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Isabelita M. Samaniego MD
Session Objectives
7,100 islands
1,700 LGUs
1 unitary/national
government
General Health Status of
the Filipinos
LifeExpectancy: 68.6 yrs
Female: 71.28 ; Male: 66.03
Highest: Central Luzon
Southern Tagalog
Lowest: ARMM & Eastern Visaya
Impact:
Higher proportion of elderly in general
population
Need to increase health & other socioeconomic
inputs in some regions
Crude Birth Rate
28.9/1000 population (1946)
30.5 (1950)
24.8% (1972 lowest)
30.7 (1973 - 1979)
Sex ratio: 109:100 (male)
Crude Death Rate
1946 to present - steady decline
1959 lowest decline - 7.3/1000
1960 to 1990 - slow but steady
decline
Death Rates: (highest) infancy &
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early childhood, decline by age
10 and sharp rise by age 40
Male death rate: 5.6/1000
Female death rate - 3.9/1000
Total Fertility Rate
Average number of births that a
woman would have at the end of
her reproductive life
3. Malignant
20,440 18,381 38,821 48.8 9.8
Neoplasm
8. Certain conditions
originating in the 8,520 5,689 14,209 17.9 3.6
perinatal period
9. Diabetes Mellitus 6,524 7,398 13,922 17.5 3.5
10. Nephritis,
nephritic syndrome 5,358 3,834 9,192 11.6 2.3
and nephrosis
• Environmental and
Occupational Issues
Battle
Of
The Bugs
Main Causes of Maternal
Mortality
1. neonatal delivery & other complications
related to pregnancy occurring in the course
of labor delivery & puerperium.
2. Hypertension complicating pregnancy ,
child birth & puerperium
3. Post partum hemorrhage
4. Pregnancy with abortive outcome
5. Hemorrhage related to pregnancy
DISEASE PATTERNS
Smallpox Ebola
Poliomyelitis AIDS
Malaria Variant
Creuzfelds-jacob
TB
SARS
Pneumonia
Bird Flu
Influenza
Ten Leading Cause of
Infant Mortality
1. Respiratory conditions of the fetus & the newborn
2. Pneumonia
3. Congenital anomalies
4. Diarrheal diseases
5. Birth injury & difficult labor
6. Septicemia
7. Meningitis
8. Avitaminosis & other nutritional disorders
9. Other diseases of the respiratory system
10 Measles
Health Care Delivery System
Mission
Guarantee equitable, sustainable and quality
health for all Filipinos, especially the poor, and
to lead the quest for excellence in health.
Overview of the General Health
Status of Filipinos points to
several Principles to
Improved Health
17 central offices
70 hospitals; and
4 attached agencies.
Central Office
Office of the Secretary and five major
function clusters
Staff support services
–Health Emergency Management Staff
– Internal Audit Staff,
– Media Relations Group
– Public Assistance Group
–Major Zonal Offices (Luzon, Visayas
and Mindanao.)
Zonal Office
Undersecretary (head) supported by an
Assistant Secretary.
Health Investments
Health System Characteristics . . .
PERSONNEL FACILITIES
BUDGET
Provinces
59%
P 2.441 B
Municipalities
38%
Cities P 1.583 B
3%
P 0.109 B
DOH Devolved Cost Compared to
Other Agencies
(in Billion Pesos)
Other DOH
Agencies
66%
(DA, DSWD,
DENR, etc.) P 4.1 B
34%
P 2.1 B
DOH Structure (Pre-devolution)
Office of the Secretary of Health
15 Regional
Field Offices
Regional Hosp.
Medical Centers
Sanitaria
Provincial Health
Offices
Provincial
Hospitals District
Health
Offices
BHSs
Health Structure (1993, Post-
devolution)
Office of the Secretary of Health
A
Health
Offices
B Hospitals
C BHSs
Comparing Governance to Health
Structure
EXECUTIVE BRANCH PUBLIC HEALTH SYSTEM
OFFICE OF THE PRESIDENT NATIONAL HEALTH SECRETARY
LEVEL
NATIONAL NATIONAL NATIONAL NATIONAL OFFICE OFFICE FOR OFFICE FOR OFFICE OFFICE OF
GOV’T GOV’T GOV’T GOV’T FOR HOSPI- TALS STAN- FOR THE CHIEF
AGENCIES AGENCIES AGENCIES AGENCIES PUBLIC & DARDS AND MANAGE- OF STAFF
HEALTH FACILITIES REGULA- MENT
SERVICES SERVICES TIONS SERVICES
REGIONAL HEALTH
REGIONAL LEVEL OFFICE
PROVINCIAL PROVINCIAL
GOV’T LEVEL HEALTH OFFICE
fundintended to
support community-
based health programs
HDF ....
to be treated as trust fund by
LGUs
covered by a MOA; LHB
resolution is a prerequisite
Provincial Health Board to
integrate all HDF-related
projects
DOH to prepare guidelines for
utilization
C. DOH Regional Field Offices
as Technical Resource and
Health Human Resource
Development Centers
RFOs serve as technical resource
management centers directing the
flow and utilization of DOH-
provided assistance to LGUs
Role of RFOs
Health Human Resource Bureau Health Policy Dev’t and Planning Bureau
Year
Lessons ...
Strategies for ensuring equity for
health workers and local government
units should be in place.
allocation of resources and assistance based on
LGUs relative financial capabilities to fund
devolved functions
A 43 258 0 301
B 23 973 1 997
C 4 222 64 290
TOTAL *70 * 1453 65 1588
* excluding ARMM Provinces, Municipalities and Cities
DFB Categories Interpretation
A LGU needing the most assistance form the National Government
B LGU can partially cover CODEF from its IRA resources
C LGU is financially capable of financing all obligations
Lessons ...
Recentralization
Decentralization
ROLE OF PHYSICIAN
PATIENT
FAMILY
COMMUNITY
PROFESSION
HIMSELF
RESPONSIBILITIES
FOCUS OF CARE
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