HEALTH CARE DELIVERY SYSTEM (MAGLAYA P.

22)

PUBLIC HEALTH (Dr. C.E.A. Winslow/ Charles Edward Amory Winslow)

- "science and art of preventing disease, prolonging life, promoting health and efficiency through
organized community effort for the sanitation of the environment, control of CD, the education of
individuals in personal hygiene, the organization of medical And nursing services for the early diagnosis
and preventive treatment of diseases, and the development of the social machinery to ensure everyone
a standard of living adequate for the maintenance of health, so organizing these benefits as to enable
every citizen to realize his birthright of health and longevity.”

3 CORE FUNCTIONS OF HCDS:

1. Assessment
- Assessment is the regular collection and analysis of health data. These data are used for
program planning and policy development.
2. Policy development
- Policy development involves advocacy and political action to develop policies in various
levels of decision making.
3. Assurance
- Assurance is making sure that health services are effective, available and accessible to
the people

Related to the core functions of public health are the 10 essential health services:

1. Monitoring health status to identify community health problems

2. Diagnosing and investigating health problems and hazards in the community
3. Informing, educating and empowering people about health issues
4. Mobilizing community partnerships to identify and solve health problems;
5. Developing policies and plans that support individual, family and community efforts;
6. Enforcing laws and regulations that protect health and ensure safety;
7. linking people to needed personal health services and ensuring the provision of health care that
is otherwise unavailable;
8. Ensuring competent public health and personal health care workforce;
9. Evaluating effectiveness, accessibility and quality of personal and population-based health
services; and
10. Researching for new insights and innovative solutions to health problems

HEALTH CARE DELIVERY (White book by cuevas p.19)

1. PRIVATE SECTOR (For profit and non-profit providers)

- Is largely-market oriented and where health care is paid through user fees at the point
of service.
 - Their involvement in maintaining the people’s health is enormous. This includes
providing health services in clinics and hospitals, health insurance, manufacture of
medicines, vaccines, medical supplies, equipment’s and other health and nutrition
products, research and development, human resource dev. and other health-related
services.

2. PUBLIC SECTOR
- is largely financed through a tax-based budgeting system at both national and local
levels and where health care is generally given free at the point of service (although
socialized user fees have been introduced in recent years for certain types of services

PUBLIC SECTOR:

A. Local levels
- Local health system is now run by Local Government Units (LGUS)
- The provincial and district hospital are under the provincial government
- The city/municipal government manages the health centers/ rural health units
(RHUS) and Barangay health stations (BHSS).
 In every province, city of municipality, there is a local health board chaired by the LOCAL CHIEF
EXECUTIVE.
o Its function is mainly to serve as advisory body to the local executive and the sanggunian
or local legislative council on health-related matters.

B. National levels - the DOH is mandated as the lead agency in health.

- It has a regional field office in every region and maintains specialty hospitals,
regional hospitals and medical centers.
- It also maintains provincial health teams made up of DOH representatives to the
local health board and personnel involved in CD control specifically malaria and
schistosomiasis.

 Other national level agencies providing health care services such as the PGH or Philippine
General Hospital are also part of this sector.

Major components of the PHCDS that constitute the context of CHN:

1. DOH
2. HSRA (Health Sector Reform Agenda)
3. F1 (FOURmula 1)
4. MDG/SDG
5. MTPDP (Medium-Term Philippine Development Plan)
 o DOH
 DOH, in its new role as the national authority on health providing technical and
other resource assistance to concerned groups as mandated by Executive order
102
 FUNCTIONS:
1. leadership in health
2. Enabler and capacity builder
3. Administrator of Specific Services
 (its mandate is to develop national plan, technical standards and guidelines on
health)

VISION:

- The DOH is the leader, staunch advocate and model in promoting Health for all in the
Philippines.
- Guarantee equitable, sustainable and quality health for all Filipinos, especially the poor and shall
lead the quest for excellence in health

o HSRA Health Sector Reform Agenda

 GOAL: Health Sector is the overriding goal of DOH (to ensure affordable access
to services of general interest). Support mechanisms will be through sound
organizational development, strong policies, systems and procedures, capable
human resources and adequate financial resources
 FF Reforms:
A. Provide fiscal autonomy to government hospitals
B. Secure funding for priority public health programs
C. Promote the development of local health systems and ensure its
effective performance
D. Strengthen the capacities of health regulatory agencies ( fda, health
care, research agencies, disease control and prevention center
E. Expand the coverage of the National Health Insurance Program

o F1 FOURmula 1
 Is the implementation framework for health sector reforms under the current
administration
 3 GOALS:
1. Better health outcomes
2. More responsive health systems
3. Equitable health care financing
 4 ELEMENTS of the strategy
1. Health financing – the goal of this health reform area is to foster
greater, better and sustained investments in health
 2. Health regulation- the goal is to ensure the quality and affordability of
health goods and services
3. Health service delivery- the goal is to improve and ensure the
accessibility and availability of basic and essential health care in both
public and private facilities and services
4. Good governance- the goal is to enhance health system performance at
the national and local levels.

o MDG/SDG ( Millennium Development Goal/ Sustainable Development Goals)

 According to Sector of Health, F1 is the guiding philosophy and strategic approach of the
DOH
 The concern is to improve people’s health is universal because there is a strong
correlation between health and development
 Poor health is a consequence and cause o poverty and underdevelopment
 Poverty also breeds despair and turmoil
 The UNITED NATIONS spearheaded the formulation of the MDGs. 8 GOALS are:
1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender equality and empower women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria and other diseases
7. Ensure developmental sustainability; and
8. Develop a global partnership for development
 The 17 Sustainable Development Goals (SDGs) are our shared vision of
humanity and a social contract between the world’s leaders and the people “UN
SECRETARY-GENERAL BAN KI-MOON said of the 2030 Agenda for SD adopted
unanimously by 193 Heads of State and other top leaders at a summit at UN
Headquarters in New York in September
  “They are a to-do list for people and planet, and a blueprint for success,” he
added of the 17 goals and 169 targets to wipe out poverty, fight inequality and
tackle climate change over the next 15 years

 The agenda addresses the 3 dimensions of sustainable development

o Social
o Economic
o And environmental
i. As well as important aspects related to peace, justice and
effective institutions.

o MTPDP Medium-Term Philippine Developmental Plan

 Spells out the priority strategies to meet the basic need of the poor
A. To empower the poor and marginalized
B. Push for improved transparency and accountability in governance
C. Fuel the economy
 ( specifically, growth shall be more inclusive by lowering poverty incidence in
the rural areas, more jobs shall be created, making individuals and
communities more resilient, driving innovation and building greater trust in
government and in society)

o NOH ( National Objective for Health)

  Is an important document that reflects the MDGs/SDGs, MTPDP, HSRA and F1 to
bring the health sector to its desired outcome.
 OBJECTIVES OF HEALTH SECTOR (NOH) by Cuevas, et al p. 27:
A. Improve general health status of the population
B. Reduce morbidity and mortality from certain diseases
C. Eliminate certain diseases as public health problems
D. Promote healthy lifestyle and environmental health
E. Protect vulnerable groups with special health and nutrition needs

o CLASSIFICATIONS OF HEALTH FACILITIES

 Category A. Primary Care Facility
 A first contact health care facility that offers basic services
including emergency services and provision for normal
deliveries. E.g. health centers, infirmaries and birth lying-in
facilities.
 Category B. Custodial Care Facility
 Provides long term care, including food and shelter to clients.
With chronic conditions requiring ongoing health and nursing
care due to impairment or reduced degree of independence in
activities of daily living and clients in need of rehabilitation. E.g.
Custodial psychiatric facilities, drug abuse treatment and rehab
centers, leprosaria/ sanitaria and nursing homes.
 Category C. Diagnostic/ Therapeutic Facility
 Facility for the examination of human body, specimens from
the human body for the diagnosis, sometimes treatment of
disease, or water for drinking water analysis. Test covers
analysis of specimens. E.g. laboratories, radiologic facility (X-ray,
CT scan, mammography, MRI, Utrasound, etc.), Nuclear facility
(Nuclear radioactive materials in diagnosis, treatment or
research.
 Category D. Specialized Outpatient Facility
 Performs highly specialized procedures on an outpatient basis.
E.g. Dialysis clinic, ambulatory surgical clinic, chemotherapeutic
clinics/ center, cancer radiation facility, Physical medicine and
rehabilitation clinic (PT).