Professional Documents
Culture Documents
CITY-WIDE INVESTMENT
PLAN FOR HEALTH
2011-2015
Prepared by the
Manuscript prepared by Dr. Portia F. Marcelo and Dr. Carl Abelardo T. Antonio for the Pasay City Urban Health Systems
Development Project Technical Working Group.
The content of this paper is a synthesis of data gathered from reports, meetings and workshops of the Pasay City Urban Health
Systems Development Project Technical Working Group.
In addition to the resource persons cited in page vii, inputs and guidance provided by the following facilitators/consultants during
the various workshops and meetings is also acknowledged: Rosalinda S. Guerrero (Bureau of Local Health Development,
Department of Health), Teresita C. Guzman (Bureau of Local Health Development, Department of Health), Rosalie Espeleta
(Center for Health Development Metro Manila), Dr. Bernardino M. Aldaba (UP Econ Foundation, Inc.), Dr. Katherine
Villegas (public policy consultant), Dr. Portia F. Marcelo (UP College of Medicine), and Dr. Edelina P. dela Paz (UP College
of Medicine). Likewise, the team would like to acknowledge the invaluable assistance provided by Maria Gilda N.
Resurreccion (Department of Health Bureau of Local Health Development consultant) in the preparation of the cost tables.
Published and printed by the City Government of Pasay, Metro Manila, Philippines through a grant from the Department of
Health Center for Health DevelopmentMetro Manila.
Suggested citation (NLM):
Pasay City Urban Health Systems Development Project Technical Working Group. City-wide
Investment Plan for Health 2010-2015, Pasay City, Metro Manila. Pasay City, Philippines: City
Government of Pasay; 2010. 41 p. Supported by the Department of Health Center for Health
DevelopmentMetro Manila.
ii
Table of Contents
Table of Contents
iii
Acronyms
iv
vii
Executive Summary
I. Introduction
IV. Goals, Performance Levels, Major Gaps, Intermediate and Reform Objectives
21
31
41
iii
Acronyms
AFGH
BEmONC
BHW
BNS
CBMS
CBO
CBR
CEmONC
CIPH
CHB
CHO
CPDO
CPR
CSWD
DOH
DOH CHD-MM
DOTS
FHSIS
FNRI
HUDCC
IMCI
IMR
LBW
LGU
LHA
MAMC
ME3
MITS
MMR
NDHS
NMR
NTP
PCGH
PCNPC
PhilHealth
PNRC
SJDEFI
SP
TB
U5MR
UHSDP-TWG
UPCM
Urban HEART
WHO
iv
SECRETARIAT
CESAR F. ENCINARES, MD, MPH
City Health Officer III
EMMA HERNANDO, RN
Nurse V
Center for Health DevelopmentMetro Manila
MARIA A. ALVARADO
CONCEPCION C. DAPLAS
JULITA B. CAYANAN
City Treasurer
REYNALDO S. DIZON, MD
JAIME R. SY, MD
MIRLA SEVERINO, MD
BIBLY L. MACAYA, MD
Medical Director
San Juan de Dios Education Foundation, Inc. (Hospital)
Medical Director
Manila Adventist Medical Center
MILAGROS B. OLPOC
Commanding Officer
Air Force General Hospital
President
Pasay City Barangay Health Workers Federation, Inc.
SECRETARIAT
CESAR F. ENCINARES, MD, MPH
City Health Officer III
MARIA A. ALVARADO
Planning Officer III
City Planning and Development Office
MYRIAM A. BALTAZAR
City Treasurer
ROSALINDA ORUBIA
CHRISTINA ESHMAWI
REYNALDO S. DIZON, MD
JAIME R. SY, MD
MIRLA SEVERINO, MD
BIBLY L. MACAYA, MD
Medical Director
San Juan de Dios Education Foundation, Inc. (Hospital)
Medical Director
Manila Adventist Medical Center
MILAGROS B. OLPOC
Commanding Officer
Air Force General Hospital
President
Pasay City Barangay Health Workers Federation, Inc.
vi
Nutrition Officer I
Francisca Arabes
Nurse II
Ronel U. Arellano
SO II
Melinda B. Bocobo
Nurse V
Medical Officer IV
Delia Camacho
President
Teresita M. Castillo
Josefito S. Castro
Officer-in-Charge
Medical Officer IV
Medical Officer IV
Medical Officer IV
Cristina Eshmawi
Officer-in-Charge
Claire Flores
Administrative Staff
Olivia M. Gamboa
Nurse V
Medical Officer IV
Teresita G. Hilario
Grace Ignacio
President
Nurse II
Medical Officer IV
Hermicita P. Llagas
Midwife IV
William Q. Logro
Sanitary Inspector I
Administrative Staff
Noraida F. Magat
Nurse II
Adoracion F. Manuit
Medical Officer IV
Judy M. Meceda
Nurse
Ricky Murillo
Traffic Enforcer
Milagros G. Olpoc
President
Rosendo Pantino
Lilia T. Parajas
Nurse
Marlene Polero
Planning Officer II
Medical Officer IV
Virginia Reye
Medical Officer IV
Nurse IV
Merisa Santos
Randy G. Pahn
Arnel Ubalde
Administrative Officer II
Nurse
Ernesto G. Vizcarra
Assistant Treasurer
Treasurers Office
vii
DEVELOPMENT THRUST
*Maximize tourism potentials
*Enhance the citys image
*Promote multi-sectoral partnership
*Upgrade infrastructure and utility system
*Support business and commercial activities
*Promote welfare of citys residents
*Raise the level of LGU services
*Increase the LGU revenue
viii
CITY-WIDE INVESTMENT
PLAN FOR HEALTH
2011-2015
Executive Summary
PASAY CITY IS A FAST-RISING URBAN CITY in Metro Manila, Philippines with a population of 403,551 as
of 2008. The Pasay City Health Office touts of numerous annual awards and recognition in health. Priority national
programs are localized, and delivered with efficiency in 13 accessible, strategically-placed government health
centers by (almost) a full complement of competent personnel. It has been an active collaborator of the Department
of Health with various development partners and the academe in innovating solutions to public health problems.
Yet despite these, major health concerns remain; priorities of which are maternal and child health and
tuberculosis. Pasay has a high infant mortality rate (IMR), the highest among four South Sector cities (Las Pias,
Muntinlupa and Paraaque). While chronic lifestyle diseases are already among the major causes of deaths in
Pasay, their epidemiology in the City and, thus, management have yet to be understood better. These concerns
become more stark in the light that the poor and marginally poor form the bulk of the clientele who are served by
the government health facilities.
This report presents a city-wide situational analysis of health and its social determinants, comparing Pasay
Citys 2008 achievements with national targets and regional averages. It presents, as well the five-year City-wide
Investment Plan for Health (CIPH, or Plan) to address these priority concerns and strengthening even more
public health advocacies. Health system issues need to be addressed immediately, i.e. more health personnel and
better staff management systems, and more health facilities. Better health financing schemes have to be set up
especially targeting the true poor and exhausting means to maximize the promised benefits of PhilHealth. While
there is a wealth of experience and information that can point to more efficient approaches, evaluation and research
have not been maximized; health information management must be enhanced. The CIPH development process
underscored the need for continued interagency collaboration; this has to be institutionalized. Measures to engage
communities, especially through community-based organizations, have to be strengthened.
The Pasay CIPH was developed using collaborative strategies, and formalized through Executive Order No.1,
s. 2010. It brought together policy makers, heads of national and local agencies working within the City, leaders of
both public and private sectors in health across all levels of care, other service providers and the community in the
spirit of dialogue to analyze and plan (and eventually implement, evaluate together) projects and programs that aim
to improve further health outcomes.
Plan management is enshrined in the Pasay City Health Board, with the support of the Sangguniang
Panglungsod. The Urban Health Systems Development Project Technical Working Group (TWG on the CIPH),
especially constituted for the CIPH, acts as its secretariat and implementing arm. The five-year CIPH costs a total
of Php660,008,907.00; the government of Pasay will fund 50.2% (or Php331,174,662.00). For the first year of
implementation, investments needed amount to Php125,354,021.90; the City government will fund
Php98,485,914.67 (or 78.57% of total), requested from the Department of Health (DOH) is Php20,208,822.23
(or 16.12% of total costs). Other parties will be asked to support Php6,659,285.00 (or 5.31% of total costs). This
includes the Php5-million grant for each year for the next five years intended for as augmentation for underscored
priority health services (39%), health system governance (29%), health regulation (12%), and financing (6%), as
well as support to address health's social determinants (14%).
The commitment and talents of the Pasay City government, especially its health sector, have been proven to
persevere despite the challenges inherent to the public sector and in the face of rapid urbanization. Efficiency and
effectiveness are shared values among all stakeholders towards self-reliant, healthy and morally upright
Pasayeos. The development and implementation of this CIPH under the new leadership of Pasay City is
committed to operationalize this mission.
I. Introduction
THE CITY-WIDE INVESTMENT PLAN FOR HEALTH (CIPH) is a key approach embarked on
nationwide by the Department of Health (DOH) for health sector reform. It aims to establish a more
responsive health system, and more equitable health care financing as requisites to achieve better health
outcomes. In Pasay, the CIPH contributes to the over-all Vision of the City a dynamic and efficient
local leadership and home to self-reliant, healthy and morally upright people.
The Pasay CIPH was developed in collaborative processes. It brought together policy makers,
heads of national and local agencies working within the City, leaders of both public and private sectors
in health across all levels of care, other service providers and the community in the spirit of dialogue to
analyze and plan (and eventually implement, evaluate together) projects and programs that aim to
improve further health outcomes. Efficiency and equity are shared values. (See full list of resource
persons in page vii.)
The development of the Pasay CIPH began towards the last quarter of 2009 when the DOH Center
for Health Development Metro Manila (DOH-CHD-MM), with the World Health Organization
Philippines (WHO), conducted an orientation workshop.
presented to, and approved by, Hon. Wenceslao B. Trinidad, the immediate-past City Mayor, during
the City Health Office Strategic Assessment and Planning Workshop. Executive Order No.1 s2010 was
passed defining the CIPH and creating the Urban Health Systems Development Technical Working
Group (TWG on the CIPH) as the steering committee, with the City Health Office (CHO) as lead
agency. A Situational Analysis of Pasay was developed using prescribed tools and available databases.
Information was also sourced from a multisectoral workshop held in November 2009 to identify the
social determinants contributory to the health problems identified. A series of inter-agency workshops
were held for the same purpose as well as to identify medium-term goals, critical interventions to attain
these goals within the five-year time frame of the project, and specific costs thereof (see textbox
below).
With the reorganization in leadership following the 2010 National and Local Elections, the Pasay
City Health Office (and TWG on CIPH) convened a meeting with Hon. Antonino G. Calixto (City
Mayor), Hon. Imelda Calixtro-Rubiano (Representative of the Lone District of Pasay) and newly
appointed key department heads on July 2010. The CIPH rationale and its current status of
development were presented. The Executive Order was thus updated.
Sources of Data / Tools Used for the Pasay City Situational Analysis and CIPH
The Urban Health Equity Assessment and Response
Tool (Urban HEART) for Pasay City (2008)
The Local Government Unit (LGU) Scorecard for Pasay
City (2008)
Various Pasay government department annual reports
(2008)
Pasay Community-based Monitoring System (CBMS),
Pasay City Health Office Databases:
Field Health Service Information System (FHSIS), 2008
THE CITY OF PASAY is located along the western coast of the National Capital Region (Metro
Manila), with a total land area of 18.50 square kilometers. Only 34.25% is devoted to residential use,
however; the rest is government and commercial land. The 2008 projected population of Pasay is
403,155 (2000 National Census; growth rate at 1.77), with a population density of 21,792 persons per
square kilometer among the densest and most congested in the Region. Pasay is a city of mostly
young people (median age is 21 years old); females outnumber males (sex ratio of 97 males for every
100 females). Dependency ratio is 53; every 100 persons in the productive age-group need to support
49 young and four older persons. Known as the Premiere Gateway to the Philippines, the City hosts
major terminals of all transport types national and domestic airports, sea ferry boats, and bus and
light train terminals.
The massive movement of persons, population growth (albeit slightly below the Regional growth
rate), rapid urbanization and its consequent pressures on the land have contributed to health and social
problems in Pasay City. This lends proof, to and is a reflection of, a global concern on the health of
urban populations, and especially among the poor (refer to Table 1).
Pasay City is known for its shopping-trade and entertainment-tourist district. In 2008, there were
107,790 income earners listed. Up to 75% of these are employed in the retail/general merchandising
industries, as well as rest-and-recreational business services, reflecting the nature of the City. The
average family income is Php 25,000 (projected from Pasay City Community Based Monitoring
System, CBMS, 2005). The employment rate is 85.53 % (conversely, unemployment rate is 14.47%).
The employment rate, however, does not fully reflect the contractual nature and lack of tenure of a
sizeable portion of the working class. Likewise, data on the underemployed and the informal sector is
also not readily available.
In the year 2000, the Housing and Urban Development Coordinating Council (HUDCC) reported
that 73.4% or 57,436 of households in Pasay City are considered informal settlers; many have since
been relocated to settlement sites outside the City. The City Planning and Development Office
(CPDO), based on the CBMS 2008, reports that housing ownership is a high 95.53%. This information,
however, belies the fact that slums and informal settlers* still abound especially along the Estero de
Tripa de Gallina and Maricaban Creek, two major waterways in the City.
Whereas the working class, as well as the affluent, of the City typically avail of health services in
the private sector, the poor and the informal sector form the bulk of the clientele of the government
health facilities. Various agencies define the City's urban poor, all essentially based on the annual
household income: first, based on the CBMS 2008 managed by the City Planning and Development
Office (CPDO), 7,965 (or 13.72%) of households have incomes below the poverty threshold. In 2008
the City Social Welfare and Development Office (CSWD) enrolled another 1,578 indigent households
in the national government's conditional cash transfer program for the poor (otherwise known as the
4Ps program Pantawid Pamilyang Pilipino Program). On another hand, the CSWD and City Health
Office (CHO) identified 13,333 households as indigents eligible to be sponsored by the local
government for the PhilHealth sa Masa Program (CHO, 2008). Similarly, the Pasay City General
The definition used for home ownership is problematic in both the City's CBMS and Urban HEART; many of informal settlers appear not to be
included, even if a significant number have become legitimate voters and have lived in the City for more than a decade. Excluded among
these informal settlers are those who live in dangerous areas but whose household income is beyond the NSCB-prescribed poverty line.
PhilHealth sa Masa (or PhilHealth) program is the Sponsored Program for Indigents under the National Health Insurance Program managed
by the Philippine Health Insurance Corporation
*
Hospital (PCGH) catered to a significant amount of service patients (also considered indigents), 76% of
the total admitted in 2008. Fifty-six of the 201 barangays in Pasay City house urban poor areas, with
the most number found in the catchment areas of Leveriza [9 barangays], San Isidro [8], San Roque
[7], and San Pablo [6] Health Centers. In terms of population, the urban poor are mostly found in
barangays served by the following health centers: San Pablo [18,843 people], San Isidro [12,568], MIA
[11,749], Doa Nena [11,196], and Leveriza [10,481].
While 100% of the households are served by the City solid waste management system i.e.,
garbage collection, construction and utilization of materials recovery facilities, and informationeducation campaign services improper dumping of solid waste into the City's waterways remains a
problem. This and direct encroachment by slum dwellers have thus led to flooding in the City, not
uncommon during the rainy days. This is aggravated further by the natural physiography * of Pasay, and
the inadequate capacity and poor maintenance of the drainage facilities.
The poor, because of the light materials for their homes and their precarious location along creeks
are often victims of floods. Their use of candles or gasoline lamps, with light materials for their
houses, makes them at highest risk to fires; their location in the highly congested residential areas of
Pasay and narrow streets make fire fighting difficult. Nearby, more established neighborhoods are also
at risk by mere proximity.
Road traffic injuries (at 0.34% in 2008), especially motorcycle crashes are numerous. The rate is
already below the national target, however. While Pasay hosts major thoroughfares, the documented
number of vehicular crashes is low. Incidence of crimes in Pasay City in 2008 is at 4%, ten-fold lower
than the national benchmark of 42% of reported crimes. Underreporting, especially for minor injuries
and petty crimes, however, is not discounted. Noteworthy is that one in four emergency room
consults at the PCGH is trauma-related injuries both intentional and unintentional.
Pasay City boasts of at least 93,655 students in 206 schools (pre-school to university levels) as
well as vocational-technical learning institutions in the public and private sectors; its literacy rate, a
high 91.39%. These, however, are contrasted to the low elementary school completion rate of 62.7%;
only about six students who would enter Grade 1 would be able to finish primary school. This is lower
than the national target of 78%. Also, one in 100 students will be unable to complete the academic year
(or a dropout rate of 1.10%). This worrisome attrition contributes negatively to the health and social
fabric of the City; in by itself, it should be addressed.
Pasay City generates up to 45.33% of its budget. The local government spends at least 49% of its
budget for health and social services, slightly above the national target of 40%. However, personnel
services take up a major portion of this allotment. For instance, 70% of the total budget for the City
Health Office (CHO) is earmarked for the health staff. While investments in personnel central to the
delivery of health services is very important, it is always a challenge to meet the health needs of the
City with the remaining small budget for operations.
Pasay City lies within the Manila Bay Watershed area. Rain water from other cities in Metro Manila courses through the City and naturally
drains into the Manila Bay.
*
Table 1. Non-health indicators (Urban HEART Policy Domains 1-4), Pasay City, 2008
Indicator
National
Baseline
2006
National
2010
Target
Regional
Average
2008
City 3 Year
Average
(2005-2007)
City
performance
level in 2007
City
Performance
Level in 2008
Analyses (color-coded/symbols)
External Benchmark
National
Regional
Internal
Benchmark
(,,=)
DATA SOURCE
82.80%
100%
SWMO
8%
6%
0.34%
PNP-SPD
72%
78%
61.35%
62.69%
No data
3. Literacy Rate
89.60%
91.39%
1.10%
1. Employment rate
91%
93%
80.20%
85.53%
2. Housing ownership
71%
89%
96.25%
95.53%
28.70%
40%
30.26%
49%
Treasurers Office
81%
89%
96.80%
42.87%
45.33%
CBMS-Pasay/CPDO
47%
42%
3.90%
4%
Pasay Police
DepEd Pasay
HEALTH RESOURCES The Pasay City Health Office (PCHO) provides, with relative efficiency, all the
priority government health services in its 14 primary care facilities. These are all accredited with
PhilHealth for outpatient benefits for indigent patients. The Pasay City General Hospital (PCGH) is a
150-bed hospital providing general adult and pediatric medical, obstetric-gynecology and surgical care.
It is a CEmONC* center and is PhilHealth-accredited. It still lacks equipment for more complex
clinical care, although this is already being addressed by government. There is fast turn-over of the
nursing staff.
The Indigent Sponsored Program of PhilHealth was actually pilot-tested as a concept, in Pasay
through the Health Passport Initiative in 1999; in 2003 the program, dubbed then as PhilHealth Plus,
was recognized as among the Galing Pook Awardees for Good Governance. Yet it was only in 2005
that the City started receiving reimbursements for the outpatient benefits for the sponsored indigent
patients (in 2008, total reimbursements received was Php 3 million for 13 health centers). While in
2008, the Pasay City Government allotted Php8,000,000.00 for the targeted poor, only 75% (10,040 of
13,333) of the targeted indigents were actually sponsored in 2009. To ensure that the enrolment process
is accessible to the poor, the City government instituted two measures: [1] an open, year-long
enrolment period for the City-sponsored program; and [2] made available barangay-based registration
of births and marriages
already significant in number, utilization of the outpatient services in the government primary care
health centers, however, is very low among these indigent members. This situation is notable even in
spite of the DSWD 4P's program which compels indigent families to monthly health care. Only eight
(out of 13) health centers are PhilHealth-accredited for the TB-DOTS package. However, it was only in
this year 2010 that payment was made for just one health center. There is one lying-in, with BemONC
capacities, which receives referred patients from the 13 government health centers where mothers who
have completed their monthly prenatal care up to their 7 th month of pregnancy. The lying-in accounts
for 11% of the City's facility-based delivery, but only a small percentage of those who avail of this
service are PhilHealth members; in 2008, Php 1.3 million was reimbursed for the maternal care
package. In 2008, only 16% (1,615 out of 9,929 patients) of those admitted to the PCGH were
PhilHealth members. Interestingly, charity/indigent or service patients form the bulk (75% or 7,493) of
the PCGH clientele, yet only 48 of these (or 0.5%) were the national government and/or LGU
sponsored indigents. Services utilization by the poor has to be studied better by the City Health Office
in order to maximize LGU's investments and more importantly, make life-saving interventions
accessible to them. Processes for the City to access promised benefits of PhilHealth have been longwinded, PhilHealth policies have even become prohibitive: i.e., difficulties of indigents to comply with
the documentary requirements of PhilHealth because of the attendant costs are a big barrier to timely
enrolment. Poor awareness among the populace about PhilHealth is also a deterrent. The City
government's plan to set up a PhilHealth desk is a step towards better financial management and ensure
better financial access to healthcare for the population.
Following the DOH-prescribed population to health personnel ratios, Pasay is in dire need of
midwives, medical technologists and nutritionists. Each health center attends to an average population
of 31, 555.
The voluntary sector also provides support at the health center and community levels. The
University of the Philippines College of Medicine (UPCM), the Philippine National Red Cross (PNRC)
Pasay City Chapter, at least nine listed community-based non-government organizations (CBOs), and
two peoples organizations (Barangay Health Workers Federation, Inc. and Pasay City Network for the
Protection of Children, PCNPC) are active partners in health in the City. Midwifery, nursing and
medical student-affiliates also contribute to health promotion activities and direct patient care services.
Partners provide financial, technical or logistical support to existing programs and projects.
Comprising the private health sector are 63 single-practitioner medical and 78 dental clinics, six
birthing or lying-in facilities and two tertiary hospitals Manila Sanitarium Medical Center (MAMC)
and San Juan de Dios Educational Foundation, Inc. (Hospital). The latter two has a combined hospitalbed capacity of 380, comprising 72% of the total bed-capacity in Pasay.*
Combined hospital
exclusive breastfeeding, 53%*) are higher than national rates. The administrative data, however, should
be reconsidered in the light of more careful community-based research such as the National
Demographic and Health Survey (NDHS), where the methodology uses a 24-hour recall period. An
increasing trend of undernutrition among the 0-71 month preschool children was observed from 2.2%
below normal low and below normal, very low weight-for-age in 2004 to 3.7% in 2007. However, a
decrease was noted in 2008 with a prevalence rate of 2.71% (2.6% among those under five years of
age). Data was collected by Barangay Nutrition Scholars (BNS) during their quarterly Operation
Timbang. This is considered low compared to the national data of 27% (FNRI Survey 2003). In the
light of the magnitude of urban poverty in the City, this data should be reconsidered.
In 2008, the crude birth rate (CBR) registered at 18/1,000 population; a daily average of 20 births
per day, or an addition of one baby to the population every hour and a half. Of the 7,493 live births
recorded, 57% (4,271) were children of registered residents of Pasay City. On the average, facilitybased deliveries account for 86% of births attended by trained health professionals. Yet, a significant
percentage of pregnant women are still delivering at home (average of 14% with a range of 11% to
28%). Health center areas with many deliveries handled by traditional birth attendants or private
unlicensed midwives were San Pablo [130 births, 28% of all home-based deliveries], Doa Marta [73,
16%], Kalayaan [62, 13%], and Doa Nena [51, 11%]. These coincide with many of the urban poor
areas in the City. Contraceptive prevalence rate (CPR) is very low at 40.1%, this despite the
commitment of the City to provide the array of family planning methods and commodities.
The factors associated with high IMR-NMR-U5MR warrant not just improving the maternal and
child health care programs but uplifting the socioeconomic conditions as well.
A perusal of Table 2 shows much of the health promotive and disease preventive programs
especially for mothers and children are in place for those who choose to seek care at the government
primary care centers. Consideration thus must be given to social determinants of health. Although
pneumonia care is integral to the Integrated Management of Childhood Illness (IMCI) guidelines
carried out by the health staff, and medications are available in the citys 14 health centers, it appears
that late consultation and diagnosis are culprits in unnecessary deaths among children. This is due, in
part, to lack of knowledge among caregivers on child illnesses as well as maternal care. Poverty (more
than 33,000 households) and the high cost of care especially for hospitalization also are deterrents for
timely consult (only 0.48% of LGU-sponsored indigents were admitted to the PCGH in 2008). A
multisectoral group of partners of the City Health Office confirm this analysis and attribute much of
these unnecessary deaths to social as well as financial exclusion from available services. Poor
education (62% primary school completion rate), high cost of basic food commodities, and poor
employment conspire to make illnesses more difficult to manage. The low prevalence of exclusive
breastfeeding (16% of infants were never breastfed), a practice already shown to substantially reduce
cases of pneumonia and diarrhea among children, is especially worrisome in the light of poor access to
safe water and sanitary toilet facilities. Teen-age pregnancy is on the rise brought about the complex
social conditions of rapid urbanization. This condition presents more psychosocial challenges many
deny and are shamed by the condition, thus seek consult late or even altogether miss out on life-saving
services. (While the City MMR is well within national and regional target, poor health seeking
National rates are 54% and 34% for breastfeeding initiation and exclusive breastfeeding, respectively. (2003 NDHS) The more recent 2008
NDHS shows at two months age, only 50% of mothers breastfeed their infants, at 3-4 months, it is 34% and only 22.6% of mothers breastfeed
their 4-5 months old infants.
The City reports that 99.7% and 97.3% have access to safe water and sanitary toilet facilities, respectively, higher than national rates at 96%
and 81%, respectively. These definitions appear to be problematic, however, since the informal settlers who fetch water in containers from
common faucets are included.
There were 891 and 1260 teen pregnancies, for the years 2007 and 2008, respectively. For the 1 st quarter of 2009 alone, 354 were already
reported.
*
behaviour is noted among a significant fraction of mothers decreasing trends are noted among
mothers who would [1] complete at least four pre-natal and immediate post-partum visits to the health
center, [2] complete at least two doses of anti-tetanus vaccine during their pre-natal care visits; and [3]
be given Vitamin A during their post-partum visit.) The analysis by the stakeholders remain intuitive;
the City will benefit from more care study especially looking into the possible relationship of teenpregnancy, economic and educational status, and newborn/infant deaths.
Prematurity among newborns, on the other hand, can be attributed to gaps in care for pregnant
women before during, and the immediate period after childbirth services under the domain of both
the City Health Office and its lone referral hospital, the Pasay City General Hospital. Special emphasis
has to be made on access to prenatal care services, during which infections (i.e. asymptomatic
bacteriuria) that are known to cause prematurity are detected and addressed appropriately. Medical
technologists shuffle between two or three health centers*, thus it happens that mothers who seek care
in one health center are asked to come back another day when the laboratory is in operation. This
presents a barrier to patient care patients can be and are lost in this system that requires repeated
follow-up. The midwife to population ratio is also below the ideal (1:7889, or one midwife doing 150%
of work s/he was hired for); thus, community outreach activities are also limited. While the City
Health Office has partnerships with CBOs, these have yet to be maximized and focused to converge on
truly problematic areas. A lasting solution to housing for informal settlers, who are recognized voters
of the City, has yet to be found.
For those who have severe pneumonia and are brought to the PCGH, while intensive care units are
available, it has limited beds for this service; furthermore, there are no respirators nor incubators (these
are rented from external companies). The high cost of care, the limited benefits of PhilHealth are real
barriers. The governments low investment in health cannot allow full subsidy for hospitalization and
medications for this type of patients. Of the 3% of budget allocated for the city health department and
6% for the PCGH, only about 30% is allotted for its operations; budget utilization is always only up to
85% of its allocation, limiting further funds that should be made available for community outreach
activities, and medical equipment and technologies.
Non-facility-based delivery (i.e. home deliveries) in the context of other social deterrents, also
appear to contribute to the burden of infant deaths in the city, as can be gleaned from a comparison of
the infant mortality rate per health center area to the proportion of facility-based deliveries and skilledattendance at birth in the same districts. In 2008, for instance, San Pablo Health Center registered the
highest IMR at 26 deaths per 1,000 livebirths, while posting only 74.8% facility-based deliveries. Doa
Marta Health Center, on the other hand, had an IMR of 12 per 1,000 livebirths, facility-based delivery
at 70.4%, and skilled attendance at birth of 85.3%. Provision of immediate and appropriate care to the
newborn, especially if premature, is a key issue, highlighting the need for additional facilities to cater
to the needs of mothers and their newborns. The remaining health center areas, while with high IMRs,
also had high rates of facility-based deliveries and skilled attendance at birth, which may point to other
causes of infant deaths. Interestingly, the area served by Doa Marta Health Center is also the district
nearest the Doa Marta Lying-in, a PhilHealth-accredited basic emergency obstetric and newborn care
(BEmONC) facility. Financial access (a normal delivery for non-PhilHealth members would cost
Php1,200 plus Php550 for newborn screening) and social access previously described are presumed
reasons. While 75% of the targeted indigents have been enrolled by the LGU in PhilHealth, only 18%
of these utilize services available to them.
Medical technologist to population ratio is currently 1:45,580; the City has only 9 medical technologists serving 13 primary care facilities.
10
TUBERCULOSIS. Tuberculosis (TB) poses a similar concern; it is as much a medical as well as social
disease, where social determinants play significant roles in its diagnosis and management. Thus, TB
control strongly warrants immediate social interventions.
percentage of defaulters (11% and 8% in 2007 and 2008, respectively), which reflect, in part the
transient nature of a significant portion of the City population. The high morbidity and mortality rates
in the City need to be evaluated further through better epidemiological analysis for even more targeted
solutions. For instance, while anecdotal, many of the TB patients are pedicab drivers organized into
some form of association. This offers an opportunity for better engagement so that patients complete
their treatment: psychosocial support for TB patients need to be intensified. Community-based
advocacy needs to be strengthened. PhilHealth for TB care is a health system as well as a patient
enabler. Yet, among TB patients, only a small fraction are PhilHealth members, as evidenced by the
small TB-DOTS* reimbursement received by the City Health Office this year. Two existing TB-DOTS
clinics in the two major private hospitals San Juan de Dios Educational Foundation, Inc. (Hospital)
and Manila Adventist Medical Center have yet to be PhilHealth-accredited. While much of the
elements of the National Tuberculosis Control Program (NTP) are in place, health system
improvements should include addition of health personnel, provision of appropriate equipment for
diagnosis and medicines (especially, more timely delivery of Regimen I and II anti-TB drugs for adults
and PPD for pediatric patients from the national government), construction of five more TB-DOTS
facilities and maintenance of existing ones, further maintenance of a sound referral system.
Community engagement as well as public-private partnerships has to be intensified.
CHRONIC LIFESTYLE DISEASES. Diabetes mellitus, cardiovascular disease and, to a lesser degree, cancer
are fast rising as leading causes of mortality in the city. They account for six out of the top 10 causes of
death in the City, four of which are cardiovascular-related.
From a primary care vantage point, however, the emphasis of service delivery is prevention of
onset of these lifestyle diseases through promotion of healthy lifestyle through vigorous lay education
campaigns. The government primary care centers provide limited diagnostic and therapeutic support
for patients. Laboratories in these health centers are incapable of providing blood chemistry analysis,
electrocardiograms and chest radiographs. Patients are thus referred to the PCGH for these procedures,
a ripe setting for losing patients.
hypertensives and metoprolol, which are given in limited quantities to patients who persevere seeking
care in the centers. The morbidity profile culled, thus, does not reflect these chronic lifestyle diseases;
hence, the basis for strengthening primary care services towards this direction is not established.
Community surveys would help provide better evidence. It has become apparent that there is a need to
scale up services, considering that primary care facilities are the first point of contact of these patients
with the healthcare system. National protocols/guidelines and support, unlike those for more traditional
maternal-child care and TB, is glaring in their absence.
PCGH, on the other hand, has cardiovascular diseases and diabetes mellitus among its top causes
of both outpatient consults, and complications thereof, as cause for in-patient admissions; hypertensive
emergencies is the top eight reason for emergency consult. While Pasay is a city of youth (median age,
21 years), the middle-age and elderly population is considerable (21.52%) at highest risk for these
diseases.
Similar to discussions on the barriers to management of severe pneumonia requiring hospital care,
above, government does not, as of the moment, fully subsidize the cost of care for patients with chronic
*
11
lifestyle diseases. This has thus led to much delayed consult where end-organ damage has set in
warranting more expensive emergency and in-patient care. Treatment of these conditions, at the current
level of government spending for health, may not be an option in the near-future, as diabetes and
cardiovascular diseases require long-term maintenance therapy. The costs per patient can be
considerable; careful study must be made for win-win solutions and how the government of Pasay can
actualize universal health care.
HIV-AIDS AND CONTROL OF SEXUALLY-TRANSMITTED INFECTIONS.
Control of sexually-transmitted
infections (STI) including HIV-AIDS continues to be a special focus of the City, especially since it is
among the first ten sentinel sites of the country for HIV-AIDS surveillance since the early part of the
decade. This springs from the City's twin nature as a tourist district and gateway to Metro Manila, as it
houses major transport terminals and thus receives thousands of commuters daily, some of whom
become transients but would need to avail of the health services in the City.
number of cases of STI from 2003 to 2007, particularly Gonorrhea, Non-gonococcal Infections, and
Bacterial Vaginosis. This is attributed to better case detection due to the strategy, Outreach Clinic
Activities, embarked on by the City Social Hygiene Clinic. The Integrated HIV/AIDS Behavioral and
Serological Surveillance (IHBSS) is conducted on a bi-annual basis and targets the most at-risk
populations. The City's karaoke bars, nightclubs and discos whose personnel represent a special group
required to be periodically examined and cleared for STI at the City Social Hygiene Clinic. However,
outreach activities need to extend to freelance people-in-prostitution (PIP) as well as the male gay
population, who have been found to have an increased risk. This, the revival of the Pasay City AIDS
Council and increasing the number of trained health personnel beyond the current staff of the Social
Hygiene Clinic (one physician, one nurse, one midwife, and one medical technologist), are needed to
further escalate efforts at control of HIV-AIDS and other sexually-transmitted infections.
HEALTH SECTOR MANAGEMENT AND GOVERNANCE. Better health outcomes especially along the domains
of maternal and child health, tuberculosis and chronic lifestyle diseases control and management can be
achieved with better health sector governance. While more health centers were established in the last
decade to provide better access to the growing population, the number of health personnel did not
increase along with the expansion. Better health human resource management systems have to be set in
place, likewise. Health officers have to be equipped better capacities on systems management as well
as updated with the technical administration of public health programs. Personnel administration
systems have to be enhanced - a database of trainings, career planning, a better system of performance
management including rewards-recognition and intensified patient - community accountability systems,
among others, have to be set up. Partnerships with CBOs and academic institutions should also be
optimized to ensure more targeted service delivery especially at the barangay level.
Frustration from the unfulfilled promise of PhilHealth (as a major potential source of revenues to
improve the health sector) has to be replaced by better health financing schemes. More importantly,
PhilHealth as the country's social health insurance scheme has to be optimized to live up to its promise
to provide financial access to health services to all, especially the poor. Setting up a Local Health
Accounts (LHA) is planned; private and volunteer sectors, as well as the patients/communities
involvement in financing is best studied so as to better manage (and maximize) their contributions. The
Pasay government invests only 9% of the City budget for health (for the CHO, 3% and PCGH, 6%);
furthermore 70% is allocated for personnel, way above the DOH-recommended ceiling of 40% for
personnel services, in order to allot more for operations.
12
Health facilities six primary care and three BEmONC centers have to be built to provide
optimum coverage; upgrading of equipment and maintenance of all government centers, as well as the
PCGH, has to be budgeted for. The low hospital occupancy rate has to be considered carefully,
especially in the context of private sector participation in health service provision, to ensure rational
use of government funds. Better health information management has to be invested in as it forms the
base for important policy decisions in health care. The formalization of the City Epidemiological and
Surveillance Unit (CESU) through a City ordinance and its concomitant budget allocation to build up
personnel and equipment are priorities. Computerization of all government health centers and their link
up with City's Management Information Technology System (MITS) is planned. The CBMS provides
strategic information; some definitions, however, have to be reviewed so as to provide a more accurate
picture of the health and social challenges. Partnerships with CBOs and academic institutions have to
be also to be maximized to provide rigor in research and maximize utilization of technical expertise for
health systems management. The Pasay health regulatory functions is also reviewed and plans are
proposed; this includes special consideration for the needs of the senior citizens for more affordable
medicines through the implementation of national laws and establishment of more functional Botika ng
Barangay. Research has yet to be done on how the providers in the private sector hospitals, clinics,
laboratories, radiographic facilities - comply with national health policies in general, and for clinics and
hospitals, the Milk Code and Mother-Baby Friendly Hospital Initiative, in particular. Similarly, better
monitoring is needed on the status of implementation of local health ordinances.
Better health literacy among the Pasayeos, stronger strategies to engage the community and thus
participation in governance in all levels of government have to be set up. The recent change in
leadership in the City administration warrants reconstitution of the City Health Board. This is an
opportunity to make this body functional and become a more inclusive and dynamic body for true and
participatory governance. The multisectoral forum convened by the City Health Office in 2009 to
explore convergence strategies to address the high IMR, partnerships with CBOs and the academe, as
well as the interagency dialogue spurred by the CIPH development process, have to be institutionalized
for better efficiency to achieve targeted health and social outcomes. The recognition and, thus,
management of social determinants of health should thus be more deliberate, henceforth.
The commitment and talents of the Pasay City government, especially its health sector, have been
proven to persevere despite the challenges inherent to the public sector and in the face of rapid
urbanization.
Efficiency and effectiveness are shared values among all stakeholders towards self-
reliant, healthy and morally upright Pasayeos. The development and implementation of this CIPH
enflesh this mission.
13
National
2010
Target
Regional
Average
2008
City 3 Year
Average
(2005-2007)
City
Performance
Level in 2008
138
90
49
40
24
17
20
32
32
Indicator
Analyses (color-coded/symbols)
Internal
Benchmark
(,,=)
DATA SOURCE
40
CHO
26
25
CHO
28.5
29
29
CHO
311
No data
No data
19
187
192
CHO
External Benchmark
National
Regional
153.5
137.3
203
179
220
CHO
31
19.6
21.2
33
32
CHO
No data
No data
19.8
<14.1
22.8
32
35
CHO
174.5
None
41.3
No data
No data
47.7
<47.7
56
53
CHO
Demographics of
hospital inpatients
2.
Leading
consultations
3.
Leading discharge
diagnosis
4.
Top 10 causes of
hospital mortality
5.
6.
7.
Leading causes of
referrals
Patient flow
Human resources
complement/comp
etencies
8.
9.
Client survey
Staff survey
City 3 Year
Average
(2005-2007)
City Performance
in 2008
Non-Philhealth
PAY- 821
CHARITY- 7493
Philhealth
PAY-354
MEMBER- 1213
INDIGENT- 48
1. Hypertension 1523
2. PTB 1298
3. URTI 1287
4. Pneumonia 896
5. UTI 798
6. DM 676
7. HPN-cardiovascular 579
8. Musculoskeletal 505
9. Cerebrovascular 173
10. Systemic Viral Infection 113
1. SEVERE PNEUMONIA- 471
2. ABORTION NI,NS-310
3. AGE some DHN- 206
4. Acute AP-128
5. CVD-99
6. Neonatal Pneumonia-69
7. Febrile Convulsion-68
8. DHF II- 46
9. Typhoid Fever- 40
10. UTI- 38
1. Hypertensive disease- 94\
2. Pneumonia- 90
3. CVD- 48
4. Cong. Pneumonia- 40
5. Disorders relating to length of gestation
and fetal growth- 39
6. Pulmonary Tuberculosis-31
7. AGE 20
8. ischemic Heart disease-16
9. chronic Lower respiratory infection-15
10. Remainder of diseases of the digestive
system- 12
No data
Physician 105
Pulmo Tech 3
Dentist 1
Rad Tech 10
Nurse 104
ECG Staff 3
Midwife 14
Nursing Attendant 28
Medical Technologist 16 Clerk 11
Nutritionist/Dietitian 3 Driver 4
Laboratory Aide 1
Utility worker 30
Pharmacist 3
Being periodically done
None
Remarks/
Internal
Benchmark
DATA
SOURCE
PCGH
PCGH
PCGH
PCGH
PCGH
PCGH
Table 3b. Hospital Indicators, Hospital Indicators, Pasay City General Hospital, 2008.
Indicator
1.
Emergency service
2.
Blood service
3.
4.
5.
6.
7.
-
Referral service
Ambulance and transport service
Diagnostics
MRI
CT scan
Endoscopy
Mammography
Inpatient service
Laparoscopy
Burns
Plastic/reconstructive surgery
Thoraco-vascular surgery
Trauma
Intensive care
Neurosurgery
Maxillo-facial surgery
Detoxification
Nuclear medicine
Management systems
SOPs
QA Programs
Hospital Information System
Procurement and Logistic System
City 3 Year
Average
(2005-2007)
City Performance
in 2008
57681(158/day)
1. Trauma 12418
2. UTI 2028
3. Pneumonia 1978
4. AGE 1899
5. URTI 1450
6. SVI 1279
7. Acute Tonsillopharyngitis
1171
8. HPN 1041
9. PTB 746
10. Hypersensitivity Reaction
653
Blood Collected
Voluntary 14
Replacement 515
Remarks/
Internal
Benchmark
DATA
SOURCE
PCGH
PCGH
PCGH
PCGH
PCGH
PCGH
PCGH
PCGH
PCGH
PCGH
PCGH
PCGH
PCGH
PCGH
PCGH
PCGH
PCGH
PCGH
PCGH
PCGH
PCGH
Table 4. Intermediate Outcome Indicators (Set I Indicators of LGU Scorecard), Pasay City, 2008
Indicator
National
Baseline
2006
National
2010
Target
Regional
Average
2008
City 3 Year
Average
(2005-2007)
City
performance
level in 2007
City
Performance
Level in 2008
Analyses (color-coded/symbols)
External Benchmark
National
Regional
Internal
Benchmark
(,,=)
DATA SOURCE
1.
69%
80%
89%
76.90%
CHO
2.
TB Cure Rate
80%
85%
83%
85%
CHO
3.
83%
95%
83.42%
106%
98.40%
CHO
4.
66%
85%
82%
78%
CHO
5.
34%
50%
76%
68.33%
6.
13%
<21%
4%
3%
3.8
2.60%
CHO
7.
37%
70%
76.70%
74.40%
76.20%
CHO
8.
53.90%
70%
92.33%
94%
9.
41%
85%
52.30%
40.10%
CHO
9%
82%
94%
85.80%
98.20%
99.70%
CHO
70%
91%
83.42%
96.40%
97.30%
CHO
3 days
5 days
5 days
4 days
CHO
62%
85%
63%
69%
CHO
1%
<1%
<1%
0.65%
CHO
1:72188
1:125000
1:410216
53%
National
Baseline
2006
National
2010
Target
Regional
Average
2008
City 3 Year
Average
(2005-2007)
City
performance
level in 2007
City
Performance
Level in 2008
48%
80%
100%
50%
50%
23%
50%
1:13
1:02
79%
Analyses (color-coded/symbols)
Internal
Benchmark
(,,=)
DATA SOURCE
100%
CHO
100%
100%
CHO
69%
77%
CHO
1:18
1:18
CHO
85%
85%
58%
100%
157%
157%
CHO, PhilHealth
28.70%
40%
30.26%
45%
Treasurers Office
28.50%
22.80%
CHO
1:34432
1:20000
1:19995
1:21000
1:20000
CHO
1:4000
1:5000
1:10394
1:7889
1:7889
CHO
69%
100%
77%
75%
CHO
67%
100%
82%
72%
CHO
55%
100%
0%
0%
Indicator
External Benchmark
National
Regional
PhilHealth
Table 5: Reform Outcome Indicators (Set II indicators of LGU scorecard), Pasay City, 2008
Indicator
Functional public-private partnerships in TB in the City
[ ] 1. All Private provider partners are oriented on the guidelines of the PPMD strategy (Certificate
Available)
[] 2. MOU of partnership between local government and engaged private providers in the established
PPMD Units within the City
[] 3. For the private initiated PPMD Unit, NTP Microscopy services are available
[] 4. TB Cases detected/managed by engaged Private Providers
Percentage of public health facilities complying with the following IMCI protocol
[] 1. Physician or nurse trained on IMCI
[] 2. Amoxicillin or Cotrimoxazole, and other essential drugs for IMCI provided by LGUs
[] 3. Referral system to next level of govt health facility established for IMCI
Functional public-private partnerships in CSR in the City
[ ] 1. Resolution endorsing:
a) Implementation of comprehensive family planning services, as an integrated component of
maternal and newborn care program packages among public and private sector providers.
b) Promote the provision of FP commodities and services in private sector workplaces
[] 2. Contraceptive Self Reliance plan that specifies strategies and activities for:
a) Quantified total volume of required FP commodities and services
b) Client segmentation and corresponding financing and service delivery mechanisms for each
segment
[] 3. Full annual budget subsidy for all Family Planning (FP)commodities and services for the poor
(Income quintile 1 &2)
[} 4. Commercial sources of FP commodities
[] 5. Referral system to private sector , among public providers
Functional health systems established to improve chronic disease prevention and control in the City
[X] 1. Integrated NCD Prevention and Control Plan implemented in the CWHS
[X] 2. Communication Plan on Diet, Physical Activity, and Smoking Control implemented for clients
in schools, workplaces, govt and non govt agencies, food establishments, etc
[X] 3. Risk assessment services established in appropriate public and private providers
[] 4. Basic and essential drugs for the management of NCDs are included in the budget of the
CWHS and available in public & private providers
City Performance
Level in 2010
( or x)
Remarks/ Internal
Benchmark
DATA SOURCE
Indicator
Functional Disease Surveillance System in the City
[] 1. Presence of manpower trained in Epidemiology
[] 2. Presence of room/space with dedicated Basic Information-communication Package (Computer unit,
Printer, Telephone, Fax Machine, Cell Phone)
[] 3. Budget Allocation for Surveillance
[X] 4. MOA on linkage with the private sector
[] 5. Monthly Report for past 6 months received from private sector partners
Functional Health Emergency Disaster Preparedness and Response Program in the City
[] 1. Presence of health emergency preparedness, response and rehabilitation plan
[] 2. Identified health emergency manager and team (assessment and first aid)
[] 3. Presence of hospital preparedness, response and rehabilitation plan
[] 4. Presence of emergency room facilities with surge capacities for disasters
Functional Ambulance in all 3rd level hospital facilities
Number of Public/Private Hospitals w hospital policy and core group for implementing Continuing
Quality Improvement (CQI)
Percentage of providers with client segmentation system or patient classification system
Functional public-private partnerships in Health facility Development for the City
[] 1. Facility Mapping of Public/Private Facilities
[] 2. Investment Plan for Priority Facilities in CWHS
[] 3. Rationalized Hospital Development Plan for all public hospitals (NOH p 97)
[] 4. Documented public-private partnerships (including MOAs on Referral Systems, service
contracts, Plans on Joint Activities, etc.)
City with means testing compliant to CBIS-MBN or PhilHealth guidelines
Percentage of increased extrabudgetary sources of financing to total financing (income retention, capitation
fund, etc)
Percentage of LGU's w budget allocation for a) 5% of category III treatment regimen for TB and b) first line
Anti Malarial drugs and services for endemic areas, c) total or partial needs for pills, IUDs and injectables)
Functional Community/Consumer-Centered Feedback Mechanism
Average percentage of Magna Carta Benefits provided by LGUs to public providers
Average man-days of a) in house training, b) external-local training, c) external-international training per staff
for all public and private providers
Functional Finance System in all public health facilities in the city
Functional Management Information System in all public facilities in the city
City Performance
Level in 2010
( or x)
100%
100%
X
80%
X
80%
Remarks/ Internal
Benchmark
DATA SOURCE
21
Table 6. Goals, Performance Levels, Major Gaps, Intermediate and Reform Objectives
A. SERVICE DELIVERY
A.1. DISEASE FREE ZONE INITIATIVES
IV. RABIES ELIMINATION AND CONTROL
GOAL:
Reduction of incidence rate of rabies from <1 per 100,000 to 0 by 2015
Performance Level:
1 human rabies case (2009)
Weak implementation of Local Ordinance
No City Pound
Major Gap:
Inadequate supply of PEP vaccines
Weak community advocacy
Intermediate Objective:
Increase implementation of responsible ownership and dog immunization based on RA 9482 to 100% of (201 bgys.)
Reform Objective:
V. LEPROSY PROGRAM
GOAL:
Sustain or reduce prevalence rate of leprosy from <1 per 10,000 to 0 by 2015
Performance Level:
Prevalence Rate of <1 per 10,000
Major Gap:
(Based on SA)
Intermediate Objective:
Sustain percentage of new cases of leprosy that complete treatment on time by 100% annually
Reform Objective:
A.2. INTENSIFIED DISEASE PREVENTION AND CONTROL
I. TB PREVENTION AND CONTROL
GOAL:
Reduce TB mortality rate from 32/100,000 to 25/100,000 by 2015.
Reduce TB morbidity rate from 220/100,000 to 150/100,000 by 2015.
Performance Level:
TB case detection rate - 77%
TB cure rate - 82%
Inadequacy of drugs (Cat 1 & 2): No anti-TB drugs available during last quarter of 2008
Major Gap:
Five (5) health centers and two (2) PPMDs not accredited for TB DOTS
Lack of community/advocacy work with focus on psychosocial support/destigmatization
Intermediate Objective:
Sustain TB case detection rate at 77% annually
Increase and sustain TB cure rate at 85% annually
Reform Objective:
To strenghten public-private partnerhsips in TB
II. HIV/AIDS AND STI PREVENTION AND CONTROL
GOAL:
Maintain prevalence rate of HIV/AIDS among the high risk or vulnerable groups at <1% by 2015.
Reduce prevalence rate of gonorrhea among the high risk or vulnerable groups from 2% to <1% by 2015.
Performance Level:
Condom use rate:(among high risk group)
RFSW - 83%
FLSW - 70%
MCSW - 47%
Major Gap:
Increasing number of STI cases from 2003-2007
Pasay City AIDS Council inactive
Inadequacy of trained personnel providing HIV services
Intermediate Objective:
Increase condom use rate from 83% to 100% annually among high risk groups.
Reform Objective:
III. EMERGING/REEMERGING INFECTIONS CONTROL SERVICES (SARS, MENINGOCOCCEMIA, AVIAN FLU, H1N1, ETC.)
GOAL:
Morbidity and Mortality from emerging/reemerging infections are reduced.
Performance Level:
Cases of emerging/reemerging infections were isolated.
Review existing surveillance system and integrate/strengthen the surveillance of emerging/reemerging infections.
Inadequate training of health personnel for prevention and control and management of cases.
Major Gap:
Inadequate public resources (medicines, medical supplies, experts) when outbreak occurs.
No Emerging/Reemerging Disease Preparedness and Response Plan
Intermediate Objective:
Increase proportion of emerging/reemerging cases isolated out of total number of cases identified.
Increase isolated and treated cases of emerging and reemerging infections to 100%.
Reform Objective:
IV. DENGUE PREVENTION AND CONTROL
GOAL:
Morbidity and Mortality from dengue infections are reduced.
Performance Level:
Case Fatality Rate of 0.68%. Cases seen and reported by sentinel hospitals and health centers is 7% higher compared to 2007.
Weak advocacy and community-based information campaign in some barangays as well as poor implementation of risk reduction measures such as environmental sanitation and removal of
Major Gap:
mosquito breeding places.
Intermediate Objective:
Maintain the Dengue Case Fatality Rate to less than 1% .
Reform Objective:
A.3. IMPROVEMENT OF MNCHN OUTCOMES
I. CHILD HEALTH PROGRAM
GOAL:
Reduction of Infant Mortality Rate from 25 to 17 per 1000 livebirths in 2015.
Reduction of Neonatal Mortality Rate from 17 to 10 per 1000 livebirth in 2015
Reduction of Under five Mortality Rate from 29 to 24 per 1000 livebirths in 2015.
Reduction in percentage of low birth weight infants from 11% to less than 10% in 2015.
Reduction of percentage of protein energy malnutrition among 0-5 years old based on weight for age anthropometric measurement from 2.6% to 2% in 2015.
Performance Level:
Percentage of fully-immunized child - 90.1%
Percentage of newborns initiated breastfeeding within 1 hour of birth - 80%
Percentage of infants exclusively breastfed 0-6 months - 62%
Percentage of under 5 given vitamin A at 92%
Inadequate promotion of exclusive breastfeeding (16% of infants have not been breastfed at all)
Major Gap:
Supply of iron not adequate
Low percentage of health human resource formally trained on IMCI and IYCF
Intermediate Objectives:
Increase and maintain percentage of FIC to 95% or more annually
Increase the percentage of newborns initiated breastfeeding within 1 hour of birth to 85% in 2015.
Increase the percentage of infants exclusively breastfed 0-6 months after delivery to 70% in 2015.
Increase percentage of under 5 given vitamin A from 92% in 2008 to 95% in 2015.
Increase percentage of under 5 children given deworming drugs annually every year
Increase percentage of infants given adequate complementary feeding at 6 months annually
Reform Objective:
To increase public health facilities complying with the IMCI protocol to 100%.
Disaster Preparedness and Response System not fully organized and functional
No Health Emergency Preparedness, Response, Recovery and Rehabilitation Plan,
Formulate Health Emergency Preparedness, Response, Recovery and Rehabilitation Plan.
Intermediate Objectives:
Upgrade emergency room facilities with capacities for disasters and emergencies.
Reform Objective:
Functional health emergency disaster preparedness and response program in province/city.
II. ACCIDENTS AND INJURIES PREVENTION MANAGEMENT
GOAL:
Reduce incidence, mortality and morbidity associated with accidents and injuries
Performance Level:
(Percentage of Fatal and Non Fatal Injuries from Accidents )(Total # People in Accidents)
Major Gap:
Documentation of incidence rate = Link with under-five mortality review
Intermediate Objectives:
Mortality secondary to accidents and injuries is reduced
Reform Objective:
B. HEALTH REGULATION
I. ENFORCEMENT AND COMPLIANCE TO NATIONAL HEALTH LEGISLATION AND STANDARDS
GOAL:
Ensure quality, accessibility and safety of health products, facilities, and services
Performance Level:
100 % of hospitals & health facilities complying with health-related laws.-MBFHI/Milk Code
(Percentage of licensed public and private: a.hospitals, b. Birthing clinics, c. X-ray facilities, and d. Laboratories)
Major Gap:
No data on private facilities (laboratories, x ray facilities; clinics) and their compliance to national health related laws and accreditation status in PhilHealth; poor monitoring of compliance to laws
Intermediate Objective:
Increase percentage of hospitals and health facilities complying with health-related laws to 100% in 5 years.
Increase percentage of public and private health facilities accredited by Philhealth to 100% in 2015.
Sustain Philhealth accreditation status of public health facilities for OPB.
Increase percentage of licensed public and private: a.hospitals, b. Birthing clinics, c. X-ray facilities, and d. Laboratories to _____ in 2015.
Reform Objective:
Enactment of counterpart local ordinances of health-related laws.
II. LEGISLATION OF HEALTH-RELATED LAWS AT THE LOCAL LEVEL
GOAL:
Ensure quality, accessibility and safety of health products, facilities, and services
Performance Level:
Passage of some local ordinances, Executive Orders in support of health ( Asin Law, Resp. Pet Ownership, etc)
Major Gap:
Weak enforcement of, and poor monitoring of compliance to, local ordinances on health
Intermediate Objective:
Passage of other health related laws in support to health.
Reform Objective:
III. IMPROVING AVAILABILITY AND ACCESS TO LOW-COST QUALITY ESSENTIAL MEDICINES
GOAL:
To reduce out-of-pocket costs for drugs and medicines to 50% of baseline
Performance Level:
Botika ng Barangay to population Ratio - 1:18
(Price-difference of 3 drugs: paracetamol, amoxicillin, metropolol from a. Commercial outlets, b. BnB, c. City/Provincial procurement list
Major Gap:
Inadequate number of BnBs established; some BnBs were not sustained; weak monitoring
Intermediate Objective:
To reduce cost of essential drugs by 50%
Increase access to low cost quality drugs (P100, etc.) in all government hospitals
Reform Objective:
C. HEALTH FINANCING
I. EXPANSION OF NATIONAL HEALTH INSURANCE PROGRAM
GOAL:
Reduce out-of-pocket spending for health.
Performance Level:
(Percentage of households enrolled in Philhealth: a. Sponsored sector, b. Informal sector
Percentage of poor households enrolled - 96.1%
(Percentage of total households enrolled)
(Percentage accredited by Philhealth among public and private: a. Hospitals, b. birthing clinics, c. Designated BEMONC/CEMONC facilities, d. TB-DOTS facilities
Percentage of RHUs accredited by Philhealth for OPB (100%), MCP (100%), and TB-DOTS (69%) package
Difficulty in complying with Philhealth documentary requirements (i.e. birth certificate, marriage certificate, etc); Poor recruitment on the part of LGU; renovation, upgrading and repair of existing HCs
Major Gap:
to comply with Philhealth accreditation requirements for TB-DOTS
Intermediate Objective:
Increase % of extrabudgetary sources of financing (income retention, capitaton, etc.)
Increase % of households enrolled: a, sponsored, b. Informal
Reform Objective:
Identification of poor compliant to CBIS-MBN
Efficiency and effectiveness of financial, procurement and logistics management systems to support health program implementation are ensured
(Percentage of annual financing utilized)
Percentage of procurement plan packages (in peso amount) completed through competitive bidding: 100%
Percentage of audit objections raised that have been cleared within one year: NO AUDIT OBJECTIONS
(Based on SA)
Increase % of fund utilization
Increase % of procurement plan packages completed through competitive bidding
Decrease audit objections raised w/n 1 year
Functional procurement and logistics system in all public health facilities based on RA 9184
Functional finance system in all public health facilities
Functional management information system in all public facilities
E. SOCIAL DETERMINANTS
E.1. PHYSICAL ENVIRONMENT AND INFRASTRUCTURE
I. HOUSEHOLD SERVED BY THE CITY SOLID WASTE MANAGEMENT
Goal:
Clean, healthy and environment-friendly Pasay City
Waste Diversion Rate 25%
Performance Level:
Barangay Compliance Rate 70%
Major Gap:
(Based on SA)
Intermediate/Reform
Increase in Waste Diversion Rate by 60% in 2015
Objectives:
Increase Barangay Compliance Rate to 100% in 2015
II. TRAFFIC ROAD INJURIES (FATAL AND NON-FATAL)
Goal:
Reduction of deaths/injuries secondary to traffic accidents
Performance Level:
396 reported injuries, 8 fatalities
Poor enforcement of traffic rules
Major Gap:
Poor maintenance of roads/sidewalks
Intermediate/Reform
Reduce the number of deaths/injuries due to vehicular crashes by 50% by 2015
Objectives:
E.2. SOCIAL AND HUMAN DEVELOPMENT
I. ELEMENTARY COMPLETION
Goal:
To ensure that children boys and girls alike will be able to complete full course of primary schooling (MDG).
Elementary completion rate - 63%
Performance Level:
Elementary Drop Out Rate - 10.28%
Nat'l Achievement Test - 61.53%
Low elementary completion rate.
Pupil to teacher ratio is high (1:75 students vs 1:50)
Major Gap:
Lack of school building to accommodate elementary pupils
Physical examination (lack of resources to manage ill pupils)
No networking with health facilities
Intermediate/Reform
Increase elementary completion rate to 72% by 2015.
Objectives:
II. TEENAGE PREGNANCY
Goal:
Performance Level:
Major Gap:
Intermediate/Reform
Objectives:
E.3. ECONOMICS
I. EMPLOYMENT
Goal:
Performance Level:
Major Gap:
Intermediate/Reform
Objectives:
II. HOUSING OWNERSHIP
Goal:
Performance Level:
Major Gap:
Intermediate/Reform
Objectives:
E.4. GOVERNANCE
I. SOCIAL PARTICIPATION
Goal:
Performance Level:
Major Gap:
Intermediate/Reform
Objectives:
II. VOTER PARTICIPATION
Goal:
Performance Level:
Major Gap:
Intermediate/Reform
Objectives:
III. INDEX CRIMES
Goal:
Performance Level:
Major Gap:
Intermediate/Reform
Objectives:
(Percentage of families with at least one member involved in legitimate peoples organization )
(Based on SA)
Increase social participation rate
Php221,938,773.00, over the medium-term five-year period. These will be in terms of logistic support
for drugs and medical supplies, re-tooling of health personnel especially for, and management/technical
assistance. This includes the Php5-million grant for each year for the next five years intended for as
augmentation for underscored priority health services (Php20,702,380.12, 55%), health regulation
(Php10,966,875.41, 29%) health system governance (Php4,396,843.47, 12%) and financing
(Php1,294,523.36, 3%), as well as support to address health's social determinants (Php439,693.00,
1%).
For the first year of implementation, investments needed amount to Php125,354,021.90; the City
government will fund Php98,485,914.67 (or 78.57% of total), requested from the Department of
Health (DOH) is Php20,208,822.23 (or 16.12% of total costs). Other parties will be asked to support
Php6,659,285.00 (or 5.31% of total costs). The Php5-million grant will be used for community
advocacy activities (Php2,548,500.00, 51%), monitoring and evaluation (Php1,006,800.00, 20%),
human resource development (Php595,000.00, 12%), health regulation (Php 411,000.00, 8%), and
public-private partnership and participation in health (Php 388,000.00, 8%).
31
2011
2012
2013
2014
2015
Total
As a % of
Component
Total
As a %
of Grand
Total
145,541,949
83,386,377
89,695,359
87,316,479
92,276,050
498,216,214
100.0%
75.5%
17,932,510
19,199,473
20,591,891
22,110,628
23,547,102
103,381,604
20.8%
15.7%
I. FILARIASIS ELIMINATION
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
4,334,700
4,556,622
4,901,930
5,129,349
5,357,573
24,280,174
4.9%
3.7%
V. LEPROSY PROGRAM
13,597,810
14,642,851
15,689,962
16,981,280
18,189,528
79,101,430
15.9%
12.0%
30,770,074
30,871,354
31,606,921
31,210,793
31,734,729
156,193,871
31.4%
23.7%
27,058,019
27,122,235
27,492,284
26,966,847
27,075,799
135,715,184
27.2%
20.6%
1,798,850
1,681,902
1,900,915
1,849,760
2,095,843
9,327,269
1.9%
1.4%
1,718,205
1,860,517
1,994,620
2,161,938
2,316,904
10,052,185
2.0%
1.5%
195,000
206,700
219,102
232,248
246,183
1,099,233
0.2%
0.2%
26,474,190
27,706,030
29,357,329
31,302,766
33,264,831
148,105,146
29.7%
22.4%
18,614,190
19,335,210
20,461,787
21,825,852
23,194,052
103,431,092
20.8%
15.7%
7,860,000
8,370,820
8,895,541
9,476,914
10,070,779
44,674,054
9.0%
6.8%
Component/ Subcomponent/
Activity
A.4. HEALTHY LIFESTYLE AND
MANAGEMENT OF HEALTH RISKS
I. ADVOCACY CAMPAIGNS FOR
RISK BEHAVIORS
II. WATER AND SANITATION
PROGRAMS
A.5. SURVEILLANCE AND EPIDEMIC
MANAGEMENT SYSTEM
A.6. DISASTER PREPAREDNESS
AND RESPONSE SYSTEM
I. DISASTER PREPAREDNESS AND
RESPONSE
II. ACCIDENTS AND INJURIES
PREVENTION MANAGEMENT
A.7. HEALTH FACILITIES
DEVELOPMENT PROGRAM
I. RATIONALIZATION OF LOCAL
HEALTH FACLITIES
Component 2: HEALTH
REGULATION
I. ENFORCEMENT AND
COMPLIANCE TO NATIONAL
HEALTH LEGISLATION AND
STANDARDS
II. LEGISLATION OF HEALTHRELATED LAWS AT THE LOCAL
LEVEL
III. IMPROVING AVAILABILITY AND
ACCESS TO LOW-COST QUALITY
ESSENTIAL MEDICINES
Component 3: HEALTHCARE
FINANCING
I. EXPANSION OF NATIONAL
HEALTH INSURANCE PROGRAM
2011
2012
2013
2014
2015
Total
As a % of
Component
Total
As a %
of Grand
Total
1,141,385
1,230,379
5,216,437
1,637,927
1,808,826
11,034,954
2.2%
1.7%
675,765
716,311
759,290
804,847
853,138
3,809,350
0.8%
0.6%
465,620
514,068
4,457,147
833,080
955,689
7,225,604
1.5%
1.1%
154,265
33,141
28,388
30,091
31,896
277,781
0.1%
0.0%
2,631,525
911,600
1,680,906
1,024,274
1,888,666
8,136,970
1.6%
1.2%
2,319,000
593,600
1,343,826
666,969
1,509,922
6,433,317
1.3%
1.0%
312,525
318,000
337,080
357,305
378,743
1,703,653
0.3%
0.3%
66,438,000
3,434,400
1,213,488
71,085,888
14.3%
10.8%
66,438,000
3,434,400
1,213,488
71,085,888
14.3%
10.8%
4,517,450
4,862,273
5,210,639
5,606,172
6,006,171
26,202,705
100.0%
4.0%
2,713,250
2,918,445
3,116,024
3,350,626
3,576,913
15,675,257
59.8%
2.4%
1,682,800
1,826,168
1,958,210
2,123,343
2,275,993
9,866,515
37.7%
1.5%
121,400
117,660
136,405
132,203
153,265
660,933
2.5%
0.1%
18,536,700
19,498,170
20,668,060
21,908,144
23,222,632
103,833,706
100.0%
15.7%
18,439,500
19,485,450
20,654,577
21,893,852
23,207,483
103,680,861
99.9%
15.7%
Component/ Subcomponent/
Activity
II. INCREASE IN LGU INVESTMENT
FOR HEALTH
Component 4: HEALTH
GOVERNANCE
D.1. LGU SECTORAL
MANAGEMENT
I. LOCAL HEALTH SYSTEMS
DEVELOPMENT
II. HUMAN RESOURCE
DEVELOPMENT
2011
2012
2013
2014
2015
Total
As a % of
Component
Total
As a %
of Grand
Total
0.1%
0.0%
97,200
12,720
13,483
14,292
15,150
152,845
5,980,567
1,962,237
2,257,949
5,177,545
1,894,431
17,272,730
100.0%
2.6%
5,085,567
1,345,317
1,555,250
4,779,746
1,472,764
14,238,644
82.4%
2.2%
4,712,000
1,115,120
1,138,881
4,521,097
1,004,932
12,492,029
72.3%
1.9%
373,567
230,197
416,369
258,649
467,832
1,746,615
10.1%
0.3%
895,000
616,920
702,699
397,799
421,667
3,034,086
17.6%
0.5%
1,284,000
4,011,040
4,251,702
3,315,789
1,621,020
14,483,551
2.9%
2.2%
603,000
639,180
677,531
718,183
761,274
3,399,167
0.7%
0.5%
0.0%
0.0%
603,000
639,180
677,531
718,183
761,274
3,399,167
0.7%
0.5%
78,000
2,732,680
2,896,641
1,879,423
98,473
7,685,217
1.5%
1.2%
0.0%
0.0%
78,000
2,732,680
2,896,641
1,879,423
98,473
7,685,217
1.5%
1.2%
E.3. ECONOMICS
0.0%
0.0%
I. EMPLOYMENT
0.0%
0.0%
0.0%
0.0%
603,000
639,180
677,531
718,183
761,274
3,399,167
0.7%
0.5%
E.4. GOVERNANCE
Component/ Subcomponent/
Activity
2011
2012
2013
2014
2015
Total
As a % of
Component
Total
As a %
of Grand
Total
I. SOCIAL PARTICIPATION
0.0%
0.0%
0.0%
0.0%
603,000
639,180
677,531
718,183
761,274
3,399,167
0.7%
0.5%
175,860,666
113,720,097
122,083,710
123,324,129
125,020,306
660,008,907
100.0%
100.0%
26.6%
17.2%
18.5%
18.7%
18.9%
100.0%
Type of Expenditure
2011
2012
2013
2014
2015
Total
As a % of
Type of
Expenditure
As a %
of Grand
Total
CAPITAL OUTLAY
5,170,000
3,052,800
7,028,118
2,239,110
479,741
17,969,769
100.0%
2.7%
3,375,000
3,792,150
7,167,150
39.9%
1.1%
Equipment
495,000
2,840,800
3,011,248
2,000,907
227,246
8,575,201
47.7%
1.3%
Motor Vehicles
800,000
800,000
4.5%
0.1%
500,000
212,000
224,720
238,203
252,495
1,427,419
7.9%
0.2%
PERSONAL SERVICES
290,000
349,800
419,103
428,766
454,492
1,942,160
100.0%
0.3%
152,400,666
91,237,497
94,411,689
99,217,965
101,361,487
538,629,304
100.0%
81.6%
64,653,969
67,487,855
70,361,132
73,214,844
75,854,444
351,572,245
65.3%
53.3%
5,938,407
3,383,315
4,705,997
2,844,749
4,440,292
21,312,760
4.0%
3.2%
89,326
200,984
213,043
503,353
0.1%
0.1%
1,100,000
318,000
224,720
238,203
252,495
2,133,419
0.4%
0.3%
Others
80,708,290
20,048,326
19,030,514
22,719,184
20,601,213
163,107,527
30.3%
24.7%
PHIC Premium
18,000,000
19,080,000
20,224,800
21,438,288
22,724,585
101,467,673
100.0%
15.4%
175,860,666
113,720,097
122,083,710
123,324,129
125,020,306
660,008,907
MOOE
Drugs and Supplies
Training
Repairs and Maintenance
Consultancy
Grand Total
As a Percentage of Grand Total
26.6%
17.2%
18.5%
18.7%
18.9%
100.0%
100.0%
219,227,588
239,924,926
1,687,838
37,375,862
498,216,214
As a % of
Component
Total
100.0%
82,604,589
17,778,275
90,000
2,908,740
103,381,604
20.8%
15.7%
I. FILARIASIS ELIMINATION
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
7,821,598
13,549,835
2,908,740
24,280,174
4.9%
3.7%
V. LEPROSY PROGRAM
74,782,990
4,228,440
90,000
79,101,430
15.9%
12.0%
97,409,244
54,616,397
597,338
3,570,892
156,193,871
31.4%
23.7%
84,248,084
49,844,006
507,338
1,115,756
135,715,184
27.2%
20.6%
3,158,228
4,658,494
90,000
1,420,547
9,327,269
1.9%
1.4%
9,850,731
113,897
87,556
10,052,185
2.0%
1.5%
152,202
947,032
1,099,233
0.2%
0.2%
34,138,661
86,308,848
1,000,500
26,657,136
148,105,146
29.7%
22.4%
26,441,211
73,014,035
1,000,500
2,975,346
103,431,092
20.8%
15.7%
7,697,450
13,294,813
23,681,790
44,674,054
9.0%
6.8%
2,946,495
7,344,363
744,096
11,034,954
2.2%
1.7%
DOH
LGU
TBI
OTHERS
GRAND TOTAL
As a % of
Grand
Total
75.5%
DOH
LGU
TBI
OTHERS
GRAND TOTAL
As a % of
Component
Total
As a % of
Grand
Total
2,891,829
173,425
744,096
3,809,350
0.8%
0.6%
54,666
7,170,938
7,225,604
1.5%
1.1%
108,599
169,183
277,781
0.1%
0.0%
1,120,000
3,521,972
3,494,998
8,136,970
1.6%
1.2%
1,120,000
3,509,447
1,803,870
6,433,317
1.3%
1.0%
12,525
1,691,128
1,703,653
0.3%
0.3%
100,000
70,185,888
800,000
71,085,888
14.3%
10.8%
100,000
70,185,888
800,000
71,085,888
14.3%
10.8%
35,215
15,200,614
10,966,875
26,202,705
100.0%
4.0%
14,728,226
947,032
15,675,257
59.8%
2.4%
15,784
9,850,731
9,866,515
37.7%
1.5%
35,215
456,605
169,113
660,933
2.5%
0.1%
51,805,346
52,028,360
103,833,706
100.0%
15.7%
51,720,146
51,960,715
103,680,861
99.9%
15.7%
85,200
67,645
152,845
0.1%
0.0%
2,675,970
10,199,917
4,396,843
17,272,730
100.0%
2.6%
2,675,970
8,624,208
2,938,466
14,238,644
82.4%
2.2%
1,000,000
8,621,208
2,870,821
12,492,029
72.3%
1.9%
DOH
LGU
TBI
OTHERS
GRAND TOTAL
As a % of
Component
Total
As a % of
Grand
Total
1,675,970
3,000
67,645
1,746,615
10.1%
0.3%
1,575,709
1,458,377
3,034,086
17.6%
0.5%
14,043,858
439,693
14,483,551
100.0%
2.2%
3,399,167
3,399,167
23.5%
0.5%
0.0%
0.0%
3,399,167
3,399,167
23.5%
0.5%
7,245,524
439,693
7,685,217
53.1%
1.2%
I. ELEMENTARY COMPLETION
0.0%
0.0%
7,245,524
439,693
7,685,217
53.1%
1.2%
E.3. ECONOMICS
0.0%
0.0%
I. EMPLOYMENT
0.0%
0.0%
0.0%
0.0%
E.4. GOVERNANCE
3,399,167
3,399,167
23.5%
0.5%
I. SOCIAL PARTICIPATION
0.0%
0.0%
0.0%
0.0%
3,399,167
3,399,167
23.5%
0.5%
Grand Total
221,138,773
331,174,662
2,487,838
105,207,634
660,008,907
100.0%
100.0%
33.5%
0.4%
15.9%
50.2%
100.0%
Table 10. Health Investment Costs by Activity by type of Expenditure, by Source of Financing, Pasay City.
Type of Expenditure
CAPITAL OUTLAY
DOH
LGU
TBI
OTHERS
As a % of
Grand
Total
17,969,769
100.0%
2.7%
7,167,150
39.9%
1.1%
1,307,338
15,975,093
7,167,150
507,338
7,380,524
687,338
8,575,201
47.7%
1.3%
Motor Vehicles
800,000
800,000
4.5%
0.1%
1,427,419
1,427,419
7.9%
0.2%
PERSONAL SERVICES
1,942,160
1,942,160
100.0%
0.3%
MOOE
220,631,434
262,523,572
1,000,500
54,473,797
538,629,304
100.0%
81.6%
186,867,501
148,079,262
1,000,500
15,624,982
351,572,245
65.3%
53.3%
13,522,959
5,030,650
2,759,151
21,312,760
4.0%
3.2%
503,353
503,353
0.1%
0.1%
1,100,000
106,000
927,419
2,133,419
0.4%
0.3%
19,140,975
108,804,307
35,162,245
163,107,527
30.3%
24.7%
50,733,837
50,733,837
101,467,673
100.0%
15.4%
105,207,634
660,008,907
Training
Repairs and Maintenance
Consultancy
Others
PHIC Premium
Grand Total
As a Percentage of Grand Total
221,138,773
33.5%
331,174,662
50.2%
687,338
As a % of Type
of Expenditure
GRAND TOTAL
2,487,838
0.4%
15.9%
100.0%
100.0%
THE PASAY CITY HEALTH BOARD (CHB), in consonance with the Local Government Code, shall
provide the direction and set the policies for the successful implementation of this Plan. The Urban
Health Systems Development Technical Working Group (TWG on the CIPH), constituted by virtue of
Executive Order No. 1, s2010, acts as its secretariat and implementing arm. The City Health Officer
chairs this TWG, which consists of representatives the CHO, CSWDO, and CPDO, and the DOH-MM,
and PhilHealth.
The City-wide Health Investment Plan shall be duly endorsed to the Sangguniang Panglungsod
(SP) upon the recommendation of the CHB. To lend legitimacy to the plan document, the SP has to
adopt it and approve its implementation.
Budget support from the DOH intended to make the CIPH fully operational shall be channelled
directly to the city government through the CHD-MM. Enforcement of agreements shall be in the form
of contract of services between the DOH and the LGU that shall implement the project. Project
monitoring shall be in accordance to a monitoring and evaluation system that shall be developed for
using the Health Sector Reform Development Approach for Health. Monitoring tools prescribed for the
project shall be adopted like the LGU scorecard, ME3* conferences, Program Implementation Review,
etc. DOH funds for the CIPH shall be allocated directly to the city government thru the CHD-MM to
avoid delays in implementation. Monitoring and accounting shall be adopted based on the
Memorandum of Agreement formulated to implement the plan.
Likewise, a similar system for resources elicited from the private and volunteer sectors, CBOs and
the academe shall be set up.
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