You are on page 1of 13

Improving the Quality of Health Services in a

Decentralized Health System:


Lessons Learned from a National Certification Program

Philippines Sentrong Sigla


Movement
Introduction
Definition

SS is a quality improvement initiative through a


certification/recognition program. Health
facilities are certified based on a set of
standards
SS also promotes continuous quality
improvement as a complementing strategy
Introduction
Steps in the Certification Process
Philippines Department of Health (DOH) provides
copies of quality standards to local government
units (LGUs)
LGU facility conducts self assessment
Mayor/Governor sends letter of intent to participate
DOH SS teams conducts assessment
LGU facility gets certified, receives SS seal
Certified facility gets monitored twice a year and
tries to strive for higher level standards
Lessons Learned
Interest in QI is universal but a supportive
environment is needed to make it happen

Everyone likes the idea of QI


SS provided simple, practical steps to improve
quality of health services
SS provided motivation through certification
Lessons Learned
SS became a successful model of how a
national government can influence local
behavior under devolution

Getting LGUs to comply with national


standards and policies: major challenge
LGUs resent heavy-handed approach
SS respects local interest and priorities without
compromising standards of quality
Lessons Learned
Political support is a critical success factor

Applies both at the national and local level


Program should have a political value and
appeal
Lessons Learned
Champions for quality in health care come
from many sectors

Politicians, planners, private sector representatives,


community influentials championed the cause for
SS
Multisectoral interest interest and support prodded
health workers to take action
Lessons Learned
Development of standards required
extensive consultations

Consensus building through consultation


Bridging gap or balancing between technical
requirements and realities in the field:
providers perspective and clients perspective
Lessons Learned
Progressive standards are needed to sustain
interest in SS certification and to provide
guidance to LGU facilities

Experience with Baby Friendly Initiative


CQI interface with static standards
Lessons Learned
Cash incentives maybe counterproductive

Divert attention away from doing real quality


improvement work
Demoralize facilities not given cash incentives in
spite of being certified
Not sustainable
Lessons Learned
Credibility of certification depends on
quality of assessment

Assessment should be accurate


Develop further skills of assessors
Lessons Learned
Minimal involvement of private sector
reduced program impact

Enhance credibility of certification program if


private sector is involved
Lessons Learned
Link with Philippine Health Sector Reform (HSR)
enhances value and sustainability of SS

Interface with Philippines HSR initiatives


Adopted by Philippine Health Insurance Corporation:
SS certified facilities are eligible to be reimbursed for
selected primary health care services
Integrate with HSR

You might also like