The Philippines Health System Review - WHO Western Pacific ...

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SPSPEDSRASSSTB-DOTSTCAMTDFTESDATHEUNUPUSAIDWASHWHOVATWHOSponsored ProgrammeSpecial educationSocial Reform AgendaSocial Security SystemTuberculosis Directly-Observed Treatment ShortcourseTraditional and Complementary/Alternative MedicineTropical Disease Foundation Inc.Technical Education and Skills Development AuthorityTotal health expenditureUnited NationsUniversity of the PhilippinesUnited States Agency for International DevelopmentWater, sanitation and hygieneWorld Health OrganizationValue Added TaxWorld Health Organizationxvi
AbstractHealth status has improved dramatically in the Philippines over the lastforty years: infant mortality has dropped by two thirds, the prevalence ofcommunicable diseases has fallen and life expectancy has increased toover 70 years. However, considerable inequities in health care access andoutcomes between socio-economic groups remain.A major driver of inequity is the high cost of accessing and using healthcare. The Philippines has had a national health insurance agency –PhilHealth – since 1995 and incrementally increased population coverage,but the limited breadth and depth of coverage has resulted in highlevelsof out of pocket payments. In July 2010 a major reform effortaimed at achieving ‘universal coverage’ was launched, which focused onincreasing the number of poor families enrolled in PhilHealth, providing amore comprehensive benefits package and reducing or eliminating copayments.Attracting and retaining staff in under-served areas is key challenge. ThePhilippines is a major exporter of health workers, yet some rural and poorareas still face critical shortages. Inefficiency in service delivery persistsas patient referral system and gatekeeping do not work well.Successive reform efforts in financing, service delivery and regulationhave attempted to tackle these and other inefficiencies and inequalitiesin the health system. But implementation has been challenged by thedecentralized environment and the presence of a large private sector,often creating fragmentation and variation in the quality of services acrossthe country.xvii
Page 1: Health Systems in TransitionVol. 1
Page 5 and 6: ContentsPreface....................
Page 7 and 8: List of TablesTable 1-1 Population/
Page 9 and 10: Figure 4-2 Number of beds in govern
Page 11 and 12: A standardized profile has certain
Page 13 and 14: Peer Reviewers on behalf of the Asi
Page 15 and 16: CPRDALEDBMDHSDILGDODOFDOHDOLEDOSTDT
Page 17: OOPOut-of-pocketOPBOutpatient Benef
Page 21 and 22: the principle governing agency of t
Page 23 and 24: Hospital admissions data from PhilH
Page 25 and 26: 1. Introduction1.1 Geography and So
Page 27 and 28: Indicator 1970 1980 1990 2000 2005
Page 29 and 30: Table 1-2 Economic indicators, 1970
Page 31 and 32: Women tend to live longer than men
Page 33 and 34: Rate per 100 000 population (Rank)R
Page 35 and 36: Table 1-7 Maternal and child health
Page 37 and 38: 2. Organization and Governance2.1 S
Page 39 and 40: Rural Health Act, which transformed
Page 41 and 42: that supplement PhilHealth coverage
Page 43 and 44: plan, covering all government emplo
Page 45 and 46: The DOH has attempted to address th
Page 47 and 48: 2.7 Regulation2.7.1 Overview and hi
Page 49 and 50: through the institutionalization of
Page 51 and 52: Figure 2-3 Nursing Licensure Examin
Page 53 and 54: epresent another level of regulatio
Page 55 and 56: The law stresses the need for a hig
Page 57: coverage of the population vary, th
Page 60 and 61: Figure 3-1Health expenditure as a s
Page 62 and 63: Figure 3-2Financial FlowsOut-of-poc
Page 64 and 65: the results are promising. As of Ap
Page 66 and 67: Table 3-6 PhilHealth Special Benefi
Page 68 and 69:
Taxes or contributions pooled by a
Page 70 and 71:
Table 3-8 Allotments, obligations &
Page 72 and 73:
LGUs procure all commodities throug
Page 74 and 75:
payment of salaries and other allow
Page 76 and 77:
Accreditation contracts are renewed
Page 78 and 79:
3.6 Voluntary Health InsuranceBased
Page 80 and 81:
pricing in local hospitals, observe
Page 82 and 83:
4. Physical and Human Resources4.1
Page 84 and 85:
Figure 4-1 Number of government and
Page 86 and 87:
Table 4-2 Beds in government and pr
Page 88 and 89:
Table 4-4 Patient care utilization
Page 90 and 91:
Figure 4-3DOH total appropriations
Page 92 and 93:
4.2.3 Medical Equipment, Devices an
Page 94 and 95:
attempted to document the number of
Page 96 and 97:
Health Worker DistributionSince dat
Page 98 and 99:
(Figure 4-6). As for the nurse-to-p
Page 100 and 101:
Figure 4-9 Ratio of pharmacists per
Page 102 and 103:
of 2002. While CNS is essentially a
Page 104 and 105:
To manage migration flows of health
Page 106 and 107:
5.2 Public HealthImproving access t
Page 108 and 109:
• The prevention of cardiovascula
Page 110 and 111:
Private sector health professionals
Page 112 and 113:
Access to essential drugs is constr
Page 114 and 115:
5.9 Palliative CareIn 1991, the Phi
Page 116 and 117:
5.12 Alternative/Complementary Medi
Page 118 and 119:
drug stores. Later in 2009, the DOH
Page 120 and 121:
Year Reform Brief description2005 F
Page 122 and 123:
health care approach of putting hea
Page 124 and 125:
asic health packages. To this end,
Page 126 and 127:
The Generics Act of 1988 aims to pr
Page 128 and 129:
know the generics of oral/suspensio
Page 130 and 131:
As a result of these strategies, th
Page 132 and 133:
Improvements in the delivery of key
Page 134 and 135:
7.4 Allocative and Technical Effici
Page 136 and 137:
8. ConclusionsAs measured by standa
Page 138 and 139:
Further elaboration of the Human re
Page 140 and 141:
De Rosas-Valera M (2009). Health te
Page 142 and 143:
Gonzaga E, Navarra D (2004). The Re
Page 144 and 145:
National Statistics Office (2006).
Page 146 and 147:
Taguiwalo M (2004). Strategy for Lo
Page 148 and 149:
9.2 Useful websitesAvailable in Eng
Page 150 and 151:
The World Bankhttp://www.worldbank.
Page 152 and 153:
Jennifer Frances E. dela Rosa is a
Page 155:
The Asia Pacific Observatory on Hea
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