health-related technologies, devices, medicines, vaccines, of citizens of other countries; or (v) trade and travel

Module 1
procedures, and all other health-related systems developed restrictions
Overview of Public Health and Health Care Delivery to solve a health problem and improve quality of lives and
System health outcomes, utilizing a multidisciplinary process to
M1-Lesson 2: Public Health vs. Clinical Medicine
evaluate the social, economic, organizational, and ethical
issues of a health intervention or health technology.
M1-Lesson 1:Keywords and Related Terms For more than two decades handling the course,
E. Individual-based health services - Refer to services usually students may perceive it as abstract or
To understand the course better, selected terms are that can be accessed within a health facility or remotely that irrelevant to clinical medicine. Only to realize later that
defined for your recall and review: can be definitively traced back to one (1) recipient, has there are various parallels that can be drawn that will
a limited effect at a population level, and does not alter the put a good bridge between the concept of public
A. Health care provider - Refers to any of the following:
underlying cause of illness such as ambulatory and inpatient health and clinical medicine.
1. A health facility which may be public or private,
care, medicines, laboratory tests, and procedures, among
devoted primarily to the provision of services for health Public health is a social and political concept aimed
others.
promotion, prevention, diagnosis, treatment, rehabilitation, at improving health, prolonging life, and improving the
and palliation of individuals suffering from illness, F. Population-based health services - Refer to quality of life among whole populations through health
disease, injury, disability, or deformity, or in need of interventions such as health promotion, disease surveillance, promotion, disease prevention, and other forms of health
obstetrical or other medical and nursing care. and vector control, which have population groups as intervention.
2. A health care professional who may be a doctor of recipients.
medicine, nurse, midwife, dentist, or other allied professional The table that follows is one way of providing you
or practitioner duly licensed to practice in the Philippines. G. Primary care - Refers to initial-contact, accessible, characteristics of public health and medicine in general as
3. Community-based health care organization - Refers continuous, comprehensive, and coordinated care that is shared by Dr. Harvey Fineberg, Dean, Harvard University
to an association of members of the community organized to accessible at the time of need including a range of services School of Public Health, 1990.
improve the health status of that community for all presenting conditions, and the ability to coordinate
4. Pharmacies or drug outlets- Refer to establishments referrals to other health care providers in the health care
licensed under RA 9711 (Food and Drug Administration Act delivery system, when necessary.
.
of 2009) which sell or offer to sell any health product directly
H. Primary health care - Refers to a whole-of-society
to the general public or entities licensed by appropriate
approach that aims to ensure the highest possible level of
government agencies, and which are involved in
health and well-being through equitable delivery of
compounding and/or dispensing and selling of
quality health services.
pharmaceutical products directly to patients or end-users as
Private health insurance - Refers to coverage of a defined
defined under RA 10918 (Philippine Pharmacy Act).
set of health services financed through private payments in
5. Laboratories and diagnostic clinics - Refer to
the form of a premium to the insurer.
licensed facilities where tests are done on the human body
or on specimens thereof to obtain information about the I. Public health emergency - Refers to an occurrence or
health status of a patient for the prevention, diagnosis, and imminent threat of an illness or a health condition that:
treatment of diseases. a. Is caused by any of the following: (i) bioterrorism;
(ii) appearance of a novel or previously controlled or
B. Health care provider network - refers to a group of
eradicated infectious agent or biological toxin; (iii) a natural
primary to tertiary care providers, whether public or private,
disaster; (iv) a chemical attack or accidental release; (v)
offering people-centered and comprehensive care in an
a nuclear attack or accident; or (vi) an attack or accidental
integrated and coordinated manner with the primary care
release of radioactive materials; and,
provider acting as the navigator and coordinator of health
b. Poses a high probability of any of the following: (i) a
care within the network.
large number of deaths in the affected population; (ii) a large
C. Health Maintenance Organization (HMO) - Refers to an number of serious injuries or long -term disabilities in the
entity that provides, offers or covers designated health affected population; (iii) widespread exposure to
services for its plan holders or members for a fixed an infectious or toxic agent that poses a significant risk of
prepaid premium. substantial harm to a large number of people in the affected The new public health seeks to address health
population; (iv) international exposure to an infectious or inequalities by advocating for population-based policies
D. Health Technology Assessment (HTA) - refers to the toxic agent that poses a significant risk to the health that improve the health of the whole population in an
systematic evaluation of properties, effects, or impact of equitable fashion.
 Let me share with you a summary of some knowledge are pharmacists’ core in tailoring information and mention that pharmacists can substantially increase health
parallels drawn between clinical and public health advice to your future patients. care savings across various settings.
medicine. Please refer to the slide/table below: *Health Workforce. A well-performing workforce consists of
human resources management, skills, and policies. *Leadership and Governance. Effective leadership
and governance ensure the existence of strategic policy
Rx ...How responsive is your pharmacist to patient’s needs frameworks, effective oversight and coalition-building,
and preferences exactly describe a well-performing one. The provision of appropriate incentives, and attention to system
manner your pharmacist involves patients in the health care design, and accountability.
decision-making process has shown greater satisfaction and
reduced complaints to offered services. I know for sure this Rx ... Pharmacists take part in public health policy
time you are aware of the paradigm shift from a product- development; linking disease prevalence and drug utilization,
oriented to patient-centered pharmacy service. Putting pharmacists enable the development of effective health
patients in high regard and treating them with dignity is a policies, as well as allow disease prevention to be placed
must. within a larger context. This time of emergencies and
*Health Information System. A well-performing system COVID-19 pandemic, pharmacists can contribute to
ensures the production, analysis, dissemination, and use of resource mobilization through optimization of medication use
timely and reliable information. and distribution.

Rx ... Do you agree with me when I say that pharmacist is Again, it is not enough that you have studied the
one of the most accessible health care professionals in your above-mentioned elements but for sustainability purposes,
community? Have you seen pharmacists in your area monitoring and evaluation are critical in strengthening the
participating in health screening and surveillance programs - system. Analyze the presented framework below. You will
TB DOTS, checking immunization status, and detecting make use of this paradigm in proposing your community
M1-Lesson 3: Building Blocks of Health System
potential public health hazards? With reliable and timely pharmacy-based intervention as you conclude this course
What can be modified to each building blocks of the health information, pharmacists support the development of (group dynamics).
health system? the public health system and collectively reduce vulnerability
to public health threats. Are you familiar with telepharmacy?
*Medical Products, Vaccines & Technology. Procurement
and supply programs need to ensure equitable access,
assured quality, and cost-effective use.
Rx ...The roles of pharmacists are not only limited to medical
products but also include vaccines and medical devices,
especially those that demand special knowledge with regard
to uses and risks. Pharmacists, therefore, are responsible
for ensuring the efficacy, integrity, and security of medical
products, devices, and, vaccines to safeguard a patient’s
health.
*Financing. A good health financing system raises
adequate funds for health, protects people from financial
What are these building blocks? How pharmacists can catastrophe, allocates resources, and purchases goods and
play an integral role in the health care system? services in ways that improve quality, equity, and efficiency.

*Service Delivery. Good service delivery comprises quality, Rx ... How can pharmacists protect vulnerable populations M1-Lesson 4: Determinants of Health
access, safety, and coverage. from financial hardships? As future pharmacists, you can
provide cost-effective medicines through the rational use of There are many factors that interfere with health
Rx ... As medicine experts, pharmacists can deliver effective, medical products and modern technologies. Pharmacists' equity and the ability of patients to get their health care
safe, and quality medicines and services to achieve optimal expertise in reducing and preventing medication-related needs to be met. For patients with complex lives and
health outcomes. Competencies and skills you will acquire problems and providing cheaper alternatives or suggesting complex health needs, these challenges are even more
while studying in the pharmacy discipline and up-to-date medicines covered by insurance are just a few examples to pronounced. These social determinants of health, such as
income, education, transportation, housing, and race or Core Functions of Public Health Agencies POLICY DEVELOPMENT must be based on the level of
ethnicity, have a powerful influence on a patient's life long scientific and technical knowledge and on the content of
before they arrive at a hospital or clinic. Public health is comprised of organized public values and popular opinions. Public health officials
community efforts aimed at the prevention of disease and must educate the public, but true priorities must be
Many factors combine together to affect the health of promotion of health. Inter- and multidisciplinary, public health established by the community through the normal democratic
individuals and communities. is built upon the scientific core of epidemiology. The political process.
organizational framework of public health encompasses both
Whether people are healthy or not, is determined by their activities undertaken within the formal structure of The promulgation of public health legislation and
circumstances and environment. To a large extent, factors government and the associated efforts of private and subsequent regulation is not a field generally associated with
such as where we live, the state of our environment, voluntary organizations and individuals. the pharmacist’s role. However, there is a myriad of public
genetics, our income, and education level, and our health concerns which legislators and regulatory agencies
relationships with friends and family all have considerable address that relate to pharmacists and the products they
impacts on health, whereas the more commonly considered dispense.
factors such as access and use of healthcare services often
have less of an impact. The determinants of health include:
ASSURANCE. Public health agencies must assure their
■the social and economic environment, constituents that the agreed-upon goals are being met.
These services do not have to be provided by public health
■the physical environment, and agencies, they just have to be guaranteed.
■the person’s individual characteristics and behaviors Health care system managers, administrators, and
evaluators are intimately involved in assuring appropriate
The context of people's lives determined their health,
and so blaming individuals for having poor health or crediting allocation of services to meet patient needs and demands.
them for good health is inappropriate. Individuals are unlikely Prominent considerations of the role of pharmacists in
to be able to directly control many of the determinants of health care management include the distribution of drugs
and supplies, delivering drug-related information, and
health.
consultation to meet the needs of patients and health team
members. Consequently, there should be more effort to
utilize the wealth of drug knowledge the pharmacist brings.
Figure 1. Core Functions of Public Health Agencies
A pharmacist currently contributes to patient care through
ASSESSMENT is the systematic collection and analysis of hospitals, home care, long-term care, community pharmacy,
available resources/data that describe the health status of the or other components of organized health care systems.
community, the needs of the community, and other Many inpatient and ambulatory care programs have added a
epidemiologic studies of health problems. clinical pharmacy segment to the traditional distribution
function, and an increasing number of pharmacy
The pharmacist can play a unique role in the practitioners are engaged in clinical practice. Furthermore,
evaluation process to assure that medications are effectively much like the role of the nurse practitioner and physician
being utilized. It is envisioned that a population analysis of assistant, the role of the pharmacist has expanded to allow
medication patterns can add to the body of public health for the provisional prescribing of medications in collaboration
knowledge-generating better treatment regimens, and with a physician within some jurisdictions. This function
improving the quality of patient care. Research would be critical in areas where there may be a shortage of
involving pharmacists can create trend analyses and report physicians or other qualified health care professionals.
longitudinal changes in patterns of medication use that may
ordinarily be missed. Such findings will ultimately benefit the The 10 essential public health services describe the
President Duterte signed R.A. 11223 or the Universal
community and population-at-large. This illustrates the need public health activities that all communities should
Health Care Act into law last February 20, 2019. The UHC
and opportunity for public health and pharmacy professions undertake. Public health systems should:
Act contains comprehensive and progressive reforms that
to work in collaboration to conduct valuable
will ensure every Filipino is healthy, protected from health
research.
hazards and risks, and has access to affordable, quality, and 1. Monitor health status to identify and solve
readily available health service that is suitable to their needs. community health problems.
M1-Lesson 5: Essential Public Health Services
2. Diagnose and investigate health problems and Community pharmacists are both knowledgeable
health hazards in the community. and skillful and can easily embrace community-oriented
activities such as speaking to groups on health-related
3. Inform, educate, and empower people about health
matters, referring patients to community
issues.
agencies, and participating in community-based
4. Mobilize community partnerships and action to programs on STDs, mental health, substance abuse,
identify and solve health problems. poisoning, and cancer signals.
5. Develop policies and plans that support individual
and community health efforts.
6. Enforce laws and regulations that protect health
and ensure safety.
7. Link people to needed personal health services and
assures the provision of health care when otherwise
unavailable.
8. Assure competent public and personal healthcare
workforce.
9. Evaluate effectiveness, accessibility, and quality of
personal and population-based health services.
10. Research for new insights and innovative solutions
to health problems.
M1-Lesson 6: Pharmacists in Public Health
The role of pharmacists in healthcare should extend
beyond the supply and management of medications and
embrace the societal responsibility of enhancing public
health through public education.
Public health services have been characterized as
occurring on two levels: the planning (or “macro”)
level and the implementation (“micro” or “provider”)
level. While many pharmacies-enabled prevention activities
have been described that can be implemented at the micro-
level by community pharmacists, evidence suggests that a
small minority of community pharmacies are involved in
preventive services delivery.

1. Planning for healthcare for wide geographic areas or