Health Sector Reform Agenda (HSRA)

The Health Sector Reform Agenda (HSRA) describes the policies, public investments, and organizational changes
needed to improve the way health care is delivered, regulated, and financed in the country. Specifically, the HSRA
seeks to undertake the following:

Provide fiscal autonomy to government hospitals. The conversion of government hospitals into corporate entities
will promote fiscal autonomy by allowing them to collect socialized user fees. This move will take a great chunk off
the DOH's yearly appropriation for hospital operations. Thus, the DOH could use this savings to finance preventive
public health programs. However, there is a need to enhance the capacities of government hospitals such as their
diagnostic equipment, laboratory and medical staff to effectively exercise fiscal autonomy. Such investment must be
cognizant of complimentary capacity provided by public-private networks. Most importantly, safety measures shall
be carefully put into place to protect the interest of the indigents such as enrolling them in the National Health
Insurance Program.

Secure funding for priority public health programs. Budget on a multi-year basis must be provided to eliminate
or significantly reduce the incidence of infectious diseases. The government should also allocate funds to effectively
address emerging health concerns and to advance health promotion and prevention programs. At the same time, the
management capacity and infrastructure of public health programs must be upgraded to ensure that these
investments are effectively utilized. Capacity building is likewise required for these programs to provide technical
leadership over local health systems.
Promote the development of local health systems and ensure their effective performance. Local government
units must enter into cooperative and cost-sharing arrangements to improve local health services. Funds must be
secured to upgrade local health facilities and build local human resource capacities. For more effective performance,
participation of the private sector and volunteer groups must also be tapped. Lastly, appropriate mechanisms for
sustainability and continued delivery of quality care must be developed and institutionalized.

Strengthen the capacities of health regulatory agencies. Health regulatory agencies, namely, the Bureau of Food
and Drug (BFAD), the Bureau of Health Devices and Technology (BHDT), the Bureau of Health Facilities and
Services (BHFS), and the Bureau of Quarantine and International Health Surveillance (BQIHS) must be
strengthened to ensure the safety, quality, accessibility and affordability of health services and products. Public
investments must be made to upgrade the facilities and manpower capability of these agencies, particularly in
standards development, technology assessment and enforcement. To achieve all these, amendments to the laws
governing these agencies are called for.

Expand the coverage of the National Health Insurance Program (NHIP). Social health insurance must be
expanded to widen its reach. Health insurance benefits must be improved to make the program more attractive to
members. As membership expands and benefit spending increases, appropriate mechanisms to ensure quality and
cost effective services must be developed and introduced. Capacities and new administrative structures must also be
developed to allow the Philippine Health Insurance Corporation (PhilHealth) to effectively service more members
and manage increased benefit spending.
These five reform areas are highly interdependent, complementary and therefore should be implemented as a
package. Health financing reforms through NHIP expansion will make hospital autonomy viable and will ensure that
the poor remains protected. Hospital reforms, in turn will free up resources for investments in public health program,
and health regulation at the national and local levels. Effective public health programs and local health systems will
relieve the NHIP from paying for hospitalizations that should otherwise have been prevented or better handled at
primary care facilities.
Implementation of the HSRA demands public investments, policy and organizational changes. The HSRA will
require public investments estimated to amount to P112 billion within a five-year period. It will also require
effective implementation of existing laws and policies like the National Health Insurance Act, the National Drug
Policy and the Local Government Code. The organizational changes needed include the continuing re-engineering of
the DOH and PhilHealth and the formation of inter-local health zones.
Ultimately, HSRA aims to: improve the health status of the people through greater and more effective coverage of
national and local public health programs; increase access to health services especially by the poor; and reduce
financial burden on individual families. It shall be the catalyst that will bring the country toward the realization of a
shared vision of health for all Filipinos.

HEALTH SECTOR REFORM AGENDA: FOURmula One for Health

FOURmula One for Health is the DOHs Road Map for Health Sector Reforms in the Philippines from 2005 to
2010. It is designed to implement critical health interventions as a single package, backed by effective management
infrastructure and financing arrangements.
FOURmula One engages every stakeholder in the health sectorthe public and private sectors, national agencies
and local government units, external development agencies, and civil society. The over-all goals are to provide (1)
better health outcomes, (2) a more responsive health system, and (3) more equitable healthcare financing.
Implementation requires achieving critical reforms with speed, precision and effective coordination directed at
improving the quality, efficiency, effectiveness and equity of the Philippine health system in a manner that is felt by
Filipinos, especially the poor.
On a more specific note, in five years, the program aims to:
(1) secure more, better and sustained financing for health;
(2) assure the quality and affordability of health goods and services;
(3) ensure access to and availability of essential and basic health packages; and
(4) improve performance of the health system.
Millennium Development Goals (MDGs)
The Millennium Development Goals (MDGs) are the world's time-bound and quantified targets for addressing
extreme poverty in its many dimensions-income poverty, hunger, disease, lack of adequate shelter, and exclusionwhile promoting gender equality, education, and environmental sustainability. They are also basic human rights-the
rights of each person on the planet to health, education, shelter, and security.

Goal 1: Eradicate Extreme Hunger and Poverty

Goal 2: Achieve Universal Primary Education

Goal 3: Promote Gender Equality and Empower Women

Goal 4: Reduce Child Mortality

Goal 5: Improve Maternal Health

Goal 6: Combat HIV/AIDS, Malaria and other diseases

Goal 7: Ensure Environmental Sustainability

Goal 8: Develop a Global Partnership for Development

Universal Health Care (UHC)

Universal Health Care (UHC) is the call and commitment of the Philippine Government to ensure that every Filipino
has access to quality and affordable health care. In 2011, the Department of Health announced its goal to achieve
UHC by 2016 under the flagship program of President Benigno Aquino III known as Kalusugan Pangkalahatan
(KP) focusing on improving access to health care services and reducing poverty from catastrophic healthcare
expenditures especially for the poor and most vulnerable population.
The Philippine agenda to achieve Universal Health Care (UHC), also referred to as Kalusugan
Pangkalahatan (KP), is defined as the "provision to every Filipino of the highest possible quality of health care that is
accessible, efficient, equitability distributed, adequately funded, fairly financed, and a appropriately used by an
informed and empowered public". The Aquino administration puts it on top of the socioeconomic agenda to improve
the heatlh and quality of life of all Filipinos.

UHC's Three Thrusts

To attain UHC, the DOH defined three strategic thrusts to be pursued from 2011-2016, namely: 1) Achieve the
health-related Millennium Development Goals (MDGs) of improving maternal and child health and combating
priority infectious and non-communicable diseases; 2) Provide financial risk protection through expansion in the
enrollment and benefit delivery of the National Health Insurance Program (NHIP); and 3) Improve access to
quality health care which includes the upgrading of public hospital and health facilities, ensuring adequate health
human resources and securing the availabilty of essential medicines.

UHC and the Philippine Medicines Policy

In line with the goal of providing equitable access to medicines for all Filipinos and attain UHC by 2016 the
Philippine Medicines Strategy was adopted in 2011 anchored on the following key principles:

Access to medicines forms part of the fulfillment of the human right to health where government plays a
primary responsibility;

Medicines are important in a well-functioning health care system as they contribute to the achievement of
the broader health objectives of reducing morbidity, mortality and burden disease;

The state plays the primary role in the progressive realization of equitable access to medicines for all its
citizens, especially the poor. Filipinos shall not be denied access to treatment nor become impoverished because
of the high cost of medicines.

The government, in partnership with all sectors, shall endeavor to provide access of individuals and the
community to medicines and promote their rational use at all levels of care at all times.