Health and History of the PH Health System - ClinPharm 140 Part 1

Health

A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity.

Health as a Fundamental Right

The right to enjoy the highest attainable standard of health for all people, without distinction based on race, religion, political belief, or socioeconomic condition.

Health Belief Model (HBM)

A psychological model that explains health behaviors by focusing on individuals' beliefs about health risks and health actions.

Perceived Susceptibility (HBM)

An individual's belief about the likelihood of getting a disease or condition.

Perceived Severity (HBM)

An individual's judgment of how serious a disease and its consequences are.

Perceived Benefits (HBM)

Belief in the efficacy of the advised action to reduce risk or seriousness of impact.

Perceived Barriers (HBM)

The individual's opinion of the obstacles in the way of adopting a new health behavior.

Cues to Action (HBM)

External or internal triggers that prompt an individual to take action.

Self-Efficacy (HBM)

Confidence in one's ability to take the necessary action for health behavior change.

Health Care

Prevention, treatment, and management of illness, and preservation of physical and mental well-being through medical services.

Quality of Life

A measure used to assess the effectiveness of healthcare, focusing on physical, emotional, social function, role performance, and symptoms like pain.

Health Systems

All organizations, people, and actions whose primary intent is to promote, restore, or maintain health.

Evolution of Health Systems

The development of health systems shaped by scientific knowledge and public acceptance of disease control as a responsibility.

Epidemiologic Transition

The shift in population patterns relating to mortality, fertility, and leading causes of death.

Population Growth Transition

Changes in population growth trajectories and age distribution from younger to older populations.

Mortality Pattern Shift

Increasing life expectancy and changing causes of death, part of the epidemiologic transition.

Reasons for the Evolution of Health Systems

1. Growth of Scientific Knowledge.

2. Growth of public responsibility and acceptance for Disease Control.

Scientific Knowledge (Evolution of Health Systems)

Growth in understanding the sources and methods to control diseases, influencing modern health systems.

Public Responsibility for Disease Control (Evolution of Health Systems)

Increased acceptance that disease control is a shared societal duty, shaping public health systems.

Pre-18th Century Health Beliefs

Illness was viewed as a result of poor moral or spiritual conditions; public health efforts included isolation and quarantine during plagues; mediated by prayer and piety.

18th Century Health Systems

Establishment of rules for trade quarantine, isolation of the sick, voluntary hospitals for the physically and mentally ill, and councils for disease control; illness was viewed less like natural effects and more controllable through public action.

19th Century Great Sanitary Awakening

Public recognition that filth caused disease, shifting focus from isolation to improving the environment and sanitation for public health.

The Sanitary Problem

The recognition that diseases could be internally generated due to poor sanitation and that disease often indicated societal problems, especially among the poor.

Industrialization and Health

Increased population density and filth from industrialization exacerbated the spread of diseases, which became known as "diseases of the poor."

Public Health Engineering

Sanitation and engineering efforts during the 19th century, including drainage systems, waste disposal, and water purification, as methods to control disease spread.

Bacteriology (Late 19th Century)

Scientific breakthroughs identifying bacteria as causes of diseases (e.g., Louis Pasteur's discovery of anthrax bacteria), leading to vaccines and preventative public health measures.

Immunization and Water Purification

Health reforms during the late 19th century focused on scientific medical and environmental measures like these, replacing earlier moral and religious interventions in public health.

Early 20th Century Health Shift

Public health expanded beyond disease prevention to include overall health promotion through medical treatment, education, and disease analysis.

Public Health (C.E.A. Winslow's Definition)

The science and art of preventing disease, prolonging life, and promoting health through community efforts, sanitation, infection control, and health services.

Crisis in Health Care Financing (Late 20th Century)

Rising healthcare costs due to the expansion of public health activities, leading to per capita health expenditure increases and national objectives for cost containment.

Expansion of Government's Role in Health (Mid-20th Century)

Government agencies took on greater responsibilities for health service planning, financing, promotion, and education, particularly in environmental sanitation and health statistics.

Composition of Public Health

(PEELIS)

• Prevention Effectiveness

• Epidemiology

• Laboratory

• Informatics

• Surveillance

World Health Organization (WHO)

A global health organization established on April 7, 1948 by the United Nations, focused on international health cooperation and promoting the health of all people.

Health Systems

All organizations, institutions, resources, and people whose primary purpose is to improve health, including preventive, promotive, curative, and rehabilitative care.

Health Systems Building Blocks

1. Service Delivery

2. Health Workforce

3. Health Information Systems

4. Access to Essential Medicines

5. Financing

6. Leadership/Governance

Health Systems Goals

• Improve health

• Responsiveness

• Social and financial risk protection

• Improved efficiency

Service Delivery

The organization of inputs into a production process that delivers a series of health interventions in a specific setting.

Sub-functions of service delivery

• Public Health

• Primary Care

• Specialist Care

Health Workforce

The people who are engaged in delivering health services, central to ensuring health systems can respond effectively to challenges.

Health Information Systems

Digital systems that collect, analyze, and utilize health data from various sources to inform decision-making and improve public health outcomes.

Access to Essential Medicines

Ensuring that quality-assured, safe, and effective medicines, vaccines, and medical devices are available, which is fundamental to a functioning health system.

Health Financing

The process of raising, pooling, and purchasing services to enable progress toward universal health coverage and financial protection.

Core Functions of Health Financing

1. Revenue Raising

2. Pooling of Funds

3. Purchasing of Services

Leadership and Governance

Ensuring strategic policy frameworks exist and are combined with effective oversight, coalition-building, regulation, system design, and accountability.

Stakeholders in Health Governance

1. State

2. Health Service Providers

3. Citizens/Service Users

Health Systems Strengthening

The process of identifying and implementing changes in a country's health system to improve its functions, leading to better health outcomes through improved access, coverage, quality, and efficiency.

Declaration of Alma Ata

A global declaration made at the International Conference on Primary Health Care (September 6-12, 1978) emphasizing the importance of primary healthcare as a key to achieving the goal of "Health for All."

Primary Health Care (PHC)

A comprehensive, accessible, community-based form of health care that serves as the first point of contact for individuals within the health system.

Declaration of Astana

A follow up on the Declaration of Alma Ata set on October 25-26, 2018, that aims to refocus efforts on primary health care.

Philippine Healthcare System

Understanding the history of the healthcare system in the Philippines and the role of the Department of Health (DOH) in promoting sustainable healthcare.

Devolution of Healthcare

The process of decentralizing healthcare services and resources to local government units (LGUs) for more effective delivery.

Spanish Colonial Period

The establishment of the first military hospitals in the Philippines, such as Hospital Real (1565) and San Lazaro Hospital (1578), and the introduction of public health measures like smallpox vaccination and cholera control.

1571

Year Hospital Real was transferred to Intramuros, Manila to cater to the Spanish army and navy.

1578

Year the Hospital De San Juan De Dios was established

Philippine Revolution and American Colonial Period

Formation of the Department of Public Works, Education, and Hygiene and the Board of Health for the Philippine Islands. Also the Establishment of the PGH and the designation of Culion Island as Culion Leper Colony.

Department of Public Works, Education, and Hygiene

Created in 1898 by General Emilio Aguinaldo during the Philippine Revolution to address public health needs.

Board of Health for the Philippine Islands

Established by the Americans in 1901 to improve public health, laying the foundation for modern health services in the Philippines.

1907

Year that the Philippine General Hospital was established.

1907

Year the Culion Island was designated as the Culion Leper Colony.

Philippine Commonwealth Period

The Department of Health and Public Welfare was established by Pres. Manuel Quezon during this period, and WWII also happened here.

Department of Health and Public Welfare

Created by President Manuel L. Quezon in 1939 to oversee health and welfare services, with an expansion of health facilities and sanitation services.

World War II Impact

A period during which diseases like tuberculosis and malaria spiked due to the war, worsening public health conditions in the Philippines.

Philippine Republic Period

Established DOH, the transformation of the DOH into the Ministry of Health during the martial law, and the Primary Health Care approach was adopted following the Declaration of Alma Ata.

Department of Health

Established in 1947 by Executive Order No. 94, the DOH supervised health agencies and local health offices, evolving into the Ministry of Health during martial law.

Primary Health Care Policy

The adoption of the Primary Health Care approach as a national policy in the Philippines, following the Alma Ata Declaration.

Dual Health System

The health system the Philippine health system follows, comprised of both the public and private sectors.

Public Sector

Largely financed through a tax-based budgeting system

Private Sector

Largely market-oriented where healthcare is generally paid for through user fees at the point of service