THE PARTNERSHIP APPROACH TO COMMUNITY  Doing one's share of the work to the best of

HEALTH PRACTICE- Mam Thai one's ability, keeping promises and

Significance:
 Focuses on mutual responsibilities and joint
efforts at minimizing or overcoming risks and
problems to achieve development goal.
 Health programs and projects become relevant.
 Community members take an active role as
partners of health professionals and other
change agents.
Virtual Role of community health nurse
 Development of Human resources
 Catalyst of Reorienting or Reformulating Values
towards open-mindedness, dynamism and
egalitarianism.
The essential ingredients of partnership
A. Belief in egalitarian relationship
 Partners consider each other as
coequals in so far as their intrinsic worth
and access to rights and privileges.
 Participate equally in assuming
responsibilities to achieve the objectives
and goals jointly identified.
appointments, maintaining a two-way
communication, being sincere and honest with
one's relationship
D. Commitment to enhance each other’s capabilities
for partnership
 Participants must construct together the
foundation of a mutually-growth-promoting
relationship, using themselves as "bricks"
 Each partner must be ready to help build up
another and he, in turn, should be willing to be
helped build up himself.
 Necessary to support each other through the
growing pains of establishing a viable
partnership.
Capabilities Necessary for Partnership
MAJOR TYPES:
 Skills necessary to work with othersin order to
function effectively as an integrated unit.
 Skills that the professional health worker and the
other partners need to perform together to attain
community health development.
Skills Necessary to function as an integrated unit

B. Open-Mindedness 1. The skill necessary to be broadminded or open-

minded.
ISSUE: PRESUMING TO DECIDE IN AN ABSOLUTE
WAY ON THE WORTH OF OTHER PEOPLE'S 2. The skill to develop and maintain trust.
CONDITIONS OR IDEAL Crucial elements:

PARTNERSHIP:  Openness

 To see and understand things, events and people  Sharing

without limitations imposed by prejudices and
 Acceptance
idiosyncrasies.
 Support
 View things and experiences from each other's
perspectives to arrive at a more relevant and  Cooperative intentions
appropriate solution to any problem that concerns
all parties. 3. Group Skills

C. Respect and Trust a) Types of behavior under task functions:

ISSUE: PARTNERS FROM DISS SOCIO-, ECONOMIC, 1. Starter

CULTURAL, EDUCATIONAL OR POLITICAL 2. Information and Opinion Seeker
BACKGROUNDS AFFECT EXPECTATIONS AND
PERCEPTIONS OF OTHERS 3. Coordinator

PARTNERSHIP: 4. Information and Opinion Giver

 Respect for each other's worth and trust on the 5. Direction Giver
potentialities and capabilities of each one despite 6. Summarizer
differences in beliefs, values and experiences.
7. Reality tester
 Does not use the other to get the honor or reward
only for himself 8. Diagnoser
 9. Evaluator  (4) Ensuring adequate preparations
10. Elaborator c) Effective handling of committee meeting
process
11. Energizer
 (1) Dealing with the topic
b) Types of behavior under group building and
maintenance functions:  (2) Dealing with people
1. Communication helper DEVELOPING WORK GROUPS FOR COMMUNITY
HEALTH DEVELOPMENT
2. Encourager of Participation
Expectations of a Nurse
3. Active listener
 Change agent
4. Interpersonal Problem Solver
 Work effectively with groups
5. Standard Setter
CHALLENGES
6. Trust builder
7. Harmonizer and compromiser • Inability of the group to carry out the program as
planned due to:
8. Tension Reliever
1. Family-oriented behavior
9. Process Observer
2. Socio-cultural tendencies and values
10. Evaluator of Emotional Climate.
3. Large numbers
4. Communication Skills
The Stages of Group Development
 Sending messages effectively — being
1. THE STAGE OF ORIENTATION
able to make others understand clearly
what one wants to communicate Tasks: 1. Determine a way of achieving the purpose for
(verbal/written form) which they joined the group.
 Receiving messages effectively 2. Find a place for themselves in the group necessary to
attain their primary task and results in additional
o (1) Communicating the intention
gratification from the pleasure of group membership
of wanting to understand the
ideas and feelings of the sender Characteristics:
o (2) Understanding and • Main concern of members: whether they are "in"
interpreting the sender's ideas or "out" of the group
and feelings
• To handle anxiety, members invest most of their
5. Skills on the Management of Committee or Task energy in a search for approval, acceptance,
Groups respect or domination.
 Committees or task groups — organized to carry • The content and style of communication are
out the goals, objectives & functions of groups relatively limited, repetitious and restricted.
and organizations
• Common experience is the search for similarities.
a) Selecting appropriately the chairman and
members using as a guideline the purpose • Giving and seeking advice.
for which the committee or task group was • Group is dependent, expecting the leader to
formed. provide structure and answers.
b) Ensuring adequate Pre-meeting
Preparations
 (1) Preparing the agenda well.
 (2) Circulating in advance, background
or proposal papers together with the
minutes of the previous meeting
 (3) Ensuring attendance
 • The lines of interaction within the group are - A sense of ending
leader-centered. - Can be temporary or permanent
- Key emotions are joy and sadness
- Tasks:
1. Finishing the agenda
2. Establishing key decisions and completing
the group product
3. Tying up loose ends and writing off
unfinished business
THE VARIOUS STAGES AT WORK
- There is no literal development sequence of all
stages
2. THE STAGE OF CONFLICT
- The group may go through the various stages in one
• Group's concern over dominance, control and session
power. - Rarely does the group permanently graduate from
one stage
• Conflict between members or between members - The group may return to the same issues but each
& leader. time from a different perspective and each time in
• Members become judgmental of others. greater depth.

• Emergence of hostility towards the leader. INTERVENTIONS TO FACILITATE GROUP GROWTH

• Counter-dependent expression begin to replace INTERVENTIONS, TASKS, TECHNIQUES

the over-dependency stage. 1. Provide the necessary orientation, structure and
directions.
• The group may be divided into competing groups.
2. Help meet members’ interpersonal needs
3. THE STAGE OF COHESIVENESS 3. Process, negotiate and resolve conflicts to
everyone’s satisfaction
- There is an increase of morale and mutual trust
4. Be aware of the effects of own behavior on the
as members feel group belongingness.
group.
- The chief concern is with intimacy and closeness.
5. Derive opportunities to apply learning on another
- There may be communication restrictions of
situation.
some kind.
- Become a mature work group when all feelings INTERVENTIONS:
can be expressed and constructively worked
PROVIDE THE NECESSARY ORIENTATION,
through.
STRUCTURE AND DIRECTIONS
4. THE WORK GROUP STAGE -Can decrease level of anxiety of the group
- The uniqueness of the members and the leaders -A great positive impact if members are introduced by the
are seen and expected. leader or facilitator
- Consensus is reached from a rational discussion
rather than from a compulsive attempt at -Structured learning exercises on group decision-making
unanimity. and consensus may be utilized
- Emerges group system for mutual support for -Lines of interaction changed from leader centered to
individuality and consistent control when group-centered
individual behavior becomes group destructive.
-The leaders create an atmosphere for productive group
- Mature group work may last for the remainder of work when interpersonal needs are met
the group’s life, with periodic short-lived
repetitions of earlier stages. -The leader should communicate that each one is
- Tension is between “work” or progress and important in the achievement of group goals.
regression to an earlier stage.
- There is feedback vehicle, wherein members
know how to clarify and evaluate each other
perceptions.
- Nursing Intervention: minimize the tendency of
regression because it could affect the outcome
THE TERMINATION STAGE- 5th Stage

-Leader’s tasks and techniques:
1. Listening attentively to what each is saying
2. Not judging the contributions of members or
commenting on every contribution made
3. Doing away with preaching, teaching or
moralizing
4. Avoiding members into participation before they
are ready
-Encourage productive participation by:
1. Observing for signs of a member’s efforts to be
heard and giving her an opportunity to contribute
2. Being sensitive in identifying those too eager to
talk as they can take up all the group’s time
3. Encouraging and supporting all members who
participate
4. Summarizing and clarifying contributions
5. Not monopolizing the discussion or commenting
too frequently
PROCESS, NEGOTIATE AND RESOLVE CONFLICTS
TO EVERYONE’S SATISFACTION
-Interventions to develop the member’s competencies to
handle conflict constructively:
1. Help members understand the nature of conflicts
2. Help members go through the coping process of
conflict resolution using the problem-solving
approach.
3. Help members generate new ways of looking at
the situation or problem
4. Help members analyze the here-and-now
experience.
The third intervention to keep the group analyze,
negotiate, and resolve conflicts is to focus on the feelings
and experiences of the members in the present moment.
This intervention helps members recognize, examine,
and understand the “how” and “why” of interactions or
behavior soon after they are experienced by the group
members. Through a focus on the here-and-now, the
blocks or barriers to group progress are pinned down and
analyzed for possible alternatives, re-direction or
behavior change.
Before such an intervention can be utilized. The
“facilitator must learn to be adept at identifying here-and-
now experiences that need to be analyzed/processed:
1. Keep an eye or concentrate not only on the content of
the group discussion but on how the messages are sent
and received.
2. Be an active participant of the here-and-now
experience.
➢ Aggressor – deflates status of others by expressing
disapproval of their values, acts, or feelings by attacking
the group or the problem it is working on, or by joking
aggressively
➢ Blocker – tends to be negative and stubbornly
resistant. Attempts to maintain or bring back issues after
the group has rejected or by passed them.
➢ Recognition seeker – calls attention to self through
boasting, reporting on personal achievements, acting in
unusual ways, or struggling to prevent being placed in an
“inferior” position.
➢ Self – confessor – uses group as audience for
expression of personal, non group-oriented feelings,
insights, or ideology
➢ Playboy – displays look of involvement in group’s
horseplay, and other more-or-less studied forms of
irrelevant behavior
➢ Nominator – tries to assert authority or superiority by
engaging in flattery, claiming superiority status or right to
attention, giving directions authoritatively, and interrupting
contribution of others.
➢ Help seeker – attempts to evoke sympathy response
from other group members or from the whole group,
through expressions of insecurity, personal confusion, or
self – depreciation beyond “reason”
➢ Special interest pleader – speaks for some underdog
– the “small business-person”, the “grass roots
community”, the “housewife”, “labor” etc. – usually
cloaking own prejudices or biases in stereotype that best
fits own individual need.
Chapter 15 Maglaya Guidelines
CONFLICT RESOLUTION MODEL
Illustrates specific interventions to help handle the
intrapersonal and interpersonal aspects of the “conflict
experience” while supporting the group towards
productive outcomes.

IMPLEMEMTED CHALLENGES FOR COMMUNITY
HEALTH WORKER PROGRAMS
1. Lack of access to transportation
• The populations that CHWS serve often have limited
access to transportation. Therefore, CHWs often travel to
rural communities to provide services or conduct
outreach. When possible, CHWs should be reimbursed
for travel costs.
2. Safety issue
• CHWs may travel to remote areas where roads may be
unsafe or impassable due to inclement weather. CHWs
also may encounter safety issues when working in
patients' homes.
• Programs may provide safety training to CHWs, which
can include strategies for maintaining awareness and
personal safety and for de-escalating unsafe situations.
• Other strategies to promote safety include daily
reporting to supervisors, sharing travel routes and
anticipated return times for home visits, providing CHWs
with emergency information cards, storing sensitive client
information in a locked file within a locked vehicle, and
not transporting cash or medications.
3. Lack of program resources
• CHW programs emphasize the importance of providing
resources such as weather survival kits, wireless Internet
access cards, and other technologies. However, if
program funds are limited, such resources may not be
available.
4. Cultural barriers
• Program implementers may need to adapt materials,
such as information packets, to ensure all program
materials are Culturally appropriate. For example, if
patients are not comfortable with computers, CHWS may
use paper charts to collect information during a home
visit.
5. Patient referral issues
• Programs may encounter difficulties referring patients to
healthcare providers or mental health professionals and
coordinating services with outside providers and
agencies. Some programs have acknowledged
challenges integrating CHWS into healthcare systems.
6. Partnership issues
• Programs with limited partnerships may struggle to
implement a program with a broad scope. Agreements
with partners in the community and identifying
opportunities to work with new organizations will help
extend the reach of the CHW program.
PLANNING FOR COMMUNITY HEALTH NURSING
PROGRAMS AND SERVICES
BOOK: Chapter 7; Maglaya (Green)
FORMAT:
PLANNING:
• Is a process that entails formulation of steps to be
undertaken in the future in order to achieve a desired
end.
• Takes place in order to efficiently allocate available
resources
• Planner assesses the nature and extent of the problems
for which the program is being planned for as well as
constraints and limitations that may affect planning
decisions
• Done in our desire to improve the present state of affairs
Factors affecting the planning process:
1. Existing health policies and legislation
2. Level of technology in the area
3. Economic resources
4. Presence of programs and institutions
Mercado (1993) summarizes the concepts of planning:
1. Planning is futuristic
2. Planning is change-oriented
3. lanning is continuous and dynamic process
4. Planning is flexible
5. Planning is systematic process
• In community health nursing, the nurse pursues the
objective of enhancing wellness, improving the health
status and quality of life of the people. She does this by
applying the nursing process in meeting identified
community health problems and needs
• Planning in community health nursing involves the
orderly process of assessing the health problems and
needs of the community. Priority goals are set according
to availability of resources. Interventions are carefully
thought of considering constraints or limitations as they
may hamper the realization of set goals.
THE PLANNING CYCLE
• As the community health nurse plans to meet the health
problems and needs of the population, four basic
questions are asked:
1. Where are we now?
2. Where do we want to go?
3. How do we get there?
4. How do we know we are there?
WHERE ARE WE NOW?
SITUATIONAL ANALYSIS:
• Involves the process of collecting, synthesizing,
analyzing and interpreting information in a manner that
will provide a clear picture of the health status of the
community.
• Activities:
1. The nurse gathers data about the health status of the
community
2. The nurse identifies and explains the problem
3. The nurse projects what situation needs to be
changed.
• It brings out the health problems of the community.
• In this phase of the planning cycle, the nurse identifies
and provides explanation of the problems. She may use
the community diagnosis report as basis for the
situational analysis.
• Problem identification and explanation are facilitated if
the nurse develops a problem tree. The problem tree can
lead her to the probable causes of the health status
problem.
Community health problems are conditions or situations
that intervene with community’s capability to achieve
wellness. They categorized as health status problems,
health resources and health-related problems. Three
domains:
1. Health status problems
- described in terms of increased/decreased morbidity,
mortality, fertility or reduced capability for wellness
2. Health resources problems
- described in terms of lack of or absence of manpower,
money, materials or institutions necessary to solve health
problems
3. Health-related problems
- described in terms of existence of social, economic,
environmental and political factors that aggravate the
illness-inducing situations in the community
Examples of problems:
1. Open drainage
2. Couples not practicing Family Planning Method
3. Cough, Cold and Fever
4. Presence of breeding or resting sites of vectors
5. High incidence and prevalence of intestinal parasitism
among children
WHERE DO WE WANT TO GO?
GOAL AND OBJECTIVE SETTING:
• Process of formulating the goals and objectives of the
health program and nursing services in order to change
the status quo
• Goals – broad, states the ultimate desired state. It is
directed towards solving the health status problems
which the nurse identified in the community diagnosis.
Not constrained by time or resources.
• Objectives – more precise, stated in specific and
measurable terms. They are considered as planned end
point of all activities. Concerned with the resolution of the
health problem itself.
HOW DO WE GET THERE?
STRATEGY AND ACTIVITY SETTING:
• Identification of resources - manpower, money,
materials, technology, time and institutions to implement
a program
• Defines the strategy or approach in a health program
Defines the strategies and the activities that the nurse
sets to achieve in order to realize the goals and
objectives
A program is defined as a time series of activities to be
carried out in order to correct the health problem.
PROGRAMS:
• An organized set of activities, projects, processes or
services which aims for the realization of specific
objectives.
Classified in terms of the focus of the activities:
1. Direct health care services - Example: immunization,
family planning, nutrition supplementation
2. Transferring knowledge and skills -Example:
community health workers training, mothers’ class
HOW DO WE KNOW WE ARE THERE?
THE EVALUATION PLAN:
• Determine whether the program is relevant, effective,
efficient and adequate
• This entails determining the specific input, process and
output/outcome indicators of the program stating the
criteria and standards of each.
• Program evaluation includes the following: 2. Demographics
3. Globalization
✓ Deciding what to evaluate in terms of relevance, 4. Poverty and growing disparities
progress, effectivity, impact and efficiency 5. Social disintegration
✓ Designing the evaluation plan specifying the The 6 Building Blocks/ Components of a Health
evaluation indictors, data needed, methods and tools for System
data collection and data sources
✓ Collection of relevant data
✓ Analyzing data

✓ Making decisions
✓ Preparing report and providing decision-makers
feedback on the program evaluation

THE PHILIPPINE HEALTH CARE DELIVERY

SYSTEM
PHILIPPINE HEALTH CARE SYSTEM

 Is a complex set of organizations

interacting to provide an array of health
services (Dizon, 1977).

Local Health System

 is a “set of interconnected and

interrelated parts forming a complex
whole” the whole we call health
 a gamut of networks, institutions,

THE HEALTH CARE DELIVERY SYSTEM

Thaiza Mithel D. Cajigas, MSN (CAR)

HEALTH SYSTEM -consists of all organizations,

people, and actions whose primary intent is to
promote, restore or maintain health.

HEALTH CARE DELIVERY

 rendering health care services to the

people (Williams-Tungpalan, 1981)

Key Elements in Health Service Delivery

 Organizing health services as networks of

primary care backed up by hospitals and
specialized care
 Providing package of health benefits with
clinical and public health interventions
 Ensuring access and quality of services
 Holding providers accountable for
access and quality and ensuring
consumer voice

Factors shaping 21st century health care delivery

system:

1. Health care “reform”

 programs and services, providers and Vision
users that relate to the health of
Filipinos are among the healthiest people in Southeast
community. –WHO
Asia by 2022, and Asia by 2040

Mission
DOH
To lead the country in the development of a
The Department of Health (DOH) holds the
productive, resilient, equitable and people centered
over- all technical authority on health as it is a
health system
national health policy-maker and regulatory
institution. Forms of Health Service Delivery in the Philippines
Basically, the DOH has three major roles in the
health sector: (1) leadership in health; (2) 1. Public Health
enabler and capacity builder; and (3)  LGU - direct delivery of public health
administrator of specific services. services
 DOH - technical assistance
 capacity building
 Its mandate is to develop national plans,
 advisory services for disease
technical standards, and guidelines on
prevention and control
health.
 provides free medicines and
 Aside from being the regulator of all
vaccines
health services and products, the DOH is
2. Private Sector
the provider of special tertiary health
 Profit and non-profit health
care services and technical assistance to
providers
health providers and stakeholders.
 Usually market-driven
While pursuing its vision, the DOH adheres to  Services are not free
the highest values of work, which are:  out-of-pocket schemes
 insurance
 Integrity – The Department believes in
 external funding
upholding truth and pursuing honesty,
accountability, and consistency in
performing its functions.
 Excellence – The DOH continuously
strive for the best by fostering
innovation, effectiveness and efficiency,
pro-action, dynamism, and openness to
change.
 Compassion and respect for human
dignity – Whilst DOH upholds the
quality of life, respect for human dignity
is encouraged by working with
sympathy and benevolence for the
people in need.
 Commitment – With all our hearts and
minds, the Department commits to
achieve its vision for the health and
development of future generations.
 Professionalism – The DOH performs its
functions in accordance with the highest
ethical standards, principles of
accountability, and full responsibility.
Classification of Hospitals
 Teamwork – The DOH employees work
According to Functional Capacity:
together with a result-oriented mindset.
A. General Hospital
 Stewardship of the health of the people
Provides medical and surgical care to the sick and
– Being stewards of health for the people, the
injured and maternity care and shall have as minimum,
Department shall pursue sustainable
the following clinical services medicine, pediatrics,
development and care for the environment
obstetrics and gynecology surgery and anesthesia,
since it impinges on the health of the Filipinos. emergency services, out-patient and ancillary services
B. Specialty Hospital
MISSION AND VISION Specializes in a particular disease or condition or in one
type of patient.
HOSPITALS OTHER
HEALTH
FACILITIES
GENERAL
Level 1 A. Primary
Care Facility

Level 2 B. Custodial
Level 3 Care Facility
C. Diagnostic
Facility

Specialty D. Specialized
Out-Patient
Facility

Examples of SPECIALTY HOSPITALS

Particular Disease
 National orthopedic Hospital
 NationaI Center
 for Mental Health
Particular Organ(s)
 Lung Center
 Philippine Heart Center
 National Kidney and Transplant Institute
Particular Group of Patients
 Philippine Children's Medical Center
 National Children's Hospital
 Dr. Jose Fabella memorial Hospital

General Level 1 Level 2 Level 3

Clinical Services Consulting Level 1 plus all: Level 2 plus all:
for in-patients specialist in
Departmentalized Teaching/ training with accredited
medicine
Clinical Services residency training program in the 4 major
Pediatrics OB-
clinical services
GYNE surgery

Emergency and Respiratory unit Physical Medicine and Rehabilitation unit

Out-patient
Services
 Isolation General ICU
facilities

Surgical/ High risk pregnancy unit Ambulatory Surgical clinic

maternity
facilities
Dental clinic NCU Dialysis Clinic

Ancillary Secondary Tertiary Clinical Tertiary lab with histopathology

Services Clinical laboratory
Laboratory
Blood Station Blood Station Blood Bank

1st level X-ray 2nd level X-ray with 3rd Level X-ray
mobile unit
Pharmacy

 Commonly known as a health center

 Primary level health facility in the municipality - Focus is
preventive and promotive health services and the
supervision of BHSs under its jurisdiction
 1 RHU:20,000 population (DOH,2009)
 Barangay Health Station
 First-contact health care facility
 Offers basic services at the barangay level -A satellite
station of the RHU
 Manned by volunteer BHWs under the supervision of
RHW

RURAL HEALTH UNIT PERSONNEL

Head: MHO (Municipal Health Officer) or Rural Health

Physician

 Public Health Nurse

 Rural Health Midwife
 Rural Sanitation Officer
 Barangay Health Workers

RURAL HEALTH UNIT PERSONNEL

Levels of Health Care Facilities
1. Primary – includes rural health units, sub-
centers, community hospitals, specialty clinics and/or
health centers operated by both government and
private entities, non-government agencies and other
groups
2. Secondary – includes smaller, often non-
departmentalized hospitals that offer a variety of
healthcare services which require moderately-
specialized knowledge and technical resources for
adequate case management, includes provincial and
regional hospitals
3. Tertiary –includes health care facilities that
offer highly technological and sophisticated
healthcare services such as those offered by specialty
national hospitals and medical centers.
RURAL HEALTH UNIT
 MHO – 1:20,000 nurse-population
 PHN – 1:20,000 nurse-population
 RHM – 1:5,000 nurse-population
 BHW – 1: 20 nurse-households
Local Health Board
 An opportunity wherein a local chief executive can
exercise his/her leadership in health
 Must be established in every province, city or
municipality as per RA of 7160
Provincial Health Board
 Chairman: Governor
 Vice-chairman: Provincial Health Officer
Members: chairman of the committee on health
of the sanggunian panlalawigan (Provincial
council), a sector or NGO and a representative
of the DOH
 Municipal Health Board
schooling and working environments.
 Chairman: Municipal mayor
 Vice-chairman: Municipal Health Officer
 Members: chairman of the committee on
health of the sanggunian bayan
(Municipal Council), a representative
from the private sector or NGO and a
representative of the DOH
The Health Referral System
UHC Reform Principles
 Usually involves movement of a
patient from the health center of first
contact and the hospital at first
referral level.
The 2-way Health Referral System
 when the intervention is complete,
the patient is referred back to the
health center
 Internal – from one health personnel
to another
 External – from one health facility to
another
The Inter-Local Health Zone
- Philippine version of the District
Health System overseas
- government and other sectors (such
as local & foreign NGOs) involved in
the delivery of health services
WORLD HEALTH ORGANIZATION
- clustering municipalities through
inter- LGU cooperation
- The Policy Board is made up of local
officials of the component LGUs,
representatives of non-government
organizations (NGOs), national
agencies (NGAs), the private sector,
and community.
- The Technical Management
Committee may be composed of the
Chief of the Core Referral Hospital,
MHOs, Representative Public Health
Nurse
 representative from the private sector or NGO
and a representative of the DOH
City Health Board
 Chairman: City mayor
 Vice-chairman: City Health Officer
 Members: chairman of the committee on
health of the sanggunian panlungsod (City
Council), a representative from the private
(PHN), Chief Nurse of Core Referral Hospital,
Representative Rural Health Midwife (RHM),
Supervising Rural Sanitary Inspector (RSI), DOH
Representative, Private Health Care Provider
UNIVERSAL HEALTH CARE
Universal Health Care means having HEALTHY living,
Universal Health Care does not mean “lahat libre”
 Every Filipino is matched to a primary care
team, who ensures that they get the
appropriate services they need in the
appropriate facility.
 Every Filipino family’s health spending is
predictable; PhilHealth ensures they are
protected from financial risk.
1. Universality means ALL Filipinos
2. Equity means preferential regard for the unserved
or underserved
3. Accountability by clear role delineation, purchaser-
provider split, management and organizational
reforms
4. Sustainability/Value by shifting emphasis to health
promotion and primary care and strategic
purchasing
5. Participation by making information available and
understandable, providing platforms for citizens to
engage, recognizing private providers
6. 6Social solidarity by pooling resources and enabling
mutual support for basic health services
7. Individual responsibility for non-basic / fringe
services
8. Progressive realization through fair and transparent
priority setting mechanisms
WHO began when our Constitution came into force on 7
April 1948 – a date we now celebrate every year as World
Health Day.
There are now more than 7000 people working in 150
country offices, in six regional offices and at their
headquarters in Geneva, Switzerland.
 More than 7000 people working in 150 country
offices, in six regional offices and at our headquarters
in Geneva, Switzerland.
 Primary role is to direct and coordinate
international health within the United Nations
system.
 Main areas of work are health systems; health
through the life - course; noncommunicable and
communicable diseases; preparedness,
surveillance and response; and corporate
services.
CORE FUNCTIONS
1. Providing leadership on matters critical to
health and engaging in partnerships where
joint action is needed.
2. Shaping the research agenda, stimulating
the generation, translation &
disseminating valuable knowledge.
3. Setting Norms and standards &
 promoting and monitoring
their implementation.
4. Articulating ethical and evidence
based policy options.
5. Providing technical support,
catalyzing change, and building
sustainable institutional capacity.
5 GOALS ON RESEARCH FOR HEALTH:
1. CAPACITY – in reference to
capacity- building to strengthen
national health research systems
2. PRIORITIES – to focus research on
priority health needs particularly in
low and middle income countries
3. STANDARDS – to promote good
research practice and enable the
greater sharing of research
evidence, tools and materials
4. TRANSLATION – to ensure that
quality evidence is turned into
products and policy
5. ORGANIZATION – to strengthen the
research culture within the
organization & improve its
management & coordination of
research activities
THE MILLENIUM DEVELOPMENT GOALS
(MDG)
SEPTEMBER 6-8, 2000: UNITED NATIONS MILLENIUM
DECLARATION (UN 2013)
Collective responsibility to uphold the principles of
human dignity, equality and equity at the global level.
Millennium Development Goals (MDGs) were the eight
international development goals for the year 2015.
• All 191 United Nations members and at least
22 international organizations, committed to helping
achieve the Millennium Development Goals by 2015.
67
• MDGs set concrete targets and indicators for
poverty reduction in order to achieve the rights set forth
in the Declaration.
• MDGs emphasized three areas: human
capital, infrastructure and human rights (social,
economic and political), with the intent of increasing
living standards. 68
• There were altogether 8 goals with 21 targets
and a series of measurable health indicators and
economic indicators for each target.
The MDGs have been superseded by the Sustainable
Development Goals
SUSTAINABLE DEVELOPMENT GOALS
Sustainable Development Goals (SDGs) are the United
Nations global development goals.
These are bold universal agreements to end poverty in all its
dimensions and craft an equal, just and secure world.
SDG has 17 goals and 169 targets and it covers multiple
aspects of growth and development.
It is also known as a successor of MDGs (Millennium
Development Goals)
It was adopted by 193 countries of United Nations General
Assembly on 25th September 2015.
SDG is officially known as “Transforming our world: the 2030
Agenda for Sustainable
Development.”
It is built on the principle agreed upon under resolution, “The
Future We Want”
#1: END POVERTY IN ALL ITS FORMS
EVERYWHERE
About 1 billion people still live in poverty - defined as an
income of less than US $1.25 per day. The targets under
Goal 1 include aiming for a world where the poor are not
vulnerable to climate thange, and have "equal rights to
economic resources."
#2: END HUNGER, ACHIEVE FOOD SECURITY AND
IMPROVED NUTRITION AND PROMOTE SUSTAINABLE
AGRICULTURE
Ending hunger also includes ending malnutrition,
protecting small farmers, and changing farming itself so
that agriculture and ecosystems can co-exist. It also
means protecting the genetic diversity of the crops we
grow, while investing in research to make farming more
and more productive, especially in developing countries.
By 2030, we need to ensure that no one ever goes hungry.
#3: ENSURE HEALTHY LIVES AND PROMOTE
WELL-BEING FOR ALL AT ALL AGES
This Goal includes a comprehensive agenda for
tackling a wide range of global health challenges,
from tuberculosis and AIDS to traffic accidents and
alcoholism. Goal 2 also calls for achieving "universal
health coverage"; reducing illness and death caused
by pollution; and increasing the global health
workforce, especially in the world's poorer
countries.
#4: ENSURE INCLUSIVE AND QUALITY EDUCATION
FOR ALL AND PROMOTE LIFELONG LEARNING
The Targets for Goal 4 cover the need for access to
university-level education, vocational training, and
entrepreneurship skills, and they pay special
attention to issues of equity. This Goal also includes
the promotion of education for sustainable
development

#5: ACHIEVE GENDER EQUALITY AND
EMPOWER WOMEN AND GIRLS
Equality and empowerment includes
freedom from discrimination and violence.
It also includes making sure woman have
their equal share of leadership
opportunities and responsibilities, as well
as property ownership and other concrete
reflections of power in society. Note that
the Targets for this Goal make several
references to the need to be nationally
appropriate" in interpreting what they
mean.
#6: ENSURE ACCESS TO WATER AND
SANITATION FOR ALL
Basic water scarcity affects 40% of the global
population, and nearly a billion people do
not have access to that most basic of
technologies:
a toilet or latrine. The targets for this goal provide
details for what we must do to rectify this situation,
including protecting the ecosystems that provide the
water in the first place.
#7: ENSURE ACCESS TO AFFORDABLE, RELIABLE,
SUSTAINABLE AND MODERN ENERGY FOR ALL
Globally, about 1.3 billion people live without
access to electricity. Modern energy is also
connected to access to water (Goal 6): you need
energy to get water. In the wealthier countries, who
have energy, this Goal pushes for a conversion to
renewable sources, and it calls for dramatic
improvements in efficiency everywhere.
#8: PROMOTE INCLUSIVE AND SUSTAINABLE
ECONOMIC GROWTH, EMPLOYMENT AND
DECENT WORK FOR ALL
At least 75 million young people around the world,
aged 15-24. are unemployed, out of school. and
looking at a bleak future. This Goal, while calling for
economic growth to help close that gap, also calls
for innovation and for "decoupling" growth from
ecosystem degradation
#9: BUILD RESILIENT INFRASTRUCTURE,
PROMOTE SUSTAINABLE INDUSTRIALIZATION
AND FOSTER INNOVATION
The world is becoming more
industrialized, but often not in ways that
are resilient and sustainable. This Goal
aims for ensurity that everyone can enjoy
the benefits of what humanity can build - and
for fostering a much more innovative and
environmentally sound approach to industrial
development.
#10: REDUCE INEQUALITY WITHIN AND AMONG
COUNTRIES
The world is astonishingly unequal: the richest 80
people have the same wealth as the bottom
3.5 billion. The Goal includes a range of measures,
including regulation of the financial markets, to
make the playing field more level. Importantly, it
also covers the issue of migration, which should
be orderly, safe, regular and responsible
#11: MAKE CITIES INCLUSIVE, SAFE, RESILIENT AND
SUSTAINABLE
More than half the world lives in cities, and by 2050,
at least 66% will- and most of the growth in cities is
happening in Africa and Asia. If those cities are not
sustainable, the world will not be, either. This Goal
also covers issues like transportation, disaster
preparedness, and even the preservation of the
world's culturdt and natural heritage
#12: ENSURE SUSTAINABLE CONSUMPTION AND
PRODUCTION PATTERNS
The world's nations through the UN) have already
agreed to a 10-year framework" to make the way
we produce and consume goods more sustainable.
This Goal references that, but also covers topics like
reducing food waste, corporate sustainability
practice, public procurement, and making people
aware of how their lifestyle choices make a
difference,
#13: TAKE URGENT ACTION TO COMBAT CLIMATE
CHANGE AND ITS IMPACTS
Goal 13 has an asterisk (*) after it, because in December
2015, another global negotiating process (UNFCCC)
determined the details of the global agreement on
climate action. That summit produced the "Paris
Agreement," which guides nations on their joint action to
limit global warming to not more than 2 degrees C. (and
preferably 1,5),
#14: CONSERVE AND SUSTAINABLY USE THE OCEANS,
SEAS AND MARINE RESOURCES
Global oceans and the life within them are over fished,
under-protected, and stressed from climate change and
pollution. This Goal describes what we must do to save
them which includes research and learning, ause we
understand so little about what lies under the water's
surface. The SDGs have given the state of our
oceans new visibility

#15: SUSTAINABLY MANAGE FORESTS, COMBAT

DESERTIFICATION, HALT AND REVERSE LAND
DEGRADATION, HALT BIODIVERSITY LOSS

Life on land, on our beautiful planet Earth, is under

terrible stress. This comprehensive Goal covers
nearly every aspect of the threat to living
ecosystems and biodiversity. We cannot afford to
lose any more of nature -- hence the repeated use
of the word "halt" in the Targets section

#16: PROMOTE JUST, PEACEFUL AND INCLUSIVE

SOCIETIES
Reduce violence. End torture. Decrease the
production and flow of arms. Reduce
corruption. Create governments and
institutions that work... for everyone. This
important Goal also includes a Target that
specifically calls for policies to promote
sustainable development, which would
certainly include the implementation of the
SDGS themselves

#17: REVITALIZE THE GLOBAL

PARTNERSHIP FOR SUSTAINABLE
DEVELOPMENT

Goal 17 is about making sure all countries

have what they need - funds, capacities,
technologies, etc. - to achieve the rest of the
SDGs. The Targets are a comprehensive list of
such needs, including the need for
partnerships and collaboration. Every
country, every sector has a role to play!