scholarly journals Addressing Primary Care Inequities in Underserved Areas of the Philippines: A Review

2020 ◽  
Vol 54 (6) ◽  
Author(s):  
Marianne Joy N. Naria-Maritana ◽  
Gabriel R. Borlongan ◽  
Ma-Ann M. Zarsuelo ◽  
Ara Karizza G. Buan ◽  
Frances Karen A. Nuestro ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Workers ◽  
Human Resources For Health ◽  
The Philippines ◽  
Universal Health Care ◽  
Publication Date ◽  
Quality Health Care ◽  
The Government ◽  
Universal Health

Background. Inequities in health care exist in the Philippines due to various modifiable and non-modifiable determinants. Through the years, different interventions were undertaken by the government and various stakeholders to address these inequities in primary care. However, inequities still continue to persist. The enactment of the Universal Health Care (UHC) Act aims to ensure that every Filipino will have equitable access to comprehensive and quality health care services by strengthening primary care. As a step towards UHC, the government endeavors to guarantee equity by prioritizing assistance and support to underserved areas in the country. This paper aims to review different interventions to promote equity in the underserved areas that could aid in needs assessment. Methods. A search through PUBMED and Google Scholar was conducted using the keywords, “inequity,” “primary care” and “Philippines.” The search yielded more than 10,000 articles which were further filtered to publication date, relevance to the topic, and credibility of source. A total of 58 full-text records were included in the review. Results and Discussion. In the Philippines, inequities in primary care exist in the context of health programs, facilities, human health resources, finances, and training. These were recognized by various stakeholders, from government and private sector, and nongovernment organizations, taking actions to address inequities, applying different strategies and approaches but with a shared goal of improving primary care. On another end, social accountability must also be instilled among Filipinos to address identified social and behavioral barriers in seeking primary care. With political commitment, improvement in primary care towards health equity can be achieved. Conclusion and Recommendation. To address inequities in primary care, there is a need to ensure adequate human resources for health, facilities, supplies such as medications, vaccination, clean water, and sources of funds. Moreover, regular conduct of training on healthcare services and delivery are needed. These will capacitate health workers and government leaders with continuous advancement in knowledge and skills, to be effective providers of primary care. Institutionalizing advocacy in equity through policies in healthcare provision would help realize the aims of the Universal Health Care Act.

Catholic Church Advocacy and the Affordable Care Act

2019 ◽  
Author(s):  
Jeanine Kraybill
Keyword(s):  
United States ◽  
Health Care ◽  
Affordable Care Act ◽  
Catholic Church ◽  
Health Care Policy ◽  
Common Ground ◽  
The United States ◽  
Universal Health Care ◽  
The Government ◽  
Universal Health

The American Catholic Church has a long history in health care. At the turn of 19th century, Catholic nuns began developing the United States’ first hospital and health care systems, amassing a high level of professionalization and expertise in the field. The bishops also have a well-established record advocating for healthcare, stemming back to 1919 with the Bishops’ Program for Social Reconstruction, which called for affordable and comprehensive care, particularly for the poor and vulnerable. Moving into the latter part of the 20th century, the bishops continued to push for health care reform. However, in the aftermath of Roe v. Wade (1973), the American bishops insisted that any reform or form of universal health care be consistent with the Church’s teaching against abortion, contraception, and euthanasia. The bishops were also adamant that health care policy respect religious liberty and freedom of conscience. In 1993, these concerns caused the bishops to pull their support for the Clinton Administration’s Health Security Act, since the bill covered abortion as a medical and pregnancy-related service. The debate over health care in the 1990s served as a precursor for the United States Conference of Catholic Bishops’ (USCCB) opposition to the Obama Administration’s Affordable Care Act (ACA) and the Department of Health and Human Services’ (HHS) contraception mandate. The ACA also highlighted a divide within the Church on health care among religious leaders. For example, progressive female religious leadership organizations, such as the Leadership Conference of Women Religious (LCWR) and their affiliate NETWORK (a Catholic social justice lobby), took a different position than the bishops and supported the ACA, believing it had enough protections against federally funded abortion. Though some argue this divide lead to institutional scrutiny of the sisters affiliated with the LCWR and NETWORK, both the bishops and the nuns have held common ground on lobbying the government for affordable, comprehensive, and universal health care.

scholarly journals A Call for an Evidence-informed Criteria Selection to Guide Equitable Health Investments in the Era of Universal Health Care: Policy Analysis

2020 ◽  
Vol 54 (6) ◽  
Author(s):  
Ma. Esmeralda C. Silva ◽  
Ma-Ann M. Zarsuelo ◽  
Marianne Joy N. Naria-Maritana ◽  
Zenith D. Zordilla ◽  
Hilton Y. Lam ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
The Philippines ◽  
Population Characteristics ◽  
Integrated Analysis ◽  
Universal Health Care ◽  
Investment Planning ◽  
Geographic Population ◽  
Health Investments ◽  
Universal Health

Background. The passage of the Universal Health Care (UHC) Act in the Philippines in early 2019 intensified the need to ensure equitable health investments by the government. Exploring the different criteria and indicators that are used to determine areas that are most in need of health services can help local and national health authorities determine priorities for health investments given finite resources. Methods. A systematic review of literature on determinants of health equity and other indicators was conducted as pre-work to generate discussion points to the roundtable discussion participated by all major key stakeholders. Shared insights and expertise were thematically analyzed to produce a policy paper with consensus policy recommendations. Results. Based on the review of the literature and the discussion, indicators (mainly physical inaccessibility and socio-economic factors) for identifying Geographically Isolated and Disadvantaged Areas (GIDA) in DOH Administrative Order 185, s. 2004 is used to prioritize municipalities for health investments. Review of other policies and guidelines to determine the level of health needs and prioritizing investments yielded to four laddered domains: geographic, population characteristics (e.g., social and cultural determinants of access), health system (e.g., health service delivery), and health status. These domains may provide a more equitable set of metrics for health investment. The Local Investment Plan for Health (LIPH) is the current process used for health-related investments at the local level and may be revised to be more responsive to the requirements set by the UHC Act 2018. Hot spotting to concentrate health services by communities may be a more rapid approach to investment planning for health. Bed capacity as a specific metric in the UHC Act 2018 highlights the need for a review of the Hospital Licensure Act 2004. Conclusion and Recommendations. To aid in determining priorities for health investments, a comprehensive integrated analysis of resources, determinants, and indicators should be done to determine the need and the gaps in the available resources. Innovative strategies can also be best implemented such as mathematical models or formulas. Lastly, current strategies in the development, monitoring, and evaluation of investment planning for health at different levels should be strengthened, expanded, and harmonized with other existing development plans.

Global Human Resources for Health: Ethical Aspects

2019 ◽  
pp. 126-143
Author(s):  
George W. Pariyo ◽  
Henry Lucas
Keyword(s):  
Health Care ◽  
Labor Market ◽  
Human Resources ◽  
Ethical Issues ◽  
Health Workers ◽  
Human Resources For Health ◽  
Quality Health Care ◽  
International Labor ◽  
Quality Health ◽  
Push And Pull

This chapter highlights the main ethical issues that arise in addressing the challenges of global human resources for health (HRH). It includes a brief overview of global HRH problems including shortages and poor working conditions that lead to pressures on the international labor market for health workers, as well as strategies that countries and the global community have taken to mitigate them. The main ethical issues that arise in dealing with global HRH are presented. These include equity of access to quality health care, implications of public versus private health care provision, privacy and confidentiality, fairness to health workers in personnel policies and practices, and managing the push and pull factors in the labor market that lead to the pressure for international migration of health personnel. The chapter highlights existing global conventions that could help governments and other policymakers to alleviate these challenges in a more ethically responsible way.

scholarly journals The Quality of Primary Care in a Country with Universal Health Care Coverage

2011 ◽  
Vol 26 (7) ◽  
pp. 724-730 ◽  
Author(s):  
Tinh-Hai Collet ◽  
Sophie Salamin ◽  
Lukas Zimmerli ◽  
Eve A. Kerr ◽  
Carole Clair ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Universal Health Care ◽  
Health Care Coverage ◽  
Quality Of Primary Care ◽  
Universal Health Care Coverage ◽  
Universal Health

scholarly journals Community health workers for universal health-care coverage: from fragmentation to synergy

2013 ◽  
Vol 91 (11) ◽  
pp. 847-852 ◽  
Author(s):  
Kate Tulenko ◽  
Sigrun Møgedal ◽  
Muhammad Mahmood Afzal ◽  
Diana Frymus ◽  
Adetokunbo Oshin ◽  
...  
Keyword(s):  
Health Care ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Universal Health Care ◽  
Health Care Coverage ◽  
Universal Health Care Coverage ◽  
Universal Health

scholarly journals Policy Analysis on Establishing Criteria for Population versus Individual-based Health Services towards Achieving Universal Health Care

2020 ◽  
Vol 54 (6) ◽  
Author(s):  
Leonardo R. Estacio Jr. ◽  
Ma-Ann M. Zarsuelo ◽  
Christine Mae S. Avila ◽  
Ma. Esmeralda C. Silva ◽  
Michael Antonio F. Mendoza ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Service Delivery ◽  
Policy Development ◽  
Supply And Demand ◽  
Policy Issue ◽  
Population Based ◽  
The Philippines ◽  
Universal Health Care ◽  
Universal Health

Background. The enactment of the Universal Health Care Act is anticipated to bring wider coverage and accessibility of quality healthcare services as stipulated in its objectives. With the integration of the healthcare system at the provincial level, determining population- and individual-based services is crucial in mapping the managerial and financial roles. Hence, this study aimed to establish the criteria for identifying population-based and individual-based health services in the Philippines. Methods. A systematic review of literature was conducted to generate evidence for the policy brief and discussion points on the roundtable discussion spearheaded by the UP Manila Health Policy Development Hub in collaboration with the Department of Health. Key stakeholders of the policy issue convened to share expertise and insights in determining criteria for population- and individual-based services, intending to generate consensus policy recommendations. Results. The general scope of individual-based health services stipulated in the Law are to be financed under the benefit packages of PHIC and HMOs. Meanwhile, population-based services are those that address public health issues such as health promotion and disease surveillance. Several services considered as ‘grey areas’ are those that fall in the overlap of the individual- and population-based services. These services may be examined through an outcome-based algorithm that examines fragmentation issues both in the supply and demand side of service delivery. Conclusion and Recommendation. Proposed criteria in identifying individual- and population-based services include the number of recipient/s, the effectivity of service delivery and utilization, and source of funding. Health programs that are in the grey areas can be examined through an outcome-based algorithm.

scholarly journals In search of universal health coverage – highlighting the accessibility of health care to students with disabilities in Ghana: a qualitative study

2020 ◽  
Author(s):  
Eric Abodey ◽  
Irene Vanderpuye ◽  
Isaac Mensah ◽  
Eric Badu
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Students With Disabilities ◽  
Universal Health Coverage ◽  
Access To Health Care ◽  
Health Workers ◽  
Policy Formulation ◽  
Health Coverage ◽  
The Government ◽  
Universal Health

Abstract Background: Accessibility of health care to students with disabilities is a global concern. This is no less important in Ghana, however, to date, no study has been undertaken regarding access to health care to students with disabilities. This study, therefore, aims to explore the accessibility of health care to students with disabilities, in the quest of achieving universal health coverage in Ghana. Methods: Qualitative methods, involving in-depth interviews were employed to collect data from 54 participants (29 students with disabilities, 17 health workers and 8 school mothers), selected through purposive sampling. Thematic analysis was used to analyze the data. Results : The study identified three themes – accessibility, adequacy, and affordability. The study findings highlighted that universal health coverage for students with disabilities has not been achieved due to barriers in accessing health care. The barriers faced by students with disabilities were unfriendly physical environments, structures, equipment, limited support services and poor health insurance policy to finance health care. Conclusion : The study concludes that the government should prioritize disability-related issues in health policy formulation, implementation and monitoring. The current provisions and requirements in the disability act should be prioritized, enforced and monitored to ensure adequate inclusion of disability issues in health services. Further, the current exemption policy under the National Health Insurance Scheme should be revised to adequately address the needs of people with disabilities.

scholarly journals Good Governance and Anti-Corruption: Responsibility to Protect Universal Health Care in Indonesia

2018 ◽  
Vol 4 (2) ◽  
pp. 162 ◽  
Author(s):  
Ratna Juwita
Keyword(s):  
Health Care ◽  
Human Rights ◽  
Health Insurance ◽  
International Law ◽  
Good Governance ◽  
Universal Health Care ◽  
Insurance Fund ◽  
Universal Health Insurance ◽  
Quality Health Care ◽  
Universal Health

The establishment of universal health care marks a new momentum for the progressive realization of the right to health in Indonesia. The problem of corruption in health sector endangers the sustainability of effective and quality health care, therefore, Indonesia established an anti-fraud system to protect the universal health insurance fund. This research seeks to analyze the current anti-fraud system in universal health insurance through the lens of international law and principles of good governance. The sociolegal approach is chosen to study the relationship between the State party obligations to international law and the implementation of international law concerning universal health care and anti-corruption in the designated anti-fraud system. Good governance principles are essential in designing an effective anti-fraud system due to the correlation between human rights and anti-corruption that both areas emphasize good governance principles as guiding principles for the realization of human rights and the making of potent anti-corruption strategy.

scholarly journals Identifying Possible Gaps and Gray Areas in the Draft Universal Health Care Act Implementing Rules and Regulations: a Thematic Analysis of a Roundtable Event on Local Health Systems

2020 ◽  
Vol 54 (6) ◽  
Author(s):  
Theo Prudencio Juhani Z. Capeding ◽  
Ma-Ann M. Zarsuelo ◽  
Michael Antonio F. Mendoza ◽  
Ma. Esmeralda C. Silva ◽  
Leonardo R. Estacio Jr.
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Thematic Analysis ◽  
The Philippines ◽  
Universal Health Care ◽  
Health Board ◽  
Local Health ◽  
Department Of Health ◽  
Gray Areas ◽  
Universal Health

Background. The Universal Health Care (UHC) Act is a landmark legislation that seeks to improve provision ofcomprehensive health services through the integration of local health systems. The Department of Health (DOH)conducted a series of roundtable discussions to gather stakeholders' inputs and concerns to refine the initial draftof the Implementing Rules and Regulations (IRR) of UHC. Methods. On April 4, 2019, the Department of Health led a roundtable discussion on the Local Health Systemssections of the UHC IRR in collaboration with University of the Philippines Manila. A total of 65 stakeholders fromdifferent sectors participated in a semi-structured roundtable event. The proceedings were audio recorded andtranscribed. A thematic analysis was done using NVivo 12 software to document gaps and gray areas identifiedby the participants. Results. Concerns of the participants revolved around the following: role of the private sector in local health systems;the integration of different municipal and other component health systems into a province-wide health system;organizational design of the health systems; pooling and utilization of the Special Health Fund (SHF). Gaps andgray areas were concentrated on the transfer of personnel and other health resources to the province-wide system,the composition of the Provincial Health Board, and the utilization and management of the SHF. Conclusion. The roundtable event acquired various perspectives from stakeholders that could help the DOH identifypriority action points that could be resolved at the agency level. The identified themes from the study analysis couldbe of value to decision makers to clarify issues, address policy gaps, and to prioritize future research directions.

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