roles of health providers in achieving uhc
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Health Indicators Benchmark Rich Urban
Communities
Poor Rural
Communities
Life Expectancyat Birth over 80years under 60years
Infant Mortality
Rate
19/1000LB less than 10 over 90
Maternal
Mortality Rate
52/100,000LB less than 15 over 150
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Province/ City
Infant
MortalityRate
(2009)
(/1000 LB)
Fully
Immunized
Children
(%)
Under 5
Mortality
Rate
(/1000 LB)
Maternal
MortalityRatio
(/100,000
LB)
AnteNatal Care
(%)
% of Births
Attended by
Skilled Health
Personnel
Facility
Based
Deliveries
(%)
FP
Prev
Rate
(%)
Tuberculosis Control
Case
Detection
Rate
Cure Rate
(2009)
Albay 8.2 73.7 12.7 56.8 73.0 69.3 54.4 31.1 96 85
Cam Norte 13.7 83.3 18.5 66.8 60.6 63.4 34.3 38.4 112 85
Cam Sur 9.1 73.6 15.2 65.5 64.9 52.2 17.0 20.8 92 84Catanduanes 8.5 81.2 12.9 121.3 45.9 71.2 66.7 44.7 91 86
Masbate 14.1 83.4 25.8 160.0 71.7 58.7 18.3 36.9 80 87
Sorsogon 6.8 79.5 12.9 142.8 59.7 82.6 82.6 36.9 99 85
Iriga City 12.1 77.3 23.1 1.1 60.9 73.1 11.0 21.7 172 83
Legazpi City 10.1 90.6 15.0 120.9 55.5 84.8 41.4 30.5 43 77
Naga City 15.7 93.4 19.0 76.0 72.5 72.4 41.9 64.4 156 88
BICOL
ACCOM 10.2 78.5 16.7 96.4 65.4 65.0 39.2 32.0 96 84Regnl Target
by 2015 8 95 16 32 80 80 80 60 70 85
Nat
l Targetby 2015 19 95 27 52 80 80 80 60 96 85
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Basic health services as well as tertiary care for themajority of Filipinos are inadequate, fragmented,inefficient, and incomplete. Services are largely
inaccessible and unaffordable.
The Philippines health sector is dominated bycommercial interests of a segment of the system that is
not really about health outcomes but is primarily aboutbottom-line profits.
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Human resources for health are insufficiently educated,inappropriately trained, and poorly motivated to address thehealth care concerns of most Filipinos.
Poorly compensated government health workers are unableto influence behaviors of their high earning private sector
counterparts within the change-resistant environments oftheir respective professional organizations.
Failure of public financing for health. The combined weightof the uncoordinated spending for health by the nationalgovernment, local governments and our national socialhealth insurance program has been low and weak resultingto on out-of-pocket payments by patients.
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Organised health care system built around theprinciple of universal coverage for all members of
society, combining mechanisms for health financing
and service provisions. (Wikipedi)
A governmental system meant to ensure that every
citizen or resident of a region has access to the
required medical services. (http://www.wisegeek.com/what-is-universal-health-care.htm)
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Addresses: Quality, Responsiveness, Availability andAccessibility
Focuses: Eliminating disparities (equity) and
inefficiencies (governance)
Guiding principle: Providing essential health carepackages to all regardless of age, gender, religion,ethnicity, socio-economic status, ideology, etc.
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Filipino should have access to high quality health
care that is Accessible
Efficient
Equitably distributed
Fairly financed
Adequately funded
Directed in conjunction with an informed andempowered public.
Overarching philosophy is that access to socialservices is based on needs and not on the capabilityto pay.
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Better Health
Outcomes
Responsive Health
System
Equitable Health
Financing
Health
Financing
Service
Delivery
Policy, standards
and regulationHealth
Human
Resource
Health
Information
Governance
for Health
Achieving Health-
related MDGs
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Multiple funding sources with the goal of significantly
reducing out-of-pocket spending especially by those in thepoorest income deciles:
Quantum increases in tax-based governmentspending at both national and local
Borrowing, additional taxes, re-allocation of non-social servicesector
Mandatory increase allocation of IRA to be spent on health
Significant increases in the PhilHealth supportvalue for identified services in the basic package
Mandatory membership to Philhealth
Development of basic health packages and expanding toincreasingly sophisticated services
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Integrate and strengthen health workforce regulatory
functions under one body attached to the DoH tounify standards and regulations of the production,practice, and deployment of the various healthprofessions.
Teaching and training institutions to tailor production forservice to underserved communities either as government(national or local) or civil society professionals
Update and rationalize practice laws of the differenthealth professions premised on health care being ateam effort taking into account the principles ofprimary health care.
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A revisiting of the Local Government Code and itsimplementation with the view of enabling governmentfacilities to be more integrated, efficient and effective.
The integration and organization of governmentfacilities in accordance with the principles of primaryhealth care by providing integrated health serviceseither directly or through a unified and formalized
referral system.
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Full implementation of the BFAD Strengthening Lawthat health goods should be re-designed to ensure notonly safety and effectiveness of health products butalso affordability especially for government agencies.
Strict regulation of marketing and other promotionalactivities for health products including advertisingprohibitions for certain goods.
Strengthening of other regulatory functions of DOH,other government agencies.
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eHealth masterplan designed to maximize the use ofinformation technology for health service delivery.
Identify, collect and analyze major health data
including burden of disease, actual costs of healthservices, historical utilization and budget for healthservices, necessary for implementation of UniversalHealth Care. Requiring health providers and facilities
to submit mandated health reports using standard
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Transparency should be the norm for all institutionsinvolved in health care.
Empower citizens as data generators and as informationusers.
Strengthen health research through the establishment
of the Philippine National Health Research System(PNHRS).
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Launch Phase
Scale-up Phase
SustainabilityPhase
2014 to 20162012 to 2013August to
December 2011
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NHIP sponsored programme of the poorest NHTS-PRhouseholds
No balance billing (NBB) policies by govt hospitalsserving NHTS-PR families
RNheals nurses and midwives deployment forcapacitation of existing community-level workers withCHT functions
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MHO
RHM
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Health facilities enhanced/upgraded to ensure thepoorest NHTS-PR families access out and inpatientbenefit packages (OP and IP packages)
Treatment packs shall be procured and distributed toRHUs CCTs (4Ps) beneficiaries
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Focused resources and efforts in areas with highestconcentration of NHTS poor families
Scale-up public health programmes like:women with unmet need for MFP
mothers giving birth at home with TBAs
children not fully vaccinated and Vit. A supplements
adults who are TB smear positive
common life-style related diseases
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Prioritise municipalities where 80% of NHTS-PRfamilies are found
In each of these municipalities, assess:NHIP Enrolment
Accreditation status of RHUs, clinics and lying in
Accreditation status of hospitals (public, private)
Position of LCE on health issuesAvailability of public health commodities (stocks)
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Determine targets and interventions for:NHIP enrolment and membership services
CHT and Rnheals deployment
Upgrading of health facilities
Securing public health commoditiesCapacity building
Draw up joint province- or city-wide agreements
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Rolled-out of a new sponsored programme with fullnational government premium to poorest familieslisted in the NHTS-PR at 2,400PhP per family.
Closure of the upgrading gap for local health facilitiesand DoH-retained hospitals to ensure access toimproved quality of health services
Inclusion of a catastrophic care coverage to beintroduced by 2013;
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Sustained coverage of NHTS-PR families in the NHIP
Enhancement of the OP and IP packages with NBB
Sustained quality care through Health Facility
Enhancement Programme
Deployment of CHTs and Rnheals
Attainment of health-related MFG by 2015
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Province/City No. of
NHTS-
PR HH(KPDO)
Required
No. of
CHTMembers
cover by
KP DO
No. of
NHTS-PR
HHtargeted
by the
CHD
CHD Target No. of NHTS-PR Households
2011(CCT)
2012(Q1)
2013(Q2 + Q1)
TOTAL
Legazpi City 18,122 906 10,322 1,405 2,064 8,258 + Q1 10,322
ALBAY 126,525 6,326 77,920 11,661 15,584 62,336 + Q1 77,920
CAM NORTE 69,192 3,459 40,802 - 8,160 32,642 + Q1 40,802
Iriga City 8,084 404 4,628 Non-CCT 926 3,702 + Q1 4,628
Naga City 10,969 548 6,193 3,768 1,239 4,954 + Q1 6,193
CAM SUR 217,226 10,861 125,387 82,135 25,077 100,310 + Q1 125,387
CATANDUANES 30,331 1,516 16,743 - 3,349 13,394 + Q1 16,743
MASBATE 160,894 8,044 103,478 77,419 20,696 82,782 + Q1 103,478
SORSOGON 141,245 2,062 75,769 - 15,154 60,615 + Q1 75,769
TOTAL 745,413 37,270 461,242 171,215 92,248 368,994 + Q1 461,242
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Province/City Required No. of
CHT Member
to Cover CHDTargets
CHD Target No. of CHT
Members to be Trained
2011
(Computed against
CCT HH)
2012
Legazpi City 516 70 446
ALBAY 3,896 513 73CAMARINES NORTE 2,040 0 2,040
Iriga City 231 0 231
Naga City 310 188 148
CAMARINES SUR 6,269 3,661 2,981CATANDUANES 837 0 837
MASBATE 5,174 3,872 3,792
SORSOGON 3,788 0 3,788
TOTAL 19,274 8,304 10,970
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Diploma in Midwifery Bachelor of Science in Midwifery
two-year program four-year degree program
Clinical Practicum in
Foundations of Midwifery
Normal OB and Care of
the Newborn
Introduction to High Risk
Obstetrics
Basic Care of Infants and
Feeding
Basic Family Planning
Primary Health Care Midwifery Ethics, Law and
Practice
Clinical Practicum in Mgt of OB
Emergencies and High-risk Pregnancies
Care of Infants and Children
Comprehensive Family Planning
Community Health Service facility Mgt
Midwifery Pharmacology
Research
Entrepreneurship
Administration and Supervision
Midwifery Majors: Education
Community Health
Reproductive Health
Administration and Supervision or
Health Care Facility Mgt