THE HEALTH CARE DELIVERY

SYSTEM
CHAPTER 2

PREPARED BY :
OLIVE T. ANTONIO
ADAPTED TO: PHYLLICE BREBONERIA
 Learning Outcomes:

After
• Compose a brief and concise
finishing reflection/ insight on the importance of
the lesson, the MDG and SDG on the provision of
Health Care Services in the Philippines.
the • Differentiate the classifications of
Health Facilities in the Philippines.
student • Set up a concept map on the Philippine
will be Health Care Delivery System.

able to:
Definition of terms

World Health Organization

• WHO, established in 1948, is an organization of the
United Nations that links countries, partners, and
individuals to advance health, ensure global security,
and assist the most vulnerable people so that everyone
can enjoy the best possible level of health.

Health Care Delivery System

• The sum of all laws, structures, tools, supplies, services,
and personnel used to address the public's health
issues and difficulties.
Do you believe the services provided are
enough in light of our current state of
health and the roles played by nurses
and other members of the healthcare
team in addressing health issues?
 WORLD HEALTH ORGANIZATION

• The mission of the World Health Organization

(WHO) is to create a better and healthier future for
everyone. The majority of the work involves health
systems, health throughout a person's life. Its
primary duty is to organize and steer cooperative
global health programs. partnerships between the
WHO and countries, the UN organization,
international bodies, civil society, foundations,
academic institutions, and research organizations.
Millennium Development Goals

•At a conference of world leaders convened at

UN headquarters in New York in September
2000, the UN Millennium Declaration was
approved. The Millennium Development Goals
(MDGs) are a set of eight time-bound
objectives that were included in the Millennium
Declaration (MDGs), which committed
nations to a new international cooperation
to end severe poverty.
• MDG (Millenium Developmental Goal )
> UN Millenium Declaration signed in September
2000 , commit world leaders to combat
poverty ,hunger,disease ,illiteracy ,environment
degradatioon and discrimination against women
.
The 8 Millennium Development Goals
1.Eradicate extreme poverty and hunger .

The Millennium Development Goals have received widespread support,

which has resulted in the most effective anti-poverty movement in
history. The MDG goal of halving the percentage of people living in
extreme poverty was attained in 2010 before the 2015 deadline.
2.Achieve universal primary education
Since 1990, especially after the MDGs were introduced in 2000, there has
been a noticeable success in expanding primary school enrollment. Less
children around the world do not attend school now than there were in
1990, but the progress rate is not high enough to achieve primary school
enrollment for all children by 2015.

3. Promote gender equality and empower women

In terms of education, employment, and political representation, women and girls have
made significant strides, yet there are still significant gaps.
 4. Reduce child mortality
Although Child mortality has dramatically dropped, more children can still be saved from dying
from avoidable causes. (vaccinnes and immunizations)

5. Improve maternal health

Maternal survival has dramatically increased since the MDGs were introduced.

6. Combat HIV/ AIDS, malaria, and other diseases

Inmany parts of the world, the number of new cases of HIV infection keeps dropping. Millions of fatalities
have been prevented thanks to the rapid expansion of antiretroviral medication access. Unfortunately, there
is still little understanding of HIV and HIV prevention among individuals.
7. Ensure environmental sustainability

Despite a slowdown in deforestation, global greenhouse gas emissions are still rising.

8. Develop a global partnership for development

Over the MDG timeframe, there was a large rise in the amount of
official development assistance given to the least developed nations.
 > Aim to transform our
world ,they are call to
SDG (SUSTAINBLE
action ,to end poverty
DEVELOPMENTAL and inequality ,protect
GOAL) the planet and ensure
that all people enjoy
health ,justice and
prosperity .
 Philippine Department of Health

The leading healthcare provider in the nation

is the Department of Health (DOH). It is in
charge of controlling the flow of healthcare-
related products and services and offering
top-notch medical care to make sure that all
Filipinos have access to basic public health
services.

• Vision
• By 2022 and 2040, Filipinos will rank among the healthiest
populations in Southeast Asia and Asia.
VISION MISION • Mission
• Must take the lead in creating a health system that is
effective, durable, fair, and people-centered.
 HISTORICAL BACKGROOUND
Year Event
1947 The Department of Health (DOH) was established by Executive
Order No. 94, series of 1947, which transferred the Bureau of
Public Welfare to the President's Office.

1987 The Secretary of Health was reorganized under Executive Order

No. 119, which created five offices under his/her control. These
departments include the Office of the Chief of Staff, Public Health
Services, Hospital and Facilities Services, Standard and
Regulations, and Management Service. An undersecretary and an
assistant secretary are in charge of each of these divisions.

1992 Republic Act No. 7160, also known as the Local Government Code,
is being fully implemented. From playing an implementation role,
the DOH now plays a governing one.

1999 Through Executive Order 102, the DOH was instructed to align its
activities with the requirements of RA 7160 and the
Administrative Code of 1987.
 Local Health System and Devolution of Health Services

• A dual health system is thought to be formed

by the public and private sectors of the Philippine
healthcare system. The federal, state, and
municipal governments all administer the
facilities where health services are offered. A
budgeting system based on taxes provides the
majority of funding for the public sector. In the
free-market private sector, which includes for-
profit and nonprofit healthcare providers, health
care is frequently paid for by user fees at the
point of service (Department of Health, 2005).
 Local Government Code of 1991 (LGC)

 Devolution is the process by which the national

government gives specific powers and authorities to the
individual LGUs so they can carry out specific
responsibilities.
 The primary characteristic of LGC is the transfer of national
government duties to local government entities in order to
provide for the common welfare.
 The LGUs were granted more authority to mobilize their own
resources in order to effectively carry out the devolved tasks.
 Aim: to enhance the quality of local and national public
health services, particularly for the underprivileged, in
order to improve the health status of the Filipino people.
also lessening the financial strain on individual
households.
Classification of Health Facilities

Hospitals Other Health Facilities

General a. Primary Care Facility

 Level 1 b. Custodia l Care Facility

 Level 2
 Level 3 (Teaching/ Training)
Specia lty c. Dia gnostic Facility
d. Specia lized Out- Patient Facility
 GENERAL LEVEL 1 LEVEL 2 LEVEL 3
Clinical services for in Consulting Specialists Level 1 plus all: Level 2 plus all:
patients in:
Medicine Departmentalized Teaching/ training with
Pediatrics clinical services accredited residency
OB-GYNE training program in the
Surgery 4 major clinical services

Emergency and Out- Respiratory unit Physical Medicine and

patient services Rehabilitation Unit

Isolation Facility General ICU Ambulatory Surgical

Clinic

Surgical/ maternity High Risk Pregnancy Dialysis Clinic

Facility Unit

Dental Clinic NICU Tertiary lab with

histopathology

Ancillary Services Secondary Clinical Tertiary Clinical Blood bank

Laboratory Laboratory

Blood station Blood station 3rd level X-ray

1st Level X-ray 2nd Level of X-ray with
mobile unit

Pharmacy
 CLASSIFICATION OF OTHER HEALTH FACILITIES
A B C D
Primary Care Custodial Care Diagnostic/ Specialized Out-
Facility Facility Therapeutic Patient Facility
Facility
With in-patient beds Psychiatric Care Laboratories: Dialysis Clinic (DC)
 Infirmary/ Facility  Clinical LAB
Dispensary  Blood service
 Birthing Home Facility
 Drug test Lab Ambulatory Surgical
 NB Screening Clinic
Lab
 Water Lab
Without beds: Drug abuse Ionizing machines as In- vitro fertilization
 Medical out- Treatment and X-ray, CT scan, (IVF) Centers
patient clinic Rehabilitation Center mammography for
 OFW clinics and others
 Dental Clinics

Sanitarium Non- ionizing Radiation oncology

Leprosarium machines as facility
ultrasound, MRI and
others
Nursing Home Nuclear medicines Oncology Center
Clinic
Philippine Health Agenda 2016- 2022

Goals

The Health System We Aspire For: • Financial Protection

• The poor, excluded, and vulnerable Filipinos are shielded from
the exorbitant cost of healthcare.
• Better Health Outcomes
• With no disparities, Filipinos achieve the highest possible
health outcomes.
• Responsiveness
• In all of their interactions with the healthcare systems,
Filipinos experience a sense of respect, value, and
empowerment.

• Equitable and inclusive to all

• Transparent and accountable
• Uses resources efficiently
The Health System We Aspire For: • Provides high quality service

Values
Motto
• “All for health towards health for all.”

Strategy
• Advance quality health promotion and primary care
(traininggs and seminar, update)
• Cover all Filipinos against health- related financial risk
• Harness the power of strategic HRH development
• Invest in eHealth and data for decision- making
• Enforce standards, accountability and transparency
• Value all clients and patients, especially the poor,
marginalized, and vulnerable
• Elicit multi-sectoral and multi-stakeholder support for health
Primary Health Care (PHC)

PRIMARY is a type of essential

healthcare that is
provided to all
individuals and families
within the community,
using techniques they
deem appropriate and
PRIMARY with their full
cooperation, at a cost
HEALTH the community and the
country can afford at
CARE every level of growth.
Hi
st
or
y
• May 1977. • The 30th World Health Assembly adopted a resolution declaring that by
the year 2000, all people should have attained a level of health that will enable
them to live socially and economically productive lives, which is the primary social
objective of the governments and of the WHO.
• September 6-12, 1978. Alma Ata, USSR (Russia), hosted an international conference
on PHC this year.
• October 19, 1979. Letter of Instruction (LOI) 949, issued by Ferdinand Marcos, the
President of the Philippines, instructed the then-Ministry of Health to adopt PHC as a
strategy for designing, developing, and implementing initiatives that prioritize
community-based health development.
 • According to the World Health Organization,
primary healthcare is defined as essential medical
care that is provided to all individuals and
families in the community using methods they
find acceptable through full participation and at a
cost the community and the nation can afford at
every stage of development.

Definition • The International Conference on Primary Health

Care (PHC) approved the Declaration of Alma-Ata.
According to Alma Ata, PHC must include eight key
components in order to be effective. First, it must
provide basic healthcare that is based on
technological advancements that are both feasible
and socially and scientifically acceptable.
 1.Health Education
• One of the best methods for disseminating information. It supports
collaboration between the family and the healthcare professional to
advance wellness and ward off illness.

2.Treatment of Locally Endemic Diseases

• The goal of endemic sickness control is to reduce the rate of morbidity by preventing it from
happening.

3.Expanded Program on Immunization

• The goal of this program is to lower the prevalence of diseases that may be avoided, especially in
young children (under the age of six). As part of an ongoing program by the DOH, the government
provides free vaccines against illnesses like poliomyelitis, measles, tetanus, diphtheria, and others
that can be prevented.
 4.Maternal and Child Health and Family Planning
• The mother and the child are seen as the group's most vulnerable members. Therefore, protecting the
mother and the child from disease and other threats would ensure the general health of the community.
Responsible parenting and child spacing are goals of family planning.

5.Provision of Essential Drugs

• This focuses on the informational campaign on drug usage and purchase. The Philippines'
GENERIC ACT is passed in response.

6.Nutrition and Promotion of Adequate Food Supply

• For the family, food is a basic need. Additionally, if the meal is prepared properly, one can ensure a healthy
family. Despite the abundance of food resources in the communities, malnutrition is one of the problems our
country suffers because it is not properly prepared and because there is a lack of knowledge about food
planning.
7.Treatment of communicable and non- communicable diseases
• Infected people are at a high risk of contracting diseases because they can spread through direct or
indirect contact. The majority of these illnesses can be avoided. The prevention, control, and
treatment of these disorders are the main objectives of this program.

8.Environmental Sanitation and Promotion of Safe Water Supply

• Environmental sanitation is the study of all aspects of the environment that are harmful
to a person's survival and wellbeing. Water, a component of the environment and a
necessary for life, is one element. Water is necessary for health upkeep. Basic health
promotion requires access to safe drinking water and sanitary conditions.
Goals

"Better health for all" is the primary objective of PHC. To accomplish

that goal, WHO identified five crucial factors:

• Lowering social inequities(inequality to health services due to descrimnation to gender ,income gap
,social class and etc.) in health and excluding people (reforms involving universal coverage).
• Changes in service delivery that center health services on the demands and expectations of the
public.
• Integrating health into all spheres of society –family ,economy,government,religion,media and
collaboration (reforms to public policy).
• Seeking cooperative methods for policy discussion (leadership reforms); and
• Increasing stakeholder involvement(a person ,group,or organization with vested interest /
bussiness)
Principles
PHC is run with the following principles:
1. 4 A’s (Accessibility, Availability, Affordability and
Acceptability, Appropriateness of Health Services
>Wherever the alleged receivers are, there should be access to
health services. They ought to utilize the community's
resources, which are more geared toward promoting health and
preventing illness.
2.Community Participation
>Primary healthcare is fundamentally about community
involvement.
3.People are the center, object, and subject of
development
The community's involvement in decision-making at all
stages, including planning, executing, monitoring, and
assessing, is crucial to the projects' success. According to
PCF (1990), each of these must be founded on the wants and
issues of the populace.
4.Self- reliance
>By engaging the community and fostering organizational
cohesiveness, they can mobilize social support, network, and
local resources to support health care. These individuals
ought to acquire management and leadership abilities. One
of the most important signs that a community is moving
toward self-reliance is the presence of long-term
healthcare facilities that are administered by the
residents.
5.Partnership between the community and the health
agencies in the provision of quality life
>Establishing connections between the government,
non-governmental organizations, and community
organizations.
6.Recognition of interrelationship between the health
and development
 Health is characterized as more than just the absence
of sickness. It also extends beyond a state of health
on the physical and mental levels. Since health is a
social phenomenon, political, sociocultural, and economic
forces interact to determine it. Therefore, advancement in
the community's living conditions and standard of living
serves as a sign of good health.
 Development is the pursuit of a higher standard of
living for all. Development has many different facets. It
has elements related to politics, society, culture,
institutions, and the environment (Gonzales, 1994).
(when there is improved in health it is the result and
benefit of development and progress )
7.Social Mobilization
It improves citizen engagement in
governance, the public sector's system of
assistance, networking, and the production of
future leaders. (key leaders)

8.Decentralization
This ensures empowerment and
demonstrates that it can only be accomplished
if the administrative structure grants political
entities at the local level more substantial tasks to
assign to development initiators. This enables
efficient financial resource allocation.
(authority or decision is delegated away from central)
 Levels of Prevention

• Promoting health, protecting health,

restoring health when it has been
compromised, and reducing pain and
anguish are the objectives of the healthcare
industry. One of our tools for achieving this
goal is prevention. Knowledge of the cause,
dynamics of transmission, identification of
risk factors, and risk groups are all
necessary for effective prevention.
 Universal Health Care (UHC)

Republic Act No. 11223

 A law mandating changes to the healthcare system and
assigning funds to fund those changes, as well as ensuring
universal health coverage for all Filipinos. "Universal
Health Care Act" shall be the name given to this legislation.
• • Declaration of principles and policies- It is the state's policy
to safeguard and advance every Filipino's right to health and
to develop a sense of wellness among them. To accomplish
this, the state shall pass:
a. A comprehensive approach to ensure that everyone in
the Philippines is health-literate, has wholesome
living conditions, and is protected from risks and
threats that could harm their health.
a. A comprehensive array of high-quality, affordably
priced preventive, curative, rehabilitation, and
palliative health treatments available to all
Filipinos. a health care system that prioritizes the
needs of the population who cannot afford such services.
b. A framework that promotes the creation, execution,
monitoring, and assessment of health policies,
initiatives, and programs from the perspective of the
entire system, the entire government, and the entire
society.
c. A people-centered approach to healthcare that
prioritizes the needs and general well-being of the
patient while taking into account the diversity in
people's cultures, values, and beliefs.
•
 Thank you
for
listening!!!