Philippine Health System: Carl A. T. Antonio

COLLEGE OF PUBLIC HEALTH UNIVERSITY OF THE PHILIPPINES MANILA
SEAMEO-TropMed Regional Centre for Public Health, Hospital Administration, Environmental and Occupational Health
HPAd 201 Session 2-3:
Philippine Health System
Carl A. T. Antonio, MD, MPH
Assistant Professor
Department of Health Policy & Administration
<ctantoniomd@gmail.com>
Session Objectives
At the end of this session, the graduate student
should be able to:
1. define a health system
2. identify the goals and functions of a health
system
3. describe the Philippine health system
2
HPAd 201 || 02: PHL Health System || CT Antonio || 18 Nov 2013
Presentation Outline
1. Definition of a health system
2. Goals and functions of a health system
Overarching principle: Primary health care
WHO Health Systems Framework
Millennium development goals
3. The Philippine health system: Current scenario
Structure/Organization
Snapshot: Health indicators
3
What does it take to raise a child?
4
Image from link.
HPAd 201 Session 2: Philippine Health System
5
What is a health system?
[A]ll the organizations, institutions
and resources that are devoted to
producing health actions.

6
A health action is defined as any effort, whether
in personal health care, public health services or
through intersectoral initiatives, whose primary
purpose is to improve health.
WHO. The World health report 2000 : health systems : improving performance [Internet]. Geneva: World Health Organization; 2000 [cited 17 Nov 2013]. 206 p. Link.
7
Fundamental tenets of Alma-Ata
Health is a
fundamental
human right
Gross inequalities
in health are
unacceptable
Peoples
participation
PHC: Appropriate,
Acceptable,
Accessible,
Affordable
Efficient use of
resources
8
WHO. Declaration of Alma-Ata. International Conference on Primary Health Care, Alma-Ata, USSR, 6-12 September 1978 [Internet]. Geneva: World Health Organization; 1978
[cited 17 Nov 2013]. Link.
WHO. WHO called to return to the Declaration of Alma-Ata [Internet]. 2013 [cited 17 Nov 2013]. Link.
Alma-Ata 30 years hence
Current trends in health systems PHC reforms
9
WHO. The world health report 2008: Primary health care now more than ever [Internet]. Geneva: World Health Organization; 2008 [cited 17 Nov 2013]. Link.
10
WHO Health Systems Framework
11
WHO. Everybodys business: Strengthening health systems to improve health outcomes [Internet]. Geneva: World Health Organization; 2007 [cited 17 Nov 2013]. Link.
Measuring outcomes: MDGs
12
Image from link.
GOAL 1:
ERADICATE EXTREME
POVERTY & HUNGER
Target 1.A:
Halve, between 1990 and 2015, the
proportion of people whose income is
less than $1.25 a day

Target 1.B:
Achieve full and productive employment
and decent work for all, including
women and young people

Target 1.C:
Halve, between 1990 and 2015, the
proportion of people who suffer from
hunger
13
Image from link.
GOAL 2:
ACHIEVE UNIVERSAL PRIMARY
EDUCATION
Target 2.A:
Ensure that, by 2015, children
everywhere, boys and girls alike, will be
able to complete a full course of primary
schooling
14
Image from link.
GOAL 3:
PROMOTE GENDER EQUALITY
AND EMPOWER WOMEN
Target 3.A:
Eliminate gender disparity in primary
and secondary education, preferably by
2005, and in all levels of education no
later than 2015
15
Image from link.
GOAL 4:
REDUCE CHILD MORTALITY
Target 4.A:
Reduce by two thirds, between 1990
and 2015, the under-five mortality rate
16
Image from link.
GOAL 5:
IMPROVE MATERNAL HEALTH
Target 5.A:
Reduce by three quarters the maternal
mortality ratio

Target 5.B:
Achieve universal access to
reproductive health
17
Image from link.
GOAL 6:
COMBAT HIV/AIDS, MALARIA
AND OTHER DISEASES
Target 6.A:
Have halted by 2015 and begun to
reverse the spread of HIV/AIDS

Target 6.B:
Achieve, by 2010, universal access to
treatment for HIV/AIDS for all those who
need it

Target 6.C:
Have halted by 2015 and begun to
reverse the incidence of malaria and
other major diseases
18
Image from link.
GOAL 7:
ENSURE ENVIRONMENTAL
SUSTAINABILITY
Target 7.A:
Integrate the principles of sustainable
development into country policies and
programmes and reverse the loss of
environmental resources

Target 7.B:
Reduce biodiversity loss, achieving, by
2010, a significant reduction in the rate
of loss

Target 7.C:
Halve, by 2015, the proportion of the
population without sustainable access to
safe drinking water and basic sanitation

Target 7.D:
Achieve, by 2020, a significant
improvement in the lives of at least 100
million slum dwellers
19
Image from link.
GOAL 8:
DEVELOP A GLOBAL
PARTNERSHIP FOR
DEVELOPMENT
Target 8.A:
Develop further an open, rule-based, predictable,
non-discriminatory trading and financial system

Target 8.B:
Address the special needs of least developed
countries

Target 8.C:
Address the special needs of landlocked
developing countries and small island developing
States

Target 8.D:
Deal comprehensively with the debt problems of
developing countries

Target 8.E:
In cooperation with pharmaceutical companies,
provide access to affordable essential drugs in
developing countries

Target 8.F:
In cooperation with the private sector, make
available benefits of new technologies, especially
information and communications
20
Image from link.
21
Health outcomes:
MDGs
The MDG Watch is compiled by the
National Statistical Coordination Board
as the official repository of MDG
indicators in the Philippines per NSCB
Resolution No. 10-2004
22
http://www.nscb.gov.ph/stats/mdg/mdg_watch.asp
Framework: Aquino Health Agenda
(Kalusugang Pangkalahatan)
23
Ona ET. The Aquino Health Agenda: Universal Health Care for All Filipinos [PowerPoint presentation]. c 2011.
L
O
C
A
L

G
O
V
E
R
N
M
E
N
T

N
A
T
I
O
N
A
L

G
O
V
E
R
N
M
E
N
T

Structure
Department of Health
DOH-retained hospitals
Centers for Health
Development
City Health Offices
Local hospitals Health centers
Provincial Health
Offices
Municipal Health
Offices
Rural Health
Units
Barangay health
stations
Local hospitals
Local hospitals
Attached agencies
Technical and Administrative
Offices
24
Health Financing
25
SOURCES OF FINANCING
1. Government (National& Local)
2. Insurance (Government & Private)
3. User fees
4. Donors
2011-2016 National Objectives for Health, Health Sector Reform Agenda Monographs. Manila, Republic of the Philippines Department of Health, 2011 (DOH HSRA Monograph No. 12)
Total health expenditure, by source,
Philippines, 2009-2011
11%
11%
12%
15%
15%
15%
8%
9%
9%
53%
53%
53%
10%
10%
10%
2%
2%
1%
0% 20% 40% 60% 80% 100%
2009
2010
2011
Y
e
a
r

NGA LGU PHIC OOP Other Pvt Others
26
NOTES: 1. Social Insurance consist of both the National Health Insurance Program and Employees Compensation. 2. Other private sources include private insurance, health
maintenance organizations, private establishments, and private schools. 3. Other sources include those derived from grnats. NGA, National Government; LGU, Local
Government; PHIC, Social Insurance; OOP, Out-of-pocket.
National Statistical Coordination Board. Philippine National Health Accounts [Internet]. 06 Jun 2013
[cited 17 Nov 2013]. Link.
Budget appropriations for the
Department of Health, 1991-2012
0.E+00
5.E+09
1.E+10
2.E+10
2.E+10
3.E+10
3.E+10
4.E+10
4.E+10
5.E+10
1
9
9
1

1
9
9
2

1
9
9
3

1
9
9
4

1
9
9
5

1
9
9
6

1
9
9
7

1
9
9
8

1
9
9
9

2
0
0
0

2
0
0
1

2
0
0
2

2
0
0
3

2
0
0
4

2
0
0
5

2
0
0
6

2
0
0
7

2
0
0
8

2
0
0
9

2
0
1
0

2
0
1
1

2
0
1
2

A
m
o
u
n
t

(
b
i
l
l
i
o
n

p
e
s
o
s
)

Year
PS
MOOE
CO
Total
27
DOH Budget [Internet]. C 2012 [cited 17 Nov 2013] Link.
Health expenditure as % of GDP, 2000 and 2010
28
Health sector budget: An analysis [Internet]. Budget Facts & Figures, vol. 1, no. 2. Pasay City: Legislative Budget research and Monitoring Office; 2013 Apr-Jun [cited 17 Nov
2013]. Link.
Distribution of out-of-pocket expenditure by
components and socio-economic status (%),
Philippines, 2000-2009
29
Health Facilities
Number of hospitals by
classification and ownership,
Philippines, 2009
Number of RHU and BHS,
Philippines, 2005
30
Human Resources for Health
Number of health professionals in the public sector, by region, Philippines, 2008
31
Summary
Health system: all organizations, people and actions
whose primary intent is to promote, restore or
maintain health
Goals of the health system:
Overall health system goals: improving health and
health equity, in ways that are responsive, financially
fair, and make the best, or most efficient, use of
available resources
Intermediate goals: Greater access to and coverage
for effective health interventions, without
compromising efforts to ensure provider quality and
safety.
32
Summary
Functions: to provide services; develop health
workers and other key resources; mobilize and
allocate finances, and ensure health system
leadership and governance
Philippine health system:
Sec. Ona: Inequity is a pervasive problem in our
country and it is more pronounced in the health
sector. We are now pursuing the goal of
Kalusugan Pangkalahatan (KP) or universal
health care to overcome inequities in our health
system and deliver better health outcomes.
33

Philippine Health System: Carl A. T. Antonio

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Philippine Health System: Carl A. T. Antonio

Uploaded by

Copyright:

Available Formats

COLLEGE OF PUBLIC HEALTH UNIVERSITY OF THE PHILIPPINES MANILA

You might also like