Health in the Philippines

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Presentation given during a Global Health Forum with Korean medical students last February 2012 in Manila

Presentation given during a Global Health Forum with Korean medical students last February 2012 in Manila

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  • greetings!

    we are inviting medical professionals to join our advocacy in fight against sugar overload.

    We wish to give product samples to those that might want to try and experience results for themselves and become part of our campaign program...

    best regards,

    camil chua
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  • Very nice presentation doctor. I will be running a RHU unit soon. The info I learned from your ppt will be put into good use.
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  • @Hisloveisclarity Thank you for your message and happy to know that you find the powerpoint useful. Please feel free to use, however 2 things: 1.) This may be outdated as the powerpoint was used last year, and it was based on some previous powerpoints by colleagues from 2011, and 2) The data are from other authoritative sources, like DOH reports, therefore you actually cannot quote me but the original documents. Cheers!
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  • Hello and good Morning Dr. Guinto. Thank you for posting this up :) It is a very helpful presentation that shows alot of information which is (kind of) hard to find on the Philippines. Would it be alright I I used some of the statistics found on this page? Of course you will be cited appropriately for the paper. Thank you very much! :D
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  • thank you
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  • 1. Health in the Philippines Status and System Ramon Lorenzo Luis Rosa Guinto Regional Coordinator for the Asia-PacificInternational Federation of Medical Students’ Associations (IFMSA) Doctor of Medicine Class of 2012 University of the Philippines Manila
  • 2. The Halo-Halo that is the Philippines!• Halo-halo in terms of –Population profile –Values and Perspectives on Health –Health care delivery and financing
  • 3. Population PyramidThe Filipino Population
  • 4. Map of the PhilippinesThe Philippine Government
  • 5. Catholic ChurchThe Catholic Church
  • 6. Brief History of the Philippines• Pre-colonial Times (Before 1521)• Spanish colonialism (1521-1898)• American regime (1898-1945)• Japanese puppet republic (1941- 1945)• The Third Republic (1945- present)
  • 7. Demographic CharacteristicsPopulation, total (millions) 94,013,200 (projected, NSO 2007)Population < 25 years 52.8 % (projected, NSO 2007)(% of total population) 49,617,400 M FilipinosPopulation > 60 years 6.7% (projected, NSO 2007)(% of total population) 6,637,100 M FilipinosBirth rate 23.4 (NDHS 2008)(births per 1,000 population) 2,162,303 live births per yearDeath rate 5.48 (NSO 2007)(deaths per 1,000 population) 515,192.34 deaths / year
  • 8. Top Ten Cause of MortalityCause Total Rate1. Diseases of the heart 70, 861 84.82. Diseases of the vascular 51,680 61.8system3. Malignant Neoplasms 40,524 48.94. Accidents 34,483 41.35. Pneumonia 32,098 38.46. Tuberculosis 26,770 31.07. Unclassified 21,278 25.58. Chronic lower respiratory 18,975 22.7diseases9. Diabetes mellitus 16,552 19.810. Conditions originating from 13,180 15.8the perinatal period Philippine Statistical Yearbook, 2009
  • 9. Mortality Trend: Communicable Diseases, Malignant Neoplasms & Diseases of the Heart Rate/100,000 Population Philippines, 1953-2005 Malignant Neoplasms &Communicable Diseases Diseases of the Heart 700 100 Communicable Diseases 90 600 Malignant Neoplasms Diseases of the Heart 80 500 70 60 400 50 300 40 200 30 20 100 10 0 0 1953 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 2000 01 02 03 05 Year Source: Philippine Health Statistics, 2005
  • 10. Towards the attainment of MDGs . Indicators 2015 Target AccomplishmentMDG 4:Under 5 mortality rate 26.7 34(per 1,000 live births) (2008 NDHS)Infant mortality rate 19.0 25(per 1,000 live births) (2008 NDHS)MDG 5:Maternal mortality ratio 52 162(per 100,000 live births) (2006 FPS)Proportion of births attended by 70.0 62skilled health professional (2010 NOH) (2008 NDHS)
  • 11. INDICATORS 2015 Target ACCOMPLISHMENTMDG 6Prevalence of HIV/AIDS among high risk <1% <1%groups 5,364 cases (1984-2010)Malaria morbidity rate 62/100,000 pop 21.6/100,000 pop 38,135 cases 19,555 cases (based from 1990 (2009) baseline)Malaria mortality rate 0.75 0.026 456 deaths 24 deaths (based from 1990 (2009) baseline)TB morbidity rate 137/100,000 129 (2008) 128,798 cases 121,277 cases (2010 NOH)TB mortality rate <44/100,000 41.0 (2007) 41,366 deaths (PhilPACT)TB case detection rate 70 % 75 % (NTP, 2007) 16TB cure rate 85 % 83 % (NTP, 2007)
  • 12. Six Building Blocks
  • 13. Office of Secretary of Health Attached Agencies Regional hospital Medical Centers Regional Offices Sanitaria City Health Offices Provincial Health Offices Provincial (Chartered Cities) Hospitals Inter-local Health Zones City HealthHospitals Centers City Health Offices Municipal health District offices/ Rural hospitals Barangay (Component Cities) Health Unit Health Health Stations City Barangay Health Centers Hospitals Stations Barangay Health Stations
  • 14. Organization of Health Services Organization of Health Services• Public- Private Sector imbalance – Highly resourced private sector servicing 20- 30 % of population – Health promotion/Disease prevention lag behind Curative Service provision• Fragmentation of Services – Overspecialization of curative services – Devolution of health services - national and local – Weak regulatory mechanisms
  • 15. HEALTH CAREFINANCINGIN THEPHILIPPINES
  • 16. Share of health expenditure per GNP 4 3.5 3 2.5 Percent 2 1.5 1 0.5 0 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 YearTotal health expenditure = P234.3 B or 3.2 percent of GDP Source: Philippine National Health Accounts
  • 17. Total expenditure on health as a Percentage of GDP Source: World Health Statistics 2010
  • 18. Distribution of Health Expenditure by Use of Funds Total health expenditure is P234.3 B (3.2 percent of GDP) Source: Philippine National Health Account, 2007
  • 19. Distribution of HealthExpenditure by Source of Funds Total health expenditure is P234.3 B (3.2 percent of GDP) Source: Philippine National Health Account, 2007
  • 20. Only those with money (i.e., the rich) canfully pay for out of pocket payments and often they have generous health insurance The near-poor and the lower middle classes can become impoverished to meet out of pocket for health care. The very poor don’t even have pockets
  • 21. HUMAN RESOURCES FOR HEALTH
  • 22. Organization of Health Services Health Worker Migration• Overproduction• Maldistribution• High out-migration• Nil in-migration• Low return migration Lorenzo and Dela Rosa, 2011
  • 23. “It is estimated that 70% of allhealth workers are employed in a private health sector that serves only the 30% of thepopulation that can afford to pay for their health care. ”
  • 24. “Sixty percent of our countrymen who succumb to sickness die without seeing a doctor.”
  • 25. LEB under 60 years IMR over 90 MM over 150LEB over 80 yearsIMR less than 10MM less than 15 Source: Dr. Ramon Paterno, University of the Philippines
  • 26. 87% of poorest 84% of richestquintile deliver at Quintiles deliver inhome health facility71% by hilots 77% by doctors
  • 27. MATERNAL MORTALITY RATE Per 100,000 Livebirths; 2002 UNDP Revision Country 1985-2002 Philippines 170 Thailand 36 Malaysia 30 South Korea 20 Japan 8 Italy 7 Spain 0 More than 3,000 Filipina mothers die UNNECESSARILY annually Source: Dr. Ramon Paterno, University of the Philippines
  • 28. Reproductive Health BillReproductive Health Bill
  • 29. Ang Philippine Disaster Situation• Pilipinas: Bulnerable sa Disaster – Geographical at pisikal na katangian – Sosyo-ekonomikal at pulitikal na kalagayan
  • 30. DOH DO No. 2011-0188Kalusugan Pangkalahatan Universal Health Care
  • 31. Priority Health Policy Directions of the Aquino Administration1. A roadmap towards universal health care through a refocused PhilHealth;2. Particular attention to the construction, rehabilitation, and support of health facilities: ◦ LGU/regional hospitals, ◦ rural health units ◦ barangay health stations3. Attainment of Millennium Development Goals 4, 5, and 6 ◦ Reduction of maternal, neonatal, and infant mortality ◦ Support to contain/eliminate age old pubic health diseases (malaria, dengue, TB)
  • 32. Alma Ata Declaration, 1978“The Conference strongly reaffirms that health is a fundamental human right”“The existing gross inequality in the health status of the people particularly between developed and developing countries as well as within countries is politically, socially and economically unacceptable”
  • 33. RIGHT TO HEALTH OF THE PEOPLE
  • 34. Source: Ravi Narayan, SOCHARA, India
  • 35. Social Determinants
  • 36. Basic question: What good does it do to treat people’s Illnessesonly to send them back to the conditions that made them sick?
  • 37. “The doctor of the future will give no medicine, but will interest his patients in the care of thehuman frame, in diet,and in the cause and prevention of disease.” Thomas Alva Edison
  • 38. “It is my aspiration that health will finally be seen not as a blessingto be wished for, but as a human right to be fought for.” Kofi Annan
  • 39. The Power of Medicine "Medicine is a social science, and politics is nothing else but medicine on a large scale. Medicine, as a social science, as the science of human beings, has the obligation to point out problems and to attempt their theoretical solution; the politician, the practical anthropologist, must find the means for their actual solution....The Dr. Rudolf physicians are the natural attorneys Virchow of the poor, and social problems fall toFather of Social Medicine a large extent within their jurisdiction.”
  • 40. The Power of Young People“The youth arethe hope of the Fatherland.” Dr. Jose Rizal National Hero of the Philippines
  • 41. Fathers of Social Medicine
  • 42. It’s more fun in the Philippines