Saturday, April 6, 2013

Universal Health Care and the Philippines


“60% of Filipinos who die, die without health professional attendance.”

What a big percentage and its alarming huh!  Would you want to die without seeing any health care professionals? I bet you, your answer is NO.

Now, this is the time for us to learn, study and know the Universal Health Care; the Aquino Health Agenda.

Universal Health Care?.. What is it?.

Imagine a picture of a poor Filipino patient on a government hospital, with financial incapability to buy medicines, to undergo diagnostic procedures or even pay the hospital bills - a major concern of the family is on how to procure medicines and how to pay for their hospital bills. This is clearly a common situation we found in the hospitals or in other health care facilities in our country, isn't it?

Now, imagine a patient who can freely go to any hospital or any health facility receiving full health professional service and with no doubts of paying their bills and the only thing they will think of is to getting themselves recover. A place wherein you can say you’re safe, health professionals cared for their patients, medicines and bills made affordable or even for free. A thing we might get from Universal Health Care.


According to the definition, Universal Health Care (UHC) or the Kalusugang Pangkalahatan (KP) is defined as 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.

Six Building Blocks of Health

The six building blocks of health are important in escalation of the country’s health care system.

  1. Health Financing – raising adequate funds for health to ensure that health is accessible to people.
  2. Health Service Delivery – ensuring health services that deliver effective, safe and good quality care with minimum waste to those who need them, and where and when they are needed.
  3. Health Regulation – ensuring safe and cost-effective medical products, vaccines and technologies are equitable and available to all.
  4. Health Human Resource – creating a health workforce that is available, responsive and is composed of well-trained, competent, efficient and responsive mix of staff.
  5. Health Information System – ensuring useful, reliable and timely information on health and health indicators are available, accessible and widely disseminated.
  6. Health Governance – guarantees the existence of strategic policies, appropriate regulations, effective oversight, and accountability.

These would be the tools in guiding our health implementers and policy makers for their planning, designing and setting priorities.

Challenges of the Government to UHC

The Aquino Health Agenda: Achieving Universal Health Care for All Filipinos provided for three strategic thrusts to achieve universal health care or Kalusugan Pangkalahatan): 1) Rapid expansion in NHIP enrollment and benefit delivery using national subsidies for the poorest families; 2) Improved access to quality hospitals and health care facilities through accelerated upgrading of public health facilities; and 3) Attainment of the health-related MDGs by applying additional effort and resources in localities with high concentration of families who are unable to receive critical public health services.

Maternal and Child Health
Photo credit: www.interaksyon.com

Last October 2010, DOH identified eight hundred ninety two (892) rural health units and ninety-nine (99) government hospitals have not yet to qualify for accreditation by PhilHealth. The public hospitals and health facilities have suffered much from being neglected of our government due to the insufficient health budget to support the upgrading and expansion for the capacity and improvement of quality health services.

This means that the worsening and pitiable quality of many government health facilities is particularly unfavorable to the poor sector of our country that needs the services the most.

The 8 MDGs Goal
Photo credit: www.healthpolicy.com
In addition, lack of human health resources and compensation to them have not yet been resolved and properly addressed. Inadequacy in health information system to guide the planning and implementation of all health programs needs also an urgent move to address this gaps.

Moving on, most of target of the Philippines for the Millennium Development Goals (MDG) is lagging behind the especially on reducing of the maternal and infant mortality. We’re still on  162 per 100,000 live births and 25 per 1,000 live births (2005 FPS and 2008 NDHS) closing the gaps to 2015 MDG targets at 52 and 19, respectively. These two indicators are still at the lowest level.

Government and NGO’s to attain UHC

Secretary’s Cup

To watch the video: The Secretary's Cup Video

The Department of Health (DOH) under the current leadership of Secretary Enrique T. Ona together with the University of the Philippines – Universal Healthcare Study Group in partnership with Asian Institute of Management (AIM), Pharmaceutical & Health Care Association of the Philippines (PHAP), Alliance of Young Nurse Leaders and Advocates International Inc. (AYNLA) launched a seven month long series of activities and campaign to highlight the Universal Health Care or Kalusugang Pangkalahatan (KP). 

This seven month long campaign of activities composed of the following: Community Town Hall Assemblies, School Debates and Health Talk Series focusing on the essential six building blocks of UHC the health financing, health service delivery, health regulation, health human resource, health governance and health information system.  

Health Talk Series was conducted several times at Asian Institute of Management with different Former DOH Secretaries talked on particular building blocks each month. A Community Town Hall assembly was conducted from Luzon to Visayas up to Mindanao gathering the different concerns of the grassroots on their health care status and experiences. School Debates was graced by different school and universities in the Philippines.

Recently, the Culmination of the Secretary’s Cup along with the Debate Championship and Awarding Ceremony was held last March 16, 2013 at  the Kachina Room of the Century Park Hotel, Manila.


Lakbay Buhay Kalusugan


It was way back in 2010 when the DOH launched the Lakbay Buhay Kalusugan (LBK) or better known now Kalusugang Pangkalahatan on Wheels, a health promotion and disease prevention campaign aiming to bring information on healthy practices to our fellow Filipino people. LBK is aligned with the Aquino Health Agenda of universal health care for access to quality and affordable health care especially to maternal and child health.

In 2011 the LBK Bus stops on ten (10) provinces including Tarlac, Pangasinan and Nueva Ecija in Luzon; Bohol, and Negros Occidental in Visayas, and; Bukidnon, Davao del Sur, Compostela Valley, South Cotabato and Maguindanao in Mindanao. In 2012, the LBK dropped by to Legaspi City, Camarines Sur, Cagayan, Quezon City and Albay.

After the re-launch of the LBK Bus last February 21, 2013, the LBK team ran to Solana, Tugegarao; Santiago City, Isabela and recently in Calumpit, Bulacan catering to around 2, 500  BulakeƱos who availed of the free services offered by the team.

LBK Bus serves as an instrument in giving information, highlighting the importance of maternal and child health including pre-natal check-up, birth spacing, safe motherhood, pregnancy and delivery, child immunization, hand washing, men's health, health promotion and disease prevention. Along with this, general and pediatric consultations were provided with medicines for free. The local government also provides exhibits, interactive games on health and entertainment shows.

The Lakbay Buhay Kalusugan Bus
Photo Credit: www.gmanetwork.com
This LBK is an initiative of the DOH through the National Center for Health Promotion (NCHP). Probe Media Foundation, Inc, (PMFI) provides technical assistance in the project implementation. Victory Lines, Alliance of Young Nurse Leaders and Advocates International Inc. (AYNLA), Philippine Press Institute, DKT Starmovers and Dakila as partners and Philippine Collective for Modern Heroism provide additional support to the project.   

This year, the LBK Bus is expected to visit other several provinces to give those services mentioned above.

Sin Tax, RH and National Insurance Act on UHC

The last session of the 15th Congress approved the enactments and passage of two health-related measures - the Sin Tax and Responsible Parenthood and Reproductive Health Laws respectively. Furthermore, the amendments of the National Insurance Act is now in process. These important policies are now in the pipeline to enhance the health care system in our country.

Through the taxes that will be collected from alcohol and tobacco, it will generate revenues of roughly more than 30 billion pesos in the first year of its implementation, these revenues will go to the Universal Health Care Program. The Reproductive Health Law which will provide access to RH information and services will prioritize the poorer households identified by the National Household Targeting System (NHTS) for poverty reduction.
Photo credit: www.gov.ph


Our government continues to push for UHC; efforts made are the achievement in terms of National Health Insurance Program (NHIP) benefit expansion and coverage of 85 percent of the population and health facilities enhancement.

Through these policies made, we have still lots of issues on health care to address for further improvements to attain our ultimate goal – the Universal Health Care.

2013 Senatorial Candidates Forum on Health

Risa Hontiveros on Senatorial Forum on Health
Photo credit: https://www.facebook.com/buttonricarte
To continue the advocacy regarding UHC, the University of the Philippines - Universal Healthcare Study Group in collaboration with Asian Institute of Management - Zuellig Center,  Pharmaceutical and Healthcare Association of the Philippines (PHAP) and the Journalism for Nation Building Foundation conducted a series of Senatorial Forum on Health last March 4 and 11, 2013 at Trader's Hotel Manila focusing on the health issues of our country.

The senatorial candidates laid down their platforms with regards to health care status and the thing that they will do when they get elected on the senate. 

"We want to remove all health care providers to the Salary Standardization Law because you're in special profession." , said Juan Miguel Zubiri, UNA Senatorial Candidate

"Nurses are not export goods. They are professionals and should be treated as professionals.", Risa Hontiveros of Liberal Party continues.


Nurses and UHC

The Alliance of Young Nurse Leaders and Advocates International Inc. (AYNLA) is one of the members of the steering committee of the DOH Secretary’s Cup and have its active participation in promoting the Universal Health Care to nurses. In fact AYNLA, being one of its partners, holds the community town hall assemblies or better known as “Usapang KP”, roving around the country to conduct series of town hall assemblies wherein the people in the community can directly consult their needs, problem and concern in health care delivery system in their locality.  These inputs will be collated for policy development and recommendation to the Secretary of Health.




Through the dedication of AYNLA, they included the UHC to the 3rd Millennium Convention – “Tetris 3.0: Building the Blocks of Universal Health Care, Achieving the MDGs and Capacitating the New Generation of Nurses”, held last September 22 & 23, 2012 at Iloilo Grand Hotel, Iloilo City. This was also the theme of the 1st AYNLA NCR Zonal Conference – “Universal Health Care: Clarion Call to Nurses”, last December 12 & 13, 2012 at Fuller Hall, Asian Institute of Management, Makati City. 

During the 3rd Health Talk Series of the Secretary’s Cup, former DOH Secretary Esperanza Cabral highlighted the importance of young nurses in pursuit of UHC. “We count on you young nurses to help us continue with our advocacies for Universal Health Care and continue providing proper and good health services to our nation.”, Dr. Cabral said.

Jose Mateo dela Cruz, President of the Alliance of Young Health Advocates, AYNLA’s sister organization expressed the importance of the youth in spreading of the UHC.  “Youth leaders and young advocates serve as the source of articulation and guardians for universal health care. Their campaign and lobbying efforts serve as the security for the people to prevent from inarticulate makes and legislation's.”

This is a timely reminder to us nurses to look back on our original sworn duty of promoting health and preventing diseases.

Registered Nurses for Health Enhancement and Local Service (RNheals)

"Nurses, it is time to stand up.  Speak for your rights. It is time to empower ourselves. Nobody would help uplift the profession than us fellow nurses. It is time to put an end to exploitation. It is but time for us nurses to unite.", Nurse Erick Bernardo said during on his interview.

RNheals was launched in collaboration with the Department of Social Welfare and Development (DSWD), Department of Interior and Local Government (DILG), Professional Regulatory Commission – Board of Nursing (PRC-BON) and Philippine Nurses Association (PNA) last February 14, 2011.

It is conceptualized in response to the Aquino Health Agenda to provide health services available to all Filipinos, especially the poor. A learning deployment project to mobilize nurses in identifying priority areas that needs improvement in the health care delivery services.

This RNheals program is not an employment rather training or learning and development for the increase employability of nurses to an institution.

Speak! Stand! Empower! 
Know your rights!
Let's Unite! 

Online Sources:
Secretary's Cup
Lakbay Buhay Kalusugan in Bulacan 

Universal Health Care
Department of Health


Other sources:
Senatorial Candidate Forum on Health, March 2013
Health Caravan to Serve Calumpit, March 21, 2013
RNheals IV Guidelines 

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