Lesson 2

HEALTH CARE SYSTEM

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•Definition of a Health Care System

•Roemer (1991) defined health system as “the combination of

resources, organization, financing and management that culminate in
the delivery of health services to the population.” In a World Health
Organization Report in 2000, health system was defined as “all the
organizations, institutions and resources that are devoted to producing
health actions.”
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•Goals and Functions of a Health System

(1)Improving the health of populations

(2)Improving the responsiveness of the health system
(3)Providing fair health financing
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• There are 4 vital health system functions:

Health Health
Service Service Stewardship Health
Provision Inputs Financing
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• HEALTH FINANCING
Revenue
Collection

Health
Financing

Strategic Risk
Purchasing Pooling
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•WHO Health System Framework

• The functions identified in the WHO report (2000) have been

broken down into a set of six essential
•groups. These are needed to improve targeted health outcomes or
overall goals.
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• Philippine Health System
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• Philippine Health System

• 2010: AO2010-0036“KalusugangPangkalahatan”–Universal health coverage and
access to quality health care for all Filipinos.
• 2013: Sin Taxes for Heath – Generating extra revenue for the Department of
Health by discouraging harmful
• consumption of alcohol and tobacco.
• 2019: Universal Health Care Law – Enrolling all Filipino citizens automatically in
the National Health Insurance Program administered by Philhealth. All Filipinos
are guaranteed equitable access to quality and affordable health care services.
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• Leadership and Governance

• The Department of Health is mandated to: provide national policy
direction and develop national plans, technical standards, and
guidelines of health, develop national plans, technical standards, and
guidelines of health, provide technical assistance, capacity building
and advisory services for disease prevention, and control supplies,
medicines, and vaccines.
• The Gus were granted autonomy and responsibility for their own
health services under the Local Government Code of 1991.
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• Decentralized and Centralized

• Under the decentralized or devolved structure, the state is
represented by national offices and the LGUs, with provincial, city,
municipal, and barangay or village offices. DOH, LGUs, and the private
sector participate, cooperate, and collaborate in the care of the
population.
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• Decentralized and Centralized

• The Department of Health, as mandated has the duty in:
• Developing health policies and programs;
• Enhancing partners’ capacity through technical assistance;
• Leveraging performance for priority health programs among these partners;
• Developing and enforcing regulatory policies and standards;
• Providing specific programs that affect large segments of the population; and
• Providing specialized and tertiary level care.
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• Directions of the Philippine Health Sector

• The Philippine Health Agenda (DOH Administrative Order 2016-0038)

• The Philippine Developmental Plan 2017-2022
• NEDA AmBisyon Natin 2040
• Sustainable Developmental Goals 2030
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• KEY POINTS TO REMEMBER

• Health system is defined as complex of resources, organization, financing, and management that come with the same purpose of
delivering health services to the population. According to a World Health Organization Report in 2000, health system is defined as “all
the organizations, institutions, and resources that are devoted to producing health actions.”
• The primary goals of the health system are improved health outcomes (attaining the best average level of health care for the entire
population and attaining the smallest feasible differences in health status among individuals and groups), more responsive health
system (meeting the people’s expectations of how they should be treated by health workforce and the degree by which people are
satisfied with the health system), and more equitable health care financing (distributing the risk that each individual faces to cost the
health care according to the ability to pay rather than the risk of illness).
• The four health system functions are delivery of health services (appropriate and cost-effective delivery); resource generation (ensure
the right level and mix of inputs, particularly human resources, technology, and capital); financing (focusing on two subfunctions:
revenue collection and pooling (to improve sustainability and solidarity and purchasing) with an emphasis on effective purchasing to
improve allocative and technical efficiency; and stewardship and initiatives to strengthen governance, accountability, and
responsiveness.
• A health system is defined as consisting of all organizations, people, and actions who share the common interest to promote, restore,
or maintain health. This can be analyzed in its totality by using different groups or blocks, such as leadership or governance, health
care financing, health workforce, medical products, vaccines and technologies, health information, and service delivery.
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• KEY POINTS TO REMEMBER

• The Department of Health (DOH) is the lead agency for Philippine health care. According to the mandate (E.O. No. 119, Sec. 3), DOH shall be responsible for the
following:
• Formulation and development of national health policies, guidelines, standards, and manual of
• operations for health services and programs
• Issuance of rules and regulations, licenses, and accreditations
• Promulgation of national health standards, goals, priorities, and indicators
• Development of special health programs and projects and advocacy for legislation on health policies and programs
• The implementing rules and regulations of Republic Act No. 11223, known as the Universal Health Care Act of 2019, is the state’s policy that aims to protect and
promote the right to health of all Filipinos and instill health consciousness. The act embodies the following principles:
• An integrated and comprehensive approach to ensure that all Filipinos are health literate, provided
• with health living conditions, and protected from hazards and risks that could affect their health;
• A health care model that provides all Filipinos access to a comprehensive set of quality and cost- effective, promotive, preventive, curative, rehabilitative,
and palliative health services without causing financial hardship and prioritizes the needs of the population who cannot afford such services;
• A framework that fosters a whole-of-system, whole-of-government, and whole-of- society approach in the development, implementation, monitoring and
evaluation of health policies, programs and plans; and
• A people-oriented approach for the delivery of health services that is centered on people’s needs and
• well-being and cognizant of the differences in culture, values, and beliefs.
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• REFERENCES
• Alliance For Improving Health Outcomes, Inc. (2017). The Philippine Health System at a Glance. Retrieved May 4, 2018, from http://www.aiho.org.ph/philippine-health-system/
• Cabral, E. I. (2016). The Philippine Health Agenda for 2016 to 2022. Retrieved May 4, 2018, from https://
• www.pcp.org.ph/files/PJIM%20Vol54%20No2/The_Philippine_Health_Agenda_2016_to_2022. pdf
• DOH. (n.d.). Philippine Health Agenda for 2016-2020. Retrieved May 4, 2018, from http://qmmc.doh.
• gov.ph/attachments/article/202/Philippine%20Health%20Agenda_Dec1_1.pdf
• DOH. (n.d.). Implementing Rules and Regulations of the Universal Health Care Act (Republic Act No. 11223).
• National Economic Development Authority. (2017). AmBisyon Natin 2040. Retrieved May 4, 2018, from
• http://2040.neda.gov.ph/
• National Economic Development Authority. (2017). Philippine Developmental Plan 2017–2022. Retrieved May 4, 2018, from
http://www.neda.gov.ph/wp-content/uploads/2017/12/AbridgedPDP-2017-2022_Final.pdf
• The World Bank. (2011). Philippine Health Sector Review: Transforming the Philippine Health Sector: Challenges and Future Directions. Retrieved May 4, 2018, from
http://documents.worldbank.org/ curated/en/500561468295233918/pdf/635630WP0Box361516B0P11906800PUBLIC00ACS.pd
• f United Nations. (2018). Transforming Our World: The 2030 Agenda for Sustainable Development. Retrieved May 4, 2018,
• from https://www.un.org/sustainabledevelopment/sustainabledevelopment-goals/
• World Health Organization. (2011). Philippine Health Systems Review. Health Transitions, 1(2). Retrieved May 4, 2018 from
• http://www.wpro.who.int/philippines/areas/health_systems/ financing/philippines_health_system_review.pdf
• World Health Organization. (2000). The World Health Report 2000: Health Systems: Improving Performance. Retrieved May 4, 2018, from http://www.who.int/whr/2000/en/whroo_en.pdf
• World Health Organization. (2007). Everybody’s Business: Strengthening Health Systems to Improve Health Outcomes. The WHO Health Systems Framework. Retrieved May 4, 2018, from
http://www.who.int/healthsystems/strategy/everybodys_business.pdf