TH E H E A LT H C A R E

DE L IV E RY S Y S T E M
 

Objectives:
1. Discuss how the World Health Organization (WHO) affects health issues in the
Philippines.
2. Describe the Philippine Health Care Delivery System as to its components and
sectors.
3. Differentiate the referral system from the interlocal health zone.
4. Distinguish the levels of healthcare, service and facilities.
5. Enumerate the various reform initiatives that shaped Philippine healthcare delivery.
6. Explain the salient features of the Universal Health Care Law in the Philippines.
 A nation’s health care delivery system has a tremendous impact not only
the health of its people but also on their total development including their
socioeconomic status. Anderson and Mcfarlene (2011) emphasized the
role of the following factors in shaping 21st century health that further
influence health care delivery system:
1. Health care “reforms”
2. Demographics
3. Globalization
4. Poverty and growing disparities
5. Social disintegration
WORLD HEALTH
ORGANIZATION
(WHO)
 
World Health Organization (WHO)- specialized agency in the United Nations (UN)
provides global leadership on health matter in the Philippines. Health services are
provided by the;
 government and
 private sector -for profit as well as non-profit to as Non- Government
Organizations (NGO).
 
On the national level, director is set by department of health (DOH) by virtue of
mandate of the Local Government Code (R.A.7160) LGU’s should have
operating mechanism to meet the priority needs and service requirements of their
communities. Basic Health Services are regarded as priority services for which
LGU’s are primary responsible.
 
Health System consist of all organizations, people and actions whose
primary intent is to promote, restore, or maintain health.

1. Service delivery
2. Health Workforce
3. Information
4. Medical Products, Vaccines, and technologies
5. Financing
6. Leadership and governance or stewardship
The World Health Organization
The WHO constitution came into force on April 7, 1948. Since then April 7 has
been celebrated each year as World Health Day.
 Objective: attainment by all peoples of the highest possible level of health
(WHO,2006)
To attain its objective, WHO carries out the following core functions:
• Providing leadership on matters critical to health and engaging partnerships
where joint action is needed. WHO has 193 members of countries and 2
associate members. WHO and its members work with UN agencies, NGO’s
and the private sector. The WHO country focus is directed toward providing
technical collaboration with member states with accordance with each country’s
needs and capacities.
 Shaping the research agenda and stimulating the generation, translation, and
disseminating valuable knowledge. The WHO strategy on research for health has 5
goals:
1. Capacity- in reference to capacity-building to strengthen the national health research
system
2. Priorities – to focus research on priority health need particularly in low and middle
income countries
3. Standards - to promote good research practice and enable the greater sharing of
research evidence, tools, and materials
4. Translation - to ensure that quality evidence is turned into products and policy
5. Organization – to strengthen the research culture within WHO and improve the
management and coordination of WHO research activities.
 
 Setting norms and standards and promoting and monitoring their implementation.
WHO develops norms and standards for various health and health –related
issues, such as pharmaceutical products including vaccines and other
biological products used in immunization, practices in maternal and child care,
and environmental conditions.
 Articulating ethical and evidence-based policy options. Through its
Department of Ethics and Social Determinants, WHO is evolved in various
issues on health ethics. In collaboration with other governmental and
nongovernmental organizations, WHO has worked on bioethical concerns such
as those related to human organ and tissue transplantation, reproductive
technology and public health response to threats of infectious diseases like
AIDS, influenza, and tuberculosis.
 Providing technical support, catalyzing change, and building
sustainable institutional capacity. WHO offers technical support training
to its member countries in the fields of maternal and child health, control of
diseases, and environmental health services. WHO is involved in monitoring
the health situation and assessing health trends. WHO has developed
guidance and tools and measurement, monitoring and evaluation.
 The Philippines is a member of a global system of nations interacting
with each other at different levels and in different ways. Events that
happen in other countries can affect the status of Filipinos. Ease of travel from
one part of the globe to another makes transmission of the communicable
disease likewise easy. This has been proven by the events as the emergence
and spread of disease like HIV/AIDS, SRAS (Severe Acute Respiratory
Syndrome), AH1N1 influenza (swine flu) and COVID 19.In contrast,
cooperation and sharing of resources among nations serve as the key in the
solution of many human problems-health.
 WHO has worked as a partner of the Philippine DOH in the Development
and provision of services towards the attainment of health-related
Sustainable Development Goals (SDGs).

The Sustainable Developmental Goals (SDGs) or Agenda 2030 aims to

continue the gains achieved thru Millennium Development Goals (MDGs)
implemented from 2000 to 2015. The SDGs contain 17 goals and 169 targets
that will cover the period 2016 to 2030. In the Philippines, the Department of
Health develops and aligns its programs to help achieve SDG 3 that focuses on
ensuring health and well being of populations.
 THE PHILIPPINE
HEALTH CARE
DELIVERY SYSTEM
Components and Sectors of the Health Care Delivery System:
The Philippine health care delivery system is composed of two sectors: (1)
the public sector and (2) private sector.

The public sector consists of the national and local government agencies
providing health services. At the national level, the Department of Health (DOH)
is mandated as the lead agency for health. It has a regional office in every
region and maintains specialty hospital, regional hospitals and medical centers.
The public sector is largely financed through a tax based budgeting system at
both national and local levels. In here, health is generally free at the point of
service.
 The private sector is a largely market oriented and health care is rapid
through users fee at the point of service. Its involvement in maintain the
people’s health include providing health insurance, manufacturer of
medicines, vaccines, medical supplies, equipment and other health and
nutrition products, research and development, human resource and
development and other health related services.
 The private sector is composed of for-profit and nonprofit agencies this
sector provides all levels of services and accounts for a large segment of health
service providers in the country. About 30% of Filipinos utilize private health
facilities. Estimated 60% of national health expenditure goes to the private sector
which employs more than 70% of the health professionals in the Philippines.
Financing of health services is provided by three major groups: The
government (national and local), private sources and social health
insurance. The National Insurance Act of 1995 (R.A. 7875) created by the
Philippine Health Insurance Corporation (PhilHealth). It is tax-exempt
government corporation attached to the DOH for policy coordination and guidance,
and aims for universal health coverage of all Filipino citizens.
 The DOH serves as the main governing body of health services in the
country. The DOH provides guidance and technical assistance to LGUs
through the center for health development in each of the 17 regions.
 Provincial governments are responsible for administration of provincial and
district hospitals.
 Municipal and city governments are in charge of primary care through rural
health units (RHUs) or health centers. Satellite outposts known as
barangay health stations (BHSs) provide health services in the periphery of
the municipality or city.
1. Primary Level of Care (prevention of illness or promotion of
health)
a. The first contact between the community members and the other levels of
health facility.

2. Secondary Level of Care (curative)

b. Capable of performing minor surgeries and perform some simple
laboratory examinations.

3. Tertiary Level of Care (rehabilitative)

a. Complicated cases and intensive care requires tertiary care and all these can
be provided.
 MILLENNIUM
DEVELOPMENT
GOALS
The Millennium Development Goals
On September 6 to 8, 2000, world leaders on UN General Assembly
participate in Millennium Summit. The result of the summit was a
resolution entitled United Nations Millennium Declaration. In this
declaration, the world leaders recognized their collective responsibility to
uphold the principles of human dignity, equality and equity at the global
level.
The declaration expressed the commitment of the 191 member
states, including the Philippines, to reduce extreme poverty and
achieve seven other targets - now called the Millennium
Development Goals (MDG’s) by the year 2015.
 The following are the eight MDG’s and the targets corresponding to
health-related MDG’s 4,5, and 6:
1. Eradicate extreme poverty and hunger.
2. Achieve universal primary education.
3. Promote gender equality and empower women.
4. Reduce child mortality. Target: reduce by 2/3, between 1990 and 2015, the
under-five mortality rate.
5. Improve maternal health. Target:
a. Reduce by three quarters the maternal mortality ratio
b. Achieve universal access to reproductive health
6. Combat HIV/AIDS, malaria and other diseases. Targets:
a. Have halted by 2015 and begun to reverse the spread of HIV/AIDS
b. Achieve by 2010, universal access to treatment for all those who need it
c. Have halted by 2015, and begun to reverse the incidence of malaria and
other major diseases.
7. Ensure environmental sustainability
8. Develop a global partnership for development
 
 SUSTAINABLE
DEVELOPMENT
GOALS
(SDGs)
The Sustainable Developmental Goals (SDGs)
or Agenda 2030 aims to continue the gains
achieved thru Millennium Development Goals
(MDGs) implemented from 2000 to 2015. The
SDGs contain 17 aspirational "Global Goals"
and 169 targets that will cover the period
2016 to 2030.
 The Sustainable Development Goals
(SDGs), aims to “ ensure that all human
beings can fulfill their potential in dignity
and equality and in a healthy environment.”
• The SDGs, otherwise known as the Global Goals, build on the
Millennium Development Goals (MDGs), eight anti-poverty
targets that the world committed to achieving by 2015.

• The MDGs, adopted in 2000, aimed at an array of issues that

included slashing poverty, hunger, disease, gender inequality,
and access to water and sanitation.

• The new Global Goals, and the broader sustainability agenda,

go much further than the MDGs, addressing the root causes of
poverty and the universal need for development that works for
all people.
In the Philippines, the
Department of Health
develops and aligns its
programs to help achieve
SDG 3 that focuses on
ensuring health and well
being of populations.
GOAL 3. Ensure Healthy Lives and Promote Well being for all Ages

TARGETS:
• By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births.
• By 2030, end preventable deaths of newborns and children under 5 years of age, with all
countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and
under-5 mortality to at least as low as 25 per 1,000 live births
• By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical
diseases and combat hepatitis, water-borne diseases and other communicable diseases
• By 2030, reduce by one third premature mortality from non- communicable diseases
through prevention and treatment and promote mental health and well-being
• Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and
harmful use of alcohol
• By 2020, halve the number of global deaths and injuries from road traffic accidents
• By 2030, ensure universal access to sexual and reproductive health-care services, including for
family planning.
 Sustainable Developmental Goals (SDGs) It is
a whole system approach to improving health
system performance and sustaining health gains. It
focuses on attention on people and communities,
calling for health systems that are of good quality,
efficient, equitable, accountable, resilient and
responsive to the needs of diver’s population
groups, including in particular those left furthest
behind.
  To truly make the Global Goals sustainable, it is vital communities are well
informed about the goals and engaged in through the process of reaching
them.

 The UN’s “Major Groups” is a great place to start and includes women,
children and youth, indigenous peoples, NGOs and non-profit organizations,
local authorities, workers and trade unions, business and industry, and
farmers.

 The Global Goals require the inclusion of local groups like these to truly be
sustainable. Moreover, the very definition of sustainability must include a
focus on children and youth.

GLOBAL GOALS ARE NOT SUSTAINABLE WITHOUT THE SDG

GENERATION
 PHILIPPINE
DEPARTMENT OF
HEALTH
 The Department of Health
The DOH is the national agency mandated to lead the health
sector towards assuring quality health care for all Filipinos.

DOH Vision: is to make “Filipinos among the healthiest in Southeast

Asia by 2022 and in Asia by 2040”

DOH Mission: “To Lead the country in the development of a

productive, resilient, equitable, and people centered health system”
(DOH,2019).
 Department of Health
Framework for Implementation of Health Reform: FOURmula One Plus
(F1 Plus)
GOALS : The FOURmula ONE Plus(F1) for Health aims to
1. Better Health Outcomes
2. More Responsive Health System
3. More Equitable Health Care Financing”

STRATEGIC PILLARS: Financing, Service Delivery, Governance

and Regulation “PLUS” Performance Accountability

VALUES : Integrity, Excellence and Compassion

 In the pursuit of its vision and execution of its mission, the
DOH has the following major roles:
1. Leader in health
2. Enabler and capacity builder
3. Administrator of specific services
ROLES and Functions of the DOH

1. Leadership in Health -elucidated in Executive Order 102,in terms of the

following functions;
 Planning and formulating policies of health programs and services
 Monitoring and evaluating the implementation of health programs, projecys,
research, training and services
 Advocating for health promotion and healthy lifestyle
 Serving as technical authority in disease control and prevention
 Providing administrative and technical leadership in health care financing
and implementing the National Health Insurance Law.
ROLES and Functions of the DOH

2. Enabler and Capacity Builder

Providing logistical support to LGUs the private sector, and
other agencies in implementing health programs and services;
Serving as the lead agency in health and medical research
Protecting standards of excellence in training and education of
health care providers at all levels of the health care system.
ROLES and Functions of the DOH

3. Administrative of Specific Services

 Serve as administrator of selected health facilities at
subnational levels that act as referral centers for local health
system,
 Provide specific program components for conditions that
affect large segments of the populations
 Develop strategies for responding to emerging health needs
 Provide leadership in health emergency preparedness and
response services, including referral and networking systems
for trauma, injuries
 The DOH core values reflect adherence to the highest standards of
work namely: (1.) Integrity (2.) Excellence (3.)Compassion and respect for
human dignity (4.) Commitment (5.) Professionalism (6.)Teamwork (7.)
Stewardship of the health of the people (DOH, 2013).

The DOH carries out its work through the various central bureaus and
services in the central office, Center for Health Development (CHD) in every
region, DOH- attached agencies, and DOH-retained hospitals.
Historical Background
of DOH
Local Health System and
Devolution of Health
Services
 R.A 7160 or Local Government Code was enacted to bring about genuine
and meaningful local autonomy. This will enable local governments to attain
their fullest development as self-reliant communities and make them more
effective partners in the attainment of national goals.
 Devolution refers to the act by which the national government confers power
and authority upon the various LGU’s to perform specific functions and
responsibilities.
 R.A 7160 provided for the creation of the Provincial Health Board and the
City/Municipal Health boards, or Local Health Boards.
 The chairman of the board is the local executive- the Provincial Governor/
Mayor. The Provincial/ City/ Municipal Health Officer serve as vice chairman.
  Integrated Provincial Health Office (IPHO) 

 City Health Office (CHO)

City Hospital (CH)  Chairman of the local health board
 Members of the board are composed of the chairman of the committee on
health of the Sanggunian, a representative from private sector or NGO involved in
health services, and a representative of the DOH.
The functions of local health boards are as follows:
1. Proposing to the Sanggunian annual budgetary allocations for the operation
and maintenance of health facilities and services within the
province/city/municipality;
2. Serving as an advisory committee to the Sanggunian on health matters; and
3. Creating committees that shall advise local health agencies on various matters
related to health service operations.
The Rural Health Unit
The RHU, commonly known as health center, is a primary level health
facility in the municipality. The focus of RHU is preventive and promotive
health services and the supervision of BHSs under its jurisdiction. The
recommended ratio of RHU to catchment population is 1 RHU: 20,000
populations.
The BHS is the first contact health care facility that offers basic
services at the barangay level. It is a satellite station of the RHU. It is
manned by Volunteer Barangay Health Workers (BHW’s) under the
supervision of Rural Health Midwife (RHM).
 The Rural Health Unit Personnel

The Municipal Health Officer (MHO) or Rural Health Physician heads

the health services at the municipal level and carries out the following
roles and functions:
1. Administrator of the RHU
a. Prepares the municipal health plan and budget
b. Monitors the implementation of basic health services
c. Management of the RHU staff
2. Community physician
a) Conducts epidemiological studies
b) Formulates health education campaigns on disease prevention
c) Prepares and implements control measures or rehabilitation plan
3. Medico-legal officer f the municipality.
The revised implementing rules and regulations (IRRSs) of R.A. 7305 or
the Magna Carta of Public Health Workers stipulate that there be one rural
health physician to a population of 20,000.
 The Rural Health Unit Personnel
The Public Health Nurse (PHN):
1. Supervise and guides all RHMs in the municipality.
2. Prepares the FHIS (Field Health Service Information System) quarterly and
annual reports of the municipality for submission to the Provincial Health
Office.
3. Utilize the nursing process in responding to health care needs, including
needs for health education and promotion of individuals, families and
catchment community.
4. Collaborate with the other members of the health team, government agencies,
private business, NGO’s and people organizations to address the
community’s health problems.
 * With limitations of LGUs to finance health human resource, the
DOH has launched Nurse Deployment Project (NDP) to augment
efforts of PHNs in their areas of jurisdiction.
 The Rural Health Unit Personnel
The Nurse Deployment Project: One of the projects under the Department of
Health (DOH) Deployment Program that aims to deploy, community-oriented and
dedicated nurses to difficult areas. Notably, the project aims to achieve the
following:
 Augment the nursing workforce in the Rural Health Units/Birthing Homes and
Barangay Health Stations thus provide access to health services for the
marginalized population;
 Provide employment and work experience for nurses in rural areas and
underserved communities and
 Address the proliferation of the so-called “volunteer nurses for a fee” (i.e., working
in hospitals without being paid, albeit, they themselves pay the hospital to obtain a
certificate of work experience
Project Description:
 Deployment of registered nurses for the improvement of local health systems
and support to the attainment of Universal Health Care or Kalusugan
Pangkalahatan
 Nurses shall be hired under contract of services with a position of Public Health
Nurse II. Contract for six 6) months that can be renewed based on a very
satisfactory
 Assignment in priority areas covering 1,491 municipalities, 143 cities and 13
districts of Metro Manila giving preference to 44 Focus Geographical Areas
(FGA), Accelerated Sustainable Anti-Poverty Program (ASAP), Whole of Nation
Initiative (WNI)
 After satisfactory completion of the project, the Nurses are awarded with a
Certificate of Completion and Employment
 FUNCTIONS:
 Focus on assisting PHNs in implementing programs, health education, and preparation of
reports.
 Conducts regular visits to priority households under the National Household Targeting
System for Poverty Reduction (NHTS-PR)
 Prepares health status reports of families based on the NHTS-PR priority households
 Plans for appropriate interventions on the identified health concerns of families under the
priority NHTS-PR
 Assists in the conduct of regular monitoring and evaluation of various health programs
under the NHTS-PR
 Focus on assisting PHNs in implementing programs, health education, and preparation of
reports.
 Assists in the conduct of disease surveillance
 Maintains Barangay Health Stations
 Conducts health education and training
 Assists in the preparation of reports on clinic and community activities.
Salaries and Benefits:
• Public Health Nurse II - Salary Grade 17
• Monthly Salary of Php 32,747.00 for 2017 2nd tranche of the Salary
Standardization Law 4
• Enrollment to PhilHealth Insurance
• Enrollment to GSIS Personal Group Accident Insurance
• Local/Regional Trainings (ie, Orientation on Disease Surveillance, Family
Planning Counselling, etc. )
 The Rural Health Unit Personnel
The Rural Health Midwife (RHM) or Public Health Midwife:
1. Manages the BHS and supervise and trains the BHW;
2. Provides midwifery services and executes health care programs and activities
for woman of reproductive age, including family planning counselling and
services.
3. Conducts patient assessment and diagnosis for referral or further
management;
4. Perform health information, education and communication services
5. Organize the community
6. Facilitates barangay health planning and other community services.
 The Rural Health Unit Personnel
• The Rural Sanitation Inspector are directed towards ensuring a healthy physical
environment
. in the municipality. This entails advocacy, monitoring and regulatory
activities such as inspection of water supply and unhygienic household
conditions.
• Barangay Health Worker (BHW) considered as the interface between the
community and the RHU. They are trained in the preventive health care, with a
strong emphasis on maternal and child care, family planning and reproductive
health, nutrition and sanitation.
 BHWs are accredited by the local health board according to DOH guidelines.
 R.A 7883 or the Barangay Health Workers Benefit and Incentives Act entitles
them to hazard and substance allowance and other benefits.
DOH Recommendations for Human Resource for Health and
Health Facilities Ratio to Population

1 RHU/ HC Physician: 20, 000 Population Ratio

1 Public Health Nurse: 10,000 Population Ratio
1 Public Health Midwife: 5,000 Population Ratio
1 Public Dentist: 50,000 Population Ratio
1 RHU(Rural Health Unit): 20,000 Population Ratio
1 BHS (Barangay Health Station): 5,000 Population Ratio
 Classification of Health
Facilities
( DOH AO – 2012-0012 )
 Levels of Health Care Services and Facilities

The DOH issued Administrative Order 2012-0012 (Rules and Regulations

Governing the new Classification of Hospitals and Other Health Facilities in
the Philippines) that provides for a new classification scheme of health facilities.
DOH administrative Order 2012-0012 classifies other health
facilities as follows:

Category A. Primary Health Care Facility – a first contact health care facility
that offers basic service including emergency services and provision for normal
deliveries.
1. Without in-patient beds like health centers, out-patient clinics, and dental
clinics.
2. With in-patient beds – a short-stay facility where the patient spends on the
average of one to two days before discharge.
Ex: Infirmaries and birthing (Lying-in) facilities.
Category B. Custodial Care Facility – a health facility that provides long-
term care, including basic services like food and shelter, to patients with
chronic conditions requiring ongoing health and nursing care due to
impairment and a reduced degree of independence in activities of daily living,
and patients in need of rehabilitation.

Ex: Custodial health care facilities, substance/drug abuse treatment and

rehabilitation centers, sanitaria, leprosaria, and nursing homes.
Category C. Diagnostic/Therapeutic Facility - a facility for the examination
of the human body, specimens from the human body for the diagnosis,
sometimes treatment of disease or water for drinking analysis. The test covers
the preanalytical, analytical and post analytical phases of examination. This
category is further classified into:
1. Laboratory Facility, such as, but not limited to the following:
a) Clinical laboratory
b) HIV/testing laboratory
c) Blood service facility
d) Drug testing laboratory
e) Newborn screening laboratory
f) Laboratory for dringking water analysis.
2. Radiologic facility providing services such as X-ray, CT scan,
mammography, MRI, and ultrasonography.

3, Nuclear medicine facility- a facility regulated by the Philippine

Nuclear Research Institute utilizing applications of radioactive
materials in diagnoses, treatment, or medical research, with the
exception of the use of sealed radiations sources in
radiotherapy as in internal radiation therapy.
Category D. Specialized outpatient facility – a facility that
performs highly specialized procedures on a outpatient basis.

Ex: Dialysis clinic, ambulatory surgical clinic, cancer

chemotherapeutic center/clinic, cancer radiation facility, and
physical medicine and rehabilitation center/clinic.
The Inter-Local Health Zone
 An Inter Local Health Zone (ILHZ) is defined to be any form of organized
arrangement for coordinating the operations of an array and hierarchy of the
health care providers and facilities, which typically includes primary health care
providers, core referral hospital and an end referral hospital, jointly serving a
common population within a local geographic area under the jurisdictions of
more than one local government.
 ILHZ, as a form of inter-LGU cooperation is established in order to better
protect the public or collective health of their community, assure the
constituents access range of services necessary to meet health care needs of
individuals, and to manage their limited resources for health more efficiently and
equitably.
The Inter-Local Health Zone
 The Inter Local Health Zone (ILHZ) functionality is defined mainly by
observable zone wide health sector performance results in term of:
1. Improved the health status and coverage of public health intervention of the
zone population.
2. Access by everyone in the zone to a qualify care;
3. Efficiency in the operations of the inter-local health services.
 The referral system functioning within the context of the Inter-Local Health
Zone (ILHZ) provides a means for consolidating health care efforts.
 The ILHZ is based on the concept of the District Health System, a generic
term used by WHO to describe an integrated health management and
delivery system based on a defined administrative a geographical area.
 An ILHZ has a defined catchment population within a defined geographical
area, it has a central or core referral hospital and a number of primary level
facilities such as RHUs and BHSs.
The ILHZ has the following components:
 People. Although WHO has described the ideal population size of a health district between
100,000 and 500,000, the number of people may vary from zone to zone, especially when taking
into consideration the number of LGUs that will decide to cooperate and cluster.
 Boundaries. Clear boundaries between ILHZs establish accountability and responsibility of health
service providers.
 Health facilities. RHUs, BHSs, and other health facilities that decide to work together as an
integrated health system and a district or provincial hospital, serving as the central referral
hospital.
 Health workers. To deliver comprehensive services, the ILHZ health workers include personnel of
the DOH, district or provincial hospitals, RHUs, BHSs, private clinics, volunteer health workers from
NGOs, and community based organizations.
The Health Referral System
 A referral is a set of activities undertaken by a health care provider or facility in
response to its inability to provide the necessary health intervention to satisfy a
patient’s need.
 A functional referral system is one that ensures the continuity and
complementation of health and medical services.
 It usually involves movement of a patient from the health center of first contact
and the hospital at first referral level.
 When hospital intervention has been completed, the patient is referred back to
the health center. This accounts for the term two-way referral system.
 Referrals may be internal or external
 Internal referrals – occur within the health facility; may be made
to request for an opinion or suggestion, comanagement, or
further management or specialty care.
 External referral – is a movement of a patient from one health
facility to another. It may be vertical, where the patient referral
may be from a lower to a higher level of health facility or the other
way round.
Health Sector Reform:
 FOURmula One Plus (F1 Plus) is the latest in aseries of
continuing efforts of the government to bring about health sector
reform covering to 2017 to 2022.
 F1 Plus was built upon strategies of two previous platforms of
reform: FOURmula One (F1) for health (2005-2010) and Kalusugan
Pangkalahatan or Aquino Health Agenda (2011-2015.)
 Administrative Order 2018-0014 entitled “Strategic Framework
and Implementing Guidelines for FOURmula One Plus (F1 Plus) for
Health.
Health Reform Framework in the DOH from 2005 to 2022.

Kalusugan Duterte Health FOURmula One

FOURmula One
Pangkalahatan Agenda Plus (F1) PLUS
2005-2010
2011-2015 2016 2017-2022
UNIVERSAL HEALTH CARE (UHC), ALSO REFERRED TO
AS KALUSUGAN PANGKALAHATAN (KP).

 The Aquino administration puts it as the availability and accessibility of

health services and necessities for all Filipinos.

 It is a government mandate aiming to ensure that every Filipino shall

receive affordable and quality resources – health human resources,
health facilities, and health financing.

 UHC law (Republic Act 11223) guarantees each Filipino citizen access
to healthcare services that are either individual-based or population
based.
UHC’S THREE THRUSTS
1) Financial risk protection through expansion in
enrollment and benefit delivery of the National Health
Insurance Program (NHIP);
2) Improved access to quality hospitals and health
care facilities; and
3) Attainment of health-related Millennium Goals
(MDGs).
PHILIPPINE HEALTH
AGENDA (2010-2022)