Adolescent and Youth Health Program (AYHP) Botika Ng Barangay (BnB) Briefer on the Urban Health System Development

(UHSD) Program Breastfeeding TSEK Blood Donation Program Child Health and Development Strategic Plan Year 2001-2004 Cancer or Malignant Neoplasms CHD Scorecard Committee of Examiners for Undertakers and Embalmers Committee of Examiners for Massage Therapy (CEMT) Dental Health Program Diabetes Mellitus Prevention and Control Program Emerging and Re-emerging Infectious Disease Program Environmental Health Expanded Program on Immunization Essential Newborn Care Family Planning Food and Waterborne Diseases Prevention and Control Program Food Fortification Program Garantisadong Pambata Human Resource for Health Network Health Development Program for Older Persons - (Bureau or Office: National Center for Disease Prevention and Control ) Health Development Program for Older Persons - R.A. 7876 (Senior Citizens Center Act of the Philippines) Health Development Program for Older Persons (Global Movement for Active Ageing (Global Embrace 1999)) Health Development Program for Older Persons - R.A. 7432 (An Act to Maximize the Contribution of Senior Citizens to Nation Building, Grant Benefits and Special Privileges) Iligtas sa Tigdas ang Pinas Infant and Young Child Feeding (IYCF) Inter Local Health Zone Integrated Management of Childhood Illness (IMCI) Knock Out Tigdas 2007 Leprosy Control Program LGU Scorecard Licensure Examinations for Paraprofessionals Undertaken by the Department of Health Malaria Control Program Measles Elimination Campaign (Ligtas Tigdas) National TB Control Program Natural Family Planning National Filariasis Elimination Program National Rabies Prevention and Control Program Newborn Screening National HIV/STI Prevention Program National Mental Health Program National Dengue Prevention and Control Program Occupational Health Program Persons with Disabilities Pinoy MD Program Philippine Cancer Control Program Province-wide Investment Plan for Health (PIPH) Rural Health Midwives Placement Program (RHMPP) / Midwifery Scholarship Program of the Philippines (MSPP) Schistosomiasis Control Program Soil Transmitted Helminth Control Program Smoking Cessation Program Unang Yakap Violence and Injury Prevention Program Women's Health and Safe Motherhood Project Women and Children Protection Program

Disease Surveillance HIV/STI Measles Dengue Influenza

MissionA Global Leader for attaining better health outcomes, competitive and responsive health care systems, and equitable health financing/ VisionTo guarantee equitable, sustainable and quality health for all Filipinos, especially the poor, and to lead the quest for excellence in health. 2010 (MILESTONE) With the appointment of Dr. Enrique T. Ona as the new Health Secretary came a new platform on health the Universal Health Care (UHC). This reform agenda aims to make essential health services, necessities, and quality health care available and accessible to all Filipinos. PhilHealth Sabado, as one of the initiatives to achieving UHC, was launched on October 2 of this year. UHC to Address Inequity in the Health System Universal Health Care and Its Aim Universal Health Care (UHC), also referred to as Kalusugan Pangkalahatan (KP), is the provision to every Filipino of the highest possible quality of health care that is accessible, efficient, equitably distributed, adequately funded, fairly financed, and appropriately used by an informed and empowered public.1 The Aquino administration puts it as the availability and accessibility of health services and necessities for all Filipinos. It is a government mandate aiming to ensure that every Filipino shall receive affordable and quality health benefits.This involves providing adequate resources health human resources, health facilities, and health financing. UHCs Three Thrusts To attain UHC, three strategic thrusts are to be pursued, namely: 1) Financial risk protection through expansion in enrollment and benefit delivery of the National Health Insurance Program (NHIP); 2) Improved access to quality hospitals and health care facilities; and 3) Attainment of health-related Millennium Development Goals (MDGs). Financial Risk Protection Protection from the financial impacts of health care is attained by making any Filipino eligible to enroll, to know their entitlements and responsibilities, to avail of health services, and to be reimbursed by PhilHealth with regard to health care expenditures. PhilHealth operations are to be redirected towards enhancing national and regional health insurance system. The NHIP enrollment shall be rapidly expanded to improve population coverage. The availment of outpatient and inpatient services shall be intensively promoted. Moreover, the use of information technology shall be maximized to speed up PhilHealth claims processing. Improved Access to Quality Hospitals and Health Care Facilities Improved access to quality hospitals and health facilities shall be achieved in a number of creative approaches. First, the quality of government-owned and operated hospitals and health facilities is to be upgraded to accommodate larger capacity, to attend to all types of emergencies, and to handle noncommunicable diseases. The Health Facility Enhancement Program (HFEP) shall provide funds to improve facility preparedness for trauma and other emergencies. The aim of HFEP was to upgrade 20% of DOH-retained hospitals, 46% of provincial hospitals, 46% of district hospitals, and 51% of rural health units (RHUs) by end of 2011. Financial efforts shall be provided to allow immediate rehabilitation and construction of critical health facilities. In addition to that, treatment packs for hypertension and diabetes shall be obtained and distributed to RHUs. The DOH licensure and PhilHealth accreditation for hospitals and health facilities shall be streamlined and unified. Attainment of Health-related MDGs Further efforts and additional resources are to be applied on public health programs to reduce maternal and child mortality, morbidity and mortality from Tuberculosis and Malaria, and incidence of HIV/AIDS. Localities shall be prepared for the emerging disease trends, as well as the prevention and control of non-communicable diseases. The organization of Community Health Teams (CHTs) in each priority population area is one way to achieve health-related MDGs. CHTs are groups of volunteers, who will assist families with their health needs, provide health information, and facilitate communication with other health providers. RNheals nurses will be trained to become trainers and supervisors to coordinate with community-level workers and CHTs. By the end of 2011, it is targeted that there will be 20,000 CHTs and 10,000 RNheals. Another effort will be the provision of necessary services using the life cycle approach. These services include family planning, ante-natal care, delivery in health facilities, newborn care, and the Garantisadong Pambata package. Better coordination among government agencies, such as DOH, DepEd, DSWD, and DILG, would also be essential for the achievement of these MDGs.

Secretary Enrique T. Ona was born on June, 4 1939 in Sagay City, Negros Occidental. His parents hail from Pagadian City, Zamboanga del Sur where his father became the first Provincial Health Officer and his mother served as a puericulture nurse. He graduated from medical school at the University of the Philippines in 1962. He further extended his medical and nephrology training abroad where he earned a medical license at the State of Massachusetts, USA. Sec. Ona belongs to the DOH family having served as the Executive Director of the National Kidney and Transplant Institute (NKTI) from 1998 until his appointment on July 1, 2010 as the new health chief. He is recognized as one of the top surgeons in the field of vascular surgery and organ implantation. He is also a dedicated advocate of preventive nephrology in the country. He is currently the President of the Transplantation Society of the Philippines, a position he holds since 1989 and also the President of Maria Corazon Torres Javier Foundation from 2009 to present. Because of his dedication and contribution to health, Secretary Ona has been the recipient of various prestigious awards including the Ten Outstanding Young Men (TOYM) awardees for Medicine in 1979, The Presidential Award of Recognition in Organ Transplantation in 2000 and the Outstanding Health Research Award by the Philippine Council for Health Research and Development presented last July 19, 2010. It was during his residency abroad that he met his beloved wife, Dr. Norma Martinez, an equally successful and nationally renowned hematologist. They are blessed with four boys namely, Arsenio Kenneth, Enrique Stanley, Victor Gabriel, and Manolo Steven. As a family man, Dr. Ona spends most of his time off at home playing with his grandson or indulging himself in a game of tennis or golf. Family and friends fondly call him Manong Ike, and they describe him as kind and generous. NKTI staff describe the Secretary as a strict but lenient chief. They recall that during his tenure at NKTI, he arrives between 8-9 am and leaves around 7 pm. At the end of the day he sees to it that everything is accomplished and every paper signed before leaving for home. No stone is left unturned, they say. With his job as Secretary of Health, he promises to develop action plans with measurable and verifiable targets for the next six years, including estimated annual resource requirements and performance benchmarks. Question: What are the barriers to health care access for rural women? Answer:Problems specific to access to care for women in rural areas include:

A higher rate of uninsured and underinsured populations than in urban areas. Access to transportation barriers, such as geographical isolation, lack of public transportation, and lack of funds for individuals to pay for their own mode of transportation. This can disproportionately affect single women with children responsible for transporting their families.

Lack of providers, particularly obstetric providers due to the recruitment and retention problems in rural areas in addition to malpractice suits, which make obstetric care particularly expensive and risky for providers.

Question: What challenges do rural women face related to childbirth? Answer:A number of state-based studies have found increased rates in infant mortality among rural residents as compared to urban residents. Studies have also shown that the infant mortality rate increases with rurality. This could be due to a number of reasons, including:

More non-metropolitan than suburban women receiving delayed or no prenatal care, and rural women receiving less adequate care when it is available. This is a major concern in rural areas as risk factors for infant death include delayed or no prenatal care, contributing to a higher rate of infant mortality in rural areas.

More mothers under age 20 or over age 40. Teen pregnancy rates are often higher in rural areas and the population is aging at a disproportional rate in rural areas as compared to the rest of the United States. Low educational attainment of mother, which is correlated with poverty. Rural poverty rates have consistently been higher than urban poverty rates, particularly in persistent poverty areas such as Appalachia, the Northern Plains states, the Delta region, the Southern Border Region, the Four Corners area, and Alaska.

Maternal smoking during pregnancy, which is higher in rural areas. More than three previous births, which is also related to poverty.

Rising malpractice insurance rates, relatively impoverished populations, lack of facilities, and too few physicians for back-up arrangements may make obstetrical practice in rural places unattractive. Lack of local care means that many women must seek prenatal care and delivery outside of their county of residence. There is some evidence that an increase in distance and travel time to prenatal care decreases the utilization of such care, leading to relatively poor outcomes. Question: Is finding quality child care a problem for rural women?

Answer:Some child care problems for women in rural areas include:

There are more working poor in rural America than in urban areas of the country. Concerning child care, this becomes a major social problem because most families are either single-parent households or have two parents working to make ends meet. This leaves children alone and there are few child care providers in most rural communities.

Lack of child care providers in rural communities can often be as much or more of a problem than accessing health care providers.

For more information about rural child care issues, see RAC's Child Care topic guide. Question: How do chronic diseases and cancer impact rural women? Answer:Rural areas report higher rates of chronic diseases, including heart disease and cancer, two diseases that affect women. This is due to:

A rural population that is older, poorer, and less educated than metro populations. A lack of provider care in rural communities. More rural residents being diagnosed with cancer in later stages of the disease than urban residents, including breast and cervical cancer.

Chronic illness persists over time, requires ongoing management, and involves major lifestyle changes and adaptations in one's environment. Most recommendations of treatment are difficult because of previously discussed barriers to access in rural areas. Question: How does mental illness impact rural women? Answer:The prevalence of mental illness, in particular depression, in rural areas is high. Access barriers to treatment include lack of mental health providers, lack of transportation, lack of child care, poverty, and lack of health insurance. Question: Is there ethnic diversity among rural women? Answer:Most women in rural areas identify themselves as non-Hispanic white. However, population shifts throughout the last decade have included changes in many communities' racial and ethnic makeup. Many growing rural counties are also experiencing growth in the diversity of residents. One source of increasing diversity is the change in immigration patterns in response to employment opportunities in rural areas. Many immigrants, especially Hispanic and Asian immigrants, are increasingly settling in the rural U.S. Question: How many rural women are elderly? Answer:In general, rural areas have a higher proportion of elderly residents. Increases in age among rural residents results in a largely female population. This trend is most dramatic in the South and Midwest. Elderly women are more likely to suffer from higher rates of chronic illness, less education, and lack of access to health care and transportation. In addition, many elderly women live alone as widows or care for a disabled spouse or family member at home. Question: How does poverty impact rural women? Answer:Women in urban areas were more likely to be living in poverty than their rural counterparts (13.9 versus 11.5 percent, respectively); this was true for most age groups. Among women in both urban and rural areas, those aged 1834 years were most likely to have incomes below 100 percent of poverty: 20.7 percent of women aged 1834 years in urban areas and 16.3 percent of those in rural areas did so. Women aged 4564 years in both urban and rural areas were least likely to be living below the poverty level (9.8 and 8.6 percent, respectively). Source Women's Health USA 2010, Health Resources and Services Administration, 2010 Question: How can health and social services providers work together to help rural women? Answer:The strong relationship between adequate income, sufficient food, strong social networks and good health necessitates coordination among various health care and social service agencies. This coordination is especially important in rural communities, where services and providers are limited in numbers. In many rural communities, service providers often make alliances with one another and exhibit extraordinary resourcefulness and resilience. This is also a concern for women as they are often either the sole providers for their family or in charge of accessing health and social services for their children.