THE PHILIPPINE HEALTH CARE DELIVERY The Philippine Health Care Delivery System

SYSTEM
Health is a basic human right guaranteed by the
INTRODUCTION Philippine Constitution of 1987. This is provided in
Health care system is an organized plan of health the Philippines through a dual health delivery
system composed of the public sector and the
services. The rendering of health care services to
private sector. The public sector is largely financed
the people is called health care delivery system.
through a tax-based budgeting system, where
Thus, health care delivery system is the network of
health services are delivered by government
health facilities and personnel which carries out the
facilities under the national and local governments.
task of rendering health care to the people. In the
Philippines health care system is complex set of The Philippine health care system has rapidly
organizations interacting to provide an array of evolved with many challenges through time.
health services. Health service delivery was devolved to the Local
Government Units (LGUs) in 1991, and for many
The National Health Situation (Philippine Health
reasons, it has not completely surmounted the
Situation)
fragmentation issue. Health human resource
struggles with the problems of underemployment,
The Philippines has made significant investments
scarcity and skewed distribution. There is a strong
and advances in health in recent years. Rapid
involvement of the private sector comprising 50%
economic growth and strong country capacity have
of the health system but regulatory functions of the
contributed to Filipinos living longer and healthier.
government have yet to be fully maximized.
However, not all the benefits of this growth have
reached the most vulnerable groups, and the health
The Department of Health (DOH) supervises the
system remains fragmented. Health insurance now
government corporate hospitals, specialty and
covers 92% of the population.
regional hospitals, while the Department of National
Defense runs the military hospitals. At the local
Maternal and child health services have improved,
level, the provincial governments manage and
with more children living beyond infancy, a higher
operate district and provincial hospitals, while
number of women delivering at health facilities and
municipal governments provide primary care,
more births being attended by professional service
including preventive and promotive health services
providers than ever before. Access to and provision
and other public health programmes through the
of preventive, diagnostic and treatment services for
rural health units, health centers and barangay
communicable diseases have improved, while there
health stations.
are several initiatives to reduce illness and death
due to non-communicable diseases (NCDs).
Highly urbanized and independent cities provide
both hospital services and primary care services.
Despite substantial progress in improving the lives
The private sector, consisting of for-profit and non-
and health of people in the Philippines,
profit health-care providers, is largely market
achievements have not been uniform and
oriented, where health care is generally paid for
challenges remain. Deep inequities persist between
through user fees at the point of service. The
regions, rich and the poor, and different population
introduction of social health insurance
groups. Many Filipinos continue to die or suffer
administered by the Philippine Health Insurance
from illnesses that have well-proven, cost-effective
Corporation (PhilHealth) since 1995 aimed to provide
interventions, such tuberculosis, HIV and dengue,
financial risk protection for the Filipino people. The
or diseases affecting mothers and children.
rapid expansion of its membership in the past 5
Many people lack sufficient knowledge to make
years is considered a positive development as the
informed decisions about their own health. Rapid
Government pursues universal health coverage.
economic development, urbanization, escalating
climate change, and widening exposure to diseases
Health Financing
and pathogens in an increasingly global world
increase the risks associate with disasters,
Health financing refers to how financial resources
environmental threats, and emerging and re-
are used to ensure that the health system can
emerging infections.
adequately cover the collective health needs of
every person. It is a cornerstone of the overall
health system and can greatly impact the quality
and access to health services. It is a foundational
component that impacts the entire health system’s
performance, including the delivery and for NCR, Northern Mindanao, Southern Mindanao
accessibility of primary health care. and CAR. Among the seventeen regions,
Autonomous Region for Muslim Mindanao
Health financing policy focuses on mobilizing and (ARMM) has the lowest bed to populationratio
pooling financial resources and allocating them to (0.17 beds per 1000 population), far lower than the
health care providers (purchasing) in an equitable national average
and efficient way. This will enable provision of
essential health services of good quality to all, In terms of physical infrastructure, the Philippine
especially to the poorer communities, and in health sector has 1224 hospitals, 2587 city/rural
populations in rural areas. health centres and 20 216 village health stations.
Sixty-four per cent of hospitals are Level 1 non-
The Philippines’s (THE) has consistently increased departmental hospitals with an average capacity of
since 2005 and compares well with neighbors like 41 beds, and 10% are Level 3 medical centres and
Indonesia. Government health expenditure has teaching hospitals, with an average capacity of 318
increased significantly in nominal terms, but it has beds.
been eclipsed by private sector funding sources,
which have grown rapidly with the economy. The private sector’s share of total hospital beds
Much of Total health expenditure is for personal increased from 46% in 2003 to 53% in 2016. The
care, although the Government has raised spending geographical distribution of these resources varies
on public health since 2007. The three major flows within the country. Almost two thirds of hospital
of public health financing have overlapping beds are in the island of Luzon, which includes the
coverage. The DOH funds regional and apex hospitals, National Capital Region (NCR). There are 23
while local government units (LGUs) fund primary- hospital beds for 10 000 people in the NCR while
and secondary-level care. the rest of Luzon, Visayas and Mindanao have only
8.2, 7.8 and 8.3 beds, respectively. Operating
PhilHealth reimburses government as well as indicators vary between public and private
private health facilities. It reportedly covers 92% of hospitals. The average bed occupancy rate of public
the population, 40% of which is the poor medical centres is significantly higher than for
population and subsidized by the Government for private hospitals. On average, patients stay about two
premium payments. Covered services are focused on days longer in public than in private medical centres.
inpatient care and inadequate outpatient care that only
covers the poor members of PhilHealth. Health Human Resource

Health Facilities The health human resources are the main drivers of
the health care system and are essential for the
Health facilities in the Philippines include efficient management and operation of the public
government hospitals, private hospitals and primary health system. They are the health educators and
health care facilities. Hospitals are classified based on providers of health services. The Philippines has a
ownership as public or private hospitals. In the huge human reservoir for health. However, they
Philippines, around 40 percent of hospitals are are unevenly distributed in the country. Most are
public (Department of Health, 2009). Out of 721 concentrated in urban areas such as Metro Manila
public hospitals, 70 are managed by the DOH while and other cities.
the remaining hospitals are managed by LGUs and
other national government agencies (Department of In terms of human resources for health, the top four
Health, 2009). Both public and private hospitals can forces of institution-based health workers are nurses
also be classified by the service capability. A new (90 308), doctors (40 775), midwives (43 044) and
classification and licensing system will soon be medical technologists (13 413) (2017 figures). The
adopted to respond to the capacity gaps of existing public sector engages a higher proportion of nurses
health facilities in all levels. At present, Level-1 (61%), midwives (91%) and medical technologists
hospitals account for almost 56 percent of the total (53%). There are also marked differences in the
number of hospitals which have very limited number of institution-employed health workers
capacity, comparable only to infirmaries. available to serve area populations. The density of
nurses per 10 000 population is highest in the NCR
The number of hospital beds is also a good indicator of at 12.6 and lowest in the ARMM at 4.2.
health service availability. Per WHO
recommendation, there should be 20 hospital beds The first point of contact for government-provided
per 10,000 population. Almost all regions have health services is the health centre and its satellite
insufficient beds relative to the population except village health station(s), which typically employs an
average of one doctor, two nurses and five Excellent service and affordability are the main
midwives reasons for being satisfied whereas poor service is
the main reason for being dissatisfied with the
Utilization of Health Facilities services given by government hospitals (Social
Weather Stations, 2006)
In the recent National Demographic and Health
Survey (NDHS), 50 percent of the clients who Health Governance and Regulation
sought medical advice or treatment consulted
public health facilities, 42 percent went to private As the national technical authority on health, the
health facilities, and almost 7 percent sought DOH provides national policy direction and strategic
alternative or traditional health care. Rural Health plans, regulatory services, standards and guidelines for
Units (RHUs) and Barangay Health Centers (33 health, and highly specialized and specific tertiary-level
percent) were the most visited health facilities in hospital services. It provides leadership, technical
almost all the regions except for NCR and CAR, assistance, capacitybuilding, linkages and
where most of the clients visited private coordination with other national government
hospital/clinic for medical advice or treatment. agencies, LGUs and private entities in
implementing health policies.
The most common reasons for seeking health care
were illness or injury (68 percent), medical checkup The LGUs, i.e. provincial, city and municipal
(28 percent), dental care (2 percent), and medical governments, on the other hand, are responsible for
requirement (1 percent) (NSO, 2008). managing and implementing local health
programmes and services. A local health board
The hospital sector in the Philippines is highly chaired by the local chief executive (governor or
segmented in nature. Utilization of hospitals may mayor) serves as an advisory body to the local chief
be driven by PhilHealth insurance coverage and executives and the local legislative council
socio-economic determinants. People with members (sanggunian) on the local health system,
PhilHealth insurance are more likely to be confined while the DOH Regional Health Office is
in a private hospital, than those without Philhealth represented by either a DOH representative or
insurance . Similarly, patients living in urban area Development Management Officer under the DOH
and belonging to the richest quintile are also more Provincial Health Team.
likely to be confined in private hospitals (Lavado et
al., 2010) In Mindanao, a distinct subnational entity called
the Autonomous Region in Muslim Mindanao
Available data shows that on the average, travel (ARMM) was created by Republic Act No. 6734, as
time to a health facility is 39 minutes; where travel amended by Republic Act No. 9054. ARMM
time is longest in ARMM which is 83 minutes and consists of five provinces and has its own regional
shortest in NCR and Northern Mindanao, 28 Department of Health that is directly responsible to
minutes. Travel time is relatively longer in rural the ARMM Regional Governor. It directly
areas than in urban areas ; and longest for persons administers the provincial, city and municipal
in the lowest wealth quintile and shortest for those health offices, and the provincial and district
in the highest wealth quintile. Older persons hospitals within the autonomous region.
seeking care (60+ years old) have longer average
travel times than younger persons (National Health Policies and Systems
Statistics Office, 2008)
The Government’s vision for the Philippines has
Satisfaction with Health Facilities been translated by the Department of Health into
the Philippine Health Agenda 2016–2022. Under the
Based on a survey by the Social Weather Station in motto All for Health Towards Health for All, universal
2006, majority of Filipinos specifically the low health coverage is the platform for health and
income households prefer to seek treatment in a development in the Philippines –driven by action
government hospital if a family member needs within and outside the health sector. Reducing
confinement. Affordability is the main reason for health inequities is singled out as the most important
going to a government medical facility, while result of three health guarantees: (a) ensuring
excellent service is the main reason for going to a financial protection for the poorest people; (b)
private medical facility (Department of Health, improving health outcomes with no disparities;
2010). and (c) building health service delivery networks
for more responsiveness
 Health Outcomes During that time, more than half of the population
had no coverage, especially the poor, the self-
The projected average life expectancy of Filipinos employed and informal sector workers (World
in 2005 to 2010 is 68.8 years, with males having an Health Organization, 2011). This led to the
average life expectancy of 66.11 years and females enactment of the National Health Insurance Act of
with 71.64 years (National Statistics Office, 2010). It 1995 or RA 9875 which aims to provide all citizens
is projected that the average life expectancy of a mechanism for financial protection with priority
Filipinos will increase to 70.38 years from 2010 to given to the poor. It created the National Health
2015 and 71.59 years from 2015 to 2020 (National Insurance Program “which shall provide health
Statistics Office). insurance coverage and ensure affordable,
acceptable, available and accessible health services
HEALTH REFORM INITIATIVES IN THE for all citizens of the Philippines.” In 1999, the
PHILIPPINES Health Sector Reform Agenda was launched as a
major policy framework and strategy to improve
Health reforms in the Philippines build upon the the way health care is delivered, regulated and
lessons and experiences from the past major health financed. With a battle cry of “Kalusugan Para sa
reform initiatives undertaken in the last 30 years. Masa”, it was designed to implement the reform
The adoption of primary health care (PHC) package in the convergence sites.
approach in 1979 promoted participatory The five reform areas are:
management of the local health care system. The 1. Public health
goal was to achieve health for all Filipinos by the 2. Hospital;
year 2000. It emphasized the delivery of eight 3. Local health systems;
essential elements of health care, including: 4. Health regulations and
1. Prevention and control of prevalent health 5. Health financing
problems
2. Promotion of adequate food supply and It was during this time that the DOH underwent a
proper nutrition major organizational reform to pursue its new role
3. Basic sanitation and adequate supply of as a result of the devolution. At the local level, the
water municipalities were joined together to form
4. Maternal and child care Interlocal Health Zones (ILHZs) to optimize
5. Mmmunization sharing of resources and maximize joint benefits
6. Prevention and control of endemic diseases from local health initiatives. The operational
7. Appropriate treatment and control of framework of health sector reforms was adopted in
common diseases; and 2005 and was called FOURmula One for Health
8. Provision of essential drugs. (F1). The objective was to undertake critical reforms
with speed, precision and effective coordination
To implement PHC, EO 851 was issued in 1983 directed at improving the efficiency, effectiveness
integrating public health and hospital services and equity of the Philippine health system in a
(World Health Organization, 2011). manner that is felt by the Filipinos especially the
poor.
The People Power Revolution strengthened the call
for legitimate local representation. In early 1990s, The F1 organized health reform initiatives into four
RA 7160 or the Local Government Code (LGC) implementation components, namely:
transferred the responsibility of health service 1. financing, regulation
provision to the local government units. The 2. service delivery and
intention of LGC was to establish a more 3. governance
responsive and accountable local government
structure. However, this has resulted to This time also marked the enactment of two pieces
fragmentation of administrative control of health of legislation; the
services between the rural health units and 1. Universally Accessible Cheaper and Quality
hospitals and between the different levels of Medicines Act of 2008
political structure (World Health Organization, 2. Food and Drug Administration Act of 2009.
2011). Prior to that, the Generics Act was adopted
in 1988 to ensure adequate supply, distribution and However, despite the important progress made,
use of generics thereby improving access to successive reforms have not succeeded in
affordable drugs and medicines. adequately addressing the persistent problem of
inequity.
 UNIVERSAL HEALTH CARE (UHC) TO number of creative approaches. First, the
ADDRESS INEQUITY IN THE HEALTH quality of government-owned and operated
SYSTEM hospitals and health facilities is to be
upgraded to accommodate larger capacity,
Universal Health Care and Its Aim to attend to all types of emergencies, and to
handle non-communicable diseases. The
Universal Health Care (UHC), also referred to as Health Facility Enhancement Program
Kalusugan Pangkalahatan (KP), is the “provision to (HFEP) shall provide funds to improve
every Filipino of the highest possible quality of facility preparedness for trauma and other
health care that is accessible, efficient, equitably emergencies. The aim of HFEP was to
distributed, adequately funded, fairly financed, and upgrade 20% of DOH-retained hospitals,
appropriately used by an informed and 46% of provincial hospitals, 46% of district
empowered public”.The Aquino administration hospitals, and 51% of rural health units
puts it as the availability and accessibility of health (RHUs) by end of 2011.
services and necessities for all Filipinos.
Financial efforts shall be provided to allow
It is a government mandate aiming to ensure that immediate rehabilitation and construction
every Filipino shall receive affordable and quality of critical health facilities. In addition to
health benefits. This involves providing adequate that, treatment packs for hypertension and
resources – health human resources, health diabetes shall be obtained and distributed to
facilities, and health financing. RHUs.

UHC’s Three Thrusts The DOH licensure and PhilHealth

accreditation for hospitals and health
To attain UHC, three strategic thrusts are to be facilities shall be streamlined and unified.
pursued, namely: 1) Financial risk protection
through expansion in enrolment and benefit 3. Attainment of Health-related MDGs
delivery of the National Health Insurance Program
(NHIP); 2) Improved access to quality hospitals and Further efforts and additional resources are
health care facilities; and 3) Attainment of health- to be applied on public health programs to
related Millennium Development Goals (MDGs). reduce maternal and child mortality,
morbidity and mortality from Tuberculosis
1. Financial Risk Protection and Malaria, and incidence of HIV/AIDS.
Localities shall be prepared for the
Protection from the financial impacts of emerging disease trends, as well as the
health care is attained by making any prevention and control of non-
Filipino eligible to enroll, to know their communicable diseases.
entitlements and responsibilities, to avail of
health services, and to be reimbursed by The organization of Community Health
PhilHealth with regard to health care Teams (CHTs) in each priority population
expenditures. area is one way to achieve health-related
MDGs. CHTs are groups of volunteers, who
PhilHealth operations are to be redirected will assist families with their health needs,
towards enhancing national and regional provide health information, and facilitate
health insurance system. The NHIP communication with other health providers.
enrollment shall be rapidly expanded to RNheals nurses will be trained to become
improve population coverage. The trainers and supervisors to coordinate with
availment of outpatient and inpatient community-level workers and CHTs. By the
services shall be intensively promoted. end of 2011, it is targeted that there will be
Moreover, the use of information 20,000 CHTs and 10,000 RNheals.
technology shall be maximized to speed up
PhilHealth claims processing. Another effort will be the provision of
necessary services using the life cycle
2. Improved Access to Quality Hospitals and approach. These services include family
Health Care Facilities planning, ante-natal care, delivery in health
facilities, newborn care, and the
Improved access to quality hospitals and Garantisadong Pambata package.
health facilities shall be achieved in a
 Better coordination among government  Devolution of health care services from
agencies, such as DOH, DepEd, DSWD, and national to local government
DILG, would also be essential for the  Use of Generics
achievement of these MDGs.  Milk Code
 PhilHealth (1995)
PHILIPPINE HEALTH AGENDA 2016-2022  DOH resources to promote local health
system development
Under the Duterte Administration a health reform  Fiscal autonomy for government hospitals
initiative “All for Health Towards Health for All"  Good governance programs
was created. This is the battle cry of the Philippine  Funding for Universal Health Care (UHC)
Heath Agenda 2016-2022 for a Healthy Philippines
2022 which aims to ensure the best health outcome Persistent Inequities in Health Outcomes
for all Filipinos, regardless of socio-economic class,  Every year, around 2000 mothers die due to
ethnicity, gender, and geographic location. pregnancy-related complications.
 A Filipino child born to the poorest family
is 3 times more likely to not reach his 5th
birthday, compared to one born to the
richest family
 Three out of 10 children are stunted.

Restrictive and Impoverishing Healthcare Costs

 Every year, 1.5 million families are pushed
to poverty due to health care expenditures
 Filipinos forego or delay care due to
prohibitive and unpredictable user fees or
co-payments
GOALS
 Php 4,000/month healthcare expenses
considered catastrophic for single income
1. FINANCIAL PROTECTION
families
 Filipinos, especially the poor,
Poor quality and undignified care synonymous
marginalized, and vulnerable are
with public clinics and hospitals
protected from high cost of health
 Long wait times
care
 Limited autonomy to choose health care
provider
2. BETTER HEALTH OUTCOMES
 Less than hygienic restrooms, lacking
 Filipinos attain the best possible
amenities
health outcomes with no disparity
 Privacy and confidentiality taken lightly
 Poor record-keeping
3. RESPONSIVENESS
 Overcrowding and under provision of care
 Filipinos feel respected, valued, and
empowered in all of their interaction
To address these health problems and inequalities,
with the health system
the government under the administration of
president Duterte created “ALL FOR HEALTH
VALUES
TOWARDS HEALTH FOR ALL (Lahat Para sa
Kalusugan! Tungo sa Kalusugan Para sa Lahat) a
 Equitable & inclusive to all
health reform initiative which focusses on universal
 Transparent & accountable
health coverage, strengthening implementation of
 Uses resources efficiently
RPRH law, war on drugs and additional funds
 Provides high quality services
from PAGCOR.
During the last 30 years of Health Sector Reform,
The main goal of Health Reform Agenda 2016-2022
the government has undertaken key structural
is to attain health-related SDG targets and
reforms and continuously built on programs that
specifically aims to achieve financial risk
take us a step closer to our aspiration. The
Protection, better health Outcomes and
milestones in the Health Sector Reform during the
responsiveness to the health care needs of the
last years include:
Filipinos. To attain these goals, the health reform
agenda is guided with values such as equity,
quality, efficiency, transparency, accountability,  Practicing gatekeeping
sustainability and resilience.  Located close to the people (Mobile Clinic
or SubsidizeTransportation Cost)
The health reform agenda 2016-2022 assures three  Enhanced by telemedicine
GUARANTEES for the Filipino utilizing strategies
( the acronym ACHIEVE) in order to achieve the GUARANTEE #3 UNIVERSAL HEALTH
goals of the health agenda. INSURANCE (Financial Freedom when Accessing
Services). Services are financed predominantly by
The Three health GUARANTEES are: PhilHealth.

GUARANTEE #1: ALL LIFE STAGES & TRIPLE A. Philhealth as the gateway to free affordable care
BURDEN OF DISEASE (Services for Both the  100% of Filipinos are members
Well & the Sick across all stages of life from  Formal sector premium paid through
pregnancy to elderly). These services include: payroll
1. First 1000 days  Non-formal sector premium paid through
2. Reproductive and sexual health tax subsidy
3. Maternal, newborn, and child health
4. Exclusive breastfeeding B. Simplify Philhealthe rules
5. Food & micronutrient  No balance billing for the poor/basic
supplementation accommodation & Fixed co-payment for
6. Immunization non-basic accommodation
7. Adolescent health
8. Geriatric Health C. Phi health as main revenue source for public
9. Health screening, promotion & health care providers
information  Expand benefits to cover comprehensive
range of services
1. Communicable diseases  Contracting networks of providers within
o HIV/AIDS service delivery networks (SDNs)
o TB
o Malaria STRATEGY
o Diseases for Elimination : Dengue,
Leptospirosis, Ebola, Zika To attain the goal of the Health Reform Agenda
2016-2022, the following strategies are put in place.
2. Non-communicable diseases & malnutrition
o Cancer A - Advance quality, health promotion and
o Diabetes primary care
o Heart Disease and their Risk Factors C - Cover all Filipinos against health-related
– obesity, smoking, diet, sedentary financial risk
lifestyle H - Harness the power of strategic HRH
o Malnutrition development
I - Invest in eHealth and data for decision-making
3. Diseases of rapid urbanization & E - Enforce standards, accountability and
industrialization transparency
o Injuries V -Value all clients and patients, especially the
o Substance abuse poor, marginalized, and vulnerable
o Mental Illness E - Elicit multi-sectoral and multi-stakeholder
o Pandemics, Travel Medicine support for health
o Health consequences of climate
change / disaster 1. Advance quality, health promotion and
primary care
GUARANTEE #2: SERVICE DELIVERY
NETWORK (Functional Network of Health o Conduct annual health visits for all poor
Facilities) families and special populations (NHTS, IP,
Services are delivered by networks that are: PWD, Senior Citizens)
 Fully functional (Complete Equipment, o Develop an explicit list of primary care
Medicines, Health Professional) entitlements that will become the basis for
 Compliant with clinical practice guidelines licensing and contracting arrangements
 Available 24/7 & even during disasters
 o Transform select DOH hospitals into mega- improve local civil registration and vital
hospitals with capabilities for multi-specialty statistics
training and teaching and reference laboratory o Automate major business processes and invest
o Support LGUs in advancing pro-health in warehousing and business intelligence tools
resolutions or ordinances (e.g. city-wide o Facilitate ease of access of researchers to
smoke-free or speed limit ordinances) available data
o Establish expert bodies for health promotion
and surveillance and response 5. Enforce standards, accountability and
transparency
2. Cover all Filipinos against health-related
financial risk o Publish health information that can trigger
better performance and accountability
o Raise more revenues for health, e.g. impose o Set up dedicated performance monitoring
healthpromoting taxes, increase NHIP unit to track performance or progress of
premium rates, improve premium collection reforms
efficiency.
o Align GSIS, MAP, PCSO, PAGCOR and 6. Value all clients and patients, especially
minimize overlaps with PhilHealth the poor, marginalized, and vulnerable
o Expand PhilHealth benefits to cover
outpatient diagnostics, medicines, blood and o Prioritize the poorest 20 million
blood products aided by health technology Filipinos in all health programs and
assessment support them in non-direct health
o Update costing of current PhilHealth case expenditures
rates to ensure that it covers full cost of care o Make all health entitlements simple,
and link payment to service quality explicit and widely published to
o Enhance and enforce PhilHealth contracting facilitate understanding, & generate
policies for better viability and sustainability demand
o Set up participation and redress
3. Harness the power of strategic HRH mechanisms
(Human Resource for Health) development o Reduce turnaround time and
improve transparency of processes
o Revise health professions curriculum to be at all DOH health facilities
more primary care-oriented and responsive to o Eliminate queuing, guarantee decent
local and global needs accommodation and clean restrooms
o Streamline HRH compensation package to in all government hospitals
incentivize service in high-risk or
geographically isolated and disadvantaged 7. Elicit multi-sectoral and multi-stakeholder
areas (GIDA) support for health
o Update frontline staffing complement o Harness and align the private sector in
standards from profession-based to planning supply side investments
competency-based o Work with other national government agencies
o Make available fully-funded scholarships for to address social determinants of health
HRH hailing from GIDA areas or IP groups o Make health impact assessment and public
o Formulate mechanisms for mandatory return health management plan a prerequisite for
of service schemes for all heath graduates initiating large-scale, high-risk infrastructure
projects
4. Invest in eHealth and data for decision- o Collaborate with Civil Service Organizations
making (CSOs) and other stakeholders on budget
development, monitoring and evaluation
o Mandate the use of electronic medical records
in all health facilities
o Make online submission of clinical, drug
dispensing, administrative and financial
records a prerequisite for registration, licensing
and contracting
o Commission nationwide surveys, streamline
information systems, and support efforts to
 THE NATIONAL OBJECTIVES FOR HEALTH
(NOH) Strategic Goal 2: More Responsive Health System
o The quality of health goods and services as
well as the manner in which they are
delivered to the population will be
improved to ensure people-centered
healthcare provision.
o This may be done through instruments that
routinely monitor and evaluate client
feedback on health goods used and services
received.

Strategic Goal 3: More equitable Healthcare

Financing
o Access of Filipinos, especially the poor and
underserved, to affordable and quality
health goods and services will be expanded
The National Objectives for Health (NOH) 2017– through mechanisms that provide them
2022 serves as the medium-term roadmap of the with adequate financial risk protection from
Philippines towards achieving universal healthcare the high and unpredictable cost of
(UHC). It specifies the objectives, strategies and healthcare.
targets of the Department of Health (DOH) o These may include efforts to reduce
FOURmula One Plus for Health (F1 Plus for catastrophic out of the pocket (OOP)
Health) built along the health system pillars of payments, such as through public subsidies
financing, service delivery, regulation, governance targeted towards the poor
and performance accountability. This ultimately
leads to the three major goals that the Philippine The priorities of F1 Plus for Health hew closely to
Health Agenda aspires for: (1) better health the thrusts of UHC. This policy reform envisions
outcomes with no major disparity among Filipinos to be among the healthiest people in
population groups; (2) financial risk protection for Southeast Asia by 2022, and in Asia by 2040. It
all especially the poor, marginalized and intends to lead the country in the development of a
vulnerable; and (3) a responsive health system productive, resilient, equitable and people-centered
which makes Filipinos feel respected, valued and health system towards the attainment of UHC,
empowered. guided by the values of professionalism,
responsiveness, integrity, compassion and
In response to the challenges identified in excellence
improving health outcomes and the health system, WHO Cooperation for Health
the DOH pursues FOURmula One Plus (F1 Plus)
for Health, which aims to provide Universal Health The global vision of the world in 2030, spelled out
Care (UHC) for all Filipinos in the medium to long in the Sustainable Development Goals, aligns with
term. The national policy on UHC espouses three the Philippines’ 25-year vision AmBisyon Natin
strategic thrusts: better health outcomes, responsive 2040. There is an ongoing process of integrating
health system, and equitable and sustainable health Sustainable Development Goals (SDGs) into
financing AmBisyon Natin 2040 and into national, sectoral
F1 Plus for Health has three strategic goals: and subnational plans and frameworks.

Strategic Goal 1: Better health outcomes The World Health Organization (WHO) supports
o The health sector will sustain gains and the Government of the Philippines to foster well-
address new challenges especially in being through action by the health sector and
maternal, newborn and child health, across sectors. WHO convenes platforms for health
nutrition, communicable disease involving multiple stakeholders and in addressing
elimination, and Non-Communicable the social, economic and environmental
Disease (NDC) prevention and treatment. determinants of health. WHO also takes the lead in
o Improvements in health outcomes will be coordinating with other health partners to ensure
measured through sentinel indicators such all stakeholders are aware of health issues and
as life expectancy, maternal and infant activities in the country.
mortalities, NCD mortalities, TB incidence,
and stunting among under-five year-olds.
World Health Organization (WHO) Country Cooperation Strategic Agenda (2017–2022)

Strategic Priorities Main Focus Areas for WHO Cooperation

STRATEGIC PRIORITY 1: Save lives: ensure full • Accelerate progress towards the targeted
access to immediate-impact interventions elimination of TB, the AIDS epidemic,
malaria and neglected tropical diseases
• Address the high burden of viral hepatitis
• Intensify control and treatment of
dengue, Zika and chikungunya
• Strengthen the implementation of
maternal, neonatal and child health
policies across the country with a special
focus on vulnerable groups
• Expand population coverage under the
national vaccination programme
STRATEGIC PRIORITY 2: Promote well-being:  Maximize opportunities for healthy
empower people to lead healthy lives and enjoy lifestyles
responsive health services  Accelerate the introduction of tobacco-
free societies
 Increase the responsiveness of health
services to people’s needs
 Enable reproductive choices for all
women and men
 Optimize the health sector contribution to
preventing and addressing gender-based
violence and violence against children
 Support the implementation of a
comprehensive nutrition programme
STRATEGIC PRIORITY 3: Protect health: • Support the implementation of the Asia
anticipate and mitigate disasters, and Pacific Strategy for Emerging Diseases
environmental and emerging health threats and Public Health Emergencies and
disaster risk management for health
• Co-lead the national Health Cluster
response in emergency situations
• Improve access to clean air, safe water
and safe food
• Advocate for “green” health-care facilities
and the reduction of carbon emissions
• Support the implementation of The
Philippine Action Plan to Combat
Antimicrobial Resistance: One Health
Approach
 STRATEGIC PRIORITY 4: Optimize the health • Improve the efficiency of health actors in
architecture: overcome fragmentation to achieve an evolving, federalized governance
universal health coverage structure
• Support the rollout of functionally
defined service delivery networks and
improved local stewardship for health
• Support efficient and effective regulatory
capacity, procurement, and management
of supplies and logistics
• Ensure protection from catastrophic
health expenditures
• Ensure equitable health workforce
distribution and capacity
• Promote evidence-informed policy-
making and planning in support of
achieving national and global target
STRATEGIC PRIORITY 5: Use platforms for • Work with Government departments,
health: support health in all settings, policies and legislators and organizations on health-
sectors related taxation laws and regulations and
to promote multisectoral collaboration
• Support the educational sector and youth
organizations, through the Department of
Education and the Commission on
Higher Education
• Enable cities and islands to act as drivers
for population health
• Enhance the Philippines’ standing in
regional and global health
• Address the issue of road and traffic
injuries as a major public health concern.
• Increase health synergies between public
and private sectors

Sources: Global Health Observatory May 2017 http://apps.who.int/gho/data/node.cco

COMPONENTS OF THE PHILIPPINE HEALTH generally paid for through user fees
CARE DELIVERY SYSTEM at the point of service.
o Include clinics. hospitals , health
Health care services are provided in the Philippines insurance, manufacturing of
through a dual health delivery system composed of medicines, vaccines -medical
the public sector and the private sector. supplies equipment - nutrition
products - research & development -
1. Public Sector or other any health related items
o The public sector is largely financed
through a tax-based budgeting In the Philippines the components of the health
system, where health services are care delivery system as mandate of the Department
delivered by government facilities of Health (DOH) is to be responsible for the
under the national and local following:
governments.  Formulation and development of national
o Include the health centers or health policies, guidelines, standards and
barangay health stations manual of operations for health services and
programs;
2. Private Sectors  Issuance of rules and regulations, licenses
o The private sector, consisting of for- and accreditations;
profit and non-profit health-care  Promulgation of national health standards,
providers, is largely market goals, priorities and indicators;
oriented, where health care is
  Development of special health programs Centers; tuberculosis clinics and hospitals of
and projects and advocacy for legislation on the Philippine Tuberculosis Society; private
health policies and programs. clinics, clinics operated by the Philippine
Medical Association; clinics operated by
CLASSIFICATION OF HEALTH CARE large industrial firms for their employees;
WORKERS community hospitals and health centers
operated by the Philippine Medicare Care
There are three levels of health workers in the Commission and other health facilities
Philippine. These are: operated by voluntary religious and civic
groups.
1. Village or grassroots health workers
 The first contacts of the community and 2. Level II (Secondary Level of Health Care
initial links of health care Facilities) is the smaller, non-
 They provide simple curative and departmentalized hospitals including
preventive health care measures promoting emergency and regional hospitals. The
healthy environment and participate in services offered to patients with
activities geared towards the improvement symptomatic stages of disease, which
of the socio-economic level of the require moderately specialized knowledge
community like food production program. and technical resources for adequate
 These are the barangay health worker, treatment.
volunteers or traditional birth attendants or
hilot. 3. Level III (Tertiary Level of Health Care
Facilities) are the highly technological and
2. Intermediate level of health workers sophisticated services offered by medical
o Represents the first source of professional centers and large hospitals. These are the
health care. specialized national hospitals. The services
o They attend to health problems beyond rendered at this level are for clients afflicted
the competence of village workers and with diseases which seriously threaten their
provide support to front-line health health and which require highly technical
workers in terms of supervision, training, and specialized knowledge, facilities and
supplies, and services. personnel to treat effectively.
o These are the medical practitioners,
nurses and midwives. TWO-WAY REFERRAL SYSTEM

3. First line hospital personnel Health Referral is a set of activities

o Provide backup health services for undertaken by a health care provider or facility in
cases that require hospitalization response to its inability to provide the necessary
and establish close contact with intervention of patient’s need. It is done from the
intermediate level health workers or community to the RHU, from the RHU to the
village health workers. hospital and within the hospital internal system
o These are the physicians with and vice versa.
specialty, nurses, dentist,
pharmacists, and other health Health referral involves not only direct
professionals. patient care but support services such as
transportation to transfer patient from one health
facility to another. It is a two-way relationship that
LEVELS OF HEALTH CARE FACILITIES requires cooperation, coordination and exchange of
information between the primary health facility
In the Philippine healthcare setting there are levels and the first referral hospital during the referral
of healthcare facilities: Level I, Level II, and Level and discharge of patient from the hospital.
III.
Rationale of Referral System
1. Level I (Primary Level of Health Care
Facility) are the rural health units, their sub- • Most common to the most complicated and
centers, chest clinics, malaria eradication life threatening diseases requires different
units, and schistosomiasis control units are levels of health workers and health care
directly operated by the DOH; puericulture facility
centers operated by League of Puericulture • Maximize limited resources.
 • Avoid duplication of services. o Primary preventive and promotive
• Promotes cooperation and complementation services such as:
of primary, secondary and tertiary health o health education campaign
facilities. for sanitation
• Appropriate level of care made available o Immunization.
considering geographic factors, time, cost o Normal delivery by midwife
and urgency o Contact tracing
• Promotes continuity of treatment o Liaison with the community
• Sustainability
2. Rural Health Unit
What are the major effects of deficiencies in o Primary referral center from
health referral system? barangay health stations( BHS)
o Promotive and secondary level
• Wastage of scarce health resources through prevention
duplication of services and underutilization o Treatment of primary cases not
of primary and secondary government needing inpatient services
hospital which results to decreased o Outpatient services (case finding
efficiency and treatment.)
• Increase in preventable morbidity and o Health education, promotive and
mortality due to lack of appropriate preventive campaigns
services, delayed referral and poor referral o Normal delivery, pre-natal and post
communications which leads to decreased natal
effectiveness. o minor surgery

Framework of a two way health referral system 3. District Hospital

should: o The first level referral hospital in the health
district.
• Include a defined packages of services o It has a catchments of 75,000 population or
provided at different levels of care. more and is about 35 kilometers to next
• Encourage an environment in which the government facility
core referral hospital is viewed as a o It should have adequate capabilities as a
community resource. secondary level hospital or should provide
• Be responsive to local situations, while surgical, radiological and routine laboratory
being part of over all province-wide services.
referral system
• Be inclusive of the private medical sector 4. Provincial Hospitals
and NGOs involved in the provision of  The highest referral level facility in
community-based health care. the province.
• Include a properly functioning  Provincial Hospitals cases not
communication and transport system treated in the district hospital are
(telephone, radiophone, ambulance, etc.) referred to the Provincial hospital.
 It has tertiary level capabilities for
When does a patient be referred to a higher levels providing medical cares to cases
of care? requiring the expertise of trained
specialists, subspecialists and other
• When a patient needs expert advice. licensed physicians using highly
• Needs a technical examination that is not specialized ancillary diagnostic and
available at the health centers therapeutic equipment.
• Requires a technical intervention that is
beyond the capabilities of the health center Roles and responsibility of Referring Physician
• Requires in-patient care o Should know what, when, whom, and where to
refer
Types of services available in each referral levels: o Accomplish referral form with all necessarily
information.
1. Barangay Health Stations o Explain to patient rationale, reasons for choice
o A satellite of the RHU where the first of doctor/hospital, preparation, expected cost,
contact of the patient occur. possible outcome of referral
o Facilitate scheduling, etc. secure result of  Consent of the patient or companion. In
referral case of an unaccompanied minor patient,
they may be transferred without consent
Roles and responsibilities of Consultant provided that the provision of section 1 of
Physician RA 8344 is strictly observed
o Respond promptly to a request for consultation.  In case of refusal of transfer, the name of the
report in detail all pertinent findings and hospital, the name(s) of person who refused
recommendation to the referring doctor and and the reason (s) for the refusal
may outline opinion to the patient.
o Communicate with patient and his family about Penal Provisions for violation of RA 8344
what they should know regarding the medical
conditions. imprisonment of not less than six months & one
o Return the patient to the referring doctor’ not to day but not more than two (2) years & four months,
attempt by word or deed, to usurp or or at time of not less that Twenty Thousand Pesos
undermine the primary physician role. (P20,000.00) but not more than One Hundred
Thousand Pesos (P100,000.00) on both at the
Republic Act 8344 discretion of the court.

An act penalizing the refusal of hospitals & medical A service delivery network (SDN) is a strategic
clinics to administer appropriate initial medical mechanism for expanding access to and
treatment & support in emergency or serious cases, strengthening the continuum of care for families
amending for the purpose Batas Pambansa Bilang across political and geographical boundaries. It
702, otherwise known as “An act prohibiting the seeks to ensure the continuing provision of quality
demand of deposits of or advance payments in care by combining the capacities of individual
hospitals & medical clinics in certain cases” health service delivery points into a unified
delivery system. This facilitates the collective
management of recurrent issues resulting from the
three-tiered health care system and uncoordinated
referral practices among health care system
facilities

Implementing Rules and Regulations Multi-Sectoral Approach to Health

Transfer of Patients:
Multisectoral approach (MSA) refers to deliberate
Transfer of Patients: collaboration among various stakeholder groups
 The transferring & receiving hospital (e.g., government, civil society, and private sector)
shall as much as practicable be within 10 and sectors (e.g., health, environment, and
km. radius of each other. economy) to jointly achieve a policy outcome. By
 The transfer of patients contemplated under engaging multiple sectors, partners can leverage
this act at all times be properly documented knowledge, expertise, reach, and resources,
 Hospitals may require a deposit or advance benefiting from their combined and varied
payment when the patient is no longer strengths as they work toward the shared goal of
under the state of emergency and he or she producing better health outcomes. Improving
refuses to be transferred public health (PH) is challenging because of the
 All hospital shall use a Uniform Discharge / size of its population and wide variation in
Transfer Slip for cases covered by RAE 8311 geography. MSA help in addressing identified
which shall include the following health issues in focused way as it helps in pooling
information: the resources and formulating the common
 Admission Form of transferring hospital objectives.
 Transfer Form of transferring hospital to
include but not necessarily limited to the One of the major advantages is optimization of usage
following: of resources by avoiding duplication of inputs and
a) Vital signs activities which tremendously improve program
b) Name of Attending Physician effectiveness and efficiency. Willingness at the
c) Treatment given to patient leadership and mandate at the policy level are
d) Name of Receiving hospital. necessary to plan and execute the successful
 Name of contact person and approving multisectoral coordination. All the major
official at receiving hospital
stakeholders require to share the common vision effectiveness and efficiency, pro-action,
and perspective. dynamism, and openness to change.
 Compassion and respect for human
Primary health care ensures interaction between dignity – Whilst DOH upholds the quality
the health sector, other sectors, and individuals and of life, respect for human dignity is
communities to deal with the main health problems encouraged by working with sympathy
and address the broad determinants of health. This and benevolence for the people in need.
applies to practitioners understanding and  Commitment – With all our hearts and
addressing the social circumstances of individuals minds, the Department commits to
as well as their health needs, and a population achieve its vision for the health and
health “management” response to promote health development of future generations.
and prevent illness and injury. This is not possible  Professionalism – The DOH performs its
without partnerships with other sectors. functions in accordance with the highest
ethical standards, principles of
Multisectoral action occurs at different levels – an accountability, and full responsibility.
example Consider the problem of drug and alcohol  Teamwork – The DOH employees work
abuse. As well as helping the individual, local together with a result-oriented mindset.
health services need to work with schools, local  Stewardship of the health of the people –
governments (e.g. to establish alcohol-free zones), Being stewards of health for the people,
the police and services that provide legal, the Department shall pursue sustainable
employment and relationship support. However, development and care for the
local collaborations will not usually be sufficient to environment since it impinges on the
tackle the problem in a comprehensive way and health of the Filipinos.
prevent further issues. This will require macro-
level policy reforms, again with multiple sectors Together with its attached agencies, the DOH –
involved to ensure appropriate policy is developed. constituted of various central bureaus and services
in the Central Office, Centers for Health
Development (CHD) in every region, and DOH-
retained hospitals – performs its roles to
continuously improve the country’s health care
system.

DEPARTMENT OF HEALTH (DOH) DOH VISION

Filipinos are among the healthiest people in Southeast
The Department of Health (DOH) holds the over- Asia by 2022, and Asia by 2040
all technical authority on health as it is a national
health policy-maker and regulatory institution. DOH MISSION
To lead the country in the development of a productive,
Basically, the DOH has three major roles in the resilient, equitable and people-centered health system
health sector: (1) leadership in health; (2) enabler
and capacity builder; and (3) administrator of HISTORY OF DOH
specific services. Its mandate is to develop national
plans, technical standards, and guidelines on Pre-Spanish and Spanish periods (before 1898)
health. Aside from being the regulator of all health • traditional health care (herbs &
services and products, the DOH is the provider of rituals)
special tertiary health care services and technical • dispensary of indigent patients of
assistance to health providers and stakeholders. Manila
• Medicus Titulares (provincial health
While pursuing its vision, the DOH adheres to the workers)
highest values of work, which are: • Superior Board of Health & Charity,
1888
 Integrity – The Department believes in
upholding truth and pursuing honesty, June 23, 1898
accountability, and consistency in • creation of E. Aguinaldo government of
performing its functions. Department of Public Works, Education &
 Excellence – The DOH continuously Hygiene
strive for the best by fostering innovation,
September 29, 1898
 • gen. order no. 15 o medical care
• established the Board of Health for the City o health education
of Manila o public health nursing

July 1, 1901 • resulted in passage of Rural Health Act of

• Act no. 157: Board of Health of Philippine 1954 (RA 1082)
Islands
• Acts no, 307 & 308: provincial and 1970
municipal boards • conceptualization of the Restructured
Health Care Delivery System (primary,
October 26, 1905 secondary & tertiary levels of care)
• Act no. 1407
• establishment of Bureau of Health June 2, 1978
1912 • P.D. 1937 renamed DOH to Ministry of
• Act no. 2156 (Fajardo Act):health fund for Health during the Martial Law
travel and salaries • Sec. Gatmaitan was the 1st minister of
health
1915
• Act no. 2568: from BOH to Philippine December 2. 1982
Health Service “ semi-military system of • E.O. 851 reorganized Ministry of Health as
public health administration” an integrated health care delivery system
through the creation of Integrated
Provincial Health Office, combining the
public health and hospital operations under
August 2, 1916 the PHOs
• Act 2711 w/c included the Public Health
Law of 1917 April 13, 1987
• E.O. no. 119: MOH was back in the name
1932 Department of Health by President Cory
• Act no. 4007: Reorganization Act of 1932 Aquino

May 31, 1939 October 10, 1991

• Commonwealth act no. 430 created the • RA 7160 known as the Local Government
Department of Public Health & Welfare, but Code: all structures, personnel & budgetary
was only completed through E.O. no. 317, allocations from the provincial health level
Jan. 7, 1941 down to the barangay were devolved to the
• Dr. Jose Fabella became its first secretary LGU to facilitate health service delivery
• From PROVINCIAL TO LOCAL
October 4, 1947 GOVERNMENT (devolution/ devolved
• E.O. no. 94: post war reorganization of the health sector)
Department of Health & Public Welfare
• resulted in the split of Department of Public May 24, 1999 - E.O. 102 “Redirecting the Functions
Welfare (w/c became Social Welfare & Operations of the DOH” by Pres. Joseph Estrada
Administration) and Philippine General
Hospital to the Office of the President 1999-2004
• another split between curative (Bureau of • Development of the Health Sector Reform
Hospitals ) & preventive services (Bureau of Agenda (HSRA)
Health) –
• Nursing Service Division was also 2005 to present
established • development of a plan to rationalize the
bureaucracy in an attempt to scale down
January 1, 1951 including the DOH
• conversion of Sanitary District to Rural
Health Unit, carrying the ff. services: ROLES AND FUNCTIONS OF FUNCTION OF
o maternal & child health DOH
o environmental health
o communicable disease control The primary function of the Department of Health
o vital statistics is the promotion, protection, preservation or
restoration of the health of the people through the 8. To develop a global partnership for
provision and delivery of health services and development.
through the regulation and encouragement of
providers of health goods and services. The DOH The MDGs are inter-dependent; all the MDG
has three major roles in the health sector: influence health, and health influences all the
MDGs. For example, better health enables children
1. Leadership in Health to learn and adults to earn. Gender equality is
o national policy & regulatory essential to the achievement of better health.
institution Reducing poverty, hunger and environmental
o leadership in formulation, degradation positively influences, but also depends
monitoring, & evaluation of health on, better health. MDG’s 4, 5 and 6 are health
policies, plans & programs related goals.
o serve as advocate in health policies,
plans & programs The Millennium Development Goals in the
Philippines
2. Enabler & Capacity Builder
o innovate new strategies in health Arising from the historic adoption of the
o monitoring & evaluation of national Millennium Declaration by 189 countries in 2000,
health policies, plans & programs the Millennium Development Goals (MDGs) give
o ensure highest achievable standards voice to the global aspiration to eradicate extreme
of quality HC, health promotion & poverty. The MDGs are eight concrete and
health protection interconnected goals, with a corresponding set of
measurable targets and indicators. This
development framework represents a remarkable
3. Administrator of Specific Services global partnership between poor countries that
o manage selected national & sub- pledge to govern better and invest in human
national health facilities & hospitals development and rich countries that promise to
w/ modern facilities that shall serve support them.
as referral centers
o administer direct services for In the Philippines, the MDGs have been tightly
emerging health concerns integrated into national development plans by the
o emergency response services in Government, and utilized to monitor their
disaster and epidemics implementation. The MDGs have also been broadly
MILLENNIUM DEVELOPMENT GOALS adopted by all relevant development organizations,
from local government units (LGUs) to civil society
(MDGS)
organizations (CSOs.) They serve as a common
foundation for development, resulting in better
The United Nations Millennium Development
alignment of interventions and coordination,
Goals are eight goals that all 191 UN member states
allocation, and use of resources.
have agreed to try to achieve by the year 2015. The
United Nations Millennium Declaration, signed in
Yet, despite strong institutional support, overall
September 2000 commits world leaders to combat
progress on the MDGs is not encouraging.
poverty, hunger, disease, illiteracy, environmental
Interventions for poverty, education, maternal
degradation, and discrimination against women.
health, HIV/AIDS, and the environment need to be
The MDGs are derived from this Declaration, and
accelerated, while addressing the glaring
all have specific targets and indicators. The Eight
disparities in rates of progress across regions. It is
Millennium Development Goals are:
clear that if success is to be achieved, efforts need to
be redoubled; current initiatives in all areas must
1. To eradicate extreme poverty and hunger;
be scaled-up, greater resources must be mobilized
2. To achieve universal primary education;
while more efficiently utilizing existing resources,
3. To promote gender equality and empower and stronger advocacy and capacity must be
women; developed, especially at the local level.
4. To reduce child mortality;
5. To improve maternal health;
6. To combat HIV/AIDS, malaria, and other
diseases;
7. To ensure environmental sustainability; and
 SUSTAINABLE DEVELOPMENT GOALS Health has a central place in SDG 3 “Ensure healthy
(SDGS) lives and promote well-being for all at all ages”,
underpinned by 13 targets that cover a wide
spectrum of WHO’s work. Almost all of the other
16 goals are related to health or their achievement
will contribute to health indirectly.

The SDGs aim to be relevant to all countries – poor,

rich and middle-income – to promote prosperity
while protecting the environment and tackling
climate change. They have a strong focus on
improving equity to meet the needs of women,
children and disadvantaged populations in
particular so that “no one is left behind”.

This agenda builds on the Millennium

Development Goals (MDGs) which were 8 goals
The Sustainable Development Goals (SDGs), also that UN Member States signed in September 2000
known as the Global Goals, were adopted by all to achieve targets to combat poverty, hunger,
United Nations Member States in 2015 as a disease, illiteracy, environmental degradation and
universal call to action to end poverty, protect the discrimination against women by 2015.
planet and ensure that all people enjoy peace and
prosperity by 2030. Everyone is needed to reach these ambitious
targets. The creativity, knowhow, technology and
The United Nations Sustainable Development financial resources from all of society is necessary
Goals (UN SDGs, also known as the Global Goals) to achieve the SDGs in every context.
are 17 goals with 169 targets that all UN Member
States have agreed to work towards achieving by
the year 2030.They set out a vision for a world free
from poverty, hunger and disease. The 17 Sustainable Development Goals are the
following:
The 17 SDGs are integrated—that is, they
recognize that action in one area will affect
1. End poverty in all its forms everywhere
outcomes in others, and that development must
balance social, economic and environmental 2. End hunger, achieve food security and
sustainability. improved nutrition and promote
sustainable agriculture
Through the pledge to Leave No One Behind,
3. Ensure healthy lives and promote well-
countries have committed to fast-track progress
for those furthest behind first. That is why the being for all at all ages
4. Ensure inclusive and equitable quality
education and promote lifelong learning
opportunities for all
SDGs are designed to bring the world to several
5. Achieve gender equality and empower all
life-changing ‘zeros’, including zero poverty,
hunger, AIDS and discrimination against women women and girls
and girls. 6. Ensure availability and sustainable
management of water and sanitation for all
The Sustainable Development Goals are a call for 7. Ensure access to affordable, reliable,
action by all countries – poor, rich and middle-
sustainable and modern energy for all
income – to promote prosperity while protecting
the planet. They recognize that ending poverty 8. Promote sustained, inclusive and
must go hand-in-hand with strategies that build sustainable economic growth, full and
economic growth and address a range of social productive employment and decent work
needs including education, health, social
for all
protection, and job opportunities, while tackling
climate change and environmental protection
 9. Build resilient infrastructure, promote All people should have access to good-quality
healthcare and medicines, including financial risk
inclusive and sustainable industrialization
protection. Another objective for 2030 is to ensure
and foster innovation universal access to sexual and reproductive
10. Reduce inequality within and among healthcare, including family planning, information
countries and education.
11. Make cities and human settlements
inclusive, safe, resilient and sustainable
The targets for SDG 3 are outlined below:
12. Ensure sustainable consumption and
production patterns
1. By 2030, reduce the global maternal
13. Take urgent action to combat climate
mortality ratio to less than 70 per 100 000
change and its impacts
live births.
14. Conserve and sustainably use the oceans,
2. By 2030, end preventable deaths of
seas and marine resources for sustainable
newborns and children under 5 years of
development
age, with all countries aiming to reduce
15. Protect, restore and promote sustainable use
neonatal mortality to at least as low as 12
of terrestrial ecosystems, sustainably
per 1,000 live births and under-5 mortality
manage forests, combat desertification, and
to at least as low as 25 per 1000 live births.
halt and reverse land degradation and halt
3. By 2030, end the epidemics of AIDS,
biodiversity loss
tuberculosis, malaria and neglected tropical
16. Promote peaceful and inclusive societies for
diseases and combat hepatitis, water-borne
sustainable development, provide access to
diseases and other communicable diseases.
justice for all and build effective,
4. By 2030, reduce by one third premature
accountable and inclusive institutions at all
mortality from non-communicable diseases
levels
through prevention and treatment and
17. Strengthen the means of implementation
promote mental health and well-being.
and revitalize the global partnership for
5. Strengthen the prevention and treatment of
sustainable development
substance abuse, including narcotic drug
SDG 3: Ensure healthy lives and promote abuse and harmful use of alcohol.
well-being for all at all ages 6. By 2020, halve the number of global deaths
and injuries from road traffic accidents.
The Millennium Development Goals (MDGs) have
made a significant contribution to improving global 7. By 2030, ensure universal access to sexual
health, e.g. in the fight against diseases such as and reproductive health-care services,
AIDS, tuberculosis and malaria. For example, the including for family planning, information
number of malaria deaths has fallen by 60% since
and education, and the integration of
2000. However, results have failed to meet
expectations in many areas, such as reducing child reproductive health into national strategies
and maternal mortality. and programmes.
8. Achieve universal health coverage,
The experience of the MDGs has shown that health
problems need to be viewed in context, not in including financial risk protection, access to
isolation. Education and food security influence the quality essential health-care services and
effectiveness of healthcare programmes. Goal 3 access to safe, effective, quality and
continues along the same lines as the MDGs, for affordable essential medicines and vaccines
example with regard to child and maternal
for all.
mortality as well as communicable diseases such as
AIDS, malaria and tuberculosis, while also 9. By 2030, substantially reduce the number of
including provisions on combating non- deaths and illnesses from hazardous
communicable diseases such as diabetes and chemicals and air, water and soil pollution
preventing traffic accidents and narcotics abuse. and contamination.
 10. Strengthen the implementation of the WHO the SDGs by 2030, if not sooner, especially as the
Global Goals are in sync with the country’s
Framework Convention on Tobacco Control
development plans and long-term aspirations for
in all countries, as appropriate. 2040.
11. Support the research and development of
vaccines and medicines for the In the Millenium Development Goals (MDGs),
communicable and non-communicable eight anti-poverty targets had been set to be
achieved by 2015 and the Philippines only made
diseases that primarily affect developing
some progress. Poverty has not been ended. The
countries, provide access to affordable development agenda called “Sustainable
essential medicines and vaccines, in Development Goals” builds on the MDGs. The
accordance with the Doha Declaration on proposed framework has 17 goals with 169 targets
the TRIPS Agreement and Public Health,
Since the adoption of the SDGs, the Philippine
which affirms the right of developing government has been setting up the policy and
countries to use to the full the provisions in enabling environment for their implementation, as
the Agreement on Trade Related Aspects of well as compiling and analyzing data for
Intellectual Property Rights regarding monitoring the country’s conditions on the SDGs.
flexibilities to protect public health, and, in The National Economic and Development Authority
particular, provide access to medicines for (NEDA), as the cabinet-level agency responsible for
development and planning in the country, looks into
all.
synergies of the SDGs indicator framework in
12. Substantially increase health financing and
relation to the monitoring of the country’s medium-
the recruitment, development, training and and long-term development plans. All concerned
retention of the health workforce in government agencies have been enjoined to
developing countries, especially in least provide the necessary data support for monitoring
developed countries and small island the Global Goals with the Philippine Statistics
developing states. Authority (PSA), an attached agency of NEDA,
13. Strengthen the capacity of all countries, in designated as the official repository of SDG
indicators
particular developing countries, for early
warning, risk reduction and management of
national and global health risks.

The Sustainable Development Goals in the

Philippines What is the AmBisyon Natin 2040?

In September 2015, the Philippines, together with AmBisyon Natin 2040 is a picture of the future, a
192 other United Nations (UN) member states, set of life goals and goals for the country. It is
committed to achieving the 17 Sustainable different from a plan, which defines the strategies
Development Goals (SDGs) and their 169 targets by to achieve the goals. It is like a destination that
2030. The SDGs, also called the Global Goals, have answers the question “Where do we want to be?”A
a range of economic, social, environmental, and plan describes the way to get to the
governance targets and there was recognition, early destination; AmBisyon Natin 2040 2040 is the
on, that these need to be achieved in order to attain vision that guides the future and is the anchor of
the long-term vision as articulated in AmBisyon the country’s plans.
Natin 2040. The SDGs present a bold commitment
to finish what has been started through the AmBisyon Natin 2040 and the Philippine
Millennium Development Goals (MDGs) in 2015. Development Plan (PDP) AmBisyon Natin 2040
The Philippines affirms its commitment to achieve represents the collective long-term vision and
aspirations of the Filipino people for themselves
and for the country. It describes the kind of life that
people want to live, and how they want the country
to be by 2040. “By 2040, the Philippines will have
been a prosperous, predominantly middle-class
society where no one is poor, our people live long
and healthy lives, are smart and innovative, and
live in a high trust society.”

This long-term vision is a basis for national unity

and is meant to guide development planning across
at least four government administrations. The
attainment of the SDGs, set at 2030, should pave the
way for the achievement of AmBisyon Natin 2040. The
vision, which necessitates inter-generational equity,
is consistent with the core principles of the SDGs of
sustainable development and leaving no one
behind. Sustainable development requires long-
term planning where present development should
never be at the expense of future generations. This
is a requisite for the Filipino AmBisyon of a life that
is matatag (strongly rooted), maginhawa
(comfortable), and panatag (secure).