Healthcare Resources in the Philippines (Group 3) PDF

HEALTHCARE RESOURCES, HUMAN RESOURCES, & PHYSICAL RESOURCES Politics and Governance Submitted by: Group 3 Betito, Samantha Nicole N. Go, Kaithe Danielle V. Marquez, Mhyca Venice N. Merced, Kurt...

HEALTHCARE RESOURCES, HUMAN RESOURCES, & PHYSICAL RESOURCES Politics and Governance Submitted by: Group 3 Betito, Samantha Nicole N. Go, Kaithe Danielle V. Marquez, Mhyca Venice N. Merced, Kurt Martin G. Polintan, Janna Andrea M. Punongbayan, Arvielyn A. Sulla, Yurica L. Villanueva, Asher Cherie Keith N. Submitted to: Dr. David Fernandez DDM 1-1 November 2024  POLITICS AND GOVERNANCE REPORTING RESEARCH OUTLINE A. Introduction - I. Healthcare Resources - a. Healthcare System Overview - b. Structure of Healthcare System - c. Levels of Healthcare - d. Government Healthcare Programs - II. Human Resources - a. Healthcare Workforce Composition - b. Ratio of Filipino Healthcare Workers to Population - c. Workforce Challenges - d. Government and Private Sector Initiatives - III. Physical Resources - a. Healthcare Facilities - b. Public and Private Facilities - c. Regional Distribution of Healthcare Facilities - d. Medical Equipment and Supplies - e. Investment and Utilization - f. Infrastructure Development B. Conclusion C. Addressing Brain Drain PPT Link: https://www.canva.com/design/DAGUHOsdzso/1-xWXZUlKQbaPDBEdLH0-Q/edit?ut m_content=DAGUHOsdzso&utm_campaign=designshare&utm_medium=link2&utm_s ource=sharebutton INTRODUCTION In 2019, the Philippine government enacted Republic Act 11223, also known as the Universal Health Care (UHC) Law, which grants all Filipinos, including Overseas Filipino Workers (OFWs), access to healthcare services through the government’s health insurance program, PhilHealth. Under this law, all Filipinos are automatically enrolled in the National Health Insurance Program managed by the Philippine Health Insurance Corporation, making them eligible for various health benefit packages. Healthcare resources help improve communication between providers and patients, also provide awareness and better understanding of medical conditions, treatment options, preventive strategies for patients, improve health literacy, and access to support services. Health research holds significant value for society by offering critical insights into disease trends, treatment outcomes, healthcare costs, and risk factors, with clinical trials controlling variables to assess the efficacy and side effects of medical interventions, while real-world clinical feedback is essential for refining the use of treatments and diagnostics. I. HEALTHCARE RESOURCES IN THE PHILIPPINES HEALTHCARE SYSTEM OVERVIEW The Philippines has a 7,000 island and is located somewhere in Southeast Asia with a population of 119,106,224. Health is the most essential need of every citizen in order to survive. The Philippine Government wants to provide good-quality healthcare services, so they establish different programs and divide them into two: the public and private sectors, and they have different priorities in the healthcare system; however, the Philippines’ healthcare system is outstanding in metropolitan areas yet inadequate in rural areas. An enormous number of Filipinos rely on public healthcare. Yet, there is a trend for Filipino medical staff to emigrate to Western countries, which puts the system under strain. As a result, certain hospitals are understaffed, and patients may see a delay in treatment. STRUCTURE OF THE HEALTHCARE SYSTEM (PUBLIC VS PRIVATE) Public - Department of Health (DOH) oversees national health policies. - Local Government Units (LGUs) manage primary healthcare facilities. - Primary Healthcare Facilities which includes Barangay Health Centers (BHC), Rural Health Units (RHUs), and City Health Centers. They are found in municipalities, rural, and urban areas and provide different services such as maternal and child health, immunizations, consultations, and disease control programs. - Secondary and Tertiary Healthcare Facilities which are: - For secondary public hospitals: Provincial and District Hospitals that provide advanced care like inpatient services, minor surgeries, and diagnostics and are managed by provincial governments. - For tertiary public hospitals: An example of this are Philippine General Hospital (PGH) and Lung Center of the Philippines where they offer specialized treatments, major surgeries, and complex medical care that are funded and managed by the national government. - PhilHealth provides insurance coverage and a wide range of medical services, including inpatient care, surgeries, maternal health, and dialysis. - The organization created the Universal Health Care (UHC) Act on 2019 to expand their service. This states that all Filipinos automatically become PhilHealth members and can access health services without significant financial burden. Private - Comprises thousands of for-profit and nonprofit health providers. - Market-oriented, paid through user fees at the point of service. - Regulated by the Government through DOH licensure and PhilHealth accreditation procedures. - Provides medical tourism, mainly for low-cost aesthetic and dental procedures. - Comprises clinics, infirmaries, laboratories, hospitals. - Includes drug manufacturers, distributors, drugstores, medical supply companies. - Includes health insurance companies, research institutions, and academics. LEVELS OF HEALTHCARE (PRIMARY, SECONDARY, TERTIARY) A. Primary - Basic level of health care. - Promotion of health, early diagnosis of disease or disability and prevention of disease. - The FIRST CONTACT between community members and other levels of health facilities. 1. Rural Health Unit (RHU) 2. Barangay Health Station (BHS)  3. Puericulture Center 4. Clinics of large Industrial firms - employee 5. Private practitioners or private clinics and others B. Secondary Moderately specialized equipment and laboratory facilities capable of minor surgeries Referral Center for PHC. (Primary health Care) 1. Emergency Hospital 2. District Hospital 3. Provincial Hospital 4. City/ Municipal Hospital C. Tertiary - High technical level - Specialized ICU - Advanced diagnostic services - Diagnosis and treatment of diseases and disabilities. 1. Regional health service 2. Regional medical services and training hospital 3. National health services 4. Medical centers 5. Teaching and training hospital GOVERNMENT HEALTHCARE PROGRAMS 1. The Philippine Acceleration Action Plan for Tuberculosis (PAAP-TB) 2023-2035 - It aims to achieve TB elimination in the Philippines by integrating TB elimination commitments into the mandates, policies, and work programs of government agencies represented in the TB National Coordinating Committee (NCC). 2. Aedes Borne Viral Diseases Prevention and Control Program. - The Philippines faces a significant problem with aedes-borne viral diseases like dengue, which can cause severe complications and even death. The program aims to expand and integrate existing programs to include prevention and control interventions for dengue, zika, and chikungunya, and other diseases with similar vectors. 3. Emerging and Re-Emerging Infectious Disease Program - This program focuses on establishing an organized system for planning, developing, and managing outbreaks of infectious diseases that could escalate into epidemics or pandemics. 4. Chronic-Kidney Disease Prevention and Control - The Philippines faces increasing morbidity and mortality due to Non-Communicable Diseases, particularly Chronic Kidney Disease (CKD). Untreated CKD can lead to severe complications, necessitating urgent interventions like renal replacement therapies. The program aims to promote prevention, control, and proper disease management for CKD patients. 5. Integrated Helmnith Control Program - Soil-transmitted Helminthiasis (STH), caused by common roundworms, whipworms, and hookworms, is a significant public health concern in the Philippines. It affects children's physical health, nutritional status, and school performance. The disease burden is high among vulnerable groups, exceeding the global standard of less than 20% Cumulative Prevalence. The program aims to reduce STH and MHII prevalence.  II. HUMAN RESOURCES IN HEALTHCARE HEALTHCARE WORKFORCE COMPOSITION - Human resources in healthcare refers to the organization of people who provide medical care to populations, which make up a large half of the healthcare system. These are the doctors, nurses, physicians, dentists, and other health workers who collaborate to protect, promote, and prevent diseases, as well as improve the health of the population, health equity, and access, which leads to economic growth. RATIO OF FILIPINO HEALTHCARE WORKERS TO POPULATION (NATIONAL) (2016) - The country’s Human Resources for Health has been fluctuating since 2016. https://www.ibon.org/philippines-declining-health-worker-ratio/ (2021) - In 2021, the distribution of health workers in the country for 2021 revealed that none of the regions met the SDG-recommended ratio of 44.5 health workers per 10,000 people. Additionally, it highlighted disparities in  health worker availability in poorer regions, making healthcare less accessible to Filipinos who are in greater need of it. https://www.ibon.org/in-2021-poorest-regions-least-healthworkers/ (2022) - In 2022, one doctor of medicine served approximately 40.68 thousand people in the Philippines. Among the regions, Region 11 had the highest population-to-doctor ratio at 40.68 thousand, followed by BARMM. In contrast, the National Capital Region (NCR) had a much lower ratio, with one doctor for every 15.3 thousand people. https://www.statista.com/statistics/1122063/philippines-number-of-doctors-by-region/ (The data for 2022 was recently updated noong October 29, 2024, so this was not included sa PPT) (2023) - In 2023, one doctor of medicine was serving about 25.28 thousand people in the Philippines. Across regions, Region BARMM accounted for the highest population-to-doctor ratio at 49.41 thousand, followed by Region 11 (Davao). In contrast, there were 14.22 thousand people for every doctor in the National Capital Region (NCR). https://www.statista.com/statistics/1122063/philippines-number-of-doctors-by-region/ WORKFORCE CHALLENGES The workforce challenges includes: 1. Low wages 2. Limited benefits 3. Migration to better-paying countries 4. Workforce shortages 5. Heavy HCW-to-patient ratio  6. Decrease in the well-being of healthcare workers (HCW) 7. Lack of healthcare facilities in rural areas Almost a fifth of Filipino HCWs are working overseas (Human Resources for Health Migration, 2020). Between April and September 2023, the majority of overseas Filipino workers (OFWs) were employed in Asia, particularly in Saudi Arabia. In contrast, 9.8% of OFWs were working in North and South America, while 8.4% were in Europe (Statista, 2024). There is a shortage of 190,000 healthcare workers in the Philippines (Department of Health, 2024). Only 2,593 rural health units are functioning in the Philippines (David, 2023). According to the Department of Health (DOH), there is a shortage of 190,000 healthcare workers in the Philippines, what prompted this is the poor working conditions, low wages, and limited benefits faced by healthcare workers which often leads to migration to other countries, almost a fifth of Filipino HCWs are working overseas (Human Resources for Health Migration, 2020). Between April and September 2023, the majority of overseas Filipino workers (OFWs) were employed in Asia, particularly in Saudi Arabia. In contrast, 9.8% of OFWs were working in North and South America, while 8.4% were in Europe (Statista, 2024). These migrations results in shortages that necessitate increased workloads and long hours of work for the remaining staff to compensate for the other responsibilities in the hospital. These demanding conditions contribute to brain drain and physical discomfort among healthcare professionals, eventually hindering the effective delivery of healthcare services. A study on the physical well-being of nurses was conducted, and the results showed that most nurses working long shifts and making up for the extra responsibilities in a hospital experienced back pain, headaches, and an overall decline in their physical health. Another pressing workforce challenge is the lack of healthcare facilities in rural regions, the majority of rural areas in the Philippines do not have the access to basic healthcare services compared to urban cities. According to the DOH’s Health Undersecretary Lilibeth David, only 2,593 rural health units are functioning in the Philippines. GOVERNMENT AND PRIVATE SECTOR INITIATIVES 1. Human Resources for Health Deployment Program - This program deploys health professionals, such as doctors, nurses, and midwives, to rural and underserved areas to address staffing shortages. In recent years, tens of thousands of healthcare workers have been deployed annually. 2. Return Service Agreements (RSA) - Government-funded scholarship recipients in health-related programs are required to serve in public health roles for a set number of years after graduation. This aims to ensure equitable distribution of healthcare professionals, especially in geographically isolated and disadvantaged areas (GIDA) PRIVATE SECTOR INVOLVEMENT 1. Public-Private Partnerships (PPP) - The private sector collaborates with the government on initiatives such as the "RESBAKUNA sa Botika" campaign, where pharmacies helped in COVID-19 vaccination efforts. This partnership between private clinics, pharmacies, and government bodies aims to make healthcare more accessible. 2. Innovations in Healthcare - Companies like AC Health and KonsultaMD are improving access to healthcare through health tech apps and expanding affordable drugstore networks. These initiatives help overcome geographical barriers to healthcare access  III. PHYSICAL RESOURCES IN HEALTHCARE A. Healthcare Facilities Types of facilities (hospitals, health centers, clinics) https://hfsrb.doh.gov.ph/list-of-licensed-health-facilities/ Ambulance Service Provider Dental Laboratories (Dental Lab) Ambulatory Surgical Clinic (ASC) Drug Abuse Treatment and Rehabilitation Birthing Home Facility Centers (DATRC) Blood Service Facility (BSF) Drug Testing Laboratories (DTL) Cancer Treatment Facility Kidney Transplant Facilities Clinical Laboratory Medical Facilities for Overseas Workers and Clinical Laboratory for Molecular Pathology Seafarers (MFOWS) Covid-19 Testing Laboratory DOH Recognized Certifying Bodies for Dialysis Clinic MFOWS Quality System Standards Hospital Laboratories for Drinking Water Analysis Infirmary (LDWA) Primary Care Facility (PCF) Laboratories for Chemical Analysis for Psychiatric Care Facilities Dialysis Water Human Stem Cell/ Cellular Therapy Facilities PUBLIC VS PRIVATE FACILITIES https://www.trade.gov/country-commercial-guides/philippines-healthcare https://www.internationalinsurance.com/health/systems/philippines.php Private - Private hospitals focus on specialized care for cardiovascular diseases, cancer, pulmonology, and orthopedics. Usually means additional comfort for patients. With fewer people seeking care, it’s often faster to obtain treatment. Plus private facilities have more up-to-date equipment. Public - Public hospitals focus their efforts on preventive and primary care while also taking the lead in educating the public on health issues. Hospitals have sometimes struggled with staffing levels, as care providers can often find better-paying jobs in the private sector or by moving overseas. Due to the issues with staffing and the fact that more patients seek care at these facilities, treatment delays are not uncommon at public hospitals. Those who can afford it often turn to private settings. REGIONAL DISTRIBUTION OF HEALTHCARE FACILITIES - Number of health facilities in the Philippines as of January 2024, by region https://www.statista.com/statistics/1447058/number-of-health-facilities-by-region-philippines/ (Visual Representation) MEDICAL EQUIPMENT AND SUPPLIES - Diagnostic equipment such as X-rays, CT scanners, and MRIs are distributed unevenly. For example, the NCR has 132 X-ray units per million people, while Mindanao only has 26.  - There are 46 X-ray machines and 4.2 CT scanners per million people, but only 0.8 MRI units per million people, indicating limited access to advanced diagnostic equipment in many areas. INVESTMENT AND UTILIZATION - The Department of Health’s (DOH) Health Facilities Enhancement Program (HFEP) focuses on upgrading primary care facilities, improving local government hospitals, and reducing congestion in tertiary hospitals. Between 2014 and 2015, the government allocated PHP 26.8 billion for infrastructure and equipment improvements. - Investments have disproportionately favored DOH hospitals, with higher per-facility funding compared to local government-run hospitals, potentially worsening disparities in health service quality between central and peripheral areas. INFRASTRUCTURE DEVELOPMENT - The number of hospital beds has grown from 79,444 in 2001 to 101,688 in 2016, with a nearly equal split between public and private sectors. - However, infrastructure development is concentrated in economically developed areas, particularly in Luzon and the National Capital Region (NCR), which has a highconcentration of hospitals and larger facilities. - 66% of hospitals are located in Luzon, with the NCR having the largest hospitals, averaging 182 beds per hospital. In contrast, hospitals in other regions are much smaller, with 58 beds in Luzon outside the NCR, 91 beds in the Visayas, and 75 beds in Mindanao. - The distribution of beds per population shows stark disparities: 23 beds per 10,000 people in the NCR, but only 7.8 to 8.3 beds in the Visayas, Mindanao, and the rest of Luzon. CONCLUSION The healthcare system in the Philippines is marked by a blend of challenges and opportunities. While the enactment of the Universal Health Care Law in 2019 has significantly enhanced access to services for all Filipinos, ongoing disparities in healthcare resources, workforce shortages, and the uneven distribution of facilities remain critical issues. Addressing these challenges requires coordinated efforts from both the government and the private sector to improve infrastructure, enhance the quality of care, and ensure the well-being of healthcare workers. By investing in human resources and fostering innovations in healthcare delivery, the Philippines can work towards a more equitable and effective healthcare system that truly serves the needs of its diverse population. Ultimately, a comprehensive approach to healthcare resource management will be essential in achieving better health outcomes and promoting overall public health in the country. ADDRESSING BRAIN DRAIN Q: How can we address the workforce challenges in the Philippines that drive healthcare workers to migrate to other countries? A: The migration of healthcare workers from the Philippines is driven primarily by low wages, limited career opportunities, and challenging working conditions within the local healthcare systems. Many healthcare workers often find better compensation, professional development, and a healthy work environment, relative to what is readily available locally. This drain has created a significant number of shortages, particularly in rural areas, where the ratio of doctors to patients and nurses to patients is extremely low. In addressing these challenges , it requires an integrated approach. First, the government could implement competitive salary packages and benefits to match global standards, such as hazard pay, health insurance, and retirement plans to compensate workers for risks they face in the medical field, especially in challenging environments. Additionally, the healthcare system in the Philippines has a high patient-to-healthcare worker ratio, which prompts staff to work long hours to compensate for the extra responsibilities in the hospital. This causes brain drain and physical discomfort among healthcare workers. The government can address this challenge by ensuring sufficient staffing levels by allocating a larger budget to hire more healthcare workers to avoid burnout, and create a positive and supportive work environment that values and respects healthcare workers, keeping more staff in the healthcare system. The government could also partner with organizations to help fund healthcare initiatives, scholarships, support staffing needs, and provide additional resources and facilities to provide a healthier workplace. Healthcare workers seek growth in their specialized fields, if the government can provide opportunities for their advancement like research and medical training to further improve their profession then it might be a chance for them to make them stay in their own country. There are some policies that can support healthcare workers in balancing their work-life. If the government can provide such an environment then the favor of the healthcare workers staying might increase. There are instances that there is only one doctor with a lot of patients and it's difficult for them to keep up, their mental, emotional, and physical health are being affected. As a healthcare professional it is important to take care of the patients so the government or the hospitals should have rules regarding the balance of work and their life to encourage them to stay and keep working in their home country. Lastly, addressing the root causes of healthcare migration requires long-term investment in the education and training of healthcare professionals. A larger budget will help improve the laws that allow Filipino professionals to earn more money and enjoy better perks. Improving the country's workforce quality will make healthcare workers more driven and effective in their jobs. 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