WEEK 3_THE HEALTH CARE DELIVERY SYSTEM

A. WORLD HEALTH ORGANIZATION

1. Sustainable Development Goals – The Sustainable Development Goals (SDGs), otherwise known as the
Global Goals, are a universal call to action to end poverty, protect the planet and ensure that all people
enjoy peace and prosperity.
2. The 2030 Agenda for Sustainable Development, adopted by all United Nations Member States in 2015,
provides a shared blueprint for peace and prosperity for people and the planet, now and into the future. At
its heart are the 17 Sustainable Development Goals (SDGs), which are an urgent call for action by all
countries - developed and developing - in a global partnership. They recognize that ending poverty and
other deprivations must go hand-in-hand with strategies that improve health and education, reduce
inequality, and spur economic growth – all while tackling climate change and working to preserve our
oceans and forests.
3. The 17 sustainable development goals (SDGs) to transform our world:
1. No poverty
2. Zero Hunger
3. Good Health and Well-being
4. Quality Education
5. Gender Equality
6. Clean Water and Sanitation
7. Affordable and Clean Energy
8. Decent Work and Economic Growth
9. Industry,, Innovation and Infrastructure
10. Reduced Inequality
11. Sustainable Cities and Communities
12. Responsible Consumption and Production
13. Climate Action
14. Life Below Water
15. Life on Land
16. Peace and Justice Strong Institutions
17. Partnership to achieve the Goal

B. PHILIPPINE DEVELOPMENT OF HEALTH

1. Mission-Vision
2. Historical Background

3. Local Health System and Devolution of Health Services

 In 1991 the Philippines Government introduced a major devolution of national government
services, which included the first wave of health sector reform, through the introduction of the Local
Government Code of 1991.
 The Code devolved basic services for agriculture extension, forest management, health services,
barangay (township) roads and social welfare to Local Government Units. In 1992, the Philippines
Government devolved the management and delivery of health services from the National
Department of Health to locally elected provincial, city and municipal governments.
  The result of the study following to the introduction of devolution, quality and coverage of health
services declined in some locations, particularly in rural and remote areas. It was found that in
1992-1997, system effects included a breakdown in management systems between levels of
government, declining utilization particularly in the hospital sector, poor staff morale, a decline in
maintenance of infrastructure and under financing of operational costs of services.

 CONCLUSION:
The aim of decentralization is to widen decision-making space of middle level managers, enhance
resource allocations from central to peripheral areas and to improve the efficiency and
effectiveness of health services management. The findings of the historical review of devolution in
the Philippines reveals some consistencies with the international literature, which describe some
negative effects of decentralization, and provide a rationale for the Philippines in undertaking a
second wave of reform in order to 'make devolution work'.

4. Classification of Health Facilities (DOH AO-0012A)

 New DOH Hospital Classifications 2015
 Functions of Hospitals and Development Partners in Micronutrient Supplementation | Creation of Inter-
Agency Task Force for Emerging and Re-emerging Infectious Diseases | Global Influenza Surveillance
and Response
 Classification of hospital shall be based on Administrative Order No. 2012–0012, dated July 18, 2012,
Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the
Philippines"
 They shall be classified according to the following:

According to Ownership
A. Government
o The hospital is created by law.
o A government health facility may be under the National Government, DOH, Local Government
Unit (LGU), Department of Justice (DOJ), State Universities and Colleges (SUCs),
Government-owned and controlled corporations (GOCC) and others
B. Private
o Owned, established, and operated with funds from donation, principal, investment, or other
means by any individual, corporation, association, or organization

According to Scope of Services

A. General Hospital
o A hospital that provides services for all kinds of illnesses, diseases, injuries or deformities
o It provides medical and surgical care to the sick and injured, maternity, newborn and child care
o It shall be equipped with the service capabilities needed to support board certified/ eligible
medical specialists and other licensed physicians rendering services in, but not limited to the
following:
 Clinical Services (Family Medicine, Pediatrics, Internal Medicine, Obstetrics and
Gynecology, Surgery)
 Emergency Services
 Outpatient Services
  Ancillary and Support Services (Clinical Laboratory, Imaging Facility, Pharmacy)
B. Specialty
o Specializes in a particular disease or condition or in one type of patient
o A specialized hospital may be devoted to the treatment of the following:
 Treatment of a particular type of illness or for a particular condition requiring a range of
treatment
 Treatment of patients suffering from a particular diseases of a particular organ or
group of organs
 Treatment of patients belonging to a group such as children, women, elderly or others

According to functional capacity

A. Level 1 General Hospital
A level 1 General Hospital shall have as minimum:
1. A staff of qualified, medical, allied medical and administrative personnel headed by a physician
duly licensed by the PRC.
2. Bed space for its authorized bed capacity, in accordance with DOH Guidelines in the Planning and
Design of Hospitals.
3. An operating room with standard equipment and provisions for sterilization of equipment and
supplies in accordance with:
 DOH Reference Plan in the Planning and Design of an Operating Room or Theater
 DOH Guidelines on Cleaning, Disinfection, and Sterilization of Reusable Medical
Devices in Hospital Facilities in the Philippines
4. A post-operative Recovery Room
5. Maternity Facilities consisting of Ward(s), Room(s), a Delivery Room, exclusively for maternity
patients and newborns
6. Isolation facilities with proper procedures for the care and control of infection and communicable
diseases as well as for the prevention of cross infection
7. A separate dental section/ clinic
8. Provision for blood donation
9. A DOH-licensed secondary clinical laboratory with the services of a consulting pathologist
10. A DOH licensed Level 1 imaging facility with the services of a consulting radiologist
11. A DOH licensed pharmacy

B. Level 2 General Hospital

As minimum, all of Level 1 capacity, including but not limited to:
1. An organized staff of qualified and competent personnel with Chief of Hospital/Medical Director
and appropriate board certified Clinical Department Heads.
2. Departmentalized and equipped with the service capabilities needed to support board certified/
eligible medical specialties and other licensed physicians rendering services in the specialties of
Medicine, Pediatrics, Obstetrics and Gynecology, Surgery, their subspecialties, and other ancillary
services.
3. Provision for general ICU for critically ill patients
4. Provision for NICU
5. Provision for HRPU
6. Provision for Respiratory Therapy Services
7. A DOH licensed tertiary clinical laboratory
 8. A DOH licensed level 2 imaging facility with mobile X-ray inside the institution and with capability
for contrast examinations

C. Level 3 General Hospital

As minimum, all of Level 2, including but not limited to:
1. Teaching and/or Training Hospital with accredited residency training program for physicians in the
four major specialties namely:
a. Medicine
b. Pediatrics
c. Obstetrics and Gynecology
d. Surgery
2. Provision for physical medicine and rehabilitation unit
3. Provision for ambulatory surgical clinic
4. Provision for dialysis facility
5. Provision for blood bank
6. A DOH licensed level 3 imaging facility with interventional radiology

D. Specialty Hospitals
As described above

E. Trauma Hospitals
The trauma capability of hospitals shall be assessed in accordance with the guidelines formulated by
the Philippine College of Surgeons
1. Trauma Capable Facility is a DOH licensed hospital designated as a Trauma Center
2. Trauma Receiving Facility is a DOH licensed hospital within the trauma service area which
receives trauma patients for transport to the point of care or a trauma center

Reference
Administrative Order 2012-0012. Rules and Regulations Governing the New Classification of Hospitals and Other
Health Facilities in the Philippines. Department of Health Philippines
on April 12, 2015

1. PHILIPPINE HEALTH AGENDA 2010-2022

 GOALS
The Health System we aspire for:
1. Financial protection
 Filipinos, especially the poor, marginalized, and vulnerable are protected from high
cost of health care
2. Better Health Outcomes
 Filipinos attain the best possible health outcomes with no disparity
3. Responsiveness
 Filipinos feel respected, valued, and empowered in all of their interaction with the
health system

 VALUES
 The Health System we aspire for:
1. Equitable & Inclusive To All
2. Uses resources efficiently
3. Transparent & accountable
4. Provides high quality services

During the last 30 years of Health Sector Reform, we have undertaken key structural reforms and
continuously built on programs that take us a step closer to our aspiration.
Milestone:
1. Devolution
2. Use of Generics
3. Milk Code
4. Philhealth (1995)
5. DOH resources to promote local health system development
6. Fiscal autonomy for government hospitals
7. Good Governance Programs (ISO, IMC, PGS)
8. Funding for UHC

 Persistent Inequities in Health Outcomes

1. Every year, around 2000 mothers die due to pregnancy-related complications.
2. A Filipino child born to the poorest family is 3 times more likely to not reach his 5th
birthday, compared to one born to the richest family.
3. Three out of 10 children are stunted.

 Restrictive and Impoverishing Healthcare Costs

1. Every year, 1.5 million families are pushed to poverty due to health care expenditures
2. Filipinos forego or delay care due to prohibitive and unpredictable user fees or co-
payments
3. Php 4,000/month healthcare expenses considered catastrophic for single income
families

 Poor quality and undignified care synonymous with public clinics and hospital
1. Long wait times
2. Limited autonomy to choose provider
3. Less than hygienic restrooms, lacking amenities.
4. Privacy and confidentiality taken lightly
5. Poor record-keeping
6. Overcrowding & under-provision of care

ALL FOR HEALTH TOWARDS HEALTH FOR ALL

(Lahat Para sa Kalusugan! Tungo sa Kalusugan Para sa Lahat)

AMBISYON NATIN 2040 (Duterte’s Administration)

Universal Health Coverage

  Investing in People
 Protection Against Instability
Strengthen implementation of Responsible
Parenthood and Reproductive Health Act of 2012
(RPRH Law)
War Against Drug
Additional Funds from Pagcor

ATTAIN HEALTH-RELATED SDG TARGETS

Financial Risk Protection | Better Health Outcomes | Responsiveness

Values: Equity, Quality, Efficiency, Transparency, Accountability, Sustainability, Resilience

3 Guarantees:
1. Service delivery A C H I E V E
2. All life stages and triple burden
3. Universal Health Insurance

GUARANTEE 1
ALL LIFE STAGES & TRIPLE BURDEN OF DISEASE

COMMUNICABLE DISEASES NONCOMMUNICABLE DISEASES OF RAPID

 HIV/AIDS DISEASES & MALNUTRITION URBANIZATION &
 TB  Cancer INDUSTRIALIZATION
 Malaria  Diabetes  Injuries
 Diseases for Elimination  Heart Disease and their  Substance abuse
 Dengue Risk Factors – obesity,  Mental Illness
 Leptospirosis smoking, diet, sedentary  Pandemics
 Ebola virus lifestyle  Travel Medicine
 Zika virus  Malnutrition  Health consequences of
climate change / disaster

Services for Both the Well & the Sick

 Pregnant
 Newborn
 Infant
 Child
 Adolescent
 Adults
 Elderly
 First 1000 days
 Reproductive and sexual health
 maternal, newborn, and child health
 exclusive breastfeeding
 food & micronutrient supplementation
 Immunization
 Adolescent health
  Geriatric Health
 Health screening, promotion & information

GUARANTEE #2
SERVICE DELIVERY NETWORK
Functional Network of Health Facilities

Guarantee 2: Services are delivered by networks that are

 FULLY FUNCTIONAL (Complete Equipment, Medicines, Health Professional)
 COMPLIANT WITH CLINICAL PRACTICE GUIDELINES
 AVAILABLE 24/7 & EVEN DURING DISASTERS (911)
 PRACTICING GATEKEEPING
 LOCATED CLOSE TO THE PEOPLE (Mobile Clinic or Subsidize Transportation Cost)
 ENHANCED BY TELEMEDICINE

GUARANTEE #3 UNIVERSAL HEALTH INSURANCE

Financial Freedom when Accessing Services

Guarantee 3: Services are financed predominantly by PhilHealth

PHILHEALTH AS THE GATEWAY TO  100% of Filipinos are members

FREE AFFORDABLE CARE  Formal sector premium paid through payroll
 Non-formal sector premium paid through tax
subsidy
SIMPLIFY PHILHEALTH RULES  No balance billing for the poor/basic
accommodation & Fixed co-payment for non-
basic accommodation
PHILHEALTH AS MAIN REVENUE  Expand benefits to cover comprehensive range
SOURCE FOR PUBLIC HEALTH CARE of services
PROVIDERS  Contracting networks of providers within SDNs

STRATEGY

A Advance quality, health promotion and primary care

1. Conduct annual health visits for all poor families and special populations (NHTS, IP,
PWD, Senior Citizens)
2. Develop an explicit list of primary care entitlements that will become the basis for
licensing and contracting arrangements.
3. Transform select DOH hospitals into mega-hospitals with capabilities for multi-
specialty training and teaching and reference laboratory.
4. Support LGUs in advancing pro-health resolutions or ordinances (e.g. city-wide
smoke-free or speed limit ordinances)
5. Establish expert bodies for health promotion and surveillance and response
C Cover all Filipinos against health-related financial risk
 1. Raise more revenues for health, e.g. impose health promoting taxes, increase NHIP
premium rates, and improve premium collection efficiency.
2. Align GSIS, MAP, PCSO, PAGCOR and minimize overlaps with PhilHealth.
3. Expand PhilHealth benefits to cover outpatient diagnostics, medicines, blood and
blood products aided by health technology assessment.
4. Update costing of current PhilHealth case rates to ensure that it covers full cost of
care and link payment to service quality.
5. Enhance and enforce PhilHealth contracting policies for better viability and
sustainability.
H Harness the power of strategic HRH development
1. Revise health professions curriculum to be more primary care-oriented and
responsive to local and global needs.
2. Streamline HRH compensation package to incentivize service in high-risk or GIDA
areas.
3. Update frontline staffing complement standards from profession-based to
competency-based.
4. Make available fully-funded scholarships for HRH hailing from GIDA areas or IP
groups.
5. Formulate mechanisms for mandatory return of service schemes for all heath
graduates
I Invest in eHealth and data for decision-making
1. Mandate the use of electronic medical records in all health facilities.
2. Make online submission of clinical, drug dispensing, administrative and financial
records a prerequisite for registration, licensing and contracting.
3. Commission nationwide surveys, streamline information systems, and support efforts
to improve local civil registration and vital statistics.
4. Automate major business processes and invest in warehousing and business
intelligence tools.
5. Facilitate ease of access of researchers to available data
E Enforce standards, accountability and transparency
1. Publish health information that can trigger better performance and accountability.
2. Set up dedicated performance monitoring unit to track performance or progress of
reforms
V Value all clients and patients, especially the poor, marginalized, and vulnerable
1. Prioritize the poorest 20 million Filipinos in all health programs and support them in
non-direct health expenditures
2. Make all health entitlements simple, explicit and widely published to facilitate
understanding, & generate demand.
3. Set up participation and redress mechanisms.
4. Reduce turnaround time and improve transparency of processes at all DOH health
facilities.
5. Eliminate queuing, guarantee decent accommodation and clean restrooms in all
government hospitals.
E Elicit multi-sectoral and multi-stakeholder support for health
1. Harness and align the private sector in planning supply side investments.
 2. Work with other national government agencies to address social determinants of
health.
3. Make health impact assessment and public health management plan a prerequisite
for initiating large-scale, high-risk infrastructure projects.
4. Collaborate with CSOs and other stakeholders on budget development, monitoring
and evaluation

2. Primary Health Care (PHC)

1. Brief History
History

 May 1977. The 30th World Health Assembly adopted resolution which decided that the main
social target of governments and of WHO should be the attainment by all the people of the
world by the year 2000 a level of health that will permit them to lead a socially and
economically productive life.

 September 6-12, 1978. International Conference in PHC was held in this year at Alma Ata,
USSR (Russia).

 October 19, 1979. The President of the Philippines (Ferdinand Marcos) issued Letter of
Instruction (LOI) 949 which mandated the then Ministry of Health to adopt PHC as an approach
towards design, development, and implementation of programs which focus health
development at the community level.

Rationale
Adopting primary health care has the following rationales:

o Magnitude of Health Problems

o Inadequate and unequal distribution of health resources
o Increasing cost of medical care
o Isolation of health care activities from other development activities

Objectives
o Improvement in the level of health care of the community
o Favorable population growth structure
o Reduction in the prevalence of preventable, communicable and other disease.
o Reduction in morbidity and mortality rates especially among infants and children.
o Extension of essential health services with priority given to the underserved sectors.
o Improvement in basic sanitation
o Development of the capability of the community aimed at self- reliance.
o Maximizing the contribution of the other sectors for the social and economic
development of the community.

Types of PHC workers

There are two types of primary health care workers in the Philippines:
  Barangay Health Worker or Village Health Worker
 Intermediate level Primary Health Worker

Four Pillars
 Active Community Participation
 Intra and Inter-sectoral linkages
 Use of appropriate technology
 Support mechanism made available

Major Strategies

A. Elevating health to a comprehensive and sustained national effort.

Will require the following:
 Expanding participation in health and health-related programs whether as service provider
or beneficiary.
 Empowerment to parents, families and communities to make decisions of their health is
the desired outcome.
 Advocacy must be directed to national and local policy making to elicit support and
commitment to major health concerns through legislations, budgetary and logistical
considerations.

B. Promoting and supporting community managed health care

The health in the hands of the people brings the government closest to the people.
 It necessitates a process of capacity building of communities and organization to plan,
implement and evaluate health programs at their levels.

C. Increasing efficiency in health sector

 Using appropriate technology will make services and resources required for their delivery,
effective, affordable, accessible and culturally acceptable.
 The development of human resources must correspond to the actual needs of the nation
and the policies it upholds such as PHC.
 The Department of Health (DOH) continue to support and assist both public and private
institutions particularly in faculty development, enhancement of relevant curricula and
development of standard teaching materials.

D. Advancing essential national health research

 Essential National Health Research (ENHR) is an integrated strategy for organizing and
managing research using intersectoral, multi-disciplinary and scientific approach to health
programming and delivery.

2. Legal Basis
 October 19, 1979 – Letter of Instruction (LOI) 949, the legal basis of PHC was signed by
Pres. Ferdinand E. Marcos, which adopted PHC as an approach towards the design,
development and implementation of programs focusing on health development at
community level.
3. Definition
 The WHO defines Primary Health Care an essential health care made universally
acceptable to individuals and families in the community by means acceptable to them
through their full participation and at a cost that the community and country and afford at
every stage of development.

4. Goals
The ultimate goal of primary health care is better health for all. WHO has identified five key
elements to achieving that goal:
 Reducing exclusion and social disparities in health (universal coverage reforms);
 Organizing health services around people’s needs and expectations (service delivery
reforms);
 Integrating health into all sectors (public policy reforms);
 Pursuing collaborative models of policy dialogue (leadership reforms); and
 Increasing stakeholder participation.

5. Elements
The following are the eight (8) essential elements of primary health care:
1. Education for Health
o This is one of the potent methodologies for information dissemination. It promotes
the partnership of both the family members and health workers in the promotion of
health as well as prevention of illness.

2. Locally Endemic Disease Control

o The control of endemic disease focuses on the prevention of its occurrence to
reduce morbidity rate. Example Malaria control and Schistosomiasis control

3. Expanded Program on Immunization

o This program exists to control the occurrence of preventable illnesses especially of
children below 6 years old. Immunizations on poliomyelitis, measles, tetanus,
diphtheria and other preventable disease are given for free by the government and
ongoing program of the DOH

4. Maternal and Child Health and Family Planning

o The mother and child are the most delicate members of the community. So the
protection of the mother and child to illness and other risks would ensure good
health for the community. The goal of Family Planning includes spacing of children
and responsible parenthood.

5. Environmental Sanitation and Promotion of Safe Water Supply

o Environmental Sanitation is defined as the study of all factors in the man’s
environment, which exercise or may exercise deleterious effect on his well-being
and survival. Water is a basic need for life and one factor in man’s environment.
Water is necessary for the maintenance of healthy lifestyle. Safe Water and
Sanitation is necessary for basic promotion of health.

6. Nutrition and Promotion of Adequate Food Supply

 o One basic need of the family is food. And if food is properly prepared then one
may be assured healthy family. There are many food resources found in the
communities but because of faulty preparation and lack of knowledge regarding
proper food planning, Malnutrition is one of the problems that we have in the
country.
7. Treatment of Communicable Diseases and Common Illness
o The diseases spread through direct contact pose a great risk to those who can be
infected. Tuberculosis is one of the communicable diseases continuously occupies
the top ten causes of death. Most communicable diseases are also preventable.
The Government focuses on the prevention, control and treatment of these
illnesses.
8. Supply of Essential Drugs
o This focuses on the information campaign on the utilization and acquisition of
drugs. In response to this campaign, the GENERIC ACT of the Philippines is
enacted. It includes the following drugs: Cotrimoxazole, Paracetamol, Amoxycillin,
Oresol, Nifedipine, Rifampicin, INH (isoniazid) and Pyrazinamide,Ethambutol,
Streptomycin,Albendazole,Quinine

6. Principles and Strategies

Principles
Primary health care is run with the following principles:
1. 4 A’s = Accessibility, Availability, Affordability and Acceptability, Appropriateness of health
services.
o The health services should be present where the supposed recipients are. They
should make use of the available resources within the community, wherein the
focus would be more on health promotion and prevention of illness.

2. Community Participation
Community participation is the heart and soul of primary health care.
3. People are the center, object and subject of development.
o So it means that the success of any undertaking that aims at serving the people is
dependent on people’s participation at all levels of decision-making; planning,
implementing, monitoring and evaluating.
o Any undertaking must also be based on the people’s needs and problems (PCF,
1990)
o Part of the people’s participation is the partnership between the community and
the agencies found in the community; social mobilization and decentralization.
o As a whole, health work should start from where the people are and building on
what they have.
1. Example: Scheduling of Barangay Health Workers in the health center

Barriers of Community Involvement

o Lack of motivation
o Attitude
o Resistance to change
o Dependence on the part of community people
o Lack of managerial skills
 4. Self-reliance
o Through community participation and cohesiveness of people’s organization they
can generate support for health care through social mobilization, networking and
mobilization of local resources. Leadership and management skills should be
develop among these people. Existence of sustained health care facilities
managed by the people is some of the major indicators that the community is
leading to self-reliance.

5. Partnership between the community and the health agencies in the provision of quality of
life.
o Providing linkages between the government and the non-government organization
and people’s organization.

6. Recognition of interrelationship between the health and development

o Health is defined as not merely the absence of disease. Neither is it only a state of
physical and mental well-being. Health being a social phenomenon recognizes the
interplay of political, socio-cultural and economic factors as its determinant. Good
Health therefore, is manifested by the progressive improvements in the living
conditions and quality of life enjoyed by the community residents.

o Development is the quest for an improved quality of life for all. Development is
multidimensional. It has political, social, cultural, institutional and environmental
dimensions (Gonzales 1994). Therefore, it is measured by the ability of people to
satisfy their basic needs.

7. Social Mobilization
o It enhances people’s participation or governance, support system provided by the
government, networking and developing secondary leaders.

8. Decentralization
o This ensures empowerment and that empowerment can only be facilitated if the
administrative structure provides local level political structures with more
substantive responsibilities for development initiators. This also facilities proper
allocation of budgetary resources.

C. LEVELS OF PREVENTION
Prevention
 Is about avoiding disease before it starts.
 It has been defined as the plans for, and the measures taken, to prevent the onset of a disease or other
health problem before the occurrence of the undesirable health event.

There are three distinct levels of prevention.

 Primary prevention—those preventive measures that prevent the onset of illness or injury before the
disease process begins.
o Examples include immunization and taking regular exercise.
  Secondary prevention—those preventive measures that lead to early diagnosis and prompt treatment of a
disease, illness or injury to prevent more severe problems developing. Here health educators such as
Health Extension Practitioners can help individuals acquire the skills of detecting diseases in their early
stages.
o Examples include screening for high blood pressure and breast self-examination.

 Tertiary prevention—those preventive measures aimed at rehabilitation following significant illness. At this
level health services workers can work to retrain, re-educate and rehabilitate people who have already
developed an impairment or disability.

Health Education can be applied at all three levels of disease prevention and can be of great help in maximizing
the gains from preventive behavior.
 For example at the primary prevention level — you could educate people to practice some of the preventive
behaviors, such as having a balanced diet so that they can protect themselves from developing diseases in
the future.

 At the secondary level, you could educate people to visit their local health center when they experience
symptoms of illness, such as fever, so they can get early treatment for their health problems.

 At the tertiary level, you could educate people to take their medication appropriately and find ways of
working towards rehabilitation from significant illness or disability.

In summary:
 Primary prevention includes those preventive measures that come before the onset of illness or injury and
before the disease process begins.
o Examples include immunization and taking regular exercise to prevent health problems developing
in the future.
 Secondary prevention includes those preventive measures that lead to early diagnosis and prompt
treatment of a disease, illness or injury.
o This should limit disability, impairment or dependency and prevent more severe health problems
developing in the future.
 Tertiary prevention includes those preventive measures aimed at rehabilitation following significant illness.
o At this level health educator’s work to retrain, re-educate and rehabilitate the individual who has
already had an impairment or disability.

D. UNIVERSAL HEALTH CARE (UHC)

Definition: Universal health coverage (UHC) means that all people and communities can use the promotive,
preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while
also ensuring that the use of these services does not expose the user to financial hardship.
1. Legal Basis
 It is a time for celebration in the Philippines. President Rodrigo Block quote_UHC law story-01Duterte has
just signed a Universal Health Care (UHC) Bill into law (Republic Act No. 11223) that automatically enrolls
 all Filipino citizens in the National Health Insurance Program and prescribes complementary reforms in the
health system.
 This gives citizens access to the full continuum of health services they need, while protecting them from
enduring financial hardship as a result.

2. Background and Rationale

 UHC is firmly based on the WHO constitution of 1948 declaring health a fundamental human right and on
the Health for All agenda set by the Alma Ata declaration in 1978. UHC cuts across all of the health-related
Sustainable Development Goals (SDGs) and brings hope of better health and protection for the world’s
poorest.

3. Objectives and Thrusts

The definition of UHC embodies three related objectives:
a. Equity in access to health services - everyone who needs services should get them, not only those who
can pay for them;
b. The quality of health services should be good enough to improve the health of those receiving services;
and
c. People should be protected against financial-risk, ensuring that the cost of using services does not put
people at risk of financial harm.