SOCSCI 2: CURRENT ISSUES & SOCIAL PROBLEMS
The Philippine
Health Problem
Presented by
Celestino, Matthew W.
Presentation Timeline
01 02 03 04 05
Definition History DOH Epidemics & Health Care
Statistics Financing
Definition of Historical Timeline The Philippine
terminologies of Philippine Health Healthcare System Epidemics and Expenditure of the
Problems Statistics of Filipino People in
Diseases prevalent Health Care
throughout the
years
Presentation Timeline
06 07 08 09
Legislation Human Marcos Q&A
Resources Admin on
Legislative Efforts Question and
in Health Care Health Care Answer Portion
Health Care
Provider and The Philippine
Worker's situation Health Care
in the Philippines System Under
Marcos
Administration
Definition of Terms
Health Care Healthcare Epidemic
Health care are the Healthcare is an industry, A widespread occurrence
specific things that people the system by which of an infectious disease in
do: see a patient or people get the health care a community at a
prescribe a medication. they need. particular time.
Definition of Terms
Legislation Human Resources
the personnel of a
The preparing and
business or organization,
enacting of laws by local,
especially when regarded
state, or national
as a significant asset.
legislatures.
History of Health Care
in the Philippines
Pre Colonial Period
Healing practices were first documented in the 16th century at the start of
Spanish colonization, so it’s hard to tell how early they began.
The babaylans or shamans — who were women but also men who dressed as
women or changed genders — maintained culture, religion, and medicine for their
tribes, and communicated with spirits that were thought to be associated with
natural phenomena.
History of Health Care
in the Philippines
Pre Colonial Period, 1565
Traditional Filipino medicine takes a holistic view of the individual, including environmental
factors that affect a person’s physical, mental, emotional, and spiritual well-being.
According to Apostol, the traditional Filipino medical system was composed of various
specialties: midwifery, pulse diagnosis, bonesetting, herbology, suction cupping, skin scraping,
herbal steam and smoke, energy medicine, and other forms of metaphysical healing.
History of Health Care
in the Philippines
Pre Colonial Period, 1565
Each area and group of people had their own set of healers, who passed down their
knowledge to children at an early age.
Along with other cultural traditions, the healing arts began to fade in the 17th century, and
continued with the introduction of hospitals and Western medicine after the Americans
arrived.
History of Health Care
in the Philippines
Colonial Period (Spanish Occupation), 1565-1898
As the Spanish were exposed to the unfamiliar environment of the Philippines, they were
stricken with foreign diseases. To combat this, they created hospitals especially for their
health. Some of the first health institutions in the country were handled by Spanish friars.
Hospital Real
Built in Cebu in 1565, Hospital Real was the first hospital in the Philippines. It was relocated to
Manila to accompany the government. The hospital aimed to nurse the Spanish army and
navy, those inflicted with disease, and military casualties.
History of Health Care
in the Philippines
Colonial Period (Spanish Occupation), 1565-1898
Hospital de Naturales
Fray Juan Clemente, a 54-year-old botanist, and lay brother were instrumental in the conception
of the Hospital de Naturales. He often made medicine for the many people who begged outside
the convent, until eventually, the number of patients grew too large for accommodations.
Hospital de San Lazaro
Although previously the Hospital de Naturales, the hospital was renamed after Japanese emperor
Iemitsu sent 150 lepers. Although viewed as a hostile act to the church for its growing influence in
Japan, the lepers were taken care of by the hospital, the clergy, and the community. As such, the
Hospital de Naturales became known as the Hospital de San Lazaro, after the patron saint of
lepers.
History of Health Care
in the Philippines
Colonial Period (American Occupation), 1898-1918
After the end of Spanish rule, the Filipino Revolutionary Government was established, including
a Bureau of Public Health. Although the Americans had been an ally in the fight against the
Spaniards, the Americans soon seized control of the Philippines, with the mission to “uplift and
civilize”.
Under General Wesley Merritt, a Board of Health for supervising public health was established
on September 29, 1898.
The Board of Health’s biggest challenge was smallpox, which they battled by standardizing
vaccine production and campaigning for vaccination.
History of Health Care
in the Philippines
Colonial Period (American Occupation), 1898-1918
Despite American efforts, public sanitation was dismal, and diseases were still spreading.
Manila faced Bubonic plague; smallpox still spread in provinces; lepers roamed the streets.
Laws requiring vaccination and isolation of infected were ignored by the public. On July 1, 1901,
The Board of Health for the Philippine Islands was established. The Board soon became the
Insular Board of Health as provincial and municipal boards were created.
The Insular Board of Health was given the power to draft legislation for sanitary and medical
practices in the Philippines. They were tasked with studying diseases and prevention methods,
as well as overseeing public health.
History of Health Care
in the Philippines
The Filipinization of Health, 1918-1941
Under the Jones Law and the governance of Governor-General Francis Harrison, the Filipinos were
slowly allowed to practice self-governance. The Department of Public Instruction, one of the four
executive departments of the government, was in charge of the Philippine Health Service.
The Department of Public Instruction was managed by Dr. Victor Heiser, during whose term the
Philippine General Hospital was put up. The Filipinization of Health Services started when Dr. Vicente
de Jesus, the first Filipino Assistant Director of the Department of Public Instruction, became Director
in 1919.
History of Health Care
in the Philippines
The Filipinization of Health, 1918-1941
Succeeding Harrison was Leonard Wood. Together with ex Governor-General William Forbes, Wood
found the health status of the Philippines to be below par. Cases of typhoid, tuberculosis, and other
preventable diseases were rampant. Facilities and trained medical personnel were insufficient to care
for the almost ten million Filipinos.
Under Wood’s administration, importance was given to health education, especially for mothers and
young children. Prevention rather than treatment was a key strategy, and Act No. 3029 required school
children to go through a health examination at least once a year. There were also initiatives to increase
the number of Filipino health workers, such as the establishment of the School of Public Health and
Hygiene.
History of Health Care
in the Philippines
The Filipinization of Health, 1918-1941
After Wood, Theodore Roosevelt, Jr. became Governor-General in 1932. He abolished several
medical agencies and combined them under the Bureau of Health and Public Welfare. Roosevelt
focused on educating the public on health. Through the Bureau of Health’s pamphlet publication
“The Health Messenger”, public radio, posters, and festivals for lectures on health, Roosevelt was
able to increase public health awareness.
On May 31, 1939, the Department of Health and Public Welfare was established through
Commonwealth Act 430. By now, the Tydings-McDuffie Act had been ratified, and the Philippines
was on its way to independence.
Department Of Health
The Philippine Healthcare System
The Philippine Healthcare System
Department of Health
The Department of Health is the executive department of the government of the
Philippines responsible for ensuring access to basic public health services by all
Filipinos through the provision of quality health care, and the regulation of all health
services and products.
the DOH has three major roles in the health sector: (1) leadership in health; (2)
enabler and capacity builder; and (3) administrator of specific services.
Its mandate is to develop national plans, technical standards, and guidelines on
health. Aside from being the regulator of all health services and products, the DOH
is the provider of special tertiary health care services and technical assistance to
health providers and stakeholders.
Department of Health Org. Chart
The Philippine Healthcare System
The Philippine Healthcare System
Public Healthcare
In general, public hospitals and other public facilities handle preventive and primary
care in the Philippines. Private facilities provide specialized care in areas such as
cardiovascular disease or orthopedics.
Barangay (village) health stations and local health centers meet much of the
country’s primary care needs. Public hospitals have sometimes struggled with
staffing levels, as care providers can often find better-paying jobs in the private
sector or by moving overseas. Due to the issues with staffing and the fact that
more patients seek care at these facilities, treatment delays are not uncommon at
public hospitals. Those who can afford it often turn to private settings.
The Philippine Healthcare System
Private Sectors
In the Philippines, as in most other nations, private treatment provides several
additional benefits to patients. Newer, cleaner and more comfortable facilities are
available. Staff are multilingual and wait times are less.
Private care in the Philippines usually means additional comfort for patients. With
fewer people seeking care, it’s often faster to obtain treatment. Plus private
facilities have more up-to-date equipment.
The Philippines’ healthcare system
relies heavily on private providers.
30% 60%
Most hospitals – almost 60% – are also
About 30% of the Philippine
privately owned. Medical tourism is an
population uses the private
important part of the economy, which
healthcare system as their main
explains why there are so many private
source of care.
hospitals and speciality clinics.
Epidemics & Statistics
Epidemics and Statistics of Diseases & Ilnesses throughout the
Philippines
Epidemics in the Philippines
An epidemic is a widespread occurrence of an infectious disease in a
community at a particular time.
Here are some of the most notable epidemics in Philippine history :
Smallpox
Most of the time people ignore the bronze statue that stands outside the Manila Cathedral in Intramuros.
Erected in the 19th century, the monument was built to honor Charles IV of Spain for giving the Philippines the
smallpox vaccine. In 1805, the Spanish royal vaccination expedition came to the country with 25 Mexican
orphan boys carrying the disease. The governor general and his own children were injected with the smallpox
virus as a vaccine, and so people got over their fear of the disease.
Bubonic Plague
The bubonic plague came to the country in 1899, 1905, and as late as 1912. It was spread by rats and the fleas
on them. In order to contain the disease, the main entry point, the port, was controlled. Filipinos started to stop
ships from getting close to wharfs, utilizing iron gangplanks for loading and unloading passengers and cargo. It
was later discovered that the pests could jump off ships and swim to Manila, so the ports were renovated and
given smooth concrete walls so that the rodents would not be able to climb their way up inland.
Epidemics in the Philippines
An epidemic is a widespread occurrence of an infectious disease in a
community at a particular time.
Here are some of the most notable epidemics in Philippine history :
Cholera
There were as many casualties from fear as from the disease itself. There was a time the natives felt that the
foreigners were poisoning the Pasig River and, because of their fear, there was a massacre of white people.
In the American period, during times of cholera, people were so scared of the Red Cross or the Medical Corps
because they would come to find the infected person, take them into a carriage, bring them to a hospital, and,
for many people, that would be the last time they would see their relatives alive.
The disease ravaged the Philippines in the early 1900s and what people do not remember is that this was the
period the Filipinos won their independence from Spain. Hidden in the historical literature was that sometimes
the American military officials would use health as a way to contain the rebellion.
Cholera’s most prominent victim was Apolinario Mabini, who died after drinking tainted carabao’s milk. The
protocol for the disease in 1943 was that the body should be cremated without any funeral. Apolinario was an
exception, as he had one of the biggest funerals of the time, and he was buried in the Chinese cemetery.
Epidemics in the Philippines
An epidemic is a widespread occurrence of an infectious disease in a
community at a particular time.
Here are some of the most notable epidemics in Philippine history :
Dengue
In the Philippines, dengue is probably the most well-known and feared tropical disease. The first recorded
dengue epidemic in Southeast Asia occurred in Manila in 1954, and dengue has since remained endemic.
In 2019, 437,563 cases were recorded in the Philippines, contributing to the highest dengue cases ever
recorded globally.
Measles
Measles outbreaks increased worldwide during 2017-19. The largest outbreak in the World Health Organisation
Western Pacific region occurred in the Philippines where first-dose measles-containing vaccine (MCV1)
coverage had reduced to 75% in 2018
Leading illnesses in the Philippines
Illness is a broad term that defines the poor state of mind, body, and, to a certain extent, spirit.
It is the general feeling of being sick or unwell (outside the person's belief of good health).
Top 10 Cause of Mortality
Source : DOH
Maternal Mortality Rate
Source : DOH
Healthcare Financing
Expenditure of the Filipino People in Healthcare
Expenditure of the Filipino People
in Healthcare
On average, every Filipino spent P8,216 for healthcare goods and services in 2020, 10.7 percent higher than the
P7,422 a year ago.
Over the past 29 years, healthcare spending in the country has been increasing at an annual average of 11.3
percent.
Despite the annual increase, the Philippines still spends less on healthcare than neighboring Southeast Asian
countries like Thailand, Vietnam, Singapore and Malaysia.
Expenditure of the Filipino People
in Healthcare
The country’s health spending or Current Health Expenditure (CHE) reached PhP 1.09 trillion in 2021, 18.5
percent higher compared with PhP 917.15 billion posted in 2020. This increment was faster than the 12.8 percent
growth registered in the previous year. Meanwhile, Gross Health Capital Formation Expenditure (HK) amounted
to PhP 71.15 billion in 2021, lower by -19.6 percent compared with PhP 88.54 billion reported in 2020.
Health spending financed through government schemes and compulsory contributory health care financing
schemes was the largest among sources of health financing in the country in 2021. It amounted to PhP 546.64
billion or 50.3 percent of CHE. Household-out-of-pocket payment (OOP) came second at PhP 451.00 billion
(41.5%), followed by voluntary health care payment schemes which contributed PhP 89.35 billion (8.2%). (Tables
10 and 12, and Figure 2)
Among health care providers, hospitals received the bulk of CHE amounting to PhP 453.23 billion or 41.7 percent
share. It was followed by retailers and other providers of medical goods (26.2%) and providers of health care
system administration and financing (14.8%). (Tables 13 and 15)
Expenditure of the Filipino People
in Healthcare
Expenditure of the Filipino People
in Healthcare
Expenditure of the Filipino People
in Healthcare
Philhealth
The PhilHealth program was set up in 1995 to provide affordable universal coverage. In 2019, the country
reached a major milestone with the Universal Health Care (UHC) Law. PhilHealth covers all kinds of medical care,
including preventive, curative, and rehabilitative services. Thanks to the UHC Law, medical consultations and
diagnostic testing, including lab tests, began to be covered.
PhilHealth counts about 90% of the country’s population as members. Much of the funding for the Philippines’
healthcare comes from “sin taxes” on alcohol and tobacco. The first of these went into effect in 2012; its
success resulted in additional such taxes in later years. Many workers and employers also pay premiums that
help support PhilHealth.
Expenditure of the Filipino People
in Healthcare
Philhealth
PhilHealth has different membership categories that vary based on work status, income, and age. The six major
groups are:
Formal Sector: Workers employed by public and private companies
Indigents: Impoverished people subsidized by the national government
Sponsored Members: People subsidized by their local governments
Lifetime Members: Retirees and pensioners who previously paid 120 months of premiums
Senior Citizens: A category open to those who are 60 years of age or older, and who do not qualify as
Lifetime Members
The Informal Economy: Self-employed people, migrant workers, and overseas Filipino workers; expats who
are legally living in the Philippines are eligible to join PhilHealth in this category
Did you know that 60% of Filipino
People who succumb to illness die
without seeing a doctor?
It is estimated that 70% of all
healthcare workers that are
employed in the privatized sector
can barely afford proper
healthcare.
Legislation
Legislative Efforts in Health Care
Philippine Legislation on
Health Care
Legislation is the preparing and enacting of laws by local, state, or national legislatures.
Listed below are the Laws regarding health care in the Philippines:
Republic Act 349 – Legalizes the use of human organs for surgical, medical and scientific purposes.
Republic Act 1054 – Requires the owner, lessee or operator of any commercial, industrial or agricultural
establishment to furnish free emergency, medical and dental assistance to his employees and laborers.
Republic Act 1080 – Civil Service Eligibility
Republic Act 1082 – Rural Health Unit Act
Republic Act 1136 – Act recognizing the Division of Tuberculosis in the DOH
Republic Act 1612 – Privilege Tax/Professional tax/omnibus tax should be paid January 31 of each year
Republic Act 1891 – Act strengthening Health and Dental services in the rural areas
Republic Act 2382 – Philippine Medical Act which regulates the practice of medicines in the Philippines
Republic Act 2644 – Philippine Midwifery Act
Philippine Legislation on
Health Care
Legislation is the preparing and enacting of laws by local, state, or national legislatures.
Listed below are the Laws regarding health care in the Philippines:
Republic Act 3573 – Law on reporting of Communicable Diseases
Republic Act 4073 – Liberalized treatment of Leprosy
Republic Act 4226 – Hospital Licensure Act requires all hospital to be licensed before it can operative
Republic Act 5181 – Act prescribing permanent residence and reciprocity as qualifications for any examination
or registration for the practice of any profession in the Philippines
Republic Act 5821 – The Pharmacy Act
Republic Act 5901 – 40 hours work for hospital workers
Republic Act 6111 – Medicare Act
Republic Act 6365 – Established a National Policy on Population and created the Commission on population
Republic Act 6425 – Dangerous Drug Act of 1992
Philippine Legislation on
Health Care
Legislation is the preparing and enacting of laws by local, state, or national legislatures.
Listed below are the Laws regarding health care in the Philippines:
Republic Act 6675 – Generics Act of 1988
Republic Act 6713 – Code of Conduct and Ethical Standards for Public Officials and Employees
Republic Act 6725 – Act strengthening the prohibition on discrimination against women with respect to terms
and condition of employment
Republic Act 6727 – Wage Rationalization Act
Republic Act 6758 – Standardized the salaries
Republic Act 7164 – Philippine Nursing Act of 1991
Republic Act 7170 – Law that govern organ donation
Republic Act 7192 – Women in development nation building
Republic Act 7277 – Magna Carta of Disabled Persons
Human Resources
Health Care Provider and Worker's situation in the Philippines
Health Care Provider's Situation
When the “heroes” “don’t feel cared for”
The migration and resignation of Philippine Health Care Workers
Recent news reports in the Philippines highlighted that Filipino nurses are resigning to work abroad. In the first
two to three weeks of October 2021 alone, it was noted that about 5% to 10% of nurses working in private
hospitals have resigned.
In another 2021 news report, a hospital director in a city mentioned that their nursing staff had decreased from
200 to 63 over the past year.
Overall, about 40% of nurses in private hospitals have resigned since the pandemic began. Thus, hospitals in the
Philippines may be understaffed due to the dwindling number of nurses during the pandemic.
Health Care Provider's Situation
When the “heroes” “don’t feel cared for”
The migration and resignation of Philippine Health Care Workers
Among the commonly cited reasons for the resignation remained to be low wages. An entry-level nurse working
in a public hospital starts with a monthly salary of about PHP33 575 (about US$670), while those working in
private hospitals may start with as little as PHP8000 (about US$160).
These wages may not be enough to cover the cost of living in the Philippines.
For example, the estimated cost of living in Metro Manila, the largest Philippine metropolitan area, is PHP50 798
(about US$1080).
Some of the nurses even go to work without benefits and hazard pay, despite the heightened health risks and
threats during the pandemic.
Health Care Provider's Situation
When the “heroes” “don’t feel cared for”
The migration and resignation of Philippine Health Care Workers
Despite the need for livable wages and just benefits for Filipino nurses, the Philippine government responded by
banning and limiting them from living and working abroad, so they could serve as a “reserve force” as the
country navigates through the pandemic. This deployment ban was largely questioned due to its possible
unconstitutionality, violation of the right to travel and earn a living wage and negative effect on the Philippine
economy.
Given the chronic understaffing, low wages, unsafe working conditions, and deployment bans, Filipino nurses
have expressed their exhaustion and dismay with statements such as “We don't feel cared for” and “We feel
exhausted...but we always keep in mind that we have to help our people because...no one else will”.
Eventually, some of them may leave the profession or try to go abroad since “it's really not worth being a nurse
at home”.
This seemed to be the sentiment of nurses and other health care worker groups who have announced their
mass resignation from the Philippine health care system
Health Care Provider's Situation
When the “heroes” “don’t feel cared for”
Filipino health-care workers have not been immune to the growing violence and impunity in the country since
President Duterte took office in 2016. Since 2017, at least ten doctors have been violently killed in various
regions of the Philippines. Six were killed in 2017 alone.
In 2020, Mary Rose Sancelan, a city health officer in Negros Oriental, and the only doctor serving in the
province's COVID-19 pandemic response, was shot dead with her husband. She was previously red-tagged by a
local anti-communist vigilante group. In December, 2021, Raul Andutan, a surgeon and medical director in
Cagayan De Oro, was killed in broad daylight for a reported bounty of US$3000.
Marcos Jr. Administration on
Health Care
President Marcos shared long-term health plans for his administration, which include priority
bills to establish a Center for Disease Control and Prevention, as well as establishing a
Vaccine Institute. Aligned with the new administration’s calls for more affordable medicine
and bringing healthcare closer to families, the Department continues to further realize the
Universal Health Care Act around the country for the benefit of every Juan and Juana.
As of today there is still no Secretary assigned for DOH.
ACCESS TO BASIC
HEALTHCARE IS ONE OF
THE MOST IMPORTANT
DOMESTIC ISSUES THAT
OUR COUNTRY IS FACING.
Question and Answer
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THANK YOU FOR
LISTENING
The Philippine Health Problem
as presented by
Celestino, Matthew W.
