HEALTH CARE SYSTEM

Alma Ata Declaration (1977)

“Health is a fundamental human right and that the attainment of the highest possible level of health is a
most important world-wide social goal whose realization requires the action of many other social and
economic sectors in addition to the health sector”

• The existing gross inequality in the health status of the people particularly between developed
and developing countries as well as within countries is politically, socially and economically
unacceptable and is, therefore, of common concern to all countries.
• The promotion and protection of the health of the people is essential to sustained economic and
social development and contributes to a better quality of life and to world peace.

“Health is a key element of human rights and social justice.”

Alma Ata

• Governments have a responsibility for the health of their people which can be fulfilled only by the
provision of adequate health and social measures.

Philippine Health Budget

• 3.4 per cent of the GDP

– Lower than the prescribed 5 % by WHO
– Lower than Japan, India, (more than 6 %)
– Lower than Vietnam (5%)
• Government expenditure for Health is 30 percent lower than half of Asian Countries

EQUALITY = Sameness
- It promotes fairness and justice by giving everyone the same thing.
- It can only work IF everyone starts from the SAME place

EQUITY = Fairness
- It is about making sure people get access to the same opportunities.
- Sometimes our differences and/or history, can create barriers to participation, so we must
FIRST ensure EQUITY before we can enjoy equality

What we have taken up so far?

• Alma Ata Declaration

–Health is a human right
–The responsibility mainly of the government
–Not the responsibility of the health sector alone
–That any form of health inequity is not acceptable
AMARTYA SEN (Nobel-Prize Winner Economist)
Even when the economy is poor, major health achievements can be achieved by using resources
in a socially productive way.
Definition of Health Care System

• “the combination of resources, organization, financing and management that culminate in the
delivery of health services to the population.”
• In World Health Organization Report in 2000, health system was defined as “all the
organizations, institutions and resources that are devoted to producing health actions.”

Health Care Delivery System

• A health system consists of all organizations, people and actions whose primary intent is to
promote, restore or maintain health

What Is A Health System?

•This includes efforts to influence determinants of health as well as more direct health-
improving activities.
• A health system is therefore more than the pyramid of publicly owned facilities that deliver
personal health services.

DETERMINANTS OF HEALTH
-Income and Social Status -Social Support Networks
-Employment and Working Conditions -Physical Environment
-Education -Healthy Child Development
-Biology and Genetic Endowment -Health Services
-Personal Health Practices and Coping Skills

GOALS AND FUNCTION OF HEALTH SYSTEM

3 main goals for health systems:
1. Improving the health of populations
2.Improving the responsiveness of the health system to the population it serves.
3. Fairness in financial contribution.
The Eight Millennium Development Goals are:

1. to eradicate extreme poverty and hunger;

2. to achieve universal primary education;
3. to promote gender equality and empower women;
4. to reduce child mortality;
5. to improve maternal health;
6. to combat HIV/AIDS, malaria, and other diseases;
7. to ensure environmental sustainability; and
8. to develop a global partnership for development.

Four (4) Vital Health System Functions

1.Health Service Provision

2.Health Service Inputs
3.Stewardship
4.Health Financing

Health Information System

- A well-functioning health information system is one that ensures the
(1) production,
(2) analysis,
(3) dissemination and use of reliable and timely information on health determinants, health systems performance
and health status.

Medical Products
• A well-functioning health system ensures equitable access to essential medical products, vaccines and
technologies of assured quality, safety, efficacy and cost effectiveness, and their scientifically sound and
cost-effective use.

Financing System
A good health financing system raises adequate funds for health, in ways
• that ensure people can use needed services, and
• are protected from financial catastrophe or impoverishment associated with having to pay for them.
Leadership and Governance
• Leadership and governance involve ensuring strategic policy frameworks exist and are combined with effective
oversight, coalition-building, the provision of appropriate regulations and incentives, attention to system-design,
and accountability.
Five Common Short Coming of Health Care Delivery
1. Inverse Care:
People with the most means, whose needs are less often consume care the most. Those with the least
means, with the greatest problems consume care the least.
2. Impoverishing Care: (to deprive)
Wherever people lack social protection and payment for care is largely out of the pocket at the point of
service. They can be confronted with catastrophic expenses.
3. Fragmented and fragmenting care:
–excessive specialization
–Narrow focus on disease control
–Health Care for the poor and marginalized; highly fragmented, severely under resources
–Development AID often aids in fragmentation
4. Unsafe care
Poor systems design is unable to ensure safety and hygiene standards leads to high rates of hospital
acquired infections, medication errors and other avoidable adverse errors
5. Misdirected care
Resource allocation cluster around curative services at great cost, neglecting the potential of primary
prevention and health promotion