The presentation was shown during the Healthy People, Wealthy Nation Forum last January 29, 2014.

1. The
Philippine
Health
Situa/on:
How
do
we
promote
health
and
prevent
diseases
under
the
Aquino
Health
Agenda?
Teodoro
J.
Herbosa,
MD,
FPCS
Undersecretary
Department
of
Health,
Philippines

2. Outline
• NCD
Philippine
Health
Situa<on
• Universal
Health
Care
• NCD
Strategic
Framework
• Accomplishment
on
NCD
Preven<on
and
Control
by
UHC
Pillars
• Why
Health
Promo<on?
• Priori<es
for
Ac<on
01/28/14
Healthy
People,
Wealthy
Na<on:
A
Forum
on
Achieving
Growth
2

3. PHILIPPINE
SETTING:
Top
Ten
Causes
of
Mortality
Cause
Total
Rate
1.
Diseases
of
the
heart
70,
861
84.8
2.
Diseases
of
the
vascular
system
51,680
61.8
3.
Malignant
Neoplasms
40,524
48.9
4.
Accidents
34,483
41.3
5.
Pneumonia
32,098
38.4
6.
Tuberculosis
26,770
31.0
7.
Unclassified
21,278
25.5
8.
Chronic
lower
respiratory
diseases
18,975
22.7
9.
Diabetes
mellitus
16,552
19.8
10.
Condi/ons
origina/ng
from
the
perinatal
period
13,180
15.8
Philippine
Sta<s<cal
Yearbook,
2009

4. 01/28/14
Source:
Philippine
Health
Sta2s2cs,
2009
4

5. Prevalence
of
hypertension,
hyperglycemia,
dyslipidemia
&
overweight
1998,
2003
and
2008
Philippine
NNS,
FNRI
1998
2003
2008
Basis
Hypertension
21.0
22.5
25.3
SBP
≥
140,
DBP
≥
90
Hyperglycemia
3.9
3.4
4.8
FBS
>
126
mg/dL
Total
cholesterol
4.0
8.5
10.2
≥
240
mg/dL
LDL-­‐c
8.1
11.7
11.8
≥
160
mg/dL
HDL-­‐c
76.6
54.2
64.1
<
40
mg/dL
Triglycerides
8.7
9.4
14.6
≥
200
mg/dL
BMI
(Overweight)
20.2
24.0
26.6
BMI
≥
25.0
Risk
factors
01/28/14
5

6. ADULT
CURRENT
SMOKERS
(15
years
old
and
above)
•
28.3%
of
total
adults
(17.3M)
•
47.7%
of
adult
males
(14.6M)
•
9.0%
of
adult
females
(
2.8M)
SOURCE:
Philippines’
Global
Adult
Tobacco
Survey,
2009
01/28/14
6

7. YOUTH
CURRENT
SMOKERS
(13
-­‐
15
years
old)
•
27.4%
currently
use
any
tobacco
product
(M-­‐34.7%;
F-­‐19.6%)
•
More
than
1
in
5
students
(21.9%)
currently
smoke
cigarefes
•
Almost
1
in
10
(9.7%)
currently
use
some
other
form
of
tobacco
•
Over
half
(57.7%)
of
students
live
in
homes
where
others
smoke
SOURCE:
Philippines’
Global
Youth
Tobacco
Survey,
2007
01/28/14
7

8. Universal
Health
Care
Deliberate
aHen2on
to
the
needs
of
millions
of
poor
Filipino
families
which
comprise
the
majority
of
our
popula2on

9. Filipino
Income
Quin/les
Monthly
income
Families
per
quin<le
Q1
3,460
5,218,267
Q2
6,073
4,094,164
Q3
9,309
3,912,443
Q4
15,064
3,707,494
Q5
38,065
3,485,067
Source:
Na2onal
Health
and
Demographic
Survey,
2008

10. Universal
Health
Care
Beaer
health
outcomes
Health
Financing
Service
Delivery
Responsive
health
system
Policy,
standards
and
regula<on
Health
Human
Resource
Equitable
health
financing
Health
Informa<on
Governance
for
Health

11. Major
Elements
of
UHC
• Addresses:
Quality,
Responsiveness,
Availability
&
Accessibility
• Focuses:
Elimina<ng
dispari<es
(equity)
&
inefficiencies
(governance)
• Guiding
principle:
Providing
essen<al
health
care
packages
to
all
regardless
of
age,
gender,
religion,
ethnicity,
socio-­‐economic
status,
ideology,
etc.
Reference:
A.O.
2010-­‐0036:
Aquino
Health
Agenda

12. OVERVIEW ON NCDS
There are 4 Major NCDs (LRDs) and
4 common shared related risk factors
Modifiable
causa/ve
risk
factors
Tobacco
use
Unhealthy
diets
Physical
inac/vity
Harmful
use
of
alcohol
Cardiovascular
disease
"
"
"
"
Diabetes
"
"
"
"
Cancer
"
"
"
"
Chronic
respiratory
disease
"
01/28/14
12

13. NCD-­‐Regional
Ac/on
Plan
Strategic
approach
and
ac/on
areas
01/28/14
Healthy
People,
Wealthy
Na<on:
A
Forum
on
Achieving
Growth
13

14. Accomplishment
on
NCD
Preven<on
and
Control
by
UHC
Pillars
01/28/14
Healthy
People,
Wealthy
Na<on:
A
Forum
on
Achieving
Growth
14

15. Health
Financing
• Primary
Care
Benefit
Packages
(PCB):
a.
PCB
1
–
consulta<on,
screening
and
diagnos<cs
for
NCDs
i.e.
Visual
Inspec<on
Using
Ace<c
Acid
Wash
(VIA)
b.
PCB
2
-­‐
management
and
provision
of
medica<ons
for
NCDs
i.e.
Complete
Treatment
Packs
for
DM
and
HPN
• Z
Packages
for
catastrophic
illnesses
i.e.
breast
cancer
and
ALL
• Case
payment
rates
for
asthma
and
essen<al
hypertension

16. Service
delivery
• School-­‐based
HPV
Vaccina<on
Demonstra<on
Project
(8,000
Gr
5
females
aged
10-­‐14
y.o.
in
selected
public
schools
given
the
1st
and
2nd
dose
of
HPV
vaccines)
• Complete
Treatment
Packages
(ComPack)
Drugs
-­‐
Na<onal
Center
for
Pharmaceu<cal
Access
and
Management
(NCPAM)

17. Policy,
Standards
and
Regula/on
A.
LEGISLATION
•
Passage
of
Sin
Tax
Law
•
Philhealth
Law
amendments
B.
POLICIES
AO
No.
2013
–
0005
or
The
Na2onal
Policy
on
the
Unified
Registry
Systems
of
the
Department
of
Health
(Chronic
Non-­‐
communicable
Diseases,
Injury
Related
Cases,
Persons
with
Disabili2es,
and
Violence
Against
Women
and
Children
Registry
Systems)
•
AO
No.
2012-­‐0029
or
The
Implemen2ng
Guidelines
on
the
Ins2tu2onaliza2on
of
Philippine
Package
of
Essen2al
NCD
Interven2ons
(PhilPEN)
on
the
Integrated
Management
of
Hypertension
and
Diabetes
for
Primary
Health
Care
Facili2es

18. Policy,
Standards
and
Regula/on
AO
No.
2011-­‐0003
or
The
Na2onal
policy
on
Strengthening
the
Preven2on
and
Control
of
Chronic
Lifestyle
Related
Non-­‐Communicable
Diseases
•
AO
No.
2011-­‐0013
or
Implemen2ng
Guidelines
on
the
DOH
Complete
Treatment
Pack
(COMPACK)
to
Ensure
Sustainable
Access
to
Essen2al
Drugs
and
Medicines
for
the
Marginalized
sector
•
AO
No.
2010
–
0036
or
The
Aquino
Health
Agenda:
Achieving
Universal
Health
Care
for
all
Filipinos

19. Policy,
Standards
and
Regula/on
C.
Standards
• On-­‐going
Development
of
Clinical
Pathways:
1.
2.
3.
4.
5.
Cardiovascular
Disease
Diabetes
Cancer
–
breast,
cervical,
prostate
and
colorectal
Chronic
Respiratory
Disease
–
COPD
and
asthma
Eye
Care
• Development
of
training
module
on
cervical
cancer
preven<on
and
control
to
include
visual
inspec<on
of
the
cervix
using
ace<c
acid
wash
(VIA)

20. Human
Resource
• Trained
43
service
providers
on
VIA
• Training
of
trainers
of
selected
medical
staff
from
Cotabato
Regional
Hospital
on
VIA

21. Human
Resource
• Conducted
trainings
on
Smoking
Cessa<on
to
16
CHDs,
51
DOH
hospitals
and
other
agencies
• Integra<on
of
Smoking
Cessa<on
in
other
health
programs
and
advocacies
such
as
in
Fitness
Camps
and
Belly
Gud
for
Health

22. Human
Resource
• Conduct
of
TOT
and
provision
of
technical
assistance
for
CHD
roll-­‐
out
trainings
on
Philippine
Package
of
Essen<al
Non-­‐
communicable
Diseases
for
Low
Resource
Seqngs
(PhilPEN)

23. %
Coverage
on
PhilPEN
Trainings
Conducted
by
CHDs
as
of
December
2013
01/28/14
23

24. Propor/on
of
Health
Personnel
Trained
on
PhilPEN-­‐Na/onal
Coverage,
As
of
December
2013
01/28/14
Status
of
PhilPEN
Implementa<on
24

25. Governance
for
Health:
Leadership
and
Stewardship
DOH
Responsible
Office
Focus
Area
Strategies
and
Key
Ac/on
Points
Lifestyle-­‐related
NCDs
Strengthening
health
system
response
to
NCDs
NCDPC
Behavioral
risk
factors
Priori<zing
key
behavioral
interven<ons
NCHP
Raising
the
priority
for
Social
determinants
mul<-­‐sectoral
ac<on
HPDPB
BLHD

26. Health
Informa/on
• Inclusion
of
indicator
in
the
KP
dashboard;
and
• Inclusion
of
indicator
in
the
LGU
scorecard
• Oriented
98
Health
Facili<es
on
Unified
Registry
System
(URS)
for
NCDs:
61
DOH
Hospitals;
14
LGU
hospitals;
23
private
head
of
medical
records
and
IT/Encoders
• Oriented
135
health
facili<es
on
URS

27. Other
Ini<a<ves
• 6-­‐year
Strategic
Plan
and
Communica<on
Plan
for
NCD
• ASEAN
Regional
Forum
on
Non-­‐Communicable
Diseases
(NCDs),
October
2013
• ASEAN
Task
Force
Mee<ng
on
NCDs,
October
2013
• Southeast
Asia
Cancer
Control
Leadership
Forum,
April
2014
01/28/14
27

28. Highlights
of
the
ASEAN
Regional
NCD
Forum
• Global
Ac<on
Plan:
Roadmap
for
Addressing
NCDs
in
the
next
decade
• ASEAN
Health
Coopera<on
in
NCDs
• Addressing
the
Risk
Factors
of
NCDs:
Innova<ons
and
Sharing
of
Experiences
• Presenta<on
of
the
ASEAN
declara<on
on
NCDs
01/28/14
Healthy
People,
Wealthy
Na<on:
A
Forum
on
Achieving
Growth
28

29. WHY
HEALTH
PROMOTION?
01/28/14
Healthy
People,
Wealthy
Na<on:
A
Forum
on
Achieving
Growth
29

30. HEALTH
PROMOTION
is
the
first
step
to
disease
preven<on.
It
must
start
with
people
who
are
basically
healthy
by
enhancing
behaviors
that
promote
well-­‐being
and
strengthening
community
measures
and
individual
lifestyles
for
the
maintenance
of
good
health.

31. WHY
PROMOTE
HEALTH?
•
Preven<on
is
befer
than
cure.
•
Studies
show
that
people
are
becoming
increasing
interested
in
improving
their
health
through
lifestyle
changes.
•
Elimina<ng
a
few
lifestyle
risks
could
immediately
improve
quality
of
life
and
prevent
life-­‐threatening
diseases.

32. What
will
Health
Promo/on
Contribute
to
KP
 Develop
Priority
Health
Messages
for
Delivery
of
Community
Health
Teams
 Promote
Services
of
Health
Facili<es
like
Facility-­‐
Based
Delivery
 PHILHEALTH
SABADO
to
promote
enrolment
to
PHILHEALTH’s
various
programs
 Health
Promo<on
Component
of
Programs
to
achieve
MDG
Max
i.e.
Lifestyle
Promo<on
to
prevent
NCDs

33. Some Health Promotion Activities…
•
LAKBAY
BUHAY
KALUSUGAN
KALUSUGAN
PANGKALAHATAN
ON
WHEELS
-­‐
1
Victory
Liner-­‐donated
Bus
-­‐
Transforma<on
of
8
China-­‐donated
Mobile
Clinic
buses
to
LBK-­‐KP

34. Incidentally…
Lakbay
Buhay
Kalusugan
is
one
of
the
recipients
of
the
Na<onal
Economic
and
Development
Authority's
Good
Prac/ce
Awards
2012

35. NCHP is the NATIONAL TOBACCO
CONTROL COORDINATING OFFICE
of the DOH
- Oversee the implementation of the
National Tobacco Control Strategy
- Convenorship of the Sector-Wide
Anti- Tobacco (SWAT) Committees
- Establishment of Regional Tobacco
Control Committees/Networks

36. HEALTHY
LIFESTYLE
PROGRAM
is
now
lodged
at
the
NCHP
-­‐
Development
of
Program
Policy,
Strategic
Plan,
Manual
of
Opera<ons,
Communica<on
Plan
-­‐
Focus
on
4
Behavioral
Risk
Factors
1)
Smoking
2)
Harmful
Use
of
Alcohol
3)
Physical
Inac<vity
4)
Unhealthy
Diet
-­‐
Co-­‐Convenorship
of
the
Philippine
Coali<on
for
the
Preven<on
and
Control
of
Non-­‐Communicable
Diseases
(NCD
Coali<on)

37. Food
Labeling
/
Healthy
Food
Op/ons
advocacy
programs
-­‐
Health
in
All
Policy
-­‐
Front-­‐of-­‐Pack
Labeling
(Salt
Reduc<on)
-­‐
Healthy
School
Canteen
-­‐
Review
of
the
ASIN
Law

38. DANCE
FOR
HEALTH
-­‐
Belly
Gud
for
Health
(Waist
Circumference
Reduc<on
in
the
Workplace)
-­‐
Galaw
Galaw
Araw
Araw
Exercise
Video
-­‐
Banat
ni
Lolo,
Hirit
ni
Lola
Exercise
Video

39. •
AKSYON
PAPUTOK
INJURY
REDUCTION
-­‐
Convenorship
of
a
Mul<-­‐
sector
-­‐
Technical
Working
Group
for
Policy
and
Campaign
Development

40. NCHP Awards
-­‐
DOH
Red
Orchid
Awards
(cash
prizes
limited
to
LGUs
only)
-­‐
Biennial
Outstanding
Healthy
Lifestyle
Advocacy
Awards
(6
categories:
LGU
City,
LGU
Municipality,
Workplace,
Academe,
Business
Establishment,
NGO/
Professional
Organiza<on)
COMING
SOON
-­‐
Parangal
sa
mga
Kuwentong
Kalusugan
Pangkalahatan
health
media
recogni<on

41. National Center for Health Promotion
NCHP
is
the
Department
of
Health’s
arm
in
promo<ng
health
in
seqngs
where
people
live,
work,
learn
and
play.

42.
Challenges
• Ensure
PhilPEN
implementa<on
up
to
the
grass-­‐roots
level
• Iden<fica<on
and
accredita<on
of
DOH
Hospitals
as
training
ins<tu<ons
on
VIA
• Ins<tu<onaliza<on
of
Belly
Gud
for
Health
and
expansion
to
other
na<onal
government
agencies

43.
Priori/es
for
Ac/on
• Afain
CHD
and
LGU
scorecard
targets
• Regular
submission
of
senior
ci<zens
vaccines
u<liza<on
reports
• Availability
of
cold
chain
facili<es
for
senior
ci<zens
(HWSC)
vaccines
• Designa<on
of
dedicated
and
commifed
coordinators
for
NCDs
and
HWSC

44. Priori<es
for
Ac<on
 Identify and set critical Health Promotion Outputs
and Outcomes at various levels (National,
Regional, Local)
 Develop a Certification Program for Health
Promotion Specialist
 Learn from the success of Multisectoral
Coordination on Tobacco Control
 Develop Health Promotion Templates for Local
Government Units and other Partners for
inclusion to PIPH and CIPH
 Access funds like sin tax, environment tax, road
users tax to promote health and safety
01/28/14
44

45. Health Promotion & ISO 9001:2008
In
the
pursuit
to
con/nuously
improve,
meet,
and
even
exceed
people’s
expecta/ons
of
a
QUALITY
MANAGEMENT
SYSTEM
that
enhances
health
care
service
delivery...