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Transcript of Aquino Health Agenda
8/3/2019 Aquino Health Agenda
http://slidepdf.com/reader/full/aquino-health-agenda 1/41
Aquino Health Agenda:
Universal Health Care
Enrique T. Ona, MD, FPCS, FACS
Secretary of Health
2nd Philippine Health Outlook Forum
22 October 2010
8/3/2019 Aquino Health Agenda
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“Sixty percent of our countrymen
who succumb to sickness diewithout seeing a doctor.”
- PNoy’s Challenge
8/3/2019 Aquino Health Agenda
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Universal Health Care
Deliberate attention to the
needs of millions of poor
Filipino families which
comprise the majority of our
population
8/3/2019 Aquino Health Agenda
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Filipino Income Quintiles
Monthly income Families per quintile
Q1 3,460 5,218,267
Q2 6,073 4,094,164
Q3 9,309 3,912,443
Q4 15,064 3,707,494
Q5 38,065 3,485,067
Source: National Health and Demographic Survey, 2008
8/3/2019 Aquino Health Agenda
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Comprehensive Reforms in Health
Universal Health Care(2010 -2016)
Fourmula One for Health(2005 – 2010)
Health Sector Reform Agenda(1999- 2004)
8/3/2019 Aquino Health Agenda
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CURRENT STATUS
Health Outcomes
8/3/2019 Aquino Health Agenda
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Demographic Characteristics
Population, total (millions) 94,013,200 (projected, NSO 2007)
Population < 25 years
(% of total population)
52.8 % (projected, NSO 2007)
49,617,400 M Filipinos
Population > 60 years
(% of total population)
6.7% (projected, NSO 2007)
6,637,100 M Filipinos
Birth rate
(births per 1,000 population)
23.4 (NDHS 2008)
2,162,303 live births per year
Death rate
(deaths per 1,000 population)
5.48 (NSO 2007)
515,192.34 deaths / year
8/3/2019 Aquino Health Agenda
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Top Ten Cause of Mortality
Cause Total Rate1. Diseases of the heart 70, 861 84.8
2. Diseases of the vascular system 51,680 61.8
3. Malignant Neoplasms 40,524 48.9
4. Accidents 34,483 41.3
5. Pneumonia 32,098 38.4
6. Tuberculosis 26,770 31.0
7. Unclassified 21,278 25.5
8. Chronic lower respiratorydiseases
18,975 22.7
9. Diabetes mellitus 16,552 19.8
10. Conditions originating from the
perinatal period
13,180 15.8
Philippine Statistical Yearbook, 2009
8/3/2019 Aquino Health Agenda
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UN Millennium Development Goals
Source:MDG Monitor: Quick Facts
(accessed 10/11/2010)
8/3/2019 Aquino Health Agenda
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Towards the attainment of MDGs ….
Indicators 2015 Target Accomplishment
MDG 4:
Under 5 mortality rate
(per 1,000 live births)
26.7 34
(2008 NDHS)
Infant mortality rate
(per 1,000 live births)
19.0 25
(2008 NDHS)
MDG 5:
Maternal mortality ratio
(per 100,000 live births)
52 162
(2006 FPS)
Proportion of births attended by
skilled health professional
70.0
(2010 NOH)
62
(2008 NDHS)
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INDICATORS 2015 Target ACCOMPLISHMENT
MDG 6
Prevalence of HIV/AIDS among high risk
groups
<1%
5,364 cases(1984-2010)
<1%
Malaria morbidity rate 62/100,000 pop
38,135 cases(based from 1990
baseline)
21.6/100,000 pop
19,555 cases
(2009)
Malaria mortality rate 0.75456 deaths
(based from 1990baseline)
0.02624 deaths
(2009)
TB morbidity rate 137/100,000
128,798 cases
(2010 NOH)
129 (2008)
121,277 cases
TB mortality rate <44/100,000
41,366 deaths
(PhilPACT)
41.0 (2007)
TB case detection rate 70 % 75 % (NTP, 2007)
TB cure rate 85 % 83 % (NTP, 2007)
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Mortality Trend: Communicable Diseases,
Malignant Neoplasms & Diseases of the HeartRate/100,000 Population
Philippines, 1953-2005
0
100
200
300
400
500
600
700
1 9 5 3
' 5 4
' 5 5
' 5 6
' 5 7
' 5 8
' 5 9
' 6 0
' 6 1
' 6 2
' 6 3
' 6 4
' 6 5
' 6 6
' 6 7
' 6 8
' 6 9
' 7 0
' 7 1
' 7 2
' 7 3
' 7 4
' 7 5
' 7 6
' 7 7
' 7 8
' 7 9
' 8 0
' 8 1
' 8 2
' 8 3
' 8 4
' 8 5
' 8 6
' 8 7
' 8 8
' 8 9
' 9 0
' 9 1
' 9 2
' 9 3
' 9 4
' 9 5
' 9 6
' 9 7
' 9 8
' 9 9
2 0 0 0
' 0 1
' 0 2
' 0 3
' 0 5
Year
Communicable Diseases
0
10
20
30
40
50
60
70
80
90
100
Malignant Neoplasms &
Diseases of the Heart
Communicable Diseases
Malignant Neoplasms
Diseases of the Heart
Source: Philippine Health Statistics, 2005
8/3/2019 Aquino Health Agenda
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CURRENT STATUS
HEALTH FINANCING
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Share of health expenditure per GNP
0
0.5
1
1.5
2
2.5
3
3.5
4
P e r c e n t
1 9 9 3
1 9 9 4
1 9 9 5
1 9 9 6
1 9 9 7
1 9 9 8
1 9 9 9
2 0 0 0
2 0 0 1
2 0 0 2
2 0 0 3
2 0 0 4
2 0 0 5
2 0 0 6
2 0 0 7
Year
Total health expenditure = P234.3 B or 3.2 percent of GDP
Source: Philippine National Health Accounts
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Total expenditure on health as a Percentage
of GDP
0
2
4
6
810
12
14
16
Total expenditure on health as % GDP
Source: World Health Statistics 2010
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Distribution of Health Expenditure by
Use of Funds
Personal
Health Care
81%
P 189.7 billion
Public Health
Care
9%
P 21.2 billion
Others
10%
P 23.3 billion
Source: Philippine National Health Account, 2007
Total health expenditure is P234.3 B
(3.2 percent of GDP)
8/3/2019 Aquino Health Agenda
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Distribution of Health Expenditure
by Source of Funds NationalGovernment
13% LocalGovernment
13%
Social HealthInsurance
9%Out-of-Pocket54%
Others11%
Source: Philippine National Health Account, 2007
Total health expenditure is P234.3 B (3.2 percent of GDP)
8/3/2019 Aquino Health Agenda
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PhilHealth
Pres. Aquino, on PhilHealth Enrolment:
“Sabi ng PhilHealth sa isang bibig,
walumpu't pitong porsyento na raw angmerong coverage. Sa kabilang bibig naman,singkuwenta'y tres porsyento. Ayon naman
sa National Statistics Office, tatlumpu'twalong porsyento ang may coverage.”
(Pnoy’s SONA – July 26, 2010; emphasis supplied)
18
8/3/2019 Aquino Health Agenda
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PhilHealth
Aquino was dismayed at the miserable “benefit
delivery rate of the National Health Insurance
Program in the country which stands at only 8
percent.” (PDI, Oct 3, 2010)
19
Coverage rate Availment
rate
Support value
Benefit
delivery rate
53% 42% 34% 8%
8/3/2019 Aquino Health Agenda
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CURRENT STATUS
HEALTH FACILITIES
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Office of Secretary of Health
Attached Agencies
Regional Offices
Provincial Health Offices
City Health Offices
(Component Cities)
Inter-local Health Zones
City
Hospitals
Health
Centers
Barangay
Health
Stations
District
hospitals
Municipal health
offices/ Rural
Health Unit
Barangay Health
Stations
Provincial
Hospitals
Regional hospital
Medical Centers
Sanitaria
City Health Offices
(Chartered Cities)
City
Hospitals
Health
Centers
BarangayHealth
Stations
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Regional Hospitals
Corazon Locsin Montelibano MemorialRegional Hospital, Negros Occidental Southern Philippines Medical Center,Davao
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Provincial Hospitals
Davao del Sur Provincial Hospital Teresita Lopez Jalandoni ProvincialHospital, Negros Occidental
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City Hospitals
Gregorio Lluch Memorial CityHospital, Butuan City
JJ. Borja Memorial City Hospital,Cagayan de Oro City
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STRATEGIC DIRECTIONSOF THE AQUINOADMINISTRATION
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Priority Health Policy Directions of
the Aquino Administration1. A roadmap towards universal health care through arefocused PhilHealth;
2. Particular attention to the construction, rehabilitation, andsupport of health facilities:
◦ LGU/regional hospitals,
◦ rural health units
◦ barangay health stations
3. Attainment of Millennium Development Goals 4, 5, and 6◦ Reduction of maternal, neonatal, and infant mortality
◦ Support to contain/eliminate age old pubic health diseases (malaria,dengue, TB)
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Health Policy Directions of the
Aquino Administration◦ Attain efficiency by using information technology (IT)
in all aspects of health care
◦ Increased attention to trauma, the 4th leading cause of
death◦ More aggressive promotion of healthy lifestyle to
prevent non communicable diseases: heart disease,
stroke, diabetes, obesity
◦ Attention to emerging diseases (Superbug, nosocomialdiseases, A(H1N1), diseases brought about by climate
change)
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Health Policy Directions of the
Aquino Administration
◦ Improve the access to quality affordable medicines
◦ Continuing efforts in improving governance and
regulation to eliminate graft and corruption in all areas
of health care
◦
Improve the plight of health workers throughinterventions in health education, placement,
compensation, among others
8/3/2019 Aquino Health Agenda
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Revitalizing the NHIP
Paradigm shift in the implementation of NHIP: Expansion of NHIP coverage
◦ Enrollment of the poorest of the poor
◦ Enforce mandatory enrolment of the informal sector (as per
the National Health Insurance Act, R.A. 7875 as amended) Improvement of membership services to increase
awareness of PhilHealth benefits and entitlements
Access to inpatient and outpatient services through
PhilHealth Zero co-payment/No balance billing for health care
costs incurred for the poorest in government hospitals
8/3/2019 Aquino Health Agenda
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Health Facilities Enhancement
Upgrading of health facilities: rural healthunits, district hospitals, provincial hospitals,
DOH Retained hospital
◦ Improved facility preparedness for trauma (4thleading cause of death)
◦ Improved capacity of clinical/hospital care for the
most common causes of mortality and morbidity
◦ Improve access to quality affordable medicines
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Strategies for Health Facilities
Enhancement Public-Private Partnership
Regional Clustering
Fiscal autonomy and income retention for
government health facilities
Streamlining of licensing and regulation for
improved accreditation
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Public-Private Partnerships
Proposed projects: IT system for DOH and PhilHealth
Philippine Orthopedic Center as Center
for Bone Diseases and Trauma Air ambulance project
Research Institute for Tropical Medicinefor commercial production of vaccines
San Lazaro Hospital as Center forInfectious Diseases
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Public-Private Partnerships
Commercial utilization of vacant hospitalland assets
Establishment of Multi-Specialty Centers
in selected regions (3) in Northern Luzon,Visayas, and Mindanao
Construction of Patient and Hospital
Staff ’s lodging facilities
8/3/2019 Aquino Health Agenda
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Regional Clustering
Clustering of health facilities composed of regional, hospitals and district hospitals aswell as rural health units and health centers,to address fragmentation of health servicesat local levels by….
Establishment of Clustered Health Boardscomposed of the Secretary of Health or his
representative, local chief executives, privatepartners, civil society/NGO for clusteredhealth facilities
8/3/2019 Aquino Health Agenda
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Attaining the MDGs
Ensure that poorest families are reached by
priority public health programs
Deployment of Community Health Teams:
Packaging of services using the Life Cycle
Approach
◦ Pre-pregnancy: Family Planning services
◦ Pregnancy: Four ante-natal care services and
delivery in health facilities (Emergency Obstetric
and Neonatal Care)
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Attaining the MDGs
Packaging of services using the Life CycleApproach
Post partum: Essential newborn care and
immediate post partum care Infancy/early childhood: Garantisadong Pambata
8/3/2019 Aquino Health Agenda
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Strategies for Public Health
• More aggressive promotion of healthy lifestyle
to prevent non communicable diseases: heart
disease, stroke, diabetes, obesity
• Attention to emerging diseases (Superbug,
nosocomial diseases, A(H1N1), diseases
brought about by climate change)
8/3/2019 Aquino Health Agenda
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ICT Tools for Health
Information and Communications Technology willplay a major part in ensuring universal health careis achieved as it can provide quality and timelyinformation to guide decision making at all levels.
Improvement of PhilHealth services will not beattained with out efficient IT Tool support Access of health to public health programs as well
as clinical services can be augmented by ICT e.g.
Telemedicine Regional Clustering will be dependent on
information sharing
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Philippine Health Outlook Forum
For the remainder of this activity, we hope that
we can explore ways on how we can harmonize
our efforts in focusing on these priority areas
towards achieving our goal of
Universal Health Care.