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Health Promotion and Disease Prevention under the Aquino Health Agenda by Usec. Teodoro Herbosa


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The presentation was shown during the Healthy People, Wealthy Nation Forum last January 29, 2014.

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Health Promotion and Disease Prevention under the Aquino Health Agenda by Usec. Teodoro Herbosa

  1. 1. The  Philippine  Health  Situa/on:  How  do  we   promote  health  and  prevent  diseases  under   the  Aquino  Health  Agenda?   Teodoro  J.  Herbosa,  MD,  FPCS   Undersecretary     Department  of  Health,  Philippines  
  2. 2. Outline   •  NCD  Philippine  Health  Situa<on   •  Universal    Health  Care   •  NCD  Strategic  Framework   •  Accomplishment  on  NCD            Preven<on  and  Control  by            UHC  Pillars   •  Why  Health  Promo<on?   •  Priori<es  for  Ac<on   01/28/14   Healthy  People,  Wealthy  Na<on:  A  Forum   on  Achieving  Growth   2  
  3. 3. PHILIPPINE  SETTING:   Top  Ten  Causes  of  Mortality   Cause   Total   Rate   1.  Diseases  of  the  heart   70,  861   84.8   2.  Diseases  of  the  vascular  system   51,680   61.8   3.  Malignant  Neoplasms   40,524   48.9   4.  Accidents   34,483   41.3   5.  Pneumonia   32,098   38.4   6.  Tuberculosis   26,770   31.0   7.  Unclassified   21,278   25.5   8.  Chronic  lower  respiratory  diseases   18,975   22.7   9.  Diabetes  mellitus   16,552   19.8   10.  Condi/ons  origina/ng  from  the   perinatal  period   13,180   15.8   Philippine  Sta<s<cal  Yearbook,  2009  
  4. 4. 01/28/14   Source:  Philippine  Health  Sta2s2cs,  2009   4  
  5. 5. Prevalence  of  hypertension,  hyperglycemia,    dyslipidemia  &  overweight     1998,  2003  and  2008  Philippine  NNS,  FNRI   1998   2003   2008   Basis   Hypertension   21.0   22.5   25.3   SBP  ≥  140,  DBP  ≥  90   Hyperglycemia   3.9   3.4   4.8   FBS  >  126  mg/dL   Total  cholesterol   4.0   8.5   10.2   ≥  240  mg/dL   LDL-­‐c   8.1   11.7   11.8   ≥  160  mg/dL   HDL-­‐c   76.6   54.2   64.1   <  40  mg/dL   Triglycerides   8.7   9.4   14.6   ≥  200  mg/dL   BMI  (Overweight)   20.2   24.0   26.6   BMI  ≥  25.0     Risk  factors   01/28/14   5  
  6. 6. ADULT  CURRENT  SMOKERS   (15  years  old  and  above)   •     28.3%  of  total  adults          (17.3M)   •    47.7%  of  adult  males        (14.6M)     •        9.0%  of  adult  females  (    2.8M)   SOURCE:  Philippines’  Global  Adult  Tobacco  Survey,  2009   01/28/14   6  
  7. 7. YOUTH  CURRENT  SMOKERS   (13  -­‐  15  years  old)   •     27.4%  currently  use  any  tobacco  product  (M-­‐34.7%;  F-­‐19.6%)   •    More  than  1  in  5  students  (21.9%)  currently  smoke  cigarefes   •    Almost  1  in  10    (9.7%)  currently  use  some  other  form  of  tobacco   •    Over  half  (57.7%)  of  students  live  in  homes  where  others  smoke   SOURCE:  Philippines’  Global  Youth  Tobacco  Survey,  2007   01/28/14   7  
  8. 8. Universal  Health  Care     Deliberate  aHen2on   to  the  needs  of   millions  of  poor   Filipino  families   which  comprise  the   majority  of  our   popula2on    
  9. 9. Filipino  Income  Quin/les        Monthly  income   Families  per  quin<le   Q1   3,460                      5,218,267     Q2   6,073                    4,094,164     Q3   9,309                    3,912,443     Q4   15,064                    3,707,494     Q5   38,065                    3,485,067     Source:    Na2onal  Health  and  Demographic  Survey,  2008    
  10. 10. Universal  Health  Care   Beaer  health   outcomes   Health   Financing   Service   Delivery   Responsive  health   system   Policy,  standards   and  regula<on   Health   Human   Resource   Equitable  health   financing   Health   Informa<on   Governance   for  Health  
  11. 11. Major  Elements  of  UHC   •  Addresses:  Quality,  Responsiveness,   Availability  &  Accessibility     •  Focuses:  Elimina<ng  dispari<es  (equity)  &   inefficiencies  (governance)   •  Guiding  principle:  Providing  essen<al  health   care  packages  to  all  regardless  of  age,  gender,   religion,  ethnicity,  socio-­‐economic  status,   ideology,  etc.        Reference:  A.O.  2010-­‐0036:  Aquino  Health  Agenda  
  12. 12. OVERVIEW ON NCDS There are 4 Major NCDs (LRDs) and 4 common shared related risk factors Modifiable  causa/ve  risk  factors   Tobacco  use   Unhealthy  diets   Physical   inac/vity   Harmful  use  of   alcohol   Cardiovascular   disease   " " " " Diabetes   " " " " Cancer   " " " " Chronic  respiratory   disease   " 01/28/14   12  
  13. 13. NCD-­‐Regional  Ac/on  Plan   Strategic  approach  and  ac/on  areas   01/28/14   Healthy  People,  Wealthy  Na<on:  A  Forum   on  Achieving  Growth   13  
  14. 14. Accomplishment  on  NCD            Preven<on  and  Control  by  UHC   Pillars   01/28/14   Healthy  People,  Wealthy  Na<on:  A  Forum   on  Achieving  Growth   14  
  15. 15. Health  Financing   •  Primary  Care  Benefit  Packages  (PCB):    a.  PCB  1  –  consulta<on,  screening  and      diagnos<cs  for  NCDs  i.e.  Visual  Inspec<on    Using  Ace<c    Acid  Wash  (VIA)    b.  PCB  2  -­‐    management  and  provision  of    medica<ons  for  NCDs  i.e.  Complete    Treatment  Packs  for  DM  and  HPN   •  Z  Packages  for  catastrophic  illnesses  i.e.  breast   cancer  and  ALL   •  Case  payment  rates    for  asthma  and  essen<al   hypertension  
  16. 16. Service  delivery   •  School-­‐based  HPV  Vaccina<on  Demonstra<on   Project  (8,000  Gr  5  females  aged  10-­‐14  y.o.  in   selected  public  schools  given  the  1st  and  2nd   dose  of  HPV  vaccines)   •  Complete  Treatment  Packages  (ComPack)   Drugs  -­‐  Na<onal  Center  for  Pharmaceu<cal   Access  and  Management  (NCPAM)  
  17. 17. Policy,  Standards  and  Regula/on   A.  LEGISLATION   •   Passage  of  Sin  Tax  Law     •   Philhealth  Law  amendments   B.  POLICIES      AO  No.  2013  –  0005  or  The  Na2onal  Policy  on  the  Unified   Registry  Systems  of  the  Department  of  Health  (Chronic  Non-­‐ communicable  Diseases,  Injury  Related  Cases,  Persons  with   Disabili2es,  and  Violence  Against  Women  and  Children  Registry   Systems)   •   AO  No.  2012-­‐0029  or  The  Implemen2ng  Guidelines  on  the   Ins2tu2onaliza2on  of  Philippine  Package  of  Essen2al  NCD   Interven2ons  (PhilPEN)  on  the  Integrated  Management  of   Hypertension  and  Diabetes  for  Primary  Health  Care  Facili2es  
  18. 18. Policy,  Standards  and  Regula/on   AO  No.  2011-­‐0003  or  The  Na2onal  policy  on   Strengthening  the  Preven2on  and  Control  of  Chronic   Lifestyle  Related  Non-­‐Communicable  Diseases   •   AO  No.  2011-­‐0013  or  Implemen2ng  Guidelines  on  the   DOH  Complete  Treatment  Pack  (COMPACK)  to  Ensure   Sustainable  Access  to  Essen2al  Drugs  and  Medicines  for   the  Marginalized  sector   •   AO  No.  2010  –  0036  or  The  Aquino  Health  Agenda:   Achieving  Universal  Health  Care  for  all  Filipinos  
  19. 19. Policy,  Standards  and  Regula/on   C.  Standards   •  On-­‐going  Development  of  Clinical  Pathways:   1.  2.  3.  4.  5.  Cardiovascular  Disease   Diabetes   Cancer  –  breast,  cervical,  prostate  and  colorectal   Chronic  Respiratory  Disease  –  COPD  and  asthma   Eye  Care   •  Development  of  training  module  on  cervical  cancer   preven<on  and  control  to  include  visual  inspec<on  of   the  cervix  using  ace<c  acid  wash  (VIA)    
  20. 20. Human  Resource   •  Trained  43  service   providers  on  VIA     •  Training  of    trainers  of   selected  medical  staff   from  Cotabato  Regional   Hospital  on  VIA  
  21. 21. Human  Resource   •  Conducted  trainings  on   Smoking  Cessa<on    to  16   CHDs,  51  DOH  hospitals  and   other  agencies   •  Integra<on  of  Smoking   Cessa<on  in  other  health   programs  and  advocacies   such  as  in  Fitness  Camps   and  Belly  Gud  for  Health  
  22. 22. Human  Resource   •  Conduct  of  TOT  and   provision  of  technical   assistance  for  CHD  roll-­‐ out  trainings  on   Philippine  Package  of   Essen<al  Non-­‐ communicable  Diseases   for  Low  Resource  Seqngs   (PhilPEN)  
  23. 23. %  Coverage  on  PhilPEN  Trainings  Conducted  by  CHDs     as  of  December  2013   01/28/14   23  
  24. 24. Propor/on  of  Health  Personnel  Trained  on  PhilPEN-­‐Na/onal  Coverage,     As  of  December  2013   01/28/14   Status  of  PhilPEN  Implementa<on   24  
  25. 25. Governance  for  Health:  Leadership  and   Stewardship   DOH   Responsible   Office   Focus  Area   Strategies  and  Key   Ac/on  Points   Lifestyle-­‐related   NCDs   Strengthening  health   system  response  to  NCDs   NCDPC   Behavioral  risk   factors   Priori<zing  key  behavioral   interven<ons   NCHP   Raising  the  priority  for   Social  determinants   mul<-­‐sectoral  ac<on   HPDPB   BLHD  
  26. 26. Health  Informa/on   •  Inclusion  of  indicator  in  the  KP  dashboard;  and     •  Inclusion  of  indicator  in  the  LGU  scorecard   •  Oriented  98    Health  Facili<es  on  Unified   Registry  System  (URS)  for  NCDs:  61  DOH   Hospitals;  14  LGU  hospitals;  23  private  head  of   medical  records  and  IT/Encoders   •  Oriented  135  health  facili<es  on  URS  
  27. 27. Other  Ini<a<ves   •  6-­‐year  Strategic  Plan    and  Communica<on  Plan   for  NCD   •  ASEAN  Regional  Forum  on  Non-­‐Communicable   Diseases  (NCDs),  October  2013   •  ASEAN  Task  Force  Mee<ng  on  NCDs,  October   2013   •  Southeast  Asia  Cancer  Control  Leadership   Forum,  April  2014   01/28/14   27  
  28. 28. Highlights  of  the  ASEAN     Regional  NCD  Forum   •  Global  Ac<on  Plan:   Roadmap  for  Addressing   NCDs  in  the  next  decade   •  ASEAN  Health   Coopera<on  in  NCDs   •  Addressing  the  Risk   Factors  of  NCDs:   Innova<ons  and  Sharing   of  Experiences   •  Presenta<on  of  the   ASEAN  declara<on  on   NCDs   01/28/14   Healthy  People,  Wealthy  Na<on:  A  Forum   on  Achieving  Growth   28  
  29. 29. WHY  HEALTH   PROMOTION?   01/28/14   Healthy  People,  Wealthy  Na<on:  A  Forum   on  Achieving  Growth   29  
  30. 30. HEALTH  PROMOTION   is  the  first  step  to  disease  preven<on.   It  must  start  with  people  who  are  basically  healthy     by  enhancing  behaviors  that  promote  well-­‐being     and  strengthening  community  measures     and  individual  lifestyles  for  the     maintenance  of  good  health.    
  31. 31. WHY  PROMOTE  HEALTH?   •  Preven<on  is  befer  than  cure.   •  Studies  show  that  people  are  becoming  increasing  interested  in   improving  their  health  through  lifestyle  changes.   •  Elimina<ng  a  few  lifestyle  risks  could  immediately  improve  quality   of  life  and  prevent  life-­‐threatening  diseases.  
  32. 32. What  will  Health  Promo/on  Contribute  to  KP    Develop  Priority  Health  Messages  for  Delivery  of   Community  Health  Teams      Promote  Services  of  Health  Facili<es  like  Facility-­‐ Based  Delivery    PHILHEALTH  SABADO  to  promote  enrolment  to   PHILHEALTH’s  various  programs    Health  Promo<on  Component  of  Programs  to   achieve  MDG  Max  i.e.  Lifestyle  Promo<on  to  prevent   NCDs  
  33. 33. Some Health Promotion Activities… •  LAKBAY  BUHAY  KALUSUGAN      KALUSUGAN  PANGKALAHATAN  ON  WHEELS      -­‐  1  Victory  Liner-­‐donated  Bus      -­‐  Transforma<on  of  8  China-­‐donated  Mobile  Clinic  buses  to  LBK-­‐KP  
  34. 34. Incidentally… Lakbay  Buhay  Kalusugan  is  one  of  the  recipients  of  the     Na<onal  Economic  and  Development  Authority's     Good  Prac/ce  Awards  2012  
  35. 35. NCHP is the NATIONAL TOBACCO CONTROL COORDINATING OFFICE of the DOH - Oversee the implementation of the National Tobacco Control Strategy - Convenorship of the Sector-Wide Anti- Tobacco (SWAT) Committees - Establishment of Regional Tobacco Control Committees/Networks
  36. 36. HEALTHY  LIFESTYLE  PROGRAM        is  now  lodged  at  the  NCHP      -­‐  Development  of  Program  Policy,            Strategic  Plan,  Manual  of  Opera<ons,          Communica<on  Plan      -­‐  Focus  on  4  Behavioral  Risk  Factors          1)  Smoking          2)  Harmful  Use  of  Alcohol          3)  Physical  Inac<vity          4)  Unhealthy  Diet      -­‐  Co-­‐Convenorship  of  the  Philippine            Coali<on  for  the  Preven<on  and  Control            of  Non-­‐Communicable  Diseases  (NCD            Coali<on)  
  37. 37. Food  Labeling  /  Healthy  Food  Op/ons  advocacy  programs   -­‐  Health  in  All  Policy   -­‐  Front-­‐of-­‐Pack  Labeling            (Salt  Reduc<on)   -­‐  Healthy  School  Canteen   -­‐  Review  of  the  ASIN  Law  
  38. 38. DANCE  FOR  HEALTH   -­‐  Belly  Gud  for  Health  (Waist  Circumference  Reduc<on  in   the  Workplace)   -­‐  Galaw  Galaw  Araw  Araw  Exercise  Video   -­‐  Banat  ni  Lolo,  Hirit  ni  Lola  Exercise  Video  
  39. 39. •  AKSYON  PAPUTOK        INJURY  REDUCTION      -­‐  Convenorship  of  a  Mul<-­‐ sector          -­‐  Technical  Working  Group   for  Policy  and  Campaign   Development  
  40. 40. NCHP Awards -­‐  DOH  Red  Orchid  Awards      (cash  prizes  limited  to  LGUs  only)   -­‐  Biennial  Outstanding  Healthy        Lifestyle  Advocacy  Awards        (6  categories:  LGU  City,  LGU        Municipality,  Workplace,   Academe,        Business  Establishment,  NGO/      Professional  Organiza<on)   COMING  SOON   -­‐  Parangal  sa  mga  Kuwentong      Kalusugan  Pangkalahatan        health  media  recogni<on  
  41. 41. National Center for Health Promotion NCHP  is  the  Department  of  Health’s  arm  in  promo<ng  health     in  seqngs  where  people  live,  work,  learn  and  play.  
  42. 42.                        Challenges   •  Ensure  PhilPEN  implementa<on  up  to  the   grass-­‐roots  level   •  Iden<fica<on  and  accredita<on  of  DOH   Hospitals  as  training  ins<tu<ons  on  VIA   •  Ins<tu<onaliza<on  of  Belly  Gud  for  Health  and   expansion  to  other  na<onal  government   agencies  
  43. 43.                                                                Priori/es  for  Ac/on         •  Afain  CHD  and  LGU  scorecard  targets   •  Regular  submission  of  senior  ci<zens  vaccines   u<liza<on  reports   •  Availability  of  cold  chain  facili<es  for  senior   ci<zens  (HWSC)  vaccines   •  Designa<on  of  dedicated  and  commifed   coordinators  for  NCDs  and  HWSC  
  44. 44. Priori<es  for  Ac<on    Identify and set critical Health Promotion Outputs and Outcomes at various levels (National, Regional, Local)  Develop a Certification Program for Health Promotion Specialist  Learn from the success of Multisectoral Coordination on Tobacco Control  Develop Health Promotion Templates for Local Government Units and other Partners for inclusion to PIPH and CIPH  Access funds like sin tax, environment tax, road users tax to promote health and safety 01/28/14   44  
  45. 45. Health Promotion & ISO 9001:2008 In  the  pursuit  to  con/nuously  improve,  meet,     and  even  exceed  people’s  expecta/ons  of  a     QUALITY  MANAGEMENT  SYSTEM     that  enhances  health  care  service  delivery...