Health Promotion andHealth Promotion and
Integrative HealthIntegrative Health
Care Sub-clusterCare Sub-cluster
Proposal fo...
Health Promotion and IntegrativeHealth Promotion and Integrative
Health Care Sub-clusterHealth Care Sub-cluster
Health pro...
Health Promotion and IntegrativeHealth Promotion and Integrative
Health Care Sub-clusterHealth Care Sub-cluster
Integrati...
 This PIM consciousness adheres to the integration ofThis PIM consciousness adheres to the integration of
different syste...
Primary Healthcare ApproachPrimary Healthcare Approach
Essential health care based on practical,Essential health care bas...
Primary care andPrimary care and
Primary HealthcarePrimary Healthcare
Primary Care, the shorter term, describes aPrimary ...
SITUATIONER/CONDITIONSITUATIONER/CONDITION
We are in a situation where the Philippine government’sWe are in a situation w...
Healthy population
Population at risk
Population with sickness
Sick that need hospitalization
but have no access to
hospit...
Percentage of DOH BudgetPercentage of DOH Budget
Support for NCD’s and NCHPSupport for NCD’s and NCHP
YEAR NON-COM
%
(fr D...
Budget of the NCHPBudget of the NCHP
Year PS MOOE CO Total
2011 14,618,000 139,360,000 153,978,000
2012 13,870,000 139,360...
AQUINO HEALTH AGENDA (AHA)AQUINO HEALTH AGENDA (AHA)
The Universal Healthcare under Aquino AdminThe Universal Healthcare u...
UHC for government is…UHC for government is…
Not a one-size-fits-all concept nor does coverageNot a one-size-fits-all con...
UHC for government is…UHC for government is…
Improving the implementation of the NationalImproving the implementation of ...
Furthermore UHC means…Furthermore UHC means…
Enhancing government healthEnhancing government health
facilities such as ho...
StrategiesStrategies
 Public-private partnership to expand, upgrade, andPublic-private partnership to expand, upgrade, an...
The three strategic thrusts:The three strategic thrusts:
Financial Risk Protection throughFinancial Risk Protection throu...
Investing in KalusuganInvesting in Kalusugan
PangkalahatanPangkalahatan
pursuant to the Social Contract provisionspursuant...
ISSUES AND CHALLENGESISSUES AND CHALLENGES
 People as patients ONLY not as partners in developing andPeople as patients O...
ISSUES AND CHALLENGESISSUES AND CHALLENGES
 Devolution of our Healthcare SystemDevolution of our Healthcare System
 Frag...
NEEDSNEEDS
Since we are in a developing country with aSince we are in a developing country with a
limited resource, then ...
JUSTIFICATIONSJUSTIFICATIONS
To clarify, preventive measures not toTo clarify, preventive measures not to
get sick and no...
VisionVision
Have a healthy citizenry for aHave a healthy citizenry for a
productive and fulfilling life!productive and fu...
““We want a healthcare system , which is designed,We want a healthcare system , which is designed,
planned, implemented an...
““The people have the right and dutyThe people have the right and duty
to participate individually andto participate indiv...
GOALGOAL
 For people to be at the heart of the healthcare system inFor people to be at the heart of the healthcare system...
The People’sThe People’s
Healthcare SystemHealthcare System
A Human Rights Based ApproachA Human Rights Based Approach
to ...
Health Promotion and Integrative Health CareHealth Promotion and Integrative Health Care
Sub-cluster: RecommendationsSub-c...
Health Promotion and Integrative HealthHealth Promotion and Integrative Health
Care Sub-cluster: RecommendationsCare Sub-c...
Recommended Budget (DOH NCHP)Recommended Budget (DOH NCHP)
Program 2013 2014 (DOH proposed) 2014 (ABI Proposed)
Tobacco an...
Recommended Budget (PITAHC)Recommended Budget (PITAHC)
Program 2013 2014 (DOH
proposed)
2014 (ABI
Proposed)
Tobacco and Al...
Possible Sources of Additional FundsPossible Sources of Additional Funds
SinTax (provision on the attainment of MDGsSinTa...
Health Promotion and IntegrativeHealth Promotion and Integrative
Health Care Sub-clusterHealth Care Sub-cluster
Members:Me...
MARAMINGMARAMING
SALAMAT PO!SALAMAT PO!
Health promotion and integrative health care alternative budget proposal
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Health promotion and integrative health care alternative budget proposal

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This proposal form part of the alternative budget on health presented before the Committee on Appropriations during the civil society presentation on the alternative budget.

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Health promotion and integrative health care alternative budget proposal

  1. 1. Health Promotion andHealth Promotion and Integrative HealthIntegrative Health Care Sub-clusterCare Sub-cluster Proposal for FY 2014Proposal for FY 2014 Alternative Budget Initiative (ABI) Health Cluster
  2. 2. Health Promotion and IntegrativeHealth Promotion and Integrative Health Care Sub-clusterHealth Care Sub-cluster Health promotion is the processHealth promotion is the process of enabling people to increaseof enabling people to increase control over their health and itscontrol over their health and its determinants, and therebydeterminants, and thereby improve their healthimprove their health Ottawa Charter 1986
  3. 3. Health Promotion and IntegrativeHealth Promotion and Integrative Health Care Sub-clusterHealth Care Sub-cluster Integrative Health Care is awareness,Integrative Health Care is awareness, a consciousness of viewing health as aa consciousness of viewing health as a state of total well-being resultingstate of total well-being resulting from the interplay of socio-economic,from the interplay of socio-economic, political and spiritual aspects of life.political and spiritual aspects of life. Basic to this consciousness is theBasic to this consciousness is the understanding that health is aunderstanding that health is a fundamental human right andfundamental human right and responsibility of the individual and,responsibility of the individual and, collectively, of the community.collectively, of the community.
  4. 4.  This PIM consciousness adheres to the integration ofThis PIM consciousness adheres to the integration of different systems of medicine based on empirical anddifferent systems of medicine based on empirical and scientific knowledge, rooted in the culture of the people.scientific knowledge, rooted in the culture of the people. Such an integrated system addresses the health problems inSuch an integrated system addresses the health problems in the community through promotive, preventive, curative andthe community through promotive, preventive, curative and rehabilitative services, which are accessible, affordable,rehabilitative services, which are accessible, affordable, available, effective and acceptable to the people.available, effective and acceptable to the people.  PIM, as an evolving consciousness, emphasizes the direct,PIM, as an evolving consciousness, emphasizes the direct, responsible and sustained participation of people in theresponsible and sustained participation of people in the development of their alternative health care systems, andevelopment of their alternative health care systems, an indicator of the fulfillment of their aspiration for self-indicator of the fulfillment of their aspiration for self- determination.determination.  Uses primary healthcare approach as a strategy (Alma-AtaUses primary healthcare approach as a strategy (Alma-Ata Declaration)Declaration) Influenced by INAM…Influenced by INAM…
  5. 5. Primary Healthcare ApproachPrimary Healthcare Approach Essential health care based on practical,Essential health care based on practical, scientifically sound and socially acceptable methodsscientifically sound and socially acceptable methods and technology made universally accessible toand technology made universally accessible to individuals and families in the community throughindividuals and families in the community through their full participation and at a cost that thetheir full participation and at a cost that the community and country can afford to maintain atcommunity and country can afford to maintain at every stage of their development in the spirit of self-every stage of their development in the spirit of self- reliance and self-determination. – Alma-atareliance and self-determination. – Alma-ata DeclarationDeclaration
  6. 6. Primary care andPrimary care and Primary HealthcarePrimary Healthcare Primary Care, the shorter term, describes aPrimary Care, the shorter term, describes a narrower concept of "family doctor-type" servicesnarrower concept of "family doctor-type" services delivered to individuals. Primary Health Care is adelivered to individuals. Primary Health Care is a broader term which derives from core principlesbroader term which derives from core principles articulated by the World Health Organization andarticulated by the World Health Organization and which describes an approach to health policy andwhich describes an approach to health policy and service provision that includes both servicesservice provision that includes both services delivered to individuals (Primary Care services) anddelivered to individuals (Primary Care services) and population-level "public health-type" functions.population-level "public health-type" functions. http://www.ncbi.nlm.nih.gov/pubmed/17120883
  7. 7. SITUATIONER/CONDITIONSITUATIONER/CONDITION We are in a situation where the Philippine government’sWe are in a situation where the Philippine government’s policy including its budget is greatly skewed towardspolicy including its budget is greatly skewed towards the curative and conventional approaches of medicinethe curative and conventional approaches of medicine and it has been happening for years now.and it has been happening for years now.  More budget towards infrastructure/hospital/medicine-based kindsMore budget towards infrastructure/hospital/medicine-based kinds of good and servicesof good and services  No clear support for the traditional and alternative healthcareNo clear support for the traditional and alternative healthcare Let’s review the current government’s policies onLet’s review the current government’s policies on health…health…
  8. 8. Healthy population Population at risk Population with sickness Sick that need hospitalization but have no access to hospital care Sick and hospitalized
  9. 9. Percentage of DOH BudgetPercentage of DOH Budget Support for NCD’s and NCHPSupport for NCD’s and NCHP YEAR NON-COM % (fr DOH budget) TOTAL NCDPC % (NON COM fr NCDPC budget) TOTAL NCHP % (fr DOH budget TOTAL DOH 2014 (Proposed) 677,891,00 0 0.85% 7,542,423,0 00 8.99% 165,227,00 0 0.21% 80,171,300, 000 2013 70,764,000 0.14% 6,736,124,0 00 1.05% 162,479,00 0 0.32% 50,442, 299,000 2012 68,766,000 0.16% 6,267,343,0 00 1.10% 153,230,00 0 0.36% 42,155,963, 000 2011 35,849,000 0.11% 5,342,956,0 00 0.67% 153,978,00 0 0.48% 31,828,616, 000 2010 35,849,000 0.14% 4,779,139,0 00 0.75% 172,322,00 0 0.70% 24,649,765, 000 2009 26,377,000 0.11% 4,509,107,0 00 0.58% 167,200,00 0 0.71% 23,666,655, 000
  10. 10. Budget of the NCHPBudget of the NCHP Year PS MOOE CO Total 2011 14,618,000 139,360,000 153,978,000 2012 13,870,000 139,360,000 153,230,000 2013 17,952,000 144,527,000 162,249,000 2014 (NEP) 16,794,000 148,433,000 165,227,000
  11. 11. AQUINO HEALTH AGENDA (AHA)AQUINO HEALTH AGENDA (AHA) The Universal Healthcare under Aquino AdminThe Universal Healthcare under Aquino Admin Primary Health CarePrimary Health Care Health Sector ReformHealth Sector Reform Integrated Referral SystemIntegrated Referral System National Health Insurance ProgramNational Health Insurance Program (PhilHealth)(PhilHealth)
  12. 12. UHC for government is…UHC for government is… Not a one-size-fits-all concept nor does coverageNot a one-size-fits-all concept nor does coverage for all people necessarily mean coverage forfor all people necessarily mean coverage for everything.everything. Maintain coverage in three critical areas: who isMaintain coverage in three critical areas: who is covered from pooled funds, what services arecovered from pooled funds, what services are covered, and how much of the cost is covered.covered, and how much of the cost is covered. Within this broad framework, we, the policyWithin this broad framework, we, the policy makers, will have to decide how and how muchmakers, will have to decide how and how much of the funds have to be raised and administered.of the funds have to be raised and administered.
  13. 13. UHC for government is…UHC for government is… Improving the implementation of the NationalImproving the implementation of the National Health Insurance Program by means of reforms inHealth Insurance Program by means of reforms in PhilHealth’s operationsPhilHealth’s operations Includes the enhancement of informationIncludes the enhancement of information dissemination activities, streamlining processes todissemination activities, streamlining processes to facilitate enrollment and other transactions forfacilitate enrollment and other transactions for members, and mobilizing our burgeoning reservesmembers, and mobilizing our burgeoning reserves to reduce out of pocket expenditures of itsto reduce out of pocket expenditures of its members which may range from 60-90% of totalmembers which may range from 60-90% of total hospital costs, depending on the disease incurred.hospital costs, depending on the disease incurred.
  14. 14. Furthermore UHC means…Furthermore UHC means… Enhancing government healthEnhancing government health facilities such as hospitals, ruralfacilities such as hospitals, rural health units, health centers, andhealth units, health centers, and placing able health workers toplacing able health workers to operate these facilities, andoperate these facilities, and stocking them with quality andstocking them with quality and affordable medicinesaffordable medicines
  15. 15. StrategiesStrategies  Public-private partnership to expand, upgrade, andPublic-private partnership to expand, upgrade, and modernize our 25 major medical centers to the tune ofmodernize our 25 major medical centers to the tune of several billion pesosseveral billion pesos  United Nations European Commission for Europe (UNECE)United Nations European Commission for Europe (UNECE) through its International PPP Center of Excellence just recentlythrough its International PPP Center of Excellence just recently selected the Philippines to be the Specialist Center for PPP inselected the Philippines to be the Specialist Center for PPP in HealthHealth  Work closely with the other national governmentWork closely with the other national government agencies, local governments, civil society and foreignagencies, local governments, civil society and foreign development organization and the private sectordevelopment organization and the private sector
  16. 16. The three strategic thrusts:The three strategic thrusts: Financial Risk Protection throughFinancial Risk Protection through expansion in National Health Insuranceexpansion in National Health Insurance Program enrollment and benefitProgram enrollment and benefit deliverydelivery Improved access to modern hospitalsImproved access to modern hospitals and health facilitiesand health facilities Attainment of health related MDGsAttainment of health related MDGs
  17. 17. Investing in KalusuganInvesting in Kalusugan PangkalahatanPangkalahatan pursuant to the Social Contract provisionspursuant to the Social Contract provisions Investing in our people, reducingInvesting in our people, reducing poverty and building nationalpoverty and building national competitivenesscompetitiveness Advancing and protecting public healthAdvancing and protecting public health Building of capacities and creation ofBuilding of capacities and creation of opportunities among the pooropportunities among the poor Increasing social protectionIncreasing social protection
  18. 18. ISSUES AND CHALLENGESISSUES AND CHALLENGES  People as patients ONLY not as partners in developing andPeople as patients ONLY not as partners in developing and implementing healthcareimplementing healthcare  Infrastructure and doctor-based; Skewed primarily toInfrastructure and doctor-based; Skewed primarily to curative care rather than preventioncurative care rather than prevention  Universal Healthcare equals universal coverageUniversal Healthcare equals universal coverage  It does not extend to the underlying determinants ofIt does not extend to the underlying determinants of health: food and nutrition, housing, access to safe &health: food and nutrition, housing, access to safe & potable water & adequate sanitation, safe & healthypotable water & adequate sanitation, safe & healthy working conditions, healthy environment, education &working conditions, healthy environment, education & participation.participation.
  19. 19. ISSUES AND CHALLENGESISSUES AND CHALLENGES  Devolution of our Healthcare SystemDevolution of our Healthcare System  Fragmented Health FinancingFragmented Health Financing  Mindset of DOH and LGU officialsMindset of DOH and LGU officials  Supply-driven rather than needs-driven in procuringSupply-driven rather than needs-driven in procuring medicines, vaccines, equipmentmedicines, vaccines, equipment  Power dynamics between doctors and otherPower dynamics between doctors and other conventional health practitioners and traditionalconventional health practitioners and traditional health / holistic medicine practitionershealth / holistic medicine practitioners
  20. 20. NEEDSNEEDS Since we are in a developing country with aSince we are in a developing country with a limited resource, then we logically need morelimited resource, then we logically need more interventions towards preventive and promotiveinterventions towards preventive and promotive healthcare.healthcare. We need affordable health goods and servicesWe need affordable health goods and services such that there would be wide-range of optionssuch that there would be wide-range of options especially to those who have less economicallyespecially to those who have less economically (e.g. traditional, alternative healing modalities).(e.g. traditional, alternative healing modalities).
  21. 21. JUSTIFICATIONSJUSTIFICATIONS To clarify, preventive measures not toTo clarify, preventive measures not to get sick and not just controlling theget sick and not just controlling the spread of diseases (e.g. Tips on How tospread of diseases (e.g. Tips on How to Control Dengue by mosquito nets, etc.Control Dengue by mosquito nets, etc. but rather focus more on properbut rather focus more on proper nutrition like eating Malunggay andnutrition like eating Malunggay and Camote Tops to strengthen resistanceCamote Tops to strengthen resistance vs Dengue and other diseases).vs Dengue and other diseases).
  22. 22. VisionVision Have a healthy citizenry for aHave a healthy citizenry for a productive and fulfilling life!productive and fulfilling life!
  23. 23. ““We want a healthcare system , which is designed,We want a healthcare system , which is designed, planned, implemented and evaluated by theplanned, implemented and evaluated by the people/community members.”people/community members.” People as principal actor, owner, participants andPeople as principal actor, owner, participants and beneficiary.beneficiary. Significantly reduced out-of-pocket expenses forSignificantly reduced out-of-pocket expenses for healthcare.healthcare. With this, what do we want ourWith this, what do we want our healthcare system to become?healthcare system to become?
  24. 24. ““The people have the right and dutyThe people have the right and duty to participate individually andto participate individually and collectively in the planning andcollectively in the planning and implementation of their healthcare.”implementation of their healthcare.” It is the responsibility of the individual and,It is the responsibility of the individual and, collectively, of the community.”collectively, of the community.” Alma-ata Declaration during the International Conference on Primary Healthcare at USSR, September 6-12, 1978
  25. 25. GOALGOAL  For people to be at the heart of the healthcare system inFor people to be at the heart of the healthcare system in terms of taking control and as informedterms of taking control and as informed participants/beneficiary of the system.participants/beneficiary of the system.  Access to affordable and quality healthcare for all.Access to affordable and quality healthcare for all.  QualityQuality would mean:would mean:  Wide range of choices of evidence-based, safe healthcareWide range of choices of evidence-based, safe healthcare modalities / integration of different systems of medicinemodalities / integration of different systems of medicine  Rooted in the culture of the peopleRooted in the culture of the people  Preventive, promotive, curative and rehabilitative medicalPreventive, promotive, curative and rehabilitative medical products and servicesproducts and services
  26. 26. The People’sThe People’s Healthcare SystemHealthcare System A Human Rights Based ApproachA Human Rights Based Approach to Universal Health Careto Universal Health Care through community-managed health plans (CMHPs)
  27. 27. Health Promotion and Integrative Health CareHealth Promotion and Integrative Health Care Sub-cluster: RecommendationsSub-cluster: Recommendations 1)1) Increase the support for Community HealthIncrease the support for Community Health Team or CHTsTeam or CHTs a.a. Provide training for interpersonal counseling andProvide training for interpersonal counseling and community health education (preventing and curing basiccommunity health education (preventing and curing basic illnesses using food , natural cures and home remedies)illnesses using food , natural cures and home remedies) b.b. Provide additional allowance/incentive for personnel in theProvide additional allowance/incentive for personnel in the CHT doing health promotion activitiesCHT doing health promotion activities c.c. Accredit barangay health workers who will be doing healthAccredit barangay health workers who will be doing health promotion activities.promotion activities. d.d. Capacitate and employ additional health professionals toCapacitate and employ additional health professionals to do health promotion at the community level (e.g. nurses)do health promotion at the community level (e.g. nurses)
  28. 28. Health Promotion and Integrative HealthHealth Promotion and Integrative Health Care Sub-cluster: RecommendationsCare Sub-cluster: Recommendations 2)2) Provide specific funding for health promotionProvide specific funding for health promotion activities (policy development to inform LGUs, andactivities (policy development to inform LGUs, and provide training for better health education) thatprovide training for better health education) that responds to NCDs (specifically diabetes,responds to NCDs (specifically diabetes, hypertension, and cancers)hypertension, and cancers) 3)3) Provide a specific budget item for the convergenceProvide a specific budget item for the convergence of stakeholders/inter-agency on health promotion-of stakeholders/inter-agency on health promotion- related initiatives (health and non-health actors).related initiatives (health and non-health actors). 4)4) On the PITAHC budget, provide additional fundingOn the PITAHC budget, provide additional funding for the standardization of herbal medicinefor the standardization of herbal medicine preparations, improvement of awarenesspreparations, improvement of awareness campaigns, and research and development.campaigns, and research and development.
  29. 29. Recommended Budget (DOH NCHP)Recommended Budget (DOH NCHP) Program 2013 2014 (DOH proposed) 2014 (ABI Proposed) Tobacco and Alcohol Control 221 Million Physical activities and Exercise 58 Million Healthy Eating Options 44 Million Exclusive Breastfeeding 61 Million Support to CHTs 7 Million Support to Various NCD Programs 100 Million Support to HP Convergence No suggestion pa Total
  30. 30. Recommended Budget (PITAHC)Recommended Budget (PITAHC) Program 2013 2014 (DOH proposed) 2014 (ABI Proposed) Tobacco and Alcohol Control Physical activities and Exercise Total
  31. 31. Possible Sources of Additional FundsPossible Sources of Additional Funds SinTax (provision on the attainment of MDGsSinTax (provision on the attainment of MDGs and health awareness campaigns)and health awareness campaigns) PDAFPDAF Others (President’s Social Fund and other lumpOthers (President’s Social Fund and other lump sums)sums)
  32. 32. Health Promotion and IntegrativeHealth Promotion and Integrative Health Care Sub-clusterHealth Care Sub-cluster Members:Members: Fatima Cabanag (KAMAO/SENTRO)Fatima Cabanag (KAMAO/SENTRO) Aida Ishikawa (Concern Inc.)Aida Ishikawa (Concern Inc.) Mercy Cepe (Health Integrated Development and Services)Mercy Cepe (Health Integrated Development and Services) Zella Pescadero (Philippine Nurses Association)Zella Pescadero (Philippine Nurses Association) Marilyn Chaguile (SBSB)Marilyn Chaguile (SBSB) Roger Broal (Earth Saver’s Movement)Roger Broal (Earth Saver’s Movement) Jofti Villena (Sarilaya)Jofti Villena (Sarilaya) Ronnel Lim (Healthcare without Harm)Ronnel Lim (Healthcare without Harm) Elen Pedrosa (Alternative Health Foundation)Elen Pedrosa (Alternative Health Foundation) Ralph Emerson Degollacion (HealthJustice)Ralph Emerson Degollacion (HealthJustice)
  33. 33. MARAMINGMARAMING SALAMAT PO!SALAMAT PO!

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