By EDU H. LOPEZ
The Asian Development Bank has approved a US$1-million technical assistance (TA) grant to support the government’s health sector reform agenda (HSRA).
The HSRA was established in 1999 to improve the efficiency of the country’s public health service delivery system by integrating health care promotion and prevention, expanding referral links, reducing the need for hospitalization, and improving the allocation and use of resources.
To support the HSRA, the TA will help the Department of Health to streamline policies and refine monitoring systems, and will assist local government units (LGUs) in initiating and carrying out these reforms.
It will help give HSRA a head start in 15 selected provinces by streamlining policies and developing guidelines, concepts, and administrative orders for the health sector in these LGUs. HSRA implementation in up to five of the 15 provinces will also be accelerated by the TA.
"The primary challenge facing the country’s health sector is identifying ways to improve the efficiency and effectiveness of health service delivery," says Karima Saleh, an ADB Senior Health Economist.
The technical assistance is expected to streamline mechanisms in core referral hospitals to improve performance and improve the quality of public health provision by introducing cost-effective interventions, clinical practice guidelines in health facilities, and piloting programs for public health interventions in LGUs.
It will provide an integrated framework for a rationalized health system at the LGU level, address priority diseases, and explore measures to improve procurement and deployment of equipment, drugs, and supplies.
The project will pilot a strategy for more cost-efficient procurement of drugs, including standardizing the quality and prices of drugs, propose new schemes to increase coverage of beneficiaries under the Philippine Health Insurance Corporation and plan a mode of financing for capital investment to LGUs.
The health status of Filipinos has continuously improved over the last few decades, although common illnesses associated with poverty, such as infectious diseases, have not fallen to acceptable levels.
Lifestyle-related diseases, such as cardiovascular diseases, malignancies, and pulmonary disorders, are moving up in the top 10 causes of mortality and morbidity.
Other potential threats are the growing incidence of HIV/AIDS and emerging diseases such as SARS and avian flu.
"With all the challenges faced by the health sector — devolution, public sector programs not prioritizing the needs of the population, and the recent budget crisis — there may be a slower pace in improvement of the health status of Filipinos," says Saleh.
"This will threaten the country’s chances of meeting the health-related Millennium Development Goals unless necessary reforms are carried out."
In December 2004, ADB approved two loans totaling US$213 million for a health sector development program also in support of the HSRA.
ADB is among the first development partners to provide the Department of Health with comprehensive support for implementing HSRA.
The technical assistance will be carried out in close coordination with the Department of Health and other agencies, the Philippines Health Insurance Corporation, local government units, and stakeholders.
It will also work in close collaboration with other development partners supporting HSRA.
The government will contribute $430,000 equivalent toward the TA’s total cost of $1,430,000. The technical assistance is due for completion around February 2007.(Edu Lopez)
