Professional Documents
Culture Documents
Midwiv
Doctors Nurses es
Active in
Professional
Regulation 74,000
Comm.1 66,000 500,000
Employed in
Government
Facility2 2,838 4,576 17,000
Ratio per 10,000
1 PRC database, 2014 1.7
population 3
0.2 0.4
2 Philippine Statistical Yearbook, 2010.
60.0
40.0 32.933.0
31.7
27.624.2
23.123.726.823.2 20.621.8
26.0
22.923.9
16.816.517.419.420.120.0 17.016.118.819.8
12.412.513.012.512.913.916.0
20.0
0.0
Tobacco Alcohol
Prevalence of Never, Current and Former
Smokers. Philippines, NNS 1998-2015
Prevalence (%)
70
63.7
Never Smoker 59.1
60 54.5 55.0 54.3
50
Current Smoker
40 34.8
32.7 31.0
30 25.4
23.3
20
Former Smoker
10 14.7 15.5
12.8 13.0
10.2
0
1998 2003 2008 2013 2015
Sin Tax Law Health Updates NNS 2015
1. Prevalence of smoking among adult Filipinos went
down from 31.0% in 2008 to 23.3% in 2015.
2. This means there are ~4 million less smokers in the
country today because of the Sin Tax Law.
3. The drop is not from people who stopped
smoking. It is from people who avoid starting to
smoke.
4. At least 70,000 deaths have been averted since
2013.
5. Health benefits were greatest in price sensitive
populations – the poor, rural folk, the very
young and the very old.
Strategic Questions
How Doctors Think
1.Where are we now ?
Diagnosis ? State of The
Nation’s Health
2. Where do we want
to go ? Towards UHC
3. How do you get
there ? Eg Plan of Action
Where are we?
(The Philippine Healthcare System)
Good News and Bad News about
the Philippine Health Situation
1. PhilHealth coverage has increased from 51% in 2010 to 88%
in 2015 (PhilHealth) 1
2. But PhilHealth utilization remains low, especially amongst
the poorest (only 33%) 2
3. The health budget increased from PhP28.7B in 2010 to
PhP205B in 2015 3
4. But the number of Filipinos who die without seeing a HCW
increased from 45% to 66% 4
5. We are the number 1 exporter of nurses in the world 5, and
the number 2 exporter of doctors 6
6. In the public sector,
- There are only 5 HCW’s per 10,000 population (ideal = 25)
- There is only 1 doctor per 20,000 (ideal = 20) 7
1 Philhealth, 2 Faraon et al, 2013, 3 Department of Health, 4 Philippine Health Statistics, 5 Matsuno et al, 6 World Health Organization, 7 Dans et al
Why healthcare workers leave 1
1. Unemployment (unfilled positions for HCW’s)
2. Underemployment (underpaid for workload)
3. Misemployment (job orders and casuals)
4. Unjust working conditions (eg - politicalization of
appointments, non-issuance of magna carta benefits)
KID IS
NEY EASE
DIS
EAS
E
THE PROBLEM
Funds have increased but services have deteriorated
INADEQUATE
WORKFORCE
INADEQUATE
INEQUITY FACILITIES
IN HEALTH
INADEQUATE
TESTS/MEDS
THE PROPOSAL
Healthcare SYSTEM reform: Tunay na KP!
1. FIRST CONTACT
Patient
& COMPREHENSIVE
CARE
2. COORDINATOR OF Primary Care 3. PRINCIPAL POINT OF
HEALTH SERVICES Provider CONTINUING CARE
REGULATE
REASSESS
Roadmap to a Primary Care System
RECRUIT
RETRAIN - Pay for outpatient care!
RETAIN - In public sector – provide and
augment salaries of HCWs
REGULATE - In private sector, subsidize
payments for healthcare.
REASSESS
Roadmap to a Primary Care System
RECRUIT
RETRAIN
RETAIN Facility – electronic records
REGULATE Health workers – accreditation
Patients – require primary care
REASSESS
Roadmap to a Primary Care System
RECRUIT
RETRAIN
RETAIN
REGULATE - Better Quality of Care
- Better health
REASSESS - Reduced healthcare expenses
- Reduced out of pocket payment
Roadmap to a Primary Care System
RECRUIT
RETRAIN
RETAIN
REGULATE
REASSESS
Summary
• Despite the rising budget and increasing Philhealth
coverage, healthcare is deteriorating.
• The deterioration is mainly due to a shortage of healthcare
workers caused by massive migration
• Healthcare workers who stay (especially those in rural areas)
are patriots who want to serve the country.
• The government need to take better care of those who care
for our health.
• Primary care is vital in achieving genuine UHC.