THE PHILIPPINE HEALTH CARE DELIVERY SYSTEM

HEALTH CARE SYSTEM

- an organized plan of health services (Miller-Keane, 1987)

HEALTH CARE DELIVERY

- rendering health care services to the people (Williams-
Tungpalan, 1981).

HEALTH CARE DELIVERY SYSTEM (Williams-Tungpalan, 1981)

- the network of health facilities and personnel which carries out
the task of rendering health care to the people.

PHILIPPINE HEALTH CARE SYSTEM

- is a complex set of organizations interacting to provide an array
of health services (Dizon, 1977).

COMPONENTS OF THE HEALTH DELIVERY SYSTEM

The Department of Health Mandate:
The Department of Health shall be responsible for the following:
formulation and development of national health policies, guidelines,
standards and manual of operations for health services and
programs; issuance of rules and regulations, licenses and
accreditations; promulgation of national health standards, goals,
priorities and indicators; development of special health programs and
projects and advocacy for legislation on health policies and programs.
The primary function of the Department of Health is the promotion,
protection, preservation or restoration of the health of the people
through the provision and delivery of health services and through the
regulation and encouragement of providers of health goods and
services (E.O. No. 119, Sec. 3).

Vision:
Health as a right. Health for All Filipinos by the year 2000 and
Health in the Hands of the People by the year 2020.
Mission:
The mission of the DOH, in partnership with the people to
ensure equity, quality and access to health care:
- by making services available
- by arousing community awareness
- by mobilizing resources
- by promoting the means to better health

LEVELS OF HEALTH CARE FACILITIES

1. PRIMARY LEVEL OF HEALTH CARE FACILITIES

- are the rural health units, their sub-centers, chest clinics,
malaria eradication units, and schistosomiasis control units
operated by the DOH; puericulture centers operated by League
of Puericulture Centers; tuberculosis clinics and hospitals of the
Philippine Tuberculosis Society; private clinics, clinics operated
by the Philippine Medical Association; clinics operated by large
industrial firms for their employees; community hospitals and
health centers operated by the Philippine Medicare Care
Commission and other health facilities operated by voluntary
religious and civic groups (Williams-Tungpalan, 1981).

2. SECONDARY LEVEL OF HEALTH CARE FACILITIES

- are the smaller, non-departmentalized hospitals including
emergency and regional hospitals.
- Services offered to patients with symptomatic stages of
disease, which require moderately specialized knowledge and
technical resources for adequate treatment.

3. TERTIARY LEVEL OF HEALTH CARE FACILITIES

- are the highly technological and sophisticated services offered
by medical centers and large hospitals. These are the
specialized national hospitals.
- Services rendered at this level are for clients afflicted with
diseases which seriously threaten their health and which
require highly technical and specialized knowledge, facilities
and personnel to treat effectively (Williams-Tungpalan, 1981)
 FACTORS ON THE VARIOUS CATEGORIES OF HEALTH
WORKERS AMONG COUNTRIES AND COMMUNITIES
1. available health manpower resources
2. local health needs and problems
3. political and financial feasibility

THREE LEVELS OF PRIMARY HEALTH CARE WORKERS

A. VILLAGE OR GRASSROOT HEALTH WORKERS
- first contacts of the community and initial links of health care.
- Provide simple curative and preventive health care measures
promoting healthy environment.
- Participate in activities geared towards the improvement of the
socio-economic level of the community like food production
program.
- Community health worker, volunteers or traditional birth
attendants.

B. INTERMEDIATE LEVEL HEALTH WORKERS

- represent the first source of professional health care
- attends to health problems beyond the competence of village
workers
- provide support to front-line health workers in terms of
supervision, training, supplies, and services.
- Medical practitioners, nurses and midwives.

C. FIRST LINE HOSPITAL PERSONNEL

- provide back up health services for cases that require
hospitalization
- establish close contact with intermediate level health workers or
village health workers.
- Physicians with specialty, nurses, dentist, pharmacists, other
health professionals.
 TWO-WAY REFERRAL SYSTEM (Niace, et. al. 8th edition 1995)
A two-way referral system need to be established between
each level of health facility e.g. barangay health workers refer cases
to the rural health team, who in turn refer more serious cases to
either the district hospital, then to the provincial, regional or the whole
health care system.
Public
P Barangay Health
O Health Worker Nurse 2nd 3rd
P HF HF
U EA EA
L Barangay RHU AC AC
A Health Midwife Physician LI LI
T Stations TL TL
I HI HI
O T T
N RHS Sanitary Y Y
Midwife Inspector

MULTISECTORAL APPROACH TO HEALTH

(NLGNI, 8th edition, 1995)

The level of health of a community is largely the result of a

combination of factors.
Other health-related
Systems (government/
private

Ways of Community Health Care

The Health System
People
(Cultural)

Environment (Social,
Economic, physical,
Etc.
 Health, therefore, cannot work in isolation. Neither can one
sector or discipline claim monopoly to the solution of community
health problems. Health has now become a multisectoral concern.
For instance, it is unrealistic to expect a malnourished child to
substantially gain in weight unless the family’s poverty is
alleviated…… In other words, improvement of social and economic
conditions need to be attended to first or tackled hand in hand with
health problems.

1. Intersectoral Linkages
- Primary Health Care forms an integral part of the health
system and the over-all social and economic development
of the community. As such, it is necessary to unify health
efforts within the health organization itself and with other
sectors concerned. It implies the integration of health plans
with the plan for the total community development.

- Sectors most closely related to health include those

concerned with:
a. Agricultural
b. Education
c. Public works
d. Local governments
e. Social Welfare
f. Population Control
g. Private Sectors

The agricultural sector can contribute much to the social

and economic upliftment of the people……. Demonstration to
mothers of better techniques and procedures for food
preparation and preservation can preserve the nutritive value of
local foods. Through joint efforts, agricultural technology that
produces side effects unsafe to health (for instance, insecticide
poisoning) can be minimized or prevented.
The school has long been recognized as an effective
venue for transmission of basic knowledge to the community.
Every pupil or student can be tapped for primary health care
activities such as sanitation and food production activities…..
 Construction of safe water supply facilities and better roads can
be jointly undertaken by the community with public works.
Community organization (e.g. establishing a barangay network
for health) can be worked through the local government or
community structure. Likewise, better housing through social
welfare agencies, promotion of responsible parenthood through
family planning services and increased employment through the
private sectors can be joint undertakings for health……We have
to recognize that oftentimes health actions undertaken outside
the health sector can have health effects much greater than
those possible within it.

2. Intrasectoral Linkages
- In the health sector, the acceptance of primary health care
necessitates the restructuring of the health system to
broaden health coverage and make health service available
to all. There is now a widely accepted pyramidal organization
that provides levels of services starting with primary health
and progressing to specialty care. Primary health care is the
hub of the health system.

A PYRAMIDAL HEALTH STRUCTURE

Tertiary
National Health
Health Care
Services
Regional
Health Services Secondary
Health
District Health Services Care
Rural (Local Hospital)
Services
Rural Health Units Primary
Barangay Health Stations Health
Care
THE NATIONAL HEALTH PLAN (Niace, et. al 8th edition 1995)
 The National Health Plan is the blue print which is followed by
the Department of Health. It defines the country’s health problems,
policy thrusts, strategies and targets.

POLICY THRUSTS AND STRATEGIES

There are policy thrusts and strategies which are commonly
important. These are:
1. Information, education, and communication programs will be
implemented to raise the awareness of the public, including
policy makers, program planners and decision makers;
2. An update of the legislative agenda for health, nutrition and
family planning (HNFP), and stronger advocacy for pending
HNFP –related legislations will be pursued;
3. Integration of efforts in the health, nutrition and family planning
sector to maximize resources in the delivery of services through
the establishment of coordinative mechanisms at both the
national and local levels;
4. Partnership between the public and the private sectors will be
strengthen and institutionalized to effectively utilize and monitor
private resources for the sector;
5. Enhancement of the status and role of women as program
beneficiaries and program implementers will be pursued to
enable them to substantially participate in the development
process.