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Dr. Yolanda E. Oliveros MPH MHSA Director IV National Center for Disease Prevention and Control

Dr. Yolanda E. Oliveros MPH MHSA Director IV National Center for Disease Prevention and Control. Bringing Health Reforms to the Next Level : Recommendations on Service Delivery for Public Health Development Program. 12 th National Health Sector Meeting Manila November 4-5, 2009.

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Dr. Yolanda E. Oliveros MPH MHSA Director IV National Center for Disease Prevention and Control

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  1. Dr. Yolanda E. Oliveros MPH MHSA Director IV National Center for Disease Prevention and Control Bringing Health Reforms to the Next Level : Recommendations on Service Delivery for Public Health Development Program 12th National Health Sector MeetingManilaNovember 4-5, 2009

  2. Objectives for Health Reforms • Promote Equity • Enhance Effectiveness • Improve Efficiency • Nurture Responsiveness • Increase Sustainability

  3. Objectives for Reforms 1. Enhance Effectiveness– outputs and results achieved by the health system and its impact on the health of the population.

  4. Objectives for Reforms 2. Improve Efficiency – maximizing the PH benefits through the best use of existing resources. Technical Efficiency- “ doing things right” Allocative Efficiency –” doing the right things”

  5. Objectives for Reforms 3. Promote Equity - increasing access for and utilization by marginalized populations by focusing on health concerns/diseases of poverty, or through other means. “ Health For All ”

  6. Objectives for Reforms 4. Nurture Responsiveness – there are variations in health status, health seeking behavior, health care preferences and quality perceptions requiring nurture context- specific approaches to health service delivery.

  7. Objectives for Reforms 5. Increase Sustainability – sustained financing, institutional building of the public health system, and sustained demand for quality service.

  8. RECOMMENDED AREAS FOR ACTION TO ENHANCE EFFECTIVENESS • POLICY OPTIONS • Consistent with the MDG commitments, policy development must take into consideration, country’s capacity to effectively deliver health services

  9. RECOMMENDED AREAS FOR ACTION TO ENHANCE EFFECTIVENESS • POLICY OPTIONS 1. MDG 4 and 5 a. MNCHN Policy localization - facility upgrading/capacity/functionality - skills development - appropriate staffing - adequate financing - demand generation

  10. RECOMMENDED AREAS FOR ACTION TO ENHANCE EFFECTIVENESS • POLICY OPTIONS 2. MDG 6 • Pursue disease-free zone initiatives and institute strong disease surveillance mechanism (LQuAS) • Drugs for MDA and treatment must be funded by the national government

  11. RECOMMENDED AREAS FOR ACTION TO ENHANCE EFFECTIVENESS • POLICY OPTIONS 2. MDG 6 b. Multi-year budgeting to pursue reduction of priority diseases such as TB, HIV-AIDS, Dengue, emerging infectious diseases, VPD • Financing support clearly identified • Procurement gap avoided

  12. RECOMMENDED AREAS FOR ACTION TO ENHANCE EFFECTIVENESS • POLICY OPTIONS 3. MDG 7 a. Water, Sanitation and Hygiene - Water Roadmap - Sanitation Roadmap - P1.5B fund for waterless municipalities - Revisiting Sanitation Code

  13. RECOMMENDED AREAS FOR ACTION TO ENHANCE EFFECTIVENESS • POLICY OPTIONS 4. MDG Max :Lifestyle Related Diseases a. disease registry b. service delivery package c. regulatory mechanism d. financing mechanism e. health promotion package

  14. RECOMMENDED AREAS FOR ACTION • POLICY OPTIONS • Development of service delivery package appropriate for each level of health care facility focusing on life cycle approach and special groups of population

  15. RECOMMENDED AREAS FOR ACTION • POLICY OPTIONS • Development of a Quality Assurance Mandatory Mechanism for Public Outpatient Facilities (RHUs/BHS) • Input, Process • Patient and Staff Safety • Service Excellence

  16. RECOMMENDED AREAS FOR ACTION • POLICY OPTIONS • Mainstreaming Climate Change Adaptation and Mitigation in Health Program Development and in Health Emergency Preparedness and Response

  17. RECOMMENDED AREAS FOR ACTION • POLICY OPTIONS • Health Promotion Foundation? • Essential and timely information for effective policy and decision making

  18. RECOMMENDED AREAS FOR ACTION • POLICY OPTIONS • Development and Dissemination of Updated National Standards with Professional Societies Endorsement for Public and Private Health Providers’ Use

  19. RECOMMENDED AREAS FOR ACTION B. PROCESSESS/STRUCTURAL CHANGE 1. Capacity Development of DOH for Emerging New Roles and Functions in Facilitating the Health Reform Initiatives particularly in Leveraging Resources for Health Outcomes and Local Health Systems Development

  20. RECOMMENDED AREAS FOR ACTION B. PROCESSESS/STRUCTURAL CHANGE 2. Restoring province wide operation system in addressing health needs and reducing health status disparity among its municipalities. DOH to support identified interventions by the province.

  21. RECOMMENDED AREAS FOR ACTION B. PROCESSESS/STRUCTURAL CHANGE 3. Reinforcing the Technical Leadership of DOH Central Office and CHD as Health Expert/ Management Specialist

  22. RECOMMENDED AREAS FOR ACTION B. PROCESSESS/STRUCTURAL CHANGE 4. Technical Leadership for Health of DOH could also mean Capacity to Build and Transfer Technology to other Stakeholders (LGUs, Academic institutions, NGO’s, CS)

  23. RECOMMENDED AREAS FOR ACTION • PROCESSESS/STRUCTURAL CHANGE 5. Health Promotion Strategies have to be localized and risk communication capacity must be strengthened 6. Surveillance system (clinical, laboratory, community-based, event based)

  24. RECOMMENDED AREAS FOR ACTION • PROCESSESS/STRUCTURAL CHANGE 7. Service delivery package in the workplace, school, prison, institutions, etc

  25. RECOMMENDED AREAS FOR ACTION • PROCESSESS/STRUCTURAL CHANGE 8. Contracting of Technical and Management Services to Private Sector ( e.g. Vaccinator, Malaria Household Spraying, Diagnostic Services, Training, Facility Design, etc.)

  26. RECOMMENDED AREAS FOR ACTION TO IMPROVE EFFICIENCY • POLICY OPTIONS 1. Investment Plan for Public Health harmonizing all sources of funds including identification of programs that require multi-year budgeting 2. Performance Based Budgeting for Public Health including Performance Based Grants to LGUs

  27. RECOMMENDED AREAS FOR ACTION • POLICY OPTIONS 3. Enhancement of PHIC Benefit Package for PH, Out Patient and Package for Catastrophic Diseases

  28. RECOMMENDED AREAS FOR ACTION • POLICY OPTIONS 4. DOH Exemption from the $100,000 Central Bank Ceiling for Dollar Payment to Facilitate the Most Economical International Procurement Process

  29. RECOMMENDED AREAS FOR ACTION • PROCESSESS/STRUCTURAL CHANGE 1. Improvement in the organization of PH program packages ( services, logistics, skills/availability of providers) 2. Central procurement of PH goods using the most cost-effective and advantageous mode

  30. RECOMMENDED AREAS FOR ACTION • PROCESSESS/STRUCTURAL CHANGE 3. Reviewing the current PHIC benefit packages and improve promotion of these packages to increase utilization

  31. RECOMMENDED AREAS FOR ACTION TO ENSURE EQUITY • POLICY OPTIONS 1. Development of a Customized Facility Mechanism in Providing Technical and Logistic Support to ARMM for Improved Health Outcomes

  32. RECOMMENDED AREAS FOR ACTION TO ENSURE EQUITY • POLICY OPTIONS 2. Addressing the needs of special population such as the disabled, the adolescents, the indigenous people, the elderly, people in difficult circumstances , urban and rural poor

  33. RECOMMENDED AREAS FOR ACTION TO ENSURE EQUITY • POLICY OPTIONS 3. Inclusion of RH commodities such as contraceptives as PH goods 4. Health human resource production, recruitment, distribution and retention (HHR Master Plan)

  34. RECOMMENDED AREAS FOR ACTION A. PROCESSESS/STRUCTURAL CHANGE 1. Strengthening the Health Service Delivery Network of Public and Private Health Providers under provincial health system to Ensure Access and Availability of Quality Health Services. The Province with the CHD, shall lead the assessment and support for its establishment

  35. RECOMMENDED AREAS FOR ACTION A. PROCESSESS/STRUCTURAL CHANGE 2. Targeting government subsidy to the marginalized groups with unmet needs

  36. RECOMMENDED AREAS FOR ACTION TO NURTURE RESPONSIVENESS • Process/Implementation • Support for Internally Driven Continuing Quality Improvement Initiatives of Health Facilities Featuring Strong Customers’ Participation in this Endeavour. • Restore Primary Health Care Approach

  37. RECOMMENDED AREAS FOR ACTION TO NURTURE RESPONSIVENESS • Process/Implementation 3. Client centered policy development and implementation

  38. RECOMMENDED AREAS FOR ACTION TO ENSURE SUSTAINABILITY • POLICY OPTION • Financial support and resource mobilization for priority health programs (MDGs) • LGU financing reforms • Private sector share in health financing • Social health insurance

  39. RECOMMENDED AREAS FOR ACTION • Process/Implementation • Nurture partnership with stakeholders to establish collaboration and networking • Incentive mechanism for health workers • Local Health System strengthening • Regional Capacity Building Initiative

  40. Thank You ! !

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