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Supply-Side Readiness of Primary Health Care in the Philippines

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Supply-Side Readiness of Primary Health Care in the Philippines Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Health CareinthePhilippines ofPrimary Supply-Side Readiness SUPPLY-SIDE READINESS OF PRIMARY HEALTH CARE IN THE PHILIPPINES 1 Acknowledgements This report was prepared as part of the analytical and advisory support provided by the World Bank to the Government of the Philippines. The report has been prepared by a team consisting of members from the World Bank’s Philippines Health, Nutrition, and Population Team (Tomo Morimoto, Roberto Rosadia, Chantelle Boudreaux, and Vida Gomez) and the Korean Development Institute School (Ha Kyeong Lee). The authors would like to thank the following World Bank staff for their contributions to the report: Damien de Walque, Mickey Chopra and Ajay Tandon as peer reviewers; Caryn Bredenkamp, Rouselle Lavado, Robert Oelrichs, Shuo Zhang and Gabriel Demombynes for advice to the team; and Regina Calzado for copy editing. The report was prepared under the overall guidance of Toomas Palu (Practice Manager for Health, Nutrition and Population). In addition, inputs received from Professor Juhwan Oh of the Seoul National University College of Medicine as peer reviewer is gratefully acknowledged. The authors are especially grateful for the advice and comments received from the Department of Health (DOH) and the Philippine Health Insurance Corporation (PhilHealth). In particular, we would like to thank the DOH’s Disease Prevention and Control Bureau, Health Facilities Services and Regulatory Bureau, Knowledge Management and information Technology Service, Health Policy Development and Planning Bureau, and Bureau of International Health Cooperation; and PhilHealth’s Health Finance Policy Sector, Quality Assurance Group, Standards and Monitoring Department, Accreditation Department, MDG Team, and Primary Care Benefit Team. The team acknowledges the generous contribution by the Strategic Impact Evaluation Fund and KDI School of Public Policy and Management to the baseline study on the implementation of PhilHealth’s Primary Care Benefit Package, since this report relies on data originally collected for this purpose. SUPPLY-SIDE READINESS OF PRIMARY HEALTH CARE IN THE PHILIPPINES 2 Table of Contents Acknowledgements ................................................................................................................................ 2 Table of Contents ..................................................................................................................................... 3 Acronyms .................................................................................................................................................... 6 Executive Summary ................................................................................................................................ 9 I. Introduction .................................................................................................................................. 13 II. Analytical Approach ................................................................................................................... 21 Data .................................................................................................................................................................................. 21 Methods .......................................................................................................................................................................... 22 III. Findings .......................................................................................................................................... 25 1. General Service Readiness .......................................................................................................................... 25 2. Maternal and Child Health ......................................................................................................................... 45 ǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤAntenatal Care................................................................................................................................................46ǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤError! Bookmark not defined. ǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤͷʹ ǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤͷ͸ ǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤ͸ʹ 3. Noncommunicable Diseases (NCD) Prevention and Treatment ............................................... 68 ǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤ͸ͻ ǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤ͹ʹ ǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤ͹͹ ǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤǤͺͲ 4. Tuberculosis ...................................................................................................................................................... 83 5. Variations in Service Readiness ............................................................................................................... 86 IV. Discussion, Limitations, and Areas for Further Work ................................................... 97 References............................................................................................................................................. 101 Annexes .................................................................................................................................................. 103 V.Annex Annex 1: Standards 1: Standards for Accreditation for Accreditation of PhilHealth’s of PhilHealth’s PCB PackagePCB Package Providers; Providers; Diagnostic and ServServiceice AvailaAvailability.............................................................................................103bility ............................................................................................. 103 VI.Annex Annex 2: Standards 2: Standards for Accreditation for Accreditation of PhilHealth’s of PhilHealth’s PCB PackagePCB Package Providers; Providers; Infrastructure and SuppliesSupplies Requirements .............................................................................. .............................................................................104 104 VII.Annex .......................................................................................................................... 3: RHU Personnel.................................................................................................................105.................................. 105 VIII.Annex 4:Annex Provinces 3: RHU and Personnel Municipalities .................................................................................................... Included In This Survey ......................................105 106 IX.Annex Annex 5: Indicators 4: Provinces in WHO and SARA Municipaliti Guidelineses Included and National In This Guidelines, Survey............................. and Data 107 Availability...........................................................................................................................................107 X. Annex 5: Indicators in WHO SARA Guidelines and National Guidelines, and Data Availability ............................................................................................................................................ 113 6833/<6,'(5($',1(662)35,0$5<+($/7+&$5(,17+(3+,/,33,1(6 Tables Table 1. Top causes of YLL due to premature mortality in the Philippines, 1990 and 2013 ........................................................................................................................................... 14 Table 2. Contents of the PCB Package ............................................................................. 16 Table 3. Details of LGU income classification at the municipality level ......................... 24 Table 4. General service readiness tracer indicators: SARA and from survey ................. 25 Table 5. General service readiness score by LGU income classification ......................... 32 Table 6. General service readiness score by region .......................................................... 33 Table 7. RHU personnel compared with PCB requirements (left) and DOH national requirements (right) .......................................................................................................... 40 Table 8. RHU and DOH-deployed personnel, average by region .................................... 43 Table 9. RHU and DOH-deployed personnel by LGU income class ............................... 43 Table 10. Access to maternal health services, 2014a ........................................................ 46 Table 11. ANC tracer indicators: SARA guidelines and indicators used for assessment . 47 Table 12. ANC service readiness score by LGU income classification ........................... 51 Table 13. ANC service readiness score by region ...........................................................
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