Q: Do LGUs especially those UHC-IS provinces need to develop their localized regulation on safety,

quality and equity of health goods and services example HTA?

We have national agencies who are mandated by law to set regulatory standards be it on health technologies (FDA)
or facilities (HFSRB). What localities can do is to align their standards/ requirements to those national standards. As
for HTA, local HTAs are done in other country settings but this is not mandated in the UHC law.

First, some parts of an assessment are common across settings (e.g., CLINICAL EVIDENCE) and can be adopted.
Second, it would be challenging because there are not many experts in the country who can perform this type of
technical work. The strategy to the national HTA efforts is to make sure that assessments are comprehensive enough
to consider its adoptability in diff settings. Example, in 2020 recommendations developed by the HTAC, a Guidance
Document for procuring entities was developed to guide technical specifications for the product

Q: How are Geographically Isolated and Disadvantaged Areas (GIDA) barangays identified?
Administrative Order 2020-0023 on the guidelines on the identification of GIDA barangays provided that Local
Government Units in coordination with the provincial/ city health offices shall conduct profiling and validation of GIDA
barangays and encode the results on the GIDA Information System and a list will be generated that should be verified
by Centers for Health Development – the list shall be updated annually and profiling shall be done every three years.
The main function of the Central Office is to facilitate the development of guidelines, tools, and mechanisms for
identifying GIDAs.

Q: Can there be different License-to-Operate (LTO) requirements for GIDA?

Same standards and requirements were set in all areas in terms of infrastructure, personnel, equipment, and service
capability to ensure the same quality of care and safety in all health facilities – the difference is that GIDAs are
provided with priority when it comes to inspection and provision of technical assistance. In terms of CON, hospitals
established on GIDAs are waived.

In setting the standards, a survey was conducted to health facilities, including RHUs, in different localities across all
regions. Other requirements were consulted with other DOH bureaus such as HHRDB for human resource
requirements and HFDB on health facility development specifically aligning them with the provisions on the manual
for primary care facilities. Barangay Health Stations as extension of RHUs are not being licensed/ accredited – only
the RHUs. As support, HHRDB supplements manpower through deployment of HRH however, with the increase in
NTA as a result of the Mandanas-Garcia ruling, LGUs shall allocate funds for the eventual creation of plantilla
positions.

Q: Are all Clinical Practice Guidelines (CPGs) applicable for all healthcare settings?
CPG development will be prioritized by National Practice Guidelines program using explicit criteria with the top
primary care conditions as priority. CPGs can also be site specific and not applicable in all settings however
developers are encouraged to clearly state the target users of their CPGs.
In the development of CPGs, the consensus panels consider applicability in all other settings - for areas that
applicability might be limited, suggestions from CPG developers will be stated on how they can still implement the
CPG recommendations. The Department od Health is also looking into the development of standards of care and
algorithms as knowledge translation products from NPG

On the updating of CPGs, it is recommended to be updated every 3 to 5 years wherein the Philippine National Drug
Formulary can also be harmonized with the NPG to include any new medications and to coincide with the turnover
of evidence. However, there is no hard and fast rule as other factors can be considered e.g. new gaps in current
knowledge or newly released evidence from large scale studies or any changes in the recommendations depending
on the lead CPG developer but implications on updating the CPGs shall be considered as well such as its cost and
conduct of meetings with consensus panels.