LESSON I
THE VISION, MISSION, GOALS
AND OBJECTIVES OF THE
INSTITUTION
EDUCATIONAL INSTITUTION
An educational institution is
a place where learners of
different ages gain education.
Education is based on an age
grade system from preschool,
primary, intermediate, and
secondary level (junior and
senior high school), to the
tertiary level (colleges and
universities). Educational
institutions carry out
educational activities that
engage students with various
learning environments and
learning spaces.
However, not all types of
educational institutions are
structured and formalized.
While established educational
institutions follow a well-
defined curriculum, some
learning environments are
spontaneous and have no fixed
timetables.
There are two types of
education: formal and
informal.
Formal education deals with
the conventional classroom
set-up where structured
methods of learning are
administered in educational
institutions. Government
recognition in terms of the
curricular offering that
predetermines the books and
materials to be used for
instruction is necessary to
establish standards in the
academic community. Faculty
and instructors follow the
curricula set by a technical
committee appointed by the
government. Formal education
starts at around age 4 from
preschool up to higher
education. It takes place in a
stipulated period in which
learners complete each level
by acquiring the required
competencies in preparation
for higher learning.
Informal education, on the
other hand, is anything learned
independently outside the
conventional classroom set-up.
It is not restricted to a certain
location and is usually
integrated with the
surroundings such as the
home, cultural setting, and
even in formal education
institutions. Informal
education involves the
students’ behavior skills
through interaction and
exploration on a daily basis as
well as the teachers’ traits that
vary by their expertise, skills,
and experience.
VISION AND MISSION
STATEMENT
Vision Statement
A vision statement conveys
the desired end of an academic
institution. It is usually a one-
sentence statement that
describes the distinct and
motivating long-term desired
transformation resulting from
institutional programs. The
vision statement should be
clear, memorable, and concise
with an average length of 14
words. The shortest contains
only three words—such as
“Equality for Everyone,” a
human rights campaign—
while the longest may contain
up to 26 words—such as “A
World in which every person
enjoys all of the human rights
enshrined in the Universal
Declaration of Human Rights
and other international human
rights instruments” of
Amnesty International.
Mission Statement
A mission statement is a one-
sentence statement relating
the intention of your
institution’s existence. This
communicates what you do or
who you do this for. The
mission must be clear by using
simple language with an
average of 5 to 20 words.
Examples include “Spreading
Ideas” by TED, “The increase
and diffusion of knowledge”
by Smithsonian, “Seeking to
put God’s love into action,
Habitat for Humanity brings
people together to build
homes, community and hope”
by Habitat for Humanity.
ABOUT VALUE
STATEMENT
A value statement, or the core
values, is a list of fundamental
doctrines that guide and direct
the educational institution.
This sets the moral direction of
the institution and its academic
community that guides
decision-making and provides
a yardstick against any action.
The core values shape the
standard structure that is
shared and acted upon by the
academic community.
In developing an institution’s
value statement, consider the
following questions:
• What values are distinct to
our educational institution?
• What values should direct
our institution?
For an educational institution
to have a useful value
statement, its values must be
incorporated in all levels of the
institution to give direction to
its engagements, viewpoints,
and decision-making
processes.
OBJECTIVES
Educational objectives, or
goals, are short statements that
learners should achieve within
or at the end of the course or
lesson. When setting the
objectives, curriculum
developers must think of the
SMART criteria; that is,
objectives must be Specific,
Measurable, Attainable,
Realistic, and Time bound.
KEY POINTS TO
REMEMBER:
 An educational
institution carries out
educational activities that
engage students with
various learning
environments and learning
spaces.
 Education is based on
an age grade system from
preschool, primary,
intermediate, and
secondary level to the
tertiary level.
 A vision statement is
the desired end of an
academic institution. It is
usually a one-sentence
statement that describes the
distinct and motivating
long-term desired
transformation resulting
from institutional
programs.
 A mission statement is
a one-sentence statement
relating the intention of an
institution’s existence.
 A value statement is a
list of fundamental
doctrines that guide and
direct the educational
institution.
 An educational
objective is a short
statement that a learner
should achieve within or at
the end of the course or
lesson.
LESSON II HEALTH SYSTEM
DEFINITION OF HEALTH
CARE SYSTEM
Health system is “the
combination of resources,
organization, financing, and
management that culminate in
the delivery of health services
to the population” (Roemer,
1991). This system consists of
many parts such as the
community, department or
ministries of health, health
care providers, health service
organizations, pharmaceutical
companies, health financing
bodies, and other organizations
related to the health sector.
Each plays a role in the system
such as governance, health
service provision, and
financing and managing
resources.
In the World Health
Organization (WHO) Report
(2000), health system is
defined as “all the
organizations, institutions,
resources, and people whose
primary purpose is to improve
health.” Thus, a well-
performing health system
provides direct health-
improving activities whether in
personal health care, public
health services, or intersectoral
initiatives, to achieve high
health equity.
GOALS AND FUNCTIONS
OF A HEALTH SYSTEM
WHO identifies three (3) main
goals of health systems:
(1) Improving the health of
populations
Improving health of the
population is the overarching
goal of a health system. Health
status should thus be measured
over the entire population and
across different socioeconomic
groups. Populations must be
protected from existing and
emerging health risks.
Intensive preparations for
resilience to impending but
still unknown health risks must
be executed to ensure the
safety of populations. Health
systems should strive for
equity in health by minimizing
inequitable disparities which
may be caused by certain
factors such as income,
ethnicity, occupation, gender,
geographic location, and
sexual orientation, among
others. There are significant
variations in health outcomes
across the world, within
regions, and within countries.
Countries and regions with
relatively similar
socioeconomic status may
have quite disparate health
outcomes. The way health
systems are organized
contributes to this disparity.
These disparities are most
effectively reduced when they
are recognized and their
minimization becomes an
explicit national goal.
(2) Improving the
responsiveness of the health
system
Responsiveness refers to
providing satisfactory health
services and engaging people
as active partners. It embodies
the values of respectfulness,
dignity, confidentiality,
autonomy, quality, and
timeliness in the delivery of
health services. Health systems
also have an obligation to
respond to the legitimate non-
health needs and expectations
of populations. Responsive
health systems maximize
people’s autonomy and
control, allowing them to make
choices and placing them at
the center of the health system.
(3) Providing fair health
financing
An ideal health system
provides social and financial
risk protection in health. Thus,
all health systems must be
adequately funded to provide
essential services to all
citizens. WHO defines a fairly
financed health system as one
that does not deter individuals
from receiving needed care
due to payments required at
the time of service, and one in
which each individual pays
approximately the same
percentage of their income for
needed services. A health
financing system that
dissuades people from seeking
needed services or
impoverishes individuals and
families worsens health
outcomes.
There are 4 vital health system
functions are:
(1) Health service provision
The most visible product of the
health system is public and
private health service
provision. A health service is
any service, not limited to
clinical services, aimed at
improving the health of
populations. Preventive
measures as well as promotion
of a healthy way of living to
avoid illnesses also form part
of the best systems. Thus, the
system has to perform a wide
range of activities to cater to
these various demands.
(2) Health service inputs
Health service inputs, or
managing resources, means
generating the essential
physical resources for the
delivery of health services
which include medications,
human resources, and medical
equipment. Resources such as
trained doctors and medical
staff and supply of
medications often take time to
be produced; hence, the health
system policymakers have to
respond and use the available
resources to address short-term
population needs.
(3) Stewardship
Stewardship, or the overall
system oversight, is the main
responsibility of the
government. This function sets
the direction, context, and
policy framework for the
overall health system.
The core of the stewardship
function includes:
a. Identifying health priorities
for allocation of public
resources;
b. Identifying an institutional
framework;
c. Coordinating activities with
other systems related to
external health care;
d. Analyzing health priorities
and resource generation trends
and their implications; and
e. Generating appropriate data
for effective decision-making
and policymaking on health
matters.
(4) Health financing
Health system financing
includes raising and pooling
resources to pay for health
services.
A. Revenue collection
Revenue is earned from
payments for health care
services. The mechanisms for
revenue collection include
general taxation, direct
household out-of-pocket
expenditures, mandatory
payroll contributions,
mandatory or voluntary risk-
rated contributions, donor
financing, and other forms of
personal savings.
Each source of health
financing is associated with a
specific manner of organizing
and pooling of funds and
purchasing services. Public
health systems rely on general
taxation for its financing,
while social security
organizations are funded
through the mandatory payroll
contributions from workers
and employers.
B. Risk pooling
Financial risk pooling is a
form of risk management
which aims to spread financial
risks from an individual to all
pool members (WHO, 2000).
It is considered a core function
of health insurance companies.
This mechanism prevents
outright payment for health
services which discourages
patients belonging to the poor
sector from seeking health
care. Participation in effective
risk pooling helps families
from financial losses due to
health shocks, thus ensuring
financial protection.
Each country has its own
approach to managing its
financial risk to finance its
health care system. Multiple
and fragmented forms of risk
pooling arrangements exist in
most developing countries.
Most high-income countries
follow one of the two main
models: the Bismarck model
and the Beveridge model.
BISMARCK MODEL
(Bismarck’s Law on Health
Insurance of 1883)
This model is named after the
Prussian Chancellor, Otto von
Bismarck, known for inventing
the welfare state in the 19th
century as part of the
unification of Germany. The
Bismarck model uses an
insurance system where the
sickness fund finances both the
employers and the employees
through payroll deduction. But
unlike the U.S. insurance
industry, the Bismarck-type
health insurance plan covers
everybody, thus collecting no
profit. This is considered a
multi-payer model with tight
regulation giving the
government the cost-control
clout. This model is widely
used in Germany, France,
Belgium, Netherlands, Japan,
Switzerland, and, to a degree,
in Latin America.
BEVERIDGE MODEL
(Beveridge Report or
theSocial Insurance and
Allied Services of 1942)
 This model is named after
William Beveridge, the social
reformer responsible for
designing Britain’s Social
Security System and the
National Health Service. In the
Beveridge model, health care
is provided and funded by the
government through tax
payments. The government
owns many, but not all,
hospitals and clinics in the
country. Doctors may be
government or private
employees who collect their
professional fees from the
government. This results in
low cost per capita since the
government controls the health
care services. Countries using
the Beveridge plan include
Hong Kong, Great Britain,
Spain, most of Scandinavia,
New Zealand, and Cuba. The
Cuban government, for
instance, uses total
government control.
C. Strategic purchasing
In strategic purchasing,
risk-pooling organizations use
collected funds and pooled
financial resources to finance
the health care services of the
members. The purchaser
defines the substantial part of
the provider's external
incentives to develop the
provider-user interaction and
the health service delivery
models.
WHO HEALTH SYSTEM
FRAMEWORK
In its World Health Report
2000, WHO released a single
framework (Figure 2.1) with
six clearly defined building
blocks and priorities which are
necessary in strengthening
health systems and improving
the overall health outcomes.
One building block is service
delivery which refers to the
timely delivery of quality and
cost-effective personal and
non-personal health services.
Another is health workforce
which includes individuals and
groups working towards the
achievement of the best health
outcomes by being responsive,
fair, and efficient. The number
of staff should be sufficient
and fairly distributed to ensure
competency, responsiveness,
and productivity. Information
(health information system)
which analyzes, disseminates,
and uses reliable and relevant
information on health status,
determinants, and systems
performance is also a valuable
building block. Another
important building block is
that of health products,
vaccines and technologies
which are made accessible
through uninterrupted supply,
well-managed pharmaceutical
services, and education on
proper use of medication.
Financing (health financing
system) is a building block
which takes care of the
funding for health care
services to guarantee that
people can use health services
when needed without fear of
having not enough resources to
pay for them. Lastly,
leadership and governance
involves the task of ensuring
effective stewardship of the
entire health system. This
building block also covers the
monitoring of the
accountability of private and
public health agencies, proper
system design, and appropriate
regulation of health systems.
PHILIPPINE HEALTH
SYSTEM
Historical Background
The health reform initiatives
carried out over the years in
the Philippines were primarily
focused on these areas of
concern: health service
delivery, health regulation, and
health financing. These health
reforms aimed at addressing
issues such as poor
accessibility, inequity, and
inefficiency of the Philippine
health system.
1. 1979: Adoption of Primary
Health Care Strategy (LOI
949) – promoted participatory
management of the local
health care system
2. 1982: Reorganization of
DOH (EO 851) – integrated
the components of health care
delivery into its field
operations
3. 1988: The Generics Act
(RA 6675) – ushered the
writing of prescriptions using
the generic name of the drug
4. 1991: Local Government
Code (RA 7160) – transferred
the responsibility of providing
health service to the local
government units
5. 1995: National Health
Insurance Act (RA 7875) –
instituted a national health
insurance mechanism for
financial protection with
priority given to the poor
6. 1999: Health Sector
Reform Agenda– ordered the
major organizational
restructuring of the DOH to
improve the way health care is
delivered, regulated, and
financed
7. 2005: FOURmula One
(F1) for Health – adopted an
operational framework to
undertake reforms with speed,
precision, and effective
coordination and to improve
the Philippine health system
8. 2008: Universally
Accessible Cheaper and
Quality Medicines Act (RA
9502) – promoted and ensured
access to affordable quality
drugs and medicines for all
9. 2010: Kalusugang
Pangkalahatan or Universal
Health Care (AO 2010-0036)
– provided universal health
coverage and access to quality
health care for all Filipinos
Leadership and Governance
The Department of Health
(DOH) is mandated to provide
the appropriate direction for
the nation’s healthcare
industry. Its other tasks include
(1) the development of plans,
guidelines and standards for
the health sector; (2) technical
assistance; (3) capacity
building; (4) advisory services
for disease prevention; and (5)
control of medical supplies
and vaccines.
DOH coordinates its
national health programs
through the local government
units (LGUs). LGUs take care
of their own health services
and are given autonomy under
the Local Government Code
(LGC) of 1991 (R.A. 7160).
78 provincial governors, 138
city mayors and 1496
municipal mayors, and 42,025
barangay chairpersons
compose the local government
units of the country (NSCB,
2010).
In terms of administration,
LGUs are grouped into 17
regions. Although they operate
in a decentralized system,
LGUs are under the
supervision of the DOH
regional health offices. The
provincial government is
tasked to provide health
services through provincial
and district hospitals. The city
and municipal governments
rely on public health and
primary health care centers
(BHCs) for their primary care.
(For a detailed organizational
structure of the Philippine
health sector, see The
Philippines Health System
Review (2011) published in
Health System in Transition,
vol. 1, no. 2.)
DOH is duty-bound to:
1. develop policies and
programs for the health sector;
2. provide technical assistance
to its partners;
3. encourage performance of
the partners in the priority
health programs;
4. develop and enforce policies
and standards;
5. design programs for large
segments of the population;
and
6. provide specialized and
tertiary level care.
Under the decentralized or
devolved structure, the state is
represented by national offices
and LGUs, with provincial,
city, municipal, and barangay
or village offices. DOH,
LGUs, and the private sector
participate, cooperate, and
collaborate in the care of the
population. Before devolution,
the national health system
consisted of a three-tiered
system under the direct control
of the DOH: (1) the tertiary
hospitals at the national and
regional levels; (2) the
provincial and district
hospitals and city and
municipal health centers; and
(3) the barangay (village)
health centers.
With the enactment of the
LGC of 1991, the government
health system now consists of
basic health services—
including health promotion
and preventive units—
provided by cities and
municipalities, provincial and
province-run district hospitals
of varying capacities, and
mostly tertiary medical
centers, specialty hospitals,
and a number of re-
nationalized provincial
hospitals managed by the
DOH.
Directions of the Philippine
Health Sector
(1) The Philippine Health
Agenda 2016 – 2022 (DOH
Administrative Order 2016-
0038)
This agenda adopts the slogan
“All for Health Towards
Health For All” as the
rallying point for its vision of
a Healthy Philippines by 2020.
It expanded the scope of the
Universal Health Care (UHC)
directions, particularly
through a whole-of-
government approach. With
this agenda, the health system
guarantees:
a. population- and individual-
level interventions for all life
stages that promote health and
wellness, prevent and treat the
triple burden of disease, delay
complications, rehabilitation,
and provide palliation for both
the well and the sick;
b. access to health
interventions through
functional service delivery
networks (SDNs); and
c. financial freedom when
accessing these interventions
through Universal Health
Insurance.
(2) The Philippine
Developmental Plan 2017-
2022
This is the first of the four key
medium-term plans to translate
the vision of a “matatag,
maginhawa, at panatag na
buhay” for the Filipinos and
the country.
(3) NEDA AmBisyon Natin
2040
A product of the Philippine
Development Plan 2017–2022,
this collective long-term plan
envisions better life for the
Filipinos and the country in the
next 25 years by formulating
policies and implementing
programs and projects to attain
this AmBisyon. This plan
focuses on four areas:
building a prosperous,
predominantly middle-class
society where no one is poor;
promoting a long and healthy
life; becoming smarter and
more innovative; and building
a high-trust society.
(4) Sustainable
Developmental Goals 2030
This is a compilation of
17 developmental goals that
targets to end poverty, fight
inequality and injustice and
confront issues involving
climate change and its effects.
KEY POINTS TO
REMEMBER:
 Health system
combines resources,
organization, financing,
and management to deliver
health services to the
population. According to
the World Health
Organization (WHO)
Report in 2000, health
system is defined as “all
the organizations,
institutions, resources, and
people whose primary
purpose is to improve
health.”
 The primary goals of
the health system are
improved health outcomes
(attaining the best average
level health care for the
entire population by
minimizing disparities),
more responsive health
system (meeting the
people’s expectations of
and satisfaction from
health service delivery),
and more equitable health
care financing (protecting
each individual from
financial risks).
 The four functions of
the health system are
health services provision
(for appropriate and cost-
effective health delivery);
health service inputs (for
generating human
resources, technology, and
capital); health financing
(by revenue collection, risk
pooling, and strategic
purchasing); and
stewardship and initiatives
(to strengthen governance,
accountability, and
responsiveness).
 A health system can be
analyzed in its totality by
using a framework
consisting of six building
blocks, i.e., leadership and
governance, health
financing, health
workforce, medical
products, vaccines, and
technologies, health
information, and service
delivery.
 The Department of
Health (DOH) is the lead
agency for Philippine
health care. According to
its mandate (E.O. No. 119,
Sec. 3), the DOH shall be
responsible for the (1)
formulation and
development of national
health policies, guidelines,
standards, and manual of
operations for health
services and programs; (2)
issuance of rules and
regulations, licenses, and
accreditations; (3)
promulgation of national
health standards, goals,
priorities, and indicators;
and (4) development of
special health programs
and projects, and advocacy
for legislation on health
policies and programs. the
ability to pay rather than
the risk of illness).
LESSON III
PRIMARY HEALTH CARE AND
THE PHILIPPINE HEALTH
CARE
DELIVERY SYSTEM
HEALTHCARE
According to the Alma-Ata
Declaration of 1978, health is
a fundamental human right. It
states that the most important
global goal is for humans to
reach the optimal level of their
health; this requires not only
the action of the health sector
but the collaboration among
other sectors such as those in
the social and economic
sectors.
Meanwhile, a common
concern of many countries,
including both developed and
developing ones, is the gross
inequality in the people’s
health status which is not
socially, economically, and
politically acceptable. Thus,
the government of each
country has the duty and
responsibility to institute
adequate measures to promote
and protect its people’s health,
and thus achieve a better
quality of life.
For better understanding, the
following concepts under
health care are defined:
1. Health Care System defined
by Miller-Keane (1987) as “an
organized plan of health
services.”
2. Health Care Delivery as
defined by Williams-
Tungpalan (1981), is “the
rendering of health care
services to the people.”
3. Health Care Delivery
System also as defined by
Williams-Tungpalan (1981), is
“the network of health
facilities and personnel which
carries out the task of
rendering health care to the
people.”
PRIMARY HEALTH CARE
As cited by WHO, the Alma-
Ata Declaration defines
primary health care as
important health care derived
from scientifically sound and
socially acceptable methods. It
must be universally accessible
to all individuals and is based
on what the community and
country can provide.
As an approach, the
primary health care (PHC)
deals with social policy which
targets health equity. PHC has
the essential elements and
objectives that ensure
attainable better health
services for all.
The ultimate goal of primary
health care is better health for
all. WHO has identified five
key elements to achieve this
goal these are:
1. universal coverage to reduce
exclusion and social disparities
in health,
2. service delivery organized
around people’s needs and
expectations,
3. public policy that integrates
health into all sectors,
4. leadership that enhances
collaborative models of policy
dialogue, and
5. increased stakeholder
participation.
ESSENTIAL ELEMENTS
OF PRIMARY HEALTH
CARE
Below are the eight (8)
elements of primary health
care:
1. Education concerning
prevailing health problems and
the methods of identifying,
preventing, and controlling
them
2. Locally endemic disease
prevention and control
3. Expanded program of
immunization against major
infectious diseases
4. Maternal and child health
care including family planning
5. Essential drugs
arrangement
6. Nutritional food
supplement, an adequate
supply of safe, and basic
nutrition
7. Treatment of
communicable and non-
communicable disease and
promotion of mental health
8. Safe water and sanitation
Other elements of primary
health care include:
1. Expanded options of
immunization
2. Reproductive health needs
3. Provision of essential
technologies for health
4. Health promotion
5. Prevention and control of
non-communicable diseases
6. Food safety and provision of
selected food supplements
Principles of Primary Health
Care (PHC):
A conceptual shift in health
care calls attention to the fact
that primary health care should
be integrated, and its principles
guide the functions of the
system as a whole. Having a
systems perspective bridges
the conflict between primary
health care as a distinguished
level of care and as a holistic
approach to the provision of
health services.
The health system should also
consider the principles of the
Alma-Ata Declaration and
other intersectoral approaches.
It should cover broader
population health issues while
reinforcing public health
functions. It should come up
with programs that provide
care and prevent diseases and
provision for services
especially for the poor and
marginalized groups. Finally,
it should be able to monitor
programs for continuous
improvement.
The basic objectives to launch
and sustain primary health care
as part of the comprehensive
health system are as follows:
1. Improve the level of health
care of the community
2. Promote favorable
population growth structure
3. Reduce the morbidity and
mortality rates especially
among infants and children
4. Reduce prevalence of
preventable, communicable,
and other diseases
5. Improve basic sanitation
6. Extend essential health
services especially to the
underserved sectors
7. Develop the capability of
the community to become self-
reliant
8. Encourage the contribution
of other sectors to the social
and economic development of
the community
9. Provide equitable
distribution of health care
10. Ensure community
participation and monitor
adequacy and distribution of
health workers who are
supported locally and at the
referral levels
11. Recognize that the formal
health sector needs other
sectors in the promotion of
health (multi-sectoral
approach)
12. Use the appropriate
technology which are
accessible, feasible, affordable,
and culturally acceptable to the
community
MANAGEMENT OF
PRIMARY HEALTH CARE
Health care managers usually
carry out the following
functions in the process of
management:
1. Planning – This means
setting priorities and
determining performance
targets. Managers are usually
required to set a direction and
determine what needs to be
accomplished.
2. Organizing – This refers to
designing the organization or
the specific division, unit, or
service for which the manager
is responsible. Furthermore, it
means designating reporting
relationships and intentional
patterns of interaction,
determining positions and
teamwork assignments, and
distributing authority and
responsibility.
3. Staffing – This function
refers to acquiring and
retaining human resources, and
developing and maintaining
the workforce through various
strategies and tactics.
4. Controlling – This function
refers to monitoring staff
activities and performance and
taking the appropriate actions
for corrective actions to
increase performance.
5. Directing – This focuses on
initiating action in the
organization through the
effective leadership,
motivation, and
communication of managers.
Below are the management
principles in relation to
organizing:
1. Authority, responsibility,
and accountability
a. Authority refers to the
formal and legitimate right of a
manager to issue orders, make
decisions, and allocate
resources to achieve desired
outcomes of the organization.
b. Responsibility is the duty
of the employee to perform the
assigned tasks and activities.
c. Accountability means
reporting and justification of
task outcomes to higher
management by those people
with authority.
2. Types of authority
a. Line authority managers
issue orders to their
subordinates and are also
responsible for the results.
b. Functional authority is for
managers that have power only
over a specific set of activities.
c. Staff authority is given to
specialists in their areas of
expertise. The staff manager
simply advises, recommends,
and counsels.
3. Centralization,
decentralization, and
formalization
a. Centralization refers to the
concentration of planning and
decision-making to the top of
the organization.
b. Decentralization refers to
the delegation of planning and
decision-making to the lower
branches of the organization.
c. Formalization refers to a
written documentation
provided for the direct control
of the employees.
4. Staffing
As regards to the process of
staffing, here is the list of
functions of the manager:
a. Assign individuals to
respective positions identified
in the management plan
b. Assess required
competencies through
• identification of the key
result areas (KRAs) per major
activity
• determination of the
competencies and
qualifications
c. Recruit qualified personnel
d. Improve existing services
and programs by
• reviewing and adjusting the
requirements accordingly
• matching the competency
requirements vis-a-vis the
responsible personnel assigned
to the activity
THE PHILIPPINE
HEALTH CARE SYSTEM
Philippine Health Care System
– According to Dizon (1977),
the Philippine health care
system is “a complex set of
organizations interacting to
provide an array of health
services.” It has progressed
due to challenges encountered
over time. In 1991, the local
government units (LGUs) took
over the management of health
service delivery but the issue
of fragmentation has not been
absolutely addressed. Health
workforce has to deal with the
pressing issues of
underemployed workers,
limited resources, and unequal
distribution. Meanwhile, the
private sector which is said to
comprise 50% of the overall
health system is strongly
involved in improving the
delivery of health services, but
the government’s power to
regulate should be optimized.
THE DEPARTMENT OF
HEALTH MANDATE
As specified in Executive
Order No. 119, Sec. 3, the
Ministry of Health [now
Department of Health (DOH)]
has the responsibility to create,
plan, implement, and
systematize national health
policies, advocacies, and
programs. Its primary function
is to promote, protect, and
preserve or restore people’s
health by giving health
services and by monitoring
and motivating health service
providers. Moreover, it is
responsible for the issuance of
health-related licenses and
accreditations and
disseminating information
about national health
indicators.
Vision
DOH vision by 2030 states
A global leader for attaining
better health outcomes,
competitive and responsible
health care system, and
equitable health financing
Mission
DOH mission states
To guarantee equitable,
sustainable and quality health
for all Filipinos, especially the
poor, and to lead the quest for
excellence in health
LEVELS OF HEALTH
CARE FACILITIES
Below are the levels of health
care facilities according to
Williams-Tungpalan (as cited
in DeDios, n.d.):
1. Primary Level of Health
Care Facilities
The primary level of health
care facilities refers to the
following:
a. Units operated by the DOH
which include the rural health
units, their respective sub-
centers, chest clinics, malaria
eradication units, and
schistosomiasis control units;
b. Puericulture center operated
by the League of Puericulture
Centers
c. Units operated by the
Philippine Tuberculosis
Society such as the
tuberculosis clinics and
hospitals;
d. Clinics operated by the
Philippine Medical
Association;
e. Clinics operated by large
industrial firms for their
employees;
f. Health centers and
community hospitals operated
by the Philippine Medical Care
Commission; and
g. Other health facilities
operated by voluntary religious
and civic groups.
2. Secondary Level of Health
Care Facilities
The secondary level of health
care facilities includes the
smaller and non-
departmentalized hospitals.
These are emergency and
regional hospitals where
adequate treatments are
offered for patients with
symptomatic stages of
diseases.
3. Tertiary Level of Health
Care Facilities
Included in the tertiary level
are specialized national
hospitals which offer highly
technological and
sophisticated services. Patients
who are afflicted with life-
threatening diseases requiring
highly technical and
specialized knowledge,
facilities, and personnel are
treated here.
LEVELS OF PRIMARY
HEALTH CARE
WORKERS
1. Grassroot or Village
Health Workers
a. They are the initial links of
the community to health care.
b. They provide preventive
health care measures and
simple curatives to promote a
healthy environment.
c. They encourage
programs/activities such as
food production programs to
improve the socio-economic
level of the community.
d. They are the volunteers,
community health workers, or
traditional birth attendants.
2. Intermediate Level Health
Workers
a. They are the first source of
professional health care.
b. They attend to health
problems which are already
beyond the competence of the
village workers.
c. They provide supervision,
training, supplies, and services
that provide support to front-
line health workers.
d. They are medical
practitioners, nurses, and
midwives.
3. First-Line Hospital
Personnel
a. When hospitalization is
required, they serve as the
backup health service
providers.
b. The intermediate level
health workers or village
health workers are in close
contact with them.
c. They are the physicians with
specialty, nurses, dentist,
pharmacists, and other health
professionals.
The categories of health  The Philippine health
workers are affected by certain care system has progressed
factors such as due to many challenges
1) the availability of health through time. The private
manpower resources, sector has been strongly
engaged but government
2) the presence of healthcare regulation should be
concerns and needs of the optimized.
locality, and
 The primary function
3) the issue of financial and of the Department of
political feasibility. Health (the Ministry of
Health) indicated in EO no.
KEY POINTS TO 119 is to promote, protect,
REMEMBER: preserve, or restore
people’s health by giving
 Health is a fundamental health services and
human right as cited in the monitoring health service
Alma-Ata Declaration of providers.
1978.
 Reaching the highest
possible level of health is
important worldwide.
 Primary health care
(PHC) is essential health
care made universally
accessible through full
participation of health care
providers and at a cost that
the community and the
country can afford.
 The ultimate goal of
primary health care is
better health for all. The
principles of primary
health care should guide
the functions of the system
as a whole.
 Management of
primary health care
includes planning,
organizing, staffing,
controlling, and directing.
 Health care facilities
are catergorized into
primary, secondary, and
tertiary levels. Primary
health care workers are
categorized as grassroot or
village health workers,
intermediate level health
workers, and first-line
hospital personnel.