BLOCK

I MODULE II - Protec/on Against Instability

LECTURE: PHILIPPINE HEALTH REFORM AGENDA - Universal Health Coverage
17 AUGUST 2017 - Strengthen Implementa/on of RPRH Law
- War Against Drugs
ALL FOR HEALTH TOWARDS HEALTH FOR ALL - Addi/onal funds from PAGCOR
Philippine Health Agenda 2016-2011
Healthy Philippines 2022 AUain Health-Related SDG Targets
- Financial Risk Protec/on
Goals - Be@er Health Outcomes
1. Financial Protec/on - Responsiveness
- Filipinos, especially the poor, marginalized and
the vulnerable are protected form high cost of Values
health care - Equity
2. Be@er Health Outcomes - Quality
- Filipinos a@ain the best possible health outcomes - Efficiency
with no disparity - Transparency
3. Responsiveness - Accountability
- Filipinos feel respected, valued, and empowered - Sustainability
in all of their interac/on with the health system - Resilience

Values 3 Guarantees
1. Equitable and Inclusive to all 1. All Life stages and Triple burden of disease
2. Transparent and accountable 2. service delivery network
3. Uses resources efficiently 3. universal health insurance
4. Provides high quality services
Guarantee 1: All Life Stages and Triple burden of disease
Milestones (Services for both the well and the sick)
During the last 30 years of Health Sector Reform, we have
undertaken key structural reforms and con/nuously built - Pregnant
on programs that take us a step closer to our aspira/on - Newborn
• Devolu/on - Infant
• Use of generics - Child
• Milk Code - Adolescent
• PhilHealth (1995) - Adults
• DOH resources to promote local health system - Elderly
development
• Fiscal autonomy for government hospitals - First 1000 days
• Good governance programs (ISO, IMC, PGS) - Reproduc/ve and sexual health
• Funding for UHC - maternal, newborn, and child health
- exclusive breasceeding
Persistent InequiGes In Health Outcomes - food and micronutrient supplementa/on
- Every year, around 2000 mothers die due to pregnancy- - immuniza/on
related complica/ons. - adolescent
- A Filipino child born to the poorest family is 3 /mes - geriatric health
more likely to not reach his 5th birthday, compared to - health screening, promo/on and informa/on
one born to the richest family.
- Three out of 10 children are stunted. - HIV/AIDS, TB, Malaria

Communicable
Diseases - Diseases for Elimination

RestricGve and Impoverished Healthcare Costs - Dengue, Lepto, Ebola,

- Every year, 1.5 million families are pushed to poverty Zika
due to health care expenditures.
- Filipinos forego or delay care due to prohibi/ve and Non-communicable - Cancer, Diabetes, Heart
unpredictable user fees or co-payments. diseases and Disease and their Risk
- Php 4,000/month healthcare expenses considered malnutrition Factors - obesity,
smoking, diet, sedentary
catastrophic for single income families.
lifestyle

- malnutrition
Poor quality and undignified care synonymous with
public clinics and hospitals Diseases of rapid - injuries

- long wait /mes urbanization and - substance abuse

- limited autonomy to choose provider industrialization - mental illness

- less than hygienic restrooms, lacking ameni/es - pandemics, travel

- privacy and confiden/ality taken lightly medicine

- poor record-keeping - health consequences of

climate change/ disaster
- overcrowding and under-provision of care

Lahat Para sa Kalusugan! Tungo sa Kalasugan Para sa Guarantee 2: Service Delivery Network (Func/onal
Lahat Network of Health Facili/es)
AmbiGon NaGn 2040
- Inves/ng in People Services are delivered by networks that are

Vergara, F.
- fully func/onal 5. Establishing expert bodies for health promo/on (Public
✓ complete equipment Health Philippines) and surveillance and response
✓ medicines (Philippine CDC)
✓ health professionals
- compliant with clinical prac/ce guidelines C:Cover all Filipinos against health-related financial risk
- available 24/7 and even during disasters 1. Mobilize more funds
- prac/ce gatekeeping ✓ sin tax
- located close to the people ✓ PAGCOR, PCSO
✓ mobile clinic ✓ Increase Premium
✓ subsidize transporta/on cost ✓ Collec/on Efficientcy
- enhanced by telemedicine 2. Enroll remaining 8% from non-formal sector into
PhilHealth
Guarantee 3: Universal Health Insurance (Financial 3. Expand PhilHealth benefits
Freedom when Accessing Services) ✓ Outpa/ent diagnos/cs
✓ drugs
Services are financed predominantly by Philhealth ✓ blood and blood produces
4. Recalculate case rates and link payment to quality
Philhealth as the gateway to free affordable care 5. Improve contrac/ng and enforce terms
- 100% of Filipinos are members ✓ Primary care trust fund
- formal sector premium paid through payroll ✓ Network-based contrac/ng
- non-formal sector premium paid through tax subsidy H: Harness the power of strategic HRH development
1. Make health professions curricula responsive to local
Simplify Philhealth Rules and global needs
- No balance billing for the poor/ basic 2. Review government HRH compensa/on package such
accommoda/on and fixed co-payment for non-basic that ARMM, IP, GIDA will have highest pay
accommoda/on 3. Shii to competency versus profession-based frontline
complement
Philhealth as main revenue source for public health care 4. Provide scholarships, financial incen/ves
providers 5. Ins/tute return service schemes
- expand benefits to cover comprehensive range of *clinicians and alien health professionals, managers
services researchers and policymakers 

- contrac/ng networks of providers within SDNs
I: Invest in eHealth and data for decision-making
Our Strategy 1. Require online data (clinical and administra/ve)
submission as requirement for licensing and
contrac/ng of health facili/es and drug outlets
A Advance quality, health promo/on and primary
2. Mandate the use of Electronic Medical Records (EMR)
care
in all health facili/es
C Cover all Filipinos against health-related 3. Invest in na/on-wide surveys, administra/ve data and
financial risk disease registries
4. Automate major business processes
H Harness the power of strategic HRH 5. Facilitate open access to anonymized data
development
E: Enforce standards, accountability and transparency
I Invest in eHealth and data for decision-making
1. Publish informa/on that can trigger be@er
E Enforce standards, accountability and performance
transparency ✓ Prices of common drugs and services
V Value all clients and pa/ents, especially the ✓ Non-compliant/ erring providers
poor, marginalized and vulnerable ✓ Na/onal objec/ves for health to guide strategies
and investments by different stake holders
E Elicit mul/-sectoral and mul/-stakeholder 2. Set up dedicated performance monitoring unit
support for health ✓ Ghost pa/ents and/or surprise visits
✓ Medical audits or third-party monitoring
A: Advance quality, health promo/on and primary care
1. Annual health visits for all poor families V: Value all clients and pa/ents, especially the poor,
2. PhilHealth to contract with func/onal networks marginalized and vulnerable
(District hospital paired up with 10+ RHUs or private 1. Focus all efforts on the poorest 20 million Filipinos
clinics) of PCB providers and DOH provide addi/onal 2. Make all health en/tlements simple and explicit
resources (HFEP, deployment vaccines, medicines, 3. Set up par/cipa/on and redress mechanism
trainings)
4. Significantly reduce turnaround /me and improve
3. Transform selected DOH hospitals into mul/-specialty,
transparency of processes
end-referral mega-hospitals, i.e teaching/ training,
reference laboratory
4. Enact/ enforce measures to improve access to E: Elicit mul/-sectoral and mul/-stakeholder support for
lifesaving interven/ons and reduce exposure to risk health
factors for premature deaths and disability 1. Harness and align Private Sector in Planning SDN,
interven/on and supply side investments

Vergara, F.
2. Ensure convergence with other government agencies - collect and - publish annually - ensure
in delivering services (DOH, DENR, DSWD, DepEd, publish relevant accountability transparent
HUDCC) informa/on report card procurement
- publish annually process in all
✓ Advocate for Health in All Policies accountability health facili/es
✓ Mul/sectoral work with different agencies to build report card - regularly submit
healthy living, working, schooling environments, data to DOH
healthy ci/es and Health in All Policies V
✓ Mandate Health impact Assessment for large-scale,
high-risk development projects (mining, - coordinate with - streamline - set up
PhilHealth in procedures for complaints and
powerplants, oil rigs) defining the availing services redress
3. Partake with CSOs in governance healthcare mechanisms
✓ Budget Development en/tlements of
every Filipino
✓ Monitoring and evalua/on and publish this
- set up call
center
DOH PhilHealth LGU

A
- facilitate the - Expand primary - conduct annual
process of care benefit to health visits for
network forming all members all poor families
- upgrade 3 DOH - Limit contrac/ng and special
hospitals into of PCB providers popula/ons
“mega- with func/onal ✓ NHTS
hospitals” networks (not ✓ IP
stand-alone) ✓ PWD
✓ Senior
Ci/zen
- collaborate with
others to form
networks

C
- support revenue - undertake - implement
genera/on cos/ng and health trust
measures revise case rates funds
- align all health - increase - provide income
financial premium rates reten/on to
assistance and collec/on health providers
programs to efficiency while retaining
support - design budgetary
Universal Health addi/onal support
Coverage benefits for
(PAGCOR, PCSO) outpa/ent
diagnos/cs,
drugs, blood
and blood
products

H
- form legisla/ve- - streamline - provide the
execu/ve health compensa/on magna carta for
human resource scheme for HCW benefit
task force health workers
2016-2017

- revise licensing - revise - implement EMR

requirements to accredita/on/ in all health
reflect regular contrac/ng rules facili/es
electronic data to reflect regular - improve local
submission electronic civil registra/on
requirements submission and vital
- open up data set requirement sta/s/cs data
for researchers - Open up data - submit data
set for electronically
researchers
- provide
incen/ves

Vergara, F.
BLOCK I MODULE II
LECTURE: PHILIPPINE HEALTH REFORM AGENDA
17 AUGUST 2017

12 LEGACIES AND DOH 30

Philippine Health Agenda
Healthy Philippines 2022

OUR LEGACIES DOH 30 (30 Things to do for CHO/ MHO)

Out of Pocket Expenditures for Health 1. Health Center property stocked with selected essen/al medicines
and OOP for medicines for the Poor
Reduced 2. Philhealth accredited health facility (4 in 1: MCP; NBP; TB-DOTS and PCB)

Universal Health Insurance Coverage 3, 100% of poor families profiled and monitored
for all Filipinos
4. % of popula/on covered by social health insurance

Reversed trend of HIV/ AIDS 5. Awareness of HIV/AIDS among the youth

6. 100% tes/ng, counseling and treatment for risk popula/on

7. Increase condom use

Lowered Malnutri/on Rate 8. Decrease malnutri/on rate (was/ng) 2%

9. Decrease stun/ng rate 3%

10. 100% of children under -5 years old weighed in all barangays

Ensured Blood Adequacy 11. 1% of popula/on dona/ng blood

12. Adequate referral system

Good Data for Decision Making 13.100% func/onal electronic medical record

14. FHSIS and Surveillance data used in the LIPH

A@ained Zero Unmet Needs for 15. No stock outs of FP commodi/es

Modern Family Planning
16. Full range of Family Planning services offered

17. Decrease in unmet needs for modern FP

Community-Based Rehabilita/on 18. 100% Tokhang assessed

Program in all communi/es
19. Outpa/ent and community services available

20. Referral system smooth and func/onal

ISO in all Government hospital 21. SDN func/onal (Part of SDN)

22. QMS in place- SS Standards

Expenditures on Health Increased 23. LDU health budget increased (above 15%)

24. PhilHealth reimbursement

Sustained Zero Open Defaca/on, 25. % household using safely managed sanita/on services
Universal Basic Drinking Water,
Universal Hand Washing and MH 26. % households using safely managed drinking water services

24/7 Access to Health Services for All 27. Func/onal and licensed ambulance
Filipinos
28. All barangay visited by MHO at least 2x a year

29. 100% of poor provided with annual health check-up

30. One member trainied on Cardiopulmonary Resuscita/on (CPR) per

household

Vergara, F.