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Transcript of Philippines 08
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354 | COUNTRY HEALTH INFORMATION PROFILES
PHILIPPINES
1. CONTEXT
1.1 Demographics
The Philippines consists of 7107 islands, with a land area of 300 000 square kilometers. Itspopulation, as of 1 August 2007, was placed at 88 574 614, giving a population density of 295per square kilometre Among the 14 regions of the country, Calabarzon (Region IV-A) had thelargest population, with 11.7 million, followed by National Capital Region (NCR), with 11.6million and Central Luzon (Region III), with 9.7 million. These three regions comprised morethan one-third (37.3%) of the Philippine population.
Based on the 2000 census figure of 76.5 million, the average annual population growth rate of2% for the period from 2000 to 2007 is the lowest recorded for the Philippines since the 1960s. The country's population is predominantly young, with the 0-14 year age group representing
33.8% and those aged 65 years and above comprising 4.4%. There is an almost equal number ofmales and females. The crude birth rate stands at 20.5 per 1000 population and the crude deathrate at 4.8 per 1000 population. Overall life expectancy is 67 years, 64 years for males and 70years for females.
1.2 Political situation
The Philippines is a democratic and republican state subscribing to the presidential form ofgovernment, with three branches: the executive, legislative and judicial branches. The countryhas a unitary form of government and a multiparty political system. Executive power is vested inthe President, who is the head of state and commander-in-chief of the armed forces. TheCabinet members are the heads of agencies and assist the President in drafting executive laws,policies and programmes of government. The Constitution ensures direct election by the peoplefor all elective positions from the President down to the members of the barangaycouncils.
In 1991, the Local Government Code transferred some of the powers of the nationalGovernment to local government officials. The code devolved basic services, including health,giving responsibility to local government units. The country is made up of political localgovernment units (LGUs) of provinces, cities, municipalities and barangays. A local chiefexecutive heads each LGU. Administrative autonomy enables the LGUs to raise local revenues,to borrow and to determine types of local expenditure, including expenditures on health care.
1.3 Socioeconomic situation
The Philippine economy in 2007 was at its strongest, with the gross domestic product (GDP) realgrowth rate for the year averaging 7.3%, the highest in 31 years. The economy continued to keeppace with population growth in the fourth quarter of 2007, as per capita GDP grew from 3.4% to5.3%.
The challenge for the Government is to enable these economic gains to be felt by the poorersectors of society. The 2006 official poverty statistics revealed an increase of 2.5 percentagepoints to 26.9% from 24.45 in 2003, meaning a total of 4.7 million poor families in 2006compared with the 4.0 million estimated in 2003. In terms of population, the number of poorFilipinos reached 27.6 million in 2006, 16% more than the 23.8 million estimated in 2003, whilefood-poor individuals increased to 12.2 million, 14% more than in 2003. In the presence of thecountrys gains in economic growth, the Government's move to realign the national budgettowards social services is a good opportunity to focus on the education and health needs of thepopulation in tandem with an effective population management programme.
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The gender gap appears to be in favour of girls as far as participation in basic education,technical-vocational education and training and higher education are concerned. There is a needfor the Government and other education stakeholders to look more seriously at the lowcompletion and retention rates among boys in the school system. Although indicators to reflectgender equality, such as the country' Gender Development Index (GDI) and GenderEmpowerment Measure (GEM) reflect gains, these do not necessarily translate into positivemeasurable changes in the roles of and status of women, given the continuing incidence of
violence against women, the predominance of female child-abuse victims, the trafficking ofwomen and children for sexual exploitation and female forced labour, among others.
The slow decline in maternal mortality means that the country is unlikely to meet the MillenniumDevelopment Goal maternal mortality target or 80% access to reproductive health services by2015. The reasons include the inadequate access to integrated reproductive health services, suchas contraceptives, family planning and responsible-parenthood education, by women, includingpoor adolescents, and men.
1.4 Vulnerabilities and hazards
There is constant concern about the Philippines' high population growth rate and it being alimiting factor for broad-based growth and reduction of poverty.
There is a hidden threat from HIV and AIDS; although prevalence is still below 0.1% of thepopulation, there was a 20% increase in the number of reported cases from 2004 to 2006.
Due to its geographical location, the country faces various natural disasters, such as typhoons,landslides, volcanic eruptions and earthquakes.
2. HEALTH SITUATION AND TREND
2.1 Communicable and noncommunicable diseases, healthrisk factors and transition
Tuberculosis continues to affect a sizeable segment of the population, although, in recent years,effective case-finding, disease management using the directly observed treatment short-course
(DOTS) strategy, and partnership with the private sector have made inroads into the preventionand control of the disease.
Mosquito-borne diseases, such as malaria, dengue and filariasis, are an ever-present danger inendemic areas. Although malaria is no longer a leading cause of death, it remains among theleading causes of morbidity in the country, particularly in rural areas. High-risk groups includeupland subsistence farmers, forest-related workers, indigenous peoples and settlers in frontierareas and migrant agricultural workers.
Dengue fever also remains a threat, with cyclical outbreaks every three to five years. Early in2008, there was a resurgence in the number of cases.
The increase in life expectancy, rapid urbanization and lifestyle trends have resulted in changes inthe health profile. Four of the most prominent noncommunicable diseases are linked by
common preventable risk factors related to lifestyle. These are cardiovascular diseases, cancer,chronic obstructive pulmonary diseases and diabetes. In a study conducted by the Food andNutrition Research Institute in 2003, it was found that 90% of Filipinos have one or more ofthese risk factors: smoking, obesity, hypertension, high blood sugar and abnormal bloodcholesterol levels. Among the risk factors found, smoking was the most common risk factor, with 12.1% of women and 56.3% of men smokers. Obesity based on waist-hip ratio is morecommon than obesity measured by BMI. Prevalence of obesity and overweight using the hip-to-weight ratio is 12.1% for men and 54.8% for women.
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2.2 Outbreaks of communicable diseases
A total of 7880 dengue cases were admitted to various sentinel hospitals nationwide from January 1 to March 29, 2008, 20.6% higher than during the same time period in 2007(6532). Cases had exceeded and reached the alert threshold in weeks 1, 8 and 9 and went abovethe epidemic threshold on the 2nd to 7th week. Ages of cases ranged from
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Undernutrition remains a challenge in the country. Only 68% of children under five have thenormal weight for age using the National Center for Health Statistics/WHO Standards. In 2005,the prevalence of underweight pre-school children (0-5 years) was 24.6%, 26.3% were stunted,4.8% were wasted and 2.0% were overweight. In its State of the worlds children 2004. The UnitedNations Childrens Fund (UNICEF) reported that 20% of infants have a low birth weight, whileaccording to the 2003 NDHS, 13% are babies of low birth weight.
Exclusive breast-feeding is on the decline, with only 33.5% of children exclusively breast-fed upto the age of six months.
Other nutritional challenges faced by the Filipino child include:
anaemiawith prevalence rates among children aged 6-12 months and 6-11 years of age stillincreasing, and presently at the high levels of 66% and 37.4%, respectively;
vitamin A deficiencythe level among children aged six months to five years increased from35% in 1993 to 40% in 2003;
iodine deficiencythere are an estimated 1.5 million schoolchildren aged 6-12 years who areat risk of mental retardation due to iodine deficiency.
2.5 Burden of disease
Tuberculosis is still among the leading causes of morbidity and mortality in the Philippines; thecountry as has the 8th highest TB incidence in the world and the 3 rd highest in the Western PacificRegion. The burden of disease of TB is disproportionately high for the poor, elderly and malepopulation, although death is highest among older persons. Since TB principally affects theproductive age group, it is estimated that the country loses some Php 26 billion (US$ 540 millionannually due to premature deaths from TB.
Environmental-related health risks have been cited as a significant problem, with air pollution, water pollution, sanitation and unhygienic practices contributing to an estimated 22% of thereported disease cases and nearly 6% of reported deaths, costing Php 14.3 billion (US$ 287million) per year in lost income and medical expenses.
3. HEALTH SYSTEM
3.1 Ministry of Health's mission, vision and objectives
The Department of Health's vision is to be "The leader of health for all in the Philippines". Itsmission is to "guarantee equitable, sustainable and quality health for all Filipinos, especially thepoor, and to lead the quest for excellence in health".
The goals of the health department align with the WHO health systems framework. Betterhealth for the entire population is the primary goal. This means making the health status of thepeople as good as possible over the entire life cycle. The second goal is related to how the healthsystem performs in meeting peoples expectations and satisfaction with the services it provides.
Equitable health care financing is the third goal because health and illness involves large andunexpected costs that may result in poverty for many people.
The strategic thrusts to achieve the three primary health goals mentioned above are anchored inthe current programme of health reforms, labelled Fourmula One for Health. It is designed toundertake critical reforms with speed, precision and effective coordination, with the end goal ofimproving the efficiency, effectiveness and equity of the Philippine health system. Vital reformsare organized into four major implementation components: health financing; health regulation;health service delivery; and good governance in health. Implementation will focus on fourgeneral objectives: (1) health financing, the general objective of which is to secure increased,
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better and sustained investments in health to provide equity and improve health outcomes,especially for the poor; (2) health regulation, which aims to assure access to quality and affordablehealth products, devices, facilities and services, especially those commonly used by the poor;(3) health service delivery, where health interventions are aimed at improving the accessibility andavailability of social and essential health care for all, particularly the poor; and (4) goodgovernance in health, aimed at improving health systems performance at the national and locallevels.
3.2 Organization of health services and delivery systems
With the devolution of health services to LGUs under the Local Government Code of 1991,fragmentation of services became evident. Service provision is regarded as dual, consisting ofboth the public and private sector. The public sector has three largely independent segments orsets of providers: (1) national government providers, which include, among others, hospitals runby national government agencies (e.g., hospitals of the Department of Health and theDepartment of National Defense), central and regional offices of the Department of Health;(2) provincial government providers, which include provincial hospitals, provincial blood banksand the Provincial Health Office; and (3) local (municipal or city) government providers,including rural health units or RHUs, city health centres and barangayhealth stations or BHSs.Each BHSs is staffed by a midwife, and each RHU by a doctor, a nurse and midwives.
The Department of Health's role now focuses on regulation, technical guidelines/orientation,planning, evaluation, and inspection, while the provincial government is responsible forprovincial and municipal hospitals, health centres and health posts, although funding flows donot exactly match responsibility. The municipal government-level role is not well defined andcapacity is reportedly weak.
With the decentralization of service delivery, local chief executives became core players in thehealth sector. The number of actors involved multiplied and hence the need for coordination andpolicy monitoring. On health financing, for instance, the Department of Health and the CentralGovernment are no longer in control of resource allocation. The need for better coordinationand a better working relationship with the local government units and other stakeholders is wellrecognized.
Private providers are predominantly located in highly urbanized areas. The private sectorconsists of a wide range of privately operated facilities, such as pharmacies, physicians in solo orgroup practices, small hospitals and maternity centres, diagnostic centres, employer-basedoutpatient facilities, secondary and tertiary hospitals, traditional birth attendants and indigenoushealers.
Ongoing reforms in health service delivery are aimed at improving the accessibility andavailability of basic and essential health care for all, particularly the poor. Public primary healthfacilities are perceived as being low quality, hence they are frequently bypassed. Clients aredissatisfied due to long waiting times; perceived inferior medicines and supplies; poor diagnosis,resulting in repeated visits; and the perceived lack of medical and people skills of the personnelavailable, especially in rural areas. The result is that secondary and tertiary facilities are inundatedwith patients needing primary health care. Since public primary facilities are more accessible tohouseholds and are mostly visited by the poor, improving the quality of those servicesparticularly demanded by the poor would improve their health. Furthermore, referralmechanisms among different health facilities across local government units need to bestrengthened.
Pharmaceutical challenges remain due to asymmetric information, income distribution and theinadequacy of the regulatory system. This stems from various factors such as massive campaignsand lucrative incentives from multinational drug firms, prolonged patent rights cases and a lackof appropriate public understanding regarding generics.
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3.3 Health policy, planning and regulatory framework
The Government's policy to achieve improvements in health includes a perspective on theintegral value of health for any nation, the coordination of resources from all sectors, the right toaccess quality care, and the presence of socioeconomic fundamentals. While the Governmentprovides the leadership and stewardship to ensure that all efforts in the health sector lead to acommon goal, greater support to local health systems development and emphasis on strong
management and administrative support systems at all levels of governance is critical. Bettercoordination between national policies and external development partner priorities would alsoplay a major role in fostering the harmonization of resources for health.
The Department of Health remains inadequate in regulating the quality of health services in thecountry. This is attributed to the immense gaps in health regulations caused by the lack ofspecific legal mandates, inadequate expertise, an inadequate number of health regulation officers,a lack of expertise and infrastructure in specialized services and laboratory facilities, and weakhealth regulatory systems and processes.
3.4 Health care financing
The financial burden on individual families remains high. The latest (2005) national healthaccounts show that the most common source of funds for health in the country today is still out-
of-pocket payments (around 49%). Paying for health care is an issue because of its povertyimpacts. Under the current health care financing arrangements, low-income families are pushedinto poverty due to payments for health care. Almost 80% of total health expenditure is spenton personal health care services. In contrast, only 11% is used for public health care services. About 10% is used for the administrative spending needed to run the entire health system.These are signs that the Philippines is not spending enough or effectively for health.
Health care financing resources are spent largely on hospital-based curative services and notenough on preventive and promotive health services, and subsidies for health services are poorlytargeted. The large hospitals in Metropolitan Manila and other urban areas get the biggest shareof spending, while non-hospital health services face difficulties in getting adequate funding.
Meanwhile, the national health insurance programme has seen only a relatively slow and cautiousincrease in its share of total health expenditure. Possible reasons for this include its low benefit
package and the fact that coverage of the informal economy has not increased. The limitedfinancial protection of the national health insurance programme, PhilHealth, is closely related toits benefit coverage and provider payment system. As physicians provide more services and raiseprices under the current fee-for-service system, medical care expenses increase rapidly. However,PhilHealth pays only up to the rather low benefit ceiling and patients pay the rest of theexpenses. At the same time, physicians have the freedom to bill without fee regulation.Discussions are now ongoing to explore the feasibility of extending benefit coverage by raisingthe benefit ceiling.
Public health facilities are funded through a mix of public subsidies, such as Philhealthreimbursements, user fees and, to a limited extent, private health insurers. At the primary carelevel, public subsidies and Philhealth capitation allocations are funding services for both insuredand non-insured members and for both public health and personal care. At the hospital level, the
mix of funding is not well understood by regulators. Moreover, several schemes may be workingat the same time, depending of local priorities and management styles. Drugs are mainlypurchased out-of-pocket from private for-profit retailers. The Government has recentlyintroduced thousands of non-profit community outlets, but their impact on access and the costssupported by patients remains to be seen.
In response to these issues, the Government is finalizing its health care financing strategy toimprove health care financing polices that would realistically enhance access, equity andeffectiveness in resource mobilization and allocation, as well as the use of health services.
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3.5 Human resources for health
In 2004, there was one physician for every 880 people, one nurse for every 235, one dentist forevery 1800, and one pharmacist for every 1664. However, these ratios have most likely changed,especially with the exodus of nurses in the past five years. The country is purportedly theleading exporter of nurses to the world and the second major exporter of physicians. Prevailingchallenges include unmanaged immigration of Filipino health workers; a weak and inadequate
human resources for health (HRH) information system; and an existing distribution imbalance,among others. Responses to HRH issues in the past have often been stopgap measures. Inaddition, the interventions of the agencies concerned have not always been well coordinated.
In order to address such complex and multi-faceted issues, a comprehensive approach is needed. A master plan for human resources for health has been developed and implementation ofactivities is underway. A high-level coordinating body and multisectoral working group wasestablished in 2006 to mobilize political commitment, donor/partner support and the fundingneeded to accomplish the priority activities of the master plan. Called the Human Resources forHealth (HRH) Network, this group was able to successfully convene a policy forum to advocatetheir policy agenda, which aims to resolve issues related to production, entry and retention ofhealth professionals, as well as their exit and re-entry.
Strategic thrusts for 2005-2010 include development of HRH policies and strategies to addressout-migration; sustaining incentive mechanisms for HRH distribution and complementation inunderserved areas; and making education, training and skills development more appropriate tolocal needs. The strategies that are being undertaken include, among others, theinstitutionalization of the health human resource management and development system;improvement of the technical competence and relevant skills of health professionals througheducation and training; provision of targeted and performance-linked compensation benefits;strengthening of the coordination mechanism between the education sector, regulatory agenciesand HRH users; and installation of and HRH information system.
3.6 Partnerships
The attainment of national health goals has significantly progressed given the well-defined,commonly-shared vision and framework for health (now called FOURmula ONE).Department of Health experience has shown that better harmonization of efforts among the various stakeholders at all levels is critical. Currently, assistance for the health sector comesmainly in the form of grants, loans and technical assistance. A sectorwide development approachfor health (SDAH) between government and partners is being initiated to maximize investments,minimize duplication of initiatives and generate the necessary resources for the health sector. TheDepartment of Health is also working closely with international organizations and globalinitiatives to strengthen implementation of priority health programmes.
3.7 Challenges to health system strengthening
The publicly funded health system has been undergoing a major reform programme since 1999. At the broadest level, this has included a review of the Department of Healths primaryfunctions, roles and responsibilities and the suitability of the existing organizational structure tosupport these at both the strategic and service-delivery level. Introducing and pilot-testing the
different concepts and strategies of heath sector reform in selected provinces has showcasedsome gains in health systems development. However, one of the gaps then was the absence of acomprehensive operational framework to implement the reform strategies. Thus, theFOURmula ONE framework was launched in August 2005 to set the direction andimplementation arrangements for strengthening the way health care is delivered, governed,regulated and financed.
FOURmula ONE is now on its third year of implementation and both the Department of Healthand the LGUs are being challenged with operational issues, such as procurement. In addition,the health care delivery system has yet to address some major issues and challenges including,
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among others: the absence of data disaggregated at provincial/municipal level (for baseline andmonitoring); the absence of a workable means of identification of the poor for targeted healthinterventions; the minimal involvement of the private sector in the delivery of public healthprogrammes; the still excessive reliance on the use of high-end hospital services rather thanprimary care; the slow improvement in maternal mortality reduction; and population growth.Issues such as geographic inequity, where people who live in rural and isolated communitiesreceive less and lower quality health services, and socioeconomic inequity, where the poor do not
receive health services due to inaccessibility and/or unaffordability, continue to abound in thecountry.
More specific issues like out-migration of skilled health workers, low salaries/wages and lack ofincentives and poor work environments, including shortages of basic medical equipment andsupplies, continue to contribute to the worsening shortage of workers in rural areas, where healthneeds are greatest. Hospitals, both public and private, all over the country lament the loss ofsenior experienced nurses and doctors. The University of the Philippines-Philippine GeneralHospital (UP-PGH), the largest hospital in the country, loses 300 to 500 nurses of their 2000nurse workforce every year. Midwives, the front liners in providing health services, are alsoseeking jobs as caregivers in other countries in need.
There is a lack of reliable, disaggregated and integrated health and health-related data, evidence
and information, and inability to use health information to ensure knowledge-based policies andprogrammes remains a major challenge. There is also low investment in health research anddevelopment systems, as well as in information management systems.
In the area of health care financing, the following challenges remain: high out-of pocketspending; inadequate government spending on health; low spending for cost-effective publichealth interventions; low social health insurance benefit spending; and identification of the truepoor for social health insurance (sponsored programme).
The high cost of drugs and medicines also remains a major challenge, as prices range from twotimes to as much as 30 times higher than in other neighbouring Asian countries. To date, theCheaper Medicines Bill, which aims to effectively reduce the cost of medicines in the country, isyet to be signed by the President of the Philippines.
The devolution of health services created new challenges for the Government in overseeing thatlocal actions are in accordance with national policies and goals. Good governance in health atthe local levels, particularly in improving transparency and accountability in finance andprocurement, and logistics management remains a big challenge. With FOURmula ONE,systems of accountability and transparency are being established to minimize unscrupulousbehaviour, thereby ensuring efficient use of available resources for health.
4. LISTING OF MAJOR INFORMATION SOURCES AND
DATABASES
Title 1 : National Statistics Office.Web address : http://www.nso.gov.ph/
Title 2 : 2007 Government of the Philippines year-end reportWeb address : http://www.gov.ph/faqs/yearend_reports.asp
Title 3 : Philippine environment monitor 2006. The World Bank Group. June 2007Web address : http://www.worldbank.org.ph/pem
Title 4 : National Epidemiology CenterOperator Department of Health, PhilippinesWeb address : http://www2.doh.gov.ph/nec/
Title 5 : 2007 Philippines Development Forum8-9 March 2007, Cebu City, Philippines.
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Title 6 : 2005-2010 National Objectives for HealthOperator : Department of Health, PhilippinesWeb address : http://www2.doh.gov.ph/nec/
Title 7 : National Nutrition and Health Survey (NNHeS): Atherosclerosis-related diseaseand risk factors
Authors : Antonio Dans, Dante Morales, Felicidad Velandria, Teresa Abola,
Artemio Roxas Jr., Felix Eduardo Punzalan, Rosa Allyn Gy,Elizabeth Paz-Pacheco, Lourdes Amarillo and Maria Vanessa VillaruzSpecification : Philippine Journal of Internal Medicine, 43:103-115, May-June 2005.
Title 8 : Philippine nutrition facts and figures 2005Operator : Food and Nutrition Research Institute.
Department of Science and TechnologyTaguig, Metro Manila
5. ADDRESSES
DEPARTMENT OF HEALTH
Office Address : San Lazaro Compound, Tayuman,Sta. Cruz, Manila
Official Email Address : [email protected] : (632) 743-8301Fax : (632) 743-1829Website : http://www.doh.gov.ph
WHOREPRESENTATIVE IN THE PHILIPPINES
Office Address : 2nd Floor, Bldg 9, Department of HealthSan Lazaro Compound, Tayuman, Sta. Cruz, Manila
Postal Address : P.O. Box 2932, ManilaOfficial Email Address : [email protected] : (632) 338-7479/ 338-8605Fax : (632) 731-3914
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6. ORGANIZATIONAL CHART: Department of Health
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Year Source
Demographics
1 300.00 2006 1
2 88 574.61 2007 2
3 2.04 2000-07 2
4
11.47 a 11.64 a 11.29 a 2005 3
22.28 a 22.70 a 21.87 a 2005 3
4.40 a 4.02 a 4.78 a 2005 3
5 64.00 2007 est 4
6 20.50 2004 7
7 4.80 2004 7
8 1.73 2005 6
9
67.00 64.00 a 70.00 a 2004 7
10.60 12.10 2002 11
10 3.18 2005-15 6
11 92.60 1995-2005 8
12 1 461.33 2007 9
13 8.10 2007 9
14 0.77 2005 8
15 30.20 2003 10
16
17
36 24 12 2004 7
45 350 416 2007 17
34 22 12 2006 5
2 218 b 84 1 374 2006 5
2 517 2006 16
35 405 122 2006 22
63 41 22 2006 5
11 374 c 5 869 c 5 505 c 2006 5
Leprosy
Malaria
Plague
364 | COUNTRY HEALTH INFORMATION PROFILES
- 514 years
- 65 years and above
COUNTRY HEALTH INFORMATION PROFILE
INDICATORS DATA
Area (1 000 km2)
Female
WESTERN PACIFIC REGION HEALTH DATABANK, 2008 Revision
Total Male
Estimated population ('000s)
Annual population growth rate (%)
Percentage of population
- 04 years
Rate of natural increase of population (% per annum)
Urban population (%)
Crude birth rate (per 1000 population)
Crude death rate (per 1000 population)
Life expectancy (years)
- at birth
- Healthy Life Expectancy (HALE) at age 60
Socioeconomic indicators
Total fertility rate (women aged 1549 years)
Adult literacy rate (%)
Proportion of vehicles using unleaded gasoline (%)
Health care waste generation (metric tons per year)
Typhoid fever
Selected communicable diseases
Per capita GDP at current market prices (US$)
Environmental indicators
- Type B
- Type C
Female
Total Urban
Human development index
Rate of growth of per capita GDP (%)
Dengue/DHF
Gonorrhoea
- Unspecified
Cholera
Encephalitis
Rural
Number of deaths
FemaleMaleTotal
Number of new cases
Total Male
Syphilis
Communicable and noncommunicable diseases
Hepatitis viral
- Type E
- Type A
PHILIPPINES
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Year Source
18 690 566 b 348 992 328 956 2006 5
19 3 538 2 069 1 469 2004 7
20
147 305 2006 16
85 740 ... 2006 16
21
106 884 d 51 980 d 54 864 d 42 686 22 551 20 135C: 2005
D: 200412, 7
14 043 d 14 043 d 4 254 55 4 199C: 2005
D: 200412, 7
8 585 d 4 737 d 3 848 d 2 230 1 234 996C: 2005
D: 200412, 7
7 277 d 7 277 d 1 111 1 111C: 2005
D: 200412, 7
992 d 647 d 345 d 452 307 145C: 2005
D: 200412, 7
4 202 d 2 243 d 1 959 d 2 460 1 234 1 226C: 2005
D: 200412, 7
4 113 d 2 140 d 1 973 d 1 927 1 201 726C: 2005
D: 200412, 7
7 629d
5 660d
1 969d
. . .
C: 2005
D: 2004 12, 7
3 932 d 2 368 d 1 564 d 1 439 811 628C: 2005
D: 200412, 7
17 238 d 13 273 d 3 965 d 7 240 5 446 1 794C: 2005
D: 200412, 7
22
54 045 30 598 23 447 2004 7
28 663 18 571 10 092 2004 7
43 077 24 322 18 755 2004 7
15 617 8 614 7 003 2004 7
13 915 7 065 6 850 2004 7
2 183 930 1 253 2004 7
23 16 552 7 970 8 582 2004 7
24 1 104 799 305 2004 7
25
12 646 11 613 1 033 2004 7
6 976 5 312 1 664 2004 7
1 818 1 400 418 2004 7
26
670 231 342 989 327 242 828.80 794.50 767.20 2006 5
572 259 295 827 276 432 707.70 685.30 648.10 2006 5537 100 265 320 271 780 689.90 614.60 637.20 2006 5
404 141 177 059 227 082 522.80 410.20 532.40 2006 5
337 275 161 446 175 829 435.00 374.00 412.20 2006 5
130 608 82 969 47 639 169.90 192.20 111.70 2006 5
38 482 17 946 20 536 49.30 41.60 48.10 2006 5
25 400 12 675 12 725 32.50 29.40 29.80 2006 5
22 284 12 128 10 156 27.60 28.10 23.80 2006 5
15 279 8 076 7 203 19.60 18.70 17.00 2006 5
1. ALRI and Pneumonia
Circulatory
- Cerebrovascular diseases
- Liver
- All forms
- Leukaemia
- Lip, oral cavity and pharynx
- Trachea, bronchus, and lung
7. Diseases of the Heart
INDICATORS DATA
Tuberculosis
Mental disorders
Male Female
- New pulmonary tuberculosis (smear-positive)
Cancers
All cancers (malignant neoplasms only)
- Hypertension
All circulatory system diseases
- Acute myocardial infarction
Number of deaths
Male
All types
- Homicide and violence
- Motor and other vehicular accidents
Female
Number of cases
Male
- Occupational injuries
- Suicide
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3. Bronchitis/Bronciolitis
2. Acute Watery Diarrhea
10. Dengue Fever
Female
6. TB Respiratory
8. Acute Febrile Illness
9. Malaria
Rate per 100 000 population
Total
4. Hypertension
5. Influenza
- Ischaemic heart disease
Number of new cases
Leading causes of mortality and morbidity
Total Male
- Stomach
- Breast
Female TotalTotal
Leading causes of morbidity (inpatient care)
Injuries
- Rheumatic fever and rheumatic heart diseases
Diabetes mellitus
- Colon and rectum
- Cervix
- Oesophagus
Communicable and noncommunicable diseases
Diarrhoeal diseases
Acute respiratory infections
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Year Source
27
70 861 40 361 30 500 85.72 96.99 74.30 2004 7
51 680 28 930 22 750 62.52 69.52 55.42 2004 7
40 524 21 395 19 129 49.02 51.42 46.60 2004 7
34 483 28 041 6 442 41.30 67.39 15.69 2004 7
32 098 15 822 16 276 38.83 38.02 39.65 2004 7
25 870 17 841 8 029 31.30 42.87 19.56 2004 7
21 278 10 916 10 362 25.74 26.23 25.24 2004 7
18 975 13 084 5 891 22.95 31.44 14.35 2004 7
16 552 7 970 8 582 20.02 19.15 20.91 2004 7
13 180 7 809 5 371 15.94 18.77 13.08 2004 7
28 35.90 2006 13
29 36.00 2007 16
30 43.90 2003 14
31 12.00 2006 13
32 54.80 2003 15
33
90.00 2007 16
87.00 2007 16
87.00 2007 16
88.00 2007 16
34
152 2004 7
317 2004 7
35
172 2007 16
39 2007 16
530 2007 16
..
121 2007 16
17 2007 16
0 0 0 2007 16
1 261 2007 16
3. Malignant Neoplasm
Leading causes of mortality
Total
366 | COUNTRY HEALTH INFORMATION PROFILES
Total Male
2. Vascular System Diseases
Number of deathsNumber of cases
Female
Total
DATA
Number of deaths Rate per 100 000 population
Male Female
MaleMaternal, child and infant diseases
1. Heart Diseases
6. Tuberculosis, all form
INDICATORS
Male FemaleTotal Male Female Total
Female
- Pertussis (whooping cough)
- Rubella
- Congenital rubella syndrome
- Sepsis
- Mumps
- Hib meningitis
- Poliomyelitis
- Eclampsia
- Haemorrhage
- Abortion
Selected diseases under the WHO-EPI
- Obstructed labour
- Measles
Percentage of pregnant women with anaemia
Percentage of pregnant women immunized with tetanus toxoid (TT2)
8. Chronic lower respiratory diseasesw
9. Diabetes Mellitus
Immunization coverage for infants (%)
- POL3
- BCG
- DTP3
- Diphtheria
Percentage of newborn infants weighing at least 2500 g at birth
4. Accidents
10. Certain conditions originating in the perinatal period
Percentage of women in the reproductive age group using modern
contraceptive methods
7. Ill-defined and unknown causes of mortality
5. Pneumonia
Neonatal mortality rate (per 1000 live births)
Maternal causes
- Hepatitis B III
- Total Tetanus
- Neonatal tetanus
-
8/2/2019 Philippines 08
14/16
PHILIPPINES
Year Source
36
37
Public health facilities 682 37 400 2006 19
21 10 374 2006 19
713 e 22 023 2006 19
2 293 2006 17
Private health facilities 1 068 36 519 2006 19
38
3 911.61 2006p 20
3.30 2006p 20
45.34 2006p 20
1 549.17 2006p 20
39.60 2006p 20
6.40 2006p 20
8.33 2006p 20
60.40 2006p 20
51.31 2006p 20
39
Year Source
40
Physicians - Number 93 862 2004 21
- Rate per 1000 population 1.14 2004 21
Dentists - Number 45 903 2004 21
- Rate per 1000 population 0.55 2004 21
Pharmacists - Number 49 667 2004 21
- Rate per 1000 population 0.60 2004 21
Nurses - Number 352 398 2004 21
- Rate per 1000 population 4.26 2004 21
Midwives - Number 136 036 2004 21
- Rate per 1000 population 1.65 2004 21
Paramedical staff - Number
- Rate per 1000 population
Community health workers - Number
- Rate per 1000 population
41 Physicians
Dentists
Exchange rate in US$ of local currency is: 1 US$ =
- external resources for health as % of general government expenditure
on health
Number of beds
COUNTRY HEALTH INFORMATION PROFILES| 367
Rural
Pu
blic
DATA
Ur
ban
Number
DATA
Human resources for health
Health insurance coverage as % of total population
Private
M
ale
Female
Total
INDICATOR
Private health expenditure
- private expenditure on health as % of total expenditure on health
External source of government health expenditure
Health facilities
INDICATORS
- general government expenditure on health as % of total expenditure on
health
Total health expenditure
- total expenditure on health as % of GDP
- amount (in million US$)
- general government expenditure on health as % of total general
government expenditure
- amount (in million US$)
- General hospitals
- Specialized hospitals
- District/first-level referral hospitals
- Primary health care centres
- per capita total expenditure on health (in US$)
Government expenditure on health
Health care financing
- Outpatient clinics
Facilities with HIV testing and counseling services
Health infrastructure
- Hospitals
Annual number of
graduates
-
8/2/2019 Philippines 08
15/16
PHILIPPINES
Year Source
41 Pharmacists
Nurses
Midwives
Paramedical staff
Community health workers
42 Physicians
Dentists
Pharmacists
Nurses
Midwives
Paramedical staff
Community health workers
Year Source
43 27.60 2003 14
44 24.00 2006 13
45 32.00 2006 13
46 92.00 2007 16
47 162.00 2006 13
48 63.70 2006 13
20.30 2006 13
42.40 2006 13
49 50.60 2006 13
50 4.80 2006 13
51 Antenatal care coverage - At least one visit
- At least four visits 59.00 2006 5
52 15.70 2006 5
53
54 0.02 2007 18
55
56 410.00 2006 16
57 0.14 2006 16
58 17.00 2006 22
59 85.00 2006 22
60 432.00 2006 16
61 45.00 2006 16
62 77.00 2006 16
63 82.00 2005 16
64 93.00 96.00 88.00 2006 23
65 78.00 81.00 72.00 2006 23
66
DATA
Proportion of population in malaria-risk areas using effective malaria
prevention measures
Health-related Millennium Development Goals (MDGs) Female
Proportion of tuberculosis cases detected under directly observed
treatment short-course (DOTS)
368 | COUNTRY HEALTH INFORMATION PROFILES
Tuberculosis death rate per 100 000 population
Total
Male
HIV prevalence among population aged 15-24 years
Estimated HIV prevalence in adultsf
Proportion of population using an improved sanitation facility
Proportion of population using an improved drinking water source
Malaria death rate per 100 000 population
Unmet need for family planning
INDICATORS
INDICATORS
Total
DATA
Private
Male
Urban
Rural
Public
Female
Under-five mortality rate (per 1000 live births)
- Percentage of deliveries at home by skilled health personnel (as % of
otal deliveries)
Infant mortality rate (per 1000 live births)
Annual number of
graduates
Workforce losses/ Attrition
Adolescent birth rate
Total Urban Rural
Proportion of population with access to affordable essential drugs
on a sustainable basis
Contraceptive prevalence rate
Proportion of tuberculosis cases cured under directly observed
treatment short-course (DOTS)
Proportion of population in malaria-risk areas using effective malaria
treatment measures
Tuberculosis prevalence rate per 100 000 population
Maternal mortality ratio (per 100 000 live births)
Prevalence of underweight children under five years of age
Proportion of 1 year-old children immunised against measles
Proportion of births attended by skilled health personnel
- Percentage of deliveries in health facilities (as % of total deliveries)
Malaria incidence rate per 100 000 population
Percentage of people with advanced HIV infection receiving ART
-
8/2/2019 Philippines 08
16/16
PHILIPPINES
p
est
NR
a
b
c
d
e
f
1
2
3
4
5
6
7
8
9
10
1112
13
14
15
16
17
18
19
20
21
22
23
COUNTRY HEALTH INFORMATION PROFILES| 369
World Health Organization and United Nations Children's Fund Joint Monitoring Programme for Water Supply and Sanitation (JMP). Progress on Drinking Water and Sanitation:
Special focus on Sanitation . UNICEF, New York and WHO, Geneva, 2008. [http://www.wssinfo.org/en/40_mdg2008.html]
WHO Regional Office for the Western Pacific, data received from technical units.
National Epidemiology Center, Department of Health, Philippines.
2007 Estimation Workshop and Concensus Meeting, National Epidemiology Unit, Department of Health, Philippines.
National Malaria Control Program, Department of Health, Philippipnes.
Professional Regulation Commission. Philippines
Official Website of the Republic of the Philippines [http://www.gov.ph/]
2007 Census of Pouplation, National Statistics Office Presss Release. [http://www.census.gov.ph/data/pressrelease/2008/pr0830tx.html]
Projected Population by Five-Year Age Group and by Sex, by Five Yr. Interval, Medium Assumption.National Statistics Office. [http://www.census.gov.ph/data/sectordata/poproj07.txt]
United Nations, Department of Economic and Social Affairs, Population Division (2007). World Population 2006. Wallchart (United Nations publication, Sales No. E.08.XIII.3).
Field Health Service Information System. Department of Health, Philippines.
NSO Quick Stat Index Page. National Statistics Office, Philippines. Feb. 2008.
National Statistical Coordination Boardm, Philippines.
Bureau of Health Facilities and Services, Department of Health
World Health Organization - National health accounts series [http://www.who.int/entity/nha/country/MYS.pdf]
Sources:
Not relevant
Not included in the official list of MDG indicators
Human Development Report 2007/2008: Fighting climate change: Human solidarity in a divided world . United Nations Development Programme, New York USA 2007.
Provisional
Estimate
2004 Philippine Health Statistics, National Statistics Office. Philippines, 2004.
Estimated figure
Notes:
Data not available
[http://hdr.undp.org/en/reports/global/hdr2007-2008/]
District hospital can be general or special
Revised data
Totals may not tally due to some reported cases with no gender breakdown
Figure includes paratyphoid fever
2006 Family Planning Survey, National Statistics Office, Philippines.
2003 National Demographic Health Survey, National Statistics Office, P hilippines.
Land Transportation Office. Department of Transportation and Communication, Philippines.
World health report 2004. Changing history. Geneva, World Health Organization, 2004.2005 Philippine Cancer Facts and Figures, by the Philippine Cancer Society, Rizal Medical center and Department of Health.
Sixth National Nutrition Survey, National Nutrition Council, Department of Health, Philippines, 2003.