IPC 43 rd Anniversary Conference on “ Culture and Technical Sphere” “Exploring Damayan and Tulungan as Core Values on Community Health Care Financing.

IPC 43rd Anniversary Conference on “ Culture and

Technical Sphere”

“Exploring Damayan and Tulungan as Core Values on Community Health Care

Financing ”

Dennis B. Batangan, M.D., M.Sc.(CHDC)Institute of Philippine CultureAteneo de Manila University

Outline of Presentation

I. Context of Community Health Care Financing

A. Health Care System Infrastructure

B. Individual Health Care Context

C. Community Health Care Financing Model

II. Core Values in Community Health Care Financing

A. ‘Damayan’ and ‘Tulungan’ in Practice

B. ‘Kapwa’ as the broader framework for solidarity and shared responsibility

C. Exploring health belief models in community health care financing

Philippine Health System Infrastructure ( Sanchez et.al, 1993,Adopted from WHO,1987)

MANAGEMENT1 Health Planning2. Administration3. Regulation

ORGANIZATIONL STRUCTURE1. Hierarchy of Health Services2. Integration of Public Health and Medical Care3. Roles of Different Sectors4. Indigenous Medicine

RESOURCE PRODUCTION1. HHR2. Health Care Facilities3. Commodities4. Science and Technology

DELIVERY OF SERVICES1. Health in the Hands of the People2. Community Health Workers3. Professional and Paraprofessional Health Personnel4. People Oriented Programs

ECONOMIC SUPPORT1. Public Health Activities2. Medical Care Services3. HHR Production4. Research

J uan or Maria and Health Care FinancingJ uan or Maria and Health Care Financing

Juan or

Maria

User Fees

Personal Health Care Providers

Health Care Services

Tax

es

Appropriat ionsPublic Health

ProgramsHealth Care Services

PremiumsInsurance Companies

Subsidies

Prem

iums

3rd party payer User Fees

Premiums

CommunityOrganizations

Contribut ions

Govern ment

Operation of a Social Health Insurance (Adopted from the DAR-Agraryong Pangkalsusugan Training Manual, 2001)

insurerDonationsGovernmentPhil HealthForeign assistance

Health Fund

insured Health Care Provider

Risk sharing and resource pooling for

Social Health Insurance

Risks-------------Resources

‘Damayan’

Damayan –– Mutual or common empathy with another’s

suffering (Gerali, 2000., Asperas, 2001)– Resources shared or contributed are outward

manifestations of this empathy and feeling of unity

– The case of the Senior Citizens ‘Damayan Assistance Program (Racimo, 2001)

‘Tulungan’

Contributing one’s resources and/or capacities towards a common good

Acceptance of one’s responsibility and contribution to achieve a desired goal (Batangan, 2002)

Shared responsibility, solidarity and shared humanity (Batangan, 2001)

“ Kapwa” (Enriquez & Santiago, 1976)“Ibang Tao” or Outsider Category

Levels: Pakikitungo

Pakikisalamuha

Pakikilahok

Pakikibagay

Pakikisama

“Kapwa”

“ Hindi Ibang Tao” or One of Us Category

Levels: Pakikipagpalagayang-loob

Pakikisangkot

Pakikiisa

References:1. Fulop and Roemer, Reviewing Health Manpower Development: Geneva: WHO, 1987

2. Gorra, M. National Social Health Insurance Conference,January 9-10, 2003. Institute of Philippine Culture, Ateneo De Manila University.

3. People-Managed Health Services and Multi-Purpose Cooperative. Designing Operational Management Systems on Community-Based Social Health Insurance Schemes:Training Manual for the Department of Agrarian Reform Agraryong Pangkalusugan Project. Quezon City. December 2001.

4. Gerali, Pedro. Saving for Health: Towards Developing a Model for Health Savings in WHSMP-PC Areas. DOH-WHSMP-PC, Manila, 2000.

5. Asperas, G. and Morales, J.The concept of Social Solidarity: A Study of the Expereinces of Two Barangays in the Municipality of Guimba in Indigenous Mutual Support Mechanisms. CSWCD, U.P. Diliman, Quezon City, 2001.

6. Racimo, J. Case Study Presented during the Pursuing Partnerships in People-Centered Health Conference, March 1-2, 2001. Institute of Philippine Culture, Ateneo De Manila University.

7. Batangan, D. Enhancing Capacities of Program Stakeholders to Implement Community-Based Social Health Insurance Schemes. Project Report for Catholic Relief Services. Manila, 2002.

8. Batangan, D. Solidarity and Shared Responsibility. Contact, No. 174, July-Sept2001, New Delhi, India.

9. Enriquez, V. Kapwa : A Core Concept in Filipino Social Psychology. Sikolohiyang Pilipino: Isyu, Pananaw at Kaalaman. Aganon, David (eds). National Bookstore, Inc. Quezon City, 1985.

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