HEALTH SYSTEM Goal of Health System

Definition: (1) Improving the health of people

 Health systems can be understood in many ways. The (2) Improving the responsiveness of the health system to the
World Health Organization (WHO) defines health population it serves, which has 2 components:
systems as “all the organizations, institutions, and - Respect for person
World Health Organization (WHO) defines health - Client orientation
systems as “all the organizations, institutions, and (3) Financial Contribution
resources whose primary purpose is to improve the
health. Government Policy and Health Policy
 - This definition includes the full range of players
engaged in the provision and financing of health Governmental Policy Levers Relevance to Health
services including the public, nonprofit, and for-profit Programs
private sectors, as well as international and bilateral Size of the total government Sets the overall limit on what
donors, foundations, and voluntary organizations health budget a government can spend
involved in funding or implementing health activities. Financing mechanisms for Determine what flexibility
 Health systems encompass all levels: funding the health care the government has for
central, regional, district, community, and system (e.g., donor support, financing health care and
household. Health sector projects engage with all levels taxes, user fees, social identify potential financial
and elements of the health system and frequently insurance contributions) barriers that may exist for
encounter constraints that limit their effectiveness. accessing care (e.g., fees,
 the four key functions of the health system: their levels, and exemptions).
(1) stewardship (often referred to as governance or Allocation of the government Reflects how the government
oversight), health budget uses its tax resources to, for
(2) financing, example, deliver services,
(3) human and physical resources, employ staff, subsidize
(4) organization and management of service delivery providers,regulate the
sector, provide information,
Stewardship (Governance), Policy, and Advocacy and configure the sector in
 The stewardship, or governance, function reflects the terms of preventive vs.
fact that people entrust both their lives and their curative services, personnel
resources to the health system. The government in vs. supplies, investment in
particular is called upon to play the role of a steward, human resources (training)
because it spends revenues that people pay through vs.physical resources
taxes and social insurance, and because government (hospital).Affects which
makes many of the regulations that govern the programs are prioritized and
operation of health services in other private and what populations will benefit
voluntary transactions (WHO 2000). (rich vs. poor, urban vs.
 developing, implementing, and enforcing policies that rural).
affect the other health system functions. WHO has Regulation of civil society Can facilitate or constrain the
recommended that one of the primary roles of a organizations functioning of private
Ministry of Health is to develop health sector policy, voluntary organizations
with the aims of improving health system performance (PVOs), nongovernmental
and promoting the health of the people (WHO 2000). organizations(NGOs), and
Governments have a variety of so-called policy levers community organizations
they exercise to affect health programs and health with regard to service
outcomes. delivery and the capacity
Relationship between the 4 functions of health systems such groups have to
influence and advocate for
health services.
Political support to raise Can be powerful for
awareness for specific health stigmatized or polemic
messages and behaviors health initiatives and
(e.g., clear government promoting high impact
support for specific health health interventions (e.g.,
messages such as prevention handwashing).
of HIV,contraceptive use, or
TB treatment)
Adoption of specific health Can improve the quality of
standards or guidelines care, expand or constrain the
number of providers, and
facilitate implementation of
approaches such as
 Integrated Management of  There are longer waiting times for patients to
Childhood Illness (IMCI) receive elective secondary and tertiary services.
Regulation of Can improve medicine
pharmaceuticals quality assurance and BEVERIDGE MODEL
rational use of medicines.  Most organized health system in the world
Can influence the ability to  William Beveridge
bring medicines and supplies  Beveridge’s idea to provide high quality medical care
into the country. rather than to seek profits was widely popular with the
Business regulations and Can influence the degree to public after the emotional and financial turmoil of
taxation which the private sector WWII.
participates in health  The Beveridge Model is a nationalized health care
care—for example, import system. Similar to how public libraries and police forces
taxes can affect are financed by the government, health care is
pharmaceutical sales; controlled through citizen tax money. Citizens of
business regulations can countries who utilize this health care plan do not
hamper private providers directly pay for their medical or other health-related
from setting up practices; bills. The goal of this plan is to provide quality health
imitations on advertising can care regardless of people’s ability to pay for their care.
limit promotion of branded  Some of the countries that use this plan include Great
health products. Britain, Spain, Italy, Scandinavia, Finland, New Zealand,
Hong Kong, and Cuba. However, each country has built
BISMARK MODEL upon and adopted its own form of the Beveridge Model.
In 1883, Prussian chancellor Otto von Bismarck created the In the US, the Beveridge Model approach is applied to
Bismarck Model as a social welfare measure for German veterans and Native Americans.
unification. His national health care model was based on Pros:
three principles:  Every citizen has access to health care because of the
1. The government is responsible for universal access to universal coverage.
health care.  The government is responsible for quality of care, and
2. Health policy is implemented by the smallest political this may be beneficial if the government keeps the cost
and administrative units in society. of health care low.
3. Elected government officials negotiate the terms of  Citizens do not receive and are not responsible for
medical care and reflect the interest of different medical bills or co-pay.
medical professions
- In the Bismarck model, the insurance system is financed Cons:
jointly by employers and employees through payroll taxes,  Every citizen must pay the higher taxes regardless of
called “sickness funds.” These taxes are directly deducted their use of health care.
from paychecks. The United States has adopted a form of the  The government is responsible for quality of care, and
Bismarck model of health care. Most Americans who are this may be harmful if the government restricts the
employed but not yet eligible for Medicare receive health services patients are allowed access to.
insurance coverage from their employers as a benefit of  There are long waiting lists and lines to receive care,
employment. However, this approach is not as advanced as especially for those with non-emergency situations.
the German version because employers limit the list of health
insurers that employees can use. CHARACTERISTICS BISMARCK BEVERIDGE
- Other countries that have adopted forms of the Bismark Coverage Based on universal
Model include Japan, Switzerland, France, Belgium, the occupation
Netherlands, and parts of Latin America. Eligibility Employers & citizenship
employees
Pros: Benefits Earnings-related Flat-rate
 Individuals do not need to worry about being uninsured Managements Representatives of Government
or going broke from expensive health care bills. employees & the
 Compared to the US, the administrative costs of this insured people
model are much lower. Decides on the Public Government
 There is little waiting time to receive primary care rights and
services. obligations of the
insured
Cons:
 The focus on low costs and efficient care means there Countries With the Most Well-Developed Public Health Care
are less health care services available for citizens living Systems
in rural areas. 1. Denmark
 Mandatory employment taxes are high in order to keep The Danish universal health care system provides Danes with
health care affordable. mostly free medical care and is predominantly financed
through income tax. All permanent residents are entitled to a
national health insurance card, and most examinations and
treatments are free of charge.
2. Sweden
The Swedish health care system is characterized by high
standards of quality care and above-average healthcare
spending. Only about 600,000 Swedes have a private health
plan, which is usually covered by their employers and can be
helpful to skip queues for treatment.
3. Canada
Canada’s publicly funded health care system is a group of
socialized health insurance plans providing coverage to all
Canadian citizens and permanent residents. Canada holds a
remarkably high life expectancy rate, which many attribute to
the efficiency of its health care system.
4. United Kingdom
Healthcare in the UK has proved to be reliable and
convenient for citizens and expatriate workers. The National
Health Service, Scottish and Northern Ireland state programs
provide many options for emergency medical treatment.
5. Germany
The healthcare system in Germany is very good, but
expensive. Health insurance is mandatory, and most
expatriates will have it added to their employee contract.
Health system building blocks
 To achieve their goals, all health systems have to carry
out some basic functions, regardless of how they are
organized: they have to provide services; develop health
workers and otherkey resources; mobilize and allocate
finances, and ensure health system leadership
andgovernance (also known as stewardship, which is
about oversight and guidance of the wholesystem). For
the purpose of clearly articulating what WHO will do to
help strengthen healthsystems, the functions identified
in the World health report 2000 have been broken
down into a set of six essential ‘building blocks’. All are
needed to improve outcomes. This isWHO’s health
system framework.
Desirable attributes
Irrespective of how a health system is organized, there are
some desired attributes for each building block that hold true
across all systems.
1. Multiple, dynamic relationships
A health system, like any other system, is a set of
inter-connected parts that must function together to be
effective.
2. Health system strengthening
Is defined as improving these six health system building
blocks and managing their
interactions in ways that achieve more equitable and
sustained improvements across health
services and health outcomes. It requires both technical and
political knowledge and
action.
3. Access and coverage
Since notions of improved access and coverage lie at the
heart of this WHO health system strengthening strategy,
there has to be some common understanding of these terms.
4. Is progress being made?
A key concern of governments and others who invest in
health systems is how to tell whether
and when the desired improvements in health system
performance are being achieved.
Convincing indicators that can detect changes on the ground
are needed.
 Good health services are those which deliver effective,
safe, quality personal and non-personal health
interventions to those who need them, when and where
needed, with minimum waste of resources.
 A well-performing health workforce is one which works
in ways that are responsive, fair and efficient to achieve
the best health outcomes possible, given available
resources and circumstances. I.e. There are sufficient
numbers and mix of staff, fairly distributed; they are
competent,responsive and productive.
 A well-functioning health information system is one
that ensures the production, analysis, dissemination and
use of reliable and timely information on health
determinants, health systems performance and health
status.
 A well-functioning health system ensures equitable
access to essential medical products, vaccines and
technologies of assured quality, safety, efficacy and
cost-effectiveness, and their scientifically sound and
cost-effective use.
 A good health financing system raises adequate funds
for health, in ways that ensure people can use needed
services, and are protected from financial catastrophe
or impoverishment associated with having topay for
them.
 Leadership and governance involves ensuring strategic
policy frameworks exist and are combined with effective
oversight, coalition building, the provision of
appropriate regulations and incentives, attention to
system-design, and accountability.

PHILHEALTH
HISTORY
The Philippine Health Insurance Corporation, or
PhilHealth, was created in 1995 to administer the National
Health. Insurance Program, which aims to provide financial
access to health services to all Filipinos. In 1998, PhilHealth
established the Sponsored Program to provide coverage for
the poor. In 2004, the Philippines passed a law to mandate
subsidized coverage of the indigent, and PhilHealth
campaigned with the Local Government Units to enroll the
poor in their jurisdiction, while the Department of Health
invested in the local health service delivery and strengthened
its regulatory function (Lagrada, 2009).
GOVERNANCE
The scheme is entirely administered byPhilHealth, a
government corporation attached to the Department of
Health. PhilHealth collects premiums,accredits providers, sets
the benefits packages and provider payment mechanisms,
processes claims, and reimburses providers for their services.
PhilHealth is responsible for oversight and administration of
public-sector insurance schemes.
FINANCING
PhilHealth is financed primarily through contributions
from members of Formal and Informal Economy Members.
HEALTH CARE
Primary Health Care
 Is a whole-of-society approach to health and well-being
centred on the needs and preferences of individuals,
families and communities. (WHO)
 Ensures people receive comprehensive care - ranging
from promotion and prevention to treatment,
rehabilitation and palliative care. (WHO)
 Art. 25 of the Universal Declaration on Human Rights:
“Everyone has the right to a standard of living adequate
for the health and wellbeing of himself and of his family,
including food, clothing housing and medical care and
necessary social services […]”. (WHO)
Elements of Primary health care
 Education
 Water and Sanitation
 Nutrition
 Maternal and child birth
 Immunization
 Prevention of endemic disease
 Treatment
 Drug availability
 Education on health problems and how to prevent and
control them.
 Development of effective food supply and proper
nutrition.
 Maternal and child healthcare, including family
planning.
 Adequate and safe water supply and basic sanitation.
 Immunization against major infectious diseases.
 Local endemic diseases control.
 Appropriate treatment of common diseases and
injuries.
 Provision of essential basic medication.
Principles of Primary health care
 Accesibility (equal distribution)
- the first and most important key to PHC.
Healthcare services must be equally shared by all
the people of the community irrespective of their
race, creed or economic status. This concept helps
to shift the accessibility of healthcare from the
cities to the rural area where the most needy and
vulnerable groups of the population live.
 Community Participation
- includes meaningful involvement of the
community in planning, implementing and
maintaining their health services. Through the
involvement of the community, maximum
utilisation of local resources, such as manpower,
money and materials. Can be utilised to fulfill the
goals of PHC.
 Health Promotion
- involves all the important issues of health
education, nutrition, sanitation, maternal and child
health, and prevention and control of endemic
diseases. Through health promotion, individuals
and families build an understanding of the
determinants of health and develop skills to
improve and maintain their health and wellbeing.
 Appropriate technology
- technology that is scientifically sound, adaptable
 to local needs, and acceptable to thoe who apply it
and from whom it is used.
 Inter-sectoral collaboration
- to be able to improve the health of local people,
the PHC programme needs not only the health
sector, but also the involvement of other sectors,
like agriculture, education and housing.
PHILIPPINE HEALTH CARE SYSTEM
THE DOH MANDATE
- DOH is mandated to be the over-all technical authority on
health.
- Major mandate is to provide nat’l policy direction & develop
nat’l plans, technical standards & guidelines on health.
- A regulator of all health services & products
- Provider of special or tertiary health care services & of
technical assistance to other health providers especially to
LGU.
DOH’s shall pursue & assure the ff:
● Promotion of health & wellbeing for every Filipino;
● Prevention & control of dse among the population at risk
● Protection of individuals, families, and communities
exposed to health hazards & risks; and
● Tx, management & rehab of individuals affected by dse &
disability.
● The lead agency in articulating nat’l objectives for health to
guide the development of local health systems, programs
& services;
● Direct service provider for specific programs that affect
large segments of the population, TB, malaria,
Schistosomiasis, HIV-AIDS, and other emerging infections
& micronutrient deficiencies
 Lead agency in health emergency response services,
including referral and networking systems for trauma,
injuries and catastrophic events;
 Technical authority in dse control & prevention;
 Lead agency in ensuring equity, access and quality of
health care services through policy formulation, standards
dev’t and regulations;
 Technical oversight agency in charge of monitoring and
evaluating the implementation of health programs,
projects research, training and services;
 Administrator of selected health facilities at sub-nat’l levels
that act as referral centers for local health systems I.e.,
tertiary & special hospitals, reference laboratories, training
centers, centers for health promotion, center for dse
control, and prevention, regulatory offices among others.
 Innovator of new strategies for responding to emerging
needs;
 Advocate for health promotion and healthy lifestyles for
the general population;
 Capacity-builder of LGUs, the private sector, non-gov’t
organizations, peoples organizations, nat’l gov’t agencies in
implementing health programs, services, through technical
collaborations, logistical support, provision of grants and
allocation and other partnership mechanism;
 Lead agency health and medical research;
 Facilitator of the dev’t of health industrial complex in
partnership with the private sector to ensure
self-sufficiency in the production of biologicals, vaccines
and drugs & medicines;
 Lead agency in health emergency preparedness and
response
 Protector of standards of excellence in the training and
education of health care providers at all levels of the
health care system;
 Implementer of the national health insurance law;
providing administrative and technical leadership in health
care financing;
 Expressing national objectives for health to lead the
progress of local health systems, programs and services.
 Formulate national policies and standards for Health;
 Prevent and control leading causes of death and
Disability;
 Develop disease surveillance and health information
systems;
 Maintain national health facilities and hospitals with
modern and advanced capabilities to support local
services;
 Promote health and well-being through public information
and to provide the public with timely an relevant on health
risks and hazards;
 Develop and implement strategies to achieve appropriate
expenditure patterns in health as recommended by
international agencies;
 Develop sub-national centers and facilities for health
promotion, disease control and prevention, standards,
regulations, and technical assistance;
 Promote and maintain international linkages for
technical collaboration;
 Create the environment for the development of a health
industrial complex;
 Assume leadership in health in times of emergencies,
calamities, and disasters and system failures;
 Ensure quality of training and health human resource
development at all levels of the health care system;
 Oversee financing of the health sector and ensure equity
and accessibility to health services;
 Articulate the national health research agenda and ensure
the provision of sufficient resources and logistics.
DOH HAS THREE SPECIFIC ROLES IN THE
HEALTH SECTOR:
leadership in health,
enabler and capacity builder and administrator of specific
services namely:
national and sun-national health facilities and hospitals
serving as referral centers, direct services for emergent
health concerns requiring complicated technologies and
assessed as critical for public welfare and health emergency
response services, referral and networking systems for
trauma, injuries, catastrophic events, epidemics and other
widespread public danger.
TO ACCOMPLISH ITS MANDATE AND ROLES THE
DEPARTMENT HAS THE FOLLOWING POWER AND
FUNCTIONS BASED ON EXECUTIVE ORDER 102:
 Formulate national policies and standards for health;
 Prevent and control leading causes of death and
disability;
 Develop disease surveillance and health information
systems;
 Maintain national health facilities and hospitals with
modern and advanced capabilities to support local
services;
 Promote health and well-being through public
information and to provide the public with timely and
relevant on health risks and hazards;
 Develop and implement strategies to achieve
appropriate expenditure patterns in health as
recommended by international agencies;
 Develop sub-national centers and facilities for health
promotion, disease control and prevention, standards,
regulations and technical assistance
 Promote and maintain international linkages for
technical collaboration;
 Create the environment for the development of a health
industrial complex;
 Assume leadership in health in times of emergencies,
calamities, and disaster and system failures;
 Ensure quality of training and health human resource
development at all levels of the health care system;
 Oversee financing of the health sector and ensure
equity and accessibility to health services;
 Articulate the national health research agenda and
ensure the provision of sufficient resources and logistics
to attain excellence in evidenced based intervention for
health.
CENTER FOR HEALTH DEVELOPMENT
 Responsible for fields operations of the department in
its administrative region and for providing catchment
area with the efficient and effective medical services;
 Tasked to implement laws, regulations, policies and
program ;
 Tasked to coordinate with regional offices of the
departments, offices and agencies as well as with the
local government
 Acts as the main catalyst and organizer in the ILHZ.
DOH HOSPITALS
- hospitals based care; specialized or general services,
research in clinical priorities, training hospitals for medical
specialization.
ATTACHED AGENCIES
 The Philippine Health Insurance Corporation
 Dangerous Drugs Boards
 Philippine Institute of Traditional and Alterna
 Philippines National AIDS Council
INTER LOCAL HEALTH ZONE
 Unit of the health system created for local health
service management and delivery in the Philippines
 Has a defined population within a define geographical
area (clustering of municipalities) and comprises a
central referral hospital and primary level facilities
 Central referral hospital:
main hospital for the ILHZ, main point of referral for
hospital services in the community
PURPOSE:
to re-integrate hospital and public health services for a
holistic delivery of health services
LEVELS OF HEALTH CARE FACILITIES
1. PRIMARY LEVEL OF HEALTH CARE FACILITIES
- are the rural health units, their sub-centers, chest
clinics, malaria eradication units, and schistosomiasis
control units operated by the DOH;
- puericulture centers operated by League of
Puericulture Centers;
- tuberculosis society;
- private clinics, clinics operated by the Philippine
medical Association;
- clinics operated by large industrial firms for their
employees;
- community hospitals and health centers operated by
the Philippine medicare care commission and other
health facilities operated by voluntary religious and civic
groups (William-Tungpalan, 1981)
2. SECONDARY LEVEL OF HEALTH CARE FACILITIES
- are smaller, non-departmentalized hospitals including
emergency and regional hospitals.
- services offered to patients with symptomatic stages
of disease, which require moderately specialized
knowledge and technical resources for adequate
treatment.
3. TERTIARY LEVEL OF HEALTH CARE FACILITIES
- are the highly technological and sophisticated services
offered by medical centers and large hospitals. These are the
specialized national hospitals.
LEVELS OF PRIMARY HEALTH CARE WORKERS
(1) GRASSROOT OR VILLAGE HEALTH WORKERS
- First contacts of the community and initial links of health
care
- Provide simple curative and preventive health care
measures promoting healthy environment
- Participate in activities geared towards the improvement of
the socio-economic level of the community like food
production program
- Community health worker, volunteers or traditional birth
attendants
(2) INTERMEDIATE LEVEL HEALTH WORKERS
- Represent the first source of professional health care
- Attends to health problems beyond the competence of
village workers
- Provide support to front-line health workers in terms of
supervision, training, supplies, and services
- Medical practitioners, nurses and midwives
(3) FIRST-LINE HOSPITAL PERSONNEL
- Provide backup health services for cases that require
hospitalization
- Establish close contact with intermediate level health
workers or village health workers
- Physician’s with specialty, nurses, dentist, pharmacists,
other health professional.
 HEALTH INFORMATION TECHNOLOGY
What is Health IT?
• The term “health information technology” (health IT) refers
to the electronic systems health care professionals – and
increasingly, patients- use to store, share, and analyze
health information.
Health IT includes
• Electronic Health Record (EHRs)
- EHRs allow doctors to better keep track of your health
information and may enable them to see it when you
have a problem even if their office is closed. EHRs also
make it easier for your doctor to share information with
specialists, so that specialists who need your
information have it available when it’s needed.
1. INTERSECTORAL LINKAGES
- Primary health care forms an integral part of the health
system and the over all social and economic development of
the community. as such, it is necessary to unify health
efforts within the health organization itself and with other
sectors concerned.
- It implies the integration of health plans with the plan for
the total community development.
- Sectors most closely related to health include
those concerned with:
 agricultural
 education
 public works
 local government
 social welfare
 population control
 private sectors
• Personal Health Records (PHRs)
2. INTRASECTORAL LINKAGES - A PHR is a lot like an HER, except that you control what
- In the health sector, the acceptance of primary health care kind of information goes into it. You can use a PHR to
necessitates the restructuring of the health system to keep track of information from your doctor visits, but
broaden health coverage and make health service available the PHR can also reflect your life outside the doctor’s
to all. priorities, such as tracking what you eat, how much you
- There is now a widely accepted pyramidal organization that exercise, and your blood pressure. Sometimes, your PHR
provides levels of services starting with primary health and can link with your doctor’s HER.
progressing to specialty care. Primary health care is the hub
of the health system.

• Electronic Prescribing (E-prescribing)

- A paper prescription can get lost or misread.
E-prescribing allows your doctor to communicate
directly with your pharmacy. This means you can go to
the pharmacy to pick up medicine without having to
bring the paper prescription.

• Privacy and security
- all these electronic systems can increase the
protection of your health information. For example,
electronic information can be encrypted sot that only
authorized people can read it. Health IT can also make it
easier to record and track who has accessed your
information.
Health Information Ecosystem
• Healthcare used to be much easier. The “ecosystem”
consisted of you-the patient-and your doctor, the
provider. If you needed medical attention or required a
hospital stay, your doctor was in charge of coordinating
your care.
Health Information in the Cloud
• A health care cloud is a cloud computing service used by
health care providers for storing, maintaining and backing
up personal health information (PHI)
• Advantages:
- Data storage capacity
 one of the biggest current applications of the cloud
in healthcare is data storage. The healthcare
industry works with a tremendous amount of data,
and even the most sophisticated hardware
installations can’t handle it all. Cloud networks
allow healthcare professionals to store all the data
they use off-site to avoid the cost and strain of
maintaining physical servers.
- Scalability of service
owned physical installations as well, but
 while the need for healthcare is 24/7, certain
periods like the cold and flu season require more
of the healthcare provider’s attention. The cloud
can scale to increase or decrease data storage and
traffic depending on the client’s needs. Thus,
healthcare providers are able to fit their network
requirements to match their service demands.
- Collaboration
 Clients who use the same cloud network are able
to easily transfer data between each other. In
situations where healthcare companies need to
share medical information with each other, this
would be a huge advantage. The data can be
shared with anybody who needs to see it, allowing
for quicker collaboration to provide healthcare
solutions.
- AI and machine learning
 The massive amount of data that the healthcare
provider deal with take up a lot of time to manage
– time that could be spent with patients. Since
more cloud platforms are integrating AI and
machine learning into their services, they can help
alleviate some of that burden. Healthcare
providers can use these systems to analyze and
respond to the enormous quantity of unstructured
data they utilize.
• Disadvantages:
- Implementation
 Switching from an on-premises installation to the
cloud means changing your entire method of
handling tasks. Healthcare providers planning to
implement a cloud solution must ensure that
everybody comes up to speed with how to work on
the cloud efficiently. Otherwise, your business risks
downtime, improper handling of data, or
information leaks.
- Security dangers
 Cloud networks provide security tools that look for,
warn you of, and deal with suspicious behavior.
However, they are not perfect. The U.S.
Department of Health and Human Services’ Office
for Civil Rights is currently investigating 416 cases
involving security breaches of health information.
Of those 416 cases, 47% were caused by hacking or
an IT incident.
- HIPAA compliance
 All cloud-based health solutions must comply with
the Health Insurance Portability and Accountability
Act (HIPAA). This includes security measures, but
also extends to protocols for patient privacy,
enforcement of laws, and breach notification
procedures. The tenants of HIPAA need to be
understood by both the healthcare and cloud
providers in order to ensure HIPAA compliance.
- Availability and control
 Despite all odds, cloud platforms will go down
from time to time. Healthcare providers need their
data to be available at any point, so any downtime
on the cloud platform’s side will have a negative
impact on productivity. This is true of
business
businesses must rely on the cloud provider – not
themselves – to bring the service back online.
Health Informatics in the Philippines
 Provides the underpinnings for decision-making and has
 Health information system collects data from health
 Data from different sources are used for multiple
HEALTH INFORMATION SYSTEM
four key functions:
- data generation
- compilation
- analysis and synthesis
- communication and use
sector and other relevant sectors, analyses the data and
ensures their overall quality, relevance and timeliness,
and converts data into information for health-related
decision-making.
purposes at different levels of the health care system
 Individual level data about the pt’s profile, health
care needs, and Tx serve as the basis for clinical
decision-making. Health care records provide the
basis for sound individual clinical care.
 Health facility level data, both from aggregated
facility-level records and from administrative
sources such as drug procurement records, enable
health care managers to determine resource needs,
guide purchasing decisions for drugs, equipment
and supplies, and develop community outreach.
 Population level data are essential for public
health decision-making and generate information
not only about those who use the services but also,
crucially, about those who do not use them.
 Household surveys have become a primary source
of data in developing countries where facility
based statistics are of limited quality.
 Public health surveillance brings together
information from both facilities and communities
with a focus mainly on defining problems and
providing a timely basis for action.
- This is especially so when responses need to be
urgent, as in the case of epidemic diseases.

SIX COMPONENTS OF HIS

A health information system can be further subdivided into
its inputs, processes and outputs
 INPUTS refer to resources
 PROCESSES touch on how indicators and data sources
are selected and data is collected and managed.
 OUTPUTS deal with the production, dissemination and
use of information.

INPUTS
(1) Health information system resources
- these include the legislative, regulatory and
planning frameworks required to ensure a fully
functioning health information system and the
resources that are prerequisites for such a system
to be functional.
- such resources involve personnel, financing,
logistics support, information and communications
technology (ICT), and coordinating mechanisms
within and between the six components.
PROCESSES
(2) Indicators
- a core set of indicators and related targets for the
three domains of health information and is the
basis for a health information system plan and
 strategy. Indicators need to encompass
determinants of health; health system inputs,
outputs and outcomes; and health status.
(3) Data sources
 Can be divided into two main categories
 (1) Population-based sources
- sources generate data on all individuals within
defined populations and can include total
population counts and data on representative
populations or sub-populations. What these data
sources have in common is that they relate to the
whole population, not only to groups using
institutional services.
- censuses: the population and housing census is
the primary information source for determining
the size of a population and its geographical
distribution, plus the social, demographic and
economic characteristics of its people.
- civil registration: the continuous, permanent,
compulsory and universal recording of the
occurrence and characteristics of vital events (live
births, deaths, foetal deaths, marriages and
divorces) and other civil status events pertaining to
the population as provided by decree or
regulation, in accordance with the legal
requirements in each country; primary purpose of
civil registration is the establishment of legal
documents as required by law, and its strategic
objectives have also been described in full
- population surveys: In many developing
countries, population surveys are the single most
important source of population health information.
 child and maternal mortality health,
nutrition, service use;
 knowledge and practices related to
health care;
 health status evaluations, descriptions &
determinants;
 knowledge, beliefs and practices related
to dse prevention and transmission
(esp HIV)
 household expenditures on health;
 inequalities in health outcomes and
access to health services.
 (2) Institution-based sources
- sources generate data as a result of
administrative and operational activities. These
activities are not confined to the health sector and
include police records, occupational reports and
food and agricultural records.
- individual health records typically consist of;
- documentation of the provision of health
services (for example, of growth monitoring,
or antenatal and delivery care) to individual
clients;
- case reports and dse records routinely
produced by health workers (of consultation
and discharge);
- information held in special dse registries
(such as those for cancer).
- service records:
- cover not only the records of health service
providers but also the records of events with
important health consequences produced in
other sectors.
- these include records made by the police,
veterinary services, environmental health
authorities, insurance companies and
occupational health agencies.
- resource and administrative records
- focus on the quality, availability and logistics
of health service inputs.
- this includes data on the density and
distribution of health facilities, human
resources for health, budgets and
expenditures, drugs and other core
commodities and key services
(4) Data Management
- this covers all aspects of data handling from
collection, storage, quality-assurance and flow, to
processing, compilation and analysis.
OUTPUTS
(5) INFORMATION PRODUCTS
- data must be transformed into information that
will become the basis for evidence and knowledge
to shape health action.
(6) DISSEMINATION AND USE
- the value of health information can be enhanced
by making it readily accessible to decision-makers
(giving due attention to behavioral and
organizational constraints) and by providing
incentives for information use.
..CONT
- FRAMEWORK AND STANDARDS FOR COUNTRY HEALTH
INFO SYSTEM P16- 37
- HEALTH INFO DRAFT P1-9