DOH-CHN-Lecture PDF

NATIONAL HEALTH PROGRAMS OF DOH PREPARED BY: SEAN PATRICK DE CASTRO, RN The Department of Health (DOH) in the Philippines implements National Health Programs to improve the well-being of the population. These programs are designed...

NATIONAL HEALTH PROGRAMS OF DOH PREPARED BY: SEAN PATRICK DE CASTRO, RN The Department of Health (DOH) in the Philippines implements National Health Programs to improve the well-being of the population. These programs are designed to address the health needs of different age groups and vulnerable sectors within the community. Among these programs, Family Health Services (FHS) play a crucial role, as they target individuals from conception to old age, focusing on maternal, newborn, child, adolescent, and elderly care. WORLD HEALTH ORGANIZATION (WHO) Is a specialized agency of the United Nations responsible for international public health MAIN OBJECTIVE: the attainment by all people of the highest possible level for health Headquarters: Geneva, Switzerland with 6 semi-autonomous regional offices 150 field offices worldwide World Health Day: April 7, 1948 WHO’s broad mandate includes: a. Advocating for universal healthcare b. Monitoring public health risks c. Coordinating responses to health emergencies d. Promoting human health and well-being MILLENNIUM DEVELOPMENT GOALS (MDGS) 1. Eliminate Extreme Poverty And Hunger 2. Achieve Global Primary Education 3. Promote Gender Equality And Empower Women 4. Reduce Child Mortality (reduce the under-five mortally rate by 2/3 in year 2015) 5. Improve Maternal Health (reduce maternal mortality by 3 quarters (3/4) in 2015) 6. Combat Malaria, HIV/AIDS, And Other Diseases (Including neglected tropical diseases) 7. Ensure Environmental Sustainability 8. Develop A Universal/Global Partnership For Development MILLENNIUM DEVELOPMENT GOALS (MDGS) The Millennium Development Goals (MDGs) were a set of eight international development goals established by the United Nations in 2000, aimed at addressing urgent global challenges in poverty, health, and education, particularly in developing countries. The goals were designed to be achieved by 2015 and focused on improving the quality of life, reducing inequalities, and promoting sustainable human development worldwide. MILLENNIUM DEVELOPMENT GOALS (MDGS) MILLENNIUM DEVELOPMENT GOALS (MDGS) JUST REMEMBER THIS MNEMONIC SUSTAINABLE DEVELOPMENT GOALS (2015-2030) SGDs SUSTAINABLE DEVELOPMENT GOALS (2015-2030) SGDs  SUSTAINABLE DEVELOPMENT GOALS (2015-2030) SDGs The Sustainable Development Goals (SDGs) are a set of 17 goals established by the United Nations in 2015 with the aim of promoting sustainable development globally by 2030. The SDGs build upon the progress of the Millennium Development Goals (MDGs), broadening the scope to include issues affecting both developing and developed countries. The 17 SDGs provide a framework for addressing a wide range of global challenges related to poverty, inequality, health, education, climate change, peace, and more.  SUSTAINABLE DEVELOPMENT GOALS (2015-2030) SGDs Adopted in 2015 Universal call-to-action to achieve peace and prosperity for all by 2030 MDGs were about lifting developing countries out of poverty SDGs also focus on our own need to transform unsustainable lifestyles, promote equality, human rights and justice  SUSTAINABLE DEVELOPMENT GOALS (2015-2030) SGDs 1. Poverty – 4P’s (Pantawid Pamilya Pilipino, Program/Partnership) 2. Hunger – zero hunger (malnutrition) 3. Health and Well Being – medical related (vaccination, HIV) 4. Education 5. Gender Equality 6. Clean water and sanitation 7. Clean Energy 8. Decent work and economic growth  SUSTAINABLE DEVELOPMENT GOALS (2015-2030) SGDs 9. Industry innovation and infrastructure – global nursing shortage 10. Reduce Inequalities 11. Sustainable cities 12. Responsible Consumption 13. Climate Action 14. Life below Water – food and water borne diseases 15. Life on Land – global pandemic COVID-19 16. Peace 17. Partnership for goals – example: PHC – approach: multi-sectoral (stake holders) MILLENNIUM DEVELOPMENT GOALS (MDGS)  DEPARTMENT OF HEALTH is the national agency mandated to lead the health sector towards assuring quality health care for all Filipinos. LEVELS OF THE HEALTH CARE SYSTEM: 1. Department of Health National health authority Policy making body Regulatory body Co-provider of specific tertiary health services  DEPARTMENT OF HEALTH Maintains specialty hospitals, regional hospitals & medical centers Has a regional office in every region Has a provincial health team made up of representatives to the local health boards & retained personnel involved in controlling malaria and other diseases  PREVENTIVE APPROACH TO HEALTH Health Promotion - activities that enhance resources directed at improving overall well- being Disease Prevention - activities that protect people from disease and its effects  PREVENTIVE APPROACH TO HEALTH PRIMARY Health promotion and specific protection E.g. Immunization, breastfeeding SECONDARY Early detection and prompt intervention E.g. Newborn screening, IMCI, hearing screen, sputum microscopy, PhilPEN, feeding program TERTIARY Limitation of disability and rehabilitation Referral of a severely malnourished child HEALTH CARE DELIVERY SYSTEM Refers to the overall field of practice where health services are provided with and for the community Characterized by different levels of service HEALTH CARE DELIVERY SYSTEM HEALTH CARE DELIVERY SYSTEM  HEALTH CARE DELIVERY SYSTEM Advances in health sciences and services have brought about the development of different types of health facilities. In response, DOH issued Administrative Order 2012-0012 (Rules and Regulations Governing the New Classification of Hospitals and Other health facilities in the Philippines). HEALTH CARE DELIVERY SYSTEM  HEALTH CARE DELIVERY SYSTEM Although the levels of health care delivery have remained basically the same-primary, secondary, and tertiary. Hospitals are broadly classified as general or specialty hospitals. A general hospital offers services and defines it as Level 1, 2 or 3. While specialty hospital offers services for a specific disease or condition or type of patient HEALTH CARE DELIVERY SYSTEM  HEALTH CARE DELIVERY SYSTEM DOH ADMINISTRATIVE ORDER 2012-0012 classifies other health facilities as follows: CATEGORY A- PRIMARY CARE FACILITY -a first-contact health care facility that offers basic services including emergency services and provision for normal deliveries 1. Without in-patient beds like health centers, out- patient clinics and dental clinics 2. With in-patient beds- a short stay facility where the px spends on the average of 1-2 days before discharge. (eg. are infirmaries and birthing (lying- in facilities).  HEALTH CARE DELIVERY SYSTEM DOH ADMINISTRATIVE ORDER 2012-0012 classifies other health facilities as follows: CATEGORY B- CUSTODIAL CARE FACILITY -a health facility that provides long-term care, including basic services like food and shelter, to patients with chronic conditions requiring ongoing health and nursing care due to impairment and a reduced degree of independence in ADLs and patients in need of rehabilitation examples are psychiatric facilities, substance/drug abuse treatment and rehab centers, nursing homes  HEALTH CARE DELIVERY SYSTEM CATEGORY C- DIAGNOSTIC/THERAPEUTIC FACILITY -a facility for the examination of the human body, specimens for diagnosis, sometimes treatment of disease, or water for drinking water analysis. Covers preanalytical, analytical and postanalytical phase of examination. This category is further classified into: 1. Laboratory facility, such as but not limited to the ff.: a. Clinical Laboratory b. HIV testing lab c. Blood Service facility d. Drug testing lab e. Newborn Screening lab f. Lab for drinking water analysis  HEALTH CARE DELIVERY SYSTEM CATEGORY C- DIAGNOSTIC/THERAPEUTIC FACILITY 2. Radiologic facility providing services such as X-ray, CT scan, mammography, MRI, and ultrasonography 3. Nuclear Medicine Facility- a facility regulated by the Philippine Nuclear Research Institute utilizing applications of radioactive materials in diagnosis, treatment, or medical research, with the exception of the use of sealed radiation sources in radiotherapy as in internal radiation therapy. Examples of Category C: Medical laboratories (e.g., Hi-Precision Diagnostics) Radiologic clinics (e.g., MyHealth Clinic)  HEALTH CARE DELIVERY SYSTEM CATEGORY D- SPECIALIZED OUTPATIENT FACILITY -a facility that performs highly specialized procedures on an outpatient basis. EXAMPLES are dialysis clinics, ambulatory surgical clinic, cancer chemotherapeutic center/clinic, cancer radiation facility, and physical medicine and rehabilitation center/clinic  HEALTH CARE DELIVERY SYSTEM THE RURAL HEALTH UNIT (RHU) Commonly known as a health center, is a primary level health facility in the municipality. The focus of the RHU is preventive and promotive health services and the supervision of BHSs under its jurisdiction (DOH, 2011). The recommended ratio of RHU to catchment population is 1 RHU: 20,000 population (DOH, 2009).  HEALTH CARE DELIVERY SYSTEM The BHS (barangay health stations) is the first-contact health care facility that offers basic services at the barangay level. It is a satellite station of the RHU. manned by volunteer Barangay Health Workers (BHWs) under the supervision of the Rural Health Midwife (RHM) (DOH, 2001).  THE RURAL HEALTH UNIT PERSONNEL The MUNICIPAL HEALTH OFFICER (MHO) or RURAL HEALTH PHYSICIAN heads the health services at the municipal level and carries out the following roles and functions: 1. ADMINISTRATOR OF THE RHU a. Prepares the municipal health plan and budget b. monitors the implementation of basic health services c. Management of the RHU staff  THE RURAL HEALTH UNIT PERSONNEL 2. COMMUNITY PHYSICIAN a. Conducts epidemiological studies b. Formulates health education campaigns on disease prevention c. Prepares and implements control measures or rehabilitation plans 3. Medico-legal officer of the municipality  THE RURAL HEALTH UNIT PERSONNEL The revised implementing rules and regulations (IRRs) of RA 7305 or the Magna Carta of Public Health Workers stipulate that there be one (1) rural health physician to population of 20,000 (DOH).  THE RURAL HEALTH UNIT PERSONNEL The PUBLIC HEALTH NURSE (PHN) 1. Supervises and guides all RHMs in the municipality 2. Prepares the FHSIS (Field Health Services Information System) quarterly and annual reports of the municipality for submission to the Provincial Health Office 3. Utilizes the nursing process in responding to health care needs, including needs for health education and promotions, of individuals, families and community 4. Collaborates with the other members of the health team, government agencies, private orgs/businesses, NGOs and other organizations to address community’s health problems.  THE RURAL HEALTH UNIT PERSONNEL R.A. 7305 IRRs provide for the same nurse- population ratio as that of the RHP, that is still 1:20,000  THE RURAL HEALTH UNIT PERSONNEL With a recommended ration of 1 for every 5000 population, The RHM: 1. Manages the BHS and supervises and trains BHW; 2. Provide midwifery services and executes health care programs and activities for women of reproductive age, including FP counseling and services 3. Conducts patient assessment and diagnosis for referral or further management 4. Performs health information, education and communication activities 5. Organizes the community; and 6. Facilitates barangay health planning and other community health services  THE RURAL HEALTH UNIT PERSONNEL HEALTH TEAM RATIO AND PROPORTION RHP : 1:20 000 PHN, RSI, BSN: 1: 20 000 RH Dentist: 1: 50 000 RHM : first health professional 1 MW : 5000 pop BHW: 1: 20 households These ratios are used as a standard guide in ensuring the equitable distribution of health services across the population, especially in rural or underserved areas. Adjustments may occur based on local health needs and available resources.  THE RURAL HEALTH UNIT PERSONNEL BHWs are accredited by the local health board according to DOH guidelines. Although they carry the status of volunteers, RA 7883 or the BARANGAY HEALTH WORKERS’ BENEFIT AND INCENTIVES ACT entitles them to hazard and subsistence allowances and other benefits LEVELS OF THE HEALTH CARE SYSTEM NOTE: RA 7610 ANTI- 2. Local Government Units (RA 7160): Local CHILD ABUSE LAW Government Code of 1991) enacted to bring about genuine and AKA Special Protection of meaningful local autonomy Children Against Abuse, enable local governments to attain their Exploitation, and fullest development as self-reliant Discrimination Act communities and make them more effective partners in the attainment of national goals. Provider of primary, secondary & tertiary health care Local policy making bodies LEVELS OF THE HEALTH CARE SYSTEM The introduction of the Local Government Code of 1991. Republic Act 7160. Devolution is the transfer of powers and funding from national to local government RA 1082 also known as the "Rural Health Act of 1954" -It is important because it ensures that decisions are made closer to the local people, communities and business they affect. LEVELS OF THE HEALTH CARE SYSTEM Aim: to transform local government unit into: SARAD Self-reliant communities Active partnership with the people Responsive to the needs of the people Accountable government representatives Decentralization system of health decision making LEVELS OF THE HEALTH CARE SYSTEM RA 7160 provided for the creation of the provincial health board and the city/municipal health boards Note: Nurse is at the middle and is considered as the Liaisons officer LEVELS OF THE HEALTH CARE SYSTEM Appointment of the position in the health center is the responsibility of the Mayor or the Governor Centralize- Top level (DOH) is the only one involved in decision making process Decentralize- All levels are involved in the decision making process  RA 1082 For every one RHU, there should only be 20,000 population (1:20,000) THREE STRATEGIES IN DELIVERING HEALTH SERVICES (ELEMENTS) Creation of Restructured Health Care Delivery System (RHCDS) regulated by PD 568 (1976) Management information system regulated by RA 3753: Vital Health Statistics Law a. All beds all births are reported at the local civil registrar/ city hall Primary Health Care (PHC) regulated by LOI 949 (1984): Legalization of Implementation of PHC in the Philippines  RESTRUCTURED HEALTH CARE DELIVERY SYSTEM 2-way Referral System RHCDS 2-way referral system Referral System –an integral part of the RHCDS 1. Client is first cared by the family which may or may not seek assistance to the barangay 2. From either of these two entities, the case is referred to the BHS  RESTRUCTURED HEALTH CARE DELIVERY SYSTEM 3. Necessary referrals may then be made to the main health center or private agencies within the poblacion. 4. Further management may be provided as the case may warrant through a system of referrals to the district/ provincial/ regional hospital and central referral system  RESTRUCTURED HEALTH CARE DELIVERY SYSTEM A functional referral system is one that ensures the continuity and complementation of health and medical services Engages all health facilities from the lowest to the highest level Usually involves movement of a patient from the health center of first contact and the hospital at first referral level When hospital intervention has been completed, px is referred back to the health center  RESTRUCTURED HEALTH CARE DELIVERY SYSTEM Referrals may be INTERNAL or EXTERNAL Internal Referral - occur within the health facility, from one health personnel to another may be made to request for an opinion or suggestion, co-management or further management/special care External Referral - is a movement of a pt from one health facility to another may be; vertical- referral may be from a lower to a higher level of health facility or vice versa horizontal- referred between similar facilities in different catchment areas  INTER-LOCAL HEALTH ZONE (ILHZ) The referral system function within the context of the Inter-Local Health Zone (ILHZ) provides a means for consolidating health care efforts. ILHZ is based on the concept of the District Health System, a generic term used by WHO to describe an integrated health management and delivery system based on a defined administrative and geographical area: Defined catchment population within a defined geographical area has a central or core referral hospital and number of primary level facilities (RHUs & BHSs) Does not only cover government health services but includes NGOs and private sector may be composed of one large municipality or several municipalities  INTER-LOCAL HEALTH ZONE (ILHZ) The Inter-Local Health Zone (ILHZ) has the following components: PEOPLE: the population size of a health district BOUNDARIES: clear boundaries between ILHz establish accountability and responsibility of health service providers HEALTH FACILITIES: RHUs, BHSs, and other health facilities that decide to work together as an integrated health system and having the district/provincial hospital as central referral hospital HEALTH WORKERS: to deliver comprehensive services LEVELS OF THE HEALTH CARE SYSTEM 3. Private Sectors Consisting of for profit & not for profit organizations  DEPARTMENT OF HEALTH Original name: Board of Health of the Philippine Island Vision: Filipinos are among the healthiest people in Southeast Asia by 2022, and Asia by 2040 Mission: To lead the country in the development of a productive, resilient, equitable and people-centered health system (PREP) The DOH holds the overall technical authority on health as it is a nation health policy-maker and regulatory institution  DEPARTMENT OF HEALTH 3 MAJOR ROLES IN THE HEALTH SECTOR “LEA” 1. Leadership in health 2. Enable and Capacity Builder 3. Administrator of specific services  DEPARTMENT OF HEALTH 1. LEADERSHIP IN HEALTH (FAR) Serve as the national policy and regulatory institution Provide leadership in formulation, monitoring and evaluation of national health policies Serve as advocate in the adoption of health policies, plans and programs to address national and sectoral concerns  DEPARTMENT OF HEALTH FORMULATE Creates the policies, protocols, rules and regulations of health in the Philippines. ADVOCATE Protect the right of the people REGULATE All hospitals must have certification of cooperation from DOH Make sure affordable and safe health services in the country  DEPARTMENT OF HEALTH 2. ENABLER & CAPACITY BUILDER “IME” INNOVATE Update of health practices in the country MONITOR All hospitals in the country have license from DOH All hospitals in the country are checked by the DOH ENSURE Must have safe and quality health services  DEPARTMENT OF HEALTH 3. ADMINISTRATOR OF SPECIFIC SERVICES “EMA” EMERGENCY SERVICES In case of emergencies, the DOH must ensure safe and quality healthcare services MANAGE SELECTED HOSPITAL Specific hospitals are funded are from DOH (Philippine General Hospital) Specialized Hospitals = Specific cases (e.g. National Kidney Institute, Philippine Heart Centre) ADMINISTER BASIC SERVICES  DEPARTMENT OF HEALTH VISION & MISSION OF DOH VISION Filipinos are among the healthiest people in Southeast Asia by 2022, and Asia by 2040 MISSION To lead country in the development of a productive, resilient, equitable and people centered health system  DEPARTMENT OF HEALTH STRATEGIC GOALS OF DOH: 1. Better health outcomes 2. More responsive health system 3. Equitable health care financing CORE VALUES: 1. Professionalism 2. Responsiveness 3. Integrity 4. Compassion 5. EXCELLENCE  DEPARTMENT OF HEALTH STRATEGIC PILLARS: 1. Financing 2. Service Delivery 3. Governance 4. Regulation STRATEGIC FOCUS of DOH: Institutionalize a people-centered service delivery network Lead a whole of society collaboration at all levels to help people live healthy  DEPARTMENT OF HEALTH STRATEGIC FOCUS 1: Institutionalize a people-centered service delivery network ENGAGE THE HEALTHY Preventive and Promotive ENGAGE THE SICK Curative, Rehabilitative and Palliative ENGAGE AFFECTED POPULATIONS Preparedness and Response for Conflicts and Disasters ENGAGE SPECIAL GROUPS Focused and Customized: 1. GIDA (Geographically Isolated and Disadvantaged Areas) 2. Indigenous Populations 3. Migrant workers  DEPARTMENT OF HEALTH STRATEGIC FOCUS 2: Lead a whole of society collaboration at all levels to help people live healthy DIET Health Markets Agricultural Produce PHYSICAL ACTIVITY Parks, Bike Paths, Public Transportation SMOKING Taxation, Smoke-free places ROAD TRAFFIC INJURIES Helmet use, Child restraint  DEPARTMENT OF HEALTH ENGAGE A RANGE OF STAKEHOLDERS 1. Civil Society/Patient groups 2. Legislators 3. National Government Agencies 4. LGUs 5. Health Boards/ Councils/Task forces 6. Private sectors (suppliers & Employers) 7. Development Partners  DEPARTMENT OF HEALTH NATIONAL OBJECTIVES ON HEALTH 1. Improve the general health status of the population 2. Reduce morbidity and mortality from certain diseases 3. Eliminate certain diseases as public health problems 4. Promote Healthy lifestyle and environmental health 5. Protect vulnerable groups with special health and nutrition needs a. Mothers b. Infants c. Elderlies d. PWDs 6. Strengthen national and local health systems to ensure better health service delivery 7. Pursue public health and hospital reform 8. Reduce the cost and ensure the quality of essential drugs  DEPARTMENT OF HEALTH ENGAGE A RANGE OF STAKEHOLDERS 1. Civil Society/Patient groups 2. Legislators 3. National Government Agencies 4. LGUs 5. Health Boards/ Councils/Task forces 6. Private sectors (suppliers & Employers) 7. Development Partners COMPREHENSIVE REFORMS IN HEALTH  COMPREHENSIVE REFORMS IN HEALTH 1. HEALTH SECTOR REFORM AGENDA (1999- 2004) Overriding goal of DOH Support mechanisms will be through sound organizational development, strong policies, systems and procedures, capable human resources and adequate financial resources. Under President Gloria Macapagal- Arroyo Administration COMPREHENSIVE REFORMS IN HEALTH 1. Slowing down in the reduction in the infant mortality rate (IMR) and the maternal mortality rate (MMR) 2. Persistence of large variations in health status across population groups and geographical areas 3. High burden from infection  COMPREHENSIVE REFORMS IN HEALTH 2. FOURMULA ONE FOR HEALTH (2005-2010) Framework for implementation of HSRA Goals of FOURmula ONE for Health a. Better health outcomes b. More responsive health systems c. Equitable healthcare financing 4 elements: 1. HEALTH FINANCING foster greater, better and sustained investments in health 2. HEALTH REGULATION quality and affordability of health goods and  COMPREHENSIVE REFORMS IN HEALTH 3. HEALTH SERVICE DELIVERY accessibility and availability of basic and essential healthcare in both public and private facilities and services 4. GOOD GOVERNANCE enhance health system performance at national and local levels  COMPREHENSIVE REFORMS IN HEALTH 3. UNIVERSAL HEALTH CARE (2010-2016) also referred to as Kalusugan Pangkahalatan “provision for every Filipino of the highest possible quality of health care that is accessible, efficient, equitably distributed, adequately funded, fairly financed, and appropriately used by an informed and empowered public” Under PNoy Administration A government mandate aiming to ensure that every Filipino shall receive affordable and quality health benefits DOH Admin. Order No. 2010-0036  COMPREHENSIVE REFORMS IN HEALTH UHC’s Three thrusts: 1. Financial risk protection through expansion in enrollment and benefit delivery of the National Health Insurance Program (NHIP) or Philippine Health Insurance Corporation (PhilHEALTH) 2. Improved access to quality hospitals and health care facilities, and 3. Attainment of health-related Millennium Development Goals (MDGs)  COMPREHENSIVE REFORMS IN HEALTH 4. FOURMULA ONE PLUS FOR HEALTH (2016-2022) Strategic Pillars of the Fourmula One + 1. FINANCING a. Increase Resources For Health b. Expand Benefit Fairly c. Improve Financial Protection And Contain Costs 2. SERVICE DELIVERY a. Enable a comprehensive primary health care approach b. Cultivate an engaged and competent health workforce c. Capacitate public hospitals to become model hospitals  COMPREHENSIVE REFORMS IN HEALTH 3. REGULATION a. Support healthy food, lifestyle and environment b. Enable patient’s choice c. Increase ability to enforce d. Ensure equitable distribution of health facilities & professionals 4. GOVERNANCE a. Drive timely, evidence-informed, data-drivers decisions b. Integrate the public system at the provincial level c. Build succession of health managers and leaders d. Upgrade supply chain and logistics management systems.  COMPREHENSIVE REFORMS IN HEALTH 5. PERFORMANCE AND ACCOUNTABILITY a. Publish scorecards in platforms easily accessed and manners easily understood Commission regular surveys in place of gaps in administrative data.  LOCAL HEALTH SYSTEM Philippine health care system was administered by a central agency based in Manila This control agency provided the singular sources of resources, policy direction, technical and administrative supervision to all health facilities nationwide Local Government Code (RA 7160) It devolves to the local government units to facilitate health service delivery Provincial governments Hospital system, provincial district hospitals City/Municipal governments Health centers/RHUs and BHSs  LOCAL HEALTH SYSTEM OBJECTIVES: Establish local health system for effective and efficient delivery of healthcare services Upgrade the health care management and service capabilities of local health facilities. Promote inter-LGU linkages and cost sharing scheme Foster participation of the private sector, non-government organizations and communities Ensure quality of health services delivery  LOCAL HEALTH SYSTEM LOCAL LEVEL: LOCAL GOVERNMENT UNITS Responsible for the direct provision of public health programs and primary secondary and tertiary hospital care within their areas of jurisdiction LOCAL HEALTH BOARD In every province, city, municipality are chaired by local chief executive  LOCAL HEALTH SYSTEM 1. COMPOSITION OF LOCAL HEALTH BOARD: a. PROVINCIAL LEVEL  LOCAL HEALTH SYSTEM 1. COMPOSITION OF LOCAL HEALTH BOARD: a. CITY AND MUNICIPAL LEVEL  LOCAL HEALTH SYSTEM INTERLOCAL HEALTH SYSTEM Espoused by the DOH in order to ensure quality of healthcare service at the local health level. Overall concept: creation of an inter local health system by clustering municipalities into inter local health zone Reason: there is a need to reintegrate hospital and public health service for a holistic delivery of health service.  LOCAL HEALTH SYSTEM EXPECTED ACHIEVEMENT OF THE INTER-LOCAL HEALTH SYSTEM Espoused by the DOH in order to ensure quality of healthcare service at the local health level. Universal coverage of health insurance Improved quality of hospital and rural health units service Integrated planning Appropriate health information system Effective referral system Improved drug management Developed human resources  LOCAL HEALTH SYSTEM EXPECTED ACHIEVEMENT OF THE INTER-LOCAL HEALTH SYSTEM Espoused by the DOH in order to ensure quality of healthcare service at the local health level. Financially visible or self-sustaining hospitals Integration of public health and curative hospital care Effective leadership through the inter-LGU corporation Strengthen cooperation between LGU and health sectors  LOCAL HEALTH SYSTEM GUIDING PRINCIPLES IIN DEVELOPING THE INTER LOCAL HEALTH SYSTEM: Financial and administrative autonomy of the provincial and municipal administrations Strong political support Strategic synergies and partnership Community participation Equity of access to health services by the population, especially the poor  LOCAL HEALTH SYSTEM COMPOSITION OF INTER LOCAL HEALTH ZONE (ILHZ) PEOPLE Number of people varies from zone to zone. Depending on the LGUs who will decide to cooperate and cluster BOUNDARIES Clear boundaries between ILHZ: Determines accountability and responsibility of HC providers. Geographical locations/Access to referral facilities: Basic in forming the boundaries.  LOCAL HEALTH SYSTEM HEALTH FACILITIES The decision to work together as an integral health system are as follows: District or Provincial hospitals No. of RHUs Barangay Health Stations (BHS) Other health services HEALTH WORKERS The right unit of HC providers is needed to deliver comprehensive health services.  PRIMARY HEALTH CARE (PHC) PRIMARY HEALTH CARE (PHC) By WHO defines PHC: Essential health care Universally accessible Acceptable to the individuals and families With full participation Affordable at every stage of development DECLARED: First International Conference on PHC VENUE: Alma Ata, USSR (September 6-12, 1978) GOAL: Health for All by the year 2000  PRIMARY HEALTH CARE (PHC) ADOPTED: in the Philippines through Letter of Instruction 349 (by Pres. Marcos) Theme: Health in the Hands of the People by 2020 Concept of PHC: Partnership and empowerment of the people Community-based, accessible, acceptable and sustainable at a cost The government can afford.  LOCAL HEALTH SYSTEM Strategy: Health on the individual, his family and the community. Recognized the interrelationship between health and the overall political, socio-cultural and economic development of society. Recent PHC Summit: February 23-24, 2006  LOCAL HEALTH SYSTEM CHARACTERISTICS OF PHC: “5 A’s and S” Acceptable- must no contradict their beliefs and practices Accessible- health center must be found within 5km of the location of the barangay Affordable- depending on the availability of the medications, services or equipments Available- health services and personnel Appropriate- realistically address the community’s most pressing health issues using the resources available Sustainable- be able to continue  PRIMARY HEALTH CARE (PHC) PRINCIPLES OF PHC: 1. Accessibility, Availability & Acceptability Of Health Services 2. Provision of Quality Basic and Essential Health Services 3. Community Participation 4. Self-Reliance 5. Recognition of Interrelationship between Health and Government 6. Social Mobilization 7. Decentralization  PRIMARY HEALTH CARE (PHC) STRATEGIES OF PHC: Reorientation and reorganization of the national HC system with the establishment of functional support mechanism in support of the mandate of devolution under the Local Government Code of 1991. Effective preparation and enabling process for health action at all levels. Mobilization of the people to know their communities and identifying their basic health needs with the end in view of providing appropriate solutions leading to self- reliance and self-determination.  PRIMARY HEALTH CARE (PHC) Development and utilization of appropriate technology focusing on local indigenous resources available in and acceptable to the community. Organization of communities arising from their expressed needs which they have decided to address and that this continually evolves in pursuit of their own development. Increase opportunities for community participation in local level planning, management, monitoring and evaluation within the context of regional and national objectives.  PRIMARY HEALTH CARE (PHC) Development of intra-sectoral linkages with other government and private agencies so that the programs of the health sector s closely linked with those of other socio-economic sectors at the national, intermediate and community levels Emphasizing partnership so that the health workers and the community leaders/members view each other as partners rather than merely providers and receiver of health care respectively.  PRIMARY HEALTH CARE (PHC) FOUR CORNERSTONES/PILLARS IN PHC: REMEMBER AIUS Active Community Participation Intra And Inter-Sectoral Linkages Use Of Appropriate Technology Support Mechanism Made Available  PRIMARY HEALTH CARE (PHC) ELEMENTS/COMPONENTS OF PHC: Education for Health World AIDS Day: Every 1st day of December RA 8504 The Philippine HIV and AIDS Policy Act of 1998 Local Endemic Diseases & Communicable Disease Control Expanded Program on Immunization (Current: National Immunization Program or NIP) RA 10152 Maternal & Child Health (including Family Planning) RA 10354 The Responsible Parenthood and Reproductive Health Act of 2012 Essential Drugs Nutrition PD# 491: National Nutrition Council Nutrition Month: July  PRIMARY HEALTH CARE (PHC) Treatment of Communicable Diseases & Non-Communicable Diseases Safe Water and Sanitation PD# 856: Sanitation Code of the Philippines RA 9275 Philippine Clean Water Act of 2004. Dental Health Oral Health Month: February Access to Sentrong Sigla (Hospitals as Center of Wellness) Mental Health RA 11036 (MENTAL HEALTH LAW)  UNIVERSAL HEALTH CARE RA11223-Universal Health Care Act of 2019 Prescribing reforms in the health care system and appropriating funds OBJECTIVES OF UHC ACT Progressively realize universal health care in the country through a systemic approach and clear delineation of roles of key agencies and stakeholders towards better performance in the health system Ensure that all Filipinos are guaranteed equitable access to quality and affordable health care goods and services and protected against financial risk  UNIVERSAL HEALTH CARE IMPACTS OF UHC Integrated and comprehensive approach to ensure health for all Filipinos Access to comprehensive set of health services without casing financial hardships People-oriented approach for delivery health services SALIENT FEATURES/ TERMS MEMBERSHIP Automatic inclusion of every Filipino into National Health Insurance Program  UNIVERSAL HEALTH CARE Simplification of PhilHealth membership into: Direct Contributors: capacity to pay premiums, are employed and are bound by an employer-employee relationship. Or are self- learning, professional migrant workers, practitioners, including dependents and lifetime members Indirect Contributors: not direct contributors and their qualified dependents, premium subsidized by the national government o Point of care (POC)- shouldered by PhilHealth Co-payments: flat free or predetermined rate paid at point of service  UNIVERSAL HEALTH CARE FINANCING SOURCE Pooling of funds from Sin Tax, PagCOR, PCSO premium, DOH annual appropriations, and national government subsidy to DOH and PhilHeath Population-based health services financed by DOH/LGUs-- Population group as recipient paid (E.g. health promotion, disease surveillance, vector control, Immunization, maternal health program)  UNIVERSAL HEALTH CARE FINANCING SOURCE Individual-based health services financed by PhilHealth- Can definitely be traced back to 1 recipient limited effect at population level Prepayment schemes (Philhealth, private health insurance, HMOs) FINANCING 50%PAGCORIncome 40%PCSOCharityFund DOH Funding from the national budget PhilHealth subsidy from the national government Premium contributions from PhilHealth member (direct contributions  UNIVERSAL HEALTH CARE ENTITLEMENT TO BENEFITS Free of charge at point of service for population based health services Immediate eligibility for health benefit package under National Health Insurance Program No Philhealth ID card required No co-payment for services in basic/ ward accommodation Fix, regulated co-payment for non-basic accommodation  CREATION OF “BOTIKA SA BARYO & BOTIKA SA HEALTH CENTER” RA 6675: Generics Act of 1988: Implementing “Oplan Walang Reseta Program” A solution to the absence of medical officer who prescribed the medicines so PHN are given the responsibility to provide or dispense generic medicines “Walong Wastong Gamot Program”- available generics in “Botika sa Baryo” & Health Center Father of Generics Act: Dr. Alfredo Bengzon 8 commonly available generics (CARIPPON)  CARIPPON CO-TRIMOXAZOLE (COMBINATION) Trimethoprim (TMP): has a bacteriostatic action that inhibits/stops multiplication of bacteria Action: Bacteriostatic Inhibits bacterial multiplication by blocking dihydrofolate reductase, an enzyme required for DNA synthesis. Slows the growth of bacteria, allowing the immune system to eliminate the infection. Indications: GUT (Genitourinary Tract): Includes infections like urinary tract infections (UTIs). GIT (Gastrointestinal Tract): Used for bacterial diarrhea and enteric infections. URTI (Upper Respiratory Tract Infection): Effective for sinusitis, pharyngitis, etc.  CARIPPON CO-TRIMOXAZOLE (COMBINATION) Sulfamethoxazole (SMX): bactericidal action Action: Bactericidal Inhibits bacterial growth by blocking dihydropteroate synthase, another enzyme critical for folate production in bacteria. Directly kills susceptible bacteria. Indications: GUT & GIT: UTIs, traveler's diarrhea, or bacterial dysentery. URTI: Infections like bronchitis or pneumonia. Skin Infections: Effective against certain strains of Staphylococcus aureus or Streptococcus. Synergy: The two drugs target sequential steps in bacterial folate synthesis, making the combination more potent than either drug alone.  CARIPPON AMOXICILLIN/AMPICILLIN commonly used to treat bacterial infections. Antibiotics mainly stop bacteria from building their protective cell walls, slowing their growth. Inhibit the cross-linking process. Indications: Respiratory infections (bronchitis, pneumonia), ear infections. throat infections (tonsillitis, strep throat),Urinary tract infections, skin infections May cause mild rashes or GI upset (common side effects)  CARIPPON TB DRUGS (RIP) Rifampicin, Isoniazid, Pyrazinamide combination of Rifampicin, Isoniazid, and Pyrazinamide is used to treat active TB, especially in the initial phase of treatment. MOA: three drugs works synergistically to: Kill the TB bacteria rapidly. Reduce the risk of drug resistance. Address the bacteria from different angles, cell wall disruption (Isoniazid), inhibition of protein synthesis (Rifampicin), and disruption of cell membrane integrity (Pyrazinamide). Rifampicin- Orange/Red colored urine Isoniazid- peripheral neuropathy Pyrazinamide- hyperuricemia  CARIPPON PARACETAMOL a commonly used medication that has two main effects: analgesic and antipyretic effect interfering with chemicals in the brain (prostaglandins) that cause pain and fever. Indications: Headaches, toothaches, muscle aches, menstrual cramps, minor injuries, fever Mild side effects may occur such as nausea, GI upset  CARIPPON ORESEOL also known as ORS or Oral Rehydration Salts a simple and effective treatment used to manage diarrhea and prevent dehydration, which can be a serious risk from frequent or severe diarrhea a special mixture of water, salts, and sugars designed to replenish lost fluids and electrolytes in the body. Diarrhea can cause the body to lose a lot of fluids, which can lead to dehydration. ORS helps to restore the balance of fluids in the body and prevent dehydration.  CARIPPON NIFEDIPINE anti-hypertensive drug, belongs to a class of medications called calcium channel blockers works by relaxing the muscles in the walls of blood vessels, allowing them to widen. This reduces the resistance the heart faces when pumping blood and helps lower blood pressure 16% of population belonging to 25 years old and above in the community are hypertensive may cause dizziness, headaches or flushing Alternative Traditional Medicine Law RA 8423 A program where patient may establishes mechanisms to opt to use herbal plants make alternative healthcare especially for drugs that are modalities accessible, not available in dosage form or particularly for communities patients has no financial with limited access to means to buy the drug conventional medicine Alternative Traditional Medicine Law RA 8423 SANTA LUBBY S- ambong L- agundi A- kapulko U- lasimang Bato N- iyog-niyogan B-ayabas T-saang gubat B- awang A-mpalaya Y-erba Buena Alternative Traditional Medicine Law RA 8423 PREPARATION/PROCEDURES DECOCTION- POULTICE- -gather leaves & wash Pounding or grinding of the thoroughly, place in a container specific plant part, involves the washed leaves and add direct application water, let it boil without cover, use extracts for washing Alternative Traditional Medicine Law RA 8423 PREPARATION/PROCEDURES INFUSION- JUICE/SYRUP- Soak to hot water for about 10-15 mash ingredient , put inside a minutes where a brown solution blender and add water (juice)then is collected, pectine which add sugar/honey then heat to serves as an adsorbent and dissolve sugar and mix it (syrup) astringent -juice more concentrated (Pure extract) Alternative Traditional Medicine Law RA 8423 PREPARATION/PROCEDURES CREAM/OINTMENT- -start with poultice to turn into semi0solid then add flour to make it pasty and adhere to lesions for ointment: add oil (mineral, baby oil) to the cream to keep it lubricated GUIDELINES TO USE HERBAL PLANTS BONUS B- Boiling, remove cover O- One kind of plant for each type of symptoms N- No insectides U- Use clay pot and plant part advocated S- Stop in case of untoward reactions, seek consulation if s/sx not relieved after 2-3 doses  SAMBONG Plant Name: Sambong Scientific Name: Blumea balsanifera Indication: Anti-urolithiasis, anti- edema (Diuretic) -Inhibits the absorption of oxalates from the gut or reduce oxalate levels in the blood and urine, lowering the risk of stone formation Part/s to be used: Leaves Preparation: Decoction  Akapulko Plant Name: Akapulko Scientific Name: Cassia alata Indication: Fungal infections or skin conditions -contain chrysophanic acid, which is effective against fungi Part/s to be used: Leaves Preparation: Decoction, poultice, cream  Niyog-niyogan Plant Name: Niyog-niyogan Scientific Name: Combretum indicum (formerly Quisqualis indica) Indication: Anti-helminthic, intestinal paratism -Contains quisqualic acid, which paralyzes and helps expel worms from the digestive tract Part/s to be used: Seeds/fruit Preparation: Decoction, poultice, juice  Tsaang Gubat Plant Name: Tsaang Gubat Scientific Name: Carmona resuta Indication: Stomach ache, GI problems (diarrhea), can also be used externally for skin irritations/rashes -helps soothe the digestive tract, reducing bloating, gas, and cramps, and may alleviate diarrhea by promoting gut health Part/s to be used: Leaves Preparation: Decoction, poultice  Ampalaya Plant Name: Ampalaya Scientific Name: Mamordica charantia Indication: anti-diabetic, especially for type II DM -contains compounds like charantin and momordicin that may help increase insulin sensitivity, lower blood sugar levels, and improve glucose metabolism. Part/s to be used: Leaves Preparation: Decoction  Lagundi Plant Name: Lagundi (Five chaste leaves) Scientific Name: Vitex negundo Indication: asthma, coughs, colds and fever (ASCOF), pain and inflammation -helps loosen mucus in the airways -contains flavonoids and terpenoids that help reduce inflammation, providing relief Part/s to be used: Leaves Preparation: Decoction, poultice  Ulasimang Plant Name: Ulasimang Bato Bato Scientific Name: Peperomia pellucida Indication: anti-uricemic (gout, arthrisis, rheumatism) -contains compounds like flavonoids and alkaloids, which help reduce inflammation and pain - promote increased urine production and help the kidneys eliminate excess waste and toxins Part/s to be used: Leaves Preparation: Decoction, poultice Plant Name: Bayabas Bayabas Scientific Name: Psidium quajava Indication: Anti-septic, wound washing, diarrhea, toothache - help reduce swelling and pain -antibacterial properties help treat acne and skin wounds, while their anti- inflammatory effects soothe skin irritations an astringent, helping to reduce inflammation and control diarrhea Part/s to be used: Leaves Preparation: Decoction Plant Name: Bawang Bawang Scientific Name: Allium Sativum Indication: lowers cholesterol, for hypertension, lowers BP and treat toothaches -helps reduce blood pressure, cholesterol levels,contains allicin, a sulfur compound that is released when garlic is crushed or chopped, has been shown to have vasodilatory effects, meaning it helps relax and widen the blood vessels -has analgesic properties, which means it can help numb the area and reduce pain Part/s to be used: Clove/bulb Preparation: Poultice  Yerba Buena Plant Name: Yerba Buena/Herba Buena Scientific Name: Mentha cordifella Indication: same as Lagundi except for asthma, analgesic/Pain reliever, for menstrual pain, arthritis pain, colds, bleeding gums, fainting, for relief of insect bites and itching - contains menthol, a compound that has soothing, cooling, and pain-relieving effects -also acts as an expectorant, helping to loosen and expel mucus from the airways Part/s to be used: Leaves Preparation: Decoction, poultice  HERBAL PLANTS “SANTA LUBBY” SCIENTIFIC INDICATION/ NAME PARTS PREPARATION NAME PURPOSE Anti- Blumea SAMBONG urolithiasis, Leaves Decoction Balsanifera anti-edema Kati-kati, fungal Decoction, AKAPULKO Cassia Alata infections or Leaves poultice, cream skin conditions Intestinal NIYOG- Combretum paratism, Decoction, Seeds, fruit NIYOGAN Indicum Anti- poultice, juice helminthic  HERBAL PLANTS “SANTA LUBBY” SCIENTIFIC INDICATION/PURPO NAME PARTS PREPARATION NAME SE Stomach ache, GI TSAANG Carmona problems, can be Leaves Decoction, poultice GUBAT resuta used externally for rashes anti-diabetic, Mamordica AMPALAYA especially for type 2 Leaves Decoction charantia DM Asthma (ASCOF), Vitex LAGUNDI ,expectorant, pain Leaves Decoction, poultice negundo and inflammation  HERBAL PLANTS “SANTA LUBBY” SCIENTIFIC INDICATION/PURPO NAME PARTS PREPARATION NAME SE anti-uricemic (gout, ULASIMANG Peperomia arthrisis, Leaves Decoction, Poultice BATO pellucida rheumatism) Psidium Anti-septic, wound BAYABAS Leaves Decoction quajava washing, toothache Allium Lowers cholesterol Clove, BAWANG Poultice sativum level, lowers BP bulb  HERBAL PLANTS “SANTA LUBBY” SCIENTIFIC INDICATION/PURPO PREPARATIO NAME PARTS NAME SE N Mentha Decoction, YERBA BUENA Analgesic Leaves cordifella poultice  HOMEMADE ORESOL A VOLUME OF 1 LITER SMALLER VOLUME OR A GLASS HOMEMADE ORESOL OF HOMEMADE ORESOL WATER 1 LITER 1/4 LITER OR 250 ML SUGAR 8 TEASPOONS 2 TEASPOONS SALT 1 TEASPOON 1/4 TEASPOON