HE PHILIPPINE HEALTH CARE DELIVERY SYSTEMHEALTH CARE SYSTEM

-an organized plan of health services (Miller-Keane, 1987)

HEALTH CARE DELIVERY
-rendering health care services to the people (Williams-Tungpalan, 1981).
HEALTH CARE DELIVERY SYSTEM (Williams-Tungpalan, 1981)
-the network of health facilities and personnel which carries outthe task of rendering
health care to the people.
PHILIPPINE HEALTH CARE SYSTEM
-is a complex set of organizations interacting to provide an arrayof health services
(Dizon, 1977).
COMPONENTS OF THE HEALTH DELIVERY SYSTEMThe Department of Health
Mandate:
The Department of Health shall be responsible for the following:formulation and
development of national health policies, guidelines,standards and manual of operations
for health services andprograms; issuance of rules and regulations, licenses
andaccreditations; promulgation of national health standards, goals,priorities and
indicators; development of special health programs andprojects and advocacy for
legislation on health policies and programs.The primary function of the Department of
Health is the promotion,protection, preservation or restoration of the health of the
peoplethrough the provision and delivery of health services and through theregulation
and encouragement of providers of health goods andservices (E.O. No. 119, Sec. 3).
Vision:
Health as a right. Health for All Filipinos by the year 2000 andHealth in the Hands of the
People by the year 2020.
Mission:
The mission of the DOH, in partnership with the people toensure equity, quality and
access to health care:
-by making services available
-by arousing community awareness
-by mobilizing resources
-by promoting the means to better health
LEVELS OF HEALTH CARE FACILITIES1. PRIMARY LEVEL OF HEALTH CARE
FACILITIES
-are the rural health units, their sub-centers, chest clinics,malaria eradication units, and
schistosomiasis control unitsoperated by the DOH; puericulture centers operated by
Leagueof Puericulture Centers; tuberculosis clinics and hospitals of thePhilippine
Tuberculosis Society; private clinics, clinics operatedby the Philippine Medical
Association; clinics operated by largeindustrial firms for their employees; community
hospitals andhealth centers operated by the Philippine Medicare CareCommission and
other health facilities operated by voluntaryreligious and civic groups (WilliamsTungpalan, 1981).

2. SECONDARY LEVEL OF HEALTH CARE FACILITIES

-are the smaller, non-departmentalized hospitals includingemergency and regional
hospitals.
-Services offered to patients with symptomatic stages of disease, which require
moderately specialized knowledge andtechnical resources for adequate treatment.
3. TERTIARY LEVEL OF HEALTH CARE FACILITIES
-are the highly technological and sophisticated services offeredby medical centers and
large hospitals. These are thespecialized national hospitals.
-Services rendered at this level are for clients afflicted withdiseases which seriously
threaten their health and whichrequire highly technical and specialized knowledge,
facilitiesand personnel to treat effectively (Williams-Tungpalan, 1981)
FACTORS ON THE VARIOUS CATEGORIES OF HEALTHWORKERS AMONG
COUNTRIES AND COMMUNITIES
1. available health manpower resources2. local health needs and
problems3. political and financial feasibility
THREE LEVELS OF PRIMARY HEALTH CARE WORKERSA. VILLAGE OR
GRASSROOT HEALTH WORKERS
-irst contacts of the community and initial links of health care.
-Provide simple curative and preventive health care measurespromoting healthy
environment.
-Participate in activities geared towards the improvement of thesocio-economic level of
the community like food productionprogram.
Community health worker, volunteers or traditional birthattendants.
B. INTERMEDIATE LEVEL HEALTH WORKERS
-represent the first source of professional health care
-attends to health problems beyond the competence of villageworkers
-provide support to front-line health workers in terms of supervision, training, supplies,
and services.
-Medical practitioners, nurses and midwives.

C. FIRST LINE HOSPITAL PERSONNEL

-provide back up health services for cases that requirehospitalization
-establish close contact with intermediate level health workers or village health workers.
-Physicians with specialty, nurses, dentist, pharmacists, other health professionals.
TWO-WAY REFERRAL SYSTEM (Niace, et. al. 8thedition 1995)
A two-way referral system need to be established betweeneach level of health facility
e.g. barangay health workers refer casesto the rural health team, who in turn refer more
serious cases toeither the district hospital, then to the provincial, regional or
the wholehealth care system.
Health, therefore, cannot work in isolation. Neither can onesector or discipline
claim monopoly to the solution of communityhealth problems. Health has now become a
multisectoral concern.For instance, it is unrealistic to expect a malnourished child
tosubstantially gain in weight unless the familys poverty isalleviated In other words,
improvement of social and economicconditions need to be attended to first or tackled
hand in hand withhealth problems.
1. Intersectoral Linkages
- Primary Health Care forms an integral part of the healthsystem and the over-all social
and economic developmentof the community. As such, it is necessary to unify
healthefforts within the health organization itself and with other sectors concerned. It
implies the integration of health planswith the plan for the total community
development.- Sectors most closely related to health include thoseconcerned with:a.
Agriculturalb. Educationc. Public worksd. Local governmentse. Social
Welfaref. Population Controlg. Private SectorsThe agricultural sector can contribute
much to the socialand economic upliftment of the people. Demonstration tomothers of
better techniques and procedures for foodpreparation and preservation can preserve
the nutritive value of local foods. Through joint efforts, agricultural technology
thatproduces side effects unsafe to health (for instance, insecticidepoisoning) can be
minimized or prevented.The school has long been recognized as an effectivevenue for
transmission of basic knowledge to the community.Every pupil or student can be tapped
for primary health careactivities such as sanitation and food production activities..
Construction of safe water supply facilities and better roads canbe jointly
undertaken by the community with public works.Community organization (e.g.
establishing a barangay networkfor health) can be worked through the local government
or community structure. Likewise, better housing through socialwelfare agencies,
promotion of responsible parenthood throughfamily planning services and increased
employment through theprivate sectors can be joint undertakings for healthWehave

to recognize that oftentimes health actions undertakenoutside the health sector can
have health effects much greater than those possible within it.
2. Intrasectoral Linkages
- In the health sector, the acceptance of primary health carenecessitates the
restructuring of the health system tobroaden health coverage and make health service
availableto all. There is now a widely accepted pyramidal organizationthat provides
levels of services starting with primary healthand progressing to specialty care. Primary
health care is thehub of the health system.
A PYRAMIDAL HEALTH STRUCTURE
National HealthHealth
CareServicesRegionalHealth Services SecondaryHealthDistrict Health Services CareRu
ral (Local
Hospital)ServicesRural Health Units PrimaryBarangay Health Stations HealthCare

Tertiary
Health Care
National
Health
Service

Regional Health
Services

Secondary
Health Care

District Health Services

Rural (Local Hospital)
Services

Rural Health Units

Barangay Health Station

Primary Health
Care

THE NATIONAL HEALTH PLAN (Niace, et. al 8th edition 1995)

The National Health Plan is the blue print which is followed bythe Department of Health.
It defines the countrys health problems,policy thrusts, strategies and targets.
POLICY THRUSTS AND STRATEGIES
There are policy thrusts and strategies which are commonlyimportant. These are:
1. Information, education, and communication programs will beimplemented to raise the
awareness of the public, includingpolicy makers, program planners and decision
makers;
2. An update of the legislative agenda for health, nutrition andfamily planning (HNFP),
and stronger advocacy for pendingHNFP related legislations will be pursued;
3. Integration of efforts in the health, nutrition and family planningsector to maximize
resources in the delivery of services throughthe establishment of coordinative
mechanisms at both thenational and local levels;
4. Partnership between the public and the private sectors will bestrengthen and
institutionalized to effectively utilize and monitor private resources for the sector;
5. Enhancement of the status and role of women as programbeneficiaries and program
implementers will be pursued toenable them to substantially participate in the
developmentprocess.

Current Health Care Delivery System | Philippines

The Philippines is an archipelago with 7,100 islands.

It has a population of around 97 million inhabitants in 2012
It has a growth rate of 1.9%
Geographically, it is divided into 3 main island groups: Luzon, Visayas and
Mindanao
There are 17 regions, including the Autonomous Region of Muslim Mindanao

There are 82 provinces, 135 cities, and 1,493 municipalities

Functional literacy rate is high at 86%

In 2011, the country was categorized as a low to middle income country with
gross national income per capita of $4,160
The decentralized health care system is managed, coordinated, and regulated by the
Department of Health (DOH) that is composed of:
The Central Office

17 Regional Offices (ROs)

Retained Hospitals

Integrated basic health services include:

TB diagnostics
TB treatment services
These are provided by
2,314 rural health units (RHUs)/ health centers (HCs)
6,219 barangay health stations (BHS)
These are under the local municipal/city governement units

Majority of the RHUs/HCs have a TB microscopy laboratory

This provides Direct Sputum Smear Microscopy (DSSM)
Thr locally managed Provincial Health Office (PHO) or City Health Office (CHO) provide
technical oversight over these peripheral health units
Communities support these health units through the community health teams
(CHTs) that include barangay health workers (BHWs)
The private sector is also engaged in the production and provision of health goods and
services through private clinics, hospitals and laboratories, drug stores, and other
facilities
The DOH encourages public-private sector collaboration in health

DOH priorities and strategies are contained in its health agenda called Universal Health
Care(UHC) or Kalusugang Pangkalahatan (KP) that aims
to ensure financial risk protection for the poor
to provide access to quality health services
to attain health related Millenium Development Goals (MDGs)
Specific health targets include that for TB control are contained in the National
Objectives for Health.

Women Leading cause of Mortality

Breast cancer
As of 2010, breast cancer became the most common cancer in the country with 16
percent of a total of 50,000 cases resulting in death. The disease had also become the
leading cause of cancer for Filipino women. Doctors advised women, and still do,
about constant self-breast examination to detect abnormal growth in the breasts so that
the cancer can be treated during its early stages. Meanwhile, the Philippine Cancer
Society had pledged to provide more free mammography services, fine needle
aspiration biopsy, and education campaigns to help more Filipinas in combating the
disease.
Cervical cancer
It is estimated that 12 Filipino women die of cervical cancer each day with 6,000 cases
being diagnosed each year. This type of cancer is common among women from age 30
to 55. Twenty-two in 100,000 women will get cervical cancer and only 44% of this
number will survive the disease. Thus, doctors are urging women to be screened three
years after their first sexual contact. They also strongly recommend administering the
cervical cancer vaccine to Filipinas age ten years and above.
Ovarian cancer
The Department of Health website cites ovarian cancer as the fifth most common
cancer among Filipino women. It is considered a silent killer as it is usually detected
when the cancer cells have already spread to other organs such as the lungs and the
liver. In March 2010, the mother of actress Francine Prieto succumbed to Stage 3
ovarian cancer.