Republic of the Philippines

Department of Health

OFFICE OF THE SECRETARY

Auggsmfi
DEPARTMENT ORDER No.201l 010ff

Subject:

Kalus ugan Psng kalahatan E-xeclution

Plan

and Implementation Arrangements

I.

RATIONALE
The main obstacles to attaining universal health care are the following: 1) The two national healthcare financing mechanisms of direct govemment subsidy through DOH and LGU budgets, and the National Health Insurance Program (NHIP) have not been able to adequately provide financial risk protection for the poor; 2) As a result, poor households have inadequate access to quality outpatient and inpatient care from health care facilities. Rural Health Units (RHUs) and City Health Units in municipalities and cities, district and provincial hospitals, and even DOH-retained regional hospitals and medical centers do not have the necessary provisions to meet the needs of poor families; and 3) Owing to the failure of the financing and health care delivery systems to address the needs of poor Filipinos, it is unlikely that the Philippines will meet its MDG commitments by 2015. This is especially problematic for our targets to reduce maternal and infant mortality.

Administrative Order No. 2010-0036 entitled, "The Aquino Health Agenda: Achieving Universal Health Care for All Filipinos" provided for three strategic thrusts to achieve universal health care or Kalusugan Pangkalahatan (Y-P):1) Rapid expansion in NHIP enrollment and benefit delivery using national subsidies for the poorest families; 2) Improved access to quality hospitals and health care facilities through accelerated upgrading of public health facilities; and 3) Attainment of the health-related MDGs by applying additional effort and resources in localities with high concentration of families who are unable to receive critical public health
services.

Implementation of KP will also involve aligning the DOH budget behind these aforementioned three strategic thrusts. Furthermore, KP execution shall use welldefined and area-specific deliverables as performance targets to be pursued by DOH managers within a set timeframe and with clearly defined accountabilities.

II.

OBJECTIVE
This Order provides for guidelines and management arrangements to implement Kalusugan Pangkalahatanby accelerating the accomplishment of specif,rc performance targets. This is intended to streamline the tasks and functions of central office units to provide critical supporl and assistance to field units, who in turn shall be better supervised by Operations ClusterAssistant Secretaries andlor

Building I, San Lazaro Compound, Rizal Avenue, Sta. Cruz, 1003 Manila Trunk Line +63 (2) 651-7800 Direct Line: +63 (2)7ll-9501 Fax: +63 Q)743-1829 URL: http://\$'w.doh.eov.ph I e-mail: osec(0doh.gov.Bh I FB: facebook.com/DOHgovph I Twitter: @DOHgovph

Undersecretaries that have direct accorxilability to the Soststary of Heolth, This 0tdEr also provides for specific accountabilities and performance targets to field units anct their respective Assistant Secretary/Undersecretary supervisors.

III.

SCOPE This Order applies to all DOH offtces and its attached agencies - Buleaus, National Centers, Centers for Health Development, including the Regional Hospitals and Medical centers, specialty Hospitals and Special Hospitals and the Philippine Health Insurance Corporation, Population Commission, National Nutrition Council, philippine National AIDS Council, Philippine Institute of Traditional and Alternative Uealih Care, and the Philippine International Trading Corporation - Pharma'

IV.

THE KP IMPLEMENTATION ROAD MAP

Implementation of KP shall be undertaken in three phases:

A. Launch

Phase (August to December 2011)

By the end of December 2}ll,all 2010 CONAP and20l1 GAA budgets shall have been spent to ensure that at least the 2.3 million beneficiary families of the DSWD's Pantawid Pamilyang Pilipino Program (4Ps) are enrolled into the NHIP, provided information and guidance on NHIP entitlements, and assigned to the n"".rrury public health and outpatient (OP) services (through upgraded rural health uniis with adequate supply of public health commodities and drugs) as well as inpatient (IP) servites (through upgraded hospitals with adequate supply of drugs and supplies).
For the KP thrust on financial risk protection: 1. 4.89 million of the poorest NHTS-PR households, including those who are beneficiaries of the 4Ps, shall be enrolled into the NHIP sponsored program, using PhP 3.0 B from the 2011 GAA subsidy for NHIP premium of indigents; 2. 10,000 RNheals nurses will be trained as trainers and supervisors to capacitate existing community-level workers (e.g. BHWs, BNS, barangay officials) with community health team (CHT) frrnctions , using remaining funds (approximately PhP 177 M) from the PhilHealth Sabado I budget; 3. All unobligated MOOE by September 15, 2011 from the remaining 2010 and2011 budgets shall be used to secure drugs, medicines, and supplies for DOH-retained hospitals serving NHTS-PR families (including 4Ps beneficiaries) for implementation of the "no balance billing" policy; For the KP thrust on health facilities enhancement: 4. Health facilities (20 percent of DOH-retained hospitals, 46 percent of provincial hospitals, 46 percent of district hospitals, and 51 percent of RHUs) shall be upgraded to ensure that the poorest 5.2MNHTS-PR families shall have access to better quality inpatient and outpatient cafe,

5.

using PhP 1.79 B cY 2010 and PhP 7.2 B cY 2011 Heatth Facilities Enhancement Program (HFEP) funds; Treatment packs for hypertension and diabetes shall be procured and then distributed at RHUs for the use of 4Ps beneficiaries, using PhP 500 M from the National Pharmaceutical Policy Development budget;

For the KP thrust on attaining health-related MDGs: 6. Public health commodities will be procured and then distributed to RHUs serving 4Ps beneficiaries, using PhP 4.2 B from various budgets related to the attainment of health-related MDGs; Preparation for the scale-up phase: 7. In preparation for the scale-up phase in20l2, the following have to be ready by the end of December 2011: i. A system of Province- or City-wide agreement for KP where DOH will consolidate its inputs supporting local implementation of KP into one instrument and negotiation process by which to leverage better health performance from Provinces/Independent Cities; ii. Amendment of the National Health Insurance Act (RA 7875, as amended) Implementing Rules and Regulations to define a new sponsored program that provides for a population based nationallocal premium counterpart scheme that maximizes enrollment of poor families by earmarking national subsidies for the NHTS-PR households with LGUs subsidizing both NHTS-poor households and LGU-identified poor; iii. An NHIP membership services program that shall include, among , others, the provision of critical NHIP information to families such as their benefrts and entitlements, their assigned primary providers, and the network of hospitals that can provide them inpatient services; iv. A new NHIP outpatient benefit package with no balance billing (OPB-NBB), based on a review of the implementation of PhilHealth Circular No. 40, s,2000; v. A new NHIP inpatient benefit package with no balance billing (IP NBB) that draws from the experience of DOH and PhilHealth in NBB implementation (e.g. implementation of AO No. 137 s'2002; implementation of case payment for22 conditions); vi. An improved financial management system in PhilHealth that, among others, translates/converts Benefit Delivery Ratio (BDR) parameters into operational terms recognized by PhilHealth operating units and which shall also serve as basis for annual perforrnance evaluation ; vii. A new HFEP that has a) a clear framework, objective criteria and transparent process in determining the necessity for providing assistance; b) a menu of options for the delivery of HFEP assistance, including mechanisms such as grants, central procurement, budget subsidy, etc.; and c) a procurement and logistics cycle synchronized with NG and LG procurement svstems: and

viii. Budget execution plans for 2012 from each CHD, including
operational plans for implomenting the MDG breakrhrough strategy in 12 areas.

B.

Scale-up Phase (2012 to 2013) For CY 2012to2013, the following shall be implemented: 1. Roll-out of a new sponsored program with full national government premium subsidy to 5.2 million poorest families listed in the NHTS-PR at PhP 2,400 per family. Provision of membership services to NHIP members shall also be ensured; 2. New OPB and IP packages with no balance billing, including catastrophic care coverase to be introduced bv 2013: 3. Closure of tire upgrading gap for local health facilities and DOH-retained hospitals to ensure that the 10.8 million poor households in the NHTS-PR shall have access to improved quality of health services by upgrading in 2A12: i. 25 DoH-retained modern medical centers financed through publicprivate partnerships; ii. 27 provincial hospitals; iii. 1 l8 district hospitals; and iv. 973 RHUs accredited to at least provide the new OPB package; 4. An MDG breakthrough strategy by focusing resources and effort in 12 areas with the highest concentration of NHTS poor, women with unmet need for family planning, mothers giving birth outside facilities, children not fully immunized, children not given Vitamin A supplementation, and adults who are TB smear positive; and 5. Mobilization of at least 100,000 Community Health Teams (CHTs) to be trained and supervised by 21,070 RNheals nurses.

C. Sustainability

Phase (2014 to 2016)

From 2014 to2016, the execution of KP budgets shall be done in the context of an expenditure framework that sets milestones for KP implementation, which include: 1. Sustained coverage of at least 10.8M NHTS-PR families in the NHIP; 2. Continued enhancement of the OPB and IP packages with no balance

3.
4. 5.

billing;
Sustained provision of quality cate at DOH-retained and local health facilities upgraded through HFEP; Deployment of CHTs and RNheals to serve at least the 10.8 M NHTS-PR families; and Attainment of health-related MDGs by 2015.

The target outputs or deliverables for 20ll-2016 KP implementation can be found in Annex A.

V.

SETTING KP PERFORMANCB TARGETS

A. KP execution

shall be guided by well-defined performance targets set at the regional, province, and city levels.

B. Performance targets
approach:

for KP implementation shall be set using the following

1.

Use the presence of NIITS-PR families to determine where to focus KP

2.

3.

4.

5.

implementation. Determine service utilization gaps at provincial, city, and municipal levels using the best available current data on total population needs versus previous utilization pattems. Set performance targets representing the three KP thrusts, including, amons others: i." The number of NHTS-PR families to enroll into the NHIP, inform, and guide on benefits and entitlements; ii. The number, type, and names/locations of facilities to be upgraded to provide quality outpatient and inpatient services to NHTS-PR families; iii. The supply and distribution points of public health commodities and life-saving drugs for use by NHTS-PR families; iv. The number of CHTs to be deployed to the NHTS-PR families; and v. The number of RNheals nurses to be trained as trainers of CHTs. Separate targets shall be issued for areas with high concentrations of families.who have not received healthcare related to MDGs. The KP breakthrough strategy for MDGs is to significantly affect national-level indicators by concentrating efforts and resources in these areas. These areas for CY 2012 are highlighted in Annex F. In order to meet output targets (shown in Annexes B, C, D, E, and F), specific annual performance benchmarks shall be determined by the CHDs and submitted to their respective Operations Cluster Assistant Secretary/Undersecretary for validation and endorsement for approval by the Secretary of Health. Guidelines for developing an operational monitoring scheme for KP implementation that includes incentives for performance shall be issued separately.

W.

MANAGEMENT AND ORGANIZATION FOR KP IMPLEMENTATION

A. Management and organizational

summarized in Annex G.

arrangements for KP implementation are

B.

Being the frontline managers of KP implementation, CHDs shall: 1. Be responsible for meeting KP performance targets in their respective provinces and cities; 2. Provide technical assistance to provinces and cities as they implement the three KP thrusts:

3.

4.
5. 6.

7.

Manage resource transfers to leverage LGU counterpart and p0d0rmance with respect to KP implementation; Sustain current efforts in the delivery of priority public health services throughout the region while applying increased effort in selected provinces/cities under the MDG breakthrough strategy; Monitor the performance of provinces and cities in the region with respect to KP implementation; Prepare region-wide budget execution plans for subsequent years to be submitted for review and endorsement by the Operations Cluster Assistant Secretary/Undersecretary prior to approval by the Secretary of Health; and Organrze a KP team dedicated to managing KP implementation in the

provinces and cities under the region. The CHD Regional Director shall be accountable to the Secretary of Health, through the Operations Cluster Assistant SecretaryAJndersecretary.

C.

Being the overall managers of KP implementation for a cluster of regions, the Operations Cluster Assistant Secretaries/Undersecretaries shall: 1. Be responsible for meeting cumulative KP targets in their respective areas; 2. Ensure that technical assistance from the technical clusters is available and delivered to the regions in a well-coordinated manner; 3. Facilitate the flow of resources, as well as manage its allocation and transfers among its regions; 4. Review and endorse regional budget execution plans, for approval by the Secretary of Health; 5. Validate and consolidate performance monitoring reports for the Execom;
and

6.
D.

Represent the Secretary of Health with respect to matters concerning KP

implementation in the Operations Cluster. Technical Clusters based at the Central Office shall provide technical support to KP implementation. Bureaus, offices and units shall be organized around the following clusters with their respective tasks:

i.

The Sector Finance and Policy (SFPTC) Technical Cluster, which shall: i. Consolidate national level performance regarding KP targets on: a) NHIP Benefit Delivery Ratio (BDR); b) Health facilities enhancement; and c) MDGs; ii. Consolidate overall resource requirements to implement KP from all sources, including the General Appropriations Act (GAA), NHIP, and Foreign Assistance Projects (FAPs); iii. Ensure that technical assistance capacities, packages, and tools are available to support the requirements of the Operations Clusters in implementing KP; iv. Develop measures, and a collection, validation, and reporting scheme for monitoring the performance of KP implementation; v. Determine national level targets with area, regional and provincial breakdowns for KP implementation;

vi. Represent the Secretary

vii.

of Health with respect to engagements with the Department of Finance (DOF) and Department of Budget and Management (DBM) in matters related to financing KP implementation; and Perform the following with respect to the catch-up and scale-up phases of the KP roadmap: a) Propose changes in the National Health Insurance Act Implementing Rules and Regulations (NHIA IRR) (e.g., LGU sharing, new sponsored program, OPB-NBB, IP NBB, membership services, rules on reserves, use of 12 percent admin cost, operationalize BDR, etc.); b) Develop a new budget preparation cycle and procedures; c) Develop a new HFEP framework and delivery mechanism; d) Build a listing of the universe of public and private OP and IP providers; e) Develop an operations plan for the MDG breakthrough
strategy.

Units in the SFPTC shall be: DOH Units Bureau of International Health Cooperation (BIHC) Health Policy Development and Planning Bureau (HPDPB) National Center for Health Promotion (NCHP)
Attached Aqencies Philippine Health Insurance Corporation (PhilHealth) Philippine National AIDS Council (PNAC)

2.

The Internal Finance and Administration Technical Cluster (IFATC), which shall: i, Consolidate annual budget execution plans; ii. Perform timely and regular monitoring of budget expenditures through the Expenditure Tracking System (ETS); iii. Facilitate the timely release of funds and delivery of commodities to CHDs; iv. Develop guidelines for the engagement and deployment of doctors to the barrios (DTTBs), RNheals nurses, and other personnel in support of KP implementation; v. Represent the Secretary of Health with respect to engagements with the DBM in matters related to budget execution and expenditure tracking; vi. Develop a CHT deployment and training plan; and vii. Perform the following with respect to the catch-up and scale-up phases of the KP roadmap: a) Train RNheals nurses as trainers for CHTs; b) Identify and assign KP implementation tasks for DTTBs;
and

c)

Intensify and expand use of thE ETS as a platform for oll financial transactions frorn csntral officg to CHDo, hospiralo and provinces.

Units in the IFATC shall be: DOH Units Administrative Service (AS) Finance Service (FS) Health Human Resources Development Bureau (HHRDB) Information Management Service (IMS)

3. The Support to Service

i. ii.

iii.
iv.

Delivery Technical Cluster (SSDTC), which shall Assist CHDs in the operationalization of the new HFEP; Develop and assist CHDs in the operationalization of a new approach to province-wide agreements for KP performance; Develop methods and assist CHDs in validating service delivery outcome measures including, among others, modern family planning (MFP) use, facility based deliveries, TB case detection and cure. etc.: and Develop a sustainable approach to secure access to essential lifesavins medicines for NHTS-PR families.

Units in the SSDTC shall be:

DOH Units Bureau of Health Facilities and Services (BHFS) Bureau of Local Health Development (BLHD) Health Emergency Management Staff (HEMS) National Center for Disease Prevention and Control (NCDPC) National Center for Health Facilities Development QICHFD) National Center for Pharmaceutical Access and Management (NCPAM)
Attached Agencies Commission on Population (POPCOM) National Nutrition Council (NINC)

E.

The Technical Cluster Assistant SecretaryAJndersecretary shall review policy issuances, guidelines, and protocols developed by the offices and bureaus, prior to endorsement to the Execom for discussion and approval by the Secretary of Health.
bureaus, and units in the Technical Clusters shall provide technical assistance related to KP implementation, through the respective Technical Cluster Assistant SecretaryAJndersecretary. Conversely, requests by the CHDs for support related to KP implementation from offices, bureaus and units under the various technioal clusters shall be coursed through their respective Operations Cluster Assistant SecretariesAjndersecretaries.

F. Offices,

c. KP implementation

tasks for the following units shall be issued dfuectly by the

Secretary of Health: 1. Special Concerns Technical Cluster (SCTC)

including the following:

DOH Units Dangerous Drugs Abuse Prevention Program (DDAPP) Drug Treatment and Rehabilitation Centers (DTRC) Medical Tourism Program (MTP) Sanitaria

2. 3.

Food and Drug Administration (FDA);

Office of the Secretary (OSEC) Support

including the following:

DOH Units Bureau of Quarantine (BOQ) Central Office Bids and Awards Committee (COBAC) Internal Audit Service (IAS) Integrity Development Committee (IDC) Legal Service National Epidemiology Center (NEC) Public-Private Partnership Management Office (PPPMO) Procurement Service
Attached Agencies Local Water Utilities Administration (LWUA) Philippine Institute for Traditional and Alternative Health Care (PTTAHC) Philippine Intemational Trading Corporation - Pharma (PITC-Pharma) Philippine Sportd Commission (PSC)

H.

Relations with the Department of Health-Autonomous Region in Muslim Mindanao (DOH-ARMM) shall be handled by the OSEC.

VII.

ANNBXES
The following Annexes are an integral part of this Order:

Annex A - Target Outputs or Deliverables for 2011-2016KP Implementation Annex B - Distribution of NHTS-PR Families; Number of CHTs to be deployed; and Number of RNheals Nurses to Support CHTs Annex C - Indicative Number of Rural Health Units and City Health Units Requiring
Upgrading

Annex D - Indicative Number of District and other Sub-Provincial Hospitals Requiring Upgrading Annex E - Indicative Number of Provincial and City Hospitals Requiring Upgrading Annex F - Distribution of Poor Families or Individuals Lacking MDG-related
Healthcare Services

Annex G - Functional Clusters for Kalusugan Pangkalahatan Implementation

VIII.

REPEALING AND SEPARABILITY CLAUSE

All orders, rules, regulations, and other related issuances inconsistent with or contrary to this Order are hereby repealed, amended, or modified accordingly. All provisions of existing issuances which are not affected by this Order shall remain valid and in effect.
ln the event that any provision or part of this Order is declared unauthorized or rendered invalid by any Court of law or competent authority, those provisions not affected by such declaration shall remain valid and effective.

IX.

EF'FECTIVITY
This Order shall take effect immediately.

ENRIQUE T. ONA, MD Secretary of Health

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DO No.

z0ll-lJhfu, Annex B

Distribution of NHTS-PR Families; Number of CHTs to be deployed; and Number of RNheals Nurses to Support CHTs:
Technical Notes: 1. The number and distribution of NHTS-PR families was obtained from PhilHealthprocessed DSWD data, as of February 28,2011. 2. The number of CHTs for deployment to cover 10.8 million NHTS-PR families was estimated by using a ratio of 100 families per CHT' 3. The total number of RNheals nurses needed to support CHTs was estimated by using a ratio of 5 CHTs per RNheals nurse. 4. The number of RNheals nurses for 2012 was obtained from assumptions of the proposed 2012budget of the DOH. 5. The total gap for RNheals nurses is the difference between the total requirement and

the 12,000 nurses to be hired rn20l2.

PHILIPPINES

10,859,845 1,910,519 545,908

108,598 19,105 5,459

742

2L,720 3,827

t2,000

$;720

NORTHERN AND CENTRAT I.UZON

2,L]t
603 82 81 98

t,7!0
489
66 66

1.

TLOCOS

REGION ILOCOS NORTE ILOCOS SUR LA UNION

t,082
148 L47

74,158 73,57L
88,544 300,690 8,945

736
88s 3,007
89

t77
601
18

79

PANGASINAN

332
10

269
8

DAGUPAN

2.

CAGAYAN

VALLEY BATANES

411,600
L,537 L49,473 L77.274
SANTIAGO

4.LL6
15

823
3

455
2

368
1

CAGAYAN
ISABELA

1.,495

299
355

165 196
TL

t34
159
9

L,773
100

9.968 48,787

20 98 49 1,438
38

NUEVA VIZCAYA QUIRINO

488

54
27

44
22

24,56t
779,L48
19,038
7

246

3.

CENTRAL

LUZON AURORA

iLgt
190

795
27

644

t7

t2

DO No.2011--010[, Annex B

"vi'

i\i

ttiiNl lirrirjtit

BATAAN BULACAN NUEVA ECIJA PA.MPANGA

41,345 163,591 195,415 124,324 10,360

4L3 1,636 1,954

83

46
181

37

327 391

L46

216
L37
11.

t75

t,243
LO4

249

LLt
9
LO4

ANGELES TARLAC

2l
232
87
11

116,042 43,516
5,517 233,853

1,160 435
55

t28
48
6

ZAMBALES

39
5

OLONGAPO
CAR

2.339
475 250 410 149 358
388

468
95 50 82 30
72 78 62

258
52 28

209
42
22 37
13

ABRA APAYAO
BENGUET

47,453
25,O12 4L,007
BAGUIO

45
L6

14,900 35,816 38,775 30,900

IFUGAO KALINGA

40 43 34 3,102

32
35 28

MOUNTAIN
PROVINCE NCR AND

309 28,069

SOUTHERN TUZON
NCR

2,806,916
651,469

5,6t4
1,303 L64
35 29 78

2,5t2
583
73 16
13

6,51s
818

720
90
19

CALOOCAN
LAS PINAS

81,835

t7,473
14,558 38,930

t75 t46
389

MAKATI MALABON MANDALUYONG

t6
43
24

35 20

22,t44
105,581

221
1,056

44
21,1

MANILA MARIKINA MUNTINLUPA

Lt7
29 32

94
23 26

25,901 28,591

259 286

52

57

13

DO No. 2011'01ffi, Annex B

NAVOTAS PARANAQUE
PASAY PASIG PATEROS

32,786 24,509

328

66

36
27 24 44
b

29 22 L9 35
5

245

49 43
79 10

2t,4t2
39,395 5,108

2t4
394
51

QUEZON CIW SAN JUAN TAGUIG VALENZUELA

126,428
5,458

L,264
55

253
LL

L40
6 31 37

113
5

27,750
33,610 901,768

278
336 9.018

56
67
11804

25

30 807

4A.

CAL,ABARZO.N

996
276

BATANGAS
CAVITE

249,755
128,518 136,823

2,498 1,285
1,368

s00
257 274
547 24

224
115

L42
151

LAGUNA QUEZON

t22
245
11

273,482
LUCENA

2,735

302
13

T2,LL6

t2L
879
132 5,083
387

RIZAL

87,874
ANTIPOLO

176
26 L,OL7 77 L67

97
15

79
L2

13,200

48, MIMAROPA
MARINDUQUE
OCCIDENTAL

50&266 38,734
83,433

562
43 92
165

455
35 75

MINDORO
ORIENTAL

834 L,498 1,568

MINDORO
PALAWAN

149,752
156,834

300

t34 t40
22

3t4
48

173
27

PUERTO PRINCESA

24,177 55,342

242
553

ROMBLON

LLL

6t
824
L40

50
6i67

5.

BICOL REGION

745,4!3 t26,525

7;454 L,265

!,49t
253

ALBAY

113

t4

DO No.

zlll-illL,

Annex B

CAMARINES
NORTE

69,t92
206,257 10,969 30,331 160,894

692 2,063
110 303

138

76

62
1,85

CAMARINES SUR

413
22

228

NAGA CATANDUANES MASBATE

SORSOGON

t2
34 L78
156

10 27

61

1.609

322 282
4.933

t44 t26
2,208 860
79 77

L4L,245 2,466,593
960,981 88,428 86,498 108,529 23,O44

L,4t2
24,666
9,610 884
865

VISAYAS

2,726

6.

WESTERN

VISAYAS.' AKLAN ANTIQUE

CAPIZ

t,922 t77

L,062
98 95

t73
2L7

1,085 230

t20
25

97
2L

GUIMARAS

46 543
62

rLorLo

271,574
ILOILO CITY

2,7t5
309 3,390
131

300 34

243
28 303
L2

30,858 338,989 13,061 786,959 166,811 315,046

NEGROS OCC.6:ENTAL

678
26

375
L4

BACOLOD

7.

CENTRAL

VISAYAS

7,870
1,668 3,150

I,574
334 630 69 31 20 460
31

870

704

BOHOL
CEBU

t84
348
38
17

t49
282
31

CEBU CITY

34,394 15,542
9,855

344
1,55

LAPU-LAPU CITY

t4
9

MANDAUE
NEGROS

99

L\
254
L7

ORIENTAL
SIQUIJOR

229,8L5
15,495
718,6,53

2,298
155

206
L4

8.

EASTERN

VISAYAS

7,r87
268

L;437
54

794
30

643 24

BILIRAN

26,847

15

DO No.

zDll-JJlL, Annex B

EASTERN SAMAR
LEYTE

81,788

818

L64 503
38 35

90

73

25t,253
TACLOBAN ORMOC

2,513
188

278
2L
19

225
L7 16

18,755

t7,456
tos,o44
70,825
146,685

L75 1,050
708

NORTHERN SAMAR SOUTHERN LEYTE SAMAR

(WESTERN)

210 L42 293

5,653 1,183 363 369

116 78

94 53 131

L,467
28;,,256

162 3;L23 654 20L 204

122

MINDANAO

2,926,558
591,549 181,550

2,530 s29

9. ZAMBOANGA
PENINSULA:

5,915 1,815 1.843 1,105

ZAMBOANGA DEL
NORTE

L62
165

ZAMBOANGA DEL :::

SUR''

,,

L84,296
110.509

ZAMBOANGA CIry ZAMBOANGA

SIBUGAY

22t
230
L:,39L

99
103

ttS,t94
69s,749 220,741

L,152
6,957 2,207
L37 1,131 497

t27
769 244
15

10.

NORTHERN

MINDANAO
BUKIDNON

623
198
L2

441
27

CAMIGUIN
LANAO DEL
NORTE

13.7t6
113,101
ILIGAN

226
99 207 287
103
11101

125
55

101

49.698 103.441 143,384 51,668 550,493 106,553

44
93

MISAMIS
OCCIDENTAL

!,o34
L,434
517

rt4
158 57

MISAMIS
ORIENTAL CAGAYAN DE ORO

L28 46 493
95 101 133

11. DAVAO PENINSULA

COMPOSTELLA
VALLEY

5,505 1,066 1.L28 1,489

957

608
118

2t3
226 298
191

DAVAO DEL
NORTE

1t2,797
L48,927

L25
165 106

DAVAO DEL SUR

DAVAO CITY

95,732

86

I6

DO No.

20ll- IJIL, Annex B

DAVAO ORIENTAL

86,474 583,463
42,O30

865

173

96

77

12.
SOCCSKSA.RGEN

5,835 420 1,839 852 1,081

363

L,t67
84
368

645
46

522
38 155 76 97 33

COTABATO CIry
NORTH

COTABATO SARANGANI
SOUTH

183,904 85,181 108.145

203
94
119

L70

COTABATO
GENERAL SANTOS

216
73

36,342

40

SULTAN KUDARAT CARAGA AGUSAN DEL

NORTE

t27,86L
4O5,304 59,561

t,279
4,053 595
393 1,065

256
811
119

t4t
448
66 43
118

tt4
363
53 35 95 100 79

BUTUAN CIW AGUSAN DEL SUR SURIGAO DEL

NORTE

39,259
106,468 111,666 88,350

79

2t3
223
177

L,717 884 8,493 956 L,757 3,5L7

L23 98

SURIGAO DEL SUR

ARMM
BASILAN

849,2s9 96,626

1,699
193 351

938

760
86 L57

to7
L94 389
183

LANAO DEL SUR

t75,719
351,673 16s,396 59,845

MAGUINDANAO
SULU

703
331

315

t,654
598

t48
54

TAWI-TAWI

L20

66

t7

DO No.

20ll-

010b, Annex C

Indicative Number of Rural Heatth Units and City Health Units Requiring Upgrading:
Technical Notes: 1. The total number of RHUs and city health units was obtained from a compilation done by the USAID-HealthGov project using different sources to produce a master list of RHUs and CHOs. 2. The number of RHUs and city health units identified for upgrading in HFEP 2010, 2011. and2}l2was obtained from official submissions of the DOH to the DBM. 3. The upgrading gap is the difference between the total number of RHUs and city health units and the total number of facilities identified for upgrading under HFEP. Some facilities in the HFEP that do not match with those listed in the master list have not

4.

been included in the counts. Since the estimated upgradin

is larger than the actual need, CHDs need to validate the actual upgrading requirements for their region.

gap

PHILIPPINES

2,3L4
LUZON

374

813 150
o 9

L54
97

L,178 245
135 15 35 19

NORTHERN:AND CENTRAI.

s96

29t
1

1.

ILOCOS REGION

t45
24 35

ILOCOS NORTE ILOCOS SUR LA UNION

19 67

PANGASINAN DAGUPAN

t
22

65

2.

CAGAYAN VALLEY

99
b 32

35

43
6
18

BATANES

CAGAYAN
ISABELA

t4
1

40
15 o

20
1

19
1

SANTIAGO NUEVA VIZCAYA QUIRINO

15

3.

CENTRAL LUZON

268
8
18

268
8 18 61 62

98
6 9 LL 27 19

87

AURORA BATAAN BULACAN NUEVA ECIJA

6L 62
51 50 32

25

PAMPANGA
ANGELES TARLAC

51 36
32

2t t4
8
19

t7
9 8

ZAMBALES OLONGAPO
CAR

84

67

18

DO No.

20ll- llfil-,

Annex C

tr""
:

,,,,,i s'l
'

"-A:, ''l@^. '

,il;...
,...i*l -,. .'
ABRA APAYAO
BENGUET

t"s
t

ru ' r'luqqqi"df R*ua

.. l.
..

ar";

t :

"'.; nfr ,r-&:l

$n'
1.1.,,=

26
7

20
7 13

22 11 8

L
a

BAGUIO IFUGAO KALINGA

r
L

10 8 9

MOUNTAIN PROVINCE
NCR AND SOUTH:ERN TUZON NER

10

767 382
23

16

776
82

580

300
23

CALOOCAN
LAS PINAS

24
25 8 2L
2

24
L7 24
1

MAKATI MALABON MANDALUYONG

24
22

MANILA MARIKINA MUNTINLUPA

NAVOTAS PARANAQUE
PASAY PASIG PATEROS

48

46
2

Ib
9 8
16 11

t4

9
8

t4
7 4 9
2

LI
27
L

34
5

QUEZON CITY
SAN JUAN

52
15

43
13

TAGUIG VALENZUELA

t4
5b 181
2
1

t4
35
1

44.

CALABARZON

BATANGAS
CAVITE

42
27 38
2
2
1

176 42
27
33

LAGUNA QUEZON
LUCENA RIZAL

43 31 77
5

43
31

ANTIPOLO

48. MIMAROP.A
MARINDUQUE OCCIDENTAL MINDORO ORIENTAL MINDORO PALAWAN
PUERTO PRINCESA

14

27 6 6
3 3

42

IL
18

tt

15

25
L7 3

22
5

ROMBLON

5.

BICOL REGION

t27
19

65
9

62
10

ALBAY

I9

DO No.

2Ul-AiL,

Annex C

,, Number of

';Jffi
CAMARINES NORTE CAMARINES SUR NAGA CATANDUANES MASBATE
SORSOGON 11

; ilumbAilof t'" nxui

I Dryaqnrne d foi tifEP

t
-"-nl*,-

.
:

zoifi*:t,
.
7
,i

il

,.,
9 32

76 45

13

tt
15 10 13
b 5 11

2t
15

VISAYAS

466 159
19 18
19
5

2st
51
5
1.1

191

6.

WESTERN VISAYAS

tt
LT

97

AKLAN ANTIQUE CAPIZ GUIMARAS

t4
7 8

t
20

4 33
31

rLorLo
ILOILO CITY
NEGROS OCCIDENTAL BACOLOD

53

45

t4

7.

CENTRAL VISAYAS

15t
50 67
CEBU CITY

73 28 29

11 9

67
13

BOHOL
CEBU

38

LAPU.LAPU CIW

MANDAUE
NEGROS ORIENTAL SIQUIJOR

29
5

13 J 2
2

L5

8.

EASTERN VISAYAS

156 8 26 51 TACLOBAN ORMOC

t27
8 22 37

27
?

BILIRAN
EASTERN SAMAR
LEYTE

t4

NORTHERN SAMAR SOUTHERN LEYTE SAMAR (WESTERN)

24

22 15
L

2t
26

6 2

23

MINDANAO

366
PENINSULA 73 27

54

t76
39
22
1

45

103

9- ZAMBOANGA

25 25

9
5

ZAMBOANGA DEL NORTE ZAMBOANGA DEL SUR ZAMBOANGA CIW ZAMBOANGA SlBUGAY

30
16

16

1.

NORTHERN MINDANAO

95 23

20
4

39 10

38
9 5

BUKIDNON

CAMIGUIN

20

DO No.

20ll- \nb, Annex C

Nlry

l,$:,ir ::;:Wi':W#,:, ' t't,- 'l-' , ,,,-*ttu

ftt$
:::::::::I

Numherof

:l
"l
I

rr..*l^ir:I$4

Ril;

f
lP.r"i

tig,
uut:::uu:t::::

.,..i*s;
::::::t:t/t :tr:
I ;

tt: fi
-,; d
5

;i,-i.,:;#i"a
,.',.:;1,

fr,,;

":tri:.:'at

LANAO DEL NORTE ILIGAN

23

19 10

MISAMIS OCCIDENTAL MISAMIS ORIENTAL

CAGAYAN DE ORO

t7
27 69 22
6 6

8 3

24
18

11. DAVAO PENINSULA

COMPOSTELLA VALLEY DAVAO DEL NORTE

37
10 9 8 10

tt
t2
35

DAVAO DEL SUR

DAVAO CITY DAVAO ORIENTAL

10

L7

t1
54
1

t
15
1 1

12.

SOCCSKSARGEN

33

COTABATO CITY NORTH COTABATO SARANGANI SOUTH COTABATO

GENERAL SANTOS

18
7

t7
6
1

t6
12

4
1,1

t2

SULTAN KUDARAT CARAGA AGUSAN DEL NORTE BUTUAN CITY AGUSAN DEL SUR SURIGAO DEL NORTE SURIGAO DEL SUR

I
5
2

75

t
1

47
11
11

23
1

t4

t4
28 19 119
13

4
7

2t
4 60
7

15

ARMM
BASILAN

s9
6 27 18 8

LANAO DEL SUR

42
33
19

15
15 11

MAGUINDANAO
SULU

TAWI-TAWI

t2

t2

2l

DO No. 2011- 0'$L, Annex D

Indicative Number of District and other Sub-Provincial Hospitals Requiring Upgrading:

Technical Notes: I. The total number of District and other Sub-Provincial Hospitals was obtained from the BHFS licensing list of 2009. Actual number of hospitals may be higher than in the 2009 facilities licensing list. 2. The number of District and other Sub-Provincial Hospitals identified for upgrading in HFEP 2010,2011, and20l2 was obtained from official submissions of the DOH to the DBM. 3. The upgrading gap is the difference between the total number of District and other Sub-Provincial Hospitals and the number of facilities identified for upgrading under HFEP. Some facilities in the HFEP that do not match with those listed in the master list have not been included in the counts. 4. Since the estimated upgrading gap is larger than the actual need, CHDs need to validate the actual upgrading requirements for their region.

PHILIPPINES

584

79 23 6

189

118
2,5

24t

NORTHERN.AND CENTRAT TUZON

152
34
6 7 5

37
7
1

7t
22
5

x. rlocos

REGToN

ILOCOS NORTE ILOCOS SUR LA UNION

0
0 0
6

0
3
2

0 0 0

4
3

PANGASINAN DAGUPAN

L6

10 0

2.

CAGAYAN VALLEY

35
2

23

11
2

BATANES

0 0

0
13
7

CAGAYAN
ISABELA

L4

0
7

t
0 0

13 SANTIAGO

NUEVA VIZCAYA QUIRINO

3
3

0
3

0 0 25
1

t
13

3.

CENTRAL LUZON

54 z
6

9
1
T

I
0
1

AURORA BATAAN BULACAN NUEVA ECIJA

0 4
3
2 2

0
7

tt
t4

0
4
2

2
L

6 o

PAMPANGA
ANGELES TARLAC

tt
L

0
2

0
z
1

0
L

I
0 4

4
5

ZAMBALES

22

DO No.

20ll-0lbb, Annex D

Ntmbiirttu ;i tdffiffi ' Hoapftilj ,

';i+
,"1

OLONGAPO
CAR

0 29 4 o
5

t
0
0 0

4 0 n 4

23 4 6

ABRA APAYAO
BENGUET

0 0

t
0
5 4
a z

BAGUIO IFUGAO KALINGA 6 4 4 148

0 0
1

0 0 0 32 0

0 0
1

MOUNTAIN PROVINCE
NCR AND SOUT}I ERN..[U:ON NCR

20
7

34
0

69
3 0

CALOOCAN LAs PINAS MAKATI MALABON MANDALUYONG

1

0
U

0
1
L

MANILA MARIKINA MUNTINLUPA

NAVOTAS PARANAQUE
PASAY PASIG PATEROS

0 0 0 0 0 0
0

0
1"

QUEZON CITY
SAN JUAN

I
0

TAGUIG VALENZUELA

I
0
35
4

4A.

CATABARZON

60
13

I
0
1

4
1

20
8

BATANGAS
CAVITE

L2
L2 16

0 0
3

t
5

10
7

LAGUNA QUEZON
LUCENA RIZAL

0 0

9 0

6
1

0 0
7

0 0
11
2 2 3

I
L

ANTIPOLO

48. MIMAROPA
MARINDUQUE
OCCIDENTAL MINDORO ORIENTAL MINDORO

35
2

0 0 0 0

t7
0
3 2

0
3 3

8 8

23

DO No. 20ll-Dl00,Annex D

PALAWAN
PUERTO PRINCESA

0
0
'l

0
0

I
7

0
2

I
4

ROMBLON

5.

BICOL REGION

49
10
2

tt
7

t7
5

t4
2

t4
0

ALBAY

CAMARINES NORTE CAMARINES SUR NAGA CATANDUANES MASBATE

SORSOGON

0
1

0
1

t
3

t
7

L2

0
8
8

0
3

0 4
7

2
3 3

9 L57

0 10
5

0 68 36
7 8

VISAYAS

47
5

38

6.

WESTERN.VISAYAS

57
8 9 6
3 13
1

IL
1

AKLAN ANTIQUE
CAPIZ

0 0
5

0
L

0
1

0 0 0 0 4

0
1

GUIMARAS

tLotLo
ILOILO CITY
NEGROS OCCIDENTAL BACOLOD

0
U

0
3

t
10 0

L7

7.

CENTRAL VISAYAS

51.

0
0

19
5

15
2 2

23
5

BOHOL
CEBU CEBU

L2

18

0 0 0 0 0 0
5

4 0
1

t2
3 2

CIW

0 0 0
11

LAPU.LAPU CITY

MANDAUE
NEGROS ORIENTAL SIQUIJOR

t
13
1

0
8

t
0 0

I
23

0
L2

8.. EASTERN VISAYAS

BILIRAN
EASTERN SAMAR
LEYTE

49

9
0

11

17 TACLOBAN ORMOC
1

0 0

10
1

0 0 0

NORTHERN SAMAR SOUTHERN LEYTE SAMAR (WESTERN)

8
6

0
1

5
3

2 2 5

0 0
16 3

6 103

0
26

MINDANAO

63 8

24

9. ZAMBOANGA

PEN.INSULA

20

t0

24

DO No.

20ll-!J98, Annex D
Nufn bn ofr

!4;i .l;:,.
i

'ti::i
ii

titii

ltll,ii\,l, !

:!:1:iil:l

:ii : a: :ti

ZAMBOANGA DEL NORTE ZAMBOANGA DEL SUR ZAMBOANGA CITY ZAMBOANGA SIBUGAY

0
0 0

4
f

6
3

0 0
2
7

t
2

0
7 3

10.

NORTHERN MINDANAO

15

0 0 0
0

8 0
a

BUKIDNON

n 0
0

CAMIGUIN
LANAO DEL NORTE ILIGAN

t
5

0
2

0
5
1 7

MISAMIS OCCIDENTAL MISAMIS ORIENTAL

CAGAYAN DE ORO

0 0 0

4 0 0
L2
2
?

0
2

t
0 0 0
0 0 0
3

11.

DAVAO PENINSULA

T4
3 3 3

t4
3 3
3

COMPOSTELLA VALLEY DAVAO DEL NORTE DAVAO DEL SUR DAVAO CITY DAVAO ORIENTAL

0
2

0 0

1 4
2'J.

0 4
15

4 8

0
L

12.

SOCCSKSARGEN

COTABATO CITY NORTH COTABATO SARANGANI SOUTH COTABATO

GENERAL SANTOS 7 5
2

0
2

t
0 0 0 0 0 0

2
3
l"

4
L

I
3

SULTAN KUDARAT CARAGA AGUSAN DEL NORTE BUTUAN CITY AGUSAN DEL SUR SURIGAO DEL NORTE SURIGAO DEL SUR

0
9
3

t
4 0

32
b

4
0

20

)
13 8

2
1.

8
7

4
5

ARMM
BASILAN

24
2

0 0 0
0

10

9
2 l. 5
L

0
2
1

0
3 2

LANAO DEL SUR

MAGUINDANAO
SULU

8
5

0 0

4
3

TAWI-TAWI

25

DO No.

20ll-

0)9Lo Annex E

Indicative Number of Provincial and City Hospitals Requiring Upgrading:

Technical Notes: l. The total number of Provincial and City Hospitals was obtained from the BHFS licensing list of 2009. Actual number of hospitals may be higher than in the 2009 facilities licensing list. 2. The number of Provincial and City Hospitals identified for upgrading in HFEP 2010, 2011, and2012 was obtained from official submissions of the DOH to the DBM. 3. The upgrading gap is the difference between the total number of Provincial and City Hospitals and the number of facilities identified for upgrading under HFEP. Some facilities in the HFEP that do not match with those listed in the master list have not been included in the counts.. 4. Since the estimated upgrading gap is larger than the actual need, CHDs need to validate the actual upgrading requirements for their region.

Provincial Hospitals

;-PHILIPPINES NORTHERN AND CENTRAL I.UZON

89
24

18 3
T

23
2 1 7

27
tr1

34

9 0
0

1.

TLOCOS REGTON

4
1

z 0
1

ILOCOS NORTE

0
0

rLocos suR
LA UNION PANGASINAN DAGUPAN

0
U

0 0 0 0

t
1

0
1

0 2
0

2,

CAGAYAN.VALLEY

5
1

BATANES CAGAYAN ISABELA SANTIAGO NUEVA VIZCAYA

0
0 0
1

1 1

0 0

L L

1
U

0 0

0 n
1

QUIRINO 3;'CENTRAL LUZON

AURORA BATAAN BULACAN

0
2

o
L

0
0 n 0 0
0 0 0

0
L

t
I

0 n
,|

0 0 0 0 0
0 0

NUEVA ECIJA PAMPANGA

ANGELES TARLAC ZAMBALES OLONGAPO
CAR

t
L 1
I I

0
1

I
0
I
1

0 0

0 0 0
U

0 n
5
I

t
7

6
1
1
1

0
0 0 0

ABRA APAYAO BENGUET BAGUIO

0
0

1 1

0 0

26

DO No.

20ll- |lbbn

Annex E

1itil,lt|

Pw'ltltf $ffitl$flLr

LI

r
&$$\i
a::at:::-:a::a::;

ffi;
Prouinciat
:il'
1 L

IFUGAO KALINGA

0 0 0
5

0 0 0
3

0
1

0 I
5

MOUNTAIN PROVINCE
NCR AND SOUTHERN LUZON
NCR

0
b

15

n 0
0 0 0 0 0 0

CALOOCAN
LAS PINAS

MAKATI MALABON MANDALUYONG MANILA MARIKINA MUNTINLUPA

NAVOTAS PARANAQUE
PASAY PASIG PATEROS

0 0 0 0 0 0
0

QUEZON CITY SAN JUAN TAGUIG VALENZUELA

0
0 0 5
I 1
1 a

4A.

CALABARZON

0 0 0 0 0 0
3

z
L

3 0
1
1 1

BATANGAS CAVITE

0
0

0 0

LAGUNA
QUEZON LUCENA RIZAL ANTIPOLO

0
0

0 z
1

0 0 z 0
0 0
2

48, MIMAROPA
MARINDUQUE
OCCIDENTAL MINDORO ORIENTAL MINDORO
1

0 0
U

1
1

t
1

0
0

0 0
0
3

PALAWAN
PUERTO PRINCESA

0
1

ROMBLON

t
2

0
L

0
L

5.

BICOL REGION

ALBAY CAMARINES NORTE CAMARINES 5UR

T

0 0

NAGA
CATANDUANES MASBATE
L 1 a
1
1,

0 0 0

r
1
U

0 0
L

soRsoGoN
VISAYAS

18

)
1

9
?
1

5.

WESTERN VISAYAS

6
1
n

2 0 0

I
0
L

AKLAN

0 0

ANTIQUE

27

DO No.

zDll-JJlL,

Annex E

"+:ttl

CAPIZ

1
1

0
L

0 0 0

GUIMARAS

I
o 0
2
1

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20ll- llbL,

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DO No. 2011-nUL, Annex E

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31

DO No.

zDll-lllLo

Annex E

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GENERAL SANTOS SULTAN KUDARAT CARAGA

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