“PROBLEM-SOLUTION TABLE”

Ken Juliana Fe M. Isaac

10-Faraday

SELECTED HEALTH INITIATIVES IN THE ISSUES/PROBLEMS IN THE

PHILIPPINE CONTEXT IMPLEMENTATION

1.) Improving Health Facilities Space

➢ Some services integration programs
require dedicated space to carry out
program activities. In particular,
co-location and one-stop shop models
require partnering agencies to share the
same office or facility. Startup costs for
program planners can be substantial,
especially if partnering agencies are
required to break existing long-term
leases. If program planners elect to
co-locate single program staff from
partnering organizations, they will also
need to consider if these staff require a
private office or meeting space in order to
maintain the client's privacy.

Differences in Priorities
➢ Services integration programs often
require collaboration across different staff
members, partners, agencies,
organizations, and other stakeholders.
Rural communities should clearly define
the goals of the services integration
program before implementation to ensure
that all partners have the same priorities.
In order to identify key priorities, rural
communities could consider conducting a
community needs assessment.

Legal Issues
➢ Some federal and state laws restrict the
sharing of patient or client information
between different organizations. In
particular, rural communities developing
healthcare integration programs need to
comply with health information privacy
and security rules. Program leaders may
 need to establish business associate
agreements with partnering organizations
and develop confidentiality policies for
program staff. Another potential
challenge, especially for models
integrating the services of clinical
providers, can be satisfying the various
licensing requirements of clinical
providers that are licensed by different
governing bodies. This challenge can be
mitigated by developing a single
treatment protocol in collaboration with
the clinical team at the outset of the
program.

Reimbursement
➢ Rural services integration programs have
found that one of the greatest challenges
they face is coordinating billing for
different services provided by different
partners. One rural services integration
program found that it was helpful to begin
the program by billing for services
through individual provider streams (e.g.,
hospital, health center). As part of the
project’s sustainability plan, this program
has plans to develop a governing board to
streamline billing through a single entity.

Transportation
➢ Transportation in rural communities is
often limited, making it difficult for
individuals to access health and human
services. Barriers to reliable transportation
include lack of public transit, costs (gas,
insurance, vehicle, fare) and harsh
weather conditions (icy roads, flooding).
Long distances to healthcare services
compound these barriers. Services
integration programs can minimize the
need for transportation by offering
one-stop shops or co-locating several
services in one facility in a centralized
location in the community.

Stigma
➢ In small and rural communities, there may
be social stigma associated with seeking
health and human services. Rural services
integration programs should carefully
 consider whether their programs reduce or
increase stigma associated with seeking
health and human services. One rural
services integration program found that
families were reluctant to seek early
childhood intervention services because
these services were located in the same
complex as an adult day care center for
individuals with behavioral and physical
disabilities.

2.) Improving Health Professionals Worker Burnout

★ People in the healthcare
industry—including physicians, nurses,
nurses’ aides, and other
employees—experience burnout more so
than those in many other industries. This
is primarily due to demanding work
schedules and an overall shortage of staff.
According to U.S. News, 60 to 75 percent
of clinicians report symptoms of
depression, exhaustion, and even sleep
disorders. Further statistics prove that
worker burnout costs this country a lot of
money each year—the figure a staggering
$4.6 billion. Clearly, finding a work/life
balance is a great obstacle in such a
demanding line of work, and hospitals and
clinics need to help facilitate that balance.

Low Salaries
★ Many healthcare workers feel underpaid,
especially for the time that they put into
their work. The Bureau of Labor Statistics
has reported a steady increase in salaries
over the years, but the numbers aren’t
high enough for many workers. According
to PayScale, nurses can make up to $43 an
hour and other medical assistants between
$12 and $21. This often doesn’t translate
to fair pay, considering the demands of the
job.

High Turnover Rate

★ According to a recent statistic, the
healthcare industry experienced a 5
percent increase in turnover in all its
occupations over the past decade. That’s
not great news when it comes to job
security and looking at a role and position
 for the long term. Healthcare has the
second-worst turnover rate, with the
hospitality sector being number one.

Workforce Shortages
★ With an aging population on the rise,
more and more patients are regularly
attending medical appointments, so
there’s an increased need for healthcare
workers. Because there’s a shortage of
those workers, this results in longer shifts
for those currently employed in the
industry. Despite additional funds being
offered for longer shifts, there is a mental
strain that occurs because of these
shortages, making this industry harder and
harder to work in.

Slow to Adapt Technology

★ For various reasons, the healthcare sector
is slow to adapt to rapidly changing and
life-altering technology. Any attempt at a
digital health revolution is bringing about
regulatory and compliance concerns that
are forcing it to go at a slower pace.
Innovation must have regulation, and
policy making can slow down the process.

Bad Work Hours

★ Overnight shifts, 12-hour
workdays—these are just a couple of
back-breaking scheduling hurdles that can
await nurses, doctors, and other healthcare
providers. According to a recent WHO
study, working more than 55 hours a week
directly correlates with serious health
conditions like heart disease, causing
many in healthcare to reevaluate how
much time they spend on the job. Finding
a schedule that works for you is
paramount in determining the right
work/life balance.

3.) Tobacco and Alcohol Policies Tobacco

❖ Limited administrative and technical
capacity, inadequate financial resources,
and pervasive interference by the tobacco
industry contributed to insufficient and
uneven implementation between countries
and regions.

Alcohol
❖ Poor progress since the endorsement of
4.) Disease Prevention and Control
5.) Child Nutrition Program
❖ Poor intersectoral coordination together
with low public and government
awareness of tobacco control as a
development issue that has implications
far beyond health is a major impediment.
the 'Global strategy to reduce the harmful
use of alcohol' by the World Health
Assembly.
❖ Most countries, particularly low- and
middle-income countries, have not
implemented a comprehensive set of
alcohol policies.
❖ Many countries are failing to implement
the best buys, with low- and
middle-income countries more likely to
have weaker policies.
➔ Higher poverty rates, which can make it
difficult for participants to pay for
services or programs.
➔ Cultural and social norms surrounding
health behaviors.
➔ Low health literacy levels and incomplete
perceptions of health.
➔ Linguistic and educational disparities.
➔ Limited affordable, reliable, or public
transportation options.
➔ Unpredictable work hours or
unemployment.
➔ Lower population densities for program
economies of scale coverage.
➔ Availability of resources to support
personnel, use of facilities, and effective
program operation.
➔ Lack of access to healthy foods and
physical activity options.
● Some schools experienced challenges
implementing the changes, reporting
difficulty obtaining whole grain and
low-sodium products, issues with student
acceptance of foods, reduced
participation, increased costs, and
increased food waste.