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PHILIPPINE HEALTH AGENDA 2016-2022
Healthy Philippines 2022
The Health System We Aspire For
Filipinos, especially the
poor, marginalized, and
vulnerable are
protected from high
cost of health care
FINANCIAL
PROTECTION
Filipinos attain the
best possible health
outcomes with no
disparity
BETTER HEALTH
OUTCOMES
Filipinos feel
respected, valued, and
empowered in all of
their interaction with
the health system
RESPONSIVENESS
GOALS
2
EQUITABLE & INCLUSIVE
TO ALL
PROVIDES HIGH
QUALITY SERVICES
USES RESOURCES
EFFICIENTLY
TRANSPARENT &
ACCOUNTABLE
The Health System We Aspire For
VALUES
3
During the last 30 years of Health Sector Reform, we have
undertaken key structural reforms and continuously built on
programs that take us a step closer to our aspiration.
PhilHealth (1995)
Good Governance
Programs
(ISO, IMC, PGS)
DOH resources to
promote local
health system
development
Milestones
Fiscal autonomy
for government
hospitals
Devolution Use of Generics
Funding
for UHC
Milk Code
2000
Every year, around
2000 mothers die due
to pregnancy-related
complications.
Persistent Inequities in Health Outcomes
Three out of 10
children are
stunted.
A Filipino child born to the
poorest family is 3 times
more likely to not reach his
5th birthday, compared to
one born to the richest
family.
5
Restrictive and Impoverishing Healthcare Costs
Every year, 1.5 million
families are pushed to
poverty due to health
care expenditures
Filipinos forego or delay
care due to prohibitive
and unpredictable user
fees or co-payments
Php 4,000/month
healthcare expenses
considered
catastrophic for single
income families
Tiisin ko na
lang ito..
6
Poor quality and undignified care synonymous
with public clinics and hospitals
Long wait times
Less than hygienic restrooms,
lacking amenities
Poor record-keeping Overcrowding &
under-provision of care
Privacy and confidentiality
taken lightly
Limited autonomy
to choose provider
7
Lahat Para sa Kalusugan!
Tungo sa Kalusugan Para sa Lahat
Investing in People
• UNIVERSAL HEALTH
COVERAGE
• STRENGTHEN
IMPLEMENTATION OF
RPRH LAW
• WAR AGAINST
DRUGS
• ADDITIONAL
FUNDS FROM
PAGCOR
Protection Against
Instability
Goals:  Attain  Health-­Related  SDG  Targets
Financial  Risk  Protection,  Better  Health  Outcomes,  Responsiveness
Values:  Equity,  Efficiency,  Quality,  Transparency
A C H I E V E
ATTAIN HEALTH-RELATED SDG TARGETS
Financial Risk Protection | Better Health Outcomes | Responsiveness
Values: Equity, Quality, Efficiency, Transparency, Accountability, Sustainability, Resilience
3 Guarantees
UNIVERSAL  
HEALTH  
INSURANCE
SERVICE  DELIVERY  
NETWORK
ALL  LIFE  STAGES  &  
TRIPLE  BURDEN  OF  
DISEASE
ALL LIFE STAGES &
TRIPLE BURDEN OF DISEASE
GUARANTEE #1
Services for Both the Well & the Sick
Guarantee 1: All Life Stages & Triple Burden of Disease
COMMUNICABLE
DISEASES
DISEASES OF RAPID
URBANIZATION &
INDUSTRIALIZATION
NON-
COMMUNICABLE
DISEASES &
MALNUTRITION
Pregnant Newborn Infant Child Adolescent Adults Elderly
First 1000 days | Reproductive and sexual health | maternal, newborn,
and child health | exclusive breastfeeding | food & micronutrient
supplementation | Immunization | Adolescent health | Geriatric Health
| Health screening, promotion & information
12
Guarantee 1: All Life Stages & Triple Burden of Disease
• HIV/AIDS, TB, Malaria
• Diseases for Elimination
• Dengue, Lepto,
Ebola, Zika
• Injuries
• Substance abuse
• Mental Illness
• Pandemics, Travel Medicine
• Health consequences of
climate change / disaster
• Cancer, Diabetes, Heart
Disease and their Risk
Factors – obesity,
smoking, diet,
sedentary lifestyle
• Malnutrition
13
COMMUNICABLE
DISEASES
DISEASES OF RAPID
URBANIZATION &
INDUSTRIALIZATION
NON-
COMMUNICABLE
DISEASES &
MALNUTRITION
SERVICE DELIVERY NETWORK
GUARANTEE #2
Functional Network of Health Facilities
Guarantee 2: Services are delivered
by networks that are
ENHANCED BY
TELEMEDICINE
AVAILABLE 24/7 &
EVEN DURING
DISASTERS
PRACTICING
GATEKEEPING
COMPLIANT WITH
CLINICAL PRACTICE
GUIDELINES
LOCATED CLOSE
TO THE PEOPLE
(Mobile Clinic or Subsidize
Transportation Cost)
FULLY FUNCTIONAL
(Complete Equipment,
Medicines, Health
Professional)
15
UNIVERSAL
HEALTH INSURANCE
GUARANTEE #3
Financial Freedom when Accessing Services
•No  balance  billing  for  the  poor/basic  
accommodation  &  Fixed  co-­payment
for  non-­basic  accommodation
• Expand  benefits  to  cover  comprehensive
range  of  services
• Contracting  networks of  providers  within  
SDNs
Guarantee 3: Services are financed predominantly by PhilHealth
PHILHEALTH  AS  MAIN  
REVENUE  SOURCE  
FOR  PUBLIC  HEALTH  
CARE    PROVIDERS
SIMPLIFY
PHILHEALTH
RULES  
PHILHEALTH  AS  THE  
GATEWAY  TO  FREE  
AFFORDABLE  CARE
• 100%  of  Filipinos are  members
• Formal  sector premium  paid  through payroll  
• Non-­formal  sector  premium  paid  through  tax  
subsidy
17
Our Strategy
A
C
H
I
E
V
E
Advance quality, health promotion and primary care
Cover all Filipinos against health-related financial risk
Harness the power of strategic HRH development
Invest in eHealth and data for decision-making
Enforce standards, accountability and transparency
Value all clients and patients, especially the poor,
marginalized, and vulnerable
Elicit multi-sectoral and multi-stakeholder support for
health
18
1. Conduct annual health visits for all poor families and
special populations (NHTS, IP, PWD, Senior Citizens)
2. Develop an explicit list of primary care entitlements that
will become the basis for licensing and contracting
arrangements
3. Transform select DOH hospitals into mega-hospitals with
capabilities for multi-specialty training and teaching and
reference laboratory
4. Support LGUs in advancing pro-health resolutions or
ordinances (e.g. city-wide smoke-free or speed limit
ordinances)
5. Establish expert bodies for health promotion and
surveillance and response
A Advance quality, health promotion and primary care
1. Raise more revenues for health, e.g. impose health-
promoting taxes, increase NHIP premium rates, improve
premium collection efficiency.
2. Align GSIS, MAP, PCSO, PAGCOR and minimize overlaps with
PhilHealth
3. Expand PhilHealth benefits to cover outpatient diagnostics,
medicines, blood and blood products aided by health
technology assessment
4. Update costing of current PhilHealth case rates to ensure that
it covers full cost of care and link payment to service quality
5. Enhance and enforce PhilHealth contracting policies for
better viability and sustainability
C Cover all Filipinos against health-related financial risk
H Harness the power of strategic HRH development
1. Revise health professions curriculum to be more
primary care-oriented and responsive to local and
global needs
2. Streamline HRH compensation package to
incentivize service in high-risk or GIDA areas
3. Update frontline staffing complement standards
from profession-based to competency-based
4. Make available fully-funded scholarships for HRH
hailing from GIDA areas or IP groups
5. Formulate mechanisms for mandatory return of
service schemes for all heath graduates
1. Mandate the use of electronic medical records in all health
facilities
2. Make online submission of clinical, drug dispensing,
administrative and financial records a prerequisite for
registration, licensing and contracting
3. Commission nationwide surveys, streamline information
systems, and support efforts to improve local civil
registration and vital statistics
4. Automate major business processes and invest in ware-
housing and business intelligence tools
5. Facilitate ease of access of researchers to available data
I Invest in eHealth and data for decision-making
1. Publish health information that can
trigger better performance and
accountability
2. Set up dedicated performance
monitoring unit to track
performance or progress of reforms
E Enforce standards, accountability and transparency
1. Prioritize the poorest 20 million Filipinos in all health
programs and support them in non-direct health
expenditures
2. Make all health entitlements simple, explicit and
widely published to facilitate understanding, &
generate demand
3. Set up participation and redress mechanisms
4. Reduce turnaround time and improve transparency
of processes at all DOH health facilities
5. Eliminate queuing, guarantee decent
accommodation and clean restrooms in all
government hospitals
V
Value all clients and patients, especially the poor,
marginalized, and vulnerable
1. Harness and align the private sector in planning
supply side investments
2. Work with other national government agencies to
address social determinants of health
3. Make health impact assessment and public health
management plan a prerequisite for initiating
large-scale, high-risk infrastructure projects
4. Collaborate with CSOs and other stakeholders on
budget development, monitoring and evaluation
E Elicit multi-sectoral and multi-stakeholder support for health
ATTAIN HEALTH-
RELATED SDGs
UNIVERSAL
HEALTH
INSURANCE
SERVICE DELIVERY
NETWORK
Financial Risk Protection
Better Health Outcomes
Responsiveness
ALL LIFE STAGES &
TRIPLE BURDEN OF
DISEASE

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Philippine Health Agenda 2016-2022 Goals: Attain SDGs, UHC, Quality Network

  • 1. PHILIPPINE HEALTH AGENDA 2016-2022 Healthy Philippines 2022
  • 2. The Health System We Aspire For Filipinos, especially the poor, marginalized, and vulnerable are protected from high cost of health care FINANCIAL PROTECTION Filipinos attain the best possible health outcomes with no disparity BETTER HEALTH OUTCOMES Filipinos feel respected, valued, and empowered in all of their interaction with the health system RESPONSIVENESS GOALS 2
  • 3. EQUITABLE & INCLUSIVE TO ALL PROVIDES HIGH QUALITY SERVICES USES RESOURCES EFFICIENTLY TRANSPARENT & ACCOUNTABLE The Health System We Aspire For VALUES 3
  • 4. During the last 30 years of Health Sector Reform, we have undertaken key structural reforms and continuously built on programs that take us a step closer to our aspiration. PhilHealth (1995) Good Governance Programs (ISO, IMC, PGS) DOH resources to promote local health system development Milestones Fiscal autonomy for government hospitals Devolution Use of Generics Funding for UHC Milk Code
  • 5. 2000 Every year, around 2000 mothers die due to pregnancy-related complications. Persistent Inequities in Health Outcomes Three out of 10 children are stunted. A Filipino child born to the poorest family is 3 times more likely to not reach his 5th birthday, compared to one born to the richest family. 5
  • 6. Restrictive and Impoverishing Healthcare Costs Every year, 1.5 million families are pushed to poverty due to health care expenditures Filipinos forego or delay care due to prohibitive and unpredictable user fees or co-payments Php 4,000/month healthcare expenses considered catastrophic for single income families Tiisin ko na lang ito.. 6
  • 7. Poor quality and undignified care synonymous with public clinics and hospitals Long wait times Less than hygienic restrooms, lacking amenities Poor record-keeping Overcrowding & under-provision of care Privacy and confidentiality taken lightly Limited autonomy to choose provider 7
  • 8. Lahat Para sa Kalusugan! Tungo sa Kalusugan Para sa Lahat
  • 9. Investing in People • UNIVERSAL HEALTH COVERAGE • STRENGTHEN IMPLEMENTATION OF RPRH LAW • WAR AGAINST DRUGS • ADDITIONAL FUNDS FROM PAGCOR Protection Against Instability
  • 10. Goals:  Attain  Health-­Related  SDG  Targets Financial  Risk  Protection,  Better  Health  Outcomes,  Responsiveness Values:  Equity,  Efficiency,  Quality,  Transparency A C H I E V E ATTAIN HEALTH-RELATED SDG TARGETS Financial Risk Protection | Better Health Outcomes | Responsiveness Values: Equity, Quality, Efficiency, Transparency, Accountability, Sustainability, Resilience 3 Guarantees UNIVERSAL   HEALTH   INSURANCE SERVICE  DELIVERY   NETWORK ALL  LIFE  STAGES  &   TRIPLE  BURDEN  OF   DISEASE
  • 11. ALL LIFE STAGES & TRIPLE BURDEN OF DISEASE GUARANTEE #1 Services for Both the Well & the Sick
  • 12. Guarantee 1: All Life Stages & Triple Burden of Disease COMMUNICABLE DISEASES DISEASES OF RAPID URBANIZATION & INDUSTRIALIZATION NON- COMMUNICABLE DISEASES & MALNUTRITION Pregnant Newborn Infant Child Adolescent Adults Elderly First 1000 days | Reproductive and sexual health | maternal, newborn, and child health | exclusive breastfeeding | food & micronutrient supplementation | Immunization | Adolescent health | Geriatric Health | Health screening, promotion & information 12
  • 13. Guarantee 1: All Life Stages & Triple Burden of Disease • HIV/AIDS, TB, Malaria • Diseases for Elimination • Dengue, Lepto, Ebola, Zika • Injuries • Substance abuse • Mental Illness • Pandemics, Travel Medicine • Health consequences of climate change / disaster • Cancer, Diabetes, Heart Disease and their Risk Factors – obesity, smoking, diet, sedentary lifestyle • Malnutrition 13 COMMUNICABLE DISEASES DISEASES OF RAPID URBANIZATION & INDUSTRIALIZATION NON- COMMUNICABLE DISEASES & MALNUTRITION
  • 14. SERVICE DELIVERY NETWORK GUARANTEE #2 Functional Network of Health Facilities
  • 15. Guarantee 2: Services are delivered by networks that are ENHANCED BY TELEMEDICINE AVAILABLE 24/7 & EVEN DURING DISASTERS PRACTICING GATEKEEPING COMPLIANT WITH CLINICAL PRACTICE GUIDELINES LOCATED CLOSE TO THE PEOPLE (Mobile Clinic or Subsidize Transportation Cost) FULLY FUNCTIONAL (Complete Equipment, Medicines, Health Professional) 15
  • 16. UNIVERSAL HEALTH INSURANCE GUARANTEE #3 Financial Freedom when Accessing Services
  • 17. •No  balance  billing  for  the  poor/basic   accommodation  &  Fixed  co-­payment for  non-­basic  accommodation • Expand  benefits  to  cover  comprehensive range  of  services • Contracting  networks of  providers  within   SDNs Guarantee 3: Services are financed predominantly by PhilHealth PHILHEALTH  AS  MAIN   REVENUE  SOURCE   FOR  PUBLIC  HEALTH   CARE    PROVIDERS SIMPLIFY PHILHEALTH RULES   PHILHEALTH  AS  THE   GATEWAY  TO  FREE   AFFORDABLE  CARE • 100%  of  Filipinos are  members • Formal  sector premium  paid  through payroll   • Non-­formal  sector  premium  paid  through  tax   subsidy 17
  • 18. Our Strategy A C H I E V E Advance quality, health promotion and primary care Cover all Filipinos against health-related financial risk Harness the power of strategic HRH development Invest in eHealth and data for decision-making Enforce standards, accountability and transparency Value all clients and patients, especially the poor, marginalized, and vulnerable Elicit multi-sectoral and multi-stakeholder support for health 18
  • 19. 1. Conduct annual health visits for all poor families and special populations (NHTS, IP, PWD, Senior Citizens) 2. Develop an explicit list of primary care entitlements that will become the basis for licensing and contracting arrangements 3. Transform select DOH hospitals into mega-hospitals with capabilities for multi-specialty training and teaching and reference laboratory 4. Support LGUs in advancing pro-health resolutions or ordinances (e.g. city-wide smoke-free or speed limit ordinances) 5. Establish expert bodies for health promotion and surveillance and response A Advance quality, health promotion and primary care
  • 20. 1. Raise more revenues for health, e.g. impose health- promoting taxes, increase NHIP premium rates, improve premium collection efficiency. 2. Align GSIS, MAP, PCSO, PAGCOR and minimize overlaps with PhilHealth 3. Expand PhilHealth benefits to cover outpatient diagnostics, medicines, blood and blood products aided by health technology assessment 4. Update costing of current PhilHealth case rates to ensure that it covers full cost of care and link payment to service quality 5. Enhance and enforce PhilHealth contracting policies for better viability and sustainability C Cover all Filipinos against health-related financial risk
  • 21. H Harness the power of strategic HRH development 1. Revise health professions curriculum to be more primary care-oriented and responsive to local and global needs 2. Streamline HRH compensation package to incentivize service in high-risk or GIDA areas 3. Update frontline staffing complement standards from profession-based to competency-based 4. Make available fully-funded scholarships for HRH hailing from GIDA areas or IP groups 5. Formulate mechanisms for mandatory return of service schemes for all heath graduates
  • 22. 1. Mandate the use of electronic medical records in all health facilities 2. Make online submission of clinical, drug dispensing, administrative and financial records a prerequisite for registration, licensing and contracting 3. Commission nationwide surveys, streamline information systems, and support efforts to improve local civil registration and vital statistics 4. Automate major business processes and invest in ware- housing and business intelligence tools 5. Facilitate ease of access of researchers to available data I Invest in eHealth and data for decision-making
  • 23. 1. Publish health information that can trigger better performance and accountability 2. Set up dedicated performance monitoring unit to track performance or progress of reforms E Enforce standards, accountability and transparency
  • 24. 1. Prioritize the poorest 20 million Filipinos in all health programs and support them in non-direct health expenditures 2. Make all health entitlements simple, explicit and widely published to facilitate understanding, & generate demand 3. Set up participation and redress mechanisms 4. Reduce turnaround time and improve transparency of processes at all DOH health facilities 5. Eliminate queuing, guarantee decent accommodation and clean restrooms in all government hospitals V Value all clients and patients, especially the poor, marginalized, and vulnerable
  • 25. 1. Harness and align the private sector in planning supply side investments 2. Work with other national government agencies to address social determinants of health 3. Make health impact assessment and public health management plan a prerequisite for initiating large-scale, high-risk infrastructure projects 4. Collaborate with CSOs and other stakeholders on budget development, monitoring and evaluation E Elicit multi-sectoral and multi-stakeholder support for health
  • 26. ATTAIN HEALTH- RELATED SDGs UNIVERSAL HEALTH INSURANCE SERVICE DELIVERY NETWORK Financial Risk Protection Better Health Outcomes Responsiveness ALL LIFE STAGES & TRIPLE BURDEN OF DISEASE