Introduction to Healthcare System

  • Health System

    • All institutions, people and action whose primary purpose is to improve health (WHO, 2000).

    • Primary Health Care (PHC) is a whole-of-society approach to health that aims at ensuring the highest possible level of health and well-being and their equitable distribution by focusing on people’s needs and as early as possible along the continuum from health promotion and disease prevention to treatment, rehabilitation and palliative care, and as close as feasible to people’s everyday environment (WHO and UNICEF. A vision for primary health care in the 21st century: Towards UHC and the SDG’s, 2018).

  • Declaration of Alma-ata (1978)

    • Goal - Health for all though primary health care.

    • Health, which is a state of complete physical, mental, and social well-being, and not merely the absence of disease of infirmity, is a fundamental human right.

    • Gross inequality in the health status of the people-world concern.

    • Cost that the community and country can afford to maintain at every stage.

    • Can be attained through a fuller and better use of the world’s resources.

  • Declaration of Astana (2018)

    • Critical role of PHC and aims to refocus efforts on primary health care to ensure that everyone everywhere is able eo enjoy the highest possible attainable standard of health.

    • Renewed political commitment to primary health care from governments, NGO’s, professional organizations, academia and global health and development organizations.

    • Commemorate and reflect on Declaration of Alma-ata.

  • Importance of Primary Health Care (PHC)

    • Provides the ‘programmatic engine’ for Universal Health Care (UHC), the health-related Sustainable Developmental Goals (SDG’s) and health security.

      • equitable, cost - effective and efficient approach to enhance people’s physical and mental health, as well as social well-being.

      • essential and affordable care that is accessible to everyone in the community.

    • Make health systems more resilient to situation of crisis, more proactive in detecting early signs of epidemics and more prepared to act early in response to surges in demand for services.

  • Objectives of Health System

    • Improving people’s health and well being

    • Responding to people’s expectations

    • Providing protection against the costs of ill health

  • Primary Care

    • Front line or First Contact

    • Person centered

    • Comprehensive in scope

    • Not limited to illness episodes or by organ system or disease process involved

  • Primary Health Care

    • operates in local community to address health problems

    • wider population focus

  • Healthcare Delivery System

    • Network of health facilities and personnel which carries out the task of rendering health care to the people.

  • Philippine Health Care Delivery System

    • It is a complex set of organizations interacting to provide an array of health services.

      • Public - Largely financed through tax-based system.

        • National - DOH; Specialty, retained and regional hospitals, medical centers, DOH representatives.

        • Local - LGU; Provincial and district hospitals, RHUs, BHSs.

      • Private - Largely market-oriented

        • Profit - Commercial, market orientation; Private practitioners, private clinics and laboratories.

        • Non-profit - Non-commercial, service orientation; Socio-civic groups, religious organizations or foundations.

  • WHO Building Blocks of Health System

    • Governance

    • Medicines and Technologies

    • Human Resources

    • Service Delivery

    • Financing

    • Information

    • People (at the very center)

  • Governance

    • Devolution

      • act by which the National Government confers power and authority upon various local government units (LGUs) to perform specific function and responsibilities.

    • RA 7160

      • “Local Government Code of 1991”

      • It devolved the following basic service

        • Agriculture, Forest management, social welfare, Barangay Level Roads, Health Services

  • Health Service Delivery

    Key Elements:

    • Organizing health service as a network of primary care backed up by hospitals and specialized care.

    • Providing package of health benefits with clinical and public health service.

    • Ensuring access and quality of service.

    • Holding providers accountable for access and quality and ensuring consumer voice.

    Forms of Health Service Delivery

    • Public Sector

      • Financed through taxes

      • Budgeting system is done at the local and national level.

      • Health care service is “free” at point of care.

    • Public Health

      • LGUs - direct delivery of public health service

      • DOH - provides technical assistance

        • Capacity Building

        • Advisory services for disease prevention and control.

        • Provides free medicines and vaccines.