Finals

• Health system


  Interrelated system in which a country organizes available resources for the maintenance and improvement of the health of its citizens
• Health care system


  Organized plan of health
• Health care delivery


  Rendering of health care services to the people
• Philippine health care system

  • Health is seen as a basic human right
  • DOH - lead agency in charge of health
  • Access to health care is hampered by high cost, physical and socio-cultural barriers, and health workforce crisis
• Four essential functions of health system

  • Service Provision
  • Resource Generation - ability to become self sufficient
  • Financing
  • Stewardship
• Health care system models


  • Private Enterprise Health Care Model
  • Social Security Health Model
  • Publicly Funded Health Care Model
  • Social Health Insurance
• Private Enterprise Health Care Model

  Purely private enterprise health care systems are comparatively rare, off subpopulation - poorer country with poor standard of health care, private clinics for small, wealthy expatriate population in an otherwise poor country
• Social Security Health Model


  Workers and their families are insured by the state, refers to the social welfare service concerned with the social protection, or protection against socially recognized conditions, in the form of SSS and GSIS (SSS for government workers) in the Philippines
• Publicly Funded Health Care Model

  Residents of the country are insured by the state, health care is financed entirely or majority part by citizen's tax payments
• Social Health Insurance


  Whole or most of the population is a member of sickness insurance company (PhilHealth), method for financing health care costs through a social insurance program, characterized by the presence of sickness funds which usually receive a proportional contribution of their members wages, affiliation to such funds is usually based on professional, geographic, religious, political, and / or non partisan criteria
• Department of Health (DOH)

  Principal agency in health in the Philippines, policy and regulatory body for health, provides the direction and national plans for health programs and activities, responsible for ensuring access to basic public health services to all Filipinos
• DOH Vision


  Filipinos are among the healthiest people in Southeast Asia by 2022, Asia by 2040, the DOH shall lead the country in the development of a people - centered, resilient, and equitable health system
• DOH Mission


  To lead the country in the development of a productive, resilient, equitable, and people centered health system
• Values of DOH


  • Integrity
  • Excellence
  • Compassion
• Agencies attached to DOH

  • Philippine Health Insurance Corporation
  • Dangerous Drug Board
  • Philippine Institute Of Traditional And Alternative Health Care
  • Philippine National Aids Council
• District Health System


  Contained segment of the national health system which comprises a well defined administrative and geographic area whose activities contribute to improve health
• 3 Level of Referral

  • Primary Level - Barangay health stations and rural health units
  • Secondary Level - District and provincial hospitals
  • Tertiary Level - Provincial and regional hospitals
• Inter Local Health Zone (ILHZ)


  Unit of health system created for local health service management and delivery in the Philippines, defines population within the confined geographical area, comprises of a central or core referral hospital and a number of primary level facilities such as RHUs and BHS
• Composition of ILHZ


  • People - Community, NGOs, People's Organizations, Local Chief Executives, Other Government Officials, Private Sectors
  • Boundaries - Clear boundaries between ILHZ
  • Health Facilities
  • Health Workers - District Health Team
• Importance of ILHZ


  • Integrate hospital and public health services for a holistic delivery of health service
  • To identify areas of complementation of the stakeholders
• Expected achievements


  • Universal coverage of health insurance
  • Improved quality of hospital and RHU services
  • Effective Referral System
  • Integrated Planning
  • Appropriate Health Information System
  • Improve Drug Management
  • Developed Human Resources
  • Effective Leadership Through Inter-LGU Cooperation
  • Financially Viable or Self Sustaining Hospital
  • Integration of Public Health and Curative Hospital
• Core Referral Hospital


  Main hospital for ILHZ and its catchment population, main point of referral for hospital services from the community, private medical practitioner and public health services at BHS and RHUs, minimum services: Outpatient Services, Lab and Radiological dx Services, Inpatient Care, Surgical Services sufficient to provide emergency care, obstetrics and trauma
• Minimum package of activity for PHC services

  • Pre - natal check up
  • Normal Delivery and postpartum care
  • Immunization
  • Family Planning
  • Nutrition - Vit A and Iron Supplements
  • Growth Monitoring
  • Control of Communicable Diseases
  • Minor Surgery - Suturing, Draining of Abscess, Circumcision
  • Dental Health
  • Appropriate Referral
  • Environmental Health Services
  • Basic Laboratory Services
  • Health Promotion and Education
  • Management of Public Health Services, Coordination with NGOs and the private medical sector, participation in ILHZ management
  • Training of Human Resources
  • Supervision of health services and human resource within the municipal catchment area
• Complementary package of activity for core referral hospitals

  • OPD Consultations for Px Referred from the Primary Level
  • Inpatient Medical and Surgical Care
  • Emergency Room Care
  • MInor Surgery - Placental Extraction, Excision, Suturing, D&C
  • Anesthesia
  • Major Surgency - CS, Trauma Surgery, Appendectomy
  • Complicated Deliveries
  • Basic Orthopedics - Simple Fractures
  • Nutrition Services
  • Referral of more urgent cases
• Tertiary package of activity for provincial government referral hospitals

  • Pediatric, Surgical, Orthopedic, Obstetric, Gynecology Department
  • Intensive Care, Neonatal Intensive Care, Coronary Care
  • Ophthalmology
  • Rehabilitative Medicine (Physiotherapy, Occupational Therapy)
  • Full Range of Dental Services
  • Public Health Lab (Malaria, Schistosomiasis, Water Analysis, BB)
  • Medical Social Services, Veterans, Senior Citizens Medical Services
  • Pharmacy
• Factors on various categories of health workers

  • Available Health Manpower Resources
  • Local Health Needs and Problems
  • Political and Financial Feasibility
• Three levels of primary health care workers

  • Barangay Health Workers - First contact of the community and initial links of health care, provide simple curative and preventative health care, participate in activities geared towards the improvement of the socioeconomic level of community
  • Intermediate Level Health Workers - The first source of professional health care, attends to health problems beyond the competence of village workers, provide support to frontline health workers in terms of survision, training, supplies, and services
  • First Line Hospital Personnel - Provide backup health services for cases that require hospitalization, establish close contact with intermediate level health workers or village health workers
• Essential health care programs in PHC

  • Family Health Program
  • Prevention And Control Of Non Communicable Diseases
  • Prevention And Control Of Communicable Diseases
  • Environmental Health And Sanitation
  • Other Priority Health Programs
• Types of family health program

  • Maternal Health Program - Increase healthy birth outcomes, promote and assure comprehensive primary care for children from birth to 21 years old, promote healthy lifestyle among school age youth, access to safe and healthy child care, caring for the mother from preconception up to post conception
• Services


  • Antenatal Registration - Pregnant women to avail free prenatal services at their respective HC
  • Tetanus Toxoid Immunization - Series of 2 doses (1 month before delivery, 3 booster after childbirth)
  • Micronutrient Supplementation - Vit A and Iron
  • Treatment of DSE and Other Condition - For high risk pregnancy
• Prenatal visits


  • 1st Visit - As early as possible before 4 months or during 1st trimester
  • 2nd Visit - 2nd Trimester
  • 3rd Visit - 3rd Trimester
  • Every month thereafter
• Types of Family Health Program

  • Maternal Health Program
  • Family Planning Program
  • Child Health Program
• Maternal Health Program


  • Increase healthy birth outcomes
  • Promote and assure comprehensive primary care for children from birth to 21 years old
  • Promote healthy lifestyle among school age youth
  • Access to safe and healthy child care
  • Caring for the mother from preconception up to post conception
• Maternal Health Program Services

  1. Antenatal Registration

  2. Tetanus Toxoid Immunization

  3. Micronutrient Supplementation

  4. Treatment of DSE and Other Condition
• Prenatal Visits


  • 1st Visit - As early as possible before 4 months or during 1st trimester
  • 2nd Visit - 2nd Trimester
  • 3rd Visit - 3rd Trimester
  • Every 2 Weeks - After 8 months until delivery
• Family Planning Program


  • Mandated priority public health program to attain the country's national health development
  • Provides information and services for the couples of reproductive age to plan for their family according to their beliefs and circumstances through legally and medically acceptable family plan
• Principles of Family Planning

  • Responsible Parenthood
  • Respect for Life
  • Birth Spacing
  • Informed Choice
• Types of Family Planning

  • Natural
  • Artificial
  • Permanent
• Natural Family Planning Methods

  • Standard Days Method
  • Lactational Amenorrhea Method
  • Basal Body Temperature
  • Billings Ovulation / Cervical Mucus Method
  • Symptothermal
• Artificial Family Planning Methods

  • Condom
  • Injectables
  • Oral Contraceptive Pills
  • Intrauterine Device