SHANZ – COMMED LE 2

HEALTH SYSTEM WHO BUILDING BLOCKS HEALTH OUTCOME/GOAL

• Address different health needs: SWIM FIN-LEG • responsive to need of population
promotive, preventive therapeutic, rehabilitative • Service Delivery • financially fair
• Health determinants: • Health Workforce • maximize available resources
o have effects on health status & health seeking behavior • Health Information system with minimal waste
o affect education, SES, culture, political and economic situation • Access to essential Medicines
• Driving force of health system is guided by: • Financing Modification by Lazarus & France:
ALMA ATA declaration → ASTANA declaration • Leadership/Governance Knowledge sharing
• Principles: Knowledge generation
equity, social justice, universal access, participation & intersectoral action Original framework: linear Patient Engagement
make sure availability, accessibility and utilization of healthcare in society Communicating
• Failure of health systems:
POOR health outcome in developing countries (restricted area)
ADDRESS THE BUILDING BLOCKS
• Usual implementation: TOP down approach
doesn’t contribute to strengthening health system
• CHALLENGES IN PH:
Lack of political will
inefficient service delivery
unstable revenue pool
maldistribution & migration of health workers
incomplete data gathering/ poor record keeping

SERVICE DELIVERY HEALTH WORKFORCE HEALTH INFORMATION SYSTEM

• Effective & good quality • All People engaged in actions to address • Services, policies, regulation
o Competent staff spectrum of health services: • KEY COMPONENTS:
o Appropriate med & equipment oHealth service provider o Health info & surveillance
o adequate funding ohealth management o STD.tools
o organizational structure osupport workers o health statistics
• Spans entire spectrum of care: oAdministrators • well functioning:
Promotive, preventive, therapeutic, rehabilitative ▪ Macro: Health ministries, LGU, MHO o ensure production, analysis, dissemination
• Examples: ▪ Micro: Hospital & clinic manager, and use of reliable & timely information
Home visits, surveys, focus group discussion school and employee’s physicians o decision makers: MHO, CHO, PHO, LGU
Big population: census & health metrics • well performing: • Domains/ data:
• RESPONSIVENESS: accessibility to care o RESPONSIVE to needs o health determinants
o address barriers to access & utilization o ENOUGH in number o health system performance
o physical, religious, cultural, social constraints o COMPETENT o health status
o EFFICIENT
e.g. LGBT population • Data must be able to:
• EFFICIENCY: integrate & organize • ENTRIES OF WORKFORCE: o generate population & facility based data
o Entry point = school (when you start
• ORGANIZED NETWORK PROVIDERS o detect, investigate and communicate
o Manpower, services, infrastructures, referral system studying) events
o avoid fragmentation of services o Exit point = moving out of health o synthesize information
o maximize available resources system
o e.g. PPP – TB DOTS
ACCESS TO ESSENTIAL MEDICINES FINANCING LEADERSHIP & GOVERNANCE
• equitable access • raise adequate funds • STEWARDSHIP
• quality, safety, efficacy, cost effectiveness • assure utilization of available service • Most complex, most critical
• Need: • protect from financial catastrophe • overseeing entire health system
o policies • functions: • protect public interest
o capacity to negotiate prices o revenue collection • requires political & technical action
o reliable manufacturing practice o poling of prepaid revenue → risk • key functions:
o procurement, supply, storage, waste minimization sharing Policy Harmonious play of other BB
o payment of provider & service guidance
• universal financial coverage: to not use Oversight Regulate action of other BB
pocket expenditures Collab & Coordinate with other
coalition industries to improve service
Regulation Use policy to regulate
System Determine the kind of health
design system for community
Accountability Essential. everyone’s
responsibility
 PHILIPPINE HEALTH AGENDA 2016-2022
GOALS VALUES
• Financial protection from high cost of healthcare • Equitable & inclusive to all
• Better health outcomes (attain best possible health outcome with no disparity) • Transparent & accountable
• Responsiveness (respected, valued, empowered) • Uses resources efficiently
• Provides high quality services

THREE GUARANTEES ACHIEVE

Health • Special Focus on triple burden of disease Advance • annual health visit to poor families & special
service for • Maternal, newborn, child services health populations (NHTS, IP, PWD, Senior)
the well & • Pre-post ante natal services promotion, • Capacity building for DOH hospital
sick • immunizations, well baby check up primary care • Support for LGU
• nutrition surveillance & monitoring services, • List down primary care entitlements for philhealth
• adolescent screening quality of contracting
• wellness & health promotion services delivery of • establish expert bodies for health promotion,
• womb to tomb: across all ages care surveillance, response
Functional • Fully functional: complete equipment, med, health Cover all • raise more revenue for health
health professional filipinos • expand philhealth coverage benefit to cover
service • practicing gatekeeping: effective referral system against outpatient bills
delivery • compliant with clinical practice guidelines health-related • regular updating of case rates
network • close location (mobile clinic/ subsidize transportation cost) financial risk • align collection with other gov agencies to
• Available 24/7 even during disaster minimize overlaps with philhealth
• enhanced by telemedicine Harness • shift focus to primary care orientation
Universal • Financial freedom & protection (Philhealth coverage) human • improve compensation packages to high risk or
health • BASIC TENET: resources for GIDA areas
insurance/ o No balance billing for poor (basic accommodation) health • financial support for IP groups/GIDA areas
package o Fair co payment scheme (non basic accommodation) • mandatory return of service for all health
scheme • MAIN REVENUS OURCE: graduates
o Work with provider within service delivery network
Invest eHealth • CHITS: community health info tracking system
o expand benefits to range of services
tech for • mandate use of electronic med record in all
• GATEWAY to affordable healthcare:
research facilities
o all filipinos are members
o formal sector: premium thru payroll • online submission of clinical, drug dispensing,
o non formal sector: premium through tax subsidies admin & financial record
• commission nationwide surveys, improve local
DOH DEPLOYMENT PROGRAMS civil registration & vital stats
Medical pool placement & Professional to DOH provincial • automate major business processes, invest in
utilization program hospitals (depending on needs) warehousing & business intelligence tools
Doctors to the barrios Physicians for 2 years to • facilitate ease of access of researchers to available
municipalities with no doctors data
RN HEALS Deploy nurses to communities in need Enforce • use performance units
(rotate b/w community services for 6 mo) standards, • make health data publicly available
Rural health midwive Assign midwives to barangay health accountability,
program station & rural health units (implement transparency
maternal & child health care) Value clients • prioritize poorest 20M filipinos
Rural health team placement Dentist, medtech, nutritionist as and patients • simplify health entitlements (improve access &
program adjunct to rural health personnel utilization)
• improve services & turn around policies
FORMULA ONE 2009 • improve transparency
Botika ng barangays Elicit multi • establish public private partnership
BEmONC: sectorial & • collaborate with civil service orgs
Basic Emergency obstetrics & new born care = lying in & health center multi • make health impact assessment
CEmONC: stakeholder • make public health management plan a
Comprehensive Emergency obstetrics & new born care = Hospital based support prerequisite for initiating large scale high risk
infrastructure project

PHILHEALTH ALLOCATION BUDGET 2018

DOCTORS TO THE BARRIOS
CONSTRUCTION OF TREATMENT & REHAB CENTER IN PROVINCES
IMPROVEMENT OF EXISTING HEALTH FACILITIES (ENHANCEMENT PROGRAM)
FREE SERVICES TO THE POOR IN GOVT HOSPITAL
 PRIORITIZATION OF HELATH AND DISEASE PROBLEM
STEP 1 ENUMERATE THE PROBLEMS NOT the cause
STEP 2 CLARIFICATION/DISCUSSION OF IDEAS Determine importance
Combine/omit overlapping ideas
STEP 3 SELECT 8 PROBLEMS & DEVELOP PRIORITIES 8 top priority problems
STEP 4 GRADE THE PRIORITY PROBLEMS Distribute 100 points
8 identified problems with highest scores = top priorities
STEP 5 FINAL RANKING OF TOP PRIORITY PROBLEM Score 1 = most important
Score 8 = least important
Score 2 = most important
Score 7 = least important
Score 3 = Most important
Score 6 = least important
Score 5 = remaining problem