Post on 16-Jul-2015
DOH Initiatives on
Kalusugan Pangkalahatan
FOR THE APPROVAL OF THE NEDA BOARD
May 28, 2012
slide 1 of 27
Kalusugan Pangkalahatan
The Aquino Health Agenda
to achieve universal health care by:
• Providing adequate financial risk protection,
especially for the poor*
• Ensuring sustainable access
to quality health care facilities and services
• Attaining Millennium Development Goals
(MDG) for health through focused public health
efforts
*refers to poor households listed in the NHTS-PR
slide 2 of 27
Financial
Risk
Protection
Access to
Quality
Health
Facilities
Attainment
of MDGs for
Health
Modernization
of the
Philippine
Orthopedic
Center
Vaccine
Self-
Sufficiency
Development
Objective
Agreement
between PHL
& USA on
Improved
Family Health
THE AQUINO
HEALTH AGENDA
slide 3 of 27
Financial Risk Protection
Access to Quality Health
Facilities
Attainment
of MDGs for
Health
Modernization of the
Philippine Orthopedic
Center
Vaccine Self-Sufficiency
Development
Objective
Agreement
between PHL
& USA on
Improved
Family Health
THE AQUINO
HEALTH AGENDA
slide 4 of 27
US-PHL Development
Objective Agreement
• Development agreement will help:
– Fulfill social contract with
the Filipino people
– Attain the MDGs on health
– Reduce inequities in health status
with a special focus on ARMM and CCT recipients
slide 5 of 27
US-PHL Development
Objective Agreement
• MOI signed by Sec. Ona and DA
Steinberg last May 5, 2012
• Agreement can be signed or
announced in Washington on
June 7, 2012
• Total project cost: US$ 197.25 M
(PhP 8.1 B)
• US $157.8 M (PhP 6.5B) of USG
grant via USAID (2012-2017)
• US $39.5 M (PhP 1.6B)
counterpart by PHL from DOH regular budget
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INDICATORBASELINE
2008 NDHS (%)DOH 2016
TARGET (%)
USAID 2017 TARGET (%)
USG Assisted-Areas
Component 1: Family Planning (FP) and Maternal and Child Health (MCH)
Contraceptive prevalence rate of modern methods
34 67 43
Unmet need for FP 20 10 14
Deliveries with skilled birth attendants 62 90 78
Facility-based deliveries 44 90 64
Pregnant women with at least 4 ANC 74 95 90
Infants exclusively breastfed (0-6 months) 34 70 63
Under 5-children with diarrheatreated with ORT
59 100 70
Fully immunized children 80 95 90
Vitamin A supplementation 76 90 90
Component 2: Tuberculosis (TB)
Case detection rate 73 (2011) 85 85
Cure rate 82 (2011) 85 90
slide 7 of 27
N
Priority Areas
• FP/MCH*
– 40 provinces/cities
including 25 current sites with high
unmet need for FP/MCH
• TB*
– 26 provinces & 10 NCR cities
with low case detection and cure
rates
* Including all ARMM provinces
slide 8 of 27
Financial Risk Protection
Access to Quality Health
Facilities
Attainment
of MDGs for
Health
Modernization of the
Philippine Orthopedic
Center
Vaccine
Self-
Sufficiency
Project II
Development Objective
Agreement between PHL &
USA on Improved
Family Health
THE AQUINO
HEALTH AGENDA
slide 9 of 27
Vaccine Self Sufficiency
Project II
• Construction of a current good
manufacturing practices (cGMP) vaccine
facility in the Research Institute for Tropical
Medicine through PPP (Build-operate-
transfer) for the production of combined
DPT, Hepatitis B and HIB vaccines;
Hepatitis B (single vaccine) and Tetanus
Toxoid
• DOH to procure from private partner for
Expanded Program for Immunization
vaccine requirements at 20% discount
slide 10 of 27
Objectives of VSSP II
Contribute to the reduction of under-5 mortality rate by:
• Ensuring adequate supply of the vaccines
• Reducing the cost of combined DPT, Hepatitis B and HIB vaccines;
Hepatitis B (single vaccine) and Tetanus Toxoid
• Ensuring acquisition of technologies in pooling and filling
of vaccines, establishment of facilities for filling, labeling and
packaging of vaccines as well as analytical laboratories
slide 11 of 27
Implementation Schedule
slide 12 of 27
Activity 2012 2013 2014 2015 2016-21
Tender Activities
Site Development / Permits
Engineering and Project Management
Production Building with Process Installation
Import (and Supply) of Naked Vials
Local Installation and Start-Up
GMP Certification and Validation
Start of Production
Cost and Financing
slide 13 of 27
ComponentForeign Component Local
Component (PhP)
Total (PhP)USD PhP
1. Basic Design Modules and Process 225,000 9,900,000 0 9,900,0002. Manufacturing Building, GMP 6,364,555 280,040,420 112,016,168 392,056,588a. Process Building, Installation & Transportation 2,205,555 97,044,420 38,817,760 135,862,188
b. Process Equipment & Piping (incl Installation) 4,064,000 178,816,000 71,526,400 250,342,400
c. Standby Power Supply 95,000 4,180,000 1,672,000 5,852,000
3. Engineering Manufacturing Bldg. & Process
800,000 35,200,000 0 35,200,000
a. Proj. Mgt., Design Mgt. & Engineering 800,000 35,200,000 35,200,000
4. Commissioning and Qualification - Bldg. & Process
130,000 5,720,000 0 5,720,000
5. Commissioning and Qualification Manufacturing Bldg. & Process VSSPI
100,000 4,400,000 0 4,400,000
6. Govt. Right-of-Way 16,500,000 16,500,0007. Site Preparation 3,000,000 3,000,0008. FS & Environmental Study 7,500,000 7,500,000Total Cost Estimate 7,619,555 335,260,420 139,016,168 474,276,588
(Exchange Rate: USD 1 = PhP 44)
Financial Viability &
Government Savings
Net present value PhP 1.08 B
Internal rate of return 24.56%
Total savings (2013-2021) PhP 6.06B
slide 14 of 27
Financial Risk Protection
Access to
Quality
Health
Facilities
Attainment of MDGs for
Health
Modernization
of the
Philippine
Orthopedic
Center
Vaccine Self-Sufficiency
Development Objective
Agreement between PHL &
USA on Improved
Family Health
THE AQUINO
HEALTH AGENDA
slide 15 of 27
Philippine
Orthopedic Center
• The proposed modernization of the Philippine Orthopedic
Center (POC) envisages its transfer into a new 700-bed
capacity facility to be located at East Avenue, Quezon City, to
be developed and operated by the private proponent along with
all required infrastructure.
• This will transform POC into the country’s leading
musculoskeletal & neurological medical services provider
comparable with global standards
slide 16 of 27
Implementation Arrangement
• Build-Operate-Transfer
• Concessionaire to design, construct, finance,equip, operate, maintain and transfer theHospital; responsible for all costs arising as aresult of its rights and obligations under theConcession Agreement
• DOH to bear the cost of site and half the annualcost of the Independent Consultant (IC)
• Voluntary transition of medical personnel to newPOC
slide 17 of 27
Site Location
slide 18 of 27
Need Gap Analysis for POCInfrastructure Constraints Solutions facilitated by Modernized POC
534 beds utilized out of 700 sanctioned beds, sub capacity operation at 70%-75% levels
Private sector efficiency in operations ensures capacity utilization at 90-95% levels
Staff to bed ratio presently at levels lower than ideal ratio
Staffing mix at New POC facility to ensure the ideal staff to bed ratio of 2.25 persons/bed
Only primary and secondary medical services being provided at present
Super specialty tertiary care with modern equipment and select medical staff
Lower than average period of discharge for admitted patients
Private sector efficiency enables reduction in discharge period from present 22 days to 6 days
Limitations in catering to non-citizen patients or medical travelers
Medical tourism patients identified as part of overall patient mix served at new facility
Present Status of POC slide 19 of 27
Plan for Modernized POC
Infrastructure Profile of New POC:
• Over 51,000 sq. mtrs const. area
• 2 blocks of 13 plus floors
• Interconnected at all floors
• 700 plus beds facility
• In house diagnostic facility
• Distinct functional services:
segregated areas for general &
specialized wards, (ICU, SICU, PICU,
etc.)
“SPECIALIZED NATIONAL ORTHEOPEDIC HEALTH CARE CENTRE”
Patient Profile:
• 70% of patients serviced comprise of Sponsored Category*
• Remaining 30% comprised of Pay patients, Medical travelers also targeted
Subsidy benefit utilized for servicing ‘needy’ sponsored category patients, in line with Universal Health Care agenda
*Sponsored Category Patients include Phil Health Service Patients & Pure Service Patientsslide 20 of 30
Total project cost: P 5,691.50 million
Government Sector counterpart: 257.70 million
Private Sector counterpart: 5,433.80 million
Total Project Cost Breakdown
Project Cost Breakdown per Component
slide 21 of 27
Key Project Costs
Estimated Patients Benefitted
Projected Cases 2013-15 2016 Operations Period 2038
In Patient Construction Period
33,000 34,750 36,500 38,250 40,000 40,500 40,500
204,500 211,750 217,000 222,000 225,500 226,750 227,500 Out Patient
Total Patients Served 237,500 246,750 253,500 260,250 265,500 267,000 268,000
Start of Operations End of
Contract
• More than 237,000 patients served each year by the
modernized POC facility in IPD & OPD
• Nearly 268,000 patients projected to be benefitted annually by
the end of the BOT contract
slide 22 of 27
Benefits for Patients Served
• Positive perception for
Government Health care - use of
latest technology & proficient staff
• Reduced duration of patient
hospitalization & quicker discharge
- operational efficiency
• Personalized care & improved
patient satisfaction – better staff to
bed ratio
Direct patient benefits
• Reduction in morbidity cases
• Reduction in mortality cases
• Improvements in work force
participation rate
• Enhanced disability adjusted life
years**
Macro level benefits
**Disability Adjusted Life Years (DALY) – Estimated life years after factoring reduction in life on account of disability. One DALY can be thought of as one lost year of "healthy" life
slide 23 of 27
Economic Benefit Head PhP Mn
Patient Satisfaction 25,536
Morbidity Related Health
Savings7,174
Mortality Related Health
Savings3,261
Medical Savings 22,943
Residual Value 2,224
Total Economic Benefit 61,138
Economic Viability Indicators
Economic Cost Head PhP Mn
Project Economic Cost 5,315
Economic O&M Costs 20,801
Equipment Renewal Eco.
Cost5,191
Total Economic Cost 31,307
Return Parameter Indicator*
Economic IRR 39.01%
NPV of Economic benefits PhP 6,740 Mn
Based on Economic Cost Benefit Analysis slide 24 of 27
O&M Period
Hospital Operator/
Project Proponent
Project Management
& Monitoring Team
• undertakes O&M in
accordance with
MPSS and O&M
Manual
• DOH representatives: POC &
NCHFD
• monitors compliance with MPSS
and O&M Manual
Private
Proponent/SPCDOH
• provides policy directions
• resolve disputes
Hospital Steering
Committee
Independent
Consultant
• Continues
providing
independent
third party
monitoring on
all operational
aspects
• Collectively constituted
with representation from
Pvt. & Govt.
slide 25 of 27
Summary
1. NEDA Board approval to sign the Development Objective
Agreement for Improved Family Health between PHL-USA
2. NEDA Board approval to enter into PPP agreement for VSSP II
3. NEDA Board approval to enter into PPP agreement for the
POC Modernization
slide 26 of 27
Maraming salamat po.
slide 27 of 27