Health Delivery System PDF

HEALTH CARE DELIVERY SYSTEM In global perspective… United Nations (UN) World Health Organization (WHO) Centers for Disease Control and Prevention (CDC)  The United Nations is an international organization founded in 1945. It is currently made up of 193 Member States. The miss...

HEALTH CARE DELIVERY SYSTEM In global perspective… United Nations (UN) World Health Organization (WHO) Centers for Disease Control and Prevention (CDC)  The United Nations is an international organization founded in 1945. It is currently made up of 193 Member States. The mission and work of the United Nations are guided by the purposes and principles contained in its founding Charter. Functions Maintain international peace and security Protect human rights Deliver humanitarian aid Promote sustainable development Uphold international law  Goal “To improve equity in health, reduce health risks, promote healthy lifestyles and settings, and respond to the underlying determinants of health”.  Objectives To develop and implement multisectoral public policies for health, integrated gender- and age-sensitive approaches that facilitate community empowerment together with action for health promotion, self-care and health protection throughout the life course in cooperation with the relevant national and international partners.  Indicators Degree of integration of health promotion into national health strategies and services and appropriate settings. Sustainability of financing of health promotion interventions in countries.  Strategic approaches WHO's health promotion strategic approaches are: advocating for policy support and investment in the development of health systems and services that support health promotion and risk prevention; fostering health-supportive environments and integrated approaches to public health services; strengthening the sustainable financing and evidence base required for health promotion; increasing the knowledge base for tackling the broad determinants of health. Mission CDC works 24/7 to protect America from health, safety and security threats, both foreign and in the U.S. Whether diseases start at home or abroad, are chronic or acute, curable or preventable, human error or deliberate attack, CDC fights disease and supports communities and citizens to do the same. CDC increases the health security of our nation. As the nation’s health protection agency, CDC saves lives and protects people from health threats. To accomplish our mission, CDC conducts critical science and provides health information that protects our nation against expensive and dangerous health threats, and responds when these arise. PHILIPPINE HEALTH CARE DELIVERY SYSTEM Department of Health DOH The Department of Health (DOH) holds the over-all technical authority on health as it is a national health policy-maker and regulatory institution. Basically, the DOH has three major roles in the health sector: (1) leadership in health; (2) enabler and capacity builder; and (3) administrator of specific services. Its mandate is to develop national plans, technical standards, and guidelines on health. Aside from being the regulator of all health services and products, the DOH is the provider of special tertiary health care services and technical assistance to health providers and stakeholders. DOH While pursuing its vision, the DOH adheres to the highest values of work, which are: Integrity – The Department believes in upholding truth and pursuing honesty, accountability, and consistency in performing its functions. Excellence – The DOH continuously strive for the best by fostering innovation, effectiveness and efficiency, pro-action, dynamism, and openness to change. Compassion and respect for human dignity – Whilst DOH upholds the quality of life, respect for human dignity is encouraged by working with sympathy and benevolence for the people in need. DOH Commitment – With all our hearts and minds, the Department commits to achieve its vision for the health and development of future generations. Professionalism – The DOH performs its functions in accordance with the highest ethical standards, principles of accountability, and full responsibility. Teamwork – The DOH employees work together with a result-oriented mindset. Stewardship of the health of the people – Being stewards of health for the people, the Department shall pursue sustainable development and care for the environment since it impinges on the health of the Filipinos. DOH 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 people-centered, resilient, and equitable health system PHILIPPINE HEALTH CARE DELIVERY SYSTEM 1. Public Sector - largely financed through a tax-based budgeting system at both national & local levels & where health care is generally given free at the point of service PHILIPPINE HEALTH CARE DELIVERY SYSTEM - National: DOH - Local: LGU *can be in the city or municipality *includes health centers or barangay health stations PHILIPPINE HEALTH CARE DELIVERY SYSTEM 2. Private Sectors – market oriented; health care is paid through user fees at the point of service - clinics - hospitals - health insurance - manufacturing of medicines - vaccines -medical supplies - equipments - nutrition products - research & development - or other any health related items PHILIPPINE HEALTH CARE DELIVERY SYSTEM Department of Health History: 1. Before 1898 During the pre-Spanish period, traditional ways of healing (i.e., herbs and rituals) were widely used. Public health services in the Philippines began in 1577 when a Franciscan friar, Fr. Juan Clemente, established a dispensary for Manila indigents. In 1659, the dispensary became the San Juan de Dios Hospital. PHILIPPINE HEALTH CARE DELIVERY SYSTEM Department of Health 2. June 23, 1898 - creation of E. Aguinaldo government of Department of Public Works, Education & Hygiene 3. September 29, 1898 - gen. order no. 15 established the Board of Health for the city of Manila  PHILIPPINE HEALTH CARE DELIVERY SYSTEM 4. August 26, 1899, the Board of Health was abolished while Dr. Guy Edie was appointed as the first Commissioner of Health. Registration of births, deaths, and marriages began during this time. 5. July 1, 1901 - Act no. 157: Board of Health of Philippine Islands 6. October 26, 1905 - Act no. 1407: establishment of Bureau of Health. Dr. Victor Heiser was the first director.  PHILIPPINE HEALTH CARE DELIVERY SYSTEM 7. 1912 - Act no. 2156 (Fajardo Act): health fund for travel and salaries 8. 1915 - Act no. 2568: from BOH to Philippine Health Service “ semi-military system of public health administration”. Dr. Vicente de Jesus was the first Filipino director. PHILIPPINE HEALTH CARE DELIVERY SYSTEM 9. 1932 - Act no. 4007: Reorganization Act of 1932 created the Office of the Commissioner of Health and Public Welfare with Dr. Basilio J. Valdez as its first Commissioner. PHILIPPINE HEALTH CARE DELIVERY SYSTEM 10. 1941 On January 7, 1941, the Executive Order No. 317 formalized the Department of Public Health and Welfare with Dr. Jose Fabella as its first Department Secretary. The Department included the following: Bureau of Quarantine; health department of chartered cities; provincial, city, and municipal hospitals; dispensaries and clinics; public markets and slaughter houses; health resorts; and all charitable agencies. PHILIPPINE HEALTH CARE DELIVERY SYSTEM 11. October 4, 1947 - E.O. no. 94: post war reorganizaton of the Department of Health & Public Welfare - resulted in the split of Department of Public Welfare (w/c became Social Welfare Administration) and Philippine General Hospital to the Office of the President PHILIPPINE HEALTH CARE DELIVERY SYSTEM 11. October 4, 1947 (cont….) - another split between curative (Bureau of Hospitals ) & preventive services (Bureau of Health) - Nursing Service Division was also established PHILIPPINE HEALTH CARE DELIVERY SYSTEM 12. January 1, 1951 - conversion of Sanitary District to Rural Health Unit, carrying the ff. services: *maternal & child health *environmental health *communicable disease control *vital statistics *medical care *health education *public health nursing  PHILIPPINE HEALTH CARE DELIVERY SYSTEM 12. January 1, 1951 (cont…) - resulted in passage of Rural Health Act of 1954 (RA 1082) 13. 1970 - conceptualization of the Restructured Health Care Delivery System (primary, secondary & tertiary levels of care) PHILIPPINE HEALTH CARE DELIVERY SYSTEM 14. June 2, 1978 - P.D. 1937 renamed DOH to Ministry of Health during the Martial Law - Sec. Gatmaitan was the 1st minister of health PHILIPPINE HEALTH CARE DELIVERY SYSTEM 15. December 2. 1982 - E.O. 851 reorganized Ministry of Health as an integrated health care delivery system through the creation of Integrated Provincial Health Office, combining the public health and hospital operations under the PHOs PHILIPPINE HEALTH CARE DELIVERY SYSTEM 16. April 13, 1987 - E.O. no. 119: MOH was back in the name Department of Health by Cory Aquino PHILIPPINE HEALTH CARE DELIVERY SYSTEM 17. 1991-1993 The Republic Act 7160 or Local Government Code of 1991 was fully implemented. The Office for Special Concerns was formed from the branching out of the Office of Public Health Services. The Office of Hospital Facilities, Standards and Regulation was created from the merging of two big offices. PHILIPPINE HEALTH CARE DELIVERY SYSTEM 17. 1991-1993 Health projects were intensified. Among these projects are National Micronutrient Campaign, Disaster Management, Urban Health and Nutrition Project, Traditional Medicine, Doctors to the Barrios Program, and "Let’s DOH It"! PHILIPPINE HEALTH CARE DELIVERY SYSTEM 18. May 24, 1999 - E.O. 102 “Redirecting the Functions & Operations of the DOH” by J. Estrada 19. 1999-2004 - Development of the Health Sector Reform Agenda PHILIPPINE HEALTH CARE DELIVERY SYSTEM 20. 2008 The Maternal, Neonatal, and Child Health and Nutrition Strategy (MNCHN) was pursued to address maternal and neonatal mortality. Republic Act No. 9502 or the Universally Accessible Cheaper and Quality Medicines Act of 2008 made quality medicines more accessible to every Filipino. PHILIPPINE HEALTH CARE DELIVERY SYSTEM 20. 2010 With the appointment of Dr. Enrique T. Ona as the new Health Secretary came a new platform on health – the Universal Health Care (UHC). This reform agenda aims to make essential health services, necessities, and quality health care available and accessible to all Filipinos. “PhilHealth Sabado,” as one of the initiatives to achieving UHC, was launched on October 2 of this year. PHILIPPINE HEALTH CARE DELIVERY SYSTEM Dec 2014 to Jun 2016 - Dr. Janette Loreto Garin (DOH Secretary) July 2016 to Oct 2017- Dr. Paulyn Jean B. Rosell-Ubial (DOH Secretary) Oct 2017 to Jun 2022 - Dr. Francisco Duque III (DOH Secretary) July 2022 to June 2023 - Dr. Maria Rosario Vergeire (OIC-DOH Secretary) Jun 2023 to present – Dr. Teodoro J. Herbosa (DOH Secretary) PHILIPPINE HEALTH CARE DELIVERY SYSTEM 2018 – RA 11223 “Universal Health Care Act” an act instituting health care for all Filipinos, prescribing reforms in the health care system and appropriating funds therefore PRIMARY HEALTH CARE AS AN APPROACH TO DELIVERY OF HEALTH CARE SERVICES PHC was declared during the 1st International Conference on Primary Health Care held in Alma Ata, USSR on Sept. 6-12, 1978 by WHO The goal was “Health for All by the Year 2000” This was adopted in the Philippines through the letter of instruction 949 signed by Pres. Marcos on Oct. 19, 1979 & has underlying theme of “Health in the Hands of the People by 2020” Components of Primary Health Care 1. Environmental Sanitation 2. Control of Communicable Diseases 3. Immunization 4. Health Education 5. Maternal and Child Health and Family Planning 6. Adequate Food and Proper Nutrition 7. Provision of Medical Care and Emergency Treatment 8. Treatment of Locally Endemic Diseases 9. Provision of Essential Drugs 4 Pillars in Primary Health Care Active community participation Intra and inter-sectoral linkages Use of appropriate technology Support mechanism made available  Types of Primary Health Care Workers Various categories of health workers make up the PHC team. It depends upon: - available health manpower services - local health needs and problems - political and financial feasibility  Types of Primary Health Care Workers 2 levels of PHC workers: 1. Village / Barangay Health Workers – trained community workers, volunteer, traditional birth attendant, or healer 2. Intermediate Level Health Workers – medical practitioners or their assistants, public health nurse, sanitary inspector, midwives LEVELS OF HEALTH CARE AND REFERRAL SYSTEM Primary Level of Care Devolved to cities and municipalities Provided by physicians, PHN, RHM, BHW, traditional healers, etc. at barangay stations or rural health units Primary health facility is usually the first contact between the community members & other levels of health facility LEVELS OF HEALTH CARE AND REFERRAL SYSTEM Secondary Level of Care Given by physicians w/ basic health training Usually given in health facilities either private or government operated Serves as a referral center for the primary health facilities Are capable of performing minor surgeries and perform simple laboratory examinations LEVELS OF HEALTH CARE AND REFERRAL SYSTEM Tertiary Level of Care Rendered by specialists in health facilities including medical centers as well as regional and provincial hospitals, and specialized hospitals This is the referral center for secondary care facilities Complicated case and intensive care requires tertiary care and all these can be provided by the tertiary care facility