The Health Care Delivery System

I. WORLD HEALTH ORGANIZATION A. Millennium Development Goals (MDGs) B. Sustainable Development Goals II. Development of Health (DOH) III. Classification of Health Facilities A. Qualifications of Nursing Service Administrators IV. Philippine Health Care Delivery System A. Private Sector B. Public Sector V. Primary Health Care VI. Universal Health Care

WORLD HEALTH ORGANIZATION (WHO)

● Founded in 1948 and headquartered in Geneva, Switzerland

● Specialized agency of the United Nations dedicated to promoting health, keeping the world safe (ex., wars, biological agents, diseases), and serving vulnerable populations globally (marginalized people)

WORLD HEALTH ORGANIZATION (WHO) core principles

○ The Right to Health and Well-being for EVERYONE (physical & mental)

■ “Health is a right, not a privilege.”

■ Given to everyone regardless of gender, financial status, etc.

■ All should have access to healthcare services, basic human needs, a good environment, and mental health support

○ Equity in access to health

■ Equity vs Equality

● Equity: adjusts based on needs

● Equality: equally given to all

○ Integrity and inclusion in its operations

■ Act with honesty, transparency, and ethical behavior in all they do

■ Ethicomoral standards

MILLENNIUM DEVELOPMENT GOALS (MDGs)

- The United Nations Millenium Development Goals (MDGs) are 8 goals that United Nations Member States have agreed to try and achieve by the year 2015

- 189 countries agreed and signed the United Nations Millenium Declaration last September 2000 in New York, committing to achieve the goals

MILLENNIUM DEVELOPMENT GOALS goal 1

Getting access to nutritious meals is already a challenge. If poverty and hunger consequences are not addressed or if a community has no access to balanced meals, nutrient deficiencies or malnutrition. If malnutrition is present = immune system instability will follow. You will get sick.

MILLENNIUM DEVELOPMENT GOALS goal 2

There are health programs in schools na pinupush. Immunizations and health teachings sa school-children. It affects health as a whole.

MILLENNIUM DEVELOPMENT GOALS goal 3

In order to empower women, nagkakaroon ng policies like sexual and reproductive health guides, mas naging clear and precise yung mga consequences if someone engages in a certain activity. It empowered women socially and economically. If a person is empowered, meron syang magagawa to take charge in his/her health.

MILLENNIUM DEVELOPMENT GOALS goal 4

May immunizations. Promotion of breastfeeding for immunity

MILLENNIUM DEVELOPMENT GOALS goal 5

Community centers lying-in improves maternal health. Health centers also has prenatal check-ups like lab tests are conducted to monitor if going well yung progress ng pregnancy and magawan agad paraan if di okay progress. Nabibigyan vaccines nga like TT

MILLENNIUM DEVELOPMENT GOALS goal 6

Combat HIV and AIDS. Until now, in coordination with DOH, led global strategies for HIV treatment. They are more proactive now to seek treatment with STI/STD testing para atleast ma manage accordingly. TB, easy na to go sa health center

MILLENNIUM DEVELOPMENT GOALS goal 7

As we all know, the environment plays such a huge factor in our health. If we don't have access to clean water for drinking, we are at greater risk for diseases. Same with air pollution where we have air pollutants so we have to address those.

MILLENNIUM DEVELOPMENT GOALS goal 8

Saan nga ba ang pondo? U tell me gela!! eme. If an epidemic breaks out, may tendency talaga that it will grow out. Detrimental effects will also be experienced by nearby countries and suffer those effects.

SUSTAINABLE DEVELOPMENT GOALS (SDGs)

• The new goals/standards

• A Universal Call to Action. The SDGs are a blueprint for peace and prosperity, applicable to all countries, and pledge to “leave no one behind.”

• Integrated Goals: Sustainable development requires integrating economic growth, social well-being, and environmental protection ○

• A 15-Year Agenda: adopted in 2015, intended to be achieved by 2030

SUSTAINABLE DEVELOPMENT GOALS 1

Everyone should receive basic healthcare, security and quality education.

SUSTAINABLE DEVELOPMENT GOALS 2

End hunger since according to statistics, 1 in every 10 people are undernourished globally. Prices of basic goods dapat lowered down. Shift to sustainable types of diets like growing our own crops

SUSTAINABLE DEVELOPMENT GOALS 3

Ensure that people are living healthy and kailangan mabawasan ang maternal and child mortality and maraise ang life expectancy

SUSTAINABLE DEVELOPMENT GOALS 4

Ensure that everyone has access to inclusive, high quality, and equitable education. If not inclusive ang institution, paano na lang yung mga di katalinuhan? Mag remain silang ganun nalang? When in fact everyone should have equal opportunities

SUSTAINABLE DEVELOPMENT GOALS 5

Gender equality should be a human right. Important sa peaceful and prosperous mundo. PH is more on leaning conservative pero … di galit sa magnanakaw nor murderer.

SUSTAINABLE DEVELOPMENT GOALS 6

Not all countries , 3 in 10 people globally has no access to clean, safe, and potable water. Water is something that is needed to consume by a human since majority ng katawan natin is water. If no access to clean water, we will be more prone to microorganisms

SUSTAINABLE DEVELOPMENT GOALS 7

Renewable energy dapata para di magcost ng negative effect sa environment and health ng nakararami.

SUSTAINABLE DEVELOPMENT GOALS 8

All countries globally should achieve economic growth. Ex. Abolishment of provincial rate. It should be based sa work mo or capacity mo.

SUSTAINABLE DEVELOPMENT GOALS 9

Ghost projects. Isang ano lang, giba na agad sira na. Ang rating ko po dyan ay 1/10 hehe kayo po na nakaupo subukan niyo namang tumayo see you luneta september 21. Byproduct ng mga panlolokong yan ay impact sa ating health

SUSTAINABLE DEVELOPMENT GOALS 10

Maachieve if lawmakers should formulate laws that would actually safeguard the people’s interest. In collaboration with gOV, NGO, and private institutions, people can be rewarded for their hard work so at least yung people na nasa laylayan, medj umanga angat naman

SUSTAINABLE DEVELOPMENT GOALS 11

Focused more on housing. Creating dapat ng mg affordable housing katulad nung initiative ng Manila na mga condominium etc. Though it should be open for all or atleast have opportunity to those affordable housing di yung kapit kapit lang sa major etc

SUSTAINABLE DEVELOPMENT GOALS 12

Eco-friendly products are needed to be reinforced so as to create or lessen yung carbon footprints so that we can safeguard our one and only earth. Ex: Reduce, reuse recycle which is an ecofriendy initiative

SUSTAINABLE DEVELOPMENT GOALS 13

Promotion of renewable type of energy kasi ang global warming, negative effects of house gases, it can actually pose a threat to our health. Ex: climate change pag ulan,s obrang ulan, pag init sobrang init which did not happen before. This is result of our previous actions. WHO now geared toward pinapabagal or prevent as a hole so that we can still live in this world

SUSTAINABLE DEVELOPMENT GOALS 14

Kailangan natin maconserve and use of bodies of water and marien resources are used sustainably. If abuse marine resouces or bodies of water, di na natin yan mapapakinabangan in diue time. Conserve and use it in sustainable manner

SUSTAINABLE DEVELOPMENT GOALS 15

Deforestation. Kailangan mapreserve ang mountains and ecosystem ng mga mountains. For ex: dolomite beach na ngalbo sila ng bundok para lang maproduce yung dolomite beach para raw sa mental health. Turns out, based on initial investigation, kaya nagkaroon ng flooding is due to remnants ng dolomite beach.

SUSTAINABLE DEVELOPMENT GOALS 16

Justice should be provided to everyone regardless of status.

SUSTAINABLE DEVELOPMENT GOALS 17

Since this is initiated by WHO and partnerships with different countries, important tong partnership to achieve tong 17 goals. Malhihirapan tau achieve yan if di magtutulong tulungan ang differnet countries.

DEPARTMENT OF HEALTH (DOH)

• Executive Department of the PH government in charge of Public Health

• Spearheaded by the Secretary of Health, Dr. Teodoro J. Herbosa, reports directly to the president

• Works hand in hand with FDA

DEPARTMENT OF HEALTH (DOH) MISSION

“To see Filipinos become among the healthiest people in Asia by the year 2040.”

DEPARTMENT OF HEALTH (DOH) VISION

“To lead the development of a health system that is productive, resilient, equitable, and people-centered.”

DEPARTMENT OF HEALTH (DOH) CORE VALUES

Integrity, Excellence, and Compassion

DOH ADMINISTRATIVE ORDER NO. 2012-0012

• This is otherwise known as “Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines.”

• Date of Issuance was July 18, 2012 under the administration of the late president Benigno Simeon Aquino III, under the leadership of Dr. Enrique T. Ona.

• Amended last September 3, 2015 under the leadership of Dr. Janette Loreto Garin.

REPUBLIC ACT NO. 4226

• Pursuant to Section 16 of Republic Act No. 4226 otherwise known as Hospital Licensure Act.

• “The licensing agency shall study and adopt a system of classifying hospitals in the Philippines as to:” (General or Special, Service Capabilities, Size and Bed Capacity, Classification of Hospital (Public or Private)”)

HOSPITAL LEVEL 1

consulting specials

• medicine

• pediatrics

• ob-gyne

• surgery

emergency and opd services

isolation facilities

dental clinic

secondary clinical laboratory

blood station

1st level x-ay

pharmacy

HOSPITAL LEVEL 2

departamentalized clinical servicces

respiratory unit

general icu

high risk pregnancy unit

nicu

tertiary clinical laboratory

blood station

2nd level x-ray with mobile unit

HOSPITAL LEVEL 3

teaching/training with accredited residency training program in the 4 major clinical services

physical medicine and rehabilitation unit

ambulatory surgical clinic

tertiary laboratory with histiopathology

blood bank

3rd level x-ray

X-Ray: ○ Lvl1

- basics, no contrast radiographic exam

X-Ray: ○ Lvl2

- lahat ng lvl1 + can do noncontrast & contrast radiographic exams

X-Ray: ○ Lvl3

- lahat ng lvl2 + invasive procedures, angiograms, visually

General Ward Units 1 Nurse Supervisor (Nurse III)

= 50 Staff Nurses

General Ward Units 1 Nurse Supervisor (Nurse II)

= 15 Staff Nurses

General Ward Units 1 Staff Nurse

= 12 Patients/Shift

General Ward Units 1 Nursing Attendant

= 24 Patients/Shift

QUALIFICATIONS OF NURSING SERVICE ADMINISTRATORS Supervisor and Managers

1. BSN with at least 9 units of management and administration courses at the graduate level

• What if iba ang masters?

• Based on RA 9173, it is not allowed; however, in DOH, they will allow you, but with a Note of Undertaking that within 2 years, you will achieve a Master's in Nursing

1. RN with at least 2 years of experience in General Nursing Service Administration (NSA)

2. Members in good standing of the Accredited Professional Organization (APO) of nurses

QUALIFICATIONS OF NURSING SERVICE ADMINISTRATORS Chief Nurse or Director of Nursing

1. BSN, with a Master’s Degree major in nursing

2. RN with at least 5 years of experience in general

3. Member of Good Standing of the APO (a.k.a PNA) of nurses

Philippine Health Care Delivery system

the network of health facilities, insititutions, and personnel that provide health care services to the population.

Republic Act 7160

known as Local Government Code of 1991. the concept of devolution of health services occured.

Devolution of health services

the transfer of authority, responsibility, and resources for health care delivery from the national government to local government.

PRIVATE SECTOR

1. Includes for-profit and non-profit health providers, their involvement in maintaining the people’s health is enormous

2. Better access to machinery, manpower, equipment, medications etc.. = bc. they have the money and connections for it

3. Includes providing health services in clinics and hospitals, health insurance, the manufacture of medicines, vaccinations, medical supplies, and equipment

4. Makes a huge difference in the industry through research and development

5. JCI Accredited - internationally acclaimed certification; international standard of care

• ex., St. Luke’s Medical Center, Asian Hospital and Medical Center, Makati Medical Center

PUBLIC SECTOR

1. Consists of national and local government agencies providing health services

2. National Level, DOH is mandated as the lead agency in health

3. Has a regional field office and maintains specialty hospitals, regional hospitals, and health centers

4. Local Health System = run by LGUs

• ex., PHG, National Kidney and Transplant Institute, Philippine Children’s Medical Center, Philippine Orthopedic Center, Sta. Ana Hospital, Ospital ng Sampaloc, Ospital ng Maynila, National Center for Mental Health, Ospital ng Tondo

PRIMARY HEALTH CARE

• essential health care made universally accessible to individuals and families in the community by means acceptable to them through their full participation and at a cost that the community and country can afford at every stage of development

• Devised by multiple countries

• The Philippines - first country in Asia to adopt the PHC approach, through Letter of Institution (LOI) 949 of 1979