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

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From 2006-2012 the country averaged just under five per cent annual GDPgrowth (albeit with some major fluctuations), at par with the region (ADB2011). The Gini coefficient decreased from 0.49 in 1997 to 0.46 in 2006,indicating that great economic inequality persists. Employment rateswere below 90% in the years 2000 to 2005, but have risen to 92.4% in2009. The underemployment rate, on the other hand, was 19.8%.As of 2006, the National Capital Region (NCR) had the highest averageannual family income of Php 310 860 (US$ 6058) (Table 1-3). RegionIV-A and the Cordillera Administrative Region (CAR) are also among thehighest earning regions. Conversely, the poorest region based on averageannual family income is the Autonomous Region in Muslim Mindanao(ARMM), whose families earn less than a third of those in NCR, followedby Region IV-B and Region XII.1.3 Political ContextSince 1897, the Philippines has had seven constitutions. The latestratified by referendum in 1987 and now in effect, established a republicangovernment patterned after that of the United States with a strongexecutive branch, a bicameral legislature, and an independent judiciaryunder a supreme court.The executive branch through the national government agencies and localgovernment units exercises administrative and/or regulatory authorityover the health system as a whole. The legislative branch influences thehealth system in two ways: a) by approving the annual budgets of nationalhealth agencies and institutions; and b) by individual congressmenallocating their “development funds” (PDAF or “pork barrel”) to specifichealth institutions for various purposes. The judiciary affects the healthsystem in both the government and private sectors when it rendersdecisions in legal disputes involving health agencies, institutions andindividuals.1.4 Health StatusPhilippine health status indicators show that the country lags behindmost of South-East and North Asia in terms of health outcomes. Whilerapid improvements were seen during the last three decades, these haveslowed in recent years.6
Women tend to live longer than men by five years, while average lifeexpectancy at birth for both sexes was about 72 years in 2007. Thereare also variations in projected life expectancy at birth across differentregions. As noted in Figure 1-2, Regions III, IV, NCR and VII had thehighest life expectancy for both men (67-69 years) and women (74 years)in 2005. By contrast, ARMM had a life expectancy of 58 years for men and62 years for women, reflecting the difficult living conditions brought byarmed conflict, poverty, poor nutrition and lack of health care.Both disability-adjusted life expectancy (DALE) and health-adjustedlife expectancy (HALE) are measures of the equivalent number of yearsexpected to be lived in full health. In 1999, the DALE for Filipinos wasapproximately 57 years for men and 61 years for women; in 2007, theHALE was 59 years for men and 64 years for women.The leading cause of death in the Philippines is heart disease, with ratessteadily rising from 70 per 100 000 population in 1997, to 90 per 100 000population in 2005 (Table 1-4). This is followed by vascular diseases andmalignant neoplasms (or cancer), with mortality rates of 63.8 and 48.9per 100 000 population, respectively.Figure 1-2 Projected life expectancy at birth by region, 200580Life Expectancy (Years)757065605550NCRS. Luzon (IV)C. Luzon (III)CAR(PHILIPPINES)Ilocos (I)Cagayan Valley (III)MaleC. Visayas (VII)SOCCKSARGEN (XII)Davao (XI)W. Visayas (VI)N. Mindanao (X)FemaleBicol (V)E. Visayas (VIII)Zamboanga (XIII)ARMMNotes: S. – Southern; C. – Central; W. – Western; N. – Northern; E. – Eastern; Regions are sequencedaccording to average annual family income as of 2003, with NCR having the highest and ARMM, thelowest.Source: PSY 2008, NSCB.7
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 and 26: 1. Introduction1.1 Geography and So
Page 27 and 28: Indicator 1970 1980 1990 2000 2005
Page 29: Table 1-2 Economic indicators, 1970
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
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(Figure 4-6). As for the nurse-to-p
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Figure 4-9 Ratio of pharmacists per
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of 2002. While CNS is essentially a
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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
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5.12 Alternative/Complementary Medi
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drug stores. Later in 2009, the DOH
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Year Reform Brief description2005 F
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health care approach of putting hea
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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
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Gonzaga E, Navarra D (2004). The Re
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National Statistics Office (2006).
Page 146 and 147:
Taguiwalo M (2004). Strategy for Lo
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9.2 Useful websitesAvailable in Eng
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The World Bankhttp://www.worldbank.
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Jennifer Frances E. dela Rosa is a
Page 155:
The Asia Pacific Observatory on Hea
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