CHN 1-2.pdf

 The Philippine Health Care Delivery System and the Primary Health Care Approach At the end of the lesson, the student should be able to: 1. assess the impact of Primary Health Care strategy in the Philippine setting. 2. explain the dynamics of the Philippine Health Care Delivery...

 The Philippine Health Care Delivery System and the Primary Health Care Approach At the end of the lesson, the student should be able to: 1. assess the impact of Primary Health Care strategy in the Philippine setting. 2. explain the dynamics of the Philippine Health Care Delivery System; and The Health Care Delivery System of the Philippines World Health Organization The premier global health organization is made up of 193 member countries, the Philippines of which is included. The core functions of the World Health Organization are the following: 1. Providing leadership on matters critical to health and engaging in partnerships where joint action is needed 2. Shaping the research agenda and stimulating the generation, translation and disseminating valuable knowledge. The goals of research are the following:  Capacity building  Focusing on priority health needs  Promoting standards for good research  Ensure translation of results to products and policy  Organization to strengthen the research culture within WHO  3. Setting norms and standards and promoting and monitoring their implementation 4. Articulating ethical and evidenced based policy options 5. Providing technical support, catalyzing change and building sustainable institutional capacity The Local Government Code of 1991 (Republic Act 7160) Devolves health services to the local government unit (LGU). This law thereby created 2 entities, the National Government and the Local Government Units (LGU). It likewise pave the way for creating of the Local health boards made up of the City/Municipal Health Boards and the Provincial Health Boards. Function of the Local Health Boards 1. Propose to Sanggunian the annual budgetary allocation 2. Serves as an advisory committee to the Sanggunian 2. Creates committees that shall advise local health agencies The Department of Health The Department of Health (DOH) serves as the main governing body of health services in the Philippines. It is a National Health Agency. It is headed by the Secretary of Health who is part of the Presidential cabinet. It is mandated to lead the health sector towards assuring quality health care for all Filipinos. DOH Vision The vision of the DOH is to be a global leader for attaining better health outcomes, competitive and responsive health care system and equitable health care financing. Major Roles of the Department of Health (DOH) 1. Leader in Health a. Planning and formulating policies of health programs and services b. Monitoring and evaluating the implementation of health programs c. Advocating for health promotion and healthy lifestyle d. Serving as a technical authority in disease control and prevention e. Providing administrative and technical leadership in health care financing and implementing the National Health Insurance Law 2. Enabler and capacity builder a. Providing logistical support to the LGUs b. Serving as the lead agency in health and medical research c. Protecting standards of excellence in the training and education of health care providers at all levels of the health care system and response services 3. Administrator of specific services a. Administrator of selected health facilities at subnational levels that act as referral centers for local health systems. This include tertiary hospitals, special hospitals, reference laboratories, training centers, centers for health promotion centers for disease control and prevention and regulatory offices b. Provide specific program components for conditions that affect large segment of the population c. Develop strategies for responding to emerging health needs d. Provide leadership in health emergency preparedness The Local Government Unit Because of the Local Government Code, key health interventions are now being cascaded to the LGU’s through their health arm 1. The City Health Offices in chartered cities 2. Integrated Provincial Health Office/Rural Health Units in provincial towns The Health Referral System Referral is a set of activities undertaken by a health care provider or facility in response of its inability to provide the necessary health intervention to satisfy a patient’s need. To ensure the continuous care when doing referral, a system is adopted to enable the patient to receive seamless care across the different levels of the health care delivery system. This is the two way referral system. The Inter-local Health Zone (ILHZ) This is based on a concept of the District Health System, a term that describes integrated health management based on a defined administrative or geographical area. An ILHZ has a defined catchment population within a defined geographical area. It is made up of the following: 1. Central or Core referral hospital 2. A number of primary level facilities like Rural Health Units and Barangay Health Centers Components of Inter-local Zone (ILHZ) 1. People- ahealth district has around 100,000 to 500,000 population 1. Boundaries- there has to be clear boundaries between ILHZs to establish accountability and responsibility 2. Health facilities – made up of Rural Health Units, Barangay Health Centers that decide to work together as an integrated health system 3. Health Workers- includes personnel of the DOH, District or Provincial Hospitals, Rural Health Units, Barangay Health Stations, Private Clinics, NGOs and Community Based Organizations Levels of Health Care Delivery A. Hospitals Level 1 General Hospitals Level 2 Specialty Hospitals Level 3 Training Hospitals B. Other facilities  Primary care facility  Custodial care facility  Diagnostic, therapeutic facility  Specialized outpatient facility Category A (Primary level Facility) -a first contact facility that offers basic services including emergency services and provision for normal deliveries a. Without in-patient beds (Example: Health centers, Out-patient clinics, Dental clinics) b. With in- patient beds (Example: Infirmaries, Birthing facilities) 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 Example: Facilities for mental health, Drug abuse treatment facilities Category C (Diagnostic/Therapeutic facility) - facility for examination of human boy for the diagnosis of diseases disabilities. Ex. Clinical laboratories, radiologic facilities, nuclear medicine facilities Category D (Specialized Out-Patient facilities) - performs highly specialized procedures Example: Dialysis clinics, Chemotherapy clinics  The Primary Health Care as a Strategy The improvement in health quality of the populace is a continuing challenge for societies and governments. In spite of the many advances, the vast majority of the population still barely meet the minimum standards for health care and human development. Hence, an overall approach in the delivery of health services is necessary- a strategy that engages both the health workers and the people themselves as partners and a strategy that is affordable to the government yet still effective and acceptable to the communities. A strategy that insures access to health care regardless of economic class. These are the very reasons why World Health Organization (WHO) has supported the global implementation of Primary Health Care. This strategy started in Sept 6-12, 1978 during the First International Conference in primary Health Care in Alma Ata, Russia. Alma Ata Declarations a. Health is a basic fundamental right; b. There exists global burden of health inequalities among populations; c. Economic and social development is of basic importance for the full attainment of health for all; and d. Governments have responsibility for the health of their people. Definition of Primary Health care (PHC) According to Alma Ata Conference, Primary Health Care is defined as an essential care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to all individuals and families through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self- determination. Health for All: The Universal Goal of Primary Health Care Main objectives: 1. Promotion of healthy lifestyles 2. Prevention of diseases 3. Therapy for existing condition Key Elements for “Health for All” 1. Reducing exclusion and social disparities in health (Universal Coverage) 2. Organizing health services around people’s needs and expectations (health service reforms) 3. Integrating health into all sectors (public policy reforms) 4. Pursuing collaborative models of policy dialogue (leadership reforms) 5. Increasing stakeholders’ participation Essential Elements of PHC E-education for health L-locally endemic disease control E-expanded program on immunization M-maternal and child health E-essential drugs N-nutrition T-treatment of communicable and non-communicable diseases S-safe water and sanitation Key Principles of PHC 1. Accessibility, affordability, acceptability and availability 2. Support mechanisms 3. Multi-sectoral approach 4. Community participation 5. Equitable distribution of health resource 6. Appropriate technology Accessibility Usually refers to the distance of a health facility or the travel time required for people to get the needed service. This requires the existence of a facility within reasonable distance from the catchment required by the people are offered in the health care facility population or the people it is meant to serve. Affordability It is not only in consideration of the individual or family’s capacity to pay for basic health services. Particularly for public health services, it is also a matter of whether the community or government can afford these services. Acceptability Means that the health care offered is in consonance with prevailing culture and traditions of the population. Availability Is a question whether the basic health services required by the people are offered in the health care facilities or is provided on a regular bases.