DOH Unified Resource Allocation

Framework (URAF)

MAY ANN L. LIWANAG

Senior Health Program Officer
Health Policy Development and Planning Bureau
Outline:
I. Background

II. Objectives

III. DOH Unified Resource Allocation Framework

a. Parameters for Prioritization

b. Grants:
■ Regular Assistance
■ Performance-based Incentives
■ Support Package for the Equity Project

Republic of the Philippines

Department of Health
/doh.gov.ph
Current Practice: Where are we now?
DOH Uses Multiple Frameworks/Tools for Prioritization
• Local Health System Maturity Model (LHS ML), Fixed Tranche &
Top-Up Grants for UHC Integration Sites (UHC-IS)
• PHFDP’s National Allocation Framework (NAF)
• Geographically Isolated and Disadvantaged Areas (GIDA)
• Quantification & Forecasting Methods for Public Health Programs
• Supportive Supervision Strategy
• Healthy Setting Program

Equity Principle - “High Gap, Low Capacity”

• Follows the same principle but packaged differently per program
(i.e. HRH deployment’s “high gap” refers to critical areas with HRH
gaps while “low capacity” refers to GIDAs and 5th to 6th income
class)
• Current PHFDP NAF: Challenges were encountered given that the
categorization of municipalities/cities is subsumed under its
province

Republic of the Philippines

Department of Health
/doh.gov.ph
Objectives of the DOH URAF:
(To be issued as a Department Order)

To harmonize and standardize systems of prioritization in resource

01 allocation in the Department, prioritizing LGUs with high gap and low
capacity; and,

02 To rationalize resource allocation by providing a custom-built assistance

that supports improvement of health service delivery and integration of
Local Health System into Province-wide City-wide Health System.

Republic of the Philippines

Department of Health
/doh.gov.ph
Scope and Limitations
Inclusion:

DOH Central Office and CHDs that provides resource allocation to LGUs from the national budget (i.e.
01 either from GOP or FAPs)

Exclusion (Exempted from the URAF):

01 DOH units WITHOUT direct resource allocation to LGUs from the respective line item budgets, including
DOH-owned health facilities, attached agencies, and attached corporations

Areas with reduced capacity due to unforeseen events caused by public health emergencies (e.g. natural
02 disasters, terrorism, disease outbreaks, etc)

03 LGUs declared as priority areas by the President or Human Development and Poverty Reduction Cabinet
Cluster (HDPRCC), etc. in separate national issuances

Republic of the Philippines

Department of Health
/doh.gov.ph
DOH Unified Resource Allocation
Framework
Note: Must be aligned with the DBM-Approved Devolution Transition Plan

GAP

LOW CAPACITY
Priority Level Category
HIGH CAPACITY
HIGH GAP HIGH GAP
1st Priority Low capacity, high gap
(Category 1) (Category 3)
2nd Priority Low capacity, low gap;
High capacity, high gap

LOW CAPACITY HIGH CAPACITY 3rd Priority High capacity, low gap
LOW GAP LOW GAP

(Category 2) (Category 4)

CAPACITY
Republic of the Philippines
Department of Health
/doh.gov.ph
 Linking the URAF to the
Medium-Term Expenditure Plan (MTEP)
GAP
Priority Category MTEP Scenario
LOW CAPACITY HIGH CAPACITY
Level
HIGH GAP HIGH GAP
1st Priority Low capacity, high gap Low Scenario
(Category 1) (Category 3) (DBM-Recommended
~NEP level)

2nd Priority Low capacity, low gap; Medium Scenario

LOW CAPACITY HIGH CAPACITY High capacity, high gap
LOW GAP LOW GAP

(Category 2) (Category 4) 3rd Priority High capacity, low gap High Scenario
(No Ceiling)
CAPACITY
Republic of the Philippines
Department of Health
/doh.gov.ph
 Parameters for Prioritization
The capacity of the LGU to
finance health programs in order
to provide essential health
services.
Gap is the difference between what the
CAPACITY GAP local health system (LHS) should look
(100%) (100%) like and the current LHS
General Concept of GAP:
Desired State - Current State

Poverty
Assessment of Capacity will be Local Health System
Computed at the municipal / city Incidence *For non-UHC-IS, only the Health
Maturity Level*
level by HPDPB. 25% Service Delivery Performance criteria
GIDA 30% shall apply, since the LHS ML is not
25% applicable.

Health Service Delivery

Financial Performance
Capacity 70%
50% (Program-set)
LGU
PRIORITIZATION
Republic of the Philippines
Department of Health
/doh.gov.ph
Parameters for Prioritization
￪HIGH CAPACITY:
● Financial (50%) ≥ MEAN* Value
CAPACITY ● GIDA (25%)
● Poverty Incidence 1st Priority: High Gap, Low
(100%) Capacity
(25%) ￬LOW CAPACITY:
< MEAN* Value
2nd Priority: High Gap,
High Capacity AND Low
Gap, Low Capacity
￪HIGH GAP:
● LHS ML (30%) ≥ MEAN* Value 3rd Priority: Low Gap, High
GAP ● Health Service Capacity
(100%) Delivery
Performance (70%) ￬LOW GAP:
< MEAN* Value

*If the normal distribution is symmetric (bell curve), the value of the mean
(average) shall be used as the threshold,
Republic ofand if the distribution is skewed,
the Philippines
the median value shall be used. /doh.gov.ph Health
Department of
 Sample Scenario
CAPACITY GAP
(Provided by HPDPB) (to be identified by the Program)

Province/ City/ 70%

25% Priority Level
Municipality 50% 25% 30% Health
Poverty 100% 100% (k=f+j)
(a) Financial GIDA Category* LHS ML Service Category*
Incidence Rating Rating
sub-rating sub-rating (f) sub-rating Delivery (j)
sub-rating (e=b+c+d) (i=g+h)
(b) (c) (g) sub-rating
(d)
(h)

LGU 1 50 25 21 96 High 27 59 86 Low Gap 3rd Priority

Capacity High Capacity, Low Gap

LGU 2 47 18 18 83 High 14 47 61 High Gap 2nd Priority

Capacity High Capacity, High Gap

LGU 3 35 16 15 66 Low 25 65 90 Low Gap 2nd Priority

Capacity Low Capacity, Low Gap

LGU 4 25 21 18 64 Low N/A 70 70 High Gap 1st Priority

Capacity Low Capacity, High Gap

*Rating greater than equal to the value of mean considered high

capacity/gap, else considered low capacity/gap.
Sample Threshold Value:
Capacity-Mean Value: 77
Republic of the Philippines
Gap-Mean Value: 73Department of Health
/doh.gov.ph
Analysis: LGU Capacity HUC/ICC/CC/Municipality Capacity
Distribution per Region
LGU Distribution: Normal 100% NCR 0%
87% CAR 13%
LGU High Capacity Low Capacity
78% R1 22%
Province 42 39 82% R2 18%

HUC/ICC/CC/ 42% R3 58%

817 817
Municipality 48% R4A 52%
45% R4B 55%

HIGH CAPACITY

LOW CAPACITY
20% R5 80%
LGU Income Class
33% R6 67%
54% R7 46%
59% R8 41%

55% 24% R9 76%

80% 53% R10 47%
31% R11 69%
18% R12 82%
80% or 1381/1715 of LGUs classified as 1st - 4th income class. Of this
Republic of the Philippines
73% R13 27%
80%, 55% or 759/1381 of LGUs that are classified as 1st - 4th income
Department of Health
/doh.gov.ph 32% BARMM 68%
class were considered low capacity in the URAF.
Provision of Grants as per Sec. 22 of UHC Act
Routine assistance provided, but are not limited to, financial grants, and
Regular Assistance non-financial grants or logistics support such as health commodities,
health infrastructure and equipment, medical transport vehicles,
deployment of human resources for health, capacity building, and policy
orientation and information dissemination, etc.

A site-specific, service-oriented, gender-responsive, and

Equity Project culture-sensitive service package to be provided to priority LGUs with the
poorest communities, GIDAs, and unserved or underserved areas

Performance-Based Monetary and non-monetary incentives awarded to LGUs that performed

well (regardless of their priority level) and have attained certain eligibility
Incentives requirements.

Republic of the Philippines

Department of Health
/doh.gov.ph
 Grants: Regular Assistance
Types of Sample Priority 1 Priority 2 Priority 3
1st Priority Assistance
100% Requested Financial Support ● Any form of cash assistance
resources Up to 100% Up to 75% Up to 50%
in the AOP
Health Commodities ● Medicines, vaccines, and other
commodities Up to 100% Up to 75% Up to 50%
2nd Priority ● ICT systems & support
75% Requested
resources Health Infrastructure ● Health Facilities
in the AOP ● Equipment
● Medical Transport Vehicles Up to 100% Up to 75% Up to 50%

3rd Priority
Human Resource ● HRH
50% Requested ● Scholarship Program Up to 100% Up to 75% Up to 50%
resources
in the AOP
Capacity Building & ● Training/Seminar
TA ● LDIs & TA 100% 100% 100%

*Percent of possible assistance to be Policy and Standards ● Policies and Guidelines

determined by programs vis-a-vis available ● Orientation 100% 100% 100%
stock inventory, supply/demand, etc. ● Technical Advisories
Republic of the Philippines
Department of Health
/doh.gov.ph
Grants: Regular Assistance
Provision of Regular Assistance at Province-level and Municipal/City-level

Province

Technical and Advocacy-Oriented

Assistance

Municipality/HUC/ICC/CC

Service Delivery-Oriented
Intervention Packages

Republic of the Philippines

Department of Health
/doh.gov.ph
Grants: Support Packages for Equity Project
(To be issued as a separate issuance ℅ BLHSD)

Target Impactful Sample

Flagship
Beneficiaries and Relevant Services
Interventions
Interventions
Poorest
Site-Specific Mobile Clinics
Communities
Tangible
Issues on Access Service-oriented Telemedicine

Operational
GIDA Gender-responsive Outreach Services

Unserved/ Culture-sensitive
underserved

Republic of the Philippines

Department of Health
/doh.gov.ph
Grants: Performance-Based Incentives
Sample Mechanism for the Provision of Performance-Based Incentives
Requirements/
Category
Eligibility
● Functional level in all
PCWHS Building Blocks
● 100% of all performance
Category 3 targets for health are
met.
● Other program-set
eligibility requirements
● Organizational level in all
PCWHS Building Blocks
● At least 90% of all
Category 2 performance targets for
health are met.
● Other program-set
eligibility requirements
● Preparatory level in all
PCWHS Building Blocks
● At least 80% of all
Category 1 performance targets for
health are met.
● Other program-set
Republic of the Philippines
Department of Health ●
eligibility requirements
/doh.gov.ph
Incentives/Rewards
● For UHC IS: xx amount
● For non-UHC IS: 30% of the allocated incentive for UHC
IS, and/or;
● Non-cash recognition (e.g. plaque, trophy, certificate)
Sample:
● UHC IS - Php 30M
● Non-UHC IS - Php 9M
● For UHC IS: xx amount
● For non-UHC IS: 30% of the allocated incentive for UHC
IS, and/or;
● Non-cash recognition (e.g. plaque, trophy, certificate)
Sample:
● UHC IS - Php 20M
● Non-UHC IS - Php 6M
● For UHC IS: xx amount
● For non-UHC IS: 30% of the allocated incentive for UHC
IS, and/or;
● Non-cash recognition (e.g. plaque, trophy, certificate)
Sample:
● UHC IS - Php 10M
Non-UHC IS - Php 3M
 Thank you!

URAF + NOH 2023-2028: External Health Partners Consultative Meeting