FINAL ASEAN EXAM

Health Inequities

• Health inequities arise from patterns of social stratification, resulting in the unequal distribution of power, prestige, and resources among social groups.
• They are characterized by the systematic and unjust distribution of social, economic, and environmental conditions necessary for good health.
• Examples of such unequal distribution include:
  • Access to quality education, healthcare, housing, transportation, and other resources.
  • Employment opportunities and pay/income.
  • Discrimination based on social status and other factors.

Health Disparities

• Health disparities refer to the differences in the incidence and prevalence of health conditions and health status between groups, based on factors such as:
  • Race/ethnicity
  • Socioeconomic status
  • Sexual orientation
  • Gender
  • Disability status
  • Geographic location
  • Combinations of these factors

Health Development Index and Life Expectancy

• Comparing Health Development Index (HDI) and Life Expectancy at Birth reveals disparities in health outcomes.
• The Philippines lags behind its ASEAN neighbors in terms of health outcomes.

Mortality Rates and NCDs

• Mortality rates of selected diseases are higher in the Philippines compared to Vietnam and Indonesia.
• Non-Communicable Diseases (NCDs) are on the rise, even as some infectious diseases are declining.

Health Sector and Economy

• The Philippine economy and public health sector have grown significantly in the last decade.
• However, chronic inequalities in health remain entrenched.

Human Resource for Health (HRH)

• The number of HRH professionals has been maldistributed and in shortage.
• This shortage affects the quality of healthcare in the Philippines.

Health Inequities and Decentralization

• Decentralization has fragmented the health system, leading to central-local tensions.
• Health inequities persist, with life expectancy at birth and infant mortality rates varying greatly across regions.

Opportunities for Reforms

• There are opportunities for reforms in the Philippine healthcare system, including addressing health inequities and improving health outcomes.
• Life expectancy at birth, total (years) is a key indicator of health outcomes.

Health Financing

• A good health financing system raises adequate funds for health, ensures people can use needed services, and protects from financial catastrophe or impoverishment.
• Three interrelated functions: collecting revenues, pooling pre-paid revenues, and purchasing interventions.
• Priorities: national health financing policies, tools and data on health expenditures, and costing.

Leadership/Governance/Stewardship

• Involves ensuring strategic policy frameworks, effective oversight, coalition-building, regulation, system design, and accountability.
• Building blocks of the health system: organizations, institutions, and resources devoted to producing health actions.

Health System

• WHO (2000): Health systems comprise all organizations, institutions, and resources that produce health actions.
• WHO (2007): Health systems include promoting, restoring, or maintaining health, and compensating for permanent disabilities.
• Figueras and McKee (2012): A health system includes delivery of health services, activities to enable delivery, and stewardship activities aimed at influencing health impact.

Service Delivery

• Good health services deliver effective, safe, quality personal and non-personal health interventions to those who need them, when and where needed, with minimum waste of resources.
• Services may be delivered in the home, community, workplace, or health facilities.
• Priorities: packages, delivery models, infrastructure, management, safety, and quality.

Health Workforce

• A well-performing health workforce is responsive, fair, and efficient to achieve the best health outcomes possible.
• Health workers are all people engaged in actions to protect and improve health.
• Priorities: national workforce policies, investment plans, advocacy, norms, standards, and data.

Health Information

• A well-functioning health information system produces, analyzes, disseminates, and uses reliable and timely information on health determinants, system performance, and health status.
• Three domains: health determinants, health systems performance, and health status.
• Priorities: facility and population-based information, surveillance systems, and global standards.

Medical Products, Vaccines and Technologies

• A well-functioning health system ensures equitable access to essential medical products, vaccines, and technologies of assured quality, safety, efficacy, and cost-effectiveness.
• Priorities: health sector policies, harmonization, alignment, oversight, and regulation.

ASEAN – a regional body for health governance

• ASEAN Way: consensus-based decision-making, non-interference in internal affairs, sovereignty, and respect for independence and national identity.
• Challenges: lack of economic commitment, limited data collection and analysis, and coordination with WHO.
• Objectives: promote exchange of experiences and best practices, not to prescribe uniform rules or deliver policy outcomes.

ASEAN Overview

• Founded on August 8, 1967, by Indonesia, Malaysia, the Philippines, Singapore, and Thailand
• Enlarged to include Brunei Darussalam (1984), Viet Nam (1995), Lao PDR and Myanmar (1997), and Cambodia (1999)
• The ASEAN Charter was established on December 15, 2008
• Ultimate goal: The ASEAN Community in 2015

The Three Pillars of ASEAN

• ASEAN Political-Security Community (APSC)
• ASEAN Economic Community (AEC)
• ASEAN Socio-Cultural Community (ASCC)

ASEAN Economic Community (AEC)

• Blueprint 2025
• Enhanced connectivity and sectoral cooperation
• Priority areas: healthcare, education, and infrastructure development

ASEAN Health Care

• Promote a strong healthcare industry for better healthcare facilities, products, and services
• Strategic measures:
  • Private healthcare market and public-private partnership (PPP) in universal healthcare
  • Harmonization of standards and conformance in healthcare products and services
  • Promote high-growth potential sectors like health tourism and e-healthcare services
  • Strong health insurance systems in the region
  • Facilitate mobility of healthcare professionals in the region
  • Development of ASEAN regulatory framework on traditional medicines and health supplements
  • Healthcare product directives to facilitate trade in healthcare products

ASEAN Socio-Cultural Community (ASCC)

• Blueprint 2025
• Committed to lifting the quality of life of its people by putting their welfare and well-being at the heart of its activities
• ASEAN Post-2015 Health Development Agenda (2016-2020)

Challenges Facing ASEAN

• Sovereignty of member states
• Economic diversity
• Varying regulatory capabilities
• Demographic shift: transition to an ageing population

ASEAN Demographic Shift

• Proportion of population by various age groups
• Percentage by various age groups
• Top three challenges facing ASEAN: sovereignty, economic diversity, and varying regulatory capabilities

ASEAN Post-2015 Health Development Agenda (APHDA) 2021-2025

• The APHDA vision is to establish a healthy, caring, and sustainable ASEAN community.

Mission

• The mission is to ensure a healthy, caring, and sustainable ASEAN community by promoting healthy lifestyles, responding to all hazards and emerging threats, strengthening health systems and access to care, and ensuring food safety.

Health Clusters

• The APHDA is divided into four health clusters: AHC 1, AHC 2, AHC 3, and AHC 4.

AHC 1: Promoting Healthy Lifestyles

• Cluster goals: achieve health potential, ensure healthy lives, and promote well-being for all at all ages.
• Health priorities:
  • Prevention and control of non-communicable diseases
  • Reduction of tobacco consumption and harmful use of alcohol
  • Prevention of injuries
  • Promotion of occupational health
  • Promotion of mental health
  • Promotion of healthy and active aging
  • Promotion of good nutrition and healthy diet

AHC 2: Responding to All Hazards and Emerging Threats

• Cluster goals:
  • Promote resilient health system in response to communicable diseases, emerging infectious diseases, neglected tropical diseases, and zoonotic diseases
  • Enhance regional preparedness and response to public health emergencies and ensure effective disaster health management
  • Prepare and respond to environmental health threats and other hazards, including climate change
• Health priorities:
  • Prevention and control of communicable diseases, emerging infectious diseases, neglected tropical diseases, and zoonotic diseases
  • Regional preparedness and response to public health emergencies
  • Strengthening laboratory capacity
  • Combating antimicrobial resistance (AMR)
  • Environmental health, health impact assessment (HIA), and health impact of climate change
  • Disaster health management

AHC 3: Strengthening Health System and Access to Care

• Cluster goals:
  • Provide universal access to safe, affordable, quality, holistic health care and essential medical supplies, including traditional and complementary medicines
  • Advance health care deliveries by adapting and working towards innovation and digital health technology
  • Promote health care delivery to vulnerable populations, such as women, children, and migrant workers
• Health priorities:
  • Traditional and complementary medicine
  • Reproductive, maternal, neonatal, and child health
  • Universal health coverage, including health financing and health service delivery
  • Migrants’ health
  • Pharmaceutical development
  • Human resources for health
  • Digital health and health information system

AHC 4: Ensuring Food Safety

• Cluster goals:
  • Promote access to safe food
  • Strengthen food safety risk analysis in ASEAN
• Health priority: food safety