Health Care Delivery System, Millennium Development Goals
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the HEALTH CARE DELIVERY SYSTEM
Objectives: Discuss how the World Health Organization (WHO) affects health issues in the Philippines. Describe the Philippine Health Care Delivery System as to its components and sectors. Differentiate the referral system from the interlocal health zone. Distinguish the levels of healthcare, service and facilities. Enumerate the various reform initiatives that shaped Philippine healthcare delivery. Explain the salient features of the Universal Health Care Law in the Philippines.
A nation’s health care delivery system has a tremendous impact not only the health of its people but also on their total development including their socioeconomic status. Anderson and Mcfarlene (2011) emphasized the role of the following factors in shaping 21 st century health that further influence health care delivery system: Health care “reforms” Demographics Globalization Poverty and growing disparities Social disintegration
WORLD HEALTH ORGANIZATION (WHO)
World Health Organization (WHO)- specialized agency in the United Nations (UN) provides global leadership on health matter in the Philippines. Health services are provided by the; government and private sector - for profit as well as non-profit to as Non- Government Organizations (NGO). On the national level, director is set by department of health (DOH ) by virtue of mandate of the Local Government Code (R.A.7160) LGU’s should have operating mechanism to meet the priority needs and service requirements of their communities. Basic Health Services are regarded as priority services for which LGU’s are primary responsible.
Health System consist of all organizations, people and actions whose primary intent is to promote, restore, or maintain health. Service delivery Health Workforce Information Medical Products, Vaccines, and technologies Financing Leadership and governance or stewardship
The World Health Organization The WHO constitution came into force on April 7, 1948. Since then April 7 has been celebrated each year as World Health Day. Objective: attainment by all peoples of the highest possible level of health (WHO,2006) To attain its objective, WHO carries out the following core functions: Providing leadership on matters critical to health and engaging partnerships where joint action is needed. WHO has 193 members of countries and 2 associate members. WHO and its members work with UN agencies, NGO’s and the private sector. The WHO country focus is directed toward providing technical collaboration with member states with accordance with each country’s needs and capacities.
Shaping the research agenda and stimulating the generation, translation, and disseminating valuable knowledge. The WHO strategy on research for health has 5 goals: Capacity- in reference to capacity-building to strengthen the national health research system Priorities – to focus research on priority health need particularly in low and middle income countries Standards - to promote good research practice and enable the greater sharing of research evidence, tools, and materials Translation - to ensure that quality evidence is turned into products and policy Organization – to strengthen the research culture within WHO and improve the management and coordination of WHO research activities.
Setting norms and standards and promoting and monitoring their implementation. WHO develops norms and standards for various health and health –related issues, such as pharmaceutical products including vaccines and other biological products used in immunization, practices in maternal and child care, and environmental conditions. Articulating ethical and evidence-based policy options . Through its Department of Ethics and Social Determinants, WHO is evolved in various issues on health ethics. In collaboration with other governmental and nongovernmental organizations, WHO has worked on bioethical concerns such as those related to human organ and tissue transplantation, reproductive technology and public health response to threats of infectious diseases like AIDS, influenza, and tuberculosis.
Providing technical support, catalyzing change, and building sustainable institutional capacity. WHO offers technical support training to its member countries in the fields of maternal and child health, control of diseases, and environmental health services. WHO is involved in monitoring the health situation and assessing health trends. WHO has developed guidance and tools and measurement, monitoring and evaluation.
The Philippines is a member of a global system of nations interacting with each other at different levels and in different ways . Events that happen in other countries can affect the status of Filipinos. Ease of travel from one part of the globe to another makes transmission of the communicable disease likewise easy. This has been proven by the events as the emergence and spread of disease like HIV/AIDS, SRAS (Severe Acute Respiratory Syndrome), AH1N1 influenza (swine flu) and COVID 19.In contrast, cooperation and sharing of resources among nations serve as the key in the solution of many human problems-health.
WHO has worked as a partner of the Philippine DOH i n the Development and provision of services towards the attainment of health-related Sustainable Development Goals (SDGs). The Sustainable Developmental Goals (SDGs) or Agenda 2030 aims to continue the gains achieved thru Millennium Development Goals (MDGs) implemented from 2000 to 2015. The SDGs contain 17 goals and 169 targets that will cover the period 2016 to 2030. In the Philippines, the Department of Health develops and aligns its programs to help achieve SDG 3 that focuses on ensuring health and well being of populations.
Components and Sectors of the Health Care Delivery System : The Philippine health care delivery system is composed of two sectors: (1) the public sector and (2) private sector. The public sector consists of the national and local government agencies providing health services. At the national level, the Department of Health (DOH) is mandated as the lead agency for health. It has a regional office in every region and maintains specialty hospital, regional hospitals and medical centers. The public sector is largely financed through a tax based budgeting system at both national and local levels. In here, health is generally free at the point of service.
The private sector is a largely market oriented and health care is rapid through users fee at the point of service. Its involvement in maintain the people’s health include providing health insurance, manufacturer of medicines, vaccines, medical supplies, equipment and other health and nutrition products, research and development, human resource and development and other health related services.
The DOH serves as the main governing body of health services in the country . The DOH provides guidance and technical assistance to LGUs through the center for health development in each of the 17 regions. Provincial governments are responsible for administration of provincial and district hospitals. Municipal and city governments are in charge of primary care through rural health units (RHUs) or health centers. Satellite outposts known as barangay health stations (BHSs) provide health services in the periphery of the municipality or city.
The private sector is composed of for-profit and nonprofit agencies this sector provides all levels of services and accounts for a large segment of health service providers in the country. About 30% of Filipinos utilize private health facilities. Estimated 60% of national health expenditure goes to the private sector which employs more than 70% of the health professionals in the Philippines. Financing of health services is provided by three major groups : The government (national and local), private sources and social health insurance . The National Insurance Act of 1995 (R.A. 7875) created by the Philippine Health Insurance Corporation (PhilHealth). It is tax-exempt government corporation attached to the DOH for policy coordination and guidance, and aims for universal health coverage of all Filipino citizens.
1. Primary Level of Care ( prevention of illness or promotion of health) The first contact between the community members and the other levels of health facility. 2. Secondary Level of Care (curative) Capable of performing minor surgeries and perform some simple laboratory examinations. 3. Tertiary Level of Care (rehabilitative) a. Complicated cases and intensive care requires tertiary care and all these can be provided.
MILLENNIUM DEVELOPMENT GOALS
The Millennium Development Goals On September 6 to 8, 2000, world leaders on UN General Assembly participate in Millennium Summit. The result of the summit was a resolution entitled United Nations Millennium Declaration. In this declaration, the world leaders recognized their collective responsibility to uphold the principles of human dignity, equality and equity at the global level. The declaration expressed the commitment of the 191 member states, including the Philippines, to reduce extreme poverty and achieve seven other targets - now called the Millennium Development Goals (MDG’s) by the year 2015.
The following are the eight MDG’s and the targets corresponding to health-related MDG’s 4,5, and 6: Eradicate extreme poverty and hunger. Achieve universal primary education. Promote gender equality and empower women. Reduce child mortality. Target: reduce by 2/3, between 1990 and 2015, the under-five mortality rate. Improve maternal health. Target: Reduce by three quarters the maternal mortality ratio Achieve universal access to reproductive health
6. Combat HIV/AIDS, malaria and other diseases. Targets: Have halted by 2015 and begun to reverse the spread of HIV/AIDS Achieve by 2010, universal access to treatment for all those who need it Have halted by 2015, and begun to reverse the incidence of malaria and other major diseases. 7. Ensure environmental sustainability 8. Develop a global partnership for development