Lesson 2 Health System PDF

LESSON 2 HEALTH SYSTEM Health Information System - Lecture Intended Learning Outcomes define health system in the international, national, and 01 local perspectives; identify the goals and functions of a health system; 02 explain the relationship between the system bu...

LESSON 2 HEALTH SYSTEM Health Information System - Lecture Intended Learning Outcomes define health system in the international, national, and 01 local perspectives; identify the goals and functions of a health system; 02 explain the relationship between the system building 03 blocks and health outcomes; and familiarize themselves with the structure of the Philippine 04 health system. HEALTH SYSTEM A health system is a combination of resources, organizations, financing, and management to deliver health services to the population (Roemer, 1991). Key components include: Each part plays a role in: Community Governance Ministries of health Health service provision Healthcare providers Resource management and Pharmaceutical companies financing Health financing bodies Other related organizations Health System In the World Health Report (WHO, 2000), the health system is defined as "all the organizations, institutions, resources, and people whose primary purpose is to improve health” A well-performing health system: Provides health-improving activities Promotes health equity Includes personal healthcare, public health services, and intersectoral initiatives 4 GOALS AND FUNCTIONS OF A HEALTH SYSTEM The World Health Organization (WHO) identifies three (3) main goals of a health system: Improving the Improving the Providing Fair health of responsiveness Health Financing populations of the health system Ensure equitable Overarching goal: Focus on providing financing so that people Enhance health for all quality, respectful, and can access needed care populations. timely health services. without financial Address health Engage people as active hardship. disparities caused by partners in their care. Avoid discouraging care- factors like income, Ensure services meet seeking due to high out- gender, and geography. both health and non- of-pocket costs. Health systems should health needs, prioritizing Fair financing means aim for equity, patient autonomy and individuals contribute a minimizing disparities dignity. similar percentage of within and between countries. income for services.  Four Vital Health System Functions 1. Health service provision 3. Stewardship The most visible product of Overall system the health system is public oversight and private health service provision. 2. Health service inputs 4. Health financing Managing resources Health system financing involves ensuring includes raising and availability of medications, pooling resources to pay staff, and equipment. for health services.  Vital Health System Functions 1. Health service provision Health service provision is the primary output of the health system. Includes both clinical services and preventive measures to improve population health. A comprehensive system addresses various health needs, from treatment to health promotion.  Vital Health System Functions 1. Health service provision  Vital Health System Functions 2. Health Service Inputs Health service inputs include the resources necessary for service delivery: medications, medical staff, and equipment. Policymakers must manage resources efficiently, often addressing short-term needs while ensuring long-term resource generation.  Vital Health System Functions 2. Health Service Inputs  Vital Health System Functions 3. Stewardship Stewardship refers to the government's oversight of the health system. Key responsibilities include setting health priorities, coordinating with related systems, and ensuring data-driven decision-making. Ensures the system's effective functioning by providing guidance and structure.  Vital Health System Functions 3. Stewardship The core of the stewardship function includes: a. Identifying health priorities for allocation of public resources; b. Identifying an institutional framework; c. Coordinating activities with other systems related to external health care; d. Analyzing health priorities and resource generation trends and their implications; and e. Generating appropriate data for effective decision- making and policymaking on health matters.  Vital Health System Functions 4. Health Financing Health financing involves raising and pooling funds to pay for services. a. Revenue Collection: Methods include taxation, payroll contributions, out-of- pocket expenditures, and donor financing.  Vital Health System Functions 4. Health Financing b. Risk Pooling: Spreads financial risks across the population, ensuring health services are accessible to all, particularly those facing financial hardship. 1. Bismarck Model: Health insurance funded through payroll deductions, used in Germany, France, etc. 2. Beveridge Model: Government-funded healthcare through taxes, used in the UK, Cuba, etc. c. Strategic Purchasing: Efficient use of pooled funds to finance healthcare services and incentivize providers. WHO HEALTH SYSTEM FRAMEWORK Health System Building Blocks 1. Service Delivery ○ Timely, quality, and cost-effective personal and non-personal health services. 2. Health Workforce ○ Sufficient, competent, and fairly distributed staff to ensure efficiency and responsiveness. 3. Health Information Systems ○ Reliable data on health status, determinants, and system performance for informed decision-making. 4. Health Products, Vaccines, and Technologies ○ Accessible health products through managed supply chains and education on proper usage. 5. Health Financing ○ Ensures sufficient funds for healthcare services, enabling access without financial barriers. 6. Leadership and Governance ○ Effective oversight and regulation, ensuring accountability and proper system design.  The Philippine Health System Historical Background The health reform initiatives in the Philippines focused on health service delivery, health regulation, and health financing, aiming to address issues of poor accessibility, inequity, and inefficiency in the health system. Historical Background 1. 1979: Adoption of Primary Health Care Strategy (LOI 949) - promoted participatory management of the local health care system 2. 1982: Reorganization of DOH (EO 851) - integrated the components of health care delivery into its field operations 3. 1988: The Generics Act (RA 6675) - ushered the writing of prescriptions using the generic name of the drug 4. 1991: Local Government Code (RA 7160) - transferred the responsibility of providing health service to the local government units 5. 1995: National Health Insurance Act (RA 7875) - instituted a national health insurance mechanism for financial protection with priority given to the poor Historical Background 6. 1999: Health Sector Reform Agenda - ordered the major organizational restructuring of the DOH to improve the way health care is delivered, regulated, and financed 7. 2005: FOURmula One (F1) for Health - adopted an operational framework to undertake reforms with speed, precision, and effective coordination and to improve the Philippine health system 8. 2008: Universally Accessible Cheaper and Quality Medicines Act (RA 9502) - promoted and ensured access to affordable quality drugs and medicines for all 9. 2010: Kalusugang Pangkalahatan or Universal Health Care (AO 2010-0036) - provided universal health coverage and access to quality health care for all Filipinos  Leadership and Governance Overview - Mandate of the Department of Health (DOH): - Provides direction for the nation's health care industry. 1. Develops plans, guidelines, and standards for the health sector. 2. Offers technical assistance, 3. Capacity building, 4. Advisory services. 5. Manages medical supplies and vaccines. Collaboration with Local Government Units (LGUs): ○ Health services managed by LGUs under the Local Government Code (R.A. 7160). ○ LGUs comprise 78 provincial governors, 138 city mayors, 1,496 municipal mayors, and 42,025 barangay chairpersons (NSCB, 2010).  Leadership and Governance Overview LGUs grouped into 17 regions under DOH regional health offices. Provincial governments manage provincial and district hospitals. Cities and municipalities rely on public health and primary care centers. DOH Responsibilities: 1. Develop policies and programs. 2. Provide technical assistance and encourage partner performance. 3. Design and enforce health standards. 4. Deliver specialized and tertiary-level care. Leadership and Governance Overview Pre-Devolution Structure: ○ Centralized system with DOH managing three tiers: 1. National and regional tertiary hospitals. 2. Provincial and district hospitals. 3. Barangay health centers. Post-Devolution Structure (LGC 1991): ○ Cities/municipalities handle basic health services (e.g., health promotion and prevention). ○ Provinces manage district hospitals. ○ DOH oversees tertiary medical centers, specialty hospitals, and re-nationalized provincial hospitals. Directions of the Philippine Health Sector Slogan: "All for Health Towards Health For All" for a Healthy Philippines by 2020” Universal Health Care (UHC) expanded through a whole-of- government approach. With this agenda, the health system guarantees: a. population- and individual-level interventions for all life stages that promote health and wellness, prevent and treat the triple burden of disease, delay complications, rehabilitation, and provide palliation for both the well and the sick; b. access to health interventions through functional service delivery networks (SDNs); and c. financial freedom when accessing these interventions through Universal Health Insurance Directions of the Philippine Health Sector 2. The Philippine Development Plan 2017-2022 This is the first of the four key medium-term plans to translate the vision of a "matatag, maginhawa, at panatag na buhay" for the Filipinos and the country. 3. NEDA AmBisyon Natin 2040 A product of the Philippine Development Plan 2017-2022, this collective long-term plan envisions better life for the Filipinos and the country in the next 25 years by formulating policies and implementing programs and projects to attain this AmBisyon. This plan focuses on four areas: building a prosperous, predominantly middle-class society where no one is poor; promoting a long and healthy life; becoming smarter and more innovative; and building a high-trust society. 4. Sustainable Development Goals 2030 Also known as the 2030 Agenda, this compilation of 17 global development goals targets to end poverty, fight inequality and injustice, and confront issues involving climate change. Thank You 27