANESE OCCUPATION MAY31,1939- Commonwealth Act No.430

created the Department Health and Welfare butthe full implementation was only completedthrough the Exe. Order No.317

1942- During Japanese occupation, various

welfare were instituted and lasted untilAmericans came.

OCT4,1947- Exe. Order No. 94 provided for the

post-war reorganization of the DOH and publicwelfare


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JAN.1,1951- The office of the president of the

sanitary district was converted into RHU,carrying out 7 basic health services:

Mother and Child Services

Environmental Health Communicable disease control

Vital Statistics

Medical Care Health Education

Public Health Nursing


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FEB.20,1958- Exe. Order No. 228 Provided for

what is prescribed as the most sweepingreorganization in the history of DOH.

1970- The RHCDS was conceptualized.

Classified Health services into primary,secondary and tertiary level of care.

JUNE 2,1978-With the proclamation of Martial

Law, Pres. Decree 1397 renamed the DOH toMOH.

DEC.2,1982- Exe. Order No. 851 signed by

president Ferdinand Marcos reorganized theministry of health as an integrated HCDS.


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APR.13,1987- Exe. Order No. 119

Reorganizing the ministry of health bypresident Aquino saw in major change in thestructure of the ministry. Transformed the MOHback to DOH.

OCT.10, 1991- R.A. 7160 known as the LGCprovided for the decentralization of the entire

.the role and functions of DOH.

MAY24, 1999- Exe. Order No. 102 redirectingthe functions and operations of the DOH by

president Estrada granted the DOH to proceedwith its rationalization and streamlining plan.


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1999-2004- Development of HSRA which

described the major strategies, organizationaland policy changes and public investmentneeded to improve the way health care is

delivered, regulated and finance. 2005 ongoing- Development of a plan to

rationalize the bureaucracy in an attempt tosca e own nc u ng e .


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National authority on health

providing technical and otherresource assistance


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Three

SpecificRoles

In the HealthSector

Leadership

inHealth

Enabler

andCapacityBuilder

Administrator

ofSpecificServices


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Leadership in Health

Serve as the national policyand regulatory institution.

rov e ea ers p n t eformulation

Serve as advocate in theadoption


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Enabler and Capacity Builder

Innovate new strategies inhealth, initiate public,

policy research outputs.

Exercise oversight functionsEnsure the highest achievable

standards of quality.


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Administrator of Specific

Services

Manage selected nationalfacilities and hospitals with

.Administer direct services

for emergent health concernsAdminister health emergency

response services


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Vision and MissionVision

The DOH is theleader staunch

Mission

Guarantee equitable,sustainable and

advocate andmodel in

promotingHealth for All inthe Philippines.

qu y rall Filipinos,especially the poor

and shall lead thequest forexcellence in

health


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Goal: Health Sector Reform

Agenda

Sound organizationalDevelopment

rong o c esSystems and Procedures

Capable Human ResourcesAdequate Financial

Resources


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Rationale for Health Sector

Reform

Following Conditions

Slowing down in the reduction Persistence of large variations in health

u High burden

Rising burden

Unattended emerging health risks

Burden of disease


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Factors Affecting the

Conditions:

Inappropriate Healthdelivery system

na equa e regu a orymechanisms for health

servicesPoor health care financing


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Implications

There is poor coverageThere is inequality access

There is low and high qualitycost


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Framework for Implementation of

HSRA: FOURmula ONE for Health

Intends to implement critical interventions as

a single package backed by effectivemanagement infrastructure and financing

approach.


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Goals of FOURmula ONE for

Health

Better health outcomes

More responsive health systems

Equitable health care financing


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Four elements of the Strategy

1. Health financing

2. Health Regulation

3. Health service delivery

4. Good governance


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Key features of the FOURmula

ONE

Engagement of the National Health

Insurance Program (NHIP) as the mainlever to effect desired changes and

implementation components


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NHIP supports each of the

elements in term of:

1. Financing

2. Governance

3. Regulation

4. Service Delivery


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Roadmap for All Stakeholders in Health:

National Objectives for Health 2005-2010

NOH 2005-2010

Provides the road map for skateholders inhealth and health-related sectors to intensify

-honored vision of health for all Filipinos

Sets the targets and the critical indicators,

current strategies based on field experinces,and laying down new avenues for improvedinterventions


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Provides concrete handle that would guide

policy makers, program managers, localgovernment executives, development

,

making crucial decisions for health


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Objectives of the Health

Sectors

A. Improve the general health status of the

populationB. Reduce morbidity and mortality from certain

diseases

C. Eliminate certain diseasesD. Promote healthy lifestyle and environmental

health

E. Protect vulnerable groups with speacialhealth and nutrition needs


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F. Strengthen national and local health systemsto ensure better health service delivery

G. Pursue public health and hospital reforms

H. Reduce the cost and ensure the quality of

essential drugsI. Institute health regulatory reforms to ensure

quality and safety of health goods and

services


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J. Strengthen health governance andmanagement support systems

K. Institute safety nets for the vulnerable andmarginalized systems

.

insurance

M. Mobilize more resources for health

N. Improve efficiency in the allocation,production and utilization of resources forhealth


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LOCAL HEALTH SYSTEM

Historical background

1. Post war independence

- Philippine Health Care System was

a m n stere y a centra agency ase nManila

2. 1992

- Major shift took place in the Local GovernmentCode also known as Republic Act 7160. LGUruns the local health systems


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Objectives Establish local health systems for effective

and efficient delivery of health care services

Upgrade the health care management andservice capabilities of local health facilities

Promote inter-LGU linkages and cost sharingschemes

Foster participation of the private sector, non-

government organization (NGOs) andcommunities in local health systemsdevelopment


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Ensure the quality of health service delivery

at the local level


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Inter Local Health Systems

Being espoused by the DOH in order to

ensure quality of health care service at thelocal level.

health system in which individuals,communities and all other health careproviders in a well-defined geographical area

Expected Achievement of the


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Expected Achievement of the

Inter-Local Health System

Universal coverage of health insurance

Improved quality of hospital and Rural HealthUnits (RHU) service

ect ve re erra system Integrated planning

Appropriate Health Information System

Improved Drug Management System

Developed human resources


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Effective leadership through Inter-LGU

corporation Financially visible or self sustaining hospitals

ntegrat on o pu c ea t an curat vehospital care

Strengthened cooperation between LGU and

health services

G idi P i i l I D l i


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Guiding Principles In Developing

The Inter-Local Health System

Financial and Administrative autonomy of the

provincial and municipal administrations(LGUs)

Strategic synergies and partnerships

Community participation

Equity of access to health services by thepopulation, especially the poor


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Affordability of health services

Appropriateness of health programs

Decentralized management

Sustainability of health initiatives Upholding of standards of quality health

service

Composition of the Inter Local


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Composition of the Inter-Local

Health Zone

1. People

2. Boundaries

3. Health Facilities

4. Health Workers


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PRIMARY HEALTH CAREPRIMARY HEALTH CAREPRIMARY HEALTH CAREPRIMARY HEALTH CARE

AN APPROACH TO DELIVERY OF

HEALTH CARE SERVICES


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PRIMARY HEALTH CAREPRIMARY HEALTH CAREPRIMARY HEALTH CAREPRIMARY HEALTH CARE

Is an essential care made

DEFINITION

access e o e

community throughacceptable means


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HISTORY

H lth r ll Y r 2

Declared during First International Conference on Primary HealthCare

Held in Alma Ata, USSRHappened on September 6-12, 1978

Organized by the World Health Organization


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HISTORYLETTER OF INSTRUCTION 949

Philippines

HEALTH IN THE

HANDS OF PEOPLE

BY 2020

Yxw|tw XA `tvYxw|tw XA `tvYxw|tw XA `tvYxw|tw XA `tvOctober 19, 1979


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HISTORY

Wespite thefailure to realize the goal

2000, the altruisticendeavor has bear fruitas it has produced

progress in the lives ofpeople from thecommunities it hasinfluenced.


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CONCEPTS

PARTNERSHIP + EMPOWERMENT OF PEOPLE = PRIMARY HEALTH CARE

EFFECTIVE

ACCESSIBLE

ACCEPTABLE

SUSTAINABLE


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ELEMENTS AND COMPONENTS

1.Environmental sanitation


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2. Control of Communicable Diseases


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3. Immunization


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4. Health Education


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5. Maternal and Child Health and Family Planning


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6. Adequate Food and Proper Nutrition


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7. Provision of Medical Care and Emergency Treatment


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8. Treatment of Locally Endemic Diseases


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9. Provision of Essential Drugs


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STRATEGIES

national health care system withthe establishment of functional

support mechanism.


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STRATEGIES

and enabling processfor health action at alllevels.


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STRATEGIES

know their communities andidentifying their basic health

needs.


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STRATEGIES

appropriate technologyfocusing on local indigenous

resources available in andacceptable to the community.


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STRATEGIES

Or anization of

communities arising fromtheir expressed needswhich they have decided toaddress.


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STRATEGIES

participation in local level planning,management, monitoring andevaluation within the context of

regional and national objectives.


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STRATEGIES

-

linkages with othergovernment and private

agencies.


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STRATEGIES

mp as z ng par ners p sothat the health workers and thecommunity leaders/members

view each other as partners.


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FOUR PILLARS/CORNERSTONES

1. Active communityparticipation

2. Intra and inter-sectorallinkages

3. Use of appropriate

technology4. Support mechanism made

available


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TYPES OF WORKERS

Available health man ower resources

Local health needs and problems

Political and financial feasibility


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TYPES OF WORKERS

Physician

Nurses

Midwives

Traditional healers

Community health workers


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LEVELS OF WORKERS

Village or Barangay health workers.

ra ne commun ty ea t wor ers. ea t

auxiliary volunteer. traditional birthattendant or healer

Intermediate level health workers.

General medical practitioners or their assistants.Public health nurse. Rural sanitary inspectors

and midwives


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LEVELS OF HEALTHCARE

SYSTEM


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PRIMARY LEVEL CARE

Devolve to the cities and themun c pa es.


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SECONDARY LEVEL OF CARE

Is given by the physicians with basichealth tranin .


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TERTIARY LEVEL OF CARE

Is rendered by specialist in healthfacilities includin medical centers as

well as regional and provincialhospitals and specialized hospitals.


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LEVELS OF

SERVICES

National Health ServicesMedical Centers

Teaching Hosptials


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Regional Health ServicesRegional Medical Centers

And Training Hospitals

Provincial / City Health ServicesProvincial / City Hospitals

Emergency / District Hospitals

Rural Health UnitCommunity Hospitals and Health CentersPrivate Practitioners / Puericulture Centers

Barangay Health Stations

Levels of Health Care and Referral System


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On Duty Marcelino, Regine

Ortua, Justine Pearl

Pata oc Jan ss A ril

Pesebre, Johnette Vinluan, Sandi

II-AN

chd1_chapterii_health care delivery system

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