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WHAT IS A HEALTH SYSTEM?
all the activities whose primary purpose is topromote, restore or maintain health
(World Health Report 2000)
the combination of health care institutions,supporting human resources, financingmechanisms, information systems, organizationalstructures that link institutions and resources, and
management structures that collectively culminatein the delivery of health services to patients
(Lassey et al 1997)
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FUNDAMENTAL OBJECTIVES OFHEALTH SYSTEMS
Improving the health of the
population they serve Responding to peoples expectations
Providing financial protection againstthe costs of ill-health
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FUNCTIONS OF HEALTH SYSTEMS
ServiceProvision
Delivering personal and non-personalhealth services
Financing Raising, pooling and allocating
revenues to purchase services
ResourceGeneration
Investing in people, facilities andequipment
Stewardship Acting as overall stewards of the resources,powers and expectations entrusted to them
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HEALTH SYSTEM GOALS:
HEALTH OUTCOMES
Improving aggregate health status
FINANCIAL FAIRNESS
Improving financial risk protection
CLIENT RESPONSIVENESS
Improving client satisfaction
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VISION/MISSION FOR THE HEALTHSECTOR
VISION
Health for all Filipinos
MISSION
Ensure accessibility and quality of
health care to improve the quality of lifeof all Filipinos especially the poor
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MILLENIUM DEVELOPMENTGOALS
Provides a benchmark for thePhilippines and other countries in
setting goals and targets to wipeout poverty and ensure humandevelopment by the year 2015
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MDG GOALS BY 2015
Reduce by two-thirds the under five mortalityrate
Reduce by three-quarters the maternalmortality rate
Halt the spread of HIV/AIDS, malaria andother major diseases
Improve access to safe drinking water
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NATIONAL OBJECTIVES FOR HEALTH
Sets the direction for the implementation ofhealth sector reform
2005-2010 FOCUS:
A. Public Health Program
andB. Institutional management support systems
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A. PUBLIC HEALTH PROGRAM
Prevention and Control of InfectiousDiseases
Prevention and Control of DegenerativeDiseases and lifestyle related diseases
Management of health risks and promotion ofHealthy Lifestyle
Protection and promotion of family healthand health of special population
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B. INSTITUTIONAL MANAGEMENT
SUPPORT SYSTEMS
1. Health System
-Governance
-Financing
- Service delivery
- Regulation
2. Management System
- Procurement- Knowledge management
- Human Resource
- Critical Infrastructure
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Health Sector Reform AgendaHealth
Financing
Hospital
Local Health
Systems
Public
HealthProgram
Health
Regulation
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FOURMULA ONE FOR HEALTHFinancing
Service Delivery
Regulation Governance
PublicHealth
ProgramHospital
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FOURMULA ONE: OVER ALL FRAME
Goals
Better health outcomes
More responsive health system
Equitable health care financing
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HEALTH CARE FINANCING to secure more, better and sustained
investments in health to improve outcomeespecially of the poor
Mobilizing resources from extra budgetaryresources
Coordinating local and national health spending
Focusing on direct subsidies to priority programs
Adopting a performance-based financing system
Expanding the National Health InsuranceProgram
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HEALTH REGULATION
To assure access to quality and affordable healthproducts, devices, facilities and services, especiallythose used by the poor.
Establish a one-stop shop for the licensing of healthfacilities
Automate regulatory systems and processes
Integrate accreditation and certification into a unified sealof approval
Introduce intensive, less frequent incentive basedregulatory procedures
Decentralize regulatory functions to regional offices andLGUs
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THE AVAILABILITY OF LOW-PRICED, QUALITYESSENTIAL MEDICINES SHALL BE ASSURED:
Promoting high quality generic pharmaceuticalproducts
Expanding drug distribution networks (National &LGU hospital pharmacies, Botika ng Barangay,Botika ng Bayan)
Identifying alternative local and foreign sourcesof low-priced branded drugs
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HEALTH SERVICE DELIVERY
to improve accessibility and availability of basic
and essential health care for all, especially thepoor
Ensuring availability of providers of essential healthservices in the locality.
Designation of providers of specific and especialservices in localities
Intensified public health programs in targeted localities
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INTENSIFIED PUBLIC HEALTH PROGRAMSIN SPECIFIC LOCALITIES:Undertaking disease-free zones initiative
Implementing intensified diseaseprevention and control strategy
Enhancing health promotion and diseasesurveillance
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GOVERNANCE
to improve local health system governance and
coordination, enhance public-private partnershipand improving central capabilities to manage thehealth sector
FOUR-IN-ONE advanced implementation sites
LGU FOURmula ONE for Health Score card
FOURmula ONE for Health Expanded Professional career
track.
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LOCAL HEALTH SYSTEMS
THE LOCAL GOVERNMENT CODE : RA 7160
Provided for devolution and decentralization ofhealth services
Autonomy and empowerment of LGUs
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DEVOLUTION OF HEALTH SERVICES
DEPARTMENT OF HEALTH
Office of the Secretary
Centers for Health Development
Execom for National Field Operations
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LOCAL GOVERNMENT UNIT -DEVOLVED
STRUCTURE
Office of the Provincial Governor
Provincial Health Office
Provincial Health Board
Provincial Hospital District Hospital
District Hospital
District Hospital
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LOCAL GOVERNMENT UNITS - DEVOLVED
STRUCTURE
Office of City / Municipal Mayor
Health Center / RHU City / Municipal Hospitals
City / Municipal Health Board
BHS
BHS
BHS
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SITUATION
FRAGMENTATION OF HEALTH SYSTEM
BURDEN OF LOCAL HEALTH CARE FINANCING DID NOTMATCH IRA
INTEGRATED HEALTH CARE PLANNING DISRUPTED
REFERRAL SYSTEM BREAKDOWN HEALTH MANAGEMENT INFORMATION SYSTEM
DISINTEGRATED
DRUG PROCUREMENT PROBLEMS
MISSED OPPORTUNITITES FOR SPECIALTYTRAININGS/LOSS OF CAREER PATH/DEVELOPMENT
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CONSEQUENCES
LOW QUALITY OF HEALTH SERVICES
RE-EMERGINGCOMMUNICABLE
DISEASES (Measles, TB)
IMPROVEMENT IN IMR& MMR INDICESSLOWED DOWN
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DEVOLUTION ALTERED THE MEANS,
IT DID NOT CHANGE THE MISSION
Still the promotion of health
Still the protection from disease
Still assurance of good care
Even more, the mission includes:
Goodness
Fairness in financial burden
Meeting public satisfaction
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LOCAL DRIVERS TO LOCAL HEALTH
SYSTEM CHANGE
Local political interest in health
New patterns of financing health
Popular new health services introduced
Local leaders catalyzing local healthsystem
Improved public health performance
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STRATEGIC OPTION:
Re-establishment of District Health Systemin a Devolved Setting or ILHZ
The present concept of the Inter-Local HealthZone (District Health System in a DevolvedSetting) uses the Inter-LGU Cooperation as
the basic framework to attain agreement
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ILHZ ORGANIZATIONAL FRAMEWORK
ILHZ BOARD
Technical Mgt.Committee
CORE REFERRAL HOSPITAL(district/provincial hospital)
POLICY
Implementation
Service Delivery
RURAL HEALTH
UNITRURAL HEALTH
UNIT
BHS
RURAL HEALTHUNIT
BHS BHS BHS BHS BHS
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KEY PLAYERS IN ILHZ
LCEs, SPs, other Local GovernmentOfficials
PHO, Chief of Hospital, MHOs, other
Healthcare Providers and Support Staff
DOH, PHIC, other Govt Agencies
NGOs, POs, Private Sector
Community Health Workers
Community Members/Leaders
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PROVINCE OF SAMAR 6 INTER-LOCAL HEALTH ZONES
INTERLOCAL HEALTH ZONES DOHREP ASSIGNED
I. ACTSS-ILHZ:1. ALMAGRO MS. FERMINA CONEJOS2. CALBAYOG CITY DR. EUFEMIA ALCANTARA3. TAGAPUL-AN MS. FERMINA CONEJOS
4. STA. MARGARITA DR. EUFEMIA ALCANTARA5. STO. NINO MRS FERMINA CONEJOS
II. PGM-ILHZ1. PAGSANGHAN DR. CRISILDA AGUILAR
2. GANDARA3. MATUGUINAO
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PROVINCE OF SAMAR- INTER LOCAL HEALTH ZONES
INTERLOCAL HEALTH ZONES DOHREP ASSIGNED
III. SAMAR CENTRAL- ILHZ:2.CATBALOGAN MS. JOCELYN NABONG3.JIABONG MR. DOLPHY PATOSA3. ZUMARRAGA
4. SAN JORGE MS. MARIETA CARPUENTE5. TARANGNAN
IV. PAHIMOSAN1.PARANAS MR. SANTIAGO GLORIA JR2.HINABANGAN MS. CRISTITA GABON
3.MOTIONG MS. CRISTITA GABON4. SAN JOSE DE BUAN MR. SANTIAGO GLORIA JR
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PROVINCE OF SAMAR INTERLOCAL HEALTH ZONES
INTERLOCAL HEALTH ZONES DOHREP ASSIGNED
V. SMB NET-ILHZ1. CALBIGA MS. DEOGENES DARADAL2. PINABACDAO 3. DARAM MS. ANNA LISSA BABON
4. SAN SEBASTIAN 5. VILLAREAL MS. DIVINA PISCOS6 TALALORA
VI. SOUTH SAMAR ILHZ
1.. BASEY MS. ALMA BANDOY2. STA. RITA 3. MARABUT