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Related Downloads
Health Service Delivery
HHRD
Policies
Policies in HRH
Presentation of Dr. Arcadio
Presentation of Dr. Montoya
Presentation of Prof Taguiwalo
Presentation of Sec. Rosero
Presentation of Usec. Lozada
summary per theme
Policies Governing the Practice of the Health Professions and Health Care Delivery Training and certification standards in the Philippines are still the highest in the Asian region, as long as they are done properly. The country’s curricular programs are known to be globally competitive with competent trainers and instructors. But this has been tainted by incidents of professional board leakages, sprouting of schools offering health profession programs without sufficient trained faculty and facilities as well as weak implementation of the regulation of non-performing schools.
When it comes to the practice of health professions, most of the laws regulating practice is are outdated and needs to be amended. The Philippine Medical Act of 1959 has not been updated since its promulgation almost 4 decades ago. Some practice acts are currently being studied in order to update them.
Health Human Resource Development
The Health Human Resources or Human Resources on Health (HRH) include the health professionals who are graduates of formal degree programs and practicing as health care professionals, and the non-health professionals who are graduates of vocational and technical schools. The former are products of higher education institutions accredited and supervised by the Commission on Higher Education (CHED) while the latter are under the Technical Education and Skills Development Authority (TESDA). The Health Human Resource Development can be divided into Planning, Production and Management.
Planning is facilitated by having a central databank of statistics that takes stock of a country’s HRH and enables one to do workforce projections. The Department of Health, however, has completed the stock survey and workforce projection validation of two regions and will hopefully finish the rest before the year ends. In the government service, unfilled positions exist. In the Department of Budget and Management data of 2004, for example, 42.3 % occupational therapy, 8.6 % physical therapy, 8.2 % medical and 5.5 nursing positions were vacant. In an International Labour Office study, the reason given was the “rapid turnover and other administrative and political factors”. In some areas, casual or contractual personnel were hired instead of full-time health employees.
Production is concerned with the enrollment and graduation by the schools and licensing of the graduates by the Professional Regulations Commission. There is a trend in some programs such as nursing. Because of the demand abroad, nursing schools have dramatically increased in number. However, there is an opposite trend in other health professions. Also, there is a disturbing decrease in the quality of graduates as evident in the decreasing passing rate in the board exams.
Management involves the retention, support and development of the workforce. In one data, many health professionals were going abroad since the 1960’s. The primary reason for this problem is the great disparity in terms of salaries between what the international market has to offer than that of the local. In the local set-up, there is also a difference between the salaries of government and private health workers. Another problem is the disproportionate distribution of health professionals with the majority of them flocking to the country’s urban areas and metropolitan centers.
Health Research and Development
Research and development in the health sector is faced with two interdependent challenges. On one hand, there is a lack of investment into health R & D. At the same time, there is also a lack of “research culture” that would create demand to push for significant investments. The lack of “research culture” means that there is a lack of interest among students and practitioners to do research.
The current curricular programs indicate that there is a deficiency in research-focused courses. Few faculty and practitioners are actively involved in research. This has resulted in minimal research output. There is a lack in collaborative and substantive research since more researches are produced only as graduation requirements for students. There is also a lack of support in terms of institutional infrastructure, access to resources such as funding and knowledge databases. Research therefore has become a means to an end, such as accreditation or compliance to requirements, rather than as an investment.
On the other hand, there is also a low utilization and dissemination of research outputs. Publications are few and far between.
Financing of Health Care
“Health financing helps individuals and communities improve their health by paying the right cost of capacity and providing the right goods and services used appropriately at the right time, i.e., the money outcome of interaction satisfies both provider and beneficiary, and there is evidence of health benefit that is generated” (Taguiwalo). Each major stakeholder in the health system has a concern as regards health financing. For the patient, the concern is how to pay for the costs of care needed. For the provider, the concern is how to get paid for costs of care provided. For the public health manager, the concern is how to get funding for the required interventions. How these concerns are addressed determine the health status of individuals and communities. There are two aspects of financing: sources or where money comes from (e.g., from government, insurance, households) and uses or where it goes (e.g., for drugs, professional fees, hospitals).
In the Philippines, the sources of financing in 2005 came from out-of-pocket payment (including private insurance, HMOs, employers) which is 59 % of the total cost; PhilHealth benefit payment which is 11 %; national government budget (DOH and ODA) which is 16 %; and LGU budget which is 13 %. The health expenditures in 2003 were used for personal health care (75.7 %), public health care (12.3 %), and others (12.0 %).
Health Services Delivery
A premise in health services delivery is that health is a right, not a privilege. This is espoused by the World Health Organization and is enshrined in the Philippine Constitution. Furthermore, health services should be viable, affordable, accessible and available.
Health services can be promotive, preventive, curative and rehabilitative. Promotive activities advocate prolonging life through healthy lifestyle (e.g., correct nutrition). Preventive activities keep individuals and communities from getting ill (e.g., vaccination). Curative activities treat sick people and prevent complications (e.g., confinement in a hospital for a certain period of time). Rehabilitative activities restore the normal functions of people who developed problems from diseases (e.g., therapy for those who get paralyzed due to stroke).
The current status of the health service delivery of the country faces a number of problems. 1) The existing promotion programs result in inefficient service. 2) Preventive and curative care is done inequitably between the rich and the poor, making it inefficient as well. 3) There is no integration of various levels of care. 4) Marketing practices do not have a deep scientific level of evidence. This is exemplified by the promotion of over-the-counter drugs and their irrational indications. Lastly, 5) Private practitioners work only along the lines of limited practice.
