CHN LEC Development Goals, while including new

areas such as climate change, economic

Module 2: THE HEALTHCARE inequality, innovation, sustainable
DELIVERY SYSTEM consumption, peace and justice, among
other priorities.
Topic I. THE HEALTH CARE DELIVERY
SYSTEM The goals are interconnected – often
the key to success on one will involve
WORLD HEALTH ORGANIZATION tackling issues more commonly
 Provides the environment that associated with another.
facilitates cooperation and sharing 1. End poverty in all forms everywhere
of resources to promote and
protect health and to resolve 2. End hunger, achieve food security and
health problems and alleviate their improved nutrition and promote
effects sustainable agriculture
 WHO constitution came into force
3. Ensure healthy lives and promote well-
on April 7, 1948 (World Health
being for all at all ages
Day)
 Headquarters: GENEVA, 4. Ensure inclusive and equitable quality
SWITZERLAND education and promote lifelong learning
 147 Country Offices and 6 world opportunities for all
regional offices
5. Achieve gender equality and empower
WHO CORE FUNCTIONS all women and girls
Objective: the attainment by all people’s 6. Ensure availability and sustainable
highest possible level of health (WHO, management of water and sanitation for
2006) all
1. Provide leadership and engage in 7. Ensure access to affordable, reliable,
partnerships on matters of health sustainable and modern energy for all
2. Shape research agenda and promote 8. Promote sustained, inclusive and
knowledge sustainable economic
 5 goals: Capacity, Priorities, growth, full and productive employment
Standards, Translation and and decent work for all.
Organization
9. Build resilient infrastructure, promote
3. Set and monitor standards inclusive and sustainable industrialization
and foster innovation
4. Provide technical support, catalyze
change and build sustainable capacity 10.Reduce inequality within and among
countries
Sustainable Development Goals
(SDGs), a universal call to action to end 11.Make cities and human settlements
poverty, protect the planet and ensure inclusive, safe, resilient and sustainable
that all people enjoy peace and
prosperity. 12.Ensure sustainable consumption and
production patterns
These 17 Goals build on the
successes of the Millennium
13.Take urgent action to combat climate  National Health Insurance Act of
change and its impacts 1995 (R.A. 7875) created the
Philippine Health Insurance
14. Conserve and sustainably use the
Corporation (PhilHealth)
oceans, seas and marine resources for
sustainable development – aims for universal health
coverage of all Filipino citizens (Congress
15. Protect, restore and promote
of the Philippines, 1995)
sustainable use of terrestrial ecosystems,
sustainably manage forests, combat VISION: The DOH is the leader, staunch
desertification and halt reverse land advocate and model in promoting Health
degradation and halt biodiversity loss for all in the Philippines.
16. Promote peaceful and inclusive MISSION: Guarantee equitable,
societies for sustainable development, sustainable and quality health for all
development, provide access to justice Filipinos, especially the poor and shall
for all and build effective, accountable lead the quest for excellence
and inclusive institutions at all levels.
In order for public health nurse to
17. Strengthen the means of fully appreciate the public health
implementation and revitalize the global system in this country, it is
partnership for sustainable development. important to have an uderstanding
of the development of the
Topic II. PHILIPPINE DEPARTMENT OF
government agency mandated to
HEALTH
protect the health of the people.
GOVERNMENT: Department of Health The following historical account on
and Local Government Units (LGU) the institutional development of
the Department of Health was
 Local Government Code (R.A. referenced from the Souvenir
7160), Devolution: LGUs should Program published during the
meet the priority needs of their 1ooth year anniversary of DOH.
communities by providing basic
health services THE HISTORICAL BACKGROUND

PRIVATE: for-profit and non-profit Pre-Spanish and Spanish Periods

agencies (before 1898)

– provides all levels of services and  Traditional health care practices

accounts for a large segment of health especially the use of herbs and
service providers in the country rituals for healing were widely
practiced during these periods.
 Financing is provided by 3 major  The western concept of public
groups health services in the country is
– government (national and traced to the first dispensary for
local) indigent patients of Manila ran by
a Franciscan friar that was began
– private sources in 1577.
 In 1876, Medicos Titulares,
– social health insurance
equivalent to provincial health
officers were already existing.
  In 1888, a Superior Board of -Republic Act 7160 known as the
Health and Charity was created by Local Government Code provided for the
the Spaniards which established a decentralization of the entire government.
hospital system and a board of
vaccination, among others.
EO 102
September 29, 1898
-Mandates the Department of
-With the primary objective of
Health to provide assistance to local
protecting the health of the American
government units, people’s organization
soldiers, General Orders No. 15
and other members of civic society.
established the Board of Health for the
City of Manila. DEVOLUTION OF HEALTH SERVICES
1915: Act No. 2468 transformed the RA 7160 OR LOCAL GOVERNMENT
Bureau of Health into a commissioned CODE
service called the Philippine Health
Services. -one of the significant laws that
radically changed the landscape of health
THE PHILIPPINE COMMONWEALTH care delivery system.
AND THE JAPANESE OCCUPATION
(1935-1945) -This code aims to: transform
local government units into self-reliant
May 31, 1939 communities and active partners in the
attainment of national goals through a
-Commonwealth Act No. 430
more responsive and accountable local
created the Department of Public Health
government structure instituted through
and Welfare, but the full implementation
the system of decentralization.
was only completed through Executive
Order No. 317, January 7, 1941. LOCAL HEALTH BOARD
-Dr. Jose Fabella became the -is a good venue for making the
first Department Secretary of Health and local health system more responsive to
Public Welfare in 1941. the needs of the people and is mandated
to propose annual budgetary allocations
1970: The Restructured Health Care
for the operation and maintenance of
Delivery System was conceptualized.
health facilities and services within the
June 2, 1978 municipality, city or province.
-With the proclamation of martial 1. At the Provincial level, it is composed
law in the country, Presidential Decree of the governor (chair), provincial health
1397 renamed the Department of Health officer (vice chair), chairman of the
to the Ministry of Health. Committee of Health of the Sangguniang
Panlalawigan, DOH representative and
December 2, 1982
NGO representative.
Executive Order No. 851 signed by
2. At the municipal level, many public
President Ferdinand E. Marcos
health nurses have been appointed as
reorganized the Ministry of Health as an
DOH representatives. Many of them
integrated health care delivery system.
however, perform dual functions—those
October 10, 1991
of a public health nurse and those of a people of the world through community
DOH representative. and individual self-reliance.
This policy agenda of “health for
all by the year 2000” technically, was a
global strategy employed in achieving
Topic III: PRIMARY HEALTH CARE three main objectives:

HISTORY OF PRIMARY HEALTH CARE (1) promotion of healthy

lifestyles,
 Alma Ata Conference of Sept. 6 -12,
1978 (Kazakhstan, formerly Kazakh (2) prevention of diseases, and
Soviet Socialist Republic)
(3) therapy for existing
 Alma Ata Declarations of PHC
conditions.
– Health as Basic Fundamental Right
ELEMENTS/COMPONENTS OF
– Global Burden of Health inequalities PRIMARY HEALTH CARE

– Economic and Social Development 1. Environmental Sanitation (adequate

supply of safe water and good waste
– Government responsibility disposal)
 LOI 949, PHC adopted in the 2. Control of Communicable Diseases
Philippines
3. Immunization
HEALTH DEFINED BY WHO
4. Health Education
In the PHC declaration, the WHO
defined health as “a state of complete 5. Maternal and Child Health and Family
physical, mental and social wellbeing, Planning
and not merely the absence of disease or
6. Adequate Food and Proper Nutrition
infirmity”
7. Provision of Medical Care and
PUBLIC HEALTH CARE:
Emergency Treatment
Alma Ata Declaration: PHC “is essential
8. Treatment of Locally Endemic
health care based on practical,
Diseases
scientifically sound and socially
acceptable methods and technology 9. Provision of Essential Drugs
made universally accessible to
STRATEGIES
individuals and families in the community
through their full participation and at a 1. Reorientation and reorganization of the
cost that the community and country can national health care system.
afford to maintain at every stage of their
development in the spirit of self-reliance 2. Effective preparation and enabling
and self-determination.” processes for health action at all levels.

HEALTH FOR ALL: Universal Goal of 3. Mobilization of the people to know their
PHC communities and identifying their basic
health needs with the end in view of
Health for all means an providing appropriate solutions.
acceptable level of health for all the
4. Development and utilization of Topic IV. UNIVERSAL HEALTH CARE
appropriate technology focusing on local
-Kalusugan Pangkalahatan /
indigenous resources available in and
Aquino Health Agenda (Administrative
acceptable to the community.
Order 2010-0036)
5. Organization of communities arising
“provision of every Filipino of the highest
from their expressed needs which they
possible quality of health care that is
have decided to address and that this is
accessible, efficient, equitably distributed,
continually evolving in pursuit of their own
adequately funded, fairly financed, and
development.
appropriately used by an informed and
6. Increase opportunities for community empowered public”
participation in local level planning,
-Universal Health Care (UHC) Bill
management, monitoring and evaluation
into law (Republic Act No. 11223) that
within the context of regional and national
automatically enrolls all Filipino citizens in
objectives.
the National Health Insurance Program
7. Development of intra-sectoral linkages and prescribes complementary reforms in
with other government and private the health system.
agencies.
GOAL AND OBJECTIVES
8. Emphasizing partnership so that the
 Equity in access to health
health workers and the community
services – those who need the
leaders/members view each other as
services should get them, not only
partners rather than merely providers and
those who can pay for them
receiver of health care respectively.
 That quality of health services
KEY PRINCIPLES OF PHC is good enough to improve the
health of those receiving
• Accessibility, affordability, acceptability,
services; and
and availability
 Financial-risk protection –
• Support mechanisms ensuring that the cost of using
care does not put people at risk of
• Multisectoral approach financial hardship.’
• Community participation 3 STRATEGIC THRUSTS
• Equitable distribution of health – Financial risk protection
resources
– Improved access to quality hospitals
• Appropriate technology and health care facilities
LEVELS OF PREVENTION (LEAVELL – Attainment of the health-related MDGs
AND CLARK, 1958)
PUBLIC HEALTH PROGRAMS - Maternal deaths
1. THE MATERNAL HEALTH 3. THE CHILD HEALTH PROGRAMS
PROGRAM (NEWBORNS, INFANTS AND
CHILDREN)
-The overall goal of the program is
to improve survival, health and well-being -Its main goal is to reduce
of mother and unborn through a package morbidity and mortality rates for children
of services for the pre pregnancy, 0-9 years with the strategies necessary
prenatal, natal and post-natal stages. for program implementation.
Essential health service packages a. Infant and Young Child Feeding: To
available in the health care facilities improve the survival of infants and young
children by improving their nutritional
a. Antenatal Registration: Every
status, growth and development through
woman has to visit the nearest health
optimal feeding.
facility for antenatal registration to avail
prenatal care services. b. Newborn Screening: To reduce the
preventable deaths of all Filipino
b. Tetanus Toxoid
newborns due to more common and rare
Immunization: This is considered one of
congenital disorders through timely
the public health concerns that we need
screening and proper management.
to address among newborns. To protect
them from deadly disease tetanus toxoid c. Expanded Program on
immunization is important for pregnant Immunization: This program aims to
women and child bearing age women. reduce the morbidity and mortality among
children against the most common
c. Micronutrient
vaccine-preventable diseases.
Supplementation: This is vital for any
pregnant woman. These are necessary to d. Management of Childhood illnesses:
prevent anemia, vitamin A deficiency and The Integrated Management of Childhood
other nutritional disorders. Illnesses (IMCI) has been established as
an approach to strengthen the provision
d. Treatment of Diseases and
of comprehensive and essential health
Other Conditions
package to the children.
e. Clean and Safe Delivery
e. Micronutrient Supplementation: This
2. THE FAMILY PLANNING PROGRAM is one of the interventions to address the
health and nutritional needs of infants
-The overall goal of Family and children and improve their growth
Planning program is to provide universal and survival.
access to family planning information and
services wherever and whenever these f. Oral Health: The delivery of basic oral
are needed. health is the responsibility of the local
government under the Local Government
Family Planning aims to contribute to: Code of 1991.
- Reduce infant death g. Child Health: The treatment and care
- Neonatal deaths of children.

- Under-five deaths
 b. Blood Donation Program: Republic
Act No. 7719 (NATIONAL BLOOD
4. THE ADOLESCENT HEALTH
SERVICES ACT OF 1994), promotes
PROGRAM
voluntary blood donation to provide
-The program aims to reduce the sufficient supply of safe blood and to
incidence of teenage pregnancies, early regulate blood banks.
sexual involvement, early marriages and
c. Dengue Control Program: Early case
other reproductive health problems such
detection, diagnosis ad correct fluid
as sexually transmitted infections and
management are key factors in reducing
HIV/AIDS among others.
dengue morbidity and mortality.
5. THE ADULT MEN AND WOMEN
-The essential components of the
health care package for adult men and
women is similar to the health services
provided to women, except maybe for
gender specific services related to the
reproductive system.
ESSENTIAL HEALTH CARE PACKAGE
FOR THE ADULT MEN AND WOMEN
a. Management of Illness
b. Counseling on Substance abuse,
sexually and reproductive tract infections
c. Nutrition and diet counseling
d. Mental Health
e. Family planning and responsible
sexual behavior
f. Dental care
g. Screening and management of lifestyle
related and other degenerative diseases.
6. THE OLDER ADULT
-The goal is to reduce morbidity
and mortality of older persons and
improve their quality of life.
7. OTHER HEALTH PROGRAMS
a. Botika ng Barangay: refers to a drug
outlet managed by a legitimate
community organization/NGO or the
Local Government Unit, with a trained
operator and a supervising pharmacist.