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Demographic
Characteristics
Population, total (millions) 94,013,200 (projected, NSO2007)
Population < 25 years(% of total population)
52.8 % (projected, NSO 2007)49,617,400 M Filipinos
Population > 60 years(% of total population)
6.7% (projected, NSO 2007)6,637,100 M Filipinos
Birth rate(births per 1,000population)
23.4 (NDHS 2008)2,162,303 live births per year
Death rate 5.48 (NSO 2007)
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Top Ten Causes of Mortality
Cause Total Rate1. Diseases of the heart 70, 861 84.8
2. Diseases of the vascularsystem
51,680 61.8
3. Malignant Neoplasms 40,524 48.9
4. Accidents 34,483 41.3
5. Pneumonia 32,098 38.4
6. Tuberculosis 26,770 31.0
7. Unclassified 21,278 25.5
8. Chronic lower respiratorydiseases
18,975 22.7
9. Diabetes mellitus 16,552 19.8
10. Conditions originating
from the perinatal period
13,180 15.8
Philippine Statistical Yearbook, 2009
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UN Millennium DevelopmentGoals
Source:MDG Monitor: Quick Facts(accessed 10/11/2010)
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6
INDICATORS 2015 Target ACCOMPLISHMENT
MDG 6
Prevalence of HIV/AIDS among high risk groups
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Mortality Trend: Communicable Diseases,
Malignant Neoplasms & Diseases of the HeartRate/ , Population111111
Philippines, -11111111
1
111
111
111
111
111
111
111
1111
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Year
Communicable Diseases
1
11
11
11
11
11
11
11
11
11
111
Malignant Neoplasms &
Diseases of the Heart
Communicable Diseases
Malignant Neoplasms
Diseases of the Heart
Source: Philippine Health Statistics, 2005
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Despite the gains inprevious health
reforms, disparities inhealth outcomes
persist
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IMR and U5MR by Region, 2008
NDHS, 2008
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IMR and U5MR by WealthQuintile, 2008
NDHS, 2008
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Maternal Mortality Rate by Region,Philippines, 2005
1 11 111 111 111
NCRCAR
IlocosCagayan Valley
Central LuzonCALABARZON
MIMAROPABicol
Western VisayasCentral VisayasEastern Visayas
ZamboangaNorthern Mindanao
DavaoSOCCSKSARGEN
CaragaARMM
Philippines
Mortality Rate
Source: PHS, 2005Source: PHS, 2005
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Inequities in access and
utilization of healthservices remain.
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Filipino Income Quintiles
Monthlyincome
Families perquintile
Q1
3,460 5,218,267
Q2 6,073 4,094,164
Q3 9,309 3,912,443Q4 15,064 3,707,494Q5 38,065 3,485,067
Source: National Health and DemographicSurvey, 2008
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Who takes care of the poor?
Sources: NSO and ORC Macro, 2003
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Births by wealth quintile, 2008
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These inequities inhealth can be explained
by insufficient financialresources directed
towards health.
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1
.11
1
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Percent
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Year
Share of health expenditure
per GNP
Source: Philippine National Health Account, 2005-2007
Total health expenditure = P234.3 B or 3.2 percent of GNP
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ppine National Health Accounts, 1997
Total Health Expenditure is
PhP 87.1B (3.6% of GDP)
Philippine National Health Accounts,
Total health
expenditure is P234.3B (3.2 percent of GDP)
National
Governme
nt
%11
Local
Governme
nt
%11
Social
Health
Insurance
%1
Out-of-
%11
Others
%11
Sources of Funds
Source of funds for Health,1997 and 2007
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Social health insurance
has yet to providesignificant financial riskprotection
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PhilHealth
Article 2, Section 2, R.A. 7875 asamended: Compulsory Coverage All citizens of the Philippines shall
be required to enroll in the NationalHealth Insurance Program in order toavoid adverse selection and social
inequity
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PhilHealth
Adequate enrolment of the governmentand private sector employed sectors
Insufficient effort in the enrolment of theindividually paying members
Sponsored program used as tool ofpolitical patronage with mixed results: Increased awareness among the indigents
of social health insurance
Erratic and unsustainable coverage (mostly1 year)
Difficulties in data gathering for coverageand entitlement
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Health Insurance coverageby wealth quintile, 2008
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Shortcomings in healthfinancing have resulted in
out of pocket expenses asthe primary source of
health expenditure.Out of pocket expenditure
has been the rate limiting
step of many of ourcountrymen in availinghealth services
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Due to scarcity of
financial resources andfragmentation of health
services as aconsequence ofdevolution, our healthfacilities have suffered
neglect
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Universal Health Care
Deliberate attentionto the needs ofmillions of poor
Filipino familieswhich comprise themajority of our
population
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Comprehensive Reforms inHealth
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Better health
outcomes
Responsive health
system
Equitable health
financing
Health Financing ServiceDelivery
Policy, standards andregulationHealth Human
Resource
Health
Information
Governance for Health
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Priority Health Policy
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Priority Health PolicyDirections of the Aquino
Administration1. A roadmap towards universal health carethrough a refocused PhilHealth;
2. Particular attention to the construction,rehabilitation, and support of health facilities:
LGU/regional hospitals, rural health units barangay health stations
1. Attainment of Millennium Development Goals 4,5, and 6 Reduction of maternal, neonatal, and infant mortality Support to contain/eliminate age old pubic health
diseases (malaria, dengue, TB)
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1. Redirecting PhilHealth
operations towards theimprovement of the nationaland regional benefit delivery
ratios2. Expanding enrollment of the
poor in the NHIP
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3. Promoting the availment of
quality outpatient and inpatientservices through reformedcapitation and no balance
billing arrangements forsponsored members
4. Increasing the support value of
health insurance for the poor
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3. Fiscal autonomy and incomeretention schemes for
government hospitals and healthfacilities;
4. Unified and streamlined DOH
licensure and PhilHealthaccreditation for hospitals andfacilities; and
5. Regional clustering of referral
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Deploying Community HealthTeams;
Utilizing the life course approach inproviding needed services
family planning
ante-natal care
delivery in health facilities
essential newborn and immediatepostpartum care; and
Garantisadong Pambata package for
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Redirecting PhilHealth
Paradigm shift in the implementation of NHIP: Expansion of NHIP coverage
Enrollment of the poorest of the poor
Enforce mandatory enrolment of the informal
sector (as per the National Health Insurance Act,R.A. 7875 as amended)
Improvement of membership services toincrease awareness of PhilHealth benefits
and entitlements Access to inpatient and outpatient services
through PhilHealth
Zero co-payment/No balance billing for health
care costs incurred for the poorest in
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Every Link in PhilHealthEvery Link in PhilHealth
Value Chain must work toValue Chain must work to
achieve financial riskachieve financial risk
protectionprotection
FINANCIALPROTECTION
PROVIDED TO THEPOPULATION
AccreditationEnrollmentClaims
AvailmentandProcessing
Insurance
Payments
Source: Joint DOH-PhilHealth Benefit Delivery Review (2010)
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Redirecting PhilHealth:Enrollment
Enforce mandatory PhilHealth coveragefor all Filipinos: Automatic enrollment of indigents
identified by the DSWD (lowest quintile)
Compulsory enrollment of members of theinformal sector, especially those who canafford to pay the premium
National government to pay for the
entire premiums of the poorest quintile National government local governmentsharing for the second poorest quintile
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Redirecting PhilHealth:Enrollment
Work with other government agencies toenforce mandatory PhilHealthmembership for all Filipinos:
School enrollment Licensing of business
Renewal of drivers license
Other government transactions
Work with the private sector to launchinnovative schemes in paying premiums(e.g. payment premium through SMS)
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Redirecting PhilHealth:Accreditation
Licensing and accreditation shall beunified to fast track accreditation ofmore health facilities in the country
Provisional accreditation for allgovernment health facilities toensure access of PhilHealth members
to health services Monitoring teams to check on needs
of health facilities for improvement
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Redirecting PhilHealth: ClaimsAvailment and Processing
PhilHealth IT upgrade to accelerateprocessing of claims
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Redirecting PhilHealth:Insurance Payments
Improve significantly support value from20% to 70% for all illnesses
Increase significantly the support valuefor catastrophic illnesses
Zero balance billing in all governmenthospitals for the identified indigents
Promote cost effectiveness: case-payment registration of the indigents under one GP National standard treatment guidelines in
all levels of health care
di i hil l h
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Redirecting PhilHealth:Insurance Payments
Determine realistic cost of care andmedical services in cooperation withthe medical community and other
stakeholders in health, guided byfairness and equity
Members shall have immediate
access to PhilHealth benefits uponregistration
Expand and roll-out outpatient
benefit package
R di i PhilH l h O h
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Redirecting PhilHealth: OtherSteps
Work with private healthmaintenance organizations (HMOs)and private health insurance in
complementing PhilHealth benefits
H lth F iliti
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Health FacilitiesEnhancement
Upgrading of health facilities: ruralhealth units, district hospitals,provincial hospitals, DOH Retained
hospital Improved facility preparedness for
trauma (4th leading cause of death)
Improved capacity of clinical/hospitalcare for the most common causes ofmortality and morbidity
Improve access to quality affordable
medicines
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H lth F iliti
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Health FacilitiesImprovement
Immediate repair and rehabilitationof selected DOH hospitals across thecountry in the next 6 months
Creation and deployment ofmonitoring teams for health facilitiesevaluation and improvement
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Public-Private Partnerships
Proposed projects:
IT system for DOH and PhilHealth
Philippine Orthopedic Center as Center
for Bone Diseases and Trauma Air ambulance project
Research Institute for Tropical Medicinefor commercial production of vaccines
San Lazaro Hospital as Center forInfectious Diseases
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Public-Private Partnerships
Commercial utilization of vacanthospital land assets
Establishment of Multi-SpecialtyCenters in selected regions (3) inNorthern Luzon, Visayas, andMindanao
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Regional Clustering
Clustering of health facilities composedof regional, hospitals and districthospitals as well as rural health unitsand health centers, to addressfragmentation of health services at locallevels by.
Establishment of Clustered Health
Boards composed of the Secretary ofHealth or his representative, local chiefexecutives, private partners, civilsociety/NGO for clustered health
facilities
Composition of Advisory
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Composition of AdvisoryBoard of Clustered Health
FacilitiesChairman: the Secretary of Health or hisrepresentative
Vice Chairman: Regional CHD or Hospital
DirectorMembers:
Local chief executives: Governors and
mayorsLegislators: Congressmen
Local health officials: PHOs and MHOs
Private Sector: civic and business leaders,
NGOs
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Attaining the MDGs
Ensure that poorest families arereached by priority public healthprograms
Deployment ofCommunity HealthTeams:
Packaging of services using the LifeCycle Approach Pre-pregnancy: Family Planning services
Pregnancy: Four ante-natal careservices and delivery in health facilities
(Emergency Obstetric and Neonatal
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Attaining the MDGs
Packaging of services using the LifeCycle Approach
Post partum: Essential newborn care
and immediate post partum care
Infancy/early childhood:Garantisadong Pambata
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Strategies for Public Health
More aggressive promotion ofhealthy lifestyle to prevent noncommunicable diseases: heart
disease, stroke, diabetes, obesity
Attention to emerging diseases
(Superbug, nosocomial diseases,A(H1N1), diseases brought about byclimate change)
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Strategies for Public Health
Inter-agency and inter-sectoralapproach for addressing publichealth concerns such as dengue:
DILG DepED
DENR
UP-NIH
RITM
Medical societies (PMA, PCP, PPS)
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ICT Tools for Health
Information and Communications Technologywill play a major part in ensuring universalhealth care is achieved as it can providequality and timely information to guide
decision making at all levels. Improvement of PhilHealth services will not
be attained with out efficient IT Tool support
Access of health to public health programs
as well as clinical services can be augmentedby ICT e.g. Telemedicine
Regional Clustering will be dependent oninformation sharing
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Human Health Resources
With reasonable compensation,adequate facilities and opportunitiesfor career growth most of our human
health resources will opt to remain inthe Philippines
Deployment and capacitating of
nurses to areas with high MMR, incoordination with the Department ofLabor and Employment and the local
government units
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Thank you