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

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The Philippines has a total land area of 343 282 square kilometers,and a coastline stretched to 36 289 kilometers. Its terrain is mostlymountainous, with narrow to extensive coastal lowlands. It has a tropicaland maritime climate, characterized by relatively high temperatures, highhumidity and abundant rainfall. Its lowest temperatures are recorded inmountain areas at between 15.6 °C (60 °F) and 21.1 °C (70 °F) during themonths of December, January and February. The highest temperaturesof up to 35 °C (95 °F) occur during the dry season from December toMay. The country’s rainy season is from June to November, although asignificant part of the country experiences continuous rainfall throughoutthe year.Because of its location in the typhoon belt of the Western Pacific, thePhilippines experiences an average of twenty typhoons each year duringits rainy season. In addition, the country is along the “Pacific Ring ofFire”, where large numbers of earthquakes and volcanic eruptions occur.These factors combine to make the country one of the most disasterproneareas of the globe.In 2007, the total population reached 88.57 million, distributed among theisland groups of Luzon, Visayas and Mindanao. The projected populationfor 2010, based on National Statistics Office’s (NSO) 2000 national census,is 94.06 million, making it the 12th most populous country in the world.Rapid urbanization in the Philippines, particularly in Metropolitan Manila,continues to create problems such as housing, road traffic, pollution andcrime. The urban population has doubled in the past three decades, from31.8% in 1970 to 50.32% in 2008, while the rest of the population remainsin rural, often isolated areas (Table 1-1).Table 1-1 Population/demographic indicators,1970-2007 (selectedyears)Indicator 1970 1980 1990 2000 2005 2007 2008Total population 36 684 486 48 098 460 60 703 206 76 504 077 -- 88 574 614 a --Population, female(% of total)Population growth(average annual %)Population density(persons/sq. km)Fertility rate, total(births per woman)44.7 49.8 49.6 49.6 -- -- --3.1 2.7 2.4 2.4 2.0 2.0 --122 160 202 225 260 260 --6.0 5.1 4.1 3.5 -- 3.3 b --2
Indicator 1970 1980 1990 2000 2005 2007 2008Crude birth rate (per1000 population)Crude deathrate (per 1000population)25.4 30.3 24.8 23.1 20.1 c 20.1 c --6.4 6.2 5.2 4.8 5.1 c 5.1 c --Sex ratio 99 101 101 101 101 101 --Age dependencyratioUrban population (%total population)Simple literacy rate(%) (10 years &above)94.6 83.2 75.1 69.0 73.0 d -- 68.331.8 37.3 47.0 48.0 -- -- 50.3-- -- 89.9 92.3 93.4 d -- --Notes: a - as of Aug. 1, 2007; b - as of 2006; c - as of 2005; d - as of 2003.Sources: PSY 2008, NSCB; NDHS 1993-2008, NSO & Philippines in Figures 2009, NSO.A population growth rate of 2.04% annually is linked to a high averagefertility rate of three children per woman of child-bearing age. Thehighest population growth rates are observed in some of the mosteconomically-deprived areas of the country, such as the Bicol andEastern Visayas Regions.The majority of the population consists of Christian Malays living mainlyon the coastal areas. In the 2000 census, the NSO reported that 92.5% ofthe population is Christian, 81.04% of which is Roman Catholic. Muslimminority groups, comprising 5.06% of the household population, areconcentrated in Mindanao, while tribes of indigenous peoples are foundin mountainous areas throughout the country. There are approximately180 ethnic groups in the country, each representing their own languagegroup. The most widespread group is the Tagalog, accounting for 28% ofthe household population. Other ethnic groups include Cebuano, Ilocano,Ilonggo, Bisaya, Bicol and Waray. The official languages in the Philippinesare Filipino, which is derived from Tagalog, and English, both widelyused in government, education, business and the media. Administrativeregions are areas covered by regional subdivisions (or offices) ofdifferent departments and bureaus of the national government. They arecomposed of provinces located in the different island groups as follows(corresponding full names are in Box 1):3
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 and 18: OOPOut-of-pocketOPBOutpatient Benef
Page 19 and 20: AbstractHealth status has improved
Page 21 and 22: the principle governing agency of t
Page 23 and 24: Hospital admissions data from PhilH
Page 25: 1. Introduction1.1 Geography and So
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
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Table 4-4 Patient care utilization
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Figure 4-3DOH total appropriations
Page 92 and 93:
4.2.3 Medical Equipment, Devices an
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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
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5.2 Public HealthImproving access t
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• The prevention of cardiovascula
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Private sector health professionals
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Access to essential drugs is constr
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5.9 Palliative CareIn 1991, the Phi
Page 116 and 117:
5.12 Alternative/Complementary Medi
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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,
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The Generics Act of 1988 aims to pr
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know the generics of oral/suspensio
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As a result of these strategies, th
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Improvements in the delivery of key
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7.4 Allocative and Technical Effici
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8. ConclusionsAs measured by standa
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Further elaboration of the Human re
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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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