Republic of the Philippines

Department of Health
OFFICE OF THE SECRETARY

JUll ~ 2017

DEPARTJ\IENT ORDER
No. 2017-_0287-

SUU,JECT: Standards for the Development of National Public Health Programs

I. BACKGROUND/RATIONALE

0:·1e of the key interventions undertaken by the Department of Health to address public
healtb issues is the development and implementation of national public health programs.
Becavse of the increased expectation for the DOH to produce tangible results, it is important
that a .;lear set of standards be established for these programs. These standards will serve as the
basis :v which these health programs are developed, and will help ensure quality processes and
outp;ts for national public health programs to achieve their goals and objectives and contribute
to the overall health of Filipinos as envisioned through the Philippine Health Agenda. In light
of th\ DOH's role as policymaker, standards developer, and as a provider of assistance to
implt •Jenters on the ground, the Department is shifting to a more client-focused approach and
work· 1g towards producing integrated guidelines that support understanding and facilitate
adop\ un by frontline healthcare workers.

II. OBJ£CTIVES
T) Jefine standards for the establishment of national public health programs

III. SCOl'E

This Jepartment Order shall apply to all Central Office directors, heads, chiefs, and all staff of
Cent'.i Office bureaus, offices, services, hospitals, health facilities, Regional Offices, DOH-
ARlv .v1, and attached agencies.

IV. GEN :•:RAL GUIDELINES

All p blic health programs for nationwide implementation, both existing and to be proposed,
shall :dhere to the following:

1. Pnblic health programs shall be clearly differentiated from public health projects. A
p1 0gram is broader in scope and objectives, requires a more complex set of regular
ac jvities, a longer period of time for completion, and substantial government investments;
w.jle a project is limited in scope, objectives, timelines, and activities. Please refer to
Ar nex A for more detailed explanations differentiating programs from projects.

2. A 11 national public health programs shall address a demonstrated need and shall have
a·<y of the following as the basis for its development:

a. Major public health issue/concern (e.g., high burden of disease - a disease condition
that constitutes part of the 80% of the total disease burden in the Philippines - and
emerging and re-emerging diseases) J. ,
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Fax: 743-1829 • URL: http://w\\w.doh.gov.ph; e-mail: officeofsoh!aldoh.gov.ph
 b. Defined need of specific priority marginalized populations, such as, but not limited to,
those identified as poor by the National Household Targeting System, persons with
disabilities, indigenous peoples, etc.
c. Neglected conditions with limited available support and resources from the health
system, such as, but not limited to, neglected tropical diseases, orphan disorders, poor
environmental sanitation (such as access to safe water, sanitation, and hygiene
services), and occupational health

3. All national public health programs must by all means integrate its implementation (i)
with programs with similar strategies, systems, tools, and with institutionalized
routine systems, and (ii) in line with the strategic directions for the health sector and
the Philippine Development Plan.

4. All national public health programs shall adopt an all life-stages approach and develop
strategies encompassing health promotion and communication, disease prevention and
management, rehabilitation, and its integration with existing orgamc governance
frameworks, systems, and standards such as, but not limited to:
a. Health facility standards;
b. Strategic human resources for health management and development;
c. Philippine National Formulary;
d. Supply chain management of medicines;
e. Primary care guarantees list;
f. Service delivery networks;
g. National Health Insurance Program;
h. Monitoring and evaluation framework; and
1. Health data management.

5. All national public health programs shall be supported by policies and strategic amd
operational plans, and shall undergo monitoring and evaluation. Planning, monitoring
and evaluation, and policy development shall be consistent with Department Order No.
2016-0269, "Guidelines on Planning, Monitoring, and Evaluation of Programs, Activities,
and Projects in the DOH" and Department Order No. 2009-0292, "Implementing
Guidelines for the Development of Executive Policies of the Department of Health" and its
revisions.

6. Existing national public health programs shall comply with the standards set forth in this
issuance within two (2) years from the effectivity date of this Order.

V. SPECIFIC GUIDELINES

The following shall be mandatory strategic components of all national public health
programs:

A. Mandate
1. Legal basis - All national public health programs shall have a clear legal basis,
mandated or supported by either a law (e.g., Executive Order or Republic Act) or an
Administrative Order.
2. International commitments or agreements - National public health programs may
also be mandated in compliance with the Department's international commitments or
agreements

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 B. Conceptual framework - This shall reflect the rationale behind the program, linking the
identified health problems, strategies that will be used to address these, goals of the
program, and the anticipated outcomes. (Please refer to Annex D of DO 2016-0269 for a
conceptual framework template).

C. Strategic and Investment Plans

1. This plan shall clearly lay out the long-/medium-term goals that will provide direction
for the program, and strategies that will be used to achieve or contribute to the National
Objectives for Health and which are in line with the national health agenda. (Please
refer to Annex C of DO 2016-0269 for the strategic plan template).
2. An investment plan shall accompany the strategic plan and shall demonstrate the
financial sustainability of the program being proposed by showing that adequate
funding for the effective implementation of the program is available and sustainable
throughout the phases and duration of its implementation. Population incre&ses and
inflation must be taken into account (Please refer to Annex B for an investment plan
template which follows the Medium Term Expenditure Framework template.)

VJ.Z-' Operational Plan (OP), Work and Financial Plan (WFP}, and Project Procurement
bJ Management Plan (PPMP)
1. All national public health programs shall have annual plans to support their
implementation, such as an OP, WFP, and PPMP.
2. Preparation and submission of these plans shall be in accordance with the
corresponding issuances that are released annually (Annual OPlan Guidelines, WFP
Guidelines, etc.), and shall be consistent with DO 2016-0269. All other required plans
shall also comply with existing guidelines/issuances (e.g., monthly disbursement
program, training plan, etc.).

t jl. Monitoring and Evaluation (M&E) System

" 1. All national public health programs shall have program-specific M&E frameworks that
are aligned with the Department's M&E system, and shall be prepared in accordance
with DO 2016-0269. (Please refer to Annex E of DO 2016-0269 for an M&E plan
template.)
2. All national public health programs shall continually monitor program performance and
regularly evaluate program strategies. Evaluations through Program Implementation
Reviews (PIRs) and Program Reviews (PRs) shall serve (1) to ensure adequate
implementation of programs (in the case of PIRs), and (2) as bases for sustaining,
correcting, adjusting or adding strategies to programs (in the case ofPRs).
3. All national public health programs shall obtain program data through institutional
mechanisms (such as FHSIS), DOH-validated/-certified electronic medical records, and
regular, commissioned national/special surveys.

f~ Research, Policy, Legislative and Technical Assistance (TA) Tools

~ 1. All national public health programs shall develop the following tools as the need arises
to support policy development, implementation, and assessment: (Please refer to
Annexes C- G for templates and suggested outlines)
a. Health policy brief/note - a concise summary of a particular issue, which includes
evidence for policy options and recommendations; usually aimed at government
policymakers and others who are interested in formulating or influencing policy
 b. White paper- a policy paper produced by government that sets out proposals on
future legislation (e.g., Republic Act) or policy development for eliciting comments
and discussion, advocacy, or adoption as a whole or in part by relevant stakeholders
c. Health technical brief - a brief presentation of facts and figures on a salient or
emerging health concern for management information or for use as basis for
decision-making
d. Health technical advisory - an advisory on the status, key messages, and actions
(contingent or urgent) to take by health stakeholders (health managers, providers,
funders, partners) on urgent or emerging health concerns
e. Public health advisory - an advisory providing general information on a health
concern for the general public
f. Electronic dashboard - a data visualization tool used to present metrics that are of
relevance to DOH policymakers
2. All national public health programs shall provide input to the DOH research, policy,
legislative, and T A agenda as deemed necessary. Agenda setting,policy development,
and preparation and approval of administrative issuances shall be consistent with DO
2009-0292 (and its revisions) and DO 2015-0284, "Revised Rules and Procedures on
the Preparation and Approval of Administrative Issuances in the Department of
Health." Templates for policy, research, legislative, and TA agenda are part of the WFP
guidelines issued annually.

~ y Manual of Operations (MOP)

'"II 1. An MOP shall serve as a guide to implementing a national public health program at all
levels of the health system - from the DOH Central Office to the Local Government
Units and local health facilities. (Please refer to Annex H for a template outline of an
MOP.)
2. All national public health programs shall contribute (and update as necessary) relevant
chapters to MOPs intended for DOH Central and Regional Offices and MOPs for
implementers (i.e., frontline service delivery providers).

H f.(. Clinical Practice Guidelines (CPGs)

<irJ 1. All national public health programs shall ensure updated CPGs to guide the provision of
cost-effective health services to patients and clients.
2. CPGs shall be developed in consultation with experts according to guidelines to be
developed by the DOH.

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<,1
Ji Annual Report
1. To ensure accountability, national public health programs must prepare an annual report
for (i) stakeholders and (ii) the general puhlic.
2. The annual report shall be a comprehensive report of the programs' activities and
accomplishments/performance, and shall comply with DO 2017-0236, "Guidelines on
the Implementation of the Freedom of Information (FOI) Program and Open Data
Initiative (ODI) in the DOH and the Data Privacy Act of2012.
3. Reports of National Public Health Programs shall be disseminated to key DOH units to
guide policymaking and provide inputs for health system improvement. A concise
version of the program annual report shall be included in the DOH Annual Report.

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VI. ROLES AND RESPONSIBILITIES

A. Health Policy Development and Planning Bureau (HPDPB) shall:

1. Ensure alignment of national public health programs with the overall medium- and
long-term health sector plans of the Department;
2. Monitor adherence to these standards and other issuances cited herein;
3. Lead the development and implementation of a strategy review of all existing national
public health programs and supporting policies;
4. Recommend on the continuation, revision, or termination of programs to the Head of
the Office of Policy and Health Systems, who then shall make the final
recommendation to the DOH Executive Committee and the Secretary of Health;
5. Provide technical assistance on the development of national legislation affecting health
programs;
6. Facilitate inclusion of priority policies supporting key national public health programs
in the health legislative agenda of the Department; and
7. Provide policy guidance to Development Partners to streamline and rationalize support
for health programs.

B. Disease Prevention and Control Bureau (DPCB) shall:

1. Undertake the technical work required to ensure that national public health programs
adhere to these standards and other issuances cited herein, including the submission of
an updated/amended WFP which should reflect additional work of reviewing and
revising national public health programs;
2. Lead the further development of standards for national public health programs in
collaboration with the HPDPB, specifically on conditions for revision and termination
of programs;
3. Develop omnibus policies for all national public health programs that harmonize and
streamline existing policies on implementation;
4. Establish mechanisms to harmonize activities and investments in national public health
programs to avoid duplication; and
5. Provide technical or program-specific inputs to Integrated MOPs for Public Health
Programs to be developed by Office for Field Implementation Management and the
Bureau of Local Health Systems Development as may be relevant.

C. Health Promotion and Communication Strvice shall:

1. Develop and disseminate a National Health Promotion and Communication plan
including prototype of Information, Education, and Communication (IEC) materials and
collaterals
2. Develop policies and guidelines to ensure implementation of major health promotion
strategies such as health settings, health lifestyles, and health population
3. Provide technical assistance and capacity development opportunities on health
promotion to Central Office (CO) clusters/bureaus/services, Regional Offices, and DOH
Hospitals
4. Collaborate with Non-Governmental Organizations, Peoples Organizations,
development partners, and other relevant government agencies
5. Serve as a clearing house for all Health Promotion and Communication plans, IEC
materials, sponsorships/partnerships, and use of DOH insignia in the conduct of events
on health

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 D. Office for Field Implementation and Monitoring (OFIM) and Bureau of Local Health
System Development (BLHSD) shall:
1. Develop and regularly update integrated MOPs for field implementers in a service
delivery network and MOPs for DOH Central Office and Regional Offices as may be
relevant; and
2. Provide feedback on the implementation and integration of health programs to DPCB.

E. Other DOH Central Office technical units shall develop tools and systems to facilitate
program requests for integration.

VII. EFFECTIVITY DATE

This Department Order shall take effect immediately.

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ANNEX A. Difference between a Project and a Program

Project Program
Definition Temporary, with specific/tangible Portfolio consisting of multiple
outputs projects that are managed and
coordinated as one unit with the
objective of achieving
outcomes/impact
Objectives Outputs are relatively easy to Outcomes are more difficult to
describe, define, and define and measure/quantify (i.e.,
measure/quantify (i.e., that there are no agreed/established methods to
established and valid methods to measure/quantify outputs)
measure/quantify outputs)
Scope Strictly limited and defined, not Can be changed
likely to change during the project
cycle
Duration Relatively short term, lasting months Relatively longer term, lasting
years
Risk profile Risk is easier to identify and manage Risk is more complex, harder to
with less impact on project success manage, and with potentially
greater impact on program success
Nature of the problem Clearly identified and simpler to More complex and therefore more
describe difficult to describe
Nature of the solution With limited number of potential With significantly more potential
solutions solutions; solutions may also be
more complex
Stakeholders Limited More diverse
Relationship to Stable and well-understood More dynamic environment
environment environment
Resources Can be reasonably estimated in More difficult to estimate
advance resources, which are limited

Adapted from http://www.independent-consulting-bootcamp.com/difference-between-a-project-and-a-program.html

ANNEX B. Medium Term Investment Plan
P/A/P: - - - - - - - - - - - - - - - -
Objective:-----------------

DETAILED MEDIUM TERM EXPENDITURE PROGRAM

Intervention/ (a) Basis/Rationale for Target (b) (c) (d) (a X b XC+ d)

Population/Formula Used/ Remarks
Commodity Target Unit Cost Quantity Indirect Cost Cost
Assumptions
Intervention A:
Baseline Year/
Current Year
Year 1
Year2
Year 3
Year4
Year 5
Year6

Add rows as needed to reflect all interventions of the P/A/P

For HRH: - Target population pertains to no. of deployment areas
i. Unit cost pertains to salaries and other benefits x 12
1i. Quantity pertains to no. ofHRH to be deployed
iii. Indirect costs pertains to deployment cost, training, etc.
iv. Computation of total cost shall not include (a) Target
For Commodities: Target pertains to target population
For Facilities: Target pertains to number of facilities to be constructed or upgraded
v. Quantity is not applicable
ANNEX C. Suggested Outline for Policy Brief/Note

Instructions: Define the type of policy brief/note that you want to prepare depending on your need.

a. Advocacy brief- argues for a particular course of action

b. Objective brief- provides balanced information for policymakers to use to decide on a
specific issue

Outline:

1. Title

2. Author/s and affiliationls

3. Summary (or policy message)- 3-4 bullet points of main points

4. Introduction/Background- is a statement of the issue/problem of concern, which should

answer the following questions:
a. What is the problem and why is it important?
b. What is the context of the problem? (who, what, where, when)
c. What are the causes of the problem? (give evidence or examples)
d. What are the effects of the problem? (give evidence or examples

5. Body - Is a detailed explanation and discussion of evidence and of policy implications

a. If advocacy brief- which supports the course of action being recommended
b. If objective brief- of policy options to be considered; includes advantages and
disadvantages of each
c. Options for structuring the body:
i. By sub-topic (e.g., if issue is HIV, sub-topics may be prevention of
transmission, treatment, and support mechanisms/systems)
ii. By example (e.g., different interventions or approaches)

6. Recommendations

7. Acknowledgements

8. References

NOTE:

1. Keep it as short as possible, 1-2 pages (maximum of3 pages)

2. Tables, graphics, and photographs may also be used

Adapted from FAO Food Security Communications Toolkit

ANNEX D. Suggested Outline for White Paper

1. Executive Summary

2. Introduction and Background

3. Methodology

4. Literature Review

5. Policy Context and Options

6. Analysis ofEvidence (e.g., research evidence, surveys, case studies, etc.)

7. Proposed policy options and recommendations

8. Implementation and next steps

9. Conclusion

10. Appendices (e.g., tables, graphs, detailed case studies, etc.)

11. References
ANNEX E. Technical Brief Outline

1. Background/definition of the topic

2. Important recent findings/information (evidence, program lessons, etc.)

3. Implications for concerned program/project/DOH unit

4. Information sources
ANNEX F. Technical Advisory Outline

1. Status ofhealth issue/topic

2. Key messages
a. Updated information/evidence
b. Implications for concerned program/project/DOH unit/health stakeholder (manager,
provider, funder, partner)

3. Actions to be taken (ranked according to urgency or type of responsible agent/stakeholder)

ANNEX G. Public Advisory Outline

1. Key facts
a. What is the health issue/concern/disease?
b. What are the relevant effect on people, the environment, and/or others?
c. Where is it occurring? Where are the affected areas?
d. Is there a travel ban or restriction? Which areas/countries?

2. Causes and/or Transmission

3. Signs and Symptoms of affected people

4. Complication/s

5. Actions needed from the population

a. Prevention
b. Treatment
c. Others
ANNEX H. Suggested Manual of Operations Outline

1. Program Overview
a. Description
b. Rationale
c. Conceptual Framework
d. Strategic Plan

2. Program Components and Processes

a. Services/Interventions
b. Standards
i. Resource Requirements
ii. CPGs

3. Program Systems
a. Governance
b. Monitoring and Evaluation

4. Financing
a. Costing/guide to costing interventions
b. Options

5. Supporting Policies

6. Relevant Form