Ron Christian G.

Sison, RMT, MPH

PHILIPPINE HEALTH CARE
DELIVERY SYSTEM
2 COMPONENTS:
1. Public Sector
- 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
- clinics
- hospitals
- health insurance
- manufacturing of medicines
- vaccines
-medical supplies
- equipment
- nutrition products
- research & development
- or other any health related items
Department of Health
History:
1. pre-Spanish and Spanish periods (before 1898)
- traditional health care (herbs & rituals)
- dispensary of indigent patients of Manila
- Medicus Titulares
- Superior Board of Health & Charity, 1888
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. July 1, 1901
- Act no. 157: Board of Health of Philippine Islands
- Acts no, 307 & 308: provincial and municipal boards
5. October 26, 1905
- Act no. 1407: establishment of Bureau of Health
PHILIPPINE HEALTH CARE
DELIVERY SYSTEM
6. 1912
- Act no. 2156 (Fajardo Act): health fund for travel and
salaries
7. 1915
- Act no. 2568: from BOH to Philippine Health
Service semi-military system of public health
administration
PHILIPPINE HEALTH CARE
DELIVERY SYSTEM
8. August 2, 1916
- Act 2711 w/c included the Public Health Law of 1917
9. 1932
- Act no. 4007: Reorganization Act of 1932
PHILIPPINE HEALTH CARE
DELIVERY SYSTEM
10. May 31, 1939
- Commonwealth act no. 430 created the
Department of Public Health & Welfare, but was
only completed through E.O. no. 317, Jan. 7, 1941

-Dr. Jose Fabella became its first secretary
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)

14. June 2, 1978
- P.D. 1937 renamed DOH to
Ministry of Health during
the Martial Law
- Sec. Gatmaitan was the 1
st

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
16. April 13, 1987
- E.O. no. 119: MOH was
back in the name
Department of Health
by President Cory Aquino

PHILIPPINE HEALTH CARE
DELIVERY SYSTEM
17. October 10, 1991
- RA 7160 known as the Local Government Code: all
structures, personnel & budgetary allocations from the
provincial health level down to the brgy were devolved
to the LGU to facilitate health service delivery

From PROVINCIAL TO LOCAL GOVERNMENT
(devolution/ devolved health sector)

PHILIPPINE HEALTH CARE
DELIVERY SYSTEM
18. May 24, 1999
- E.O. 102 Redirecting the Functions & Operations of
the DOH by Pres. Joseph Estrada

19. 1999-2004
- Development of the Health Sector Reform Agenda
PHILIPPINE HEALTH CARE
DELIVERY SYSTEM
20. 2005 to present
- development of a plan to
rationalize the
bureaucracy in an attempt
to scale down including
the DOH
PHILIPPINE HEALTH CARE
DELIVERY SYSTEM
The Department of Health
Roles and Functions
1. Leadership in Health
- national policy & regulatory institution
- leadership in formulation, monitoring, &
evaluation of health policies, plans & programs
- serve as advocate in health policies, plans &
programs
The Department of Health
Roles and Functions
2. Enabler & Capacity Builder
- innovate new strategies in health
- monitoring & evaluation of national health policies,
plans & programs
- ensure highest achievable standards of quality HC,
health promotion & health protection
The Department of Health
3. Administrator of Specific Services
- manage selected national & sub-national health
facilities & hospitals w/ modern facilities that shall
serve as referral centers
- administer direct services for emerging health
concerns
- emergency response services in disaster and
epidemics
Department of Health: Organizational Structure
The Department of Health
Dr. Enrique T. Ona
The Department of Health
VISION
The DOH is the leader, staunch advocate and
model in promoting health for all in the
Philippines
The Department of Health
MISSION

Guarantee equitable, sustainable and quality health for
all Filipinos, especially the poor and shall lead the
quest for excellence in health.
The Department of Health
Goal: Health Sector Reform Agenda (HSRA)

-health sector reform: overriding goal of DOH

The Department of Health
Rationale for Health Sector Reform
For the last 50 yrs, the ff conditions are still seen
among the popn:

-slowing down in reduction of IMR & MMR
-persistence in large variations in health status across
popn groups & geographic areas
The Department of Health
Rationale for Health Sector Reform (cont)

- High burden from infectious diseases
- Rising burden of chronic & degenerative diseases
- Unattended emerging health risks from
environmental & work related factors
- Burden of disease is heaviest in poor

The Department of Health
Framework for Implementation of HSRA:
FOURmula ONE for Health
Goals of FOURmula ONE for
Health
1. Better health outcomes
2. More responsive health systems
3. EQUITABLE health care financing
Framework for Implementation of HSRA:
FOURmula ONE for Health
4 elements of strategy
1. Health financing
2. Health regulation
3. Health service delivery
4. Good governance
Local Health System
Objectives:
1. Establish local health systems for effective & efficient
delivery of health care services
2. Upgrade health care management & service
capabilities of local health facilities
3. Promote inter-LGU linkages & cost sharing schemes
including local health care financing systems for
better utilization of local health resources
Local Health System
Objectives:
4. Foster participation of the private sector, NGOs &
communities in local health systems development.
5. Ensure the quality of health service delivery at the
local level
Local Health System
Inter Local Health System
- Espoused by DOH to ensure quality HC at local level
- Clustered into Inter Local Health Zone (ILHZ)
Local Health System
Expected Achievement of the Inter-local Health
System:
1. Universal coverage of health insurance
2. Improved quality of hospital & RHU service
3. Effective referral system
4. Integrated planning
5. Appropriate health information system
6. Improved drug management
Local Health System
Expected Achievement of the Inter-local Health
System:
7. Developed human resources
8. Effective leadership through inter-LGU corporation
9. Financially visible or self-sustaining hospitals
10. Integration of public health & curative hospital care
11. Strengthened cooperation between LGU & health
sectors
Local Health System
Guiding Principles
1. Financial & Administrative autonomy of the
provincial & municipal administrations
2. Strong political support
3. Strategic synergies & partnerships
4. Community participation
5. Equity of access to health services by the population,
especially the poor
Local Health System
Guiding Principles
6. Affordability of health services
7. Appropriateness of health programs
8. Decentralized management
9. Sustainability of health initiatives
10. Upholding of standards of quality health service

Local Health System
Composition of the Inter-Local Health Zone

1. People
2. Boundaries
3. Health Facilities
4. Health Workers
Alma Ata Declaration
of 1978

International Conference on Primary Health Care,
Alma-Ata, USSR, 6-12 September 1978
The International Conference on Primary Health Care,
meeting in Alma-Ata this twelfth day of September in the
year Nineteen hundred and seventy-eight, expressing the
need for urgent action by all governments, all health and
development workers, and the world community to protect
and promote the health of all the people of the world

Alma Ata Declaration of 1978
The Declaration consists of ten parts each reinforcing widely
accepted values and policies on health care.
Definition of Health
Concern over inequity between countries
Health as a pre-requisite for economic progress of countries
People's right to participate in planning and implementation of health
services
State responsibility in provision of health care to all citizens
Reaffirmation of primary health care as an important strategy to
organize health services
Components of primary health care
Align national policies and build political will to achieve primary
health care
Cooperation between countries to achieve these goals
Health for all by 2000