Health Promotion and Disease Prevention under the Aquino Health Agenda by Usec. Teodoro Herbosa

The Philippine Health Situa/on: How do we promote health and prevent diseases under

the Aquino Health Agenda?

Teodoro J. Herbosa, MD, FPCS

Undersecretary Department of Health, Philippines

Outline •  NCD Philippine Health Situa<on •  Universal Health Care •  NCD Strategic Framework

•  Accomplishment on NCD

Preven<on and Control by

UHC Pillars

•  Why Health Promo<on?

•  Priori<es for Ac<on 01/28/14

Healthy People, Wealthy Na<on: A Forum on Achieving Growth 2

PHILIPPINE SETTING: Top Ten Causes of Mortality

Cause Total Rate

1. 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 respiratory diseases 18,975 22.7

9. Diabetes mellitus 16,552 19.8

10. Condi/ons origina/ng from the perinatal period

13,180 15.8

Philippine Sta<s<cal Yearbook, 2009

Source: Philippine Health Sta2s2cs, 2009 01/28/14 4

Prevalence of hypertension, hyperglycemia, dyslipidemia & overweight

1998, 2003 and 2008 Philippine NNS, FNRI

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Risk factors 1998 2003 2008 Basis

Hypertension 21.0 22.5 25.3 SBP ≥ 140, DBP ≥ 90

Hyperglycemia 3.9 3.4 4.8 FBS > 126 mg/dL

Total cholesterol 4.0 8.5 10.2 ≥ 240 mg/dL

LDL-‐c 8.1 11.7 11.8 ≥ 160 mg/dL

HDL-‐c 76.6 54.2 64.1 < 40 mg/dL

Triglycerides 8.7 9.4 14.6 ≥ 200 mg/dL

BMI (Overweight) 20.2 24.0 26.6 BMI ≥ 25.0

ADULT CURRENT SMOKERS (15 years old and above)

•  28.3% of total adults (17.3M)

• 47.7% of adult males (14.6M)

• 9.0% of adult females ( 2.8M) SOURCE: Philippines’ Global Adult Tobacco Survey, 2009

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YOUTH CURRENT SMOKERS (13 -‐ 15 years old)

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•  27.4% currently use any tobacco product (M-‐34.7%; F-‐19.6%)

• More than 1 in 5 students (21.9%) currently smoke cigarefes

• Almost 1 in 10 (9.7%) currently use some other form of tobacco

• Over half (57.7%) of students live in homes where others smoke

SOURCE: Philippines’ Global Youth Tobacco Survey, 2007

Universal Health Care

Deliberate aHen2on to the needs of millions of poor Filipino families which comprise the majority of our popula2on

Filipino Income Quin/les

Monthly income Families per quin<le

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: Na2onal Health and Demographic Survey, 2008

Universal Health Care Beaer health outcomes

Responsive health system

Equitable health financing

Health Financing

Service Delivery

Policy, standards and regula<on

Health Human Resource

Health Informa<on

Governance for Health

Major Elements of UHC •  Addresses: Quality, Responsiveness, Availability & Accessibility

•  Focuses: Elimina<ng dispari<es (equity) & inefficiencies (governance)

•  Guiding principle: Providing essen<al health care packages to all regardless of age, gender, religion, ethnicity, socio-‐economic status, ideology, etc. Reference: A.O. 2010-‐0036: Aquino Health Agenda

Modifiable causa/ve risk factors

Tobacco use Unhealthy diets Physical inac/vity

Harmful use of alcohol

Cardiovascular disease

" " " "

Diabetes " " " "

Cancer " " " "

Chronic respiratory disease

"

OVERVIEW ON NCDS There are 4 Major NCDs (LRDs) and 4 common shared related risk factors

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01/28/14 Healthy People, Wealthy Na<on: A Forum

on Achieving Growth 13

NCD-‐Regional Ac/on Plan Strategic approach and ac/on areas

Accomplishment on NCD Preven<on and Control by UHC

Pillars



Health Financing

•  Primary Care Benefit Packages (PCB): a. PCB 1 – consulta<on, screening and

diagnos<cs for NCDs i.e. Visual Inspec<on Using Ace<c Acid Wash (VIA)

b. PCB 2 -‐ management and provision of medica<ons for NCDs i.e. Complete Treatment Packs for DM and HPN

•  Z Packages for catastrophic illnesses i.e. breast cancer and ALL

•  Case payment rates for asthma and essen<al hypertension

Service delivery

•  School-‐based HPV Vaccina<on Demonstra<on Project (8,000 Gr 5 females aged 10-‐14 y.o. in selected public schools given the 1st and 2nd dose of HPV vaccines)

•  Complete Treatment Packages (ComPack) Drugs -‐ Na<onal Center for Pharmaceu<cal Access and Management (NCPAM)

Policy, Standards and Regula/on A. LEGISLATION

•  Passage of Sin Tax Law •  Philhealth Law amendments

B. POLICIES

AO No. 2013 – 0005 or The Na2onal Policy on the Unified Registry Systems of the Department of Health (Chronic Non-‐communicable Diseases, Injury Related Cases, Persons with Disabili2es, and Violence Against Women and Children Registry Systems)

•  AO No. 2012-‐0029 or The Implemen2ng Guidelines on the Ins2tu2onaliza2on of Philippine Package of Essen2al NCD Interven2ons (PhilPEN) on the Integrated Management of Hypertension and Diabetes for Primary Health Care Facili2es

Policy, Standards and Regula/on

AO No. 2011-‐0003 or The Na2onal policy on Strengthening the Preven2on and Control of Chronic Lifestyle Related Non-‐Communicable Diseases

•  AO No. 2011-‐0013 or Implemen2ng Guidelines on the DOH Complete Treatment Pack (COMPACK) to Ensure Sustainable Access to Essen2al Drugs and Medicines for the Marginalized sector

•  AO No. 2010 – 0036 or The Aquino Health Agenda: Achieving Universal Health Care for all Filipinos

Policy, Standards and Regula/on

C. Standards

•  On-‐going Development of Clinical Pathways: 1.  Cardiovascular Disease 2.  Diabetes 3.  Cancer – breast, cervical, prostate and colorectal 4.  Chronic Respiratory Disease – COPD and asthma 5.  Eye Care

•  Development of training module on cervical cancer preven<on and control to include visual inspec<on of the cervix using ace<c acid wash (VIA)

Human Resource

•  Trained 43 service providers on VIA

•  Training of trainers of selected medical staff from Cotabato Regional Hospital on VIA

Human Resource

•  Conducted trainings on Smoking Cessa<on to 16 CHDs, 51 DOH hospitals and other agencies

•  Integra<on of Smoking Cessa<on in other health programs and advocacies such as in Fitness Camps and Belly Gud for Health

Human Resource

•  Conduct of TOT and provision of technical assistance for CHD roll-‐out trainings on Philippine Package of Essen<al Non-‐communicable Diseases for Low Resource Seqngs (PhilPEN)

% Coverage on PhilPEN Trainings Conducted by CHDs as of December 2013

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Propor/on of Health Personnel Trained on PhilPEN-‐Na/onal Coverage, As of December 2013

01/28/14 Status of PhilPEN Implementa<on 24

Governance for Health: Leadership and Stewardship

Focus Area Strategies and Key

Ac/on Points

DOH Responsible

Office

Lifestyle-‐related NCDs

Strengthening health system response to NCDs

NCDPC

Behavioral risk factors

Priori<zing key behavioral interven<ons

NCHP

Social determinants Raising the priority for mul<-‐sectoral ac<on

HPDPB BLHD

Health Informa/on

•  Inclusion of indicator in the KP dashboard; and •  Inclusion of indicator in the LGU scorecard •  Oriented 98 Health Facili<es on Unified Registry System (URS) for NCDs: 61 DOH Hospitals; 14 LGU hospitals; 23 private head of medical records and IT/Encoders

•  Oriented 135 health facili<es on URS

Other Ini<a<ves •  6-‐year Strategic Plan and Communica<on Plan for NCD

•  ASEAN Regional Forum on Non-‐Communicable Diseases (NCDs), October 2013

•  ASEAN Task Force Mee<ng on NCDs, October 2013

•  Southeast Asia Cancer Control Leadership Forum, April 2014

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Highlights of the ASEAN Regional NCD Forum

•  Global Ac<on Plan: Roadmap for Addressing NCDs in the next decade

•  ASEAN Health Coopera<on in NCDs

•  Addressing the Risk Factors of NCDs: Innova<ons and Sharing of Experiences

•  Presenta<on of the ASEAN declara<on on NCDs





WHY HEALTH PROMOTION?

HEALTH PROMOTION is the first step to disease preven<on.

It must start with people who are basically healthy by enhancing behaviors that promote well-‐being

and strengthening community measures and individual lifestyles for the maintenance of good health.

WHY PROMOTE HEALTH?

• Preven<on is befer than cure.

• Studies show that people are becoming increasing interested in improving their health through lifestyle changes.

• Elimina<ng a few lifestyle risks could immediately improve quality of life and prevent life-‐threatening diseases.

What will Health Promo/on Contribute to KP

 Develop Priority Health Messages for Delivery of Community Health Teams

 Promote Services of Health Facili<es like Facility-‐Based Delivery

 PHILHEALTH SABADO to promote enrolment to PHILHEALTH’s various programs

 Health Promo<on Component of Programs to achieve MDG Max i.e. Lifestyle Promo<on to prevent NCDs

Some Health Promotion Activities…

• LAKBAY BUHAY KALUSUGAN KALUSUGAN PANGKALAHATAN ON WHEELS

-‐ 1 Victory Liner-‐donated Bus -‐ Transforma<on of 8 China-‐donated Mobile Clinic buses to LBK-‐KP

Incidentally…

Lakbay Buhay Kalusugan is one of the recipients of the Na<onal Economic and Development Authority's

Good Prac/ce Awards 2012

NCHP is the NATIONAL TOBACCO CONTROL COORDINATING OFFICE of the DOH

- Oversee the implementation of the National Tobacco Control Strategy

- Convenorship of the Sector-Wide Anti- Tobacco (SWAT) Committees

- Establishment of Regional Tobacco Control Committees/Networks

HEALTHY LIFESTYLE PROGRAM is now lodged at the NCHP

-‐ Development of Program Policy, Strategic Plan, Manual of Opera<ons, Communica<on Plan

-‐ Focus on 4 Behavioral Risk Factors 1) Smoking 2) Harmful Use of Alcohol 3) Physical Inac<vity 4) Unhealthy Diet

-‐ Co-‐Convenorship of the Philippine Coali<on for the Preven<on and Control of Non-‐Communicable Diseases (NCD Coali<on)

Food Labeling / Healthy Food Op/ons advocacy programs

-‐ Health in All Policy (Salt Reduc<on) -‐ Review of the ASIN Law

-‐ Front-‐of-‐Pack Labeling -‐ Healthy School Canteen

DANCE FOR HEALTH -‐ Belly Gud for Health (Waist Circumference Reduc<on in the Workplace) -‐ Galaw Galaw Araw Araw Exercise Video -‐ Banat ni Lolo, Hirit ni Lola Exercise Video

• AKSYON PAPUTOK INJURY REDUCTION

-‐ Convenorship of a Mul<-‐sector -‐ Technical Working Group for Policy and Campaign Development

NCHP Awards -‐ DOH Red Orchid Awards (cash prizes limited to LGUs only)

-‐ Biennial Outstanding Healthy Lifestyle Advocacy Awards (6 categories: LGU City, LGU Municipality, Workplace, Academe, Business Establishment, NGO/ Professional Organiza<on)

COMING SOON -‐ Parangal sa mga Kuwentong Kalusugan Pangkalahatan health media recogni<on

National Center for Health Promotion

NCHP is the Department of Health’s arm in promo<ng health in seqngs where people live, work, learn and play.

Challenges

•  Ensure PhilPEN implementa<on up to the grass-‐roots level

•  Iden<fica<on and accredita<on of DOH Hospitals as training ins<tu<ons on VIA

•  Ins<tu<onaliza<on of Belly Gud for Health and expansion to other na<onal government agencies

Priori/es for Ac/on

•  Afain CHD and LGU scorecard targets •  Regular submission of senior ci<zens vaccines u<liza<on reports

•  Availability of cold chain facili<es for senior ci<zens (HWSC) vaccines

•  Designa<on of dedicated and commifed coordinators for NCDs and HWSC

Priori<es for Ac<on

 Identify and set critical Health Promotion Outputs and Outcomes at various levels (National, Regional, Local)

 Develop a Certification Program for Health Promotion Specialist

 Learn from the success of Multisectoral Coordination on Tobacco Control

 Develop Health Promotion Templates for Local Government Units and other Partners for inclusion to PIPH and CIPH

 Access funds like sin tax, environment tax, road users tax to promote health and safety

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Health Promotion & ISO 9001:2008

In the pursuit to con/nuously improve, meet, and even exceed people’s expecta/ons of a

QUALITY MANAGEMENT SYSTEM that enhances health care service delivery...

Health Promotion and Disease Prevention under the Aquino Health Agenda by Usec. Teodoro Herbosa

Health & Medicine

Transcript of Health Promotion and Disease Prevention under the Aquino Health Agenda by Usec. Teodoro Herbosa