Community and public health

• Health care system

  An organized plan of health services
• Health care delivery

  The rendering of health care services to the people
• Health care delivery system

  The network of health facilities and personnel which carries out the task of rendering health care to the people
• The Philippine health care system: is a complex set of organizations interacting to provide an array of health services
• Filipinos now bear a triple burden of disease (negative aspect)

  • Communicable Diseases
  • Noncommunicable diseases (NCDs)
  • Diseases of rapid urbanization and industrialization
• Filipinos tend to live longer now than in previous decades due to 1. improvements in living conditions, 2. better access to health services, 3. improved management and treatment of infectious diseases like pneumonia and tuberculosis (TB)
• Over the years, health reform initiatives have been carried out in the Philippines, primarily focused on: health service delivery, health governance and regulation, and health financing
• Historical Background

  1. Adoption of Primary Health Care in 1979

  2. Reorganization of DOH in 1982

  3. Enactment of The Generics Act in 1988

  4. Enactment of the Local Government Code in 1991

  5. Enactment of the National Health Insurance Act in 1995

  6. Implementation of the Health Sector Reform Agenda in 1996

  7. Adoption of the FOURmula One (F1) for Health in 2005

  8. Enactment of the Access to Cheaper and Quality Medicines Act in 2008

  9. Implementation of Kalusugang Pangkalahatan in 2010
• Components of the Health Delivery System

  • Public Sector
  • Private Sector
• Public Sector

  Largely financed through a tax-based budgeting system, where health services are delivered by government facilities under the national and local governments
• Private Sector

  Consisting of for-profit and non-profit health-care providers, is largely market oriented, where health care is generally paid for through user fees at the point of service
• The Department of Health (DOH) is the principal health agency in the Philippines, responsible for ensuring access to basic public health services to all Filipinos through the provision of quality health care and regulation of providers of health goods and services
• The DOH mandate

  • Formulation and development of national health policies, guidelines, standards and manual of operations for health services and programs
  • Issuance of rules and regulations, licenses and accreditations
  • Promulgation of national health standards, goals, priorities and indicators
  • Development of special health programs and projects and advocacy for legislation on health policies and programs
• DOH's primary function

  Promotion, protection, preservation or restoration of the health of the people through the provision and delivery of health services through the regulation and encouragement of providers of health goods and services
• DOH vision by 2030

  Filipinos are among the healthiest people in Southeast Asia by 2022, and Asia by 2040
• DOH mission

  To lead the country in the development of a productive, resilient, equitable and people-centered health system
• The Local Government Code of 1991 (RA 7160) transferred the responsibility of health service provisions to the local government units (LGUs)
• Levels of Health Care Facilities

  • Primary
  • Secondary
  • Tertiary
• Primary Level of Health Care Facilities

  • DOH operated units, Puericulture centers, Tuberculosis clinics and hospitals, Private clinics, Clinics operated by large industrial firms, Community hospitals and health centers operated by the Philippine Medicare Care Commission and other health facilities operated by voluntary religious and civic groups
• Secondary Level of Health Care Facilities

  • Smaller, non-departmentalized hospitals including emergency and regional hospitals
• Tertiary Level of Health Care Facilities

  • Highly technological and sophisticated services offered by medical centers, large hospitals, and specialized national hospitals
• Primary health services

  Offered at this level are to individuals in air health and to patients with diseases in the early symptomatic stage
• Secondary health services

  For patients with symptomatic stages of disease, which require moderately specialized knowledge and technical resources
• Tertiary health services

  For clients afflicted with diseases which seriously threaten their health and which require highly technical and specialized knowledge, facilities and personnel to treat effectively
• Two-Way Referral System

  Barangay Health Stations (BHS) refer cases to the rural health team, who in turn refer more serious cases to either the district hospital, then to the provincial, regional or the whole health care system
• Factors impinging on health

  • Community Health
  • Health Care Systems (gov't/private)
  • Environment (Social-Economic-Physical)
  • Other Health-related Systems
  • Ways of the people/Cultural practices
• Multi-Sectoral Approach to Health

  • Understanding of the various factors influencing the health of the community
  • Realization by all professional and technical personnel of the contribution of each in the delivery of health care
  • Establishing a mechanism for joint planning, implementation and evaluation of community health and related programs
  • Sharing of community resources to attain a common goal
• Intersectoral Linkages

  • Agricultural
  • Education
  • Public Works
  • Local governments
  • Social Welfare
  • Population Control
  • Private Sectors
• Intrasectoral Linkages

  The acceptance of the PHC (Primary Health Care) in the health sector necessitates the restructuring of the health systems to broaden the health coverage and make health services available to all
• Filipinos now bear a triple burden of diseas

  1. Communicable Diseases
• Region: 17
• Province: 81
• City: 146
• Municipality: 1488
• Barangay: 42046