HEALTH CARE DELIVERY
SYSTEM
A health system, also sometimes
referred to as health care
system, is the organization of
people, institutions, and
resources that deliver health
care services to meet
the health needs of target
populations.
Health system according
to WHO:
The health system consists of all
organizations, people and actions
whose primary intent is to promote,
restore or maintain health. This
includes efforts to influence
determinants of health as well as
more direct health-improving
activities.
The World Health
Organization (WHO) is
a specialized agency of the
United Nations that is
concerned with
international public health.
It was established on
7 April 1948.
There are 6 WHO regions,
each with a regional office.
In addition, WHO has 149
field offices in countries,
territories or areas. Countries
without a WHO office are
covered by nearby field
offices or by the appropriate
regional office.
REGIONAL OFFICE
Africa
Americas
South-East Asia
Europe
Eastern Mediterranean
Western Pacific
REGIONAL OFFICE
Africa
Americas
South-East Asia
Europe
Eastern Mediterranean
Western Pacific
The objective of
WHO is the
attainment by all
peoples of the
highest possible
level of health.
The organization’s Eleventh General Programme of
Work 2006-2015 details the six core functions it is focusing
on between 2006 and 2015. These functions are:
1. Providing leadership on matters critical to health and engaging in
partnerships where joint action is needed;
2. Shaping the research agenda and stimulating the generation,
translation and dissemination of valuable knowledge;
3. Setting norms and standards and promoting and monitoring their
implementation;
4. Articulating ethical and evidence-based policy options;
5. Providing technical support, catalysing change, and building
sustainable institutional capacity;
6. Monitoring the health situation and addressing health trends
MILLENIUM
DEVELOPMENT GOALS
The Millennium Development
Goals (MDGs) were
eight international
development goals for the year
2015 that had been established
following the Millennium Summit of
the United Nations in
September 6-8, 2000, following the
adoption of the United Nations
Millennium Declaration.
“To uphold these principles
is their duty to all the people
of the world, especially the
most vulnerable and in
particular, the children”
1. To eradicate extreme
poverty and hunger
2. To achieve universal primary education
3. To promote gender equality and
empower women
4. To reduce child mortality
5. To improve maternal health
6. To combat HIV/AIDS, malaria, and other
diseases
7. To ensure environmental sustainability
8. To develop a global partnership for
development
1. To eradicate extreme
poverty and hunger
2. To achieve universal
primary education
3. To promote gender
equality and empower
women
4. To reduce child mortality
5. To improve maternal health
6. To
combat HIV/AIDS, malaria, and
other diseases
7. To ensure environmental
sustainability
8. To develop a global
partnership for development
HEALTH RELATED MDG
GOAL 4: To reduce
child mortality
GOAL 5. To improve
maternal health
GOAL 6. To combat HIV/AIDS,
malaria, and other diseases
GOAL 4: To reduce
child mortality
Target: Reduce by two-thirds,
between 1990 and 2015, the
under-five mortality rate
GOAL 5: To improve
maternal health
Targets:
- Reduce by three quarters,
between 1990 and 2015,
the maternal mortality ratio
-Achieve, by 2015, universal
access to reproductive health
GOAL 6: To combat HIV/AIDS, malaria,
and other diseases
Targets:
- Have halted by 2015 and begun to
reverse the spread of HIV/AIDS
- Achieve, by 2010, universal access to
treatment for HIV/AIDS for all those who
need it
- Have halted by 2015 and begun to
reverse the incidence of malaria and other
major diseases
The Sustainable Development
Goals (SDGs) are a collection of
17 global goals set by the United
Nations General Assembly in
2015 for the year 2030.
1. No Poverty
2. Zero Hunger
3. Good Health and Well-being
4. Quality Education
5. Gender Equality
6. Clean Water and Sanitation
7. Affordable and Clean Energy
8. Decent Work and Economic Growth
9. Industry, Innovation, and Infrastructure
10. Reducing Inequality
11. Sustainable Cities and Communities
12. Responsible Consumption and Production
13. Climate Action
14. Life Below Water
15. Life On Land
16. Peace, Justice, and Strong Institutions
17. Partnerships for the Goals.
SDG 3:
"Ensure healthy lives and
promote well-being for
all at all ages."
The Department of Health (DOH) is the
principal health agency in the
Philippines. It is responsible for
ensuring access to basic public health
services to all Filipinos through the
provision of quality health care and
regulation of providers of health goods
and services.
Vision by 2030
A global leader for attaining better
health outcomes, competitive and
responsive health care system, and
equitable health financing.
Mission
To guarantee equitable, sustainable
and quality health for all Filipinos,
especially the poor, and to lead the
quest for excellence in health.
MAJOR ROLES OF THE
DEPARTMENT OF HEALTH
1. LEADER IN HEALTH
2. ENABLER AND CAPACITY
BUILDER
3. ADMINISTRATOR OF SPECIFIC
SERVICES
CORE VALUES OF THE DOH
INTEGRITY – The Department believes in upholding truth and
pursuing honesty, accountability, and consistency in
performing its functions.
EXCELLENCE – The DOH continuously strive for the best by
fostering innovation, effectiveness and efficiency, pro-
action, dynamism, and openness to change.
COMPASSION AND RESPECT FOR HUMAN DIGNITY – Whilst
DOH upholds the quality of life, respect for human dignity is
encouraged by working with sympathy and benevolence
for the people in need.
COMMITMENT – With all our hearts and minds, the
Department commits to achieve its vision for the health and
development of future generations.
PROFESSIONALISM – The DOH performs its functions in
accordance with the highest ethical standards, principles
of accountability, and full responsibility.
TEAMWORK – The DOH employees work together with a
result-oriented mindset.
STEWARDSHIP OF THE HEALTH OF THE PEOPLE – Being
stewards of health for the people, the Department shall
pursue sustainable development and care for the
environment since it impinges on the health of the Filipinos.
The following agencies are
attached to the DOH:
1. Philippine Institute of Traditional
and Alternative Health Care
2. Philippine Health Insurance
Corporation
3. Philippine National AIDS Council
4. Commission on Population
5. National Nutrition Council
1. Philippine Institute of Traditional and
Alternative Health Care
- Republic Act 8423 (R.A. 8423)
mandates the Philippine Institute of
Traditional and Alternative Health Care
(PITAHC) “to improve the quality and
delivery of health care services to the
Filipino people through the development
of traditional and alternative health care
and its integration into the national
health care delivery system“.
2. Philippine Health Insurance Corporation
(PHILHEALTH)
It was created in 1995 to
implement universal health coverage in
the Philippines. It is a tax-exempt,
government-owned and controlled
corporation (GOCC) of the Philippines, and
is attached to the Department of Health. Its
stated goal is to "ensure a
sustainable national health
insurance program for all", according to
the company.
3. Philippine National AIDS Council
The PNAC is a national advisory body
which reviews and recommends policies
on HIV/AIDS to the President and directs
national approaches against HIV/AIDS
domestically.
President Fidel Ramos signed Executive
Order 39, creating the Philippine
National AIDS Council (PNAC) on
December 3, 1992,
4. Commission on Population
The Commission on Population
(POPCOM) is the central
policymaking, planning,
coordinating, and monitoring body
of the population program.
5. National Nutrition Council
Abbreviated as NNC, is an agency of
the Philippine government under
the Department of Health responsible for
creating a conducive policy
environment for national and local
nutrition planning, implementation,
monitoring and evaluation, and
surveillance using state-of the art
technology and approaches.
REPUBLIC ACT 7160
otherwise known as the Local
Government Code was enacted
into law, transferring control and
responsibility of delivering basic
services to the hands of local
government units (LGU). It aimed to
enhance provision of services in the
grass roots level as well as improve
the efficiency in resource allocation.
UNIVERSAL HEALTHCARE ACT
or RA 11223 was signed into
law by President Duterte on
February 20, 2019
The act will automatically enroll
Filipino citizens into the National
Health Insurance Program and
expand PhilHealth coverage to
include free medical consultations
and laboratory tests.
WHAT MIGHT
CITIZENS BE
ABLE TO
EXPECT?
1. ALL FILIPINOS ARE
COVERED
Every single Filipino citizen is
automatically enrolled into the
newly-created National Health
Insurance Program (NHIP)
The program classified
membership into two types:
DIRECT CONTRIBUTORS – those who pay
PhilHealth premiums, are employed and
bound by an "employer-employee
relationship," self-earning, professional
practitioners, and migrant workers.
Members’ qualified dependents and lifetime
members are also included.
INDIRECT CONTRIBUTORS – those not
considered as direct contributors, along with
their qualified dependents, whose health
premiums are subsidized by the government.
All Filipinos will be granted
“immediate eligibility” and
access to the full spectrum of
health care which includes
preventive, promotive,
curative, rehabilitative, and
palliative care. This can be
expected for medical, dental,
mental, and emergency
health services.
Filipinos will also be enrolled with
a primary health care provider
of their choice. The primary care
provider is the health worker they
can go and seek treatment from
for health concerns. They will
also serve as the person in charge
of referring and coordinating with
other health centers if patients
need further treatment.
Filipinos will also be enrolled with
a primary health care provider
of their choice. The primary care
provider is the health worker they
can go and seek treatment from
for health concerns. They will
also serve as the person in charge
of referring and coordinating with
other health centers if patients
need further treatment.
Citizens will not need to
present any PhilHealth ID to
avail of these benefits.
Meanwhile, poor Filipinos or
those who are located in
geographically isolated areas
will also be given priority
when ensuring access to
health services.
2. IT IS NOT
COMPLETELY FREE.
UHC does not mean every single
health expense will be made free.
The law outlines that basic
services accommodations will be
covered by PhilHealth
1. Regular meals,
2. Bed in a shared room with
fan ventilation
3. Shared toilet and bath
4. Essential health benefit
package (primary care, medicines,
diagnostic, and laboratory tests. It
also includes preventive, curative, and
rehabilitative services)
As long as a patient avails of these
basic accommodations, it will be
covered by PhilHealth whether in a
public or private hospital.
1. Regular meals,
2. Bed in a shared room with
fan ventilation
3. Shared toilet and bath
4. Essential health benefit
package (primary care, medicines,
diagnostic, and laboratory tests. It
also includes preventive, curative, and
rehabilitative services)
As long as a patient avails of these
basic accommodations, it will be
covered by PhilHealth whether in a
public or private hospital.
HOSPITAL ALLOCATIONS:
GOVERNMENT HOSPITAL
90%
HOSPITAL ALLOCATIONS:
SPECIALTY HOSPITAL
70%
HOSPITAL ALLOCATIONS:
PRIVATE HOSPITAL
10%
The law also states that if
patients need to pay for extra
expenses, their
“CO-PAYMENT”
or what is paid on top of basic
services – should be regulated
by the DOH in public
hospitals.
3. PHILHEALTH WILL BECOME THE
“NATIONAL PURCHASER” OF HEALTH
GOODS AND SERVICES
This means that PhilHealth will be
in charge of paying health care
providers like hospitals and clinics
for services given to Filipinos.
Funds for PhilHealth will be sourced
from the following:
1. Philippine Amusement and Gaming
Corporation – 50% of national government’s share
2. Philippine Charity Sweepstakes Office
(PCSO) – 40% of its charity fund, net of document
stamp tax payments, and mandatory PCSO
contributions
3. Premium contributions of direct contributory
members
4. PhilHealth annual budget
4. DOH WILL STILL BE IN CHARGE
OF “POPULATION-BASED” HEALTH
SERVICES
While PhilHealth, along with other
private health insurance companies,
is expected to cover services for
individuals, the DOH is still in charge
of delivering health services that
cover entire populations.
5. HEALTH SYSTEMS WILL
BECOME CITY-WIDE AND
PROVINCE-WIDE
Provinces and highly urbanized cities
will now be in charge of overseeing
health services in areas as opposed to
the current set-up where
municipalities are tasked with
managing their own health centers.
6. RETURN SERVICE IN
THE PUBLIC
HEALTH SECTOR
Graduates of health and health-related
courses who received government-funded
scholarships will be required to work in
the public health sector for at least 3 full
years. This will address the need for
health workers across the country.
7. A “HEALTH TECHNOLOGY
AND ASSESSMENT COUNCIL”
(HTAC) WILL BE CREATED
Another important feature of the law
is the creation of the HTAC – a group
of health experts who will be
responsible for evaluating latest
health developments and
recommending their use to DOH and
PhilHealth.
The HTAC will be attached
to the DOH for the first
5 years after the law is
implemented. After this, it
will become an independent
body attached to the
Department of Science and
Technology.
8. HEALTH
INFORMATION WILL BE
COLLECTED
Both public and private hospitals and
health insurers will be required to
maintain a health information system
that will contain electronic health
records, prescription logs, and
“human resource information.”
Lahat Para sa
Kalusugan!
Tungo sa
Kalusugan Para
sa Lahat
THE RURAL
HEALTH UNIT
THE RURAL HEALTH UNIT
It is commonly known as the
Health Center.
It is a primary level health facility in
the municipality that focuses on
preventive and promotive health
services and the supervision of
Barangay Health Stations under its
jurisdiction.
THE RURAL HEALTH UNIT
Recommended ratio of
RHU to catchment
population is
1 RHU: 20,000 population
(DOH, 2009)
BARANGAY HEALTH STATION
On the other hand, a Barangay Health
Station (BHS) is the first contact health
care facility that offers basic services
at the barangay level.
It is a satellite station of the RHU.
It is manned by a volunteer Barangay
Health Worker (BHW) under the
supervision of a Rural Health Midwife.
THE RHU
PERSONNEL
THE MUNICIPAL
HEALTH OFFICER (MHO)
He is also called as the Rural Health
Physician who heads the health
services at the municipality level.
FUNCTIONS OF THE MHO
1. Administrator of the RHU
a. Prepares the municipal health plan and budget
b. Monitors the implementation of basic health services
c. Management of the RHU staff
2. Community Physician
a. Conducts epidemiological studies
b. Formulates health education campaigns on disease
prevention
c. Prepares and implements control measures or
rehabilitation plans
3. Medico-legal officer of the
municipality
Recommended ratio of
Rural Health Physician to
catchment population is
1 MHO: 20,000 population
Implementing Rules and Regulations (IRR) of RA 7305
or the Magna Carta of Public Health Workers
THE PUBLIC HEALTH
NURSE (PHN)
FUNCTIONS OF THE PHN
1. Supervises and guides all Rural Health Midwives
(RHM) in the municipality.
2. Prepares the FHSIS quarterly and annual reports of the
municipality for submission to the Provincial Health
Office.
3. Utilizes the nursing process in responding to health
care needs of IFC.
4. Collaborates with other members of the healthcare
team, government agencies, private businesses, NGOs
and people organizations to address the community’s
health problems.
Recommended ratio of
Public Health Nurse to
catchment population is
1 PHN: 20,000 population
Implementing Rules and Regulations (IRR) of RA 7305
or the Magna Carta of Public Health Workers
THE RURAL HEALTH
MIDWIFE (RHM)
FUNCTIONS OF THE RHM
1. Manages the BHS and supervises and trains BHW.
2. Provides midwifery services and executes health care
programs and activities for women of reproductive age,
including family planning counseling and service.
3. Conducts patient assessment and diagnosis for
referral or further management.
4. Performs health information, education, and
communication activities.
5. Organizes the community.
6. Facilitates barangay health planning and other
community health services.
Recommended ratio of
Rural Health Midwife to
catchment population is
1 RHM: 5,000 population
Implementing Rules and Regulations (IRR) of RA 7305
or the Magna Carta of Public Health Workers
THE RURAL SANITATION
INSPECTOR (RSI)
FUNCTIONS OF THE RSI
Ensure a healthy environment in the
municipality by advocating, monitoring
and regulating activities such as
inspection of water supply and
unhygienic household conditions.
THE BARANGAY
HEALTH WORKER (BHW)
The barangay health workers are considered as the
interface between the community and the RHU.
They are trained in preventive health care with
emphasis on maternal and child care, family
planning and reproductive health, nutrition and
sanitation.
They are equipped with basic skills for prevention
and management of common illness.
They assist in providing basic services at the BHS
and RHU.
BARANGAY HEALTH WORKERS’
BENEFIT AND INCENTIVE ACT (RA 7883)
Entitles BHW to
hazard and
subsistence
allowances and
other benefits.
Recommended ratio of
Barangay Health Worker to
catchment population is
1 BHW: 20 households
Implementing Rules and Regulations (IRR) of RA 7305
or the Magna Carta of Public Health Workers
RA 7160
LOCAL GOVERNMENT CODE
This law is enacted to bring about
genuine and meaningful local
autonomy.
This will enable LGU to attain their fullest
development as self-reliant communities
and make them more effective partners
in the attainment of national goals.
It mandates the devolution of services,
including health services.
DEVOLUTION
It refers to the act by which
the national government
confers power and authority
upon the various LGU to
perform specific functions
and responsibilities.
THE LOCAL HEALTH
BOARD
The chairman is then local executive with the
vice chairman in the person of the
Provincial/City/Municipal
Health Officer.
Members of the board are composed of the chairman of the
committee on health of the Sanggunian, a representative from
the private sector or NGO involved in health services and a
representative from DOH.
FUNCTIONS OF THE LHB
1. Proposing to the Sanggunian annual
budgetary allocations for the operation and
maintenance of health facilities and services
within the province, city or municipality.
2. Serving as advisory committee to the
Sanggunian on health matters.
3. Creating committees that shall advise local
health agencies on various matters related to
health service operation.
THE HEALTH
REFERRAL SYSTEM
REFERRAL
It is a set of activities
undertaken by a healthcare
facility in response to its
inability to provide the
necessary health
interventions to satisfy a
patient’s need.
TYPES OF REFERRAL
1. INTERNAL REFERRAL
Occurs within the health facility. It is made to
request for an opinion or suggestion, co-
management, or further management of
specialty care.
2. EXTERNAL
It is a movement of a patient from one health
facility to another. It may be vertical or
horizontal.
COMMUNITY
BHS
RHU Private Hospital
Municipal District
Hospital
Provincial Hospital
Medical Regional
Center
