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Decentralization and National Health Accounts

Decentralization and National Health Accounts. Ma. Paz G. De Sagun Office of Population, Health & Nutrition USAID/Philippines. October 9, 2002. Health. Local planning. Social welfare services. Environmental Management. Housing. LGU. Agricultural extension. Investment support. Tourism.

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Decentralization and National Health Accounts

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  1. Decentralization and National Health Accounts Ma. Paz G. De Sagun Office of Population, Health & Nutrition USAID/Philippines October 9, 2002

  2. Health Local planning Social welfare services Environmental Management Housing LGU Agricultural extension Investment support Tourism

  3. 595 hospitals 12,859 rural health units 46,080 personnel 78 provinces 1,543 municipalities 41,924 barangays By 1993: LGUs

  4. Selected Indicators 1 National Demographic Survey 1993 2 National Demographic and Health Survey 1998 3 Maternal and Child Health Survey 1999 4 Maternal and Child Health Survey 1999 5 Philippine National Safe Motherhood Survey 1993 6 Family Planning Survey 7 FETP-DOH Cluster Survey

  5. DEVOLUTION OF HEALTH SERVICES Department of Health DOH Retained Hospital Regional Health Offices DOH City Health Offices Provincial Hospitals Provincial Health Offices City Hospital Province/City LGUs District Hospitals District Health Offices Municipal Health Offices Municipal LGU Rural Health Units Barangay Health Stations Barangay Health Stations

  6. Average Total Cost of Devolved Functions, 1993 (Million Pesos)

  7. Workbook and Manual: Management and Organizational Options for Devolved Hospitals A Manual for Regional Health Coordination National Health Accounts Provincial Health Accounts: Selected LGUs National Health Insurance Act Provincial Health Insurance Program: A Manual of Operation Operational Health Planning under a Decentralized Set Up (Training Modules) Health Budgeting and Financial Management under a Decentralized Set Up (Training Modules)

  8. Share of Health Expenditure to GNP Percent Year

  9. DISTRIBUTION OF HEALTH EXPENDITURE BY SOURCE OF FUND

  10. 1991 Distribution of Health Expenditure by Use 2000 Distribution of Health Expenditure by Use

  11. And so ….. • Devolution is complex and challenging but it is desirable. • NHA is a useful tool and framework for health sector reform. • Remaining key challenges: • Financing of essential public health services including FP/RH • Covering poverty groups via risk sharing and social health insurance

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