Health Leadership and Governance PDF

MODULE 7: HEALTH LEADERSHIP AND GOVERNANCE Leadership and Governance is crucial for a health system (WHO). One of six building blocks identified by WHO for a health system. Other five building blocks: Health Human Resource, Access to Medicine and Technology, Health Service Delivery,...

MODULE 7: HEALTH LEADERSHIP AND GOVERNANCE Leadership and Governance is crucial for a health system (WHO). One of six building blocks identified by WHO for a health system. Other five building blocks: Health Human Resource, Access to Medicine and Technology, Health Service Delivery, Health Information, Health Financing. It is important that these 6 building blocks are established, strengthened and monitored in order for a health system to produce better health outcomes especially among the most vulnerable groups.  Leadership and governance (also known as stewardship ) is arguably the most complex but critical building block of any health system. It is about the role of the government in health and its relation to other actors whose activities impact on health. ○ Involves overseeing and guiding the whole health system, private as well as public, in order to protect the public interest. ○ Requires both political and technical action, because it involves reconciling competing demands for limited resources, in changing circumstances, for example, with rising expectations, more pluralistic societies, decentralization or a growing private sector. Leadership and Governance is the “wheel in the middle of the wheel”. It drives the rest of the building blocks. Without it, the rest of the building block won’t work (WHO).  Philippine Health Care System ○ Devolved health system, also known as decentralized. ○ In order to understand this, one must first review how bureaucracy is structured and organized. Administrative Levels in the Philippines: ○ There are at least 4 levels of administrative division, Each is referred to as Local Government Unit (LGU). ○ The President of the Republic of the Philippines as the overall Chief Executive, oversees these administrative regions. Administrative Regions: Province, City, Municipality, Barangay A special administrative division would be the Autonomous Regions and currently there are two: ○ Cordillera Autonomous Region (CAR) ○ Autonomous Region for Muslim Mindanao (ARMM) Pre decentralization, this is the health system in the Philippines: Post decentralization Post decentralization One opportunity wherein a local chief executive can exercise his or her leadership in health is at the Local Health Board. As mandated by the Philippine RA of 7160 or also known as the Local Government Code of 1991, a local health board must be established in every province, city or municipality. PROVINCIAL HEALTH BOARD ○ Members: Governor as Chairman The provincial health officer as vice-chairman of the committee on health of the Sangguniang Panlalawigan (Provincial Council), a representative from the private sector or NGO involved in health services, and a representative of the DOH in the province  CITY HEALTH BOARD ○ City mayor as chairman ○ City health officer as vice-chairman of the committee on health of the Sangguniang Panlungsod (City Council), ○ Representative from the private sector or NGO involved in health services, and ○ Representative of the DOH in the city. The MUNICIPAL HEALTH BOARD ○ Municipal mayor as chairman ○ Municipal health officer as vice-chairman of the committee on health of the Sangguniang Bayan (Municipal Council), ○ Representative from the private sector or NGO involved in health services, and ○ Representative of the DOH in the municipality.  The functions of the local health board are: ○ To propose to the council concerned, in accordance with standards and criteria set by the Department of Health, annual budgetary allocations for the operation and maintenance of health facilities and services within the municipality, city or province, as the case may be; ○ To serve as an advisory committee to the council concerned on health matters such as, but not limited to, the necessity for, and application of local appropriations for public health purposes; and ○ Consistent with the technical and administrative standards of the DOH, create committees which shall advise local health agencies on matters such as, but not limited to, personnel selection and promotion, bids and awards, grievance and complaints, personnel discipline, budget review, operations review and similar functions.