Suchergebnisse

Understanding the direct and indirect health consequences of the COVID-19 pandemic is critical in designing a holistic public health response. This study has two objectives. First, we demonstrated the disruption of essential healthcare services using data from selected government facilities. Second, we estimated the productivity losses from direct and indirect health impacts of the pandemic. Validating our earlier study using health insurance claims, our findings showed a sharp decline in admissions and consultations in selected government facilities, particularly among the vulnerable population. Based on our estimates, the long-run costs from productivity losses from direct and indirect health impacts of the pandemic amount to PHP 2.3 trillion (at net present value). Indirect health impacts account for the majority of these costs. Click here to download the discussion paper.

This paper measures Philippine hospitals' management practices and service capability based on their structural inputs. The authors collected a wide range of data on hospital management and service delivery of selected public and private health facilities using a validated online profiling questionnaire. They identified the challenges and limitations that hospitals commonly encounter, particularly in governance and administration and service capacity. The authors recommend systematically collecting healthcare quality indicators and providing incentives and grants to enable the collection, measurement, and submission of data from health facilities.

In 2012, the Philippines passed the Responsible Parenthood and Reproductive Health (RPRH) Act. The law aimed to educate and empower Filipinos to make choices regarding their reproductive health (RH), improve the lives of families, and promote sustainable human development for the nation. Key to realizing this vision, was multisectoral coordination among national government agencies (NGAs), local government units, civil society organizations and multilateral donors. The law is a culmination of efforts among these sectors to provide access to RH services to a country clamoring for greater access to RH information and commodities. Since then, the RPRH Law has expanded RH care all over the country. Unmet need for family planning (FP) methods has continued to shrink, closing the gap with the country's goal of zero unmet need. In the years following the passage of the law, adolescent fertility rate began to decrease from the highest it has been since 1971. Despite these accomplishments, other RH outcomes stagnated or fell behind. In 2015, the country failed to meet its Millennium Development Goals for reducing maternal mortality, lowering HIV/AIDS incidence, and improving child health and nutrition. Moreover, the country's RH outcomes lag behind those of its low-and-middle income neighbors. Given its wide scope, understanding the progress made by the RPRH Law requires an acknowledgement of the many movers that set its machinery in motion. In this paper, we analyzed the governance role played by NGAs to facilitate the implementation of the RPRH Law over the last eight years. We focused on nine components of governance, namely, Organizational Presence, Policy Infrastructure, Financing, Human Resources, Stewardship, Coordination, Monitoring & Evaluation, and Accountability, in their RPRH activities.

This study is a critical analysis of health services purchasing undertaken by the PhilHealth, which implements the National Health Insurance Program of the Philippines. Purchasing is about how an institution should determine, negotiate for, and obtain health services on behalf of a group of people that has contributed resources, either through taxes, premiums, or point-of-service payments, in exchange for anticipated health services.The study employs a principal/agent framework for analyzing three critical relationships: that between the purchaser and health-care providers, between the purchaser and citizens (or members of Philhealth), and between the purchaser and the government, both as regulator and as funder of services, at the national government and local government levels. The study is an analysis of the key alignments and variances of purchasing practices vis-a-vis the "design" and the theoretical ideal in each of the three relationships. To do this, the study employs an extensive document review as well as key informant interviews of decisionmakers and other stakeholders, including PhilHealth management and staff, the Department of Health, provider representatives, and consumer representatives. It is part of a multicountry analysis of purchasing of health services in selected African and Asian health-financing organizations. It also provides key findings and policy implications.

This study summarizes estimates and lessons learned from application of the scaling up nutrition (SUN) methodology to assess public financing for nutrition in Bhutan. Using Bhutan's classification of nutrition interventions, per capita public financing for addressing malnutrition is estimated to be Nu 2,003 (approximately United States (U.S.) 29 dollars, 1 percent of gross domestic product (GDP), and 3 percent of total government expenditures), 30 percent of which was for nutrition-specific activities, and about one-third the level of public spending on health. The level of public spending for nutrition is similar in magnitude - and in the shares across nutrition-specific and nutrition-sensitive interventions - when compared with other developing countries; recent estimates from Asia indicated an average of 2 percent of aggregate government expenditures went toward addressing nutrition, with a 20 percent share for nutrition-specific interventions. Despite the level of spending increasing from Nu 1,744 in financial year (FY) 2013-14, there does not appear to be any increase in priority to nutrition over the course of the 11th five-year plan (FYP): increases in the levels of expenditure for nutrition have resulted from growth of the economy and not because of higher budget allocation to addressing nutrition. The largest nutrition-specific expenditures were those related to the national school feeding program and the largest nutrition-sensitive expenditures were those related to water, sanitation, and hygiene (WASH) programs. Notably, the financing locus for nutrition-related expenditures lies within the Ministry of Education (MoE) and the Ministry of Works and Human Settlement (MoWHS). Although Bhutan defines nutrition-specific and nutrition-sensitive interventions somewhat differently from how they are defined globally, the magnitude of resources allocated toward improving nutrition appears similar to those in other developing countries even when adjusted to enhance global comparability.

The unprecedented coronavirus disease (COVID-19) pandemic is the most challenging public health crisis the world has faced in a century. It has overwhelmed global and national health service and disaster management infrastructure and brought economies to a standstill/halt. It serves as both an eye-opener and an impetus to leapfrog reforms to strengthen governance systems and structures. It propels us to innovate and install more forward-looking systems and strategies that will enable us to permanently gain the capacity to survive and win over multiple and complex challenges that we face now and in the future. In the public sector, the pandemic shows the importance of having harmonization and synergy between and among national government agencies and sub-national governments. It has illustrated the importance of investing in digital education, e-commerce, and innovative ways of delivering social protection as well as fostering business innovations to meet fast-changing demand. The literature discusses quite a number of public sector innovations particularly in developed countries and the approaches are combinations of various governance methods, with styles varying depending on the context. Yet on the overall, the public sector has very few models for innovation. This background paper briefly scans the recent literature of public sector innovations and other efforts implemented in the strengthening of governance systems. The goal is to gather insights that may be useful for the Philippines case for enhancing its governance strategies, improving overall performance in service delivery, and building resilience against risks in the long-term.

One of the major challenges in the Philippine health sector is to secure adequacy of appropriate health facilities. To address this problem, the Health Facilities Enhancement Program (HFEP) was implemented by the Department of Health (DOH) in 2007. Specifically, HFEP aims to improve facilities such as health centers and barangay health stations to sufficiently provide for emergency and primary care services. It also aims to upgrade government hospitals. This study examines the implementation of the program and probes at the rationale for the selection of facilities for upgrading. It lays out policy options to improve equity and efficiency in allocation of funds.

As a recognition of the valuable role of private sector in the healthcare delivery system, this paper attempts to collate vital information on private hospitals in the Philippines. This paper looks at the different characteristics and structures of private hospitals sector with regard to geographical distribution, services, financing, human resource, and other information needed by policymakers, investors, and other interested stakeholders. To better understand the current health care delivery system in the country, other sections compare private hospitals vis-a-vis government-owned facilities.

The study identifies outstanding issues and bottlenecks and provides recommendations to facilitate the Philippines' full compliance to its commitments to the ASEAN Economic Community (AEC). Various in-depth interviews and surveys were conducted with concerned stakeholders from government agencies and the private sector to bring to fore the issues and bottlenecks for policymakers' action. Although its focus is mainly on services and investment liberalization, this study also tracks policy changes in trade facilitation, nontariff measures, standards and conformance, and mutual recognition arrangements after the release of the 2010/2011 AEC Scorecard Reports.