‘ SOCIAL AND ADMINISTRATIVE PHARMACY TERM

PHARM AD 32 - Gemma G. Amutan 02

Lesson 1. ● The average bed occupancy rate of public
Healthcare Delivery System and Administration medical centers is significantly higher than for
private hospitals.
Overview of the Philippines Health System ● On average, patients stay about two days longer
● Is a dual health system composed of public and in public than in private medical centers.
private sectors.
● Health services in the PUBLIC SECTOR HEALTH GOVERNANCE AND REGULATION
- are provided by health facilities run by the ● DOH
National and local governments and are largely - provides national policy direction and
financed through a tax-based budgeting strategic plans, regulatory services, standards
system. Services are run by the national and and guidelines for health, and highly specialized
local governments. and specific tertiary-level hospital services.
- provides leadership, technical assistance,
○ Department Of Health capacity building, linkages and coordination with
- supervises the government corporate hospitals, other national government agencies, LGUs and
specialty and regional hospitals private entities in implementing health policies.
- in charge of licensing hospitals, laboratories
○ Department of National Defense and other health facilities through the Health
- runs the military hospitals Facilities and Service Regulatory Bureau
(HFSRB) and health products through the
● The PRIVATE SECTOR Food and Drug Administration (FDA).
- is largely market-oriented, where health
services are generally paid for through user fees ● LGUs
at the point of service, though the Philippine - provincial, city and municipal governments
Health Insurance Corporation (PhilHealth) - are responsible for managing and implementing
also purchases services from both the public local health programmes and services
and private sector.
- consisting of for-profit and non-profit health-care ● Local Health Board
providers - chaired by the local chief executive (governor
or mayor)
○ Philippine Health Insurance Corporation - serves as an advisory body to the local chief
(PhilHealth) executives and the local legislative council
- social health insurance since 1995 aimed to members (sanggunian) on the local health
provide financial risk protection for the Filipino system
people.
- is regulated through a Board of Directors, ● DOH Regional Health Office
chaired by the Secretary of Health. - is represented by either a DOH representative
or Development Management Officer under
● With the enactment of the Local Government the DOH Provincial Health Team
Code of 1991, a decentralized system was
organized, wherein LGUs have full autonomy to ● Insurance Commission (IC)
finance and operate the local health systems. - under the Department of Finance
○ provincial governments are tasked with - regulates and supervises the operations of
providing primary and secondary hospital care private insurance companies, including health
- manage and operate district and insurance and pre-need companies as well as
provincial hospitals mutual benefit associations.
○ city and municipal governments are tasked - health maintenance organizations (HMOs)
with providing primary health care, promotive are also regulated by the IC.
health services and other public health
programmes through the rural health units, HEALTH SYSTEM PERFORMANCE
health centers and barangay health stations and ● PhilHealth
basic ambulatory clinical care. - its benefit coverage remains mainly for
○ Highly urbanized and independent cities inpatient care and it provides only limited
provide both hospital services and primary care financial support.
services.

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 - Access remains highly inequitable due to the ● Parallel funding by three sources (DOH, PhilHealth
maldistribution of facilities, health staff and and LGU)
specialists - and lack of demarcation and harmonization in
premium-funded benefits versus tax-funded
The limited number of health facilities relative to the services are the primary reasons for confusion
growing population, overprovision of physicians, and inefficiencies in Philippine health-care
underprovision of care and poor physician adherence to financing
clinical practice guidelines contribute to a low quality of
care. ● Absence Of A Facilitated Referral System
- robs the patient of the opportunity to navigate
LESSONS LEARNT FROM HEALTH SYSTEM the health system effectively
REFORMS - referral system can cut short waiting times,
● DOH lead to timely care, prevent duplication of
- was successful in generating political and diagnostic tests and procedures, and even
financial support to pursue KP and in legislating improve the course of treatment
various policy proposals, most notably the Sin
Tax Law and the Reproductive Health Law ● implementing the National Health Insurance
- there is lack of institutional capacity to translate Program
policy into effective programme implementation, - to provide financial risk protection and
monitoring and evaluation. leverage its payments to ensure quality and
responsive health care.
● Addressing Critical Health Needs
- such as the rise in NCDs, including mental and Introduction
oral health, remain inadequately funded. Geography and sociodemography
- The Philippines is located between the South
● Reproductive Health Law of 2012 China Sea and the Pacific Ocean.
- that guarantees universal and free access to the - The country comprises 7107 islands, of which
most modern contraceptives for all Filipinos Luzon in the north is the largest, where the
capital city of Manila is located.
● Philippine Disaster Risk Reduction and - South of Luzon is the Visayas group of islands,
Management Act of 2012 where the major city is Cebu.
- that ensures engagement of all stakeholders in - Further south is the second-largest island,
pursuing a holistic, comprehensive and Mindanao, where Davao City is the main urban
integrated approach to reducing the centre
socioeconomic and environmental impacts of - 17 administrative regions
disasters
Economic context
● Reforms ● Conditional Cash Transfer (CCT) Program
- were achieved by expanding internally - a project initiated by the Arroyo administration
generated (non-budgetary) funds, initially and expanded by the Aquino administration, is a
through patient fees and increasingly through well-targeted social protection programme.
PhilHealth payments. - Also dubbed as the 4Ps (Pantawid Pamilyang
- progressive local government leaders and Pilipino Program), it was vital in helping the
hospital managers direct governance reforms poor and is expected to contribute more to a
to expand services robust poverty reduction in the future.

REMAINING CHALLENGES Political context

● Filipinos suffer from diseases that are preventable - The President is both the head of State and the
and treatable with cost-effective interventions head of the Government within a multiparty
- HIV, TB, dengue and VPDs such as measles system.
and diphtheria. - Power is equally divided among its three
interdependent branches – executive,
● Addressing health system inefficiencies and legislature and judiciary.
health inequities
- due to disorganized governance, fragmented ● Executive power
health financing, and devolved and pluralistic - is vested with the President of the Republic, who
service delivery remain critical challenges is elected by popular vote.

● Legislative power
- influences the health system by passing laws
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 - is vested in the bicameral Congress of the
Philippines, consisting of the Senate and the ● PhilHealth
House of Representatives. - The provision of a compulsory social health
insurance (SHI) scheme is largely through them
The collaborative relationship between the legislative - Government corporation mandated to implement
and the executive branches of the Government was the National Health Insurance Program
demonstrated in the passage of Responsible (NHIP).
Parenthood and Reproductive Health Act of 2012 - principal government agency that purchases
(RH Law) health services on behalf of its members.
- determines and assesses the services that its
Health status members need, accredits health facilities and
- The leading cause of death in the Philippines is service providers, ascertains the cost of
heart disease services, negotiates on price and pays
- While the country continues to combat providers through several schemes such as
pneumonia and TB as the leading causes of case-based payment, fee for service and
death among Filipinos, it is facing an increasing capitation
number of diseases of the heart, diseases of the
vascular system, malignant neoplasms and ● Professional Regulation Commission (PRC)
diabetes. - responsible for the registration and licensing
- road traffic accidents are also becoming a of all professionals in the Philippines
major cause of death
- NCDs consistently and increasingly contribute to ● Commission on Higher Education
the number of years of healthy life lost due to - regulates both public and private institutions
premature death and disability of higher learning, which covers colleges and
- Social, economic and geographical barriers universities offering medical and other
often lead to variations in access to services, professional health degrees.
which eventually result in inequity in health
outcomes. ● Insurance Commission (IC)
- regulates private health insurance companies
Natural and human-induced disasters and oversees the financial viability of health
- The Philippines is one of the world’s disaster maintenance organizations.
“hot spots”.
- Throughout the archipelago’s history, natural Government Sector
hazards such as earthquakes, volcanic - Several National Government agencies and
eruptions, typhoons, floods and droughts have LGUs are responsible for ensuring that health
occurred with such frequency that they have policies are implemented and health programs and
helped shape Filipino society services are delivered in the population.
- the Philippines is third among the countries with
the highest disaster risk in the world ➢ National Government Level (DOH)
○ Acts as the national lead agency in health
Organization ○ The central office consists of 18 bureaus and
services responsible for policy development,
● Private Sector
- consists of clinics, infirmaries, laboratories, program planning, standards settings and
hospitals, drugstores, pharmaceutical and regulation, and related management support
medical supply companies, health insurance services
companies, academic and research institutions ○ To provide technical assistance to LGUs and
and informal service providers that include monitor field operations
traditional healers (herbolarios) and traditional
○ It also manages and operates several regional
birth attendants (hilots).
- contribution to health service provision is hospitals, medical centers, sanitaria, treatment
enormous and their capacity augments the gaps and rehabilitations centers, and special
and inadequacies of the public sector. hospitals that provide tertiary specialized
health services and specialty training to health
● DOH professionals.
- as the national health agency, is mandated to
lay down national policies and plans, develop ➢ Attached to the DOH are several autonomous
technical standards, enforce health regulations, agencies such as the;
and monitor, evaluate and deliver tertiary and ○ National Nutrition Council (NNC)
specialized hospital services. ○ Population Commission
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 ○ Corporate entities - The city government, specifically in highly
■ Philhealth urbanized and independent cities, manages city
■ Philippine Institute of Traditional and hospitals, medical centers, health centers and
Alternative Health Care, BHSs.
■ And four highly specialized corporate
hospitals ● Local Health Board
- chaired by the local chief executive (governor
Figure 2.1 Functional structure of the Department of or mayor)
Health, Philippines, 2017 - serves as an advisory body to the local chief
executives and the local legislative council
members (sanggunian) on health-related
matters.

DOH maintains representation in all local health boards

through the DOH representatives (organized most
recently as Development Management Officers under
the DOH Provincial Health Teams)
Private sector and NGOs
- The private sector is generally a fragmented health
system composed of thousands of for-profit and
non-profit providers involved in the delivery of
various health products and services.
- It consists of clinics, infirmaries, laboratories,
hospitals, drugstores, pharmaceutical and medical
● Republic Act No. 9711 supply companies, health insurance companies,
- to strengthen and rationalize the regulatory academic research institutions and informal
capacity of the old Bureau of Food and Drugs service providers that include traditional healers
by establishing adequate testing laboratories (herbolarios) and traditional birth attendants (hilot).
and field offices, upgrading its equipment, - not covered by any licensing or accreditation
augmenting its human resource complement, system by the Government.
giving it authority to retain its income, and
renaming it as the FDA. ➢ Specialty societies and specialty boards in
the medical profession
➢ Besides DOH, ○ Philippine College of Physicians
○ Department of National Defense (DND) ○ Philippine College of Surgeons
○ Philippine National Police ○ Philippine Academy of Family Physicians
○ Department of Education (DepEd) ○ Philippine Pediatrics Society
○ State colleges and universities ○ Philippine Obstetrical and Gynecological
○ Department of Labor and Employment Society
(DOLE) - involved in the accreditation of training
- provide direct health services within their institutions, administration of qualifying
respective legal mandates to specific sectors: examinations and granting of certificates for
■ Military and the police Diplomates and Fellows for medical
■ Students, teachers and the workforce specialists
- private professional entities given recognition
by the Professional Regulatory Board of
Local Government Level
Medicine under the PRC
- With the devolution of health services under the
Local Government Code of 1991, the direct
➢ Professional groups
provision and management of health services such
○ Philippine Medical Association
as public health programs, promotive and
○ Philippine Nurses Association
preventive health care, and primary and secondary
○ Philippine Dental Association
general hospital services were transferred to LGUs.
○ Philippine Pharmacists Association
- Provincial government headed by the governor,
○ Integrated Midwives Association of the
manages the provincial and district hospitals.
Philippines
- The municipal government, headed by the mayor,
- involved in the promotion of the highest
manages the municipal health systems (RHUs and
standards of practice and competence in the
BHSs).
health professions, and the promotion of the

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 rights and privileges regarding such practice

● Professional Regulations Commission

- Regulated the professional practice in the health
professions
- a government entity composed of several
professional regulatory boards, which
administers qualifying licensure
examinations and exercises administrative and
quasi-judicial powers over their respective
professions

➢ Numerous NGOs, volunteer organizations,

civil society groups are also vital partners of
the Government in the provision of
health-related services.
○ Philippine Red Cross
■ Disasters and calamities
- providing staff and volunteers for
humanitarian services
■ Blood services (blood donation, testing
and processing)
- ensuring safe and quality blood services
through its active role in voluntary blood
donation
■ Promote health
- through its primary health care and
community based health programmes