HIS MT 102 LEC - Health Care Delivery System in the Philippines

Alma-Ata Declaration of 1978

health is a fundamental human right, that is, " the attainment of the highest possible level of health is a most important worldwide social goal whose realiztion requires the action of many other social and economic sectors in addition to the health sector."

promotion and protection of the health

the __________ are essential to sustain economic and social development and contribute to a better quality of life and world peace

Health Care System (Miller-Keane, 1987)

refers to an organized plan of health services

Health Care Delivery (Williams-Tungpalan, 1981)

it is the rendering of healthcare services to the people

Health Care Delivery System (Williams-Tungpalan, 1981)

The network of health facilities and personnel which carries out the task of rendering health care to the people

primary healthcare - Alma-Ata declation

an important health care derived from scientifically sound and socially acceptable methods

primary healthcare - Alma-Ata declation

must be universally accessible to all individuals and is based on what the community and contry can provide

Primary Health Care

an essential health care made universally accessible and acceptable to individuals through full participation and at a cost the community and country can afford, focusing on health-equity

Primary Health Care

has basic essential elements and objectives that help to attain better health services for all

1. Universal coverage to reduce exclusion and social disparities in health

2. service delivery organized around needs and expectations

3. public policy that integrates health into all sectors

4. leadership that enhances collaborative models of policy dialogue; and increased stajeholder participation

WHO Five keey elements in achieving primary health care, better for all

1. education concerning prevailing health problems and methods of identifying, preventing, and controlling them

2. locally endemic disease prevention and control

3. expanded program of immunization against majors

4. maternal and childe health care

5. essential drugs arrangement

6. nutritional food supplement, safe and basic nutrition

7. treatment of communicable and noncommunicable diseases and promotion of mental health

8. safe water and sanitation

enumerate the eight essential elements of primary health care

expanded options of immunizations;

reproductive health needs;

provision of essential technologies for health;

health promotion;

prevention and control of non-communicable diseases

food safety and provision of food supplements

other elements of primary health care

System perspective of health systems

the potential conflict between primary health care as a discrete level of care and as an overall approach to responsive, equitable health service provision can be reconciled

1. build alma-ata principals of equity, universal access, community participation, intersectoral approaches

2. take account of broader population health issues

3. create conditions for effection provision of services to poor and excluded groups

5. organize integrated and seamless care, linking prevention, acute care, and chronic care across all components

5. continuously evaluate and strive to improve performance

enumerate the things a health system based on primary care will do

1. Improvement in the level of health care of the community

2. Favorable population growth structure

3. Reduction in the prevalence of preventable, communicable, and other diseases

4. Reduction in morbidity and mortality rates, especially among infants and children

5. Extension of essential health services with priority given to the underserved sectors

6. Improvement in basic sanitation

7. Development of the capability of the community aimed at self-reliance

8. Maximizing the contribution of the other sectors for the social and economic development of the community

9. Equitable distribution of health care - According to this principle, primary care and other services to meet the main health problems in a community must be provided equally to all individuals irrespective of their gender, age, and caste, urban/rural and social class.

10. Community participation

basic objections that should be formulated to launch and sustain primary health care as part of a comprehensive health system

Planning, Organizing, Staffing, Controlling, Directing

enumerate the management functions of primary health care

Planning

managers are usually required to set a direction and determine what needs to be accomplished. It means setting priorities and detmining performance targets

Organizing

designing the organization or the specific divisiom, unit, or service for which the manager is responsible

Organizing

designating reporting relationships and intentional patterns of interaction, determinging positions, assignments and distribution of authority and responsability

Staffing

function that refers to acquiring and retaining human resources.

Staffing

developing and maintaing the workforce through various strategies and tactics

controlling

function that refers to monitoring staff activities and performance and taking the appropriate actions for corrective action to increase performance

directing

initiates action in the organization through effective leadership and motivation of, and communication with subordinates

Authority

a managers formal and legitimiate right to make decisions, issue order and allocate resources to achieve organizationally desired outcomes

Responsability

an employees duty to perform assigned task or activities

Accountability

those with authority and responsability must report and justify task outcomes to those above them in the chain of command

Line, Functional, Staff authority

enumerate the types of authority

Line authority

Formal, direct authority to control immediate subordinates by issuing orders, and is responsible for the result

Functional Authority

where managers have formal powers over a specific subset of activities

Staff Authority

granted to staff specialists in their areas of expertise

Staff Authority

it is not a real authroity in the sense that a staff manager does not order or instruct but simply advises, recommends, and councils

Centralization

the location of decision-making authority near top organizational levels

Decentralization

the location of decision-making authority near lower organizational levels

Formalization

the writeen documentation used to direct and control employees

Staffing

refers to the assignment of individuals to responsible positions identified in a management plant

Staffing

determins the competencies required for a position through identifying key result areas per major activities in the plan, determining qualifications and competencies required to perform the activities

Staffing

review and adjusting the competency requirements for each major activity within correspondings KRAs

Staffing

matching competency requirements from the responsible person already assigned to the activity

Dizon (1977) - Philippine Healthcare System

a complex set of organizations interacting to provide an array of health services

Health workforce

has to deal with the pressing issues of underemployed workers, limited resources, and unequal distribution

Private Sector

50% of the overall health system

Private Sector

strongly involved in imporving the delivery of health services

Executive Order No. 119, Sec 3 - Ministry of Health (DOH)

_______ has the responsability to create, plan, implement, and systematize national health policies

Executive Order No. 119, Sec 3 - Ministry of Health (DOH)

primary function is to promote, protect, and preserve or restore peoples health by giving health services and by monitoring and motivating health service providers

Executive Order No. 119, Sec 3 - Ministry of Health (DOH)

responsible for the issuance of health-related licenses and accrediations and disseminating information about national health indicators

1.formulation and development of national health policies, guidelines, standards, and manual of operations for health services and programs;

2. issuance of rules and regulations, licenses, and accreditations;

3. promulgation of national health standards, goals, priorities, and indicators;

4. development of special health programs and projects; and

5. advocacy for legislation on health policies and programs.

Department of health shall be responsible for the following:

Executive Order No. 119, Sec 3 - Ministry of Health (DOH)

The primary function of this is the promotion, protection, or preservation of the health of the people through the provision of health services and through the regulation and encouragement of providers of health goods and services

VISION

Health as a right: Health for all FIlipinos by the year 2000 and Health in the Hands of the People by the year 2020

MISSION

in partnership with the people, is to ensure equity, quality, and access to health care:

- by making services available;

- by arousing community awareness;

- by mobilizing resources; and

- by promoting the means to better health.

Primary Level, Secondary Level, Tertiary Level

Enumare the levels of Health Care Facilities

Primary Level

This includes rural health units, their sub-centers, chest clinics, malaria eradication units, and schistosomiasis control units operated by the DOH; puericulture centers operated by League of Puericulture Centers; tuberculosis clinics and hospitals of the Philippine Tuberculosis Society; private clinics, clinics operated by the Philippine Medical Association; clinics operated by large industrial firms for their employees; community hospitals and health centers operated by the Philippine Medical Care Commission and other health facilities operated by voluntary religious and civic groups (Williams-Tungpalan, 1981).

Secondary Level

These are the smaller, non-departmentalized hospitals, including emergency and regional hospitals in which services to patients with symptomatic stages of the disease, which require moderately specialized knowledge and technical resources for adequate treatment is offered.

Tertiary Level

These are medical centers and large hospitals that offer highly technological and sophisticated services.

Tertiary Level

These are the specialized national hospitals. The services rendered at this level are for clients afflicted with diseases that seriously threaten their health and which require highly technical and specialized knowledge, facilities, and personnel for effective treatment (Williams-Tungpalan, 1981).

Factors on the Various Categories of Health Workers Among Countries and Communities

available health manpower resources

local health needs and problems

political and financial feasibility

Village/Grass root, Intermediate Level, First Line Hospital Personnel

enumerate the three levels of primary health care workers

Village/Grass Root

First contacts of the community, simple curative and preventive healthcare measures promoting healthy environment

Village/Grass Root

in activities geared towards the imporvement of the socio-economic level of the community, including community health workers, volunteers, and birth attendants

Intermediate Level

workers represent the first source of professional care, attenfing to health problems beyond the competence of village workers

Intermediate Level

provide support to front-line workers in terms of supervision, training supplies, and services

Intermediate Level

include medical practitioners, nurses, and midwives

First Line Hospital Personnel

provide back up health services for cases that require hospitalization, establishing a close contact with intermediate level health workers or village health workers

First Line Hospital Personnel

This set of workers includes physicians with specialty, nurses, dentist, pharmacists, and other health professionals.