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Shaping the Next Generation Health System of the Philippines: Policy Alternatives in the Health Sector July 4, 2007 Elmer S. Soriano, MD Institute of Public Health Management

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Why “Next Generation” Health System? <ul><li>Builds upon current DOH initiatives </li></ul><ul><li>Redesigns some features to cope with new challenges </li></ul><ul><li>From financial capital to knowledge capital. </li></ul><ul><li>From hierarchy to wirearchy. </li></ul><ul><li>From sectoral to “hyper”sectoral </li></ul><ul><li>Need for institutional leaders in the health sector. </li></ul>

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Phases in the Phil. Health System <ul><li>Centralized </li></ul><ul><li>Devolution – 1992 </li></ul><ul><li>Health Sector Reform Agenda – 1998 </li></ul>

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Globalization and Migration of Health Personnel <ul><li>No.1 exporter of nurses and No.2 for MDs </li></ul><ul><li>163,756 (or 85 % of all employed nurses) are abroad </li></ul><ul><li>70 % of all Filipino nursing graduates are working overseas. </li></ul><ul><li>over 100T nurses left the country in the last ten years. </li></ul><ul><li>more than 50,000 licensed nurses opted to work abroad 2000-2003 </li></ul><ul><li>68% of Filipino MDs were working overseas in late 70s </li></ul><ul><li>17,927 Filipino MDs in US </li></ul><ul><li>3,500 Filipino doctors have left as nurses since the year 2000. </li></ul><ul><li>2,000 doctors leave yearly (Philippine Medical Association) </li></ul>

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Globalization and its effects on the Philippine Health System <ul><li>Emerging infectious diseases (SARS, Avian Flu) </li></ul><ul><li>Migration </li></ul><ul><li>JCI hospital accreditation for Medical Tourism </li></ul><ul><li>US Embassy Accreditation of St.Lukes for TB treatment of Filipino migrants </li></ul><ul><li>Seasonal OFW Beekeepers </li></ul><ul><li>Globalized Health Governance of Health Human Resources –Gov.Chavit Signs Nurses MOA with Governor of Hawaii </li></ul><ul><li>Global Health Ecosystem </li></ul>

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Health Policy Analysis using the Knowledge Management Framework <ul><li>Have we surpassed knowledge-carrying capacity for health? </li></ul><ul><li>Types of Knowledge Capital </li></ul><ul><ul><li>Human knowledge capital </li></ul></ul><ul><ul><li>Structural knowledge capital </li></ul></ul><ul><ul><li>Customer/stakeholder/relationship knowledge capital </li></ul></ul><ul><li>Ecosystem Approach </li></ul><ul><li>Managing Ecosystem Architecture to increase velocity of innovation </li></ul>

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Possible Features in the NGHS 1/3 <ul><li>a. Build alternative service delivery systems </li></ul><ul><ul><li>Build up 1 midwife per Barangay </li></ul></ul><ul><ul><li>De-sectoralized health system (school-based health, employer-based health, workplace-based health) </li></ul></ul><ul><ul><li>Telemedicine </li></ul></ul><ul><ul><li>Knowledge process outsourcing </li></ul></ul>

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Possible Features in the NGHS 1/3 <ul><li>a. Build alternative service delivery systems </li></ul><ul><ul><li>Build up 1 midwife per Barangay </li></ul></ul><ul><ul><li>De-sectoralized health system (school-based health, employer-based health, workplace-based health) </li></ul></ul><ul><ul><li>Telemedicine </li></ul></ul><ul><ul><li>Knowledge process outsourcing </li></ul></ul>

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Possible Features in the NGHS 2/3 <ul><li>b. New Business Models </li></ul><ul><li>Medical Tourism </li></ul><ul><li>Medical Education-tourism – 35,000 Koreans in the Philippines, many learning English </li></ul><ul><li>Micro-franchising – foot spa, nail spa, tooth spa, eye spa, kidney spa, heart spa? (multiplies human, structural, and customer knowledge capital) </li></ul><ul><li>build social architecture-based biz models, social contracts </li></ul><ul><li>Wikinomics-based businesses </li></ul>

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Possible Features in the NGHS 2/3 <ul><li>b. New Business Models </li></ul><ul><li>Medical Tourism </li></ul><ul><li>Medical Education-tourism – 35,000 Koreans in the Philippines, many learning English </li></ul><ul><li>Micro-franchising – foot spa, nail spa, tooth spa, eye spa, kidney spa, heart spa? (multiplies human, structural, and customer knowledge capital) </li></ul><ul><li>build social architecture-based biz models, social contracts </li></ul><ul><li>Wikinomics-based businesses </li></ul>

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Possible Features in the NGHS 3/3 <ul><li>c. New Governance Models </li></ul><ul><li>e-Governance for health </li></ul><ul><li>DOH University (learning management system), DSWD University </li></ul><ul><li>Inter-state health governance – expand unit of health governance; re-circulate Migrant Health Personnel – 10+2 – Chavit arrangement </li></ul>

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<ul><li>Thank you. </li></ul>

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<ul><li>Sources: </li></ul><ul><li>Sources: </li></ul><ul><li> www.philippineservicescoalition.com/docs/Health%20Services%20Sector%20by%20Dr.%20Galvez%20Tan.pdf </li></ul><ul><li> Sustainable Health, Sustainable Wealth; Asian Institute of Management Policy Center, Volume XI, No.1, 2007 </li></ul>