Local health systems maturity levels provide a framework for monitoring and evaluating progress on integrating local health systems. They serve as a basis for planning assistance and incentives to support integration. The levels determine the kind and level of support given to local government units based on their level of integration. They also provide a pathway for progressively realizing health system reforms through integration.

1. Policy and Health Systems
Local Health Systems
Maturity Level

2. Local Health Systems Maturity Levels
Local Health Systems Maturity Levels
General framework in the
monitoring and evaluation
of the progress of LHS
integration
Pathway to progressively
realize the reform on
integration
Basis in formulating and
updating PPAs in relation
to LHS integration
Used in complementation
with the LGU Health
Scorecard and other
existing M&E Systems
Reference to determine kind and level of
assistance, incentives, and/or recognition and
awards for LGUs to support LHS integration

3. Local Health Systems Maturity Levels

4. CHARACTERISTICS Cluster/ Unit Responsible
Unified Governance of the Local Health System
Strategic and Investment Planning
Financial Management
HRH Management and Development
Information Management System
Epidemiologic Surveillance System
Procurement and Supply Chain Management
Referral System
Disaster Risk Reduction Management for Health
(DRRM-H) System
Health Promotion Programs or Campaigns

5. Policy and Health Systems
Leadership and Governance:
Unified Governance of the Local Health
Systems

6. CONCERNS :
UHC related policiesarmory of policy templatesPolicy requirements under L1 LHS-ML.docx

7. CONCERNS :

8. TECHNICAL
WORKING
GROUP  Core - Health Office; Inner circle;
Focus
 LGU-wide – Inter-agency; Inclusivity
 Committees for integration
 Managerial
 Technical
 Financial
 Simultaneous initiatives

9. CONCERNS :
UHC related policiesarmory of policy templatesPolicy requirements under L1 LHS-ML.docx

10. CONCERNS :

11. Provincial / City Health Board Composition
Chair of Committee
on Health of the
Sanggunian
Panlalawigan /
Panlungsod
ICC/IP
Representative,
as applicable
(R.A 8371)
PO, NGO or
Private Sector
Representative
DOH
Representative
Representative of
Municipalities and
Component Cities
included in the
PWHS (RA 11223)*
Chairperson: Provincial Governor / City Mayor
Vice-Chairperson: Provincial / City Health Officer
*PHB only
PHIC
Representative
o Pres. of LMP
o All LCEs
o ILHZ chairs
UHC related policiesarmory of policy templatesPolicy requirements under L1 LHS-ML.docx

12. Functions of the P/CHB
Provincial/City Health Board
Steward of the Integrated Local Health System
Based on RA No. 11223
Oversee and coordinate the
integration and delivery of
health services
Set the overall health policy
directions and strategic thrusts
Exercise administrative and
technical supervision over
health facilities and health
human resources within their
territorial jurisdiction
Manage the Special Health
Fund (SHF)

13. CONCERNS :

14. Provincial/City Health Office
Hospital and other
Health Facilities
Operations
Primary Care
Provider Networks
Operations
Public Health
Program
Implementation
Performance
Monitoring
Health Financing
Local Health
Regulation
Information System
Procurement and
Supply Chain for
Health Products
and Services
Office of the Provincial/ City
Health Officer
Health Service
Delivery Division
Epidemiologic
Surveillance
Disaster Risk
Reduction and
Management
Health Promotion
Health Human Resource
Development
Asst. PHO/CHO Officer of same level
Health Systems
Support Division
Administrative Unit

15. Hospital Other Health
Facilities Operations
PHO PEEM/DO
LGU
Technical Other Health
Facilities Operations
PHO I PHO I
PHO II
Hospital
Davao Norte and de Oro
Davao Oriental, Sur and Occidental

16. Provincial/City
Health Office
• Not existing in the PHO
– under the provincial
Government in a
separate office
• How to transition?
• Designation
• Creation of plantilla
position (HR plan)

17. CONCERNS :

18. Support Units to the P/CHB
Management Support Unit
Administrative Secretariat
Assist in the management of
the SHF
Provide administrative and
technical support
Coordinate with necessary
P/CWHS stakeholders

19. CONCERNS :

20. Policy and Health Systems
Leadership and Governance:
Strategic and Investment Planning

21. CONCERNS :

22. • Situational and Gap Analysis Form
• Filling up the Situational and Gap Analysis Form
• M and E Framework and Gap Analysis
• Root Cause Analysis
• Status of Local Health Systems Integration
B. Accomplishing the AOP Forms
A. Situational and Gap Analysis
• Strategy and PPA Formulation
• Filling-up the AOP Forms
C. Writing the Narrative
D. Program Standards and Menu

23. Policy and Health Systems
Service Delivery:
Referral System

24. CONCERNS :

25. CONCERNS :

26. CONCERNS :

27. A. Establish Primary Care Provider Network
Conduct facility mapping and readiness
assessment
TOOL:
- HFDB mapping tool (minimum DOH req.)
- CHD/ LGU can develop their own mapping tool/
system (we can assist on the technical input for
development of the tool)

28. A. Establish Primary Care Provider Network
STAND ALONE DIAGNOSTIC FACILITIES - SERVICE CAPABILITY
Background
 AIO 2017-0014: Service delivery network as model of care in providing care
 SDN: network of organizations that provide equitable, comprehensive, integrated and
continuous good quality health services, based on primary health care approach
 Patient-centered care: need to understand demand side
 Service capability: need to understand the distribution, scope and scale of supply side
(government and private)
Objectives:
 Gather geographic mapping data of all health facilities listed in NHFR
 Gather data on service capability for each health facility
Methodology
• Use NHFR as base source of all health facilities (government and private)
• District to discuss the status of all listed facilities and fill-up the tool below
FACILITY SURVEY: STAND-ALONE DIAGNOSTIC FACILITIES
(diagnostic imaging and laboratory facilities)
Head of Facility:
Designation of the Head of Facility:
Contact Number of Facility/Email Address:
A Background information
A1 Name of Facility A2 Facility Code
A3 Region A4 Province
A5 City/ Municipality A6 District
Address(St. /Brgy)
A7 Facility ownership
 Government – DOH
 Government – LGU
 Government – Other: _____________
 Private
A8 Facility type
 Stand-alone imaging clinic
 Stand-alone laboratory clinic
 Other: ______________________
A9 Philhealth certified programs (check all that apply)
 None
 Maternal & Child Health package
 Newborn care package
 TB-DOTS package
 Animal bite package
 Primary care benefit package
 Malaria package
 Other: ______________
• Data gathered in these files
are encoded in the HFDB
link (Excel file format)
• Linked with the National
Health Facility Registry
(NHFR)
• Digital map with filtering/
search capacity by:
 Type of facility
 Services
 Distance, etc.

29. Facility Mapping: Instructions
For BHS/ Clinics:
• Please note the services that are
only obtained in the RHU/
Birthing Facility/ Infirmary.
Identify to what facility you will
refer the clients/patients for the
specific services. This may not be
the RHU but any facility nearest
you which can provide the
services.
BHS/ Clinics Referral
Facility
RHU/ Birthing
Facility/ Infirmary
Referral
Facility
PREGNANCY
√ History and Physical
Examination
History and Physical
Examination
X Nutritional
Assessment and
Counseling
BHS A Nutritional
Assessment and
Counseling
√ Pre-natal
Consultation
Pre-natal
Consultation
STI testing using
syndromic
approach
Private
Medical
Clinic A
Mental Health
Service Screening
RHU A

30. Facility Mapping: RHUs and BHSs

31. Facility Mapping: Diagnostic Facilities

32. Facility Mapping: Clustering

33. Facility Mapping: Clustering
Services:
Pregnancy
- History and Physical Examination
- Nutritional Assessment and
Counseling
- Pre-natal Consultation
- Pregnancy Test
- Ferrous Sulfate with Folic acid
- Calcium Carbonate
- Albendazole
- Tetanus Diphtheria Toxoid Vaccines
Services:
Pregnancy
- History and Physical Examination
- Nutritional Assessment and
Counseling
- Pre-natal Consultation
- Ferrous Sulfate with Folic acid
- Calcium Carbonate
- Albendazole
- Tetanus Diphtheria Toxoid
Vaccines

34. Infrastructure General Design Parameters: Cluster Clinics

35. Infrastructure General Design Parameters: BHSs

36. Equipment and supplies: Cluster Clinic

37. A. Establish Primary Care Provider Network
Conduct facility mapping and readiness
assessment
Assist the LGUs on how to do population
mapping and matching to providers
LGUs to
conduct annual
profiling
Assist LGUs
in crude
mapping/
matching of
population
(Brgy to
facilities)
Assist LGUs
in actual
assigning of
profiled
families to
mapped
providers

38. Simple Instructional Tool in Mapping and Matching the population to PCPN
1. Each municipality/ city shall create a table with the following heading:
Table 1.
Name of
Barangay
(1)
Total Population
(2)
No. of Households
(3)
No. of NHTS
(4)
No. of 4Ps
(5)
No. of IPs
(6)
BHS
(7)
RHU
(8)
Level 1
Hospital
(9)
Level 2
Hospital
(10)
Level 3
Hospital
(11)
2. Each municipality/ city shall fill in the Column 1 – 6.
3. To fill in columns 7 to 11, please refer to figure below as a sample as you go through the following instructions. The municipality/ city shall identify which BHS, RHU, Level 1 Hospital, Level
2 Hospital and Level 3 Hospital are the nearest to the barangay. These would be the facilities people will be referred to. Hence, each barangay shall be assigned to the nearest primary
care facility (eg. BHS or RHU) and linked to the next higher level of care. (primary – secondary – tertiary facilities).
Example: Brgy. Cambagan to BHS Cambagan to RHU Municipality 1 to Provincial Hospital 1 to DOH Retained Hospital
Brgy. Mahayahay to BHS Paloc to RHU Municipality 1 to Provincial Hospital 1 to DOH Retained Hospital
4. Referral Facilities identified need not be in the same municipality/ city where the barangays are located. The identification of the referral facilities should be based on geographical access.
5. Barangays and puroks that are in the boundary areas that shall be assigned to facilities outside the municipality/ city need to be specified. Barangays and puroks from other municipalities/
cities that avail and access services from the municipality shall also be identified.
Example: Brgy. New Manay to BHS Panoraon
Prk. Buhangin to BHS Panoraon
6. After all areas have been identified, fill in the table as seen in table 2 below.
TOOL:
- Simple Instructional Tool in Mapping and Matching the Population to PCPN

39. Population Mapping
Lake Seloton
Lake Lahit
Lamlahak
Talisay
Lamfugon
Takunel
Tasiman
3347
2902
4392
2873
5425
3250
2908
RHU
Lake
Sebu
Poblacion
6199
Luhib
2048
Bacdulong
253
Landero Hospital
Surallah Comty. Hospital
Lariosa Hospital
LSCHCC
Upper Valley Comty Hospital
(SOCSARGEN Gen Hospital)
Landero Hospital
Surallah Comty Hospital
Lariosa Clinic
DIAGNOSTICS
LEVEL 1
INFIRMARY
OPD SPECIALISTS
El-Lumet
460
Datal Fubaw
421
Kamsugma/ Kulon Bong
547
Sepaca
El-Lumet
314
Lariosa Hospital
268 Lamsufo

40. Population Mapping
Lamcade
Klubi
Hanoon
Halilan
Upper Maculan
Denlag
2912
3977
1204
2690
3714
3019
RHU
Lake
Sebu
Lamdalag
5339
Lower Maculan
1829
El Nino
372
Lemtablow
165
Bluno
Rojas
165
126
BHS New Dumangas
El Naw/ Laconon
434
BHS Laconon
Landero Hospital
Surallah Comty. Hospital
Lariosa Hospital
LSCHCC
Upper Valley Comty Hospital
(SOCSARGEN Gen Hospital)
Landero Hospital
Surallah Comty Hospital
Lariosa Clinic
DIAGNOSTICS
LEVEL 1
INFIRMARY
OPD SPECIALISTS
Lariosa Hospital
RHU
Surallah
RHU
Tboli
Smangkaw/ Luyong/ Bakngeb
164

41. A. Establish Primary Care Provider Network
Link profiling to Konsulta registration and LGU
EMR by creating harmonization mechanisms
TOOL:
- FHSIS profiling tool
- iClinicsys
- RHIS profiling tool (Region 11)
- Check App (Region 7)
- PCB Individual Health Profile

42. FHSIS RHIS
Data generated:
- Demographics
- Health profile of households
and individuals

43. PCB Individual Health Profile (2013)
Data generated:
- Demographics
- Medical, surgical, family
history
- Physical examination upon
consultation

44. iClinicSys
Data generated:
- Demographics
- Individual treatment record
PER Present system:
• Passively done – enrollment/
encoding done once individual
comes in the facility
• 60% of (Total number enrolled x
500) = outright capitation
ITR Present system:
• Passively done – encoding/ updating done
once individual comes for consultation
• 40% of (Total number enrolled x 500) =
additional capitation based on performance
Ideal:
• Actively done – Household/ individuals are profiled and encoded
to PER
• Maximized outright capitation
• Consultation – updating of ITR for performance-based capitation

45. Population Mapping
Lamcade
Klubi
Hanoon
Halilan
Upper Maculan
Denlag
2912
3977
1204
2690
3714
3019
RHU
Lake
Sebu
Lamdalag
5339
Lower Maculan
1829
El Nino
372
Lemtablow
165
Bluno
Rojas
165
126
BHS New Dumangas
El Naw/ Laconon
434
BHS Laconon
Landero Hospital
Surallah Comty. Hospital
Lariosa Hospital
LSCHCC
Upper Valley Comty Hospital
(SOCSARGEN Gen Hospital)
Landero Hospital
Surallah Comty Hospital
Lariosa Clinic
DIAGNOSTICS
LEVEL 1
INFIRMARY
OPD SPECIALISTS
Lariosa Hospital
RHU
Surallah
RHU
Tboli
Smangkaw/ Luyong/ Bakngeb
164
CAPITATION
PROFILED

46. A. Establish Primary Care Provider Network
Link profiling to Konsulta registration and LGU
EMR by creating harmonization mechanisms
Assist the registration of the PCP/ PCPN
- assist the LGU in understanding of the accreditation/ benefits
availment guideline for ePCB/ KONSULTA, focusing on FP benefits
availment under these packages
- Orientation on PCP/N registration policy
- Assist the LGUs in complying with the requirements of PCP
registration
- Assist the policy issuance on creating the PCPN

48. Initial and follow up consultation with a
Primary Care Provider
Targeted health risk screening and
assessment to include DRE, breast exam
SERVICES
Initial and follow up
consultation with a Primary
Care Provider
Targeted health risk screening
and assessment including DRE
& breast exam
LABORATORIES (13)
CBC w/ platelet count
Urinalysis
Fecalysis
Sputum Microscopy
Fecal Occult Blood
Pap smear
Lipid profile (Total
Cholesterol, HDL and LDL
Cholesterol, Triglycerides)
FBS
Oral Glucose Tolerance Test
ECG
Chest X-Ray
Creatinine
HbA1C
MEDICINES (21)
Anti-microbial
• Amoxicillin
• Co-Amoxiclav
• Nitrofurantoin
• Cotrimoxazole
• Ciprofloxacin
• Clarithromycin
Fluid &
electrolytes
• Oral Rehydration Salts
Anti-asthma
• Prednisone
• Salbutamol
• Fluticasone + Salmeterol
Antipyretics • Paracetamol
Anti-dyslipidemia • Simvastatin
Anti-diabetic
• Gliclazide
• Metformin
Anti-hypertensive
• Enalapril
• Metoprolol
• Amlodipine
• Hydrochlorothiazide
• Losartan
Anti-thrombotics • Aspirin
Antihistamine • Chlorpheniramine Maleate

49. Accreditation Requirements (shortlist)
Services
Consultation services
Laboratory services*
X-ray services*
Pharmacy*
Electronic medical record
(PHIC will provide an
interim IT solution called
eKonsulta)
Human Resource
Physician
2 support staff, with at
least 1 nurse
Microscopist/MedTech
(if labs are contracted out,
this may not be a
requirement)
Others
Basic consultation
equipment, device and
supplies
Applicable license to
operate or Mayor’s
permit, if applicable
(DOH license, Mayor’s
permit)
*may be outsourced
For full list: Konsulta Survey Assessment Tool (SAT)
Safe and clean spaces to
conduct consultations

50. The following documents must be submitted to PhilHealth in order to
become a PhilHealth Konsulta Provider
1. Provider Data Record (PDR)
2. Performance Commitment (PC) for PhilHealth
Konsulta Provider – signed by the two (2) authorized
representatives
3. Certified True Copy of updated licenses for
Hospitals, Infirmaries, Ambulatory Surgical Clinics
(ASCs) and Dialysis Clinics (DCs).
4. Certified True Copies of any of the following as
applicable: Business/Mayor’s permit or updated
Professional tax receipt and updated licenses of
laboratory/x-ray/ drug-outlet (for private)
5. Certification of Service Delivery Support for all
subcontracted services
6. Proof of payment of Accreditation Fee (P1,000.00)
7. Non-disclosure agreement (NDA) signed by all staff
in the PhilHealth Konsulta facility
8. Self-assessment tool (SAT)
9. Photos and/or videos of all requirements identified
in the Technical Standards for PhilHealth Konsulta
Providers
Primary
Care
Facilities
Primary Care
Physician
1. Completely filled-out
Provider Data Record
2. Performance
Commitment for health
care professionals
3. Photocopy of the
updated PRC ID card
4. Proof of assignment in
the primary care facility
Only paper evaluation and virtual facility visits during the
pandemic

51. Role of the LGU

52. Department of Health, Philippines
The Role of LGUs
LGUs will play an integral role in implementing primary care.
Administration
Manages the local
health system (public
and private).
Registration
Ensures their
constituents are
registered to the
program.
Service Provision
Manages facilities
that provide services
to their constituents.

53. Department of Health, Philippines
The Role of LGUs
ADMINISTOR &
PROVIDER
prepare public facilities
and apply for
accreditation
&
encourage private
providers in their
jurisdiction to accredit
REGISTRATION
FACILITATOR
Help facilitate
registration of their
constituents & other
residents living in their
area

54. Engaging the Private Sector
The private sector can be engaged in two ways:
Contract private providers to provide
services and commodities that public
primary care providers can’t deliver
Engage private providers to serve as
stand-alone primary care providers
catering to the needs of their
constituents

55. Registration to a Primary Care Provider
Section 6 of the UHC Act
Every Filipino shall register with a public or private primary care provider of choice with
consideration of proximity, ease of travel, and the capacity of the provider.
Assisted Registration
Self Registration
Through PhilHealth offices
or Third party organizations
Online registration
(under development)
Filipinos
or
Availability of the system for registration
through third party organizations is currently
for clearance

56. Capitation Tranches (2020)
40% of the
Capitation
(paid on a monthly basis)
60% of the
Capitation
(paid within the first quarter of
the preceding year)
Based on Fair Fixed Costs
Computed based on number of
members registered with first
patient encounter
Based on Performance
Computed based on weighted
indicators, pro-rated based on
service delivery
+
PHP 200.00
+
PHP 300.00
(max)
=
PHP 500.00
/capita