The Health Care Delivery System

Health System – consist of

all organizations , people,
and actions whose primary
intent is to promote,
restore , or maintain health.
It has 6 building blocks :
1.Service delivery
2.Health workforce
3.Information
4.Medical products ,
(vaccines and technologies)
5.Financing
6.Leadership and
governance stewardship
 Health Care Delivery System
Health care delivery system
is the totality of all policies,
infrastructures, facilities,
equipment, product, human
resources, and services that
address the health needs,
problems and concerns of
the people.
 Health Care Delivery System

Composed of 2 sectors
a.Public sector- largely financed
through tax-based budgeting system at
both national and local levels and where
health care is generally given free at the
point of service
b.Private sector- largely market-
oriented and where health care is paid
through user fees at the point of service
 World Health Organization
ü a specialized agency of the United
Nations that provides global
leadership on health matters The
WHO constitution; states that its
objective is the attainment by all
peoples highest possible level of
health . It came into force on April
7,1948.
 Millennium Development Goals
-were 8 goals that all 189 UN Member States
have agreed to try to achieve by the year
2015. The United Nations Millennium
Declaration, signed in September 2000,
committed world leaders to combat poverty,
hunger, disease, illiteracy, environmental
degradation, and discrimination against
women. The MDGs were derived from this
Declaration, and had specific targets and
indicators.
• A common vision of poverty reduction and sustainable
development in response to the global and country health trends.
• Imperatives:
- shifts in demographic and epidemiological trends in disease.
- new technologies for healthcare, communication and
information
- existing and emerging environmental hazards
- Health norms
 8 MDG’S
1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender equality and empower women.
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria & other diseases
7. Ensure environmental sustainability
8. Develop a global partnership for development.
 Sustainable Development Goals
are the blueprint to achieve a better
and more sustainable future for all.
They address the global challenges we
face, including those related to poverty,
inequality, climate change,
environmental degradation, peace
and justice
The 17 Goals are
all interconnected, and in order to
leave no one behind, it is important
that we achieve them all by 2030
 17 SDG’s

1.No Poverty
2.Zero Hunger
3.Good health and well
being
4.Quality education
5.Gender equality
6.Clean water and sanitation
7. Affordable and clean
energy
8. Decent work and
economic growth
9.Industry, Innovation and
infrastructure
10. Reduced Inequality
11. Sustainable cities and
communities
12.Responsible Consumption and
production
13.Climate Action
14. Life Below Water
15.Life on Land
16.Peace and Justice Strong
Institutions
17.Partnership to achieve the goal
NOTE: It has 15 years lifespan ;2016 marks the 1st year
of its implementation
 Philippine Department of Health
DOH- is the national agency mandated to lead
the health sectors toward assuring quality
health care for Filipinos .
–national government’s biggest health care
provider
–exercises regulatory powers of health facilities
and product
–takes the lead in the formulation of policies
and standards related to health facilities, health
products and health human resource
 Major Role of DOH

1. Leader in health -elucidated in EO 102 series of 1999 in

terms of the ff. specific functions:
ü planning and formulating policies on health programs and services
ü Monitoring and evaluating the implementation of health programs , projects,
training, research , and services
ü advocating for health promotion and healthy lifestyle
ü serving as technical authority in disease control and prevention
ü providing administrative and technical leadership in health care financing
and implementing the National Health Insurance Law
2. Enabler and capacity builder - the DOH performs the
following functions :
ü providing logistic support to LGUs the private sector and other agencies in in
implementing health programs and services
ü serving as the lead agency in health and medical research
ü protecting standards of excellence in the training and education of health
care providers at all levels of health care systems
3. Administrator of specic services - DOH is tasked to:
üserve as administrator of selected health facilities at
subnational levels that act as referral centers for local
health systems
üprovide specific program components for conditions that
affect large segments of the population like TB ,
malaria ,schistosomiasis , HIV/AIDS , and micronutrient
defeciencies
üdevelop strategies for responding emerging health needs
üprovide leadership in health emergency preparedness
and response services including referral and networking
systems for trauma , injuries, and catastrophic events
 DOH CORE VALUES REFLECT THE ADHERENCE TO HIGHEST
STANDARDS OF WORK , NAMELY

1. Integrity
2. excellence
3. compassion and respect for human dignity
4. commitment
5. professionalism
6. teamwork
7. stewardship of the health of the people
 Mission-Vision
VISION: The DOH is the leader, staunch advocate and
model in promoting HEALTH FOR ALL in the Philippines
MISSION :Guarantee equitable, sustainable, and quality
health for all Filipinos, especially the poor and shall lead the
quest for excellence in health.
•by making services available
•By arousing community awareness
•By mobilizing resources
•By promoting the means to better health
Goal
•Overriding goal of the DOH is the Health Sector Reform
Agenda.
Health Sector Reform Agenda
The five major reforms contained in the HRSA are:
1. provide fiscal autonomy to government hospitals
2. secure funding for priority public health programs
 3. promote the development of local health systems and
ensure its effective performance
4. strengthen the capacities of health regulatory agencies
5. expand the coverage of the National Health Insurance
Program
Framework for Implementation for of HRSA : FOURmula
ONE for Health - it is the strategy for implementing health
reforms .
•Spells out the program imperatives of the health sector
•Intends to implement critical interventions as a single
package backed by effective management infrastructure
and financing arrangements following a sectoral approach
Goals of FOURmula ONE for Health
•Better health outcomes
•More responsive health systems
•Equitable health care financing
National Objectives for Health -provides the road map for
stakeholders in health and health-related sectors to
intensify and harmonize their efforts to attain its vision and
mission
Principles
•Universal access to basic health services must be ensured.
•The health and nutrition of vulnerable groups must be
prioritized.
•The epidemiologic shift from infectious to degenerative
diseases must be managed.
• The performance of the health sector must be enhanced
 Goals and Objectives
1.Improve the general health status of the population.

2.Reduce morbidity and mortality from certain diseases

3.Eliminate certain diseases as public health problems
4.Promote healthy lifestyle and environment health
5.Protect vulnerable groups with special health and nutrition
needs
Local Health Systems and Devolution of Health
Services
Local Health Systems
A health system at the sub-national level (Dorotan, et al)
The core element of local or district health system is the
integrated primary health care and the first referral hospital
serving a well-defined population (Segall, 2003).
 Inter -Local Health Zone
Any form of organized arrangement for coordinating the
operations of an array and hierarchy of health providers and
facilities serving a common population within a local
geographic area under the jurisdictions of more than one
local government (DOH, CY 2006)
-is the ideal governance structure for local health system
development. It is a district health system in a devolved
setting. It addresses the problem of fragmentation of the
delivery of health services
 Composition of an ILHZ

1. Primary Health Care Providers (Barangay Health Station,

Rural Health Unit, health centers, community hosp., private
practitioners, traditional/alternative providers, caregivers,
household
2. Core referral hospital(s): District Hospital or Provincial
Hospital
3. End referral hospital(s): Higher level hospitals
Guiding Principles for ILHZs
1. Voluntary actions for mutual benefits
2. Flexible forms of organization
3. Results -oriented
4. Sustained and evolutionary
5. Purposive and developmental
6. Universal and non –partisan
 Devolution of Health Services
RA 7160 a.k.a. Local Government Code
–One of the significant laws that radically changed the
landscape of health care delivery
–Aims:
•To transform local government units into self-reliant
communities and active partners in the attainment of
national goals through a
more responsive and accountable local government
structure instituted through a system of decentralization
1993- Health services were devolved or transferred from
the DOH to the LGU-all provincial, district and municipal
hospitals to the provincial governments and the rural health
units (RHUs) and barangay health stations (BHSs) to the
municipal governments