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DOH 2018 Annual Report - Full Report
DOH 2018 Annual Report - Full Report
REPORT
2018
DEPARTMENT OF HEALTH
1
© Department of Health 2019
Published by
The mention of specific companies or of certain products does not imply preferential endorsement or
recommendation by the Department. This report may be reproduced in full or in part for non-profit purposes
without prior permission, provided proper attribution to the Department is made. Furnishing the Department
a copy of the reprinted or adapted version will be appreciated.
EDITORIAL TEAM
Mario Villaverde, MD, MPH, MPM, CESO I
Maylene Beltran, MPA, CESO III
Frances Rose Mamaril, MPH
WRITERS
Emmylou Magbanua
Faith Obach, MD
Josant Lopez, RN, MAN
COPY EDITOR
Renerio Cordova Jr.
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REPUBLIC OF THE PHILIPPINES
DEPARTMENT OF HEALTH
ANNUAL
REPORT
2018
3
Table of Contents
Message from the
5 Secretary of Health
DOH-Office of the
9 Secretary (OSEC) Budget
Health Financing 14
Service Delivery 16
Regulation
28
Governance 32
Performance
Accountability 35
38 Legislative Acts
40 Administrative Orders
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Message of the Secretary
W e are pleased to share with you the
Department of Health’s 2018 Annual
Report.
STRATEGIC GOALS
Better Health Outcomes, More Responsive Health System, and
More Equitable Healthcare Financing for Health
PERFORMANCE ACCOUNTABILITY
A s shown in this Strategy Map, the DOH envisions Filipinos to be among the healthiest
people in Southeast Asia by 2022, and in Asia by 2040. It aims to lead the country in
the development of a productive, resilient, equitable and people-centered health system
towards the attainment of UHC, guided by the values of professionalism, responsiveness,
integrity, compassion and excellence.
6
A ligned closely with the thrust of Universal Health Care
(UHC), the F1 Plus for Health is a comprehensive strategy
for achieving the DOH’s three strategic goals, namely: better
health outcomes, more responsive health system, and more
equitable healthcare financing.
1
STRATEGIC GOALS
BETTER HEALTH OUTCOMES
Sustain gains and address new challenges
in maternal, newborn, child health, nutrition,
2
communicable disease elimination, and
NCD prevention and treatment
3
MORE EQUITABLE HEALTHCARE FINANCING
Expand access of Filipinos, especially
the poor and underserved, to affordable
and quality health goods and services,
through mechanisms that provide adequate
financial risk protection from the high and
unpredictable cost of healthcare.
7
F1 PLUS FOR HEALTH
STRATEGIC PILLARS
T hrough F1 Plus, the DOH is currently pursuing reforms and interventions
toward Universal Health Care as espoused in five pillars, namely: financing,
service delivery, regulation, governance, and performance accountability.
GOVERNANCE PERFORMANCE
ACCOUNTABILITY
The Governance pillar, on
the other hand, is about The Performance Accountability
strengthening of sectoral pillar, incorporates the
leadership and management, performance governance
and strengthening of system across the first four
evidence generation from pillars, to enable better public
research to guide policy accountability and transparency
development and program in all health programs, projects,
implementation. and activities.
8
DOH-OFFICE OF
DOH ANNUAL REPORT 2018
THE SECRETARY
(OSEC) BUDGET*
*The DOH-OSEC budget comprises of all budgetary requirements of Central Office bureaus, Centers for Health Development, DOH
hospitals and Treatment and Rehabilitation Centers.
9
DOH BUDGET 2018
Budget Allocation
Particular (PhP, in Thousand)
% to Total
Operations comprised PhP 95 billion of the campaign, salaries for the deployed human
DOH-OSEC budget or 90 percent of the total. resources for health (HRH), and also financial
The biggest portion of this is allotted to curative support for capital outlay projects of LGU
and rehabilitative healthcare services (OO2) owned primary care facilities (i.e. barangay
worth PhP 52 billion. This includes the subsidy health stations, rural health units, health centers
for the operations of DOH hospitals and other and polyclinics).
health facilities, and financial support for capital
The remaining budget is allotted to health
outlay projects of LGU hospitals.
regulation services (OO3) to ensure that the
This is followed by promotive and preventive public has access to safe, quality and affordable
healthcare services (OO1) worth PhP 37 billion healthcare, and social health protection (OO4)
which takes 35 percent of the total budget. to ensure that indigent patients are free of
Preventive and promotive healthcare services financial risks when accessing health services
include the budget for the provision of public in government owned hospitals, through the
health commodities, conduct of learning and medical assistance for indigents program.
development activities, health awareness
10
DOH ANNUAL REPORT 2018
BUDGET DISTRIBUTION BY
EXPENSE CLASS
For 2018, allotment for Figure 2: DOH Budget by Expense Class in billion pesos (2018)
maintenance and other operating
expenses (MOOE) comprised
the biggest share of the budget
at Php 40.9 billion. The capital
outlay is 31.29 Billion or 29.5
percent of the DOH budget. 31.29 40.9
(29.5%) (38.6%)
With a budget allocation of
Maintenance and Other
Php 33.9 billion for Personnel Capital Outlay
Operating Expenses
Services in 2018, Php 5.9 billion
higher than the previous year,
the DOH is able to cover the
third tranche increase in salary
of the Salary Standardization 33.9
Law of 2015. (32.0%)
Personnel Services
94% 60%
Obligation Disbursement
In 2018, the obligation rate
of the DOH was at 94 percent,
however disbursement over
total allotment was only 60
percent. This is driven by low
Rate Rate over total disbursement in MOOE and
CO.
SOURCE: DOH - FMS
allotment
11
DOH BUDGET 2018
12
DOH 2018
DOH ANNUAL REPORT 2018
PERFORMANCE
F1 PLUS PILLARS
HEALTH FINANCING
SERVICE DELIVERY
REGULATION
GOVERNANCE
PERFORMANCE
ACCOUNTABILITY
13
DOH 2018 PERFORMANCE
HEALTH FINANCING
PILLAR
KEY ACCOMPLISHMENTS
Increased Philhealth Coverage at 98 percent.
PHILHEALTH COVERAGE
Table 2: PhilHealth Coverage from 2016 to 2018
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DOH ANNUAL REPORT 2018
NO-BALANCE BILLING
The No Balance Billing (NBB) Figure 3: No Balance BIlling Compliance and Support Value
policy allows PhilHealth members
under the Indigent and Senior 90%
Citizen categories to pay nothing
more in excess of PhilHealth
82%
case rates when confined at
73%
government health facilities.
63%
In 2018, around 82 percent of 50%
55%
NBB-eligible members had zero
50%
out-of-pocket payments for their
42%
hospitalization. On the other
hand, support value, which may
be described as the proportion
of the total cost incurred during NBB Coverage
SOURCE: PhilHealth
STREAMLINING ACCESS TO
MEDICAL ASSISTANCE MEDICAL ASSISTANCE FUNDS
TO INDIGENT OF THE GOVERNMENT
PATIENTS PROGRAM
In order to cover Filipinos against financial health
The DOH Medical Assistance to risk, an important strategy is to mobilize, streamline,
Indigent Patients (MAIP) program and harmonize access to various, discrete fund pools
provides financial assistance to to avoid inefficient overlaps in health financing.
qualified patients whose hospital As an interim measure, a Joint Administrative
expenses could not be entirely covered Order No. 2018- 0001 entitled “Streamlining Access
by PhilHealth. to Medical Assistance Funds of the Government”
In 2018, the MAIP program was issued by the DOH, Philippine Charity
served a total of 1,360,885 patients Sweepstakes Office, Department of Social Welfare
in partnership with DOH-retained and Development, and PhilHealth. This policy aimed
hospitals and DOH Centers for Health to define the roles of DOH, PCSO, and DSWD in
Development (CHDs). augmenting the financing provision of the NBB
Policy for Case Rates and Z Benefits; and outline a
streamlined process for accessing these funds by the
members and dependents.
15
DOH 2018 PERFORMANCE
SERVICE DELIVERY
PILLAR
KEY ACCOMPLISHMENTS
16
DOH ANNUAL REPORT 2018
66.18%
64%
62%
60% SOURCE: DOH Field Health Services
Information System (FHSIS)
2016 2017 2018
Year
MASS DEWORMING
The Oplan GoodBye For 2018, around 52 percent of pre-school children and 45
Bulate campaign aims percent of school-age children from public schools were provided
to eradicate intestinal free deworming medicines.
parasitism in children,
while raising awareness
on the transmission
and prevention of soil-
transmitted helminths.
Coinciding with the
National Deworming
Months in January and
July, this campaign was
made possible through the
collaboration of the DOH,
Department of Education,
Department of the Interior
and Local Government,
and Local Government
Units.
17
DOH 2018 PERFORMANCE
50%
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DOH ANNUAL REPORT 2018
COMMUNICABLE DISEASES
TUBERCULOSIS
TB incidence (new cases per 100,000 population) in the
Philippines has increased from 434 in 2016 to 554 in 2018.
On the other hand, the case notification rate has also increased
from 317 in 2016 to 350 in 2018.
Treatment coverage has increased from 60 percent in 2016
to 63 percent in 2018. Furthermore, TB treatment success
rate was sustained at 91 percent from 2016 to 2018.
HIV/AIDS
Figure 6: Total reported HIV Cases, Persons Living with HIV By 2018, the total
(PLHIV) on Antiretroviral Therapy (ART), and Reported Deaths number of reported HIV
(cumulative number since January 1984) cases (since January 1984)
has risen to 62,029, which
was 22.3 percent higher
Total reported HIV cases Total Persons Living with HIV on ART Reported Deaths
than the total reported
70000
cases that had been
recorded by 2017.
60000 The cumulative number
62,029
Number of Cases/Patients
33,593
20000
HIV/AIDS that have been
reported since January
17,940
2,466
3,076
10000
SOURCE: HIV/AIDS and ART Registry of the Philippines, DOH - Epidemiology Bureau
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DOH 2018 PERFORMANCE
Interior and Local Government, 2010 2011 2012 2013 2014 2015 2016 2017
27 filariasis by 2020. As of
20 2018, 40 (out of the 46
20 endemic provinces) have
12 been declared filariasis-
9 free. The latest areas
7 to have been cleared of
2 filariasis in 2018 were
0 the provinces of Basilan
2009 2010 2011 2012 2013 2014 2015 2016 2017
and Davao del Sur, and
the cities of Isabela and
Year
Davao.
MALARIA
The DOH aims to increase the remain to have local transmission,
proportion of malaria-free provinces namely: Palawan, Sulu, Occidental
to 91 percent (74 out of 81) by 2022. Mindoro, and Sultan Kudarat. Out
In 2018, eight additional provinces of the 4,936 cases reported in 2018,
were declared malaria-free, namely: around 95 percent came from six
Agusan del Sur, Bukidnon, Bulacan, municipalities in Southern Palawan,
Davao Occidental, Ifugao, Ilocos and 5 percent from the rest of the
Sur, Kalinga, and Pampanga. The country.
proportion of malaria-free provinces
The DOH continues to work
in the country increased to 61.7
towards eliminating malaria by
percent (50 out of 81), from 51.8
2030, by instituting effective
percent in 2017.
measures to reduce transmission,
Twenty-seven provinces, on and collaborating closely with LGUs,
the other hand, are now under agencies, representatives from key
elimination phase, and only four affected populations, and other
development partners.
80
Declared Free
Endemic
50
50
Number of Malaria-free provinces
42
40 32 32
27 27 28
23 24
0
2010 2011 2012 2013 2014 2015 2016 2017
Year
21
DOH 2018 PERFORMANCE
The Mission witnessed the achievements of the Philippine Government in developing whole-of-
government and whole-of-society responses to NCDs, including the recently updated Multisectoral
NCD Action Plan 2015-2025, the FOURmula One Plus framework for health, the recently updated
national tobacco control strategy, Philippine Package of Essential NCD Interventions for the
management of hypertension and diabetes (PhilPEN), and tobacco and sugar sweetened beverage
taxation. The mission has also identified examples of good policies on NCDs in the Manila Metro
area, such as in Valenzuela City.
PHONE-BASED
COUNSELLING SERVICES
Quitline is a phone/mobile-centered support
service made available to all Filipinos who would
like to quit smoking. In 2018, 11 percent of callers
who availed of this service were able to quit with
the help Quitline.
Other phone-based counselling services
offered by the DOH are Hope Line, which aims to
talk people out of suicide, depression, and crises;
and Help Line, which helps persons or families
seeking confidential advice, referral, and support
to address substance abuse.
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DOH ANNUAL REPORT 2018
DOH Secretary Duque during the NDRRMC meeting for Boracay Rehabilitation on April 23, 2018
First Coordination Meeting of DOH (represented by Usec Second Coordination Meeting of DOH (represented by
Myrna C. Cabotaje), DENR (Secretary Cimatu) and Aklan Assistant Secretary Vergeire), DENR (Secretary Cimatu) and
Provincial Government (Governor Miraflores) in Boracay on Aklan Provincial Government (Governor Miraflores) in Boracay
May 24, 2018 on August 8, 2018
23
DOH 2018 PERFORMANCE
The 2018 version of the NEHAP was formally turned-over by Dr. Gundo Weiler (WHO Representative in the Philippines) to DOH
Undersecretary Dr. Myrna C. Cabotaje (representing the DOH as IACEH Chair) and DENR Undersecretary Atty. Jonas Leones (representing
the DENR as IACEH Vice Chair)
24
DOH ANNUAL REPORT 2018
DOH SCHOLARSHIPS
Pre-service In-service
Scholarships Scholarships The DOH granted full scholarships
to a total of 881 medical and 871
midwifery students under the Pre-
25
DOH 2018 PERFORMANCE
Left and Top Right: Usec. Rolando Enrique Domingo leads the ceremonial MOA signing during the BNB launch in San Mariano, Isabela.
Lower Right: Mayor Sara Duterte during Ceremonial Dispensing with the Licensed Pharmacists of BNB Pagkalinga sa Bayan in Davao
City.
26
DOH ANNUAL REPORT 2018
IWAS PAPUTOK
DOH registered a
34 percent reduction in
fireworks-related injuries
(FWRI) from December 21,
2018 to January 25, 2019,
compared to the same
reporting period in the
previous year. This is 60
percent lower (513 cases)
than the five-year average.
Furthermore, no stray bullet
injuries, nor deaths due to
FWRI were noted.
The Department will
continue the Iwas Paputok
Campaign to achieve zero
FWRI in the coming years.
27
DOH 2018 PERFORMANCE
REGULATION PILLAR
KEY ACCOMPLISHMENTS
last August 2017, increases penalties for SUBJECT: Implementing Rules and Regulation of Republic Act 10932 “An Act
the refusal of hospitals and medical clinics to Strengthening the Anti-Hospital Deposit Law by Increasing the Penalties
for the Refusal of Hospitals and Medical Clinics to Administer
administer appropriate initial medical treatment Appropriate Initial Medical Treatment and Support in Emergency or
Serious Cases, Amending for the Purpose Batas Pambansa Bilang 702,
Otherwise Known as “An Act Prohibiting the Demand of Deposits or
in emergency or serious cases. Advance Payments for the Confinement or Treatment of Patients in
Hospitals and Medical Clinics in Certain Cases” As Amended By
Republic Act No. 8344, And For Other Purposes”
Such penalties include imprisonment of not Pursuant to the provisions of RA. 10932 under Section 9, the Department of Health (DOH), in
less than six months and one day but not more
coordination with PhilHealth and the Bureau of Internal Revenue (BIR), and in consultation with Non-
Government Offices (NGOs) advocating for patients’ rights and public health, is mandated to
promulgate the necessary rules and regulations to carry out the provisions of the aforementioned law
than two years and four months, or a fine of to promulgate the necessary rules and regulations of the said Act, the following are hereby issued:
Section 1 of the said Act provides: “ In emergency or serious cases, it shall be unlawful for any
not less than P100,000.00 but not more than
1.
proprietor, president, director, manager or any other officer, and/or medical practitioner or employee
of a hospital or medical clinic to request, solicit, demand or accept any deposit or any other form of
P300,000.00 or both. Higher penalties of advance payment as a prerequisite for administering basic emergency care to any patient, confinement
or medical treatment of a patient in such hospital or medical clinic or to refuse to administer medical
one million pesos, or both, are imposed upon receiving hospital or medical clinic agrees to the transfer:
Provided, however, That when the patient is unconscious, incapable of giving consent and/or
unaccompanied, the physician can transfer the patient even without his consent: Provided, fiuther,
directors or officers of hospitals or clinics Republic Act No. 10932
That such transfer shall be done only after necessary emergency treatment and support have been
administered to stabilize the patient and after it has been established that such transfer entails less risks
responsible for formulating and implementing than the patient’s continued confinement: Provided, furthermore, That no hospital or clinic, after being
informed of the medical indications for such transfer, shall refuse to receive the patient nor demand
policies or instructions that violate this law. Alleged violations of the law should be
from the patient or his next of kin any deposit or advance payment: Provided, finally, That strict
compliance with the foregoing procedure on transfer shall not be construed as a refusal made
punishable by this Act.”
Three repeated violations shall result in the reported
Section
toDefinition
2.
theofHealth
2—
Facilities Oversight Board,
terms, for the purpose of implementing the above, the following definitions
revocation of the health facility’s license to which is lodged under the DOH’s Health Facilities
are provided:
jg,.
f
//H
M
Building 1, San Lazaro Compound, Rizal Avenue, Sta. Cruz, 1003 Manila 0 Trunk Line 651-7800 local 1113, 1108, 1135
Direct Line: 711-9502; 711-9503 Fax: 743-1829 0 URL: http://www.doh.gov.ph; e-mail: ftdugueQdohgovph
1
28
DOH ANNUAL REPORT 2018
ADMINISTRATIVEORDER
NO. 2018 — (2010
Administrative
of
Order 2018-0016
of of
Administration (FDA) Act 2009, necessitated transfer the then DOH Bureau Health
Devices and Technology (BHDT) to Alabang, Muntinlupa, when it became the FDA-Center
for Device Regulation, Radiation Health and Research (CDRRHR). Consequently, the filing
of application and payment of fees for radiation facilities are now received at the FDA main
office. Moreover, the varied modes of payment (direct to DOH Central/Regional Cashier,
Online Licensing and Regulatory System (OLRS).
online bank payments), the separate schedules for inspection, and the different processing
timelines being followed by the concerned regulatory offices are no longer in consonance
with the OSS Licensing System, and contributed further to the delay in the issuance of the
DOH—License to Operate (DOH-LTO) or DOH-Certificate of Accreditation (DOH-COA).
Cognizant of the situation and the need for a more efficient and harmonized system in
the issuance of DOH-LTO and DOH-COA, the OSS Licensing System is to be adopted once
again. As a refinement to the current regulatory scheme and to create more impact by
making the licensing process timely, easy and convenient to the clients, the
concerned regulatory offices shall accept and process applications online through the
Online Licensing and Regulatory System (OLRS). Furthermore, this is in support of the
President’s directive to streamline all government processes including regulationM
29
DOH 2018 PERFORMANCE
ENSURING HIGH-QUALITY
PRODUCTS AND DEVICES
For 2018, the FDA successfully sustained the campaign
against unregistered and violative products in the market.
At the same time, it collaborated with other government
agencies to ensure that health products which have issues
in other countries do not enter the Philippine market.
The FDA issued a total of 330 public health advisories
for 1,420 health products. Most of these FDA Advisories
were discussed in traditional and social media. Some
were published as newspaper and tabloid articles or
broadcasted in radio and television. The FDA also posted
these advisories on its website and social media account
for the followers to read or share.
These FDA Advisories serve as a warning to the public,
and provide an opportunity for consumers to be educated
and to protect themselves from buying unsafe and toxic FDA Advisory No. 2019-190
health products.
30
DOH ANNUAL REPORT 2018
The 2018 Health Technology Assessment The event was attended by high-level officials
(HTA) Accelerator Forum (HAF) was held on from the Department of Health, PhilHealth,
November 16, 2018. Entitled, ‘HTA: An Integral development partners, representatives from
STEP to UHC’, the forum launched the new international HTA agencies, the academe,
DOH policy on HTA, and formally introduced industry, and patient groups. Presentations
the DOH’s HTA body, “Sentro ng Pagsusuri highlighted the role of HTA in ensuring the
ng Teknolohiyang Pangkalusugan” or STEP. efficient and effective adoption of healthcare
The forum also gathered the commitment and technologies, based on high-quality evidence
support of key stakeholders to institutionalize and transparent and accountable processes.
and sustainably implement HTA in the
The forum also featured a discussion of
Philippines.
HTA experiences in other countries, key steps
forward, and recommendations on how the
HTA unit, partners, and stakeholders can work
towards strengthening HTA in the country.
31
DOH 2018 PERFORMANCE
GOVERNANCE
PILLAR
KEY ACCOMPLISHMENTS
32
DOH ANNUAL REPORT 2018
33
DOH 2018 PERFORMANCE
34
DOH ANNUAL REPORT 2018
PERFORMANCE
ACCOUNTABILITY
PILLAR
KEY ACCOMPLISHMENTS
DOH institutionalized PGS as the governance
framework. Sixteen DOH hospitals are already
PGS certified.
Hospital Status
Philippine Heart Center Institutionalized
36
DOH ANNUAL REPORT 2018
37
Legislative
Acts
38
LEGISLATION
39
Administrative
Orders 2018
40
DOH ANNUAL REPORT 2018
ISSUANCE
NUMBER SUBJECT
41
ADMINISTRATIVE ORDERS 2018
ISSUANCE
NUMBER SUBJECT
2010-0019-A Amendment to DOH Administrative Order No. 2010-0019 on the
Establishment of a National Program for Sharing of Organs from
Deceased Donors Pertinent to Section VII.5
2018-0017 Revised Implementing Rules and Regulation (RIRR) of Chapter VII-
Industrial Hygiene of the Code on Sanitation of the Philippines, P.D.
856
2018-0018 National Policy on the Mobilization of Health Emergency Response
Teams
2018-0007-A Amendment to Administrative Order (AO) No. 2018-0007 entitled
Interim Guidelines on Investigating Deaths related to Dengvaxia
Immunization
2018-0019 Guidelines on the Institutionalization and Implementation of the
National Clinical Practice Guidelines Program
2018-0020 Amendment to Administrative Order (AO) No. 2016-0009 Revised
Implementing Guidelines on Electronic Drug Price Monitoring System
(EDPMS)
2018-0021 Guidelines for the Nationwide Implementation of the Enhanced
4S-Strategy against Dengue, Chikungunya and Zika
2018-0022 Guidelines on the Implementation of the Department of Health’s Pre-
Service Scholarship Program (PSSP) for Priority Allied Health Courses
2018-0023 Guidelines in Strengthening the Capacity of Public Health Units
of DOH Hospitals and All Level Three Hospitals (Government and
Private) on Sentinel Surveillance System for Notifiable Diseases of
Epidemic Potential
2018-0024 Revised Policies and Guidelines on the Use of Antiretroviral Therapy
(ART) among People Living with Human Immunodeficiency Virus (HIV)
and HIV-Exposed Infants
2018-0025 National Policy and Strategic Framework on Expanded Newborn
Screening for 2017-2030
2018-0026 Framework for the Use of Health Technology Assessment to Guide
Coverage Decisions in Support of Universal Health Care
2018-0027 Guidelines on the Allocation and Utilization of Mobile Dental Vehicle
(MDV)
2018-0021-A Amendment to Administrative Order No. 2018-0021 entitled
“Guidelines for the Nationwide Implementation of the Enhanced
4S-Strategy against Dengue, Chikungunya and Zika” dated July 25,
2018
2018-0028 Guidelines for the Inclusion and Delisting of Diseases, Syndromes and
Health Events in the List of Notifiable Diseases, Syndromes and Health
Events of Public Health Concern (NDEPH)
42
43
44