Aquino Health Agenda

8/3/2019 Aquino Health Agenda

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Aquino Health Agenda:

Universal Health Care

Enrique T. Ona, MD, FPCS, FACS

Secretary of Health

2nd Philippine Health Outlook Forum

22 October 2010



“Sixty percent of our countrymen

who succumb to sickness diewithout seeing a doctor.”

- PNoy’s Challenge



Universal Health Care

Deliberate attention to the

needs of millions of poor

Filipino families which

comprise the majority of our

population



Filipino Income Quintiles

Monthly income Families per quintile

Q1 3,460 5,218,267

Q2 6,073 4,094,164

Q3 9,309 3,912,443

Q4 15,064 3,707,494

Q5 38,065 3,485,067

Source: National Health and Demographic Survey, 2008



Comprehensive Reforms in Health

Universal Health Care(2010 -2016)

Fourmula One for Health(2005 – 2010)

Health Sector Reform Agenda(1999- 2004)



CURRENT STATUS

Health Outcomes



Demographic Characteristics

Population, total (millions) 94,013,200 (projected, NSO 2007)

Population < 25 years

(% of total population)

52.8 % (projected, NSO 2007)

49,617,400 M Filipinos

Population > 60 years

(% of total population)

6.7% (projected, NSO 2007)

6,637,100 M Filipinos

Birth rate

(births per 1,000 population)

23.4 (NDHS 2008)

2,162,303 live births per year

Death rate

(deaths per 1,000 population)

5.48 (NSO 2007)

515,192.34 deaths / year



Top Ten Cause of Mortality

Cause Total Rate1. Diseases of the heart 70, 861 84.8

2. Diseases of the vascular system 51,680 61.8

3. Malignant Neoplasms 40,524 48.9

4. Accidents 34,483 41.3

5. Pneumonia 32,098 38.4

6. Tuberculosis 26,770 31.0

7. Unclassified 21,278 25.5

8. Chronic lower respiratorydiseases

18,975 22.7

9. Diabetes mellitus 16,552 19.8

10. Conditions originating from the

perinatal period

13,180 15.8

Philippine Statistical Yearbook, 2009



UN Millennium Development Goals

Source:MDG Monitor: Quick Facts

(accessed 10/11/2010)

http://www.mdgmonitor.org/country_progress.cfm?c=PHL&cd=608

http://www.mdgmonitor.org/country_progress.cfm?c=PHL&cd=608



Towards the attainment of MDGs ….

Indicators 2015 Target Accomplishment

MDG 4:

Under 5 mortality rate

(per 1,000 live births)

26.7 34

(2008 NDHS)

Infant mortality rate


19.0 25

(2008 NDHS)

MDG 5:

Maternal mortality ratio


52 162

(2006 FPS)

Proportion of births attended by

skilled health professional

70.0

(2010 NOH)

62

(2008 NDHS)



INDICATORS 2015 Target ACCOMPLISHMENT

MDG 6

Prevalence of HIV/AIDS among high risk

groups

<1%

5,364 cases(1984-2010)

<1%

Malaria morbidity rate 62/100,000 pop

38,135 cases(based from 1990

baseline)

21.6/100,000 pop

19,555 cases

(2009)

Malaria mortality rate 0.75456 deaths

(based from 1990baseline)

0.02624 deaths

(2009)

TB morbidity rate 137/100,000

128,798 cases

(2010 NOH)

129 (2008)

121,277 cases

TB mortality rate <44/100,000

41,366 deaths

(PhilPACT)

41.0 (2007)

TB case detection rate 70 % 75 % (NTP, 2007)

TB cure rate 85 % 83 % (NTP, 2007)



Mortality Trend: Communicable Diseases,

Malignant Neoplasms & Diseases of the HeartRate/100,000 Population

Philippines, 1953-2005

0

100

200

300

400

500

600

700

1 9 5 3

' 5 4

' 5 5

' 5 6

' 5 7

' 5 8

' 5 9

' 6 0

' 6 1

' 6 2

' 6 3

' 6 4

' 6 5

' 6 6

' 6 7

' 6 8

' 6 9

' 7 0

' 7 1

' 7 2

' 7 3

' 7 4

' 7 5

' 7 6

' 7 7

' 7 8

' 7 9

' 8 0

' 8 1

' 8 2

' 8 3

' 8 4

' 8 5

' 8 6

' 8 7

' 8 8

' 8 9

' 9 0

' 9 1

' 9 2

' 9 3

' 9 4

' 9 5

' 9 6

' 9 7

' 9 8

' 9 9

2 0 0 0

' 0 1

' 0 2

' 0 3

' 0 5

Year

Communicable Diseases

0

10

20

30

40

50

60

70

80

90

100

Malignant Neoplasms &

Diseases of the Heart

Communicable Diseases

Malignant Neoplasms

Diseases of the Heart

Source: Philippine Health Statistics, 2005



CURRENT STATUS

HEALTH FINANCING



Share of health expenditure per GNP

0

0.5

1

1.5

2

2.5

3

3.5

4

P e r c e n t

1 9 9 3

1 9 9 4

1 9 9 5

1 9 9 6

1 9 9 7

1 9 9 8

1 9 9 9

2 0 0 0

2 0 0 1

2 0 0 2

2 0 0 3

2 0 0 4

2 0 0 5

2 0 0 6

2 0 0 7

Year

Total health expenditure = P234.3 B or 3.2 percent of GDP

Source: Philippine National Health Accounts



Total expenditure on health as a Percentage

of GDP

0

2

4

6

810

12

14

16

Total expenditure on health as % GDP

Source: World Health Statistics 2010



Distribution of Health Expenditure by

Use of Funds

Personal

Health Care

81%

P 189.7 billion

Public Health

Care

9%

P 21.2 billion

Others

10%

P 23.3 billion

Source: Philippine National Health Account, 2007

Total health expenditure is P234.3 B

(3.2 percent of GDP)



Distribution of Health Expenditure

by Source of Funds NationalGovernment

13% LocalGovernment

13%

Social HealthInsurance

9%Out-of-Pocket54%

Others11%

Source: Philippine National Health Account, 2007

Total health expenditure is P234.3 B (3.2 percent of GDP)



PhilHealth

Pres. Aquino, on PhilHealth Enrolment:

“Sabi ng PhilHealth sa isang bibig,

walumpu't pitong porsyento na raw angmerong coverage. Sa kabilang bibig naman,singkuwenta'y tres porsyento. Ayon naman

sa National Statistics Office, tatlumpu'twalong porsyento ang may coverage.”

(Pnoy’s SONA – July 26, 2010; emphasis supplied)

18



PhilHealth

Aquino was dismayed at the miserable “benefit

delivery rate of the National Health Insurance

Program in the country which stands at only 8

percent.” (PDI, Oct 3, 2010)

19

Coverage rate Availment

rate

Support value

Benefit

delivery rate

53% 42% 34% 8%



CURRENT STATUS

HEALTH FACILITIES



Office of Secretary of Health

Attached Agencies

Regional Offices

Provincial Health Offices

City Health Offices

(Component Cities)

Inter-local Health Zones

City

Hospitals

Health

Centers

Barangay

Health

Stations

District

hospitals

Municipal health

offices/ Rural

Health Unit

Barangay Health

Stations

Provincial

Hospitals

Regional hospital

Medical Centers

Sanitaria

City Health Offices

(Chartered Cities)

City

Hospitals

Health

Centers

BarangayHealth

Stations



Regional Hospitals

Corazon Locsin Montelibano MemorialRegional Hospital, Negros Occidental Southern Philippines Medical Center,Davao



Provincial Hospitals

Davao del Sur Provincial Hospital Teresita Lopez Jalandoni ProvincialHospital, Negros Occidental



City Hospitals

Gregorio Lluch Memorial CityHospital, Butuan City

JJ. Borja Memorial City Hospital,Cagayan de Oro City



STRATEGIC DIRECTIONSOF THE AQUINOADMINISTRATION



Priority Health Policy Directions of

the Aquino Administration1. A roadmap towards universal health care through arefocused PhilHealth;

2. Particular attention to the construction, rehabilitation, andsupport of health facilities:

◦ LGU/regional hospitals,

◦ rural health units

◦ barangay health stations

3. Attainment of Millennium Development Goals 4, 5, and 6◦ Reduction of maternal, neonatal, and infant mortality

◦ Support to contain/eliminate age old pubic health diseases (malaria,dengue, TB)



Health Policy Directions of the

Aquino Administration◦ Attain efficiency by using information technology (IT)

in all aspects of health care

◦ Increased attention to trauma, the 4th leading cause of

death◦ More aggressive promotion of healthy lifestyle to

prevent non communicable diseases: heart disease,

stroke, diabetes, obesity

◦ Attention to emerging diseases (Superbug, nosocomialdiseases, A(H1N1), diseases brought about by climate

change)



Health Policy Directions of the

Aquino Administration

◦ Improve the access to quality affordable medicines

◦ Continuing efforts in improving governance and

regulation to eliminate graft and corruption in all areas

of health care

◦

Improve the plight of health workers throughinterventions in health education, placement,

compensation, among others



Revitalizing the NHIP

Paradigm shift in the implementation of NHIP: Expansion of NHIP coverage

◦ Enrollment of the poorest of the poor

◦ Enforce mandatory enrolment of the informal sector (as per

the National Health Insurance Act, R.A. 7875 as amended) Improvement of membership services to increase

awareness of PhilHealth benefits and entitlements

Access to inpatient and outpatient services through

PhilHealth Zero co-payment/No balance billing for health care

costs incurred for the poorest in government hospitals



Health Facilities Enhancement

Upgrading of health facilities: rural healthunits, district hospitals, provincial hospitals,

DOH Retained hospital

◦ Improved facility preparedness for trauma (4thleading cause of death)

◦ Improved capacity of clinical/hospital care for the

most common causes of mortality and morbidity

◦ Improve access to quality affordable medicines



Strategies for Health Facilities

Enhancement Public-Private Partnership

Regional Clustering

Fiscal autonomy and income retention for

government health facilities

Streamlining of licensing and regulation for

improved accreditation



Public-Private Partnerships

Proposed projects: IT system for DOH and PhilHealth

Philippine Orthopedic Center as Center

for Bone Diseases and Trauma Air ambulance project

Research Institute for Tropical Medicinefor commercial production of vaccines

San Lazaro Hospital as Center forInfectious Diseases



Public-Private Partnerships

Commercial utilization of vacant hospitalland assets

Establishment of Multi-Specialty Centers

in selected regions (3) in Northern Luzon,Visayas, and Mindanao

Construction of Patient and Hospital

Staff ’s lodging facilities



Regional Clustering

Clustering of health facilities composed of regional, hospitals and district hospitals aswell as rural health units and health centers,to address fragmentation of health servicesat local levels by….

Establishment of Clustered Health Boardscomposed of the Secretary of Health or his

representative, local chief executives, privatepartners, civil society/NGO for clusteredhealth facilities



Attaining the MDGs

Ensure that poorest families are reached by

priority public health programs

Deployment of Community Health Teams:

Packaging of services using the Life Cycle

Approach

◦ Pre-pregnancy: Family Planning services

◦ Pregnancy: Four ante-natal care services and

delivery in health facilities (Emergency Obstetric

and Neonatal Care)



Attaining the MDGs

Packaging of services using the Life CycleApproach

Post partum: Essential newborn care and

immediate post partum care Infancy/early childhood: Garantisadong Pambata



Strategies for Public Health

• More aggressive promotion of healthy lifestyle

to prevent non communicable diseases: heart

disease, stroke, diabetes, obesity

• Attention to emerging diseases (Superbug,

nosocomial diseases, A(H1N1), diseases

brought about by climate change)



ICT Tools for Health

Information and Communications Technology willplay a major part in ensuring universal health careis achieved as it can provide quality and timelyinformation to guide decision making at all levels.

Improvement of PhilHealth services will not beattained with out efficient IT Tool support Access of health to public health programs as well

as clinical services can be augmented by ICT e.g.

Telemedicine Regional Clustering will be dependent on

information sharing



Philippine Health Outlook Forum

For the remainder of this activity, we hope that

we can explore ways on how we can harmonize

our efforts in focusing on these priority areas

towards achieving our goal of

Universal Health Care.



Thank you!

Aquino Health Agenda

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