Rationalizing the Health Care Delivery System based on Health by stw43683

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									Rationalizing the Health Care
  Delivery System based on
        Health Needs


        National Staff Meeting
          7 September 2006
   Pryce Hotel, Cagayan De Oro City
Rationalization


  Enhances the effectiveness of the health
    care delivery system through
    appropriate placement of health
    providers, facilities and resources
    where best advantage can be derived
    given the demand for health care and
    current health financing system.
How do we design the delivery system
where best advantage can be derived?

    First, we need to know the demand
    for healthcare by doing a health care
    needs analysis. This describes the
    health profile and disease patterns of
    communities. (Scope can be provincial,
    ILHZ or City Government)
    Then we identify the available health
    resources and its capacities.
How do we design the delivery system
where best advantage can be derived?

    Compare findings with DOH
    standards for health outcomes and
    health facilities and professionals.
    These are the goals of rationalization.
    Identify the gaps in attaining these
    standards/goals
    Formulate a strategic plan
        Strategic plan

The strategic plan will tell which elements
in the delivery system should be
maintained, enhanced or changed. These
elements are:
  Facilities including equipment and patient mix
  Manpower, including supply and capability
  Rewards and incentives for personnel
  performance
  Health care processes
       Investment plan

Translate the elements into financial terms
Would the available funds be enough to
attain the targeted health outcomes and
resources?
If not, identify financing alternatives and
other organizational arrangements to
ensure sustainability of the plan
   Approval of the plan

The local Health Board shall endorse
the plan to the local chief executive
Issuance of an ordinance
Support is needed from all
stakeholders (materially affected and
interested parties)
Stakeholder Mobilization

The office of the local health
executive should mobilize the entire
health system to initiate Plan
implementation
Stakeholder analysis, mobilization,
Consultations, public hearings,
agreements.
 Who would help the LGU?

CHDS
 They shall be responsible in the
 implementation of this AO, providing
 technical assistance, and monitoring
 health care delivery systems in their
 coverage area
 Submit Annual Accomplishment Reports
 of their efforts to the BLHD copy
 furnished the Field Implementation
 Coordinating Office (FICO)
 Who would help the LGU?

FICO
  They shall provide oversight functions
 which include monitoring and evaluation
 with the CHDs and development of an
 Annual Situationer of Health Care Delivery
 System in their area. They shall collect and
 act on all issues and concerns related to
 the implementation of this AO and shall
 request for amendments when necessary.
 Who would help the LGU?

NCHFD
 They shall provide the technical assistance
 in developing the rationalization of
 HEALTH CARE FACILITIES.
 In partnership with NCDPC, BLHD, BHFS,
 they shall develop national plans and
 standards, advocacy tools, monitoring and
 evaluation tools, technical assistance
 packages, training modules and regular
 training programs for CHDs, LGUs and
 other stakeholders.
 Who would help the LGU?

NCDPC
 They shall provide the technical assistance
 in developing the rationalization of PUBLIC
 HEALTH SERVICES.
 In partnership with the NCHFD, BLHD and
 BHFS, they shall develop national plans and
 standards, advocacy tools, monitoring and
 evaluation tools, technical assistance
 packages, training modules and regular
 training programs for CHDs, LGUs and
 other stakeholders.
 Who would help the LGU?

BLHD
 They shall ensure
 INSTITUTIONALIZATION of objectives
 of rationalization in local health system
 policies.
 In coordination with NCHFD, NCDPC and
 BHFS, they shall develop national plans and
 standards, technical assistance packages,
 training modules and regular training, for
 CHDs, LGUs and other stakeholders,.
 Who would help the LGU?

BHFS
 Develop regulatory standards for
 health facilities consistent with
 rationalization.
 They shall access compliance of
 health facilities to regulatory
 standards.
 Implementing procedure

The LGU may request for technical assistance
from the DOH –Centers for Health
Development (CHD), for guidance on the
process
The draft Strategic Plan developed for the
health system shall be the basis for
negotiations between stakeholders in the
health system and DOH
The Strategic Plan shall be institutionalized in
all health plans of stakeholders in the health
system (public or private sector).
Implementation of the Plan

Office of the Governor or City Mayor or ILHZ
board – primarily responsible for
implementation
  Lead change initiatives
  Communicating the plan
  Managing the rationalization and strategic
  realignment of annual investments and resources
  Institutionalizing the changes and assessing
  achievement of health care system objectives
OBJECTIVES

  To improve health outcomes, responsiveness and equity
  in the health care delivery system

  To ensure the right and access of every Filipino to
  quality health care services, and with special attention
  to the marginalized sectors of society

  To promote efficient use of health care facilities and
  resources

  To reduce the financial burden of operating and of
  paying for services of health care facilities
Monitoring and Evaluation


   Progress of the implementation plan
   must be monitored by the Province or
   City Health Office or ILHZ
   Monitor extent of achievement of
   objectives of rationalization – DOH-CHD
    THE END
MARAMING SALAMAT
GENERAL GUIDELINES

 Rationalization shall be guided by
 national and local health goals and
 outcomes desired.

 Rationalization shall support the
 autonomy of LGUs to assess and
 develop its healthcare delivery system,
 and the pursuit of LGUs for increasing
 levels of functionality and coordination
 in interlocal health zones (ILHZ).
GENERAL GUIDELINES

 It shall recognize and utilize existing
 relevant    international     and     national
 standards (eg.      Millenium Development
 Goals, National Objectives for Health, DOH
 licensing, Sentrong Sigla Certification, and
 PHIC accreditation standards), and local
 instruments     for   institutionalizing    all
 strategies and agreements (i.e. Local
 Health Boards, Provincial Health and
 Investment     Plans,    Provincial    Health
 Budgets, Resolutions and ordinances, etc.)
GENERAL GUIDELINES


  It shall be done through a participative
 approach, with the LGUs working together
 with all stakeholders, public and private, as
 well as national and local health providers
 within its health system and          health
 referral networks. Agreements shall be
 made through a negotiated process
GENERAL GUIDELINES

 It   is necessarily    a   strategic   and
 developmental process taking place over the
 medium and long term (5-10 year) period.

 Selective development and investments shall
 prioritize development and completion of
 more progressive and cost effective primary
 care facilities, before pursuing completion of
 more complex higher level health care
 facilities.

								
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