MODULE 5: DEVOLUTION AND DECENTRALIZATION

Health devolution or decentralization of health services

Was initially geared towards efficiency and effectiveness of health service delivery by reallocating decision-making capability and resources to Local government unit.

Decentralization

is a core element of the implementation of the Primary Health Care, which is a strategy adopted by Department of Health in the late 1970’s in compliance with the Declaration of Alma Ata on Primary Health Care to ensure that essential health care is “made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford it was an Alma-Ata Declaration of 1978

Republic Act 71, 60 the Local Government Code of 1991.

introduced a major devolution of national government services, which included the first wave of health sector reform. The Code devolved basic services for agriculture extension, forest management, health services, barangay roads and social welfare to Local Government Units. And was signed into law on October 10, 19, 91 and took effect on January 1, 1992.

1992

he Philippines Government devolved the management and delivery of health services from the National Department of Health to locally elected provincial, city and municipal governments.

1993

when health services were devolved or transferred from the DOH to the local government units

aim of decentralization

To widen decision-making space of middle level managers, enhance resource allocations from central to peripheral areas and to improve the efficiency and effectiveness of health services management. The findings of the historical review of devolution in the Philippines reveals some consistencies with the international literature, which describe some negative effects of decentralization, and provide a rationale for the Philippines in undertaking a second wave of reform in order to 'make devolution work'.

LOCAL HEALTH BOARD

is a body that is good venue for making the local health system more responsive to the needs of the people. It’s mandate to propose annual budgetary allocations for the operation and maintenance of health facilities and services within the municipality, city or province

PROVINCIAL HEALTH BOARD COMPOSITION

* Governor- Chairman
* Provincial Health Office- Vice-Chairman
* Chairman of the Committee of Sangguniang Panlalawigan
* Department of Health Representative • Non-Government
* Organization Representative

MUNICIPAL HEALTH BOARD COMPOSITION

* Mayor- Chairman
* Municipal Health Officer- Vice Chairman
* Chairman of the Committee on Health
* Sangguniang Bayan
* Department of Health Representative \n - Many of the Public Health Nurses have been appointed as DOH, Representative
* Private and Non-Government Organization Representative

FUNCTIONS OF LOCAL HEALTH BOARD

1\. To propose to the Sanggunian concerned, in accordance with standards and criteria set by the Department of Health, annual budgetary allocations for the operation and maintenance of health facilities and services within the municipality, city or province.

\n 2. To serve as an advisory committee to the Sanggunian concerned on health matters such as, but not limited to, the necessity for, and application of, local appropriations for public health purposes.

\n 3. Consistent with the technical and administrative standards of Department of Health, create committees which shall advise local health agencies on matters such as, but not limited to, personnel selection and promotion, bids and awards, grievances and complaints, personnel discipline, budget review, operations review and similar functions.