LESSON 1: EDUCATIONAL INSTITUTION through interaction and exploration on a daily basis as

well as the teachers’ traits that vary based on their

⎯ a place where learners of different ages gain education. expertise, skills, and experience.
Education is based on an age grade system from preschool, ⎯ No credential, only recognition
primary, intermediate, and secondary level (junior and senior
high school), to tertiary level VMVG – make up the identity of institution, united in purpose and has consistency
(colleges and universities).
Vision statement
⎯ Educational institutions carry out educational activities
⎯ It shows boldness
that engage students with various learning
⎯ It is usually a one-sentence statement that describes the
environments and spaces.
distinct and motivating long-term desired transformation
Two Types Of Education: resulting from institutional programs.
⎯ The vision statement should be clear, memorable, and concise with an
▪ Formal education average length of 14 words.
⎯ deals with the conventional classroom ⎯ The shortest contains only 3-26 words
setup where structured methods of learning
are administered in educational Mission Statement
institutions. ⎯ a one-sentence statement relating the intention of an institution's
⎯ Government recognition in terms of the curricular offering existence.
that predetermines the books and materials to be used for ⎯ This communicates what you do or who you do this for.
instruction is necessary to establish standards in the ⎯ The mission statement must be clear by using simple language with an
average of 5 to 20 word
academic community.
⎯ Faculty and instructors follow the curricula set
by a technical committee appointed by the
government.
⎯ You can get degree and has level of competency
▪ Informal education
⎯ anything learned independently outside the conventional
classroom setup.
⎯ It is not restricted to a certain location and is usually
integrated with the surroundings such as the home,
cultural setting, and even in formal education
institutions.
⎯ Informal education involves the students’ behavior skills
Table 1.1 Comparison between a vision statement and a mission statement

Vision Mission
Function It inspires to give the best and It defines the key measure of the
shapes your understanding of why you are institution's success.
in the institution. What makes you different?
Developing Statement When do we want to reach What do we do today?
success? For whom do we do it?
Where do we want to go forward? Why do we do what we do?
How do we want to do it?
Time Talks about the future Talks about the present leading to
the future
Question Where do you aim to be? How will you get where you want to
Where do you want to be? be?

Value Statement of the course or lesson.

⎯ Implement strategy
⎯ or the core values, is a list of fundamental doctrines that guide and
⎯ When setting the objectives, curriculum developers must think
direct the educational institution.
of the SMART criteria; that is, objectives must be Specific,
⎯ This sets the moral direction of the institution and its academic
Measurable, Attainable, Realistic, and Time bound.
community that guides decision-making and provides a yardstick
Curiosity Questions:
againstany action.
⎯ The core values shape the standard structure that is shared and 1. Why is it important to delve into learning institution?
acted upon by the academic community. guide/direct
⎯ They provide a structured environment that fosters personal growth
In developing an institution's value statement, consider the following questions: and development, allowing individuals toacquire essential

▪ What values are distinct to our educational institution? ⎯ knowledge andskills.

▪ What values should direct our institution? ⎯ can significantly enrich an individual’s life and contribute positively to
For an educational institution to have a useful value statement, its values must society, fostering personal fulfillment, career success, and
be incorporated in all levels of the institution to give direction to its collective advancement.
engagements, viewpoints, and decision-making processes.

Educational objectives, or goals

⎯ are short statements that learners should achieve within or at the end
LESSON 2: HEALTH SYSTEM factors such as income, ethnicity, occupation, gender, geographic
location, and sexual orientation, among others.
Health system is "the combination of resources, organization,
financing, and management that culminate in the delivery of health Organizational Impact: There are significant variations in health
services to the population (Roemer, 1991)." This system consists of outcomes across the world, within regions and within countries.
many parts such as the community, department or ministries of Countries and regions with relatively similar socioeconomic status
health, health care providers, health service organizations, may have quite disparate health outcomes. The way health systems
pharmaceutical companies, health financing bodies, and other are - organized contributes to this disparity. These disparities are
organizations related to the health sector. Each plays a role in the most effectively reduced when they are recognized and their
system such as governance, health service provision, and financing minimization becomes an explicit national goal.
and managing resources.
2. Improving the responsiveness of the health system
In the World Health Report (WHO, 2000), health system is defined as
- the Responsiveness refers to providing satisfactory health services
"all the organizations, institutions, resources, and people whose
and engaging people as active partners. It embodies the values of
primary purpose is to improve health." Thus, a well-performing
respectfulness, dignity, confidentiality, autonomy, quality, and
health system provides direct health-improving activities whether in
timeliness in the delivery of health services. Health systems also have
personal health care, public health services, or intersectoral
an obligation to respond to the legitimate non-health needs and
initiatives, to achieve high health equity.
expectations of populations.
GOALS AND FUNCTION OF A HEALTH SYSTEM
A responsive health system empowers individuals by promoting their
The World Health Organization (WHO) identifies three (3) main goals autonomy and involvement in decision making, ultimately making
of a health system: them at the center of the healthcare system, allowing them to make
choices and placing them at the center of the health system.
1. Improving the health of populations
3. Providing fair health financing
Objective: Improving the health of the population is the overarching
goal of a health system. Health status should thus be measured over Adequate funding: health systems must be adequately funded to
the entire population and across different socioeconomic groups. provide essential services to all citizens.
Populations must be protected from existing and emerging health
Fairness and Non-deterrence: An ideal health system provides social
risks. Intensive preparations for resilience to impending but still
and financial risk protection in health. WHO defines a fairly financed
unknown health risks must be executed to ensure the safety of
health system that ensure that individuals are not discourage from
populations.
seeking necessary care due to upfront payments. And one in which
Health Equity: Health systems should strive for equity in health by each individual pays approximately the same percentage of their
minimizing inequitable disparities which may be caused by certain income for needed services.
Impact on health outcomes: A health financing system that dissuades -outside the immediate control of health system policy makers
people from seeking needed services or impoverishes individuals and
families worsens health outcomes.

THE FOUR (4) VITAL HEALTH SYSTEM FUNCTIONS ARE:

3. Stewardship
1. Health service provision
- Stewardship, or the overall system oversight, is the main
- The most visible product of the health system is public and private
responsibility of the government. This function sets the direction,
health service provision. A health service is any service, not limited to
context, and policy framework for the overall health system. The core
clinical services, aimed at improving the health of populations.
of the stewardship function includes:
Preventive measures as well as promotion of a healthy way of living
to avoid illnesses also form part of the best systems. Thus, the system a. Identifying health priorities for allocation of public resources;
has to perform a wide range of activities to cater to these various
demands. b. Identifying an institutional framework;

- core function, ensures access and equity c. Coordinating activities with other systems related to external
health care;
- Levels of care:
d. Analyzing health priorities and resource generation trends and
Primary care – prevention, diagnostics, therapeutic svcs., health their implications; and
education, minor surgery. “Approach to providing health care”
e. Generating appropriate data for effective decision-making and
Secondary Care – short term; sporadic consultation with specialist policymaking on health matters.
for advanced interventions not available in pc
4. Health financing
Tertiary care - for condition that are relatively uncommon;
institution based, highly specialized (open heart surgery) - Health system financing includes raising and pooling resources to
pay for health services.
2. Health service inputs
3 key components:
Health service inputs, or managing resources, means generating the
essential physical resources for the delivery of health services which a. Revenue collection
include medications, human resources, and medical equipment. - Revenue is earned from payments for health care services. The
Resources such as trained doctors and medical staff and supply of mechanisms for revenue collection include general taxation, direct
medications often take time to be produced; hence, the health household out-of-pocket expenditures, mandatory payroll
system policymakers have to respond and use the available resources contributions, mandatory or voluntary risk-rated contributions, donor
to address short-term population needs. financing, and other forms of personal savings.
- Each source of health financing is associated with a specific manner Japan, Switzerland, and, to a degree, in Latin America.
of organizing and pooling of funds and purchasing services. Public
health systems rely on general taxation for its financing, while social • Beveridge Model (Beveridge Report or the Social Insurance and
security organizations are funded through the mandatory payroll Allied Services of 1942)
contributions from workers and employers. - This model is named after William Beveridge, the social
reformer responsible for designing Britain's Social Security
b. Risk pooling
System and the National Health Service. In the Beveridge
- Financial risk pooling is a form of risk management which aims to model, health care is provided and funded by the
spread financial risks from an individual to all pool members. It is government through tax payments. The government owns
considered a core function of health insurance companies. This many, but not all, hospitals and clinics in the country.
Doctors may be government or private employees who
mechanism prevents outright payment for health service which
collect their professional fees from the government. This
discourages patients belonging to the poor sector from seeking
results in low cost per capita since the government
health care. Participation in effective risk pooling helps families from controls the health care services. Countries using the
financial losses due to health shocks, thus ensuring financial Beveridge plan include Hong Kong, Great Britain, Spain,
protection. most of Scandinavia, New Zealand, and Cuba. The Cuban
government, for instance, uses total government control.
- health insurance system (e.g philhealth)

- Each country has its own approach to managing its financial risk to • Strategic purchasing
finance its health care system. Multiple and fragmented forms of risk - In strategic purchasing, risk-pooling organizations use
pooling arrangements exist in most developing countries. Most high- collected funds and pooled financial resources to finance
income countries follow one of the two main models: the Bismarck health care services for the members. The purchaser
model and the Beveridge model. defines the substantial part of the health provider's
external incentives to develop the provider-user
• Bismarck Model (Bismarck's Law on Health. interaction and the health service delivery models.
- This model is named after the Prussian Chancellor, Otto
von Bismarck, known for inventing the welfare state in the WHO HEALTH SYSTEM FRAMEWORK (2000)
19th century as part of the unification of Germany. The
Bismarck model uses an insurance system where the
sickness fund finances both the employers and the
employees through payroll deduction. But unlike the US
insurance industry, the Bismarck-type health insurance
plan covers everybody, thus collecting no profit. This is
considered a multi-payer model with tight regulation giving
the government the cost-control clout. This model is
widely used in Germany, France, Belgium, Netherlands,
 - The Philippines is highly exposed to disaster risk, ranking third globally,
with frequent strong typhoons ad tuberculosis
One building block is service delivery which refers to the timely delivery
of quality and cost-effective personal and non-personal health - The country most pressing health issue are: inequities in health
services. Another is health workforce which includes individuals and status, access to healthcare services
groups working towards the achievement of the best health outcomes
- Current population (August 17,2024): 115,964,644, equivalent to
by being responsive, fair, and efficient. The number of staff should be
1.42% of worlds population, rank 14
sufficient and fairly distributed to ensure competency, responsiveness,
and productivity. Information (health information system) which - total land area: 298, 170 Km2 (115,124 sq.miles)
analyzes, disseminates, and uses reliable and relevant information on
health status, determinants, and systems performance is also a - 48.7 % urban (56,434,179 in 2024)
valuable building block. Another important building block is that of - Median age: 25.7
health products, vaccines, and technologies which are made
accessible through uninterrupted supply, well-managed
pharmaceutical services, and education on proper use of medication.
Financing (health financing system) is a building block which takes care
of the funding for health care services to guarantee that people can use
health services when needed without fear of having not enough
resources to pay for them. Lastly, leadership and governance involves
the task of ensuring effective stewardship of the entire health system.
This building block also covers the monitoring of the accountability of
private and public health agencies, proper system design, and
appropriate regulation of health systems.
- Top 3 causes of Death in the country from Jan – May 2024

(1) Ischemic heart diseases (2) Neoplasms (3) Cerebrovascular

I. THE PHILIPPINE HEALTH SYSTEM AND SERVICES
disease

- Philippines is an archipelago in Southeast Asia, population of 104.9

million as of 2017 (Catholic- 92.2%, Muslim- 6.6 %). Literacy rate of
96.5%. Agrarian economy growth of 6.7% in 2017.

- Life expectancy in the Philippines has risen from 62.2 years in 1980 to
69.1 years in 2016
ORGANIZATION OF THE HEALTH CARE SYSTEM

-Private sector mainly active in hospital care and maternities

- Government caters for primary care and first-line facilities

- Health facilities are regulated by DOH – Health Facilities & Services

Regulatory Bureau (HFSRB)

PUBLIC HEALTH CARE SYSTEM

In The Philippines, the health system is a complex, multi- layered

system in which responsibilities in the health care sector are
fragmented
Responsibility is shared between the central government (the Ministry (1) the tertiary hospitals at the national and regional levels;
of Health), and Local Government Units that have full autonomy to
(2) the provincial and district hospitals and city and municipal health
organize and finance their 'own' regional systems.
centers; and

(3) the barangay (village) health centers.

-With the enactment of the LGC of 1991, the government health system
now consists of basic health services-including health promotion and
preventive units-provided by cities and municipalities, provincial and
province-run district hospitals of varying capacities, and mostly tertiary
medical centers, specialty hospitals, and a number of re-nationalized
provincial hospitals managed by DOH.

PRIVATE HEALTH CARE SYSTEM

- for-profit and non-profit health providers market-oriented health care

is generally paid for through user fees at the point of service.

Reflects the major organizational changes brought about by a strategic - regulated by the Government through a system of standards and
review and rationalization of government agencies and functions under guidelines implemented through the licensure procedures of the DOH
insecutive order no. 366 in 2013 and the accreditation procedures of PhilHealth

1. The standardized immanclature of bureau services and - provides also medical tourism, mostly for low cost aesthetic and
regional offices dental procedures.
2. 2. They stream line the function , tradition, and staff, and
pattern of entire agency - Five hospitals hold accreditation from the Joint Commission
3. They emphasized the DOH leadership and settings and role of International:
the whole healthcare system Asian Hospital and Medical Centre, Chong Hua Hospital, The Medical
City, St. Luke's Medical Centre, Makati Medical Centre
Under the decentralized or devolved structure, the state is represented
by national offices and LGUs, with provincial, city, municipal, and
barangay or village offices. DOH, LGUs, and the private sector
participate, cooperate, and collaborate in the care of the population.
Before devolution, the national health system consisted of a

three-tiered system under the direct control of the DOH:

 SERVICES THAT THE NATIONAL AND LOCAL GOVERNMENT PROVIDE
AND PAY FOR

NON-FORMAL PRIVATE HEALTH CARE SECTOR

- traditional healers (herbolarios)

- traditional birth attendants (hilots)

- Other relevant private organizations and NGOs in the health system

including Professional groups such as:

The Philippine Medical Association, The Philippine Nurses

Association, Philippine Dental Association, The Integrated Midwives FINANCING HEALTH CARE
Association of the Philippines
 DISTRIBUTION OF HEALTH PROFESSIONALS
The National Health Insurance Program (NHIP) is carried out by
PhilHealth Top 4 categories of health professionals working in health institutions
are
PhilHealth reimburses health care costs at both public and private
-nurses (90,308) doctors (40,775) midwives (43, 044) medical
facilities. However, it matches only part of the total health care costs,
ranging between 30-70% maximum. technologists (13,413)

- Although central in organized health care financing, > 90 percent of Institution-based doctors are equally affiliated in public and private
Philippines were directly or indirectly covered before 2019 institutions, but nurses (61%), midwives (91%), and medical
technologists (53%) tend to work more often in public institutions.
- Role of PhilHealth is limited due to the: skewed distribution of health Compensation is considered better in public facilities.
facilities, limitations in type of care covered, limited 'depth' of financing
services, or the share of the health care costs reimbursed The distribution in terms of place of work of institutional health workers
is hospital-centric, thus curative in nature. Only 9 percent of doctors
- established in 1995 work outside the hospital in primary care settings.
- administers the NHIP MIGRATION OF HEALTH PROFESSIONALS
- funded by member contributions and government subsidies - Despite many different policy efforts to reduce the flow, in recent years
still an average of 15,000 nurses migrate very year
- supports the UNIVERSAL HEALTH CARE ACT
 - Bilateral agreements between The Philippines and destination 7. 2005: FOURmula One (F1) for Health - adopted an operational
countries have proven difficult to implement and are not considered framework to undertake reforms with speed, precision, and effective
effective in reducing outflow of health professionals coordination and to improve the Philippine health system

- Both push (e.g. wages, job positions) and pull-factors (wages and 8. 2008: Universally Accessible Cheaper and Quality Medicines Act (RA
overseas experience) contribute to ongoing migration. 9502) - promoted and ensured access to affordable quality drugs and
medicines for all
- In 2020 migration was put on hold due to pandemic situation. In 2021
policies expected to limit outflow to 5,000 nurses. 9. 2010: Kalusugang Pangkalahatan or Universal Health Care (AO 2010-
0036) universal health coverage and access to quality health care for all
II. HEALTH SECTOR REFORMS
Filipinos

The health reform initiatives carried out over the years in the Philippines UNIVERSAL HEALTH CARE
were primarily focused on these areas of concern: health service
delivery, health regulation, and health financing. These health reforms • KALUSUGAN PANGKALAHATAN (KP)
aimed at addressing issues such as poor accessibility, inequity, and - Aquino Health Agenda for Universal Health Care
[Administrative Order No. 2010-0036]
inefficiency of the Philippine health system.
- 2010-2016
1. 1979: Adoption of Primary Health Care Strategy (LOI 949) Three main goals:
management of the local health care system promoted participatory
- Sustained health financing
2. 1982: Reorganization of DOH (EO 851) - integrated the components - Responsive health system
of health care delivery into its field operations - Better health outcomes
3. 1988: The Generics Act (RA 6675) - ushered the writing of
prescriptions using the generic name of the drug UNIVERSAL HEALTH CARE STRATEGIC THRUST
4. 1991: Local Government Code (RA 7160) - transferred the Universal Health Status Of The Filipinos
responsibility of providing health service to the local government units
1. Financial Risk Protection
5. 1995: National Health Insurance Act (RA 7875) instituted a national 2. Improved access to healthcare facilities
health insurance mechanism for financial protection with priority given 3. Attainment of health-related MDG’s
to the poor

6. 1999: Health Sector Reform Agenda - ordered the major UNIVERSAL HEALTH CARE LAW
organizational restructuring of the DOH to improve the way health care
is delivered, regulated, and financed - March 2019: President Duterte signed the Universal Health Care
(UHC) Bill into law (Republic Act No. 11223)
- Major step by enrolling all Filipino citizens automatically in the - E-Health
National Health Insurance Program administered by PhilHealth
• Philippines have reportedly one of the slowest internet speeds
- Extra resources to health insurance earmarked to Special Fund among Asian countries
exclusive for LGUS for improvement of local health systems and health • Health sector digitalization is taking hold in different areas
infrastructure such an e-prescriptions, hospital management information
systems, Integrated Clinic Information System (iClinicSys) for
- Stricter delineation in mandates between DOH and PhilHealth primary care facilities, electronic patients records.
• DOH to focus on population- based health services • The Philippines has an eHealth Strategic Framework since
• PhilHealth to focus on Individual based Health Services 2014.
• Philippine Health Information Exchange (PHIE)
platform for secure electronic access and efficient exchange of
ISSUES IN HEALTH CARE REFORM health data and/or information among health facilities, health-
care providers, health information organizations and
- Oral diseases is a serious public health problem
government agencies in accordance with set national
• 87.4% of school children suffer from tooth decay standards.
• close to half of Filipinos have periodontal disease
• urban areas: 9 million denture wearers (35-69 years old) III. STREGTH AND WEAKNESSES OF THE PHILIPPINE HEALTH
SECTOR
- Issues in health reform -inequity in health and care

• Improvements in health status as a national average can mask

inequality in health outcomes, socioeconomic status,
educational attainment, and regional disparities.
• Disparities across socioeconomic status are associated with
maternal education, regional allocation, and access to health
services.
• The National Demographic and Health Survey (NDHS) found
that the proportion of women who receive prenatal care from a
provider is associated with the mother's level of education and
economic status.
• The highest prevalence of underweight, stunting, and wasting
among the poorest quintile (29.8%, 44.8%, and 9.5%,
respectively) and among those in rural areas (22.6%, 35.0%,
and 8.1%, respectively) (FNRI, 2014).
IMPORTANT GOVERNMENT ORGANIZATIONS (3) capacity building:

1. Department of Health – main body of healthcare (4) advisory services for disease prevention; and
2. PPP Center NEDA (Public Private Partnership Center National
(5) control of medical supplies and vaccines.
Economic and Development Authority) – mandated to facilitate
the implementation of the country’s PPP program and projects - DOH coordinates its national health programs through the local
3. Food & Drug Administration – main regulatory agency for government units (LGUs). LGUs take care of their own health services
registration of drugs, medical equipment, supply, and cosmetics and are given autonomy under the Local Government Code (LGC) of
4. PhilHealth (Philippine Health Insurance Corporation) – single 1991 (R.A. 7160). 78 provincial governors, 138 city mayors, 1,496
government health insurance agency municipal mayors, and 42,025 barangay chairpersons compose the
5. IITS Knowledge Management & Information Technology Service - local government units of the country (NSCB, 2010).
DOH unit in charge of digital health applications
6. NIH University of the Philippines National Institutes of HeaIth - - In terms of administration, LGUs are grouped into 17 regions. Although
The NIH was created on Jan 26, 1996 by the UP Board of Regents to they operate in a decentralized system, LGUs are under the supervision
strengthen the research facility of UP Manila, and serve as an of the DOH regional health offices. The provincial government is tasked
institutional home of a network of researchers and research to provide health services through provincial and district hospitals. The
institutions. city and municipal governments rely on public health and primary
7. University of the Philippines - The UP is the country's national health care centers for their primary care. (For a detailed organizational
university. This premier institution of higher learning was structure of the Philippine health sector, see The Philippines Health
established in 1908 & is now a university system composed of 8 System Review (2011) published in Health System in Transition, vol. 1,
constituent universities spread throughout 17 campuses in the no. 2.)
archipelago.
8. Philippine General Hospital - The country's leader in transforming DOH is duty-bound to:
the lives of the people through excellent health care, education and
1. develop policies and programs for the health sector,
research, accessible to all.
2. provide technical assistance to its partners,
LEADERSHIP AND GOVERNANCE 3. encourage performance of the partners in the priority health
programs,
- The Department of Health (DOH) is mandated to provide the
appropriate direction for the nation's health care industry. 4. develop and enforce policies and standards,
Its other tasks include 5. design programs for large segments of the population, and
(1) the development of plans, guidelines and standards for the health 6. provide specialized and tertiary level care.
sector;

(2) technical assistance;

DIRECTIONS OF THE PHILIPPINE HEALTH SECTOR where no one is poor; promoting a long and healthy life; becoming
smarter and more innovative; and building a high-trust society.
1. The Philippine Health Agenda 2016-2022 (DOH Administrative
Order 2016-0038) 4. Sustainable Development Goals 2030

This agenda adopts the slogan "All for Health Towards Health For All" as Also known as the 2030 Agenda, this compilation of 17 global
the rallying point for its vision of a Healthy Philippines by 2020. It development goals targets to end poverty, fight inequality and injustice,
expanded the scope of the Universal Health Care (UHC) directions, and confront issues involving climate change.
particularly through a whole-of-government approach. With this
agenda, the health: guarantees:
LESSON 3: PRIMARY HEALTHCARE AND THE PHILIPPINE
a. population- and individual-level interventions for all life stages that
HEALTHCARE DELIVERY SYSTEM
promote health and wellness, prevent and treat the triple burden of
disease, delay complications, rehabilitation, and provide palliation for Health Care
both the well and the sick;
-According to the Alma-Ata Declaration of 1978, health is a
b. access to health interventions through functional service delivery fundamental human right. It states that the action of the health sector
networks (SDNs); and c. financial freedom when accessing these but the collaboration among other sectors such as those in the social
interventions through Universal Health Insurance. 2. The Philippine and economicand most important global goal is for humans to reach
Development Plan 2017-2022 the optimal level of their health (To attain your highest sense of well-
being and potential physically, emotionally, and spiritually, and to live
This is the first of the four key medium-term plans to translate the vision
your life as fully as possible despite any health condition); this requires
of a "matatag maginhawa, at panatag na buhay" for the Filipinos and the
economic sectors.
country.
Meanwhile, a common concern of many countries, including both
2. The Philippine Development Plan 2017-2022
developed and developing one is the gross inequality in the people's
This is the first of the four key medium-term plans to translate the vision health status which is not socially, economically, and politically
of a "matatag maginhawa, at panatag na buhay" for the Filipinos and the acceptable. Thus, the government of each country has the duty and
country. responsibility to institute adequate measures to promote and protect
its people's health, and thus achieve a better quality of life.
3. NEDA AmBisyon Natin 2040
Important Health Care Concepts:
A product of the Philippine Development Plan 2017-2022, this
collective long-term plan envisions better life for the Filipinos and the 1. Health care system is defined by Miller & Keane (1987) as "an
country in the next 25 years by formulating policies and implementing organized plan of health services
programs and projects to attain this AmBisyon. This plan focuses on
2. Health care delivery, as defined by Williams & Tungpalan (1981), is
four areas: building a prosperous, predominantly middle-class society
"the rendering of health care services to the people."
3. Health care delivery system, also as defined by Williams & 5. increased stakeholder participation – everyone has a chance to
Tungpalan (1981), is "the network of health facilities and personnel have a say on how their own service are being delivered to the
which carries out the task of rendering health care to the people" commuity

In simpler words: Health care system is the outline plan, health care Essential Elements of Primary Health Care
delivery is the implementation of such plan, Health care delivery
Below are the eight (8) elements of primary health care:
system is facilities or the people that will implement such plan
1. Education concerning prevailing health problems and the methods
How Do Country Ensure That The Certain Services Are Being
of identifying, preventing, and controlling them
Delivered To Its Constituents? Concepts:
2. Locally endemic disease prevention and control
Primary Health Care
3. Expanded program of immunization against major infectious
-As cited by WHO, the Alma-Ata Declaration defines primary health care
diseases
as important health care derived from scientifically sound and socially
acceptable methods. It must be universally accessible to all individuals 4. Maternal and child health care including family planning
and is based on what the community and country can provide.
5. Essential drugs arrangement
- it strengthens national health systems to bring services closer to the
communities 6. Nutritional food supplement, an adequate supply of safe, and basic
nutrition
-As an approach, the primary health care (PHC) deals with social policy
which targets health equity PHC has the essential elements and 7. Treatment of communicable and non-communicable disease and
objectives that ensure attainable better health services for all not just promotion of mental health
for people that have money or power 8. Safe water and sanitation
The ultimate goal of primary health care is better health for all. WHO Other elements of primary health care include:
has identified five key elements to achieve this goal. These are
1. Expanded options of immunization
1. universal coverage to reduce exclusion and social disparities in
health 2. Reproductive health needs

2. service delivery organized around people's needs and expectations 3. Provision of essential technologies for health

3. public policy that integrates health into all sectors (health is 4. Health promotion
multifactorial) 5. Prevention and control of non-communicable diseases
4. leadership that enhances collaborative models of policy dialogue 6. Food safety and provision of selected food supplements
PRINCIPLES OF PRIMARY HEALTH CARE 9. Provide equitable distribution of health care

A conceptual shift in health care calls attention to the fact that primary 10. Ensure community participation and monitor adequacy and
health care should be integrated, and its principles guide the functions distribution of health workers who are supported locally and at the
of the system as a whole. Having a systems perspective bridges the referral levels
conflict between primary health care as a distinguished level of care
11. Recognize that the formal health sector needs other sectors in the
and as a holistic approach to the provision of health services.
promotion of health (multi sectoral approach)
The health system should also consider the principles of the Alma-Ata
12. Use the appropriate technology which are accessible, feasible,
Declaration and other intersectoral approaches. It should cover
affordable, and culturally acceptable to the community
broader health issues of populations while reinforcing public health
functions. It should come up with programs that provide care and Note: Basic objective starts with a verb but the essential elements they
prevent diseases and provision for services especially for the poor and are nouns/adjective
marginalized groups. Finally, it should be able to monitor programs for
continuous improvement. MANAGEMENT OF PRIMARY HEALTH CARE

The basic objectives to launch and sustain primary health care as Health care managers usually carry out the following functions in the
part of the comprehensive health system are as follows: process of management:

1. Improve the level of health care of the community – important 1. Planning - This means setting priorities and determining
objective performance targets. Managers are usually required to set a direction
and determine what needs to be accomplished.
2. Promote favorable population growth structure
2. Organizing - This refers to designing the organization or the specific
3. Reduce the morbidity and mortality rates especially among infants division, unit, or service for which the manager is responsible.
and children Furthermore, it means designating reporting relationships and
intentional patterns of interaction, determining positions and teamwork
4. Reduce prevalence of preventable, communicable, and other
assignments, and distributing authority and responsibility (This is where
diseases
job application and organizational charts usually formulated)
5. Improve basic sanitation
3. Staffing This function refers to acquiring and retaining human
6. Extend essential health services especially to the underserved resources, and developing and maintaining the workforce through
sectors various strategies and tactics (This is actually hiring and the organizing
takes place)
7. Develop the capability of the community to become self-reliant
4. Controlling - This function refers to monitoring staff activities and
8. Encourage the contribution of other sectors to the social and
performance and taking the appropriate actions for corrective actions
economic development of the community
to increase performance.
5. Directing- This focuses on initiating action in the organization a. Centralization refers to the concentration of planning and
through the effective leadership, motivation, and communication of decision-making to the top of the organization (only top has
managers. power to make decision)

Below are the management principles in relation to organizing: b. Decentralization refers to the delegation of planning and
decision-making to the lower branches of the organization
1. Authority, responsibility, and accountability (are important to
(both low and top has power of decision)
maintain the relationship establish in the organizational chart made
during organizing process) c. Formalization refers to a written documentation provided for
the direct control of the employee (write who will control)
a. Authority refers to the formal and legitimate right of a
manager to issue orders, make decisions, and allocate 4. Staffing
resources to achieve desired outcomes of the organization.
As regards to the process of staffing, here is the list of functions of the
b. Responsibility is the duty of the employee to perform the manager:
assigned tasks and activities.
a. Assign individuals to respective positions identified in the
c. Accountability means reporting and justification of task management plans
outcomes to higher management by those people with
b. Assess required competencies through
authority
• identification of the key result areas (KRAS) per major activity
2. Types of authority
diss to loved
a. Line authority managers issue orders to their subordinates • determination of the competencies and qualifications
and are also responsible for the results (Boss: Chief Medical
Technologist) c. Recruit qualified personnel
b. Functional authority is for managers that have power only d. Improve existing services and programs by
over a specific set of activities (a restricted/limited line
authority: Section head) • reviewing and adjusting the requirements accordingly
• matching the competency requirements vis-à-vis the
c. Staff authority is given to specialists in their areas of responsible personnel assigned to the activity
expertise. The staff manager advises, recommends, and
counsels rather than managing
THE PHILIPPINE HEALTH CARE SYSTEM
3. Centralization, decentralization, and formalization (Management
-According to Dizon (1977), the Philippine health care system is "a
Principles)
complex set of organizations interacting to provide an array of health
services." It has progressed due to challenges encountered over time. In
1991, the local government units (LGUs) took over the management of DOH ORGANIZATIONAL CHART
health service delivery but the issue of fragmentation has not been
absolutely addressed. Health workforce has to deal with the pressing
issues of underemployed workers, limited resources, and unequal
distribution. Meanwhile, the private sector which is said to comprise
50% of the overall health system is strongly involved in improving the
delivery of health services, but the government's power to regulate
should be optimized.

THE DEPARTMENT OF HEALTH MANDATE

As specified in Executive Order No. 119, Sec. 3 of 1987, the Ministry of

Health [now Department of Health (DOH)] has the responsibility to
create, plan, implement, and systematize national health policies,
advocacies, and programs. Its primary function is to promote, protect,
and preserve or restore people's health by giving health services and by
monitoring and motivating health service providers. Moreover, it is
responsible for the issuance of health-related licenses and
accreditations and disseminating information about national health
indicators.

It provides policy health direction, strategic plans, regulatory services,

standards and guidelines for health, and highly specialized and specific
tertiary level hospital services

DOH vision by 2030 states

A global leader for attaining better health outcomes, competitive and

responsible health care system, and equitable health financing

DOH mission states

To guarantee equitable, sustainable and quality health for all Filipinos,

especially the poor, and to lead the quest for excellence in health
LEVELS OF HEALTH CARE FACILITIES Tertiary Level of Health Care Facilities

Below are the levels of health care facilities according to Williams & Included in the tertiary level are specialized national hospitals which
Tungpalan (as cited in DeDios, n.d.): 1. Primary Level of Health Care offer highly technological and sophisticated services. Patients who are
Facilities (these are small facilities found in the community; usually afflicted with life-threatening diseases requiring highly technical and
implementor of essential elements) specialized knowledge, facilities, and personnel are treated here.

The primary level of health care facilities refers to the following: PHILIPPINE HEALTH CARE INFASTRACTURE (2016)

a. Units operated by the DOH which include the rural health units, their - 1124 hospitals: 64% are level 1 non-departmental hospitals, 10% are
respective sub-centers, chest clinics, malaria eradication units, and level 3 centers and teaching hospitals
schistosomiasis control units;
- 2587 City/Rural Health Centers
b. Puericulture center operated by the League of Puericulture Centers-
- 20 216 Village Health Stations
maternity
Beds per 10,000 people
c. Units operated by the Philippine Tuberculosis Society such as the
tuberculosis clinics and hospitals; -23 Ncr
d. Clinics operated by the Philippine Medical Association; - 8.2 Luzon
e. Clinics operated by large industrial firms for their employees; - 7.8 Visayas
f. Health centers and community hospitals operated by the Philippine - 8.3 Mindanao
Medical Care Commission (precursor company of philhealth and used
to run filipino health insurance back in the day) LEVELS OF PRIMARY HEALTH CARE WORKERS

g. Other health facilities operated by voluntary religious and civic 1. Grassroot or Village Health Workers (most active in the
groups community/major agent)

Secondary Level of Health Care Facilities a. They are the initial links of the community to health care.

The secondary level of health care facilities includes the smaller and b. They provide preventive health care measures and simple curatives
non-departmentalized hospitals. These are emergency and regional to promote a healthy environment.
hospitals where adequate treatments are offered for patients with c. They encourage programs/activities such as food production
symptomatic stages of diseases. programs to improve the socio- economic level of the community.

d. They are the volunteers, community health workers, or traditional

birth attendants.
2. Intermediate Level Health Workers

a. They are the first source of professional health care.

b. They attend to health problems which are already beyond the

competence of the village workers.

c. They provide supervision, training, supplies, and services that provide

support to front-line health workers.

d. They are medical practitioners, nurses, and midwives.

3. First-Line Hospital Personnel (handle the most complex)

a. When hospitalization is required, they serve as the backup health

service providers.

b. The intermediate level health workers or village health workers are in

close contact with them.

c. They are the physicians with specialty, nurses, dentist, pharmacists,

and other health professionals.

The categories of health workers are affected by certain factors such as:

1. the availability of health manpower resources (most are volunteers)

2. the presence of health care concerns and needs of the locality

3. the issue of financial and political feasibility