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CPH
PROF. IMELDA DE LEON AND PROF. RITCHER QUETEVIS || PRELIMS
Transcriber M

OUTLINE B. HUMAN DEVELOPMENT

1. Health in the Context of Human Development  Human development is defined as the process of enlarging
2. Benchmarking with WHO people’s freedom allowing them to lead a healthy life,
 Millennium Development Goal (2000) having decent standard of improved living and guaranteed

 Sustainable Development Goals (2030) human rights

3. Philippine Health Agenda (2016-2022)  It values capabilities related to health, education, long life

4. DOH Community and Public Health Programs nutrition as ends in itself and it sees income as the means
to achieve these.
LEARNING OUTCOMES
At the end of the session, the learners are expected to :
1. Relate Health as component or one of the
dimensions in Human
2. Development Index
3. Recall the WHO 2020 Millennium Goals and relate
them to the 2030 Sustainable Development Goals
4. Know the Philippine Health Agenda and DOH
Community and Public Health Programs
5. Understand and Analyze the role of UNIVERSAL
HEALTH CARE & PhilHealth as Health Insurance
System for all Filipinos.

PART 1: OVERVIEW OF PUBLIC HEALTH IN PHILIPPINE

Dimension Pre 2010 Post 2010 Current
CONTEXT
s
Indicator Min. Max. Indicator Min. Max
Health Life 25 85 Life 20 85
A. COMPONENTS OF THE HUMAN DEVELOPMENT expectancy expectanc
at birth y at birth
INDEX
Education Adult 0 100 Expected 0 18
literacy years of
rate schooling
HEALTH (Years)
Gross 0 100 Mean 0 15
HDI

EDUCATION enrollment years of

ratio schooling
(Years)
LIVING STANDARS
Standard of Real GDP 100 40000 Gross 100 7500
living per capita national
(PPP S) income per

THREE DIMESITIONS AND FOUR INDICATORS capita

 HEALTH

 life expectancy at birth – birth until death

 EDUCATION

 expected years of schooling

 mean years of schooling

 LIVING STANDARS

 gross national income per capita

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FRAMEWORK MDG SDG

POVERTY 1. Eradicate GOAL 1: No

extreme poverty Poverty.
and hunger GOAL 2: Zero
Hunger
GOAL 8: Decent
Work and
Economic Growth

EDUCATION Achieve universal GOAL 4: Quality

primary education Education

GENDER Promote gender GOAL 5: Gender

equality and Equality
empower women.
HEALTH & WELL Reduce child GOAL 3: Good
BEING mortality Health and Well-
Improve maternal being
health

C. WHO MILLENNIUM DEVELOPMENT GOAL COMMUNICABLE Combat

1. Eradicate extreme poverty and hunger DISEASES HIV/AIDS,

2. Achieve universal primary education malaria, and other

3. Promote gender equality and empower women diseases

4. Reduce child mortality ENVIRONMENT Ensure GOAL 7:

5. Improve maternal health environmental Affordable and
6. Combat HIV/AIDS, malaria, and other diseases sustainability Clean Energy
7. Ensure environmental sustainability
8. Develop a global partnership for development
GOAL 8. Develop
D. WHO SUSTAINABLE DEVELOPMENT GOALS
a Global
GOAL 1: No Poverty Partnership
GOAL 2: Zero Hunger inclusive and
GOAL 3: Good Health and Well-being sustainable
GOAL 4: Quality Education industrialization
GOAL 5: Gender Equality and
GOAL 6: Clean Water and Sanitation
GOAL 7: Affordable and Clean Energy
GOAL 9: Build
GOAL 8: Decent Work and Economic Growth
resilient
GOAL 9: Industry, Innovation and Infrastructure
infrastructure,
GOAL 10: Reduced Inequality
promote
GOAL 11: Sustainable Cities and Communities
GOAL 12: Responsible Consumption and Production RESPONSSIBLE Goal 12: Ensure

GOAL 13: Climate Action CONSUPTION sustainable

GOAL 14: Life Below Water AND consumption and

GOAL 15: Life on Land PRODUCTION climate

GOAL 16: Peace and Justice Strong Institutions

GOAL 17: Partnerships to achieve the Goal
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CLIMATE GOAL 13: Take  GOALS

urgent action to o Ensure the best health outcomes for all, without socio-
combat economic, ethnic, gender and geographic disparities;
change and its
impacts* o Promote health and deliver healthcare through means
that respect, value and empower clients and patients
LIFE BELOW GOAL 14:Take as they interact with the health system
WATER urgent action to
combat climate o Protect all families especially the poor, marginalized,
change and its and vulnerable against the high cost of healthcare.
impacts*
 VALUES

LIFE ON LAND Goal 15: Protect, o Equity, quality, efficiency, transparency, accountability

restore and sustainability and resilience

promote
sustainable use of
terrestrial
ecosystems

PEACE AND Goal 16: Promote

JUSTICE peaceful and
inclusive societies
for sustainable
developmentTH F. NATIONAL OBJECTIVES OF HEALTH (NOH)

• The National Objectives for Health (NOH) 2017-2022 serves as

SOCIO, Goal 10: Reduce the medium-term roadmap of the Philippines towards achieving

ECONOMIC inequality within universal healthcare (UHC).

POLITICAL and among • It specifies the objectives, strategies and targets of the

countries Department of Health (DOH)

PARTNERSHIP Goal 17:

 FOURmula One Plus for Health (F1 Plus for Health)
FOR STRONG Strengthen the
built along the health system pillars of:
INSTITUTIONS means of
o FINANCING
implementation
and revitalize the o SERVICE DELIVERY

Global o REGULATION
o GOVERNANCE
Partnership for o PERFORMANCE ACCOUNTABILITY
Sustainable
Development

E. Philippine Health Agenda 2016-2022

HEALTHY PHILIPPINES 2022

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101 million persons in 2015, which translated to an

average population growth rate (PGR) of 1.7 percent
 2020 - 110 Million

G. GEOGRAPHIC CHARACTERISTICS K. HEALTH SERVICE DELIVERY

 The Philippines has a mixed public-private healthcare

 an archipelago in Southeast Asia with 7,641 islands system that
bordered by the West Philippine Sea on the west and the  operates within a fragmented environment.
Pacific Ocean on the east with Malaysia to the south-west,
Indonesia to the south, Vietnam to the west, and mainland  The private sector caters to only about 30 percent of
China to the north (World Atlas, 2018a) the population but is far larger than the public system
 It is grouped into three geographic areas: Luzon, Visayas (70%) in terms of financial resources and staff
and Mindanao (Oxford Business Group, 2018).
 located along the seismic Pacific Ring of Fire and Pacific
Typhoon Belt  It provides healthcare that is generally paid through
H. GOVERNMENT AND POLITICS user fees at point of service.

 Philippines has a presidential form of government, with the

 President as head of government and of the State
 Constitution mandates a tripartite system of governance
L.
where the powers of government are distributed equally
among three branches: the Executive, the Legislative and
the Judiciary (Pimentel, 2008).
 President heads the executive branch and appoints Cabinet
 About 65 percent of the 1,224 hospitals in the country
in 2016 were private (DOH-HFSRB, 2016).
HEALTH FINANCING
 The National Health Insurance Act of 1995 created the
Philippine Health Insurance Corporation (PhilHealth) to
provide health insurance coverage for all Filipinos but

members who lead the various government agencies enrolment was not made compulsory.

organized into Cabinet Clusters

I. SOCIOECONOMIC TRENDS  In 2013, it was amended, expanding the contribution-
based national health insurance program (NHIP)
 Philippine Statistics Authority (PSA) data shows that
beyond formal employment to include the
the country’s gross domestic product (GDP) was 28
underprivileged, sick, elderly, persons with disabilities
percent higher in 2016 at PhP8.1 trillion compared to
(PWDs) and women and children.
the PhP6.3 trillion in 2012
J. DEMOGRAPHIC TRENDS
 It strengthened the roles of the LGUs and health
 Based on the 2015 Census of Population, the
providers in NHIP enrolment.
Philippine population went up from 92 million in 2010 to
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o PhilHealth serves as the national social health insurance

agency which purchases services from public and private

providers on behalf of its members.

o However, healthcare provision, health regulation, facility

improvements and human resource deployment as well as
capacitation are still subsidized by the government, mainly
through the DOH.
M. UNIVERSAL HEALTH CARE (UHC)

 7 May 2021
 Republic Act (RA) No. 11223 or the Universal Health
Care (UHC) Act
 Objectives And Vision
 increasing financial risk protection particularly for the
poor, marginalized, and vulnerable;
 Enhancing health system responsiveness to make
 Filipinos feel respected, valued, and empowered; and,
improving health outcomes with no major disparity
among population groups.

N. HEALTH GOVERNANCE AND REGULATION

 The enactment of LGC in 1991 led to dual governance in

health, with the DOH governing at the national level and the
LGUs at the subnational level. O. PERFORMANCE MEASURES
 Th e DOH serves as the over-all steward and technical
(Coded Score Cards)
authority on health being the national health policy-maker
•Color Indicators:
and regulatory institution. It is mandated to develop national
 green - good
plans
 yellow - sustained
 red - poor
•Directional arrows:
 ↑ reached almost 90%
 = no improvement
 ↓ lowered the expected output
•Rankings: 1,2,3,4, et or 1st, 2nd 3rd
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STRATEGIC COMMUNITY HEALTH PROGRAMS

o August 4, 1969
o Republic Act 6111 or the Philippine Medical Care Act
of 1969 was signed by President
o Ferdinand E. Marcos which was eventually
implemented in August 1971.
P. MANDATE

 The National Health Insurance Program to provide health

insurance coverage and ensure affordable, acceptable,
available and accessible health care services for all citizens
of the Philippines.

 shall serve as the means for the healthy to help pay for the
care of the sick and for those who can afford medical care
to subsidize those who cannot.

Q. SYSTEM & OPERATION

 sustainable system of funds constitution, collection,

management and disbursement for financing the utility of a
basic minimum package and other supplementary
packages of health insurance benefits by a progressively
expanding proportion of the population.
 program shall be limited to paying for the utilization of
health services by covered beneficiaries.

Quality health Increased utilization

+
based on need risk protection
care services
( reduced OOP ) ( improve
health
outcomes of patients)
 Sustainable Financing
 Build a deep revenue - collection system
 Maintain an active - risk pool through,

PART -2 COMMUNITY AND PUBLIC strategic purchasing

 Innovation and Growth
HEALTH IN
 Design an agile and adaptive organization
PHILIPPINE CONTEXT
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 Transform human resource management

with competency based approach
 Develop lean and member-centric processes
 Enhance information system through
enterprise integration
 Strong Corporate Governance

R. UNIVERSAL HEALTH CARE ACT

,
 RA11223, otherwise known as the Universal Health
Care Act, hereinafter referred to as the Act.
 Hereinafter, these rules and regulations shall be
referred to as the Rules. It is the policy of the State to
protect and promote the right to health of all Filipinos
and instill health consciousness among them.


DIRECT CONTRIBUTORS PART 2: COMMUNITY AND PUBLIC

•Employees with formal employment HEALTH IN PHILIPPINE CONTEXT
- Kasambahays
A. DEFINITION: POLICY
• Self-earning individuals; Professional practitioners • A formal statement by a government,organization or
- Overseas Filipino Workers institution that expresses a set of goals, the priorities within
- Filipinos living abroad and those with dual citizenship those goals and the preferred strategies for achieving those
• Lifetime members goals; policy is based on the mandate of the institution (WHO)
- All Filipinos aged 21 years and above with capacity to
DIFFERENT POLICY NOMENCLATURE AND
pay
HIERARCHY OF LAWS
• Republic Act
INDIRECT CONTRIBUTORS
• Presidential Decree
• Indigents identified by the DSWD
• Executive Order
- Beneficiaries of Pantawid Pamilyang Pilipino Program
• Administrative Order
• Senior citizens
• Department Order
• Persons with disability
• Implementing Rules and Regulations
• Sangguniang Kabataan officials
• Guidelines
- Previously identified at point-of-service / sponsored by
• Procedures
LGUs
• Protocols
- Filipinos aged 21 years old and above without capacity
• Manual of Operations
to pay premiums
POLICIES AT DIFFERENT LEVELS & WHO MAKES THEM
NEW RATE OF CONTRIBUTION
POLICY TYPE WHAT IT IS WHO MAKES IT
Republic Act Legislation used Congress of the
to create policy in Philippines
order to carry
out the principles
of the Constitution
Presidential Acts of the Office of the
Decrees and President President
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Executive Orders providing for rules

of a
general or
permanent
character in
implementation or
execution of
constitutional or

statutory powers

LOCAL GOVERNMENT CODE OF 1991 : HEALTH

Policy (AO, DO, What must be Department DEVOLUTION
DM) done  Primary health services of PHO/MHO/CHO through its
RHUs and BHS include:
Guidelines How to implement Department
❖health education
The policy
“technical how” ❖control of locally endemic diseases such as malaria, dengue,

Procedures How to Implementing schistosomiasis and other notifiable disease (RA 11332)

implement Units (RO, ❖immunization against TB, polio, measles, and tetanus, among
the policy, Hospitals, LGUs, others (RA 10152)
“administrative partners) ❖maternal and child health and family planning (RA10354)
how” ❖environmental sanitation and provision of safe water supply
(PD856)
Plan Who does what, ALL
when, where ❖nutrition

❖treatment of common diseases

POLICY ADAPTATION IS TRANSLATING AND CONTEXTUALIZING
POLICIES FOR IMPLEMENTATION ❖supply of essential drugs
THE LOCAL GOVERNMENT CODE OF 1991 AND THE Emergency and Disasters RRM-H (RA10121)

MANDANAS-GARCIA SUPREME COURT RULING OF LOCAL GOVERNMENT CODE OF 1991 : HEALTH

2018 DEVOLUTION ISSUES AND CHALLENGES

B. LOCAL GOVERNMENT CODE OF 1991 : HEALTH C. FINANCING FOR HEALTH

DEVOLUTION • mismatch between IRA and the cost of devolved
• Changed the way basic government health services are functions (CODEF);
delivered at the local government units cost of implementing the Magna Carta for public health
• Health Service Provision: From DOH to LGUs workers (PHWs) as mandated in RA 7305 of 1992 was
• GOAL : Efficiency and Effectiveness of HSD through not factored in the CODEF estimation which put more
empowered LGU strain on LGUs’ limited budget
LOCAL GOVERNMENT CODE OF 1991 :HEALTH
➢Health personnel – resistance from devolved DOH personnel
DEVOLUTION 2022
and LGUs (i.e., to absorb the cost of devolved staff), and
geographical job displacement due to political differences
between the LCEs and health personnel, at the early stage of
health devolution (Perez 1998b);
➢Organization/structural change – issue on whether the
LHBs and ILHZs are functional; issue on fragmentation of health
services because health devolution disintegrated the chain of
health care delivery system when the administration of health
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facilities was transferred from the provinces to different  Immunization of children lowest in 25 years at 60%
jurisdictions such as barangays, municipalities, and cities (NDHS 2013)
MANDANAS-GARCIA SUPREME COURT Financial Risk
RULING  OOP at 56% of Total Health Expenditures (2014)
• Filipinos’ access to health services may be affected
 Compliance to No Balance Billing for indigent and
once the Mandanas Ruling takes effect in 2022 and
sponsored members at 63% (2016)
more functions are devolved to local government units
 1.5 million Filipinos pushed to poverty from access to
(LGU).
health services (WB 2014)
- LGUs are entitled to a “just share” on all national taxes
collected and not only from the Bureau of Internal Health System Responsiveness

Revenue (BIR).  Inequitable distribution of health workers

- 27.61 percent increase in the overall internal revenue  Government health facilities remain overcrowded
allotment (IRA) shares.
The Department of Health (DOH) capacity-building for LGUs

UNIVERSAL HEALTH CARE REFORM

PRINCIPLES
o Universality means ALL Filipinos
The F1Plus for Health Strategy Map o Equity means preferential regard for the unserved or
 Logical Framework: The FOURmula One Plus for
underserved
Health (F1Plus for Health) is the blueprint of the health
sector plans and commitments for the medium term. o Accountability by clear role delineation, purchaser-
 Multi-sectoral collaboration: The overarching goal of
provider split, management and organizational reforms
providing Universal Health Care (UHC) can only be
achieved through the collective efforts of all o Sustainability by shifting emphasis to health
stakeholders.
promotion and primary care and strategic purchasing
UNIVERSAL HEALTH CARE
o Participation by making information available and
understandable, providing platforms for citizens to
1. UHC Salient Features
engage, recognizing private providers
2. What is UHC for Juan and Juana?
o Social solidarity by pooling resources and enabling
3. Key components of the UHC Act
mutual support for basic health services
4. What is a UHC Integration Site
o Individual responsibility for non-basic / fringe
5. Expectations for Strategic Planning
services
SITUATIONAL OVERVIEW:
o Progressive realization through fair and transparent
PHILIPPINES REMAIN DEEPLY priority setting mechanisms
UNDERSERVED UNIVERSAL HEALTH CARE MEANS
EVERYONE WINS!
Health Outcomes
 Patients receive effective care without financial
 High infant-child-maternal mortality rates, especially
hardship
among the poor (NDHS, FHS)
 Providers earn a positive margin for efficiently treating
 1 out of 3 children stunted (NNS 2015)
patients and producing good outcomes
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 Payers (private insurers, governments, or self-pay
individuals) able to shape provider behavior towards
efficiency and effectiveness
 Physicians can earn predictable income such that
they will no longer need to charge huge price
differentials
 Suppliers of drugs, devices, and diagnostic tests
that improve outcomes and/or lower total costs find
their products incorporated into the treatments used by
effective and efficient providers
UNIVERSAL HEALTH CARE DOES NOT
MEAN “LAHAT LIBRE”
 Every Filipino family is matched to a primary care
team, who ensures that they get the appropriate
services they need in the appropriate facility
 Every Filipino family’s health spending is predictable;
PhilHealth ensures they are protected from financial
risk
WHEN IN NEED OF OUTPATIENT
SERVICES...
What is covered?
 Face-to-face/tele consultation with the Primary Care
Team
 Laboratory, diagnostic tests, outpatient drugs covered
as long as PRESCRIBED by the Primary Care Team
How much is covered?
 If Primary Care Team is linked to public system – no
co-payments
 If Primary Care Team is linked to a private system - co-
payment rate for all services based on allowable mark-
ups
 Prices posted/made available in all providers
FINANCING
Clarifying roles:
 1.DOH and LGU for population-based services
 2.PhilHealth for individual-based services
Pooling funds to PhilHealth
 for all individual-based health services (e.g. Sin Tax,
PAGCOR, PCSO)
CPH
Simplifying membership into two types:
 Direct & Indirect Contributory
Contracting
 by network based on adherence to quality and co-
payment standards + third party accreditation
SERVICE DELIVERY
 Institutionalizing primary care as a prerequisite in
contracting by network
 Consolidating fragmented providers into province-
wide and city-wide service delivery networks
practicing gatekeeping and referral
 Enabling income retention for all public providers
through a Special Health Fund
REGULATION
 Mandating transparent pricing of health goods and
medical services
 Basic and non- basic accommodation bed ratio of
90:10 for government hospitals, 70:30 for specialty
hospitals, and 10:90 for private hospitals
 Ensuring benefit complementation between
PhilHealth and Private Health Insurance (PHIs) and
Health Maintenance Organizations (HMOs)
 Expanding scholarship programs, requiring 3 years
return service in underserved areas for government
scholars, augmenting HRH through national health
workforce support system, primary care-
oriented education, health professionals registry
GOVERNANCE
 Requiring submission of health and financial data by
healthcare providers and suppliers harmonized to an
interoperable system; sharing of publicly-funded data
sets
 Institutionalizing
Health Technology Assessment as prerequisite for
public financing of goods/services, and Health Impact
Assessment for various programs, policies, and
projects
 Strengthening Health Promotion and medicines
procurement
 Streamlining PhilHealth board from 17 to 13
HOW THE UHC IMPACTS ON DOH
PLANS AND BUDGET?
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2020  To progressively realize universal health care

through systemic approach and clear role
 Organization of SDNs per F1 Plus Commitments delineation

 Full support to advance implementation sites

(HRH, HFEP, PS, MOOE of municipality health
operations)

2021
RA 11223: UNIVERSAL HEALTH CARE
 Organization of SDNs per F1 Plus Commitments ACT
 Roll out advance implementations sites (HRH,
HFEP, PS, MOOE of municipality health
operations)  DECLARATION OF PRINCIPLES

2022 Integrated and

Everyone is actively People at the
Comprehensive
participating Center
Approach
 Organization of SDNs per F1 Plus Commitments People-
Whole-of-system Whole-
Ensure health literacy, oriented
of- government, Whole-
 Transitioning budget for individual-based health healthy living, and approach
of-society approach in
commodities to Philhealth financial integration) protection from centered on
the development of health
hazards and risks. people’s needs
policies
and well-being
 Support to remaining provinces (HRH, HFEP,
PS, 28 MOOE of municipality health operations)

WHAT IS UHC FOR JUAN AND JUANA?

WHAT WILL UHC BE FOR YOU?
1. RURAL HEALTH UNIT

2. BARANGAY HEALTH STATION UHC ensures that EVERYONE will be

receiving OPTIMAL HEALTH
3. DIAGNOSTICS SERVICES.
4. LABORATORIES  Every Filipino family is matched to a primary care
team, who ensures that they get the appropriate
5. PHARMACIES services they need in the appropriate facility.

6. SPECIALIST CLINICS
UHC ensures that NO PATIENT WILL
7. HOSPITAL BE LEFT ALONE.
 Creation of health networks that will navigate
8. APEX HOSPITAL H the patients throughout the process of their Health
Care Needs. From BHS to Higher Health Facilities
back to the BHS.
Key Components of the UNIVERSAL
HEALTH CARE UHC ensures that PRIMARY CARE /
COMMUNITY HEALTH will be
RA 11223: UNIVERSAL HEALTH CARE STRENGTHENED.
ACT
 Primary Care Services and Community Health will
be strengthened. Prevention is always better than
 To ensure equitable access to quality and
Cure.
affordable health care and protection
against financial risk.
LGUs will be provided with additional
funding for Health Services.
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 Health Services in the LGU will be funded through a
pooled fund. Health Workers will be incentivized
and compensated properly (Additional health
workers may be employed). Pooled fund will remain
and be reflected as LGU Income.
LGUs will be provided with additional
funding for Health Services.
 Health Services in the LGU will be funded through a
pooled fund. Health Workers will be incentivized
and compensated properly (Additional health
workers may be employed). Pooled fund will remain
and be reflected as LGU Income.
LOCAL CHIEF EXECUTIVES
CHAMPIONS OF HEALTH
 LGUs will be empowered to lead on Public Health
in their areas. Health Governance is key to a
Healthy Community. (RA 11223 did not explicitly
repeal LGC)
UNIVERSAL HEALTH CARE MEANS...
✔ healthy living, schooling & working environments
o Payers (private insurers, governments, or self-pay
individuals) able to shape provider behavior towards
quality and efficiency
o Providers earn a positive margin for producing good
outcomes at low cost
o Suppliers of drugs, devices, and diagnostic tests
that improve outcomes and/or lower total costs find
their products incorporated into treatment protocols
used and reimbursed
Healthcare Provider Networks
• Philhealth to contract public, private or mixed health
care provider networks
as
 geographically-defined catchment area
 service quality
 co-payment/co-insurance
 data submission
• PhilHealth and DOH to incentivize health care providers
that form networks

✔primary care provider

✔ health spending is team for every family predictable,

not “lahat libre”

✔ care is provided for by providers organized as

INTEGRATED NETWORKS

IT MEANS EVERYONE WINS!

o Filipinos/Patients are health literate, practice healthy
lifestyle, live in low-risk environments, receive effective
care without financial hardship

o Health Care Workers earn decent predictable income

and able to pursue career paths
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ratio in all BHS

Assure that your

HCWs actively

coordinate and
navigate care for
patients seeking
consultation Health Board is
functional
Create healthy Improve facility
settings and healthy equipment and Capacitate health
environment in your infrastructure through sound
communities budgeting
Ensure no stock-out
Make sure that all of medicines and Create Ordinances and
families are profiled supplies Resolutions supporting
and with up-to-date UHC and other health
civil registration programs
● Make sure all
essential health
 Be responsible in Engage DOH,
disseminating the
services prescribed PhilHealth, and
message of UHC Development Partners
by UHC are
available 24/7 for programs and
initiatives

Bank on good data

for sound decision-
making in health

 Make sure doctor

Special Health Fund visits every
barangay at least 2x
o Province-wide and City-wide Health System shall pool a year
and manage all resources in order to finance
population-based and individual-based health services

o DOH, in consultation with DBM and LGUs, shall

develop guidelines for Special Health Fund

o PhilHealth payments shall accrue to the Special Health

Fund and credited as Annual Regular Income (ARI) of
the LGU

AS AN LGU, WHAT CAN YOU DO?

FOR FAMILIES/ IN YOUR IN YOUR

HOUSEHOLDS BARANGAYS... GOVERNMENT
UNDER YOUR OFFICE...
PURVIEW... Ensure good HCW
Make sure that a Local