The Birth of Sentrong Sigla

Quality Assurance Program (QAP)

Goal: To make DOH and LGUs active partners in providing quality health
services

Key Strategies:

1. Certification/Recognition Program - CRP

2. Continuous Quality Improvement - CQI

Sentrong Sigla Movement

Goal: Quality Health

Objectives: Better and more effective collaboration between DOH and LGUs

DOH: as provider of technical and financial assistance packages for health care
LGU: prime developers of health systems and direct implementers of health programs

Sentrong Sigla Movement

Pillars:

• quality assurance
• grants and technical assistance
• awards
• health promotion

Phase Period Standards

I 1998-2000 Input
II 2001-2004 Process
III 2005-2010 Outcome or Impact

Achievements of Sentrong Sigla

SS - Certified as of end of 2003

• 53% of health centers

• 15% of district and provincial hospital
• 3% of BHSs
• Additional awards for several facilities
Positive Outcome of Sentrong Sigla

• created a quality service-orientation among public health service providers

• promoted interest and participation of LGUs in raising quality health services
• generated additional support from LCEs for health; channeled local resources to fund
supplies, basic, equipment of facilities
• Improved quality of services in general'changed attitudes of service providers; perceived
increased utilization of services
• effective tool to maitain DOH leadership in health that would ultimately redound to health
impact
• serveral health centers received CQI training; some established quality circles

Valuable Lessons

• realization to the need for total systems quality standards that combine simple yet basic
input. process and output standards
• importance of careful selection of incentives

• the need for changin procedures to provide adequate time for crucial processes to take
place and be internalized prior to the assessment
The Sentrong Sigla Certification
- Phase II
Background/Framework

• efforts to raise quality of health services to be intensified

• expansion of concern on quality beyond DOH-LGU interaction to the entire health sector
• to be coordinated by a mulit-sectoral Quality Health Care Commitee

Quality in Health Framework

Guiding Principles

• recognition of achieving quality the main incentive in SS certification

• quality improvement is an unending process
• certification to focus on public health programs proven most cost-beneficial to the people
• roles and responsibilities including contributions must promote appropriate counterpart
and reciprocity
• purposive DOH assistance
• involvement of non-DOH partners to ensure objectivity and broader perspective

Goals

Long Term: Institutionalize within the health sector the leadership, processes, knowledge,
attitudes, skills and organizations to generate continuous quality improvement in health care

Intermediate (2003-07): to improve quality of health care in outpatient health faciities, hospitals
and public health services in the communities

Specific: to improve the quality of outpatient health care (public and private and of public health
service in communities)

Objectives

1) To establish an efficient system of:

 • providing technical and other forms of assistance to the LGUs
• assessing health services against established standards
• monitoring key indicators in the SS Certification process

2) To progressively raise the average quality of public health services through recognition of
successful attainment of quality standards

• at least 50% of health centers successfully meet the revised SS-Phase II basic Certification
Standards (Level I)
• at least 20% of Level I certified health centers successfully meet SS-Phase II
Specialty Award (Level 2) standards for all core public health programs

3) To raise public health awareness of public support and demand for, and client participation in
SS Certification of their health services and facilities

Level and Scope of the Certification

Level Category Description

minimum input, processes and output standards for integrated
I Basic SS Certification public health services for 4 core programs, facility systems,
regulatory functions and basic curative services
second level quality standards for selected core public health
II Specialty Award
programs
highest level quality standards for maintaining Level 2 standards
III Award for Excellence for the 4 core public health programs and Level 2 facility systems
for at lease 3 consecutive years

Recognition Scheme

Level Recognition Given by

I SS Seal, individual recognition CHD
II Specialty Banner, individual recognition others CHD
III SS trophy, individual National recognition, media exposure, others

Validity of Certification

1. facilities which did not progress to a higher level of certification but maintained current
certification are:
 - given stickers to confirm the renewal of the validity of seal
- no ther incentives given for mere renewal of SS status

2. facilities that slide back: seal will not be removed but not issued a SS sticker

Similarities

• ultimate aim - to improve quality of health services

• certification/recognition and continuous quality improvement remain as key strategies
• continue as a partnership with LGUs
• regions remain as overall in-charge of certification health facilities
• CHD TA Teams to provide assistance
• LGU participation is voluntary

Differences

• standards include inputs, process, outcome

• standards cover health facility and systems, 4 core public health programs, basic curative
services and regulatory function
• covers initially only RHUs/Health centers; to expand to BHSs, private clinics and
community-based facilities; hospitals not covered
• minimal cash awards
• no prequalification based on inputs
• all standards, tolls in assessment to be transparent
• purposive TA to be provided
• TA Packages to be disseminated
• LGU self-assessment assited/facilitated by the DOH Reps

• training of TA Teams and Assessors