PHA 6146 Exam

• Priority Public Health Programs: Challenges (5)

  1. Tuberculosis

  2. HIV/AIDS

  3. MMR

  4. Immunization coverage

  5. Family planning & Reproductive health
• Tuberculosis


  - cure rates improved

  - high disease burden
• HIV/AIDS


  increasing prevalence among at-risk groups
• MMR stands for


  Maternal Mortality Rate
• MMR


  high due to inadequate facilities for emergency obstetric care
• Immunization coverage


  - high rates

  - fall short of target

  - integrity of the (national) cold chain requires evaluation
• Family Planning & Reproductive Health

  - deprioritized

  - due to political pressures from pro-life advocates & Catholic Church
• Iron deficiency anemia in infants & pregnant women

  target was reached
• low-birth-weight infants and underweight children under 5 years


  showed minimal or no improvement
• increasing breastfeeding initiation rates

  impact of Essential Intrapartum and Newborn Care (EINC) and Infant and Young Child Feeding (IYFC)
• reducing child mortality


  - significant progress

  - target rates for perinatal, neonatal, infant and under 5 mortality are not likely to be met
• stagnant immunization coverage rate

  received three booster shots during this 192 reform period
• Stagnant Immunization Coverage Rate: Booster Shots (3)

  1. RA 10152 - free 8 basic immunizations

  2. UHC High Impact Strategies - identify active seeking of immunization defaulters as a key strategy

  3. funds from Sin Taxes - 3 doses of PCV, dengue, HPV, measles-rubella, tetanus-diphtheria vaccines to children 2015-2016
• Among the MDG targets, the reduction in _ is the most unlikely to be attained.


  Among the MDG targets, the reduction inmaternal deathsis the most unlikely to be attained.
• Implementations that Improved Maternal Care and Family Planning Indicators (3)

  1. Health Facilities Enhancement Program

  2. Responsible Parenthood and Reproductive Health Law in 2012

  3. amendment of the PhilHealth Law in 2013
• Health Financing


  PhilHealth allows government hospitals to pay a one-year premium for an indigent patient upon admission

  - indigent patient is not in NHTS list

  - patient's economic status is assessed
• PhilHealth Provider Payment


  from fee for service to case rates for 23 medical conditions & surgical procedures
• PHC Benefit


  amendment of outpatient benefit package
• PHC Benefit: Objectives (4)

  1. appropriate utilization of preventive & promotive personal care

  2. incentives for health providers to promote healthy behavior

  3. supports the prevention & treatment of the most common diseases seen at the primary care level

  4. facilitates appropriate referral
• Outpatient Medicines Package for NCDs

  - dispensed through accredited drug stores via an electronic prescription

  - provides first-line medicines for selected high-burden NCDs

  - adopts the DOH guideline for managing these diseases

  - pays for the medicines at negotiated prices from an accredited pharmacy

  - no-balance billing policy
• Z Benefits


  - catastrophic benefit packages

  - for medical conditions requiring a high level of clinical expertise and costly management + good survival rates with early treatment
• Automatic Accreditation of DOH-Licensed Health Facilities


  - took the streamlining policy even further between DOH licensing and PhilHealth accreditation

  - supported by a special provision in the General Appropriations Act of 2012: all government health facilities would be deemed automatically accredited by PhilHealth
• Devolution of Health to LGUs

  - fragmented service delivery and financing

  - lack of management capacity
• DOH Addressing Devolution of Health to LGUs

  1. province-wide investment plan

  2. form ILHZs

  3. LGU scorecard

  4. DOH-funded construction & rehab of LGU-owned health facilities using HFEP funds

  5. deployed key health professionals to far-flung LGUs

  6. health information system
• 1. province-wide investment plan

  basis for DOH's financial health and in-kind support
• 3. LGU scorecard


  assess the overall outcome of implementing health reforms in the provincewide health system
• 6. health information system


  generate harmonized, quality, relevant and responsive data for better decision-making
• The Aquino Health Agenda


  - Administrative Order No. 2010-0036

  - Achieving Universal Health Care for All Filipinos
• The Aquino Health Agenda: Key Reform Pillars (3)

  1. Universal and sustainable PhilHealth membership

  2. Upgrade & modernize government health facilities

  3. Enhance efforts to achieve the MDG targets
• The Aquino Health Agenda: Governance-Related Strategies

  1. fiscal autonomy and income-retention schemes for government health facilities;

  2. streamlined DOH licensing requirements & PhilHealth accreditation of hospitals and health facilities

  3. strengths of interagency and intersectoral cooperation
• Leadership of PhilHealth Board of Directors

  - expansion of PhilHealth membership

  - transition of the payment mechanism from fee for service to all case rates

  - streamlining DOH licensing & PhilHealth accreditation requirements

  - development of new packages of benefits
• DOH + DSWD


  collaboration to identify the poorest families to be provided PhilHealth coverage
• Pushing for Sin Tax


  - DOH formed a coalition with the Office of the President, Department of Finance, civil society, medical professionals and international development partners

  - to promote health and raise revenues for KP
• DOH hospitals join ISO Certification

  - Executive Order No. 60527 s. 2007

  - institutionalize the quality management system.
• formalized the health research system management


  - DOH increased its funding for health research

  - more health system studies being undertaken
• DOH + DOST


  updated the Philippine e-health Strategic Framework and Plan 2014-2020
• Tsekap


  - creates financial incentives

  - at least one comprehensive health check-up every year for every client registered in their facility
• Tsekap: Medicine Benefits


  1. provides complete treatment

  2. ensures treatment compliance

  3. promotes complete patient care
• Challenges in Implementation (6)

  1. increased fiscal space for health

  2. OOP share of total health spending remains high

  3. DOH's capacity to effectively utilize its (massive) budget has become strained

  4. Reproductive Health Law's full potential to enable the provision of services to the most vulnerable groups has yet to be realized.

  5. HIV/AIDS reached epidemic proportions

  6. KP implementation challenges
• increased fiscal space for health

  - in the past 5 years

  - not impacted financial risk protection