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Trans 2: Health Care System In communities with high population Dr.

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density, residentsJune 15, 2011 poor Date: tend to have health status due to improper waste disposal and poor hygiene making them more prone to diseases. Each district in Manila has only 7-8 health centers

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Specific Objectives: To describe the socio-demographic profile of the citizens of Manila To describe the general health status of the City of Manila To discuss the role of the Manila Health Department in the delivery of health care in the City of Manila a. Organizational Structure b. Vision / Mission c. Goals The history of Manila Health Department d. Programs / Strategies e. Resource allocation / Budget The Manila Health Department (MHD) was f. Linkages created on the 1st of July 1940 under the Commonwealth Act No. 561. Socio Demographic Status It was named the City Health Department and Welfare (CHDW). The City of Manila as the capital of the Philippines: This was a new branch of the government Made up 6 congressional districts that was made to cater to the citys public A total land area of 38.28km2 health services, which was previously 2nd most populous city in the Philippines done by the then Bureau of Health with a total population of 1,660,714 (2007 census) Manila is also considered as the most It was given an initial budget of 350,000 densely populated city in the world with pesos by the then President Manuel L. 43,079 residents/km2 Quezon, who also appointed the first CHO Considered nations chief seaport Dr. Mariano Icasiano and first ACHO Dr. Also the residents are employed by Demetrio Belmonte. various industries, which include food and beverages, local entrepreneur, tourism, The first staff members were initially shopping malls and manufacturing of outsourced from the Bureau of Health. different products. Health Status By year 2009, the top ten leading causes of morbidity in Manila in order are the following: 1. acute respiratory infection 2. Bronchitis 3. Diarrhea 4. Pneumonia 5. TB 6. Bronchial asthma 7. Dengue fever 8. Conjunctivitis 9. Influenza 10. Chicken pox. Leading causes of mortality in Manila in order are the following: District 1 and 2 are the two districts with the highest mortality and morbidity rate. Also, these 2 districts have the highest population density among the districts. In 1941, the first program of the CHDW was started, including 17 Puericulture centers that were manned by nursemidwife teams along with a physician. The budget of the CHDW was also increased to 450,000.

Along with its project, the personnel of the department also grew to 923, which were subdivided into different divisions, namely: Division of Administration Division of Sanitary Engineering Division of Medical and Social Service Division of Sanitary Supervision Division of Epidemiology and Vital Statistics Division of Markets Division of Veterinary Service Division of Public Recreation City Physicians Office City Registrars Office

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February 1942 brought about an expansion of the supervisions of the CHDW. These extensions included control over the health facilities and activities of greater Manila, Quezon City, Caloocan, Pasay, Paraaque, Makati, Mandaluyong and San Juan.

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meat inspection services coordinated with food establishments improved control for insects and vermin as well as the institution of a high sanitary standards for eating places.

Administration of Public Markets was


transferred to the City Health Department.

Nursing Service by the MHD was


When the War came, the CHDW also played an important role in the delivery of public health services at that time. The department increased clinics all over the city and opened a Childrens Hospital. recognized as the leader and center for student training in nursing and midwifery for those who will enter the government service in any place in the country.

Office of City Physicians conducted


physical examinations with lab and home visits to employees, puericulture centers were expanded to become general Health Centers, Day nurseries and Premature Infant programs were all started during the post-war period.

They performed a 40-day city-wide typhoid and cholera vaccination. Mendicants homes were opened and Community Kitchens were started in the different locations in the cities.

1945 was the year when a new Division of Social Hygiene was created to stop the spread of venereal diseases In October of that same year, the Public Health Laboratory Section of the Division of Preventable Diseases was established, undertaking researches in Public Health.

The following year, it was converted to the


Division of Public Health Laboratory of the Manila Health Department (MHD). After the war, the City Health Department took over the Local Civil Registry, manning the birth, marriage, death and disease statistics. Programs of the Sanitation Department included: 1. adoption of septic well toilets 2. introduction of oriental types of sanitary toilets 3. sanitary fill method of garbage disposal

Level of health care and referral from MHD to Barangay health stations

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As illustrated on the pyramid the hierarchy of services on city level would start from City Health Services/ city hospitals next would be emergency and district hospital down to rural health unit or community hospitals and health center and private practioner down to the health stations on each barangay.

Level of Health care and referral would follow a hierarchy of services starting from national health services, medical centers, teaching and training hospital down to regional health services. The manila health department is headed by the city health officer which serves as the top level managers, with a dotted line connecting to the NGOs which Health Programs and Services signify relationship with the non government organization but no official For the year 2009, the Manila Health responsibility and authority. Department have done a lot of programs Under the authority of city health officer that aim to further the efforts of the city of follows the assistant city health officer Manila to make available the health which serves as middle managers and has programs and services to the less the authority over the three major fortunate population. divisions of MHD, which are the Included in these programs are Administrative services, Health Operations infrastructure projects as well as Services and Planning, Training, Research, innovative means to reach more people Development and Evaluation Services with than what is usually able to avail of the different sections and divisions under citys health services. each services. Among the many projects of the Manila Health Department was the establishment The Manila Health Department Mission and of new Health Centers and satellite clinics Vision in the different districts of Manila. This includes the following: Vision: Patricia Health Center (District V) A strong and dominant force in the May 23, 2009 Health Care System of Manila by providing high Barangay 105 Satellite Clinic August standard of health care services 2009 Barangay 752 Satellite Clinic June Mission: 2009 To conduct Health Care Services in the highest form of professionalism guided by the high standard of competence, integrity and Another project of the MHD in 2009 was excellence. the Health on Wheels (HOW), proposed by the city Mayor Alfredo Lim started last May 2009. It was a mobile clinic that was aimed to reach the less marginalized population and provide them basic health services. The HOW offers medical consultations and treatment related to acute ambulatory care, minor surgical operations, ECG, dental services as well as provision of necessary drugs and laboratory services. On the other hand, improved health Goals services were also coupled to the new The objectives of a Local Health System are as infrastructures that the MHD was able to follows: construct for the past year. Enhanced Emergency Disaster Teams in all districts as well as increased manpower

Establish local health systems for efficient and effective delivery of health care services Upgrade the health care management and service capabilities of local health facilities Promote inter-LGU linkages and cost sharing schemes including local health care financing systems for better utilization of local health resources Foster participation of the private sector, non-government organizations (NGO) and communities in local health systems development. Ensure quality of health service delivery at local level.

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in the different projects of the MHD were implemented. Medical-Dental Missions (Lingap Iyong Maasahan), PhilHealth Medicare programs and Senior Citizens Clinics were given manpower and necessary medicines to better maintain daily operations. Indigent families were also given free burial. During the Ondoy and Pepeng calamities, free medical assistance was initiated by the Emergency Management Rescue Team for the affected families in Manila. Free deliveries to the 12 Lying-in Clinics in Manila were also started last year. Government employees also underwent regular conduct of health activities such as health packages which includes Preventive Cardiology Programs, Cholesterol and Fasting Blood Sugar determination, Pap smear and Digital Rectal Exam among others. Blood bags were also given free of charge for select families in need. Fogging and spraying of selected communities and schools were also done last year All these efforts of the Manila Health Department were not done in only a handful of projects. The MHD boasts of a number of health programs that caters to all aspects of maintaining the quality of health in Manila and its citizens.

Womens Health, and Communicable and Non-Communicable diseases) seek the help of Barangay officials, community leaders, volunteers, and health workers. This allows the MHD to direct their programs to the target recipients in the community. Environmental health programs such as Water Sanitation, Urban Cleaning and Greening, and Insect and Vermin Control is coordinated with MAYNILAD, Department of Public Works and Highways, and Metro Manila Development Authority. MHD also coordinates with Department of Education to address health issues in the schools in Manila. Most importantly, MHD forms linkages with public and private hospitals in Manila to effectively deliver health care to citizens of Manila. These alliances with different agencies and organizations are essential in implementing the programs of MHD and to assure that the programs will reach its target recipients.

Resource Allocation and Budget The Manila Health Department aims to deliver health core in the City of Manila through health system improvement and financing by providing additional manpower to deploy in the city health facilities. By providing additional budget for the purchase of essential drugs provided free for Manileos. To increase allocated health budget from Php 390 million in 2007 to Php 454 million in 2008 and Php 492 million in 2009. In addition, providing seven (7) computers for the purposes of information management.

Linkages The Manila Health Department coordinates with both government and non-government organizations to implement their programs. Programs regarding the health awareness and health promotion (i.e. Breast Feeding, Under Five Clinic, Safe Motherhood and

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