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

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Figure 2-1Organizational structure & accountability in the health caresystemNational GovernmentLocal Government UnitsPrivate SectorOther DepartmentsDepartment of HealthProvincialHospitalsHealth CareFacilitiesHealth Human ResourceDevelopment BureauHealth EmergencyManagement StaffHealth PolicyDevelopment andPlanning BureauOffice of the SecretaryNational Centers forSpecialized Health CareDangerous Drug BoardPhilippines Institute ofTraditional andAlternative Health CarePhilippine HealthInsurance CorporationMunicipal/CityHospitalsRural HealthUnitsBarangayHealth StationsHealth CareProvidersPharmaciesPatientsExternal AffairsHealth RegulationHealth OperationsBureau of Quarantineand InternationalHealth SurveillanceBureau ofInternationalHealth CooperationBureau of Local HealthDevelopmentRetained HospitalsCenters forHealthDevelopmentBureau of HealthFacilities and ServicesFood and DrugAdministrationBureau of HealthDevices and TechnologyRegional Hospitals,Medical Centersand SanitariaNational EpidemiologyCenterNational Center forDisease Prevention andControlNational Center forHealth PromotionNational Center forHealth FacilitiesDevelopmentThe LGUs serve as stewards of the local health system and thereforethey are required to formulate and enforce local policies and ordinancesrelated to health, nutrition, sanitation and other health-related matters inaccordance with national policies and standards. They are also in chargeof creating an environment conducive for establishing partnerships withall sectors at the local level.Among the LGUs, the Autonomous Region of Muslim Mindanao (ARMM)has a unique organizational and governance structure. It has retained thecentralized character of its health system under the ARMM DOH, whichdirectly runs the provincial hospitals and the municipal health centresunder its jurisdiction instead of the component provinces and towns ofARMM.2.5 Planning2.5.1 Planning of human resourcesThe initial HRH plans developed by the DOH focused exclusively onhealth workers employed directly by DOH. The first truly national HRH18
plan, covering all government employees (DOH and also health workersemployed by the Department of Education, the armed forces etc) aswell as those in private facilities, was crafted in the 1990s, but itsimplementation was hampered by changes such as migration of healthworkers, the increase in the number of nursing schools and globalization.In 2005, the DOH, in collaboration with WHO-WPRO, prepared a longtermstrategic plan for HRH development. The 25-year human resourcemaster plan from 2005 to 2030, was to guide the production, deploymentand development of HRH systems in all health facilities in the Philippines.The plan includes a short-term plan (2005- 2010) that focuses on theredistribution of health workers as well as the management of HRH localdeployment and international migration. A medium-term plan (2011-2020) provides for the increase in investments for health. A long-termplan (2021-2030) aims to put management systems in place to ensurea productive and satisfied workforce. The DOH also created an HRHnetwork composed of different government agencies with HRH functionsto support implementation of the master plan.2.5.2 Health Facility PlanningIn 1995, the National Centre for Health Facilities Development (NCHFD)of the DOH crafted the Philippine Hospital Development Plan to createa more responsive hospital system by delivering equitable qualityhealth care across the country. The Plan underscored the importance ofleadership; strategic planning based on population needs; accessibilityof services especially those in hard-to-reach areas; technical andhuman resource development; operational standards and technology;and networking in the development of hospitals. As part of HSRA, thePlan was revised in 2000. The new Plan included an investment of Php46.8 billion to develop 256 LGU district hospitals, 70 provincial hospitals,10 city hospitals and 70 DOH retained hospitals. In 2008, the plan wasexpanded and renamed the Philippine Health Facility EnhancementProgramme (HFEP). The expansion included the inclusion of rural healthcentres and village health stations. From 2007 to 2010, a further Php 8.43billion was invested in infrastructure and equipment upgrade projects tosupport health sector reforms and the MDGs (Abesamis, 2010).The building of hospitals and other health facilities is planned anddesigned according to appropriate architectural practices, functionalprogrammes and codes of the DOH. Relevant guidelines include AO 29series of 2006 (Guidelines for Rationalizing the Health Care Delivery19
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 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: that supplement PhilHealth coverage
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
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attempted to document the number of
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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
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
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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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