the national health situation - copy
TRANSCRIPT
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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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THE NATIONAL HELATH SITUATION
- 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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THE NATIONAL HELATH SITUATION
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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THE NATIONAL HELATH SITUATION
- 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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THE NATIONAL HEALTH SITUATION
- 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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THE NATIONAL HELATH SITUATION
- 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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THE NATIONAL HELATH SITUATION
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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THE NATIONAL HEALTH SITUATION
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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THE NATIONAL HEALTH SITUATION
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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THE NATIONAL HEALTH SITUATION
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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THE NATIONAL HEALTH SITUATION
*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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THE NATIONAL HEALTH SITUATION
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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THE NATIONAL HELATH SITUATION
- 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
10/11/2014 85
NATIONAL OBJECTIVES FOR HEALTH
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NATIONAL OBJECTIVES FOR HEALTH
Mission:
Ensure accessibility and quality of health
care to improve the quality of life of all
Filipinos, especially the poor
NATIONAL OBJECTIVES FOR HEALTH
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Principles
universal access to basic health services must be
ensured.
the health and nutrition of vulnerable groups must
be prioritized.
NATIONAL OBJECTIVES FOR HEALTH
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The epidemiologic shift from infectiousto degenerative diseases must be
managed.
The performance of the health sector
must be enhanced.
NATIONAL OBJECTIVES FOR HEALTH
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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
NATIONAL OBJECTIVES FOR HEALTH
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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
NATIONAL OBJECTIVES FOR HEALTH
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b. Eliminate the certain diseases as public healthproblems
- Schistosomiasis
- malaria
- filariasis- leprosy
- rabies
NATIONAL OBJECTIVES FOR HEALTH
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c. Eradicate poliomyelitis
- vaccine-preventable diseases: measles,tetanus, diptheria, and pertussis
- Vitamin A deficiency
- Iodine deficiency disorders
NATIONAL OBJECTIVES FOR HEALTH
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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
NATIONAL OBJECTIVES FOR HEALTH
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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.
NATIONAL OBJECTIVES 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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FOURmula ONE FOR HEALTH
GOALS
Better health outcomes
More responsive health systems
Equitable health care financing
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FOURmula ONE FOR HEALTH
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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FOURmula ONE FOR HEALTH
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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FOURmula ONE FOR HEALTH
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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FOURmula ONE FOR HEALTH
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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FOURmula ONE FOR HEALTH
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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FOURmula ONE FOR HEALTH
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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FOURmula ONE FOR HEALTH
FINANCING
GOAL
Secure increased, better and sustained
investments in health to improve health
outcomes especially of the poor.
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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
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FOURmula ONEFINANCING
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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FOURmula ONEFINANCING
- 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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FOURmula ONEFINANCING
NATIONAL HEALTH FINANCING REFORMS1.Public finance management system
2.Institutionalization of revenue-enhancement
measures
*full retention of income
*asset management
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FOURmula ONEFINANCING
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
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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
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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
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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
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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
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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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