Suchergebnisse

Understanding the direct and indirect health consequences of the COVID-19 pandemic is critical in designing a holistic public health response. This study has two objectives. First, we demonstrated the disruption of essential healthcare services using data from selected government facilities. Second, we estimated the productivity losses from direct and indirect health impacts of the pandemic. Validating our earlier study using health insurance claims, our findings showed a sharp decline in admissions and consultations in selected government facilities, particularly among the vulnerable population. Based on our estimates, the long-run costs from productivity losses from direct and indirect health impacts of the pandemic are PHP 2.3 trillion (at net present value). Indirect health impacts account for the majority of these costs.

This paper has two objectives: (1) assess the health sector performance of the Philippines relative to other ASEAN member states, and (2) assess regional health integration and cooperation in the Philippines, and identify challenges and opportunities. The Philippines is lagging in critical health outcome and access indicators in the region. This is a reflection of the longstanding challenges in terms of health financing, health service delivery, governance, and health human resources. Health integration and cooperation could be instrumental in achieving health system goals. While the country has made significant stride in facilitating regional integration and cooperation in recent years, challenges related to regulations, infrastructure, and implementation remain.

As the Philippines adopts major reforms under the Universal Health Care Act and embarks on an integrated and primary healthcare (PHC)-oriented system, it is critical to assess its readiness to manage noncommunicable diseases (NCDs)—the leading disease burden in the country. In 2019, NCDs accounted for about 70 percent of 600,000 deaths nationwide. Today, premature deaths caused by NCDs are increasing at a much faster rate, especially in poor communities. The Philippine health system, however, is historically designed to address infectious diseases and maternal and child health conditions. The delivery of health services in the country has also remained episodic and fragmented, a model unfit for the management of NCDs. This study assesses the readiness of the country's PHC in the context of governance, financing, service delivery, human resources, and information and communications technology. It identifies challenges in the availability, quality, and equity of the country's health system, which hamper the provision of comprehensive and continuous healthcare services in local communities.

As the Philippines adopts major reforms under the Universal Health Care Act and embarks on an integrated and primary healthcare (PHC)-oriented system, it is critical to assess its readiness to manage noncommunicable diseases (NCDs)—the leading disease burden in the country. In 2019, NCDs accounted for about 70 percent of 600,000 deaths nationwide. Today, premature deaths caused by NCDs are increasing at a much faster rate, especially in poor communities. The Philippine health system, however, is historically designed to address infectious diseases and maternal and child health conditions. The delivery of health services in the country has also remained episodic and fragmented, a model unfit for the management of NCDs. This study assesses the readiness of the country's PHC in the context of governance, financing, service delivery, human resources, and information and communications technology. It identifies challenges in the availability, quality, and equity of the country's health system, which hamper the provision of comprehensive and continuous healthcare services in local communities.

In hospitals, nutrition care is a set of actions that allows for the identification of patient nutritional needs and the provision of care to address those needs. Optimal nutrition for inpatients has a critical role in the prevention and treatment of diseases: It helps boost the body's immune system, reduces the risk of disease and infection, and aids in the recovery from illness. In Philippine public hospitals, nutrition care is provided by the Nutrition and Dietetics Service. In this work, we give a case study on the one of the hospital processes—the quality of hospital nutrition. Processes refer to the way care is delivered and whether it is aligned to evidenced-based practice or standards. We looked at whether Philippine public hospitals deliver high-quality, nutritionally appropriate meals to inpatients, adhere to the minimum meal allowance budget, and follow the minimal NDS inputs and process standards. Apart from the issue of unmet minimum meal allowance budget and nutritional content, we were able to unpack concerns related to human resources, equipment, management functions, and other NDS processes that could have an impact on the quality of nutrition care delivered. The general insight in enhancing the nutritional care offered in hospitals is to look at Nutrition and Dietetics Service as a whole, rather than just increasing the minimum meal allowance budget. The Department of Health must also guarantee that the value of high-quality nutrition care is recognized in hospitals, as it is often overlooked that it has an impact on total patient care quality.

In 2012, the Philippines passed the Responsible Parenthood and Reproductive Health (RPRH) Act. The law aimed to educate and empower Filipinos to make choices regarding their reproductive health (RH), improve the lives of families, and promote sustainable human development. Key to realizing this vision, was multisectoral coordination among national government agencies (NGAs), local government units and non-state actors. Given its wide scope, understanding the progress made by the RPRH Law requires an acknowledgement of the many movers that set its machinery in motion. In this paper, we analyzed the governance role played by NGAs in the implementation of the RPRH Law over the last eight years. We focused on nine components of governance, namely, Organizational Presence, Policy Infrastructure, Financing, Human Resources, Stewardship, Coordination, Monitoring & Evaluation, and Accountability, in their RPRH activities. While NGAs had accomplished or at least begun to accomplish most of their mandates and responsibilities, performance was siloed within implementing units of agencies, with modest interagency coordination. Despite the vision for multisectoral RH services, programs focused on biomedical and healthcare interventions, particularly in the area of family planning. Moreover, national-level governance for RPRH implementation focused on specific programs and their operational concerns. Fragmented governance activities result from a lack of integrated plans and coordination mechanisms in the nine governance components to bridge NGAs' efforts across sectors.

Health care providers such as hospitals and primary health care facilities form an integral part of any health system. Providers must have both financial sustainability, such that they are able to continuously deliver health care services without bankruptcy, and sufficient profits to maintain and improve the quality of their services. In this context, the Philippine Health Insurance Corporation (PhilHealth) is envisioned to be the national purchaser of health services that can support both inpatient and primary health care providers in the country while providing financial risk protection for Filipinos. In this paper, we (1) described the financial health of select public and private hospitals in the Philippines, and (2) examined PhilHealth's current position in relation to its envisioned role as national strategic purchaser for Universal Health Care (UHC). On the financial health of select Philippine hospitals, we found that the size of public and private hospitals in our sample has been growing steadily from 2015 to 2020, with public hospitals turning to government capital investment programs and private hospitals using debt and profits from patients to expand assets. Private hospitals showed decent profitability margins, but they may easily fall into financial distress if their cash flows are disrupted such as from inability to collect on receivables from health insurance payments. Meanwhile, prior to any government subsidies, public hospitals faced continuous negative profitability margins, signaling that they continuously operate on financial deficits. Ultimately, their heavy reliance on subsidies indicates that public facilities are not self-sufficient and may be chronically underfunded. Limited budgets seem to be channeled towards essential expenses, like personnel services, to keep operations going. Compared with the expectations of UHC for the institution, PhilHealth is still far from functioning effectively as the country's envisioned national purchaser. In gathering monopsonistic power, PhilHealth has ...

The unprecedented COVID-19 pandemic is the most challenging public health crisis the world has faced in a century. It has overwhelmed global and national health service and disaster management infrastructure and brought economies to a standstill/halt. It serves as both an eye-opener and an impetus to leapfrog reforms to strengthen governance systems and structures. It propels us to innovate and install more forward-looking systems and strategies that will enable us to permanently gain the capacity to survive and win over multiple and complex challenges that we face now and in the future. In the public sector, the pandemic shows the importance of having harmonization and synergy between and among national government agencies and sub-national governments. It has illustrated the importance of investing in digital education, e-commerce, and innovative ways of delivering social protection as well as fostering business innovations to meet fast-changing demand. The literature discusses quite a number of public sector innovations particularly in developed countries and the approaches are combinations of various governance methods, with styles varying depending on the context. Yet on the overall, the public sector has very few models for innovation. This background paper briefly scans the recent literature of public sector innovations and other efforts implemented in the strengthening of governance systems. The goal is to gather insights that may be useful for the Philippines case for enhancing its governance strategies, improving overall performance in service delivery, and building resilience against risks in the long-term.

In 2012, the Philippines passed the Responsible Parenthood and Reproductive Health (RPRH) Act. The law aimed to educate and empower Filipinos to make choices regarding their reproductive health (RH), improve the lives of families, and promote sustainable human development for the nation. Key to realizing this vision, was multisectoral coordination among national government agencies (NGAs), local government units, civil society organizations and multilateral donors. The law is a culmination of efforts among these sectors to provide access to RH services to a country clamoring for greater access to RH information and commodities. Since then, the RPRH Law has expanded RH care all over the country. Unmet need for family planning (FP) methods has continued to shrink, closing the gap with the country's goal of zero unmet need. In the years following the passage of the law, adolescent fertility rate began to decrease from the highest it has been since 1971. Despite these accomplishments, other RH outcomes stagnated or fell behind. In 2015, the country failed to meet its Millennium Development Goals for reducing maternal mortality, lowering HIV/AIDS incidence, and improving child health and nutrition. Moreover, the country's RH outcomes lag behind those of its low-and-middle income neighbors. Given its wide scope, understanding the progress made by the RPRH Law requires an acknowledgement of the many movers that set its machinery in motion. In this paper, we analyzed the governance role played by NGAs to facilitate the implementation of the RPRH Law over the last eight years. We focused on nine components of governance, namely, Organizational Presence, Policy Infrastructure, Financing, Human Resources, Stewardship, Coordination, Monitoring & Evaluation, and Accountability, in their RPRH activities.

This study is a critical analysis of health services purchasing undertaken by the PhilHealth, which implements the National Health Insurance Program of the Philippines. Purchasing is about how an institution should determine, negotiate for, and obtain health services on behalf of a group of people that has contributed resources, either through taxes, premiums, or point-of-service payments, in exchange for anticipated health services.The study employs a principal/agent framework for analyzing three critical relationships: that between the purchaser and health-care providers, between the purchaser and citizens (or members of Philhealth), and between the purchaser and the government, both as regulator and as funder of services, at the national government and local government levels. The study is an analysis of the key alignments and variances of purchasing practices vis-a-vis the "design" and the theoretical ideal in each of the three relationships. To do this, the study employs an extensive document review as well as key informant interviews of decisionmakers and other stakeholders, including PhilHealth management and staff, the Department of Health, provider representatives, and consumer representatives. It is part of a multicountry analysis of purchasing of health services in selected African and Asian health-financing organizations. It also provides key findings and policy implications.

The unprecedented coronavirus disease (COVID-19) pandemic is the most challenging public health crisis the world has faced in a century. It has overwhelmed global and national health service and disaster management infrastructure and brought economies to a standstill/halt. It serves as both an eye-opener and an impetus to leapfrog reforms to strengthen governance systems and structures. It propels us to innovate and install more forward-looking systems and strategies that will enable us to permanently gain the capacity to survive and win over multiple and complex challenges that we face now and in the future. In the public sector, the pandemic shows the importance of having harmonization and synergy between and among national government agencies and sub-national governments. It has illustrated the importance of investing in digital education, e-commerce, and innovative ways of delivering social protection as well as fostering business innovations to meet fast-changing demand. The literature discusses quite a number of public sector innovations particularly in developed countries and the approaches are combinations of various governance methods, with styles varying depending on the context. Yet on the overall, the public sector has very few models for innovation. This background paper briefly scans the recent literature of public sector innovations and other efforts implemented in the strengthening of governance systems. The goal is to gather insights that may be useful for the Philippines case for enhancing its governance strategies, improving overall performance in service delivery, and building resilience against risks in the long-term.

One of the major challenges in the Philippine health sector is to secure adequacy of appropriate health facilities. To address this problem, the Health Facilities Enhancement Program (HFEP) was implemented by the Department of Health (DOH) in 2007. Specifically, HFEP aims to improve facilities such as health centers and barangay health stations to sufficiently provide for emergency and primary care services. It also aims to upgrade government hospitals. This study examines the implementation of the program and probes at the rationale for the selection of facilities for upgrading. It lays out policy options to improve equity and efficiency in allocation of funds.

As a recognition of the valuable role of private sector in the healthcare delivery system, this paper attempts to collate vital information on private hospitals in the Philippines. This paper looks at the different characteristics and structures of private hospitals sector with regard to geographical distribution, services, financing, human resource, and other information needed by policymakers, investors, and other interested stakeholders. To better understand the current health care delivery system in the country, other sections compare private hospitals vis-a-vis government-owned facilities.

The study identifies outstanding issues and bottlenecks and provides recommendations to facilitate the Philippines' full compliance to its commitments to the ASEAN Economic Community (AEC). Various in-depth interviews and surveys were conducted with concerned stakeholders from government agencies and the private sector to bring to fore the issues and bottlenecks for policymakers' action. Although its focus is mainly on services and investment liberalization, this study also tracks policy changes in trade facilitation, nontariff measures, standards and conformance, and mutual recognition arrangements after the release of the 2010/2011 AEC Scorecard Reports.