Objectives:

At the end of the Discussion, the Masteral students will be to:

 Define Universal Health care
 Identify the three thrust of Universal Health Care.
 Understand the key concepts of Philippine health agenda to achieve health for all
Filipinos.

Universal Health Care

Universal Health Care (UHC), also referred to as Kalusugan Pangkalahatan (KP)
It is the “provision to every Filipino of the highest possible quality of health care that is
accessible, efficient, equitably distributed, adequately funded, fairly financed, and appropriately
used by an informed and empowered public”.
Universal Health Care is an approach that seeks to improve, streamline, and scale up the
reform strategies in Health Sector Reform Agenda and FOURMULA l in order to address
inequities in health outcomes by ensuring that all Filipinos, especially those belonging to the
lowest two income quintiles, have equitable access to quality health care.
This approach shall strengthen the National Health Insurance Program (NHIP) as the
prime mover in improving financial risk protection, generating resources to modernize and
sustain health facilities, and improve the provision of public health services to achieve the
Millennium Development Goals (MDGs).
It is a government mandate aiming to ensure that every Filipino shall receive affordable
and quality health benefits. This involves providing adequate resources – health human
resources, health facilities, and health financing.

Universal HealthCare’s Three Thrust

1. Financial risk protection through expansion in enrollment and benefit delivery of the
National Health Insurance Program (NHIP)
2. Improved access to quality hospitals and health care facilities
3. Attainment of health-related Millennium Development Goals (MDGs)

Financial Risk Protection

Protection from the financial impacts of health care is attained by making any Filipino
eligible to enroll, to know their entitlements and responsibilities, to avail of health services, and
to be reimbursed by PhilHealth with regard to health care expenditures.
PhilHealth operations are to be redirected towards enhancing national and regional health
insurance system. The NHIP enrollment shall be rapidly expanded to improve population
coverage. The availment of outpatient and inpatient services shall be intensively promoted.
Moreover, the use of information technology shall be maximized to speed up PhilHealth claims
processing.
Improved Access to Quality Hospitals and Health Care Facilities
Improved access to quality hospitals and health facilities shall be achieved in a number of
creative approaches. First, the quality of government-owned and operated hospitals and health
facilities is to be upgraded to accommodate larger capacity, to attend to all types of emergencies,
and to handle non-communicable diseases. The Health Facility Enhancement Program (HFEP)
shall provide funds to improve facility preparedness for trauma and other emergencies. The aim
of HFEP was to upgrade 20% of DOH-retained hospitals, 46% of provincial hospitals, 46% of
district hospitals, and 51% of rural health units (RHUs) by end of 2011.

UNIVERSAL HEALTH CARE AND PHILIPPINE HEALTH AGENDA |NRS 503 PRIMARY HEALTH CARE
Rachelle Joy S. Suba, RN, MSN 2nd year
 Financial efforts shall be provided to allow immediate rehabilitation and construction of
critical health facilities. In addition to that, treatment packs for hypertension and diabetes shall be
obtained and distributed to RHUs.
The DOH licensure and PhilHealth accreditation for hospitals and health facilities shall
be streamlined and unified.
Attainment of Health-related MDGs
Further efforts and additional resources are to be applied on public health programs to
reduce maternal and child mortality, morbidity and mortality from Tuberculosis and Malaria, and
incidence of HIV/AIDS. Localities shall be prepared for the emerging disease trends, as well as
the prevention and control of non-communicable diseases.
The organization of Community Health Teams (CHTs) in each priority population area is
one way to achieve health-related MDGs. CHTs are groups of volunteers, who will assist
families with their health needs, provide health information, and facilitate communication with
other health providers. RNheals nurses will be trained to become trainers and supervisors to
coordinate with community-level workers and CHTs. By the end of 2011, it is targeted that there
will be 20,000 CHTs and 10,000 RNheals.
Another effort will be the provision of necessary services using the life cycle approach.
These services include family planning, ante-natal care, delivery in health facilities, newborn
care, and the Garantisadong Pambata package.
Better coordination among government agencies, such as DOH, DepEd, DSWD, and
DILG, would also be essential for the achievement of these MDGs.
The six (6) strategic instruments shall be optimized to achieve the AHA strategic
thrusts:
1. Health Financing - instrument to increase resources for health that will be effectively
allocated and utilized to improve the financial protection of the poor and the vulnerable
sectors.
2. Service Delivery – instrument to transform the health service delivery structure to
address variations in health service utilization and health outcomes across socio-
economic variables.
3. Policy, Standards and Regulation - instrument to ensure equitable access to health
services, essential medicines and technologies of assured quality, availability and safety.
4. Governance for Health - instrument to establish the mechanisms for efficiency,
transparency and accountability and prevent opportunities for fraud.
5. Human Resources for Health - instrument to ensure that all Filipinos have access to
professional health care providers capable of meeting their health needs at the appropriate
level of care
6. Health Information - instrument to establish a modern information system that shall:
a. Provide evidence for policy and program development
b. Support for immediate and efficient provision of health care and management of
province-wide health systems

A huge disparity of health outcomes persists between a rich minority and a poor majority
in the Philippines. The current government is committed to reducing these inequities through a
universal healthcare scheme called Kalusugan Pangkalahatan, which involves addressing
problems in the “six building blocks” of UHC: information systems, regulation, services
delivery, human resources, financing, and governance, though many challenges remain.
Universal Health Care addresses the problem of health inequity by improving access to services
and financial protection. However, gaps in the six building blocks of health care must be
addressed if the Philippines is to truly achieve “universal healthcare.”

UNIVERSAL HEALTH CARE AND PHILIPPINE HEALTH AGENDA |NRS 503 PRIMARY HEALTH CARE
Rachelle Joy S. Suba, RN, MSN 2nd year
 Philippine health agenda 2016 2022
Health For All- All for Health
ALL FOR HEALTH TOWARDS HEALTH FOR ALL

GOALS:
The Health System We Aspire For Filipinos:
 FINANCIAL PROTECTION -especially the poor are protected from high cost of
health care
 BETTER HEALTH OUTCOMES -Filipinos attain the best possible health
outcomes with no disparity
 RESPONSIVENESS GOALS -Filipinos feel respected, valued, and empowered
in all of their interaction with the health system
VALUES:
The Health System We Aspire For VALUES
 EQUITABLE & INCLUSIVE TO ALL
 PROVIDES HIGH QUALITY SERVICES
 USES RESOURCES EFFICIENTLY
 TRANSPARENT & ACCOUNTABLE
During the last 30 years of Health Sector Reform, we have undertaken key structural reforms
and continuously built on programs that take us a step closer to our aspiration .
MILESTONES:
 PhilHealth (1995)
 Good Governance Programs (ISO, IMC, PGS)
 DOH resources to promote local health system development
 Fiscal autonomy for government hospitals
 Devolution
 Use of Generics
 Funding for UHC
 Milk Code
Persistent Inequities in Health Outcomes
 2000 Every year, around 2000 mothers die due to pregnancy-related complications.
 Three out of 10 children are stunted.
 A Filipino child born to the poorest family is 3 times more likely to not reach his 5th
birthday, compared to one born to the richest family.
Restrictive and Impoverishing Healthcare Costs:
 Every year, 1.5 million families are pushed to poverty due to health care expenditures
 Filipinos forego or delay care due to prohibitive and unpredictable user fees or co-
payments
 Php 4,000/month healthcare expenses considered catastrophic for single income families
Poor quality and undignified care synonymous with public clinics and hospitals
 Long wait times
 Less than hygienic restrooms, lacking amenities
 Poor record-keeping
 Overcrowding & under-provision of care
 Privacy and confidentiality taken lightly
 Limited autonomy to choose provider

UNIVERSAL HEALTH CARE AND PHILIPPINE HEALTH AGENDA |NRS 503 PRIMARY HEALTH CARE
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3

GUARANTEES:
GUARANTEE #1 : ALL LIFE STAGES & TRIPLE BURDEN OF DISEASE Services for Both
the Well & the Sick
Its covers: Pregnant, Newborn ,Infant, Child ,Adolescent ,Adults and Elderly
First 1000 days | Reproductive and sexual health | maternal, newborn, and child health |
exclusive breastfeeding | food & micronutrient supplementation | Immunization| Adolescent
health | Health screening, promotion & information.
COMMUNICABLE
• HIV/AIDS, TB, Malaria • Diseases for Elimination • Dengue, Lepto, Ebola,
Zika
DISEASES OF RAPID URBANIZATION & INDUSTRIALIZATION
• Injuries • Substance abuse • Mental Illness • Pandemics, Travel Medicine •
Health consequences of climate change / disaster
NON- COMMUNICABLE, INCLUDING MALNUTRITION
• Cancer, Diabetes, Heart Disease and their Risk Factors – obesity, smoking, diet,
sedentary lifestyle • Malnutrition
GUARANTEE #2: SERVICE DELIVERY NETWORK Functional Network of Health
Facilities
Services are delivered by networks that are:
 ENHANCED BY TELEMEDICINE
 AVAILABLE 24/7 & EVEN DURING DISASTERS
 PRACTICING GATEKEEPING
 COMPLIANT WITH CLINICAL PRACTICE GUIDELINES
 LOCATED CLOSE TO THE PEOPLE (Mobile Clinic or Subsidize Transportation Cost)
FULLY FUNCTIONAL (Complete Equipment, Medicines, Health Professional)

UNIVERSAL HEALTH CARE AND PHILIPPINE HEALTH AGENDA |NRS 503 PRIMARY HEALTH CARE
Rachelle Joy S. Suba, RN, MSN 2nd year
GUARANTEE #3: UNIVERSAL HEALTH INSURANCE Financial Freedom when Accessing
Services

A -Advance health promotion, primary care and quality

1.Annual health visits for all poor families
2. PhilHealth to contract with functional networks* of PCB providers and DOH provide
additional resources*
3. Transform selected DOH hospitals into multi-specialty, end- referral “mega-hospitals”,
i.e. teaching/training, reference laboratory
4. Enact/enforce measures to improve access to lifesaving interventions and reduce
exposure to risk factors for premature deaths and disability
5. Establishing expert bodies for health promotion (Public Health Philippines) and
surveillance and response (Philippine CDC)
*District hospital paired up with 10+ RHUs or private clinics *HFEP, deployment vaccines,
medicines, trainings
DOH-
 Facilitate the process of network forming
 Upgrade 3 DOH hospitals into “mega- hospitals”
PhilHealth-
 Expand primary care benefit to all members
 Limit contracting of PCB providers with functional networks (not stand-alone)

UNIVERSAL HEALTH CARE AND PHILIPPINE HEALTH AGENDA |NRS 503 PRIMARY HEALTH CARE
Rachelle Joy S. Suba, RN, MSN 2nd year
LGU
 Conduct annual health visits for all poor families and special populations (NHTS, IP,
PWD, Senior Citizen)
 Collaborate with others to form networks

C- Cover all Filipinos against financial health risk

1. Mobilize more funds Sin Tax | PAGCOR, PCSO | Increase Premium | Collection
Efficiency
2. Enroll remaining 8% from non-formal sector into PhilHealth
3. Expand PhilHealth benefits Outpatient diagnostics, drugs, blood & blood products
4. Recalculate case rates & link payment to quality
5. Improve contracting and enforce terms Primary care trust fund | Network-based
contracting
DOH
 Support revenue generation measures
 Align all health financial assistance programs to support Universal Health Coverage
(PAGCOR, PCSO)
PhilHealth
 Undertake costing and revise case rates
 Increase premium rates and collection efficiency
 Design additional benefits for outpatient diagnostics, drugs, blood & blood products
LGU
 Implement Health Trust Funds
 Provide income retention to health providers while retaining budgetary support
H -Harness the Power of Strategic HRH
1. Make health professions curricula responsive to local and global needs
2. Review government HRH compensation package such that ARMM, IP, GIDA will
have highest pay
3. Shift to competency versus profession-based frontline complement
4. Provide scholarships, financial incentives
5. Institute return service schemes
*clinicians and allied health professionals, managers, researchers and policymakers
DOH
 Form Legislative- Executive Health Human Resource Task Force 2016 – 2017
PhilHealth
 Streamline compensation scheme for health workers
LGU
 Provide the Magna Carta for HCW benefit H Harness the Power of Strategic HRH LGU

UNIVERSAL HEALTH CARE AND PHILIPPINE HEALTH AGENDA |NRS 503 PRIMARY HEALTH CARE
Rachelle Joy S. Suba, RN, MSN 2nd year
I- Invest in eHealth and data for decision-making
1. Require online data* submission as requirement for licensing & contracting of health
facilities and drug outlets
2. Mandate the use of Electronic Medical Records (EMR) in all health facilities
3. Invest in nation-wide surveys, administrative data and disease registries
4. Automate major business processes
5. Facilitate open access to anonymized data I clinical and administrative
DOH
 Revise licensing requirements to reflect regular electronic data submission requirement
 Open up data set for researchers
PhilHealth
 Revise accreditation/ contracting rules to reflect regular electronic submission
requirement
 Open up data set for researchers
 Provide incentives
LGU
 Implement EMR in all health facilities
 Improve local civil registration and vital statistics data
 Submit data electronically

E- Enforce accountability and transparency

1. Publish information that can trigger better performance
• Prices of common drugs and services
• Non-compliant / erring providers
• National Objectives for Health to guide strategies and investments by different
stakeholders
2. Set up dedicated performance monitoring unit
• Ghost patients and/or surprise visits •
Medical audits or third-party monitoring
DOH
 Collect and publish relevant information
 Publish annually accountability report card
PhilHealth
 Publish annually accountability report card
LGU
 Ensure transparent procurement process in all health facilities
 Regularly submit data to DOH

V Value clients and patients, especially the poor and vulnerable

1. Focus all efforts on the poorest 20 million Filipinos
2. Make all health entitlements simple and explicit
3. Set up participation & redress mechanism
4. Significantly reduce turnaround time and improve transparency of processes

UNIVERSAL HEALTH CARE AND PHILIPPINE HEALTH AGENDA |NRS 503 PRIMARY HEALTH CARE
Rachelle Joy S. Suba, RN, MSN 2nd year
DOH
 Coordinate with PhilHealth in defining the healthcare entitlements of every Filipino and
publish this
 Set up call center
PhilHealth
 Streamline procedures for availing services
LGU
 Set up complaints & redress mechanisms

E-Elicit multi-sector multi-stakeholder support for health

1. Harness and align Private Sector in planning SDN, intervention, and supply side
investments
2. Ensure convergence with other government agencies in delivering services (DOH,
DENR, DSWD, DepEd, HUDCC)
• Advocate for Health in All Policies
• Multisectoral work with different agencies to build healthy living, working,
schooling environments, healthy cities, and Health in All Policies
• Mandate Health Impact Assessment for large-scale, high-risk development
projects, e.g. mining, power plants, oil rigs
3. Partake with CSOs in governance
• Budget Development
• Monitoring and Evaluation
DOH
 Develop policy agenda with NGAs, CSOs and private sector on mainstreaming Health in
All Policies
 nstitutionalize health impact assessment for large scale projects
PhilHealth
 Expand contracting mechanisms to include the private sector (Z benefits, PCB)
LGU
 Implement healthy communities/cities interventions

CONCLUSION:
 The Philippines is one of the countries that aim to develop a health care system that
provides access to health for all its citizens.
 Health for all became the slogan for a movement, everybody needs and is entitled to the
highest possible standard of health. Turning that vision into reality calls for clarity both
on the possibilities and on the obstacles that have slowed and in some cases reversed
progress towards meeting the health needs of all people. We have a real opportunity now
to make progress that will mean longer, healthier lives for millions of people, turn despair
into realistic hope, and lay the foundations for improved health for generations to come.

UNIVERSAL HEALTH CARE AND PHILIPPINE HEALTH AGENDA |NRS 503 PRIMARY HEALTH CARE
Rachelle Joy S. Suba, RN, MSN 2nd year
REFERENCE:
Cueva, F.P. (2007). Public Health Nursing in the Philippines. 10th Edition. Publications of
Committee, National League of Philippine Government Nurses, Incorporated.
Acuin Cecilia S., Lim, Bryan Albert., Lasco, Paul Gideon. “Universal Health Care in the
Philippines: An Introduction.” In Acta Medica Philippina Special Issue on Universal
Health Care for Filipinos: A Proposal, Vol. 44 No. 4, October-December 2010.
INTERNET SOURCE:
Department of Health. (2011) Universal Health care. Retrieved from
http://www.doh.gov.ph/universal-health-care
Department of Health.(2016) Philippine Health Agenda. Retrieved from
http://www.doh.gov.ph/philippine_health_agenda

UNIVERSAL HEALTH CARE AND PHILIPPINE HEALTH AGENDA |NRS 503 PRIMARY HEALTH CARE
Rachelle Joy S. Suba, RN, MSN 2nd year
 Universal Health Care

Philippine health agenda 2016 2022

Health For All- All for Health
ALL FOR HEALTH TOWARDS HEALTH FOR ALL

In partial fulfillment of the requirement of the course

NRS 503- Advanced Primary Health care 1

by

Rachelle Joy S. Suba, RN

MSN 2nd year

Baliuag University

September 2017

UNIVERSAL HEALTH CARE AND PHILIPPINE HEALTH AGENDA |NRS 503 PRIMARY HEALTH CARE
Rachelle Joy S. Suba, RN, MSN 2nd year