OPEN HOUSE

							FOURMULA ONE for Health:
    Gauging Performance After Year One


  an interim F1 Report Card presented by :

  FRANCISCO. T. DUQUE III, MD, MSc.
          Secretary of Health
         Department of Health
Happy 2007!
Welcome to 4th National Staff Meeting !

   Outline of Presentation

       A Season of Milestones :
          F1 Key Accomplishments


       The Challenge Ahead :
         Why we must be better leaders for health


       More Races to Win :
         F1 Targets 2007-2010
A Season of Milestones:
F1 Key Accomplishments

     F1 charted a clear road map for comprehensive health
      sector reforms

     F1 set targets & identified PPAs to plan better for the
      medium- and long-term

     F1 has driven efficiency in the health system through
      budget/corporate/human restructuring

    - Performance-based budgeting for Public Health & Hospitals
    - DOH Budget Restructuring linked with core functions and
      desired organizational outcomes (CY 2008)
    - 100 % Income retention & utilization of hospitals
    - DOH Rationalization Plan
    - Retooling/Retraining of personnel
    - National Human Resource for Health Master Plan
A Season of Milestones:
F1 Key Accomplishments

   F1 has boosted partnerships & stakeholder participation
    at all levels

    - 16 F1 sites are on board with PIPH finalized
    - Effective donor coordination pooled some $530 M worth
      of ODA through SDAH
    - Public –private partnerships have strengthened the
      fight against some priority diseases:
             TB, malaria, filariasis, NCDs, avian flu
    - Inter-sectoral collaboration was forged to tackle concerns with
      obvious impact on health
       *Human Resources for Health
       *Hunger Mitigation Program
       *Sanitation & Safe/sustainable water supply
       *Environmental disasters
A Season of Milestones:
F1 Key Accomplishments

    F1 has enabled us to
     improve health and reach
     the poor more effectively
* Philhealth reached out to 77% of
      total population
    - New benefit packages targeted MDG
      priorities: MCH, TB, malaria,
      HIV/AIDS

* Poor has greater access to low-cost, high-quality medicines
  - 53% of Filipinos now using generics
  - nearly 7,500 Botika ng Barangays are functional nationwide
  - 1,263 Botika ng Bayan (PITC) outlets are now accredited nationwide
  - Parallel importation generated consumer savings up to 82%
 Opinion on the Current Cost of Medicines
 SWS Survey (3rd Quarter 2006)


               Dec 99    Sep 01   Sep 03   Sep 06




Very cheap /    11%       7%      43%      45%
 Somewhat
   cheap


   Very        88%       93%      57%      55%
Expensive /
Somewhat
 expensive
   Type of Medicine Bought in the Past 6 Months
   SWS Survey (3rd Quarter 2006)


TYPE OF MEDICINE         September   September
                           2003        2006
Generics                    39%        44%
Branded                     28%        27%
Both generics/branded       16%        19%

Did not buy medicine        17%        10%
A Season of Milestones:
F1 Key Accomplishments

   And still more strides to improve health…

* TB control effective and sustained
* Benguet, Masbate & Cavite were declared Malaria-Free
* Emerging diseases kept at bay : HIV/AIDS, Bird Flu
* Massive assault vs vaccine preventable diseases (VPD)
 - EPI coverage raised to 84%
 - RP is 13 out of 55 countries with high FIC rate
 - Hepa B vaccine now part of national immunization
* RP Breastfeeding campaign won us local and global
  partners to safeguard maternal and child health

* DOH responded quickly to 21 major disasters/events out of 381
  health emergencies monitored in 2006
A Season of Milestones:
F1 Key Accomplishments

    F1 has ushered in increased transparency
     and accountability of DOH, curbed graft
     and corruption and boosted public
     confidence in the health sector

    - DOH is least corrupt line agency of government (PAGC,
     SWS 2005-2006)

- DOH is #1 government agency in terms of overall
  performance (Pulse Asia, 3rd Quarter 2006)
PAGC : DOH is #1 Government agency
       in fighting corruption
            COMPARATIVE PERFORMANCE RATINGS OF
            SELECTED GOVERNMENT AGENCIES
            Pulse Asia (July 2005-July 2006)
    Selected                 Net Approval Rating                     Undecided
  Gov’t Agencies

                       Jul 05   Oct 05   Mar 06   Jul 06   Jul 05   Oct 05   Mar 06   Jul 06

Supreme Court           +6        +8      +16     +12       28       27       25       24
Senate                  +4        +1       0       0        28       30       32       29
House of Rep            +5         0      +3       0        28       30       31       28

DOH                    +40       +50      +48     +49       15       12       15       12
DSWD                   +46       +53      +57     +49       11       11       12       10
DepEd                  +30       +42      +48     +45       19       17       15       13
DOT                    +9        +22      +22     +22       25       21       23       18
Dept. of Land Reform   ___       ___      ___     +15       __       __       __       22
DOE                     -9       -13      +13     +10       36       39       32       22

CHED                    __        __       __     +32       __       __       __       15
PNP                    +6        +10      +19     +17       29       30       25       24
AFP                    +12       +19      +19     +20       26       25       25       21
MMDA                   +13       +17      +13     +14       24       21       25       21
BIR                    +9         __       __      -6       37       __       __       27
Napocor                -20       -19       -1     +8        43       42       34       25
Comelec                ___       ___      ___      -5       __       __       __       34
PCGG                   ___       ___      ___     +3        __       __       __       23
     The Challenge Ahead
     Why we must be better leaders for health

Good governance
     in health matters.

    And we need to exert even
    more…

   to turn evidence into action
   to make right policy decisions
   to implement health reforms
   to get to our targets
   to win greater political support
   to influence other health players
   to unify health and non-health
    initiatives from other sectors
   to turn promises into better health for all
..……………. More Races to Win




            F1 TARGETS
             2007-2010
                    Target 1
                    Mothers, babies and children at the center of reforms

• RP is on-track to meet
MDG-4 but way off-target                                • Re-think & re-launch
to achieve MDG-5 (lower                                    Safe Motherhood (20th year)
MMR)
                                                        • Facility / human resource
• Get on with what works!                                mapping and needs assessment
- Continuum of MCH
                                                         for CEmOC/ BEmOC facilities
  services important but…

- Focus on intrapartum care                             • Link accreditation of birthing
w/c will lower MMR by 74%                                 clinics to Philhealth
(skilled attendant at birth,
facility-based delivery)                                • Enhance referral networks for
                                                         complicated pregnancies
 - FP services for unplanned
pregnancies will prevent 25-
40% of maternal deaths                                  • Improve maternal behavior to
                                                        avail complete MCH services
- 16 known low-cost essential
interventions will cut IMR by
72%                               Time to make the case…
           - Lancet Series 2005
                                  for improved maternal, newborn and child health
                     More of the same is not enough.
                      Let’s think out of the box
                      …and do our business right!




          Amuasi, J. , from the essay Moving from Combating Disease to Winning Against Disease
                                                          N
                     The Diagonal Approach for M^CH :
Full package of proven high-impact maternal, newborn and child health services that
                      will bridge clinics, hospitals and homes

Strong maternal and child health services will transform the entire health system!
       Target 2
       Universal Social Health Insurance Coverage




• Social health insurance still the driver of reforms in HCF

• Improved collection efficiency

• Wider reach toward the poor and informal sectors

• More interventions, more conditions covered with excellent
  quality and enhanced benefits based on changing needs
  --- e.g. catastrophic cases, NCDs
                  Target 3
                  Medicines for the Masses


     1) Hype promotion of Generics

  2) Unify DOH-PITC efforts to set up
  more BnB outlets nationwide
  (1 BnB : 2 Barangays)

 3) Make the National Drug
 Formulary responsive to prevailing
 needs of local communities

 4) Develop drug benefits/reimbursement
schemes w/ PHIC for commonly used
generics

5) Fast track processing of essential, 6) New National Pharmaceutical
   low cost, high quality               Policy Service to lead in initiatives
   essential drugs (BFAD)               to lower drug prices in the country
                  Target 4
                  Safe and Well Hospitals


• Patient-centered care & patient safety must become a national priority
 and a core agenda to improve quality of care in all hospitals.

• System-wide reforms to protect both patients and doctors from faulty
  systems that promote preventable medical errors

 -  Strengthen hospital Ethics, Grievance & Infection Control Committees
 -  Patient safety programs must be part of requirement for hospital licensing
 -  Sharpen regulatory oversight to enhance compliance to safety/quality standards
 -  Create a nationwide reporting system for alleged medical mishaps and an
     independent Nat’l Grievance Committee to study merit of malpractice reports
  - Open Policy: Disclosure of preventable medical errors to families
                  and compensate patients when necessary
 - Reward/publish high-performing & safe hospitals and/or give sanctions
    to erring ones
             Target 5
             Empowered Local Health Systems


 • Ensure smooth integration
 of reform pillars in
 F1 Convergence sites

   • Revive / strengthen
    ILHZ in non-F1 sites

• CHDs to develop local
health systems plan with LCEs


• Implement the Hospital        • Yearly benchmark reports
 Development Program for         (LGU scorecard) using coverage
 selected LGU hospitals           of essential services as gauge for
 nationwide                       performance and basis for
                                  incentives
                   Target 6
                   Evidence-based Health Reforms

Leadership can bridge the gulf between
            knowledge and action.

• Create a culture of evidence in DOH (KM culture)

• Use available global knowledge goods to advance
  local health
                                                            New Health Information
                                                            Center (former BFAD
• Generate local research/knowledge for
                                                            building) shall be the nerve
  health system transformation                              center of DOH and the
                                                            information hub of the entire
• Strengthen DOH capacity for health research,              health sector
  information management and then translation of research into action through PNHRS

• PHIN / NEC to harmonize fragmented sources of health data (i.e. LGUs, private sector)
  and promote health information sharing

• Document F1 experience as a source of local & global lessons on health reforms
          “Evidence is good for your health system.”
                                      --- Mexican Health Reform Series, Lancet 2006
Perspective of the
DOH Health Info Center (former BFAD)
             Target 7
             Communicate Health Effectively



• Creation of a Speakers’ Bureau

• Step up Health Promotion and advocacy
 campaign for key programs of DOH

Year-round campaigns for the following
programs:
- Dengue                - Generics
- Healthy Lifestyle     - Breastfeeding
- Anti-tobacco campaign - MCH programs

• Development of Health Promotion Foundation

      The goal of effective communication should be
      for listeners to say, "Me, too!" versus "So what?”
                                           -- Jim Rohn
      4th NSM’S Programme
                               F1 National
                             Investment Plan
      Logistics Management                     PIPH Implementation
             Reforms                                & Roll Out


    Procurement
      Reforms
                                                           SDAH


                         GOOD GOVERNANCE

 Financial Asset Mgt./                                  Re-tooling/
Internal Audit Reforms                                Re-training Plan


        Philippine Health                           F1 M & E
       Information System                         + Score Card
                            Accountability &
                         Integrity Development
      Thank you!
… and participate actively
       in the discussions!