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NCM 104 Lecture Chapter 2.1 Health-Care-Delivery-System 2

The SDGs build on the Millennium Development Goals (MDGs) from 2000, which aimed to reduce poverty. The SDGs go further by addressing the root causes of issues like poverty and promoting sustainable development for all people. The goals were adopted by 193 UN member states and include targets to end hunger and poverty, achieve gender equality, ensure access to clean water and sanitation, provide affordable and clean energy, reduce inequalities, and take action on climate change by
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0% found this document useful (0 votes)
120 views124 pages

NCM 104 Lecture Chapter 2.1 Health-Care-Delivery-System 2

The SDGs build on the Millennium Development Goals (MDGs) from 2000, which aimed to reduce poverty. The SDGs go further by addressing the root causes of issues like poverty and promoting sustainable development for all people. The goals were adopted by 193 UN member states and include targets to end hunger and poverty, achieve gender equality, ensure access to clean water and sanitation, provide affordable and clean energy, reduce inequalities, and take action on climate change by
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SUSTAINABLE

DEVELOPMENT GOALS
• The Sustainable Development Goals (SDGs), officially
known as Transforming our world: the 2030 Agenda for
Sustainable Development is a set of seventeen
aspirational "Global Goals" with 169 targets between
them.
• Spearheaded by the United Nations, through a
deliberative process involving its 193 Member States,
as well as global civil society, the goals are contained in
paragraph 54 United Nations Resolution A/RES/70/1 of
25 September 2015.

WHAT IS SDG ALL ABOUT?


• The history of the SDGs can be traced to 1972 when
governments met under in Stockholm, Sweden, for the United
Nations Conference on the Human Environment , to consider the
rights of the human family to a healthy and productive
environment.

• It was not until 1983 that the United Nations decided to create the
World Commission on Environment and Development which
defined sustainable development as "meeting the needs of the
present without compromising the ability of future generations to
meet their own needs."

HISTORY OF SDG
• In 1992 the first United Nations Conference on
Environment and Development was held in Rio.

• It was here that the first agenda for Environment and


Development was developed and adopted, also known as
Agenda 21.

• Twenty years later, at the Rio+20 Conference, a


resolution, known as The Future We Want was reached
by member states.

HISTORY OF SDG
At the Sustainable Development Summit on 25
September, 2015, UN Member States will adopt
the 2030 Agenda for Sustainable Development,
which includes a set of 17 Sustainable
Development Goals (SDGs) to end poverty, fight
inequality and injustice, and tackle climate change
by 2030.

WHAT IS THE 2030 AGENDA FOR SUSTAINABLE DEVELOPMENT?


• The SDGs, otherwise known as the Global Goals, build on the
Millennium Development Goals (MDGs), eight anti-poverty
targets that the world committed to achieving by 2015.

• The MDGs, adopted in 2000, aimed at an array of issues that


included slashing poverty, hunger, disease, gender inequality,
and access to water and sanitation.

• The new Global Goals, and the broader sustainability agenda,


go much further than the MDGs, addressing the root causes of
poverty and the universal need for development that works for
all people.

GLOBAL GOALS
"THIS AGREEMENT MARKS AN IMPORTANT
MILESTONE IN PUTTING OUR WORLD ON AN
INCLUSIVE AND SUSTAINABLE COURSE. IF
WE ALL WORK TOGETHER, WE HAVE A
CHANCE OF MEETING CITIZENS’
ASPIRATIONS FOR PEACE, PROSPERITY, AND
WELLBEING, AND TO PRESERVE OUR
PLANET." By UNDP Administrator Helen Clark
WHAT ARE THE PROPOSED GLOBAL GOALS?
1. NO POVERTY

End poverty in all its


forms everywhere.
2. ZERO HUNGER

End hunger, achieve


food security and
improved nutrition and
promote sustainable
agriculture.
3. GOOD HEALTH &
WELL - BEING

Ensure healthy lives


and promote well-being
for all at all ages.
4. QUALITY
EDUCATION

Ensure inclusive and


equitable quality education
and promote lifelong
learning opportunities for all.
5. GENDER EQUALITY

Achieve gender equality and


empower all women and
girls.
6. CLEAN WATER &
SANITATION

Ensure availability and


sustainable management of
water and sanitation for all.
7. AFFORDABLE & CLEAN
ENERGY

Ensure access to affordable,


reliable, sustainable and
modern energy for all.
8. DECENT WORKPLACE
& ECONOMIC GROWTH

Promote sustained, inclusive


and sustainable economic
growth, full and protective
employment and decent
work for all.
9. INDUSTRY, INNOVATION
& INFRASTRUCTURE

Build resilient infrastructure,


promote inclusive and
sustainable industrialization
and foster innovation.
10. REDUCED
INEQUALITIES

Reduce inequality and


among countries.
11. SUSTAINABLE CITIES
AND COMMUNITIES

Make cities and human


settlements inclusive, safe,
resilient and sustainable.
12. RESPONSIBLE
CONSUMPTION &
PRODUCTION

Ensure sustainable
consumption and production
patterns.
13. CLIMATE ACTION

Take urgent action to combat


climate change and its
impact.
14. LIFE BELOW WATER

Conserve and sustainably


use the oceans, seas, and
marine resources for
sustainable development.
15. LIFE ON LAND

Protect, restore and promote


sustainable use of terrestria;
ecosystems, sustainably
manage forests, combat
desertification, and halt and
reverse land degradation and
halt biodiversity loss.
16. PEACE, JUSTICE AND
STRONG INSTITUTIONS

Promote peace and inclusive


societies for sustainable
development, provide access to
justice for all and build effective,
accountable and inclusive
institutions at all levels.
17. PARTNERSHIPS FOR
THE GOALS

Strengthen the means of


implementation and
revitalize the global
partnership for sustainable
development.
• To truly make the Global Goals sustainable, it is vital communities are
well informed about the goals and engaged in through the process of
reaching them.

• The UN’s “Major Groups” is a great place to start and includes women,
children and youth, indigenous peoples, NGOs and non-profit
organizations, local authorities, workers and trade unions, business and
industry, and farmers.

• The Global Goals require the inclusion of local groups like these to truly
be sustainable. Moreover, the very definition of sustainability must
include a focus on children and youth.

GLOBAL GOALS ARE NOT SUSTAINABLE WITHOUT THE SDG


GENERATION
SO WHAT ABOUT THE PHILIPPINES?
• On May 13, 2016 the Philippines is taking further steps to identify the
country’s roadmap towards sustainable development in the next 15 years.

• The National Economic and Development Authority (NEDA) and the


Philippine Statistics Authority (PSA), with support from the United Nations
Development Programme (UNDP), recently held the “2nd Technical
Workshop on the Sustainable Development Goals Indicators”

• The activity is second in a series of multi-stakeholder consultations


spearheaded by the Philippine Government to pin down targets and
corresponding indicators to help the country achieve the Sustainable
Development Goals (SDGs) by 2030.

PHILIPPINES TAKES FURTHER STEPS TOWARDS SUSTAINABLE


DEVELOPMENT BY 2030
• The Philippines is one of the 193 member states that
adopted the 2030 Agenda for Sustainable Development on
25 September last year during the United Nations General
Assembly in New York.

• The Agenda, which consists of 17 Sustainable Development


Goals with 169 targets and 230 indicators, is a plan of action
for people, planet and prosperity.

• In adopting the SDGs, the Philippines pledged “to make the


2030 Agenda a reality and leave no one behind.

PHILIPPINES TAKES FURTHER STEPS TOWARDS SUSTAINABLE


DEVELOPMENT BY 2030
“THE IMPLEMENTATION OF THE 2030 AGENDA MUST BE
INCLUSIVE AND TRANSLATED INTO DATA-DRIVEN,
EVIDENCEBASED AND TARGET-SPECIFIC POLICIES,
PROGRAMS, AND PROJECTS AT THE GRASSROOTS LEVEL.
THE AVAILABILITY OF DATA THAT ARE UPDATED AND WITH
LOWER LEVELS OF DISAGGREGATION WILL AID IN THE
MONITORING, PRIORITIZATION AND COMING-UP OF BETTER
TARGETED PROGRAMS.”

By NEDA Director General and Socioeconomic Planning Secretary


Emmanuel Esguerra
PHILIPPINE
DEPARTMENT OF HEALTH
The Department of Health
The DOH is the national agency mandated to lead the health
sector towards assuring quality health care for all Filipinos.

DOH Vision: is to make “Filipinos among the healthiest in Southeast


Asia by 2022 and in Asia by 2040”

DOH Mission: to “ Lead the country in the development of a


productive, resilient, equitable, and people centered health system”
(DOH,2019).
VISION BY 2030 (DREAM OF DOH)
“A Global Leader for attaining better
health outcomes, competitive and
responsive health care systems, and
equitable health financing.”
The Department of Health

In the pursuit of its vision and execution of its mission, the


following has the major roles:
1. Leader in health
2. Enabler and capacity builder
3. Administrator of specific services
ROLES and Functions of the DOH

1. Leadership in Health -elucidated in Executive Order 102,in terms of the


following functions;
 Planning and formulating policies of health programs and services
 Monitoring and evaluating the implementation of health programs, projecys,
research, training and services
 Advocating for health promotion and healthy lifestyle
 Serving as technical authority in disease control and prevention
 Providing administrative and technical leadership in health care financing
and implementing the National Health Insurance Law.
ROLES and Functions of the DOH

2. Enabler and Capacity Builder


Providing logistical support to LGUs the private sector, and
other agencies in implementing health programs and services;
Serving as the lead agency in health and medical research
Protecting standards of excellence in training and education of
health care providers at all levels of the health care system.
ROLES and Functions of the DOH

3. Administrative of Specific Services


 Serve as administrator of selected health facilities at
subnational levels that act as referral centers for local health
system,
 Provide specific program components for conditions that
affect large segments of the populations
 Develop strategies for responding to emerging health needs
 Provide leadership in health emergency preparedness and
response services, including referral and networking systems
for trauma, injuries
The DOH core values reflect adherence to the highest standards of work namely:
1. Integrity
2. Excellence
3. Compassion and respect for human dignity
4. Commitment
5. Professionalism
6. Teamwork
7. Stewardship
The DOH carries out its work through the various central bureaus and services in the central
office, Center for Health Development (CHD) in every region, DOH- attached agencies, and
DOH-retained hospitals.
HISTORICAL BACKGROUND OF DEPARTMENT OF HEALTH
HISTORICAL BACKGROUND OF DEPARTMENT OF HEALTH
HISTORICAL BACKGROUND OF DEPARTMENT OF HEALTH
HISTORICAL BACKGROUND OF DEPARTMENT OF HEALTH
HISTORICAL BACKGROUND OF DEPARTMENT OF HEALTH
HISTORICAL BACKGROUND OF DEPARTMENT OF HEALTH
HISTORICAL BACKGROUND OF DEPARTMENT OF HEALTH
HISTORICAL BACKGROUND OF DEPARTMENT OF HEALTH
Principles to attain the vision of DOH
Equity: equal health services for all-no discrimination

Quality: DOH is after the quality of service not the quantity

Philosophy of DOH: “Quality is above quantity”

Accessibility: DOH utilize strategies for delivery of


health services
HEALTH CARE DELIVERY SYSTEM
“the totality of all policies, facilities, equipment,
products, human resources and services which
address the health needs, problems and concerns
of the people. It is large, complex, multi-level and
multi-disciplinary.”
THREE STRATEGIES IN DELIVERING HEALTH
SERVICES (ELEMENTS)
• Creation of Restructured Health Care Delivery System
(RHCDS) regulated by PD 568 (1976)

• Management Information Systems regulated by R.A.


3753: Vital Health Statistics Law

• Primary Health Care (PHC) regulated by LOI 949 (1984):


Legalization of Implementation of PHC in the Philippines
• RHO (National Health Agency) or existing national
agencies like PGH or specialized agencies like Heart
Center for Asia, NKI

• MHO & PHO (Municipal/Provincial Health Office)

• BHS & RHU (Barangay Health Station/Rural


Health Unit)

Creation of Restructured Health Care Delivery System


On October 10, 1991, President Corazon Aquino signed
into law Republic Act 7160 of the Local Government Code,
the Code defined wider areas for genuine self-rule. Principally
based on Article 10 of the 1987 Constitution, the Code
mandates, among other things, that the territorial and political
subdivisions of the Republic shall enjoy local autonomy.
According to Senator Aquilino Pimentel the principal sponsors
of the bill, the Code was passed "to accelerate the
development of the nation and to help change the culture of
dependency among Filipinos.

Devolution of Health Services


With the passage of RA 7160, local government units are mandated to
institute management systems that would translate to better and
more efficient delivery of basic services (LGUs). Thus, the code
features the following; (1 .) It devolves to local government units the
responsibility for the delivery of basic services that has always belonged to
the national government; (2.) It grants local government units significant
regulatory powers that traditionally belonged to the national agencies. (3).
It significantly increases the financial resources available to local
government units through increased internal revenue allotment (IRA) (4). It
recognizes-and encourages-the active participation of the private sector,
nongovernmental organization and people's organizations in the
processes of governance.

Devolution of Health Services


 R.A 7160 or Local Government Code was enacted to bring about genuine
and meaningful local autonomy. This will enable local governments to attain
their fullest development as self-reliant communities and make them more
effective partners in the attainment of national goals.
 Devolution refers to the act by which the national government confers power
and authority upon the various LGU’s to perform specific functions and
responsibilities.
 R.A 7160 provided for the creation of the Provincial Health Board and the
City/Municipal Health boards, or Local Health Boards.
 The chairman of the board is the local executive- the Provincial Governor/
Mayor. The Provincial/ City/ Municipal Health Officer serve as vice chairman.
 Integrated Provincial Health Office (IPHO) 

 City Health Office (CHO)


City Hospital (CH)  Chairman of the local health board
The said Code clearly devolves the delivery of
basic services and the operation and maintenance
of local health facilities form the Department of
Health (DOH) to provinces, cities, and
municipalities. Local government unit is now
responsible for the performance of functions that
were mandated previously in the said agency.

Devolution of Health Services


Members of the board are composed of the chairman of the committee on
health of the Sanggunian, a representative from private sector or NGO involved in
health services, and a representative of the DOH.
The functions of local health boards are as follows:
1. Proposing to the Sanggunian annual budgetary allocations for the operation
and maintenance of health facilities and services within the
province/city/municipality;
2. Serving as an advisory committee to the Sanggunian on health matters; and
3. Creating committees that shall advise local health agencies on various matters
related to health service operations.
The Rural Health Unit
The RHU, commonly known as health center, is a primary level health
facility in the municipality. The focus of RHU is preventive and promotive
health services and the supervision of BHSs under its jurisdiction. The
recommended ratio of RHU to catchment population is 1 RHU: 20,000
populations.
The BHS is the first contact health care facility that offers basic
services at the barangay level. It is a satellite station of the RHU. It is
manned by Volunteer Barangay Health Workers (BHW’s) under the
supervision of Rural Health Midwife (RHM).
The Rural Health Unit Personnel

The Municipal Health Officer (MHO) or Rural Health Physician heads


the health services at the municipal level and carries out the following
roles and functions:
1. Administrator of the RHU
a. Prepares the municipal health plan and budget
b. Monitors the implementation of basic health services
c. Management of the RHU staff
2. Community physician
a) Conducts epidemiological studies
b) Formulates health education campaigns on disease prevention
c) Prepares and implements control measures or rehabilitation plan
3. Medico-legal officer f the municipality.
The revised implementing rules and regulations (IRRSs) of R.A. 7305 or
the Magna Carta of Public Health Workers stipulate that there be one rural
health physician to a population of 20,000.
The Rural Health Unit Personnel
The Public Health Nurse (PHN):
1. Supervise and guides all RHMs in the municipality.
2. Prepares the FHIS (Field Health Service Information System) quarterly and
annual reports of the municipality for submission to the Provincial Health
Office.
3. Utilize the nursing process in responding to health care needs, including
needs for health education and promotion of individuals, families and
catchment community.
4. Collaborate with the other members of the health team, government agencies,
private business, NGO’s and people organizations to address the
community’s health problems.
* With limitations of LGUs to finance health human resource, the
DOH has launched Nurse Deployment Project (NDP) to augment
efforts of PHNs in their areas of jurisdiction.
The Rural Health Unit Personnel
The Nurse Deployment Project: One of the projects under the Department of
Health (DOH) Deployment Program that aims to deploy, community-oriented and
dedicated nurses to difficult areas. Notably, the project aims to achieve the
following:
 Augment the nursing workforce in the Rural Health Units/Birthing Homes and
Barangay Health Stations thus provide access to health services for the
marginalized population;
 Provide employment and work experience for nurses in rural areas and
underserved communities and
 Address the proliferation of the so-called “volunteer nurses for a fee” (i.e., working
in hospitals without being paid, albeit, they themselves pay the hospital to obtain a
certificate of work experience
Project Description:
 Deployment of registered nurses for the improvement of local health systems
and support to the attainment of Universal Health Care or Kalusugan
Pangkalahatan
 Nurses shall be hired under contract of services with a position of Public Health
Nurse II. Contract for six 6) months that can be renewed based on a very
satisfactory
 Assignment in priority areas covering 1,491 municipalities, 143 cities and 13
districts of Metro Manila giving preference to 44 Focus Geographical Areas
(FGA), Accelerated Sustainable Anti-Poverty Program (ASAP), Whole of Nation
Initiative (WNI)
 After satisfactory completion of the project, the Nurses are awarded with a
Certificate of Completion and Employment
FUNCTIONS:
 Focus on assisting PHNs in implementing programs, health education, and preparation of
reports.
 Conducts regular visits to priority households under the National Household Targeting
System for Poverty Reduction (NHTS-PR)
 Prepares health status reports of families based on the NHTS-PR priority households
 Plans for appropriate interventions on the identified health concerns of families under the
priority NHTS-PR
 Assists in the conduct of regular monitoring and evaluation of various health programs
under the NHTS-PR
 Focus on assisting PHNs in implementing programs, health education, and preparation of
reports.
 Assists in the conduct of disease surveillance
 Maintains Barangay Health Stations
 Conducts health education and training
 Assists in the preparation of reports on clinic and community activities.
Salaries and Benefits:
• Public Health Nurse II - Salary Grade 17
• Monthly Salary of Php 32,747.00 for 2017 2nd tranche of the Salary
Standardization Law 4
• Enrollment to PhilHealth Insurance
• Enrollment to GSIS Personal Group Accident Insurance
• Local/Regional Trainings (ie, Orientation on Disease Surveillance, Family
Planning Counselling, etc. )
The Rural Health Unit Personnel
The Rural Health Midwife (RHM) or Public Health Midwife:
1. Manages the BHS and supervise and trains the BHW;
2. Provides midwifery services and executes health care programs and activities
for woman of reproductive age, including family planning counselling and
services.
3. Conducts patient assessment and diagnosis for referral or further
management;
4. Perform health information, education and communication services
5. Organize the community
6. Facilitates barangay health planning and other community services.
The Rural Health Unit Personnel
• The Rural Sanitation Inspector are directed towards ensuring a healthy physical
environment
. in the municipality. This entails advocacy, monitoring and regulatory
activities such as inspection of water supply and unhygienic household
conditions.
• Barangay Health Worker (BHW) considered as the interface between the
community and the RHU. They are trained in the preventive health care, with a
strong emphasis on maternal and child care, family planning and reproductive
health, nutrition and sanitation.
 BHWs are accredited by the local health board according to DOH guidelines.
 R.A 7883 or the Barangay Health Workers Benefit and Incentives Act entitles
them to hazard and substance allowance and other benefits.
DOH Recommendations for Human Resource for Health and
Health Facilities Ratio to Population

1 RHU/ HC Physician: 20, 000 Population Ratio


1 Public Health Nurse: 10,000 Population Ratio
1 Public Health Midwife: 5,000 Population Ratio
1 Public Dentist: 50,000 Population Ratio
1 RHU(Rural Health Unit): 20,000 Population Ratio
1 BHS (Barangay Health Station): 5,000 Population Ratio
Classification of Health Facilities
( DOH AO – 2012-0012 )
Republic Act No. 4226 otherwise known as Hospital Licensure Act,
“The licensing agency shall study and adopt a system of classifying
hospitals in the Philippines as to: (1) general or special; (2) service
capabilities; (3) size or bed capacity and (4) classification of hospital
whether training or not".

Regulation of health facilities takes into account their service


capacities and compliance with standards for manpower, equipment,
construction and physical facilities. It is of the essence that the actual
situation be taken into consideration in dealing with the current
classification of hospitals and other health facilities. 
CLASSIFICATION ACCORDING TO SCOPES OF SERVICES
CLASSIFICATION ACCORDING TO FUNCTIONAL CAPACITY
CLASSIFICATION OF OTHER HEALTH FACILITIES
DOH administrative Order 2012-0012 classifies other health
facilities as follows:

Category A. Primary Health Care Facility – a first contact health care facility
that offers basic service including emergency services and provision for normal
deliveries.
1. Without in-patient beds like health centers, out-patient clinics, and dental
clinics.
2. With in-patient beds – a short-stay facility where the patient spends on the
average of one to two days before discharge.
Ex: Infirmaries and birthing (Lying-in) facilities.
Category B. Custodial Care Facility – a health facility that provides long-
term care, including basic services like food and shelter, to patients with
chronic conditions requiring ongoing health and nursing care due to
impairment and a reduced degree of independence in activities of daily living,
and patients in need of rehabilitation.

Ex: Custodial health care facilities, substance/drug abuse treatment and


rehabilitation centers, sanitaria, leprosaria, and nursing homes.
Category C. Diagnostic/Therapeutic Facility - a facility for the examination
of the human body, specimens from the human body for the diagnosis,
sometimes treatment of disease or water for drinking analysis. The test covers
the preanalytical, analytical and post analytical phases of examination. This
category is further classified into:
1. Laboratory Facility, such as, but not limited to the following:
a) Clinical laboratory
b) HIV/testing laboratory
c) Blood service facility
d) Drug testing laboratory
e) Newborn screening laboratory
f) Laboratory for dringking water analysis.
2. Radiologic facility providing services such as X-ray, CT scan,
mammography, MRI, and ultrasonography.

3, Nuclear medicine facility- a facility regulated by the Philippine


Nuclear Research Institute utilizing applications of radioactive
materials in diagnoses, treatment, or medical research, with the
exception of the use of sealed radiations sources in
radiotherapy as in internal radiation therapy.
Category D. Specialized outpatient facility – a facility that
performs highly specialized procedures on a outpatient basis.

Ex: Dialysis clinic, ambulatory surgical clinic, cancer


chemotherapeutic center/clinic, cancer radiation facility, and
physical medicine and rehabilitation center/clinic.
The Inter-Local Health Zone
 An Inter Local Health Zone (ILHZ) is defined to be any form of organized
arrangement for coordinating the operations of an array and hierarchy of the
health care providers and facilities, which typically includes primary health care
providers, core referral hospital and an end referral hospital, jointly serving a
common population within a local geographic area under the jurisdictions of
more than one local government.
 ILHZ, as a form of inter-LGU cooperation is established in order to better
protect the public or collective health of their community, assure the
constituents access range of services necessary to meet health care needs of
individuals, and to manage their limited resources for health more efficiently and
equitably.
The Inter-Local Health Zone
 The Inter Local Health Zone (ILHZ) functionality is defined mainly by
observable zone wide health sector performance results in term of:
1. Improved the health status and coverage of public health intervention of the
zone population.
2. Access by everyone in the zone to a qualify care;
3. Efficiency in the operations of the inter-local health services.
 The referral system functioning within the context of the Inter-Local Health
Zone (ILHZ) provides a means for consolidating health care efforts.
 The ILHZ is based on the concept of the District Health System, a generic
term used by WHO to describe an integrated health management and
delivery system based on a defined administrative a geographical area.
 An ILHZ has a defined catchment population within a defined geographical
area, it has a central or core referral hospital and a number of primary level
facilities such as RHUs and BHSs.
The ILHZ has the following components:
 People. Although WHO has described the ideal population size of a health district between
100,000 and 500,000, the number of people may vary from zone to zone, especially when taking
into consideration the number of LGUs that will decide to cooperate and cluster.
 Boundaries. Clear boundaries between ILHZs establish accountability and responsibility of health
service providers.
 Health facilities. RHUs, BHSs, and other health facilities that decide to work together as an
integrated health system and a district or provincial hospital, serving as the central referral
hospital.
 Health workers. To deliver comprehensive services, the ILHZ health workers include personnel of
the DOH, district or provincial hospitals, RHUs, BHSs, private clinics, volunteer health workers from
NGOs, and community based organizations.
The Health Referral System
 A referral is a set of activities undertaken by a health care provider or facility in
response to its inability to provide the necessary health intervention to satisfy a
patient’s need.
 A functional referral system is one that ensures the continuity and
complementation of health and medical services.
 It usually involves movement of a patient from the health center of first contact
and the hospital at first referral level.
 When hospital intervention has been completed, the patient is referred back to
the health center. This accounts for the term two-way referral system.
 Referrals may be internal or external
 Internal referrals – occur within the health facility; may be made
to request for an opinion or suggestion, comanagement, or
further management or specialty care.
 External referral – is a movement of a patient from one health
facility to another. It may be vertical, where the patient referral
may be from a lower to a higher level of health facility or the other
way round.
• Barangay Health Station (BHS) is under the management of Rural Health
Midwife (RHM)
• Rural Health Unit (RHU) is under the management or supervision of
PHN
• Public Health Nurse (PHN) caters to 1:10,000 population, acts as
managers in the implementation of the policies and activities of RHU,
directly under the supervision of MHO (who acts as administrator)

Referral System in Levels of the Health Care


Referral System in Levels of the Health Care
Health Sector Reform:
 FOURmula One Plus (F1 Plus) is the latest in aseries of
continuing efforts of the government to bring about health sector
reform covering to 2017 to 2022.
 F1 Plus was built upon strategies of two previous platforms of
reform: FOURmula One (F1) for health (2005-2010) and Kalusugan
Pangkalahatan or Aquino Health Agenda (2011-2015.)
 Administrative Order 2018-0014 entitled “Strategic Framework
and Implementing Guidelines for FOURmula One Plus (F1 Plus) for
Health.
Health Reform Framework in the DOH from 2005 to 2022.

Kalusugan Duterte Health FOURmula One


FOURmula One
Pangkalahatan Agenda Plus (F1) PLUS
2005-2010
2011-2015 2016 2017-2022
UNIVERSAL HEALTH CARE (UHC), ALSO REFERRED TO
AS KALUSUGAN PANGKALAHATAN (KP).

 The Aquino administration puts it as the availability and accessibility of


health services and necessities for all Filipinos.

 It is a government mandate aiming to ensure that every Filipino shall


receive affordable and quality resources – health human resources,
health facilities, and health financing.

 UHC law (Republic Act 11223) guarantees each Filipino citizen access
to healthcare services that are either individual-based or population
based.
UHC’S THREE THRUSTS
1) Financial risk protection through expansion in
enrollment and benefit delivery of the National Health
Insurance Program (NHIP);
2) Improved access to quality hospitals and health
care facilities; and
3) Attainment of health-related Millennium Goals
(MDGs).
PHILIPPINE HEALTH
AGENDA

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