Lessons Learned from a National Certification Program
Philippines Sentrong Sigla
Movement Introduction • Definition
– SS is a quality improvement initiative through a
certification/recognition program. Health facilities are certified based on a set of standards – SS also promotes continuous quality improvement as a complementing strategy Introduction • Steps in the Certification Process – Philippines Department of Health (DOH) provides copies of quality standards to local government units (LGUs) – LGU facility conducts self assessment – Mayor/Governor sends letter of intent to participate – DOH SS teams conducts assessment – LGU facility gets certified, receives SS seal – Certified facility gets monitored twice a year and tries to strive for higher level standards Lessons Learned • Interest in QI is universal but a supportive environment is needed to make it happen
– Everyone likes the idea of QI
– SS provided simple, practical steps to improve quality of health services – SS provided motivation through certification Lessons Learned • SS became a successful model of how a national government can influence local behavior under devolution
– Getting LGUs to comply with national
standards and policies: major challenge – LGUs resent “heavy-handed approach” – SS respects local interest and priorities without compromising standards of quality Lessons Learned • Political support is a critical success factor
– Applies both at the national and local level
– Program should have a political value and appeal Lessons Learned • Champions for quality in health care come from many sectors
community influentials championed the cause for SS – Multisectoral interest interest and support prodded health workers to take action Lessons Learned • Development of standards required extensive consultations
– Consensus building through consultation
– Bridging gap or balancing between technical requirements and realities in the field: provider’s perspective and client’s perspective Lessons Learned • Progressive standards are needed to sustain interest in SS certification and to provide guidance to LGU facilities
improvement work – Demoralize facilities not given cash incentives in spite of being certified – Not sustainable Lessons Learned • Credibility of certification depends on quality of assessment
– Assessment should be accurate
– Develop further skills of assessors Lessons Learned • Minimal involvement of private sector reduced program impact
– Enhance credibility of certification program if
private sector is involved Lessons Learned • Link with Philippine Health Sector Reform (HSR) enhances value and sustainability of SS
– Interface with Philippines’ HSR initiatives
– Adopted by Philippine Health Insurance Corporation: SS certified facilities are eligible to be reimbursed for selected primary health care services – Integrate with HSR