Health Policy and Administration (HPAd 201)

Saturday, 3:00 5:00 PM CPH Auditorium Francisco S. Cruz, MD., MPH.

Health Policy and Administration (HPAd 201 Saturdays) June 30 3rd Session
At the end of the two sessions, the graduate students should be able to:
Session No. 3 Plan

1. 2. 3.
4. 5. 6. 7.

Define health and development; Discuss the public health model; Discuss the fundamental concepts of social development and health development; Discuss the human rights framework in the context of health and development; Discuss the health system and its major components; Define the 1978 Alma Ata Declaration; Know the topic and reading materials for next session

3:00 Review of Session 3:30 1978 Alma Ata Declaration 4:00 2008 WHO Report 4:30 Updates on MDGs 4:50 Preparing for the Next Session: WHO- Essential Elements of Health System; Philippine Health Care Delivery System; DOH Kalusugan Pangkalahatan; LGU Health System (Hospital and PHC systems) by DOH Asec Paulyn Ubial

Health Policy and Administration (HPAd 201) 3rd Session: Review of 2nd Session
Health and Development

State of complete physical, mental and social well-being and not merely the absence of disease. Sustainable development: environment, participatory approaches to development (civil society) leading to (a)healthy and growing economy, (b) equally shared benefits of economic growth, (c) human rights and good governance and (d) environmental protection and promotion. Prevention, promotion, social management and rehabilitation (emphasis on social processes not biological causes) Health determinants: physical, socio-cultural, economic, environmental, organizational aspects; can be modified to doable, cost-efficient programs Health system goal: health promotion and maintenance; responsiveness and comprehensive health care financing; leadership and effective management; health infrastructure and organization; provision of quality health services

Health Policy and Administration (HPAd 201) 3rd Session: Primary Health Care
1978 Alma Ata Declaration: PHC
International conference on Primary Health Care Multi-sectoral approach to attain Health for All (HFA) Rights of citizens to individually and collectively participate in the planning and implementing in their health care (community-based) PHC is essential health care based on practical, scientifically sound, and socially acceptable methods and technology. Accessible, affordable and promoting self-reliance. A main social target of governments, international organizations and the whole world community in the coming decades should be the attainment by all peoples of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life. An acceptable level of HFA by the year 2000 can be attained through a fuller and better use of the world's resources

Health Policy and Administration (HPAd 201) 3rd Session: Primary Health Care
1978 Alma Ata Declaration: PHC
reflects and evolves from the economic conditions and sociocultural and political characteristics of the country and its communities and is based on the application of the relevant results of social, biomedical and health services research and public health experience; addresses the main health problems in the community, providing promotive, preventive, curative and rehabilitative services accordingly; includes at least: (1) education concerning prevailing health problems and the methods of preventing and controlling them; (2) promotion of food supply and proper nutrition; (3) an adequate supply of safe water and basic sanitation; (4) maternal and child health care, including family planning; (5)immunization against the major infectious diseases; (6) prevention and control of locally endemic diseases; (7) appropriate treatment of common diseases and injuries; and (8) provision of essential drugs;

Health Policy and Administration (HPAd 201) 3rd Session: Primary Health Care
1978 Alma Ata Declaration: PHC
involves, in addition to the health sector, all related sectors and aspects of national and community development, in particular agriculture, animal husbandry, food, industry, education, housing, public works, communications and other sectors; and demands the coordinated efforts of all those sectors; requires and promotes maximum community and individual self-reliance and participation in the planning, organization, operation and control of primary health care, making fullest use of local, national and other available resources; and to this end develops through appropriate education the ability of communities to participate; should be sustained by integrated, functional and mutually supportive referral systems, leading to the progressive improvement of comprehensive health care for all, and giving priority to those most in need; relies, at local and referral levels, on health workers, including physicians, nurses, midwives, auxiliaries and community workers as applicable, as well as traditional practitioners as needed, suitably trained socially and technically to work as a health team and to respond to the expressed health needs of the community.

Health Policy and Administration (HPAd 201) 3rd Session: Primary Health Care
1978 Alma Ata Declaration: PHC
All governments should formulate national policies, strategies and plans of action to launch and sustain primary health care as part of a comprehensive national health system and in coordination with other sectors. To this end, it will be necessary to exercise political will, to mobilize the country's resources and to use available external resources rationally. The International Conference on Primary Health Care calls for urgent and effective national and international action to develop and implement primary health care throughout the world and particularly in developing countries in a spirit of technical cooperation and in keeping with a New International Economic Order. It urges governments, WHO and UNICEF, and other international organizations, as well as multilateral and bilateral agencies, non-governmental organizations, funding agencies, all health workers and the whole world community to support national and international commitment to primary health care and to channel increased technical and financial support to it, particularly in developing countries. Equity, social justice, and health for all; community participation; health promotion; appropriate use of resources and inter-sectoral action

Health Policy and Administration (HPAd 201) 3rd Session: Primary Health Care
2008 WHO Report on PHC
Old health challenges remain and new priorities have emerged (eg,HIV/AIDS, chronic diseases, and mental health. Accelerated scale-up of PHC services necessary to achieve the MDGs From under-investment, to single disease focus, and now to increased funding and multiple new initiatives. Selective (vertical) vs comprehensive (horizontal) delivery, but is now shifting towards combining the strengths of both approaches in health systems. Community vs facility-based health care: building integrated health systems. Achievement of high and equitable coverage of integrated primary health-care services requires consistent political and financial commitment, incremental implementation based on local epidemiology, use of data to direct priorities and assess progress, especially at district level, and effective linkages with communities and non-health sectors. Community participation and intersectoral engagement seem to be the weakest strands in primary health care.

Health Policy and Administration (HPAd 201) 3rd Session: Primary Health Care
2008 WHO Report on PHC
Need for long-term human resource planning and better training and supportive supervision. Essential drugs policies have made an important contribution to PHC but other appropriate technology lags behind. Other challenges: expanding demand by an increasing population; high cost of treatment, bio-terrorism; climate change and disaster; (plus migrant workers health FSC). Global health priorities: the challenges of linking health and development: promoting cost-effective sets of interventions, encouraging increased government spending in health and greater private sector involvement. Tensions between comprehensive and selective primary health care Programmatic shifts: from competition to integration within the continuum of care The reality of comprehensive primary healthcare services (HHR tasks and responsibilities, available resources, political will and governance; disease surveillance)

Health Policy and Administration (HPAd 201) 3rd Session: Updates on MDGs
Progress toward the MDG for health has been mixed. In the Philippines, there is a high chance of achieving MDG4 but low in MDGs 5 and 6. Accelerating progress toward the MDGs for health is possible in all regions and countries. Additional resources are required but will not be sufficient to reach the MDGs. Many governments lack credible and resource backed strategies for the prevention, treatment, and control of communicable diseases. Some countries appear to spend less than they can afford. Why the MDGs matter its the worlds poor who die earlier. The poorest countries are progressing slowest toward the MDGS.

Health Policy and Administration (HPAd 201) 3rd Session: Updates on Phl MDGs
First, the MDGs have been integrated into the 2011-2016 Philippine Development Plan , thus allowing government strategies, policies, and action plans to simultaneously address MDG targets. Second, the government has closely monitored its own rate of progress with MDG indicators, and has used this information to fine-tune planning and implementation processes, particularly at the local level. Nevertheless, serious challenges and threats remain with regard to targets on maternal health, access to reproductive health services, nutrition, primary education, and environmental sustainability. Moreover, glaring disparities across regions persist, as do severe funding constraints. The probability of attaining the targets depends largely on the confluence of several factors. Among them are the scaling up of current efforts on all target areas; more efficient synchronization and allocation of available limited resources; and stronger advocacy as well as the enhanced capability of MDG implementation at the LGUs.

Principle of Health Administration Preparing for the Next (4th) Session

Reading Materials for July 7, 2012 Any WHO article on Essential Elements of Health System Primary Health Care Approach (1978 and 2008) DOH Kalusugan Pangkalahatan (D.O. 2011 0188)* Any local article (updates) on devolved health services in provinces, cities and municipalities in the Philippines* Visit www.doh.gov.ph and review LGU Scorecard* * Attachments in Session No. 6 (Planning as Management Function)