unit 1.4: sustainable development goals

**Dual** health system

**Philippine Health System:**

Organization and Governance

Public Sector

**Philippine Health System:**

* Health services are provided by health facilities **run by the National and local governments** and are largely financed through a **tax-based budgeting system**
* Department of Health
* Local Government Units

Private sector

**Philippine Health System:**

* Largely **market-oriented**, where HS are generally paid for through **user fees at the point of service**
* clinics, infirmaries, laboratories, hospitals, drugstores, pharmaceutical and medical supply companies, health insurance companies, academic and research institutions and informal service providers

**Some of the facilities of the University of Santo Tomas Faculty of Medicine and Surgery in 1887**

a chemistry laboratory used for research and experiments

**Some of the facilities of the University of Santo Tomas Faculty of Medicine and Surgery in 1887**

a special room for people suffering from mental disorder

The Philippine Revolution and American colonial period

**Philippine Health System:** *Historical Background*

* The **Bureau of Public Health** was organized under the revolutionary government established by General __Emilio Aguinaldo__ (1898)
* Department of Public Works, Education and Hygiene (1898)

The Philippine Commonwealth and establishment of the Republic

**Philippine Health System:** *Historical Background*

* The **Department of Health and Public Welfare** was organized on 31 May 1939 under the administration of __President Manuel Quezon__
* Provided additional **health facilities and expansion of sanitation and MCH services fell into disarray** with the start of World War II, with the **Japanese forces occupying the entire islands**
* The incidences of **TB, malaria, malnutrition and other diseases increased** during the war years.

Establishment of the Department of Health

**Philippine Health System:** *Historical Background*

* 4 October 1947, through **Executive Order No. 94**, the **DOH was established with supervision over the Bureau of Health, Bureau of Quarantine, Bureau of Hospitals** and all local health offices in the country.

**Ministry of Health**: Dr. Clemente S. Gatmaitan

**Philippine Health System:** *Historical Background:* __*Establishment of the Department of Health*__

* in 1978, the **DOH was transformed into the** _______
* **___** as first minister of health.

Alma Ata Declaration

**Philippine Health System:** *Historical Background:* __*Establishment of the Department of Health*__

* The **primary health-care approach was adopted as a national policy** in the late 1970s following the ___

* Integrated Provincial Health Office

**Philippine Health System:** *Historical Background:* __*Establishment of the Department of Health*__

* **EO No. 852**, issued by President Ferdinand Marcos in 1983, integrated **public health and hospital services under** the ___ headed by the provincial health officer

Dr. Afredo Bengzon

**Philippine Health System:** *Historical Background:* __*Establishment of the Department of Health*__

* On April 13, 1987, the Department of Health was created from the previous Ministry of Health with ___ as the secretary of health

The Department of Health

holds the **over-all technical authority** on health as it is a national health policy-maker and regulatory institution.

* policy development,
* program planning,
* standards setting and regulation, and
* related management support services

**The Department of Health:**

Responsibilities

* **National Nutrition Council (NNC) and the Population Commission**, and
* corporate entities such as **PhilHealth, the Philippine Institute of Traditional and Alternative Health Care**, and
* four highly **specialized corporate hospitals**.

**The Department of Health:**

autonomous agencies

Dr. Francisco Duque III

**The Department of Health:**

Incumbent Health Secretary

* Headquarters at San Lazaro Compound along Rizal Ave

A global leader for attaining better health outcomes, competitive and responsive health care system, and equitable health financing

**The Department of Health:**

Vision

To guarantee equitable, sustainable and quality health for all Filipinos, especially the poor, and to lead the quest for excellence in health.

**The Department of Health:**

Mission

**Mixed** health outcomes

**Philippine Health System:** *Challenges and Implications*

* **Modest gains** in selected health outcome indicators and weak performance in others were not enough to realize the country’s targets in the NOH 2011-2016 and the **Millennium Development Goals (MDGs)**.
* Availability, accessibility and affordability of quality healthcare have impeded healthcare utilization

**Disjointed** health system

**Philippine Health System:** *Challenges and Implications*

* **Overlapping** and sometimes, **conflicting mandates** of the DOH and LGUs.
* **Problematic referral system**
* **Decentralization** fragmentation in service delivery.
* The **flow of health funds** was made more **complicated and inequitable** with the weak link between health budget allocation and devolved health functions

**FOURmula One Plus** (F1 Plus) for Health

**Philippine Health System:** *Strategic Goals and Targets*

* It envisions **Filipinos to be among the healthiest people** in __Southeast Asia by 2022, and in Asia by 2040__.
* It intends to lead the country in the development of a productive, resilient, equitable and people-centered health system towards the attainment of UHC, guided by the values of professionalism, responsiveness, integrity, compassion and excellence

To provide **Universal Health Care for all Filipinos** in the medium to long term

**Philippine Health System:** *Strategic Goals and Targets*

F1 Plus goal

Better health outcomes

**Philippine Health System:** *Strategic Goals and Targets:* __*FOURmula One Plus*__

Strategic Goal 1

More responsive health system

**Philippine Health System:** *Strategic Goals and Targets:* __*FOURmula One Plus*__

Strategic Goal 2

More equitable healthcare financing

**Philippine Health System:** *Strategic Goals and Targets:* __*FOURmula One Plus*__

Strategic Goal 3

* Professionalism
* Responsiveness
* Integrity
* Compassion
* Excellence

**Philippine Health System:** *Strategic Goals and Targets:* __*FOURmula One Plus*__

core values

Financing

**Philippine Health System:** *Strategic Goals and Targets:* __*FOURmula One Plus*__

secure sustainable investments to improve health outcomes and ensure efficient and equitable use of health resources

Service Delivery

**Philippine Health System:** *Strategic Goals and Targets:* __*FOURmula One Plus*__

ensure the accessibility of essential quality health services at appropriate levels of care

Regulation

**Philippine Health System:** *Strategic Goals and Targets:* __*FOURmula One Plus*__

ensure high quality and affordable health products, devices, facilities, and services

Governance

**Philippine Health System:** *Strategic Goals and Targets:* __*FOURmula One Plus*__

strengthen leadership & management capacities, cooperation, and support mechanisms necessary to ensure functional people-centered and participatory health systems

Performance Accountability

**Philippine Health System:** *Strategic Goals and Targets:* __*FOURmula One Plus*__

use management systems to drive better excecution of policies and programs in the DOH while ensuring responsibility to all stakeholders

Millennium Development Goals (MDGs)

1. eradicate extreme poverty & hunger
2. achieve universal primary education
3. promote gender equality & empover women
4. reduce child mortality
5. improve maternal health
6. combat HIV/AIDS, malaria, and other diseases
7. ensure environmental sustainability
8. global partnership for development

Sustainable Development Goals (SDGs)

* set of goals to **end poverty, protect the planet, and ensure prosperity** for all
* each goal has to be achieved over the **next 15 years**
* **everyone** needs to do their part

MDG: 8

SDG: 17

**MDGs vs SDGs:**

Goals

MDG: 21

SDG: 169

**MDGs vs SDGs:**

Targets

MDG: Experts

SDG: UN members

**MDGs vs SDGs:**

Creator of the concept

MDG: Poor

SDG: World

**MDGs vs SDGs:**

Implementation

MDG: Social

SDG: Socioeconomical

**MDGs vs SDGs:**

Focus

Financial Protection

**The Health System We Aspire For:** *Goals*

Filipinos, especially the poor are protected from high cost of health care

Better Health Outcomes

**The Health System We Aspire For:** *Goals*

Filipinos attain the best possible health outcomes with no disparity

Responsiveness

**The Health System We Aspire For:** *Goals*

Filipinos feel respected, valued, and empowered in all of their interaction with the health system

* Equitable & inclusive to all
* Transparent & accountable
* Uses resources efficiently
* Provides high quality services

**The Health System We Aspire For:**

Values

* Devolution
* Use of Generics
* Milk Code
* PhilHealth (1995)
* DOH Resources to promote local health system development
* Fiscal autonomy for government hospitals
* Good Governance programs
* Funding for UHC

**2017 DOH Annual Report:**

Milestones

2000

**Persistent Inequities in Health Outcomes:**

Every year around, ___ mothers die due to pregnancy-related complications

3 times more likely

**Persistent Inequities in Health Outcomes:**

A Filipino child born to the family is ___ to not reach his 5th birthday, compared to a rich family

stunted

**Persistent Inequities in Health Outcomes:**

3 out of 10 children are ___

healthcare expenditures

**Restrictive & Impoverishing Healthcare Costs:**

Every year, 1.5 million families are pushed to poverty due to ___

forego or delay care

**Restrictive & Impoverishing Healthcare Costs:**

Filipinos ___ due to prohibitive & unpredictable user fees or co-payments

catastrophic

**Restrictive & Impoverishing Healthcare Costs:**

Php 4,000/month healthcare expenses considered ___ for single income families

* Long wait times
* Limited autonomy to choose provider
* Less than hygienic restrooms lacking amenities
* Privacy & confidentiality taken lightly
* Poor record keeping
* Overcrowding & under-provision of care

Poor quality & undignified care synonymous with public clinics & hospitals

* Attain Health-Related SDG Targets
* Financial Risk Protection
* Better Health Outcomes
* Responsiveness

**Philippine Health Agenda Framework:**

Goal

* Equity
* Efficiency
* Quality
* Transparency

**Philippine Health Agenda Framework:**

Values

All Life Stages & Triple Burden of Disease

**Philippine Health Agenda Framework:**

Guarantee 1

Service Delivery Network

**Philippine Health Agenda Framework:**

Guarantee 2

Universal Health Insurance

**Philippine Health Agenda Framework:**

Guarantee 3