Roles of Health Providers in Achieving UHC

7/31/2019 Roles of Health Providers in Achieving UHC

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Health Indicators Benchmark Rich Urban

Communities

Poor Rural

Communities

Life Expectancyat Birth over 80years under 60years

Infant Mortality

Rate

19/1000LB less than 10 over 90

Maternal

Mortality Rate

52/100,000LB less than 15 over 150


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Province/ City

Infant

MortalityRate

(2009)

(/1000 LB)

Fully

Immunized

Children

(%)

Under 5

Mortality

Rate

(/1000 LB)

Maternal

MortalityRatio

(/100,000

LB)

AnteNatal Care

(%)

% of Births

Attended by

Skilled Health

Personnel

Facility

Based

Deliveries

(%)

FP

Prev

Rate

(%)

Tuberculosis Control

Case

Detection

Rate

Cure Rate

(2009)

Albay 8.2 73.7 12.7 56.8 73.0 69.3 54.4 31.1 96 85

Cam Norte 13.7 83.3 18.5 66.8 60.6 63.4 34.3 38.4 112 85

Cam Sur 9.1 73.6 15.2 65.5 64.9 52.2 17.0 20.8 92 84Catanduanes 8.5 81.2 12.9 121.3 45.9 71.2 66.7 44.7 91 86

Masbate 14.1 83.4 25.8 160.0 71.7 58.7 18.3 36.9 80 87

Sorsogon 6.8 79.5 12.9 142.8 59.7 82.6 82.6 36.9 99 85

Iriga City 12.1 77.3 23.1 1.1 60.9 73.1 11.0 21.7 172 83

Legazpi City 10.1 90.6 15.0 120.9 55.5 84.8 41.4 30.5 43 77

Naga City 15.7 93.4 19.0 76.0 72.5 72.4 41.9 64.4 156 88

BICOL

ACCOM 10.2 78.5 16.7 96.4 65.4 65.0 39.2 32.0 96 84Regnl Target

by 2015 8 95 16 32 80 80 80 60 70 85

Nat

l Targetby 2015 19 95 27 52 80 80 80 60 96 85


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Basic health services as well as tertiary care for themajority of Filipinos are inadequate, fragmented,inefficient, and incomplete. Services are largely

inaccessible and unaffordable.

The Philippines health sector is dominated bycommercial interests of a segment of the system that is

not really about health outcomes but is primarily aboutbottom-line profits.


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Human resources for health are insufficiently educated,inappropriately trained, and poorly motivated to address thehealth care concerns of most Filipinos.

Poorly compensated government health workers are unableto influence behaviors of their high earning private sector

counterparts within the change-resistant environments oftheir respective professional organizations.

Failure of public financing for health. The combined weightof the uncoordinated spending for health by the nationalgovernment, local governments and our national socialhealth insurance program has been low and weak resultingto on out-of-pocket payments by patients.


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Organised health care system built around theprinciple of universal coverage for all members of

society, combining mechanisms for health financing

and service provisions. (Wikipedi)

A governmental system meant to ensure that every

citizen or resident of a region has access to the

required medical services. (http://www.wisegeek.com/what-is-universal-health-care.htm)


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Addresses: Quality, Responsiveness, Availability andAccessibility

Focuses: Eliminating disparities (equity) and

inefficiencies (governance)

Guiding principle: Providing essential health carepackages to all regardless of age, gender, religion,ethnicity, socio-economic status, ideology, etc.


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Filipino should have access to high quality health

care that is Accessible

Efficient

Equitably distributed

Fairly financed

Adequately funded

Directed in conjunction with an informed andempowered public.

Overarching philosophy is that access to socialservices is based on needs and not on the capabilityto pay.


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Better Health

Outcomes

Responsive Health

System

Equitable Health

Financing

Health

Financing

Service

Delivery

Policy, standards

and regulationHealth

Human

Resource

Health

Information

Governance

for Health

Achieving Health-

related MDGs


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Multiple funding sources with the goal of significantly

reducing out-of-pocket spending especially by those in thepoorest income deciles:

Quantum increases in tax-based governmentspending at both national and local

Borrowing, additional taxes, re-allocation of non-social servicesector

Mandatory increase allocation of IRA to be spent on health

Significant increases in the PhilHealth supportvalue for identified services in the basic package

Mandatory membership to Philhealth

Development of basic health packages and expanding toincreasingly sophisticated services


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Integrate and strengthen health workforce regulatory

functions under one body attached to the DoH tounify standards and regulations of the production,practice, and deployment of the various healthprofessions.

Teaching and training institutions to tailor production forservice to underserved communities either as government(national or local) or civil society professionals

Update and rationalize practice laws of the differenthealth professions premised on health care being ateam effort taking into account the principles ofprimary health care.


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A revisiting of the Local Government Code and itsimplementation with the view of enabling governmentfacilities to be more integrated, efficient and effective.

The integration and organization of governmentfacilities in accordance with the principles of primaryhealth care by providing integrated health serviceseither directly or through a unified and formalized

referral system.


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Full implementation of the BFAD Strengthening Lawthat health goods should be re-designed to ensure notonly safety and effectiveness of health products butalso affordability especially for government agencies.

Strict regulation of marketing and other promotionalactivities for health products including advertisingprohibitions for certain goods.

Strengthening of other regulatory functions of DOH,other government agencies.


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eHealth masterplan designed to maximize the use ofinformation technology for health service delivery.

Identify, collect and analyze major health data

including burden of disease, actual costs of healthservices, historical utilization and budget for healthservices, necessary for implementation of UniversalHealth Care. Requiring health providers and facilities

to submit mandated health reports using standard


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Transparency should be the norm for all institutionsinvolved in health care.

Empower citizens as data generators and as informationusers.

Strengthen health research through the establishment

of the Philippine National Health Research System(PNHRS).


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Launch Phase

Scale-up Phase

SustainabilityPhase

2014 to 20162012 to 2013August to

December 2011


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NHIP sponsored programme of the poorest NHTS-PRhouseholds

No balance billing (NBB) policies by govt hospitalsserving NHTS-PR families

RNheals nurses and midwives deployment forcapacitation of existing community-level workers withCHT functions


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MHO

RHM


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Health facilities enhanced/upgraded to ensure thepoorest NHTS-PR families access out and inpatientbenefit packages (OP and IP packages)

Treatment packs shall be procured and distributed toRHUs CCTs (4Ps) beneficiaries


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Focused resources and efforts in areas with highestconcentration of NHTS poor families

Scale-up public health programmes like:women with unmet need for MFP

mothers giving birth at home with TBAs

children not fully vaccinated and Vit. A supplements

adults who are TB smear positive

common life-style related diseases


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Prioritise municipalities where 80% of NHTS-PRfamilies are found

In each of these municipalities, assess:NHIP Enrolment

Accreditation status of RHUs, clinics and lying in

Accreditation status of hospitals (public, private)

Position of LCE on health issuesAvailability of public health commodities (stocks)


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Determine targets and interventions for:NHIP enrolment and membership services

CHT and Rnheals deployment

Upgrading of health facilities

Securing public health commoditiesCapacity building

Draw up joint province- or city-wide agreements


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Rolled-out of a new sponsored programme with fullnational government premium to poorest familieslisted in the NHTS-PR at 2,400PhP per family.

Closure of the upgrading gap for local health facilitiesand DoH-retained hospitals to ensure access toimproved quality of health services

Inclusion of a catastrophic care coverage to beintroduced by 2013;


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Sustained coverage of NHTS-PR families in the NHIP

Enhancement of the OP and IP packages with NBB

Sustained quality care through Health Facility

Enhancement Programme

Deployment of CHTs and Rnheals

Attainment of health-related MFG by 2015


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Province/City No. of

NHTS-

PR HH(KPDO)

Required

No. of

CHTMembers

cover by

KP DO

No. of

NHTS-PR

HHtargeted

by the

CHD

CHD Target No. of NHTS-PR Households

2011(CCT)

2012(Q1)

2013(Q2 + Q1)

TOTAL

Legazpi City 18,122 906 10,322 1,405 2,064 8,258 + Q1 10,322

ALBAY 126,525 6,326 77,920 11,661 15,584 62,336 + Q1 77,920

CAM NORTE 69,192 3,459 40,802 - 8,160 32,642 + Q1 40,802

Iriga City 8,084 404 4,628 Non-CCT 926 3,702 + Q1 4,628

Naga City 10,969 548 6,193 3,768 1,239 4,954 + Q1 6,193

CAM SUR 217,226 10,861 125,387 82,135 25,077 100,310 + Q1 125,387

CATANDUANES 30,331 1,516 16,743 - 3,349 13,394 + Q1 16,743

MASBATE 160,894 8,044 103,478 77,419 20,696 82,782 + Q1 103,478

SORSOGON 141,245 2,062 75,769 - 15,154 60,615 + Q1 75,769

TOTAL 745,413 37,270 461,242 171,215 92,248 368,994 + Q1 461,242


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Province/City Required No. of

CHT Member

to Cover CHDTargets

CHD Target No. of CHT

Members to be Trained

2011

(Computed against

CCT HH)

2012

Legazpi City 516 70 446

ALBAY 3,896 513 73CAMARINES NORTE 2,040 0 2,040

Iriga City 231 0 231

Naga City 310 188 148

CAMARINES SUR 6,269 3,661 2,981CATANDUANES 837 0 837

MASBATE 5,174 3,872 3,792

SORSOGON 3,788 0 3,788

TOTAL 19,274 8,304 10,970


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Diploma in Midwifery Bachelor of Science in Midwifery

two-year program four-year degree program

Clinical Practicum in

Foundations of Midwifery

Normal OB and Care of

the Newborn

Introduction to High Risk

Obstetrics

Basic Care of Infants and

Feeding

Basic Family Planning

Primary Health Care Midwifery Ethics, Law and

Practice

Clinical Practicum in Mgt of OB

Emergencies and High-risk Pregnancies

Care of Infants and Children

Comprehensive Family Planning

Community Health Service facility Mgt

Midwifery Pharmacology

Research

Entrepreneurship

Administration and Supervision

Midwifery Majors: Education

Community Health

Reproductive Health

Administration and Supervision or

Health Care Facility Mgt

Roles of Health Providers in Achieving UHC

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