Health Care Delivery

System
Ivan N. Tanodra, M.D. RPh
Objectives

 To know the structure of health care

delivery system in the Philippines
 To define primary health care
 To know the levels of health care
 To be aware of the different agencies
that deliver health care
Philippine Healthcare
Delivery System
 Public sector
- financed through a tax-based budgeting
system at both national & local levels
- health care is delivered free at the point of
service
 Private sector
- profit & non-profit providers
- market-oriented, health care is paid
through user fees at point of service
 PUBLIC SECTOR

NATIONAL LOCAL

PGH
LOCAL GOVERNMENT UNITS

DOH
PROVINCIAL GOVERNMENT CITY/MUNICIPAL GOVERNMENT

HEALTH CENTER/
RURAL HEALTH UNITS (RHU)
PROVINCIAL/DISTRICT HOSPITALS BARANGGAY HEALTH STATIONS
(BHS)
Primary Health Care

 Essential health care made universally

accessible to individuals and families in
the community by means acceptable
to them through their full participation
and at a cost that the community and
the country can afford at every stage
of development
Primary Health Care

 Declared during the First International

Conference on Primary Health Care in
Alma Ata, USSR on Sept 6-12, 1978
by WHO
 Goal “Health for All by the Year 2000”
Primary Health Care

 Adopted in the Philippines through

Letter of Instruction 949 signed by
President Marcos on Oct 19, 1979
 Theme “Health in the Hands of the
People by 2020”
Elements/Components of
Primary Health Care
 Environmental Sanitation (adequate
supply of safe water & good waste
disposal)
 Control of Communicable Diseases
 Health Education
 Maternal & Child Health and Family
Planning
Elements/Components of
Primary Health Care
 Adequate Food and Proper Nutrition
 Provision of Medical Care and
Emergency Treatment
 Treatment of Locally Endemic Diseases
 Provision of Essential Drugs
Strategies of Primary
Health Care
 Reorientation/reorganization of the
national health care system with the
establishment of functional support
system
 Effective preparation and enabling
process for health actions at all levels
Strategies of Primary
Health Care
 Mobilization of the people to know
their communities and identifying their
basic health needs with the end in
view of providing solutions leading to
self reliance and self determination
Strategies of Primary
Health Care
 Development & utilization of
appropriate technology focusing on
local indigenous resources available in
and acceptable to the community
 Organization of communities arising
from their expressed needs which they
have decided to address and that this
is continually evolving in pursuit of
their development
Strategies of Primary
Health Care
 Increase opportunities for community
participation in local level planning,
management, monitoring and
evaluation within the context of
regional and national objectives
 Development of intrasectoral linkages
with other government and private
agencies
Strategies of Primary
Health Care
 Emphasizing partnership so that the
health workers and the community
leaders/members view each other as
partners rather than merely provider
and receiver of health care
respectively
Four Pillars of PHC

 Active community participation

 Intra and inter-sectoral linkages
 Use of appropriate technology
 Support mechanism made available
Types of PHC Workers

 Vary in different communities

depending upon:
1. Availability of health manpower
resources
2. Local health needs and problems
3. Political and financial feasibility
Types of PHC Workers
 Village or Baranggay health workers
- trained community health workers,
traditional birth attendants, health auxiliary
volunteer, healer

 Intermediate level health workers

- general medical practitioners, public health
nurses, rural sanitary inspectors, midwives
Levels of Health Care and
Referral System
 Primary level of Care
 Secondary level of Care
 Tertiary level of Care
Levels of Health Care and
Referral System
 Primary level of Care
- devolved to the cities / municipalities
- provided by center physicians, public
health nurses, rural health midwives,
baranggay health workers
- first contact between the community
members and other levels of health
facility
Levels of Health Care and
Referral System
 Secondary level of Care
- given by physicians with basic health
training
- either privately owned/government
operated (infirmaries,
municipal/district/provincial hospital,
OPD)
- referral center for the primary health
facilities
Levels of Health Care and
Referral System
 Secondary level of Care
- capable of performing minor surgeries
and some simple laboratory examination
Levels of Health Care and
Referral System
 Tertiary level of Care
- rendered by specialists in health
facilities including medical centers,
regional and provincial hospitals,
specialized hospitals
- referral center for the secondary care
facilities
- complicated cases/intensive care
 National/Regional
Medical Centers
And Training
Hospitals

Rural Health Unit,

Community Hospitals
Emergency/District Hospitals

Provincial/City Hospital
Baranggay Health Stations
Sentrong Sigla

 1998- DOH embarked Quality

Assurance Program in providing
quality health services
 1999- renamed Sentrong Sigla or
Centers of Vitality Movement (SSM)
 Goal: Quality healthcare services and
facilities
 SS Phase 1
Sentrong Sigla

 2001 – concern for quality health care

into the entire health sector
 SS Phase 2
Guiding Principles of
Sentrong Sigla
 Recognition for achieving good quality
shall be the main incentive in SS
Certification
 Quality improvement is an unending
process, promote the continuing drive
for ever improving quality by providing
higher quality standards
Guiding Principles of
Sentrong Sigla
 Focus shall be on core health
programs that have proven to be most
benificial to the people such as child
health, maternal care and family
planning, prevention & control of
infectious diseases
Guiding Principles of
Sentrong Sigla
 Quality improvement is a partnership
that empowers all stakeholders, and is
based on trust and transparency
 All quality standards and methods
shall be openly shared and discussed
to ensure clear understanding and
strong commitment by all concerned
Guiding Principles for
Sentrong Sigla
 DOH shall give purposive technical
assistance to targeted health facilities
to help them achieve quality
improvement particularly in the
underserved and marginalized areas
 Assessment for certification shall
involve other stakeholders in order to
provide objectivity and varying
perspective in the process
Thank you!