There’s a well-understood correlation that as the economy of a country improves, so the health of its citizens improves.
What may be less obvious is that the opposite is also true — improving the health of a nation’s citizens can directly result in economic growth, because there will be more people able to conduct effective activities in the workforce.” – Francis S. Collins, Director, National Institutes of Health, USA.
Indeed, health presents a challenge for all countries, more particularly, poor countries where the running government are very much deficient in resources; that it can use not only to protect and promote the health of its people but also to meet their multifarious needs in other areas of governance, like in education, infrastructures and other basic pre-conditions for development.
When a country is poor, there also abound a great number of families needing health services. Nationally, health ranked second in the way the national government budget is allocated.
This is probably because the delivery of education services is still one of those retained by the national government under the existing local government code. Under this code, health service delivery is now decentralized to the local government units, that is to the provincial, city and municipal local government units.
For two meetings recently, I had the good opportunity to talk with Dr. Rene Catan, the acting chief of the Provincial Health Office (PHO). Coming from the private sector, Dr. Catan appeared to me to have all the necessary knowledge and skills to plan and carry out the health program of the province which presently is constrained by many factors.
For one, the island province of Cebu is generally mountainous and elongated which makes the people in the province needing medical care to take much longer time to reach the city of Cebu where most of the health facilities and trained medical specialists are concentrated.
For another, we only have four level-two government hospitals in the province located in Danao, Bogo, Carcar and Balamban which are very much deficient in facilities and health personnel, forcing many poor patients from the province especially on emergent and urgent cases to be referred to Vicente Sotto Memorial Medical Center (VSMMC) in Cebu City.
More worrying is the fact that, presently, the health service delivery of the province is more focused on the curative rather on the integration of both curative and preventive health services.
Under the guidance of Dr. Catan, the Province of Cebu aims to make it’s provincial health delivery system world class and becomes ISO certified and where the four provincial hospitals will be upgraded to level three at least, and make them competitive and attract good health personnel and paying patients that will make their operation sustainable in the long run.
Under the new provincial health plan, health care delivery will now be integrated which will involve not only the four provincial hospitals but also the existing Primary Care Facilities (PCF) or district hospitals, the Rural Health Units (RHUs), Barangay Health Stations (BHS) and Municipal Health Offices.
The key result areas of the provincial health delivery system under the new plan includes not only making the four provincial hospital attain level three but also increase their revenues and minimize outside referrals particularly to VSMMC where up to 97 percent of the patients presently comes from the province.
For public health initiatives, the system will focus on group monitoring to decrease the rates of infant, maternal and dengue mortality. It’s programs will also include the elderly (arthritis and 20/20 vision), peritoneal dialysis, HIV/AIDS monitoring, health education, and the strengthening of health programs that are aligned with the national health programs of the Department of Health.
Many things still need to be done under the new plan.
Among these are the restructuring of the PHO by creating a separate Hospital Management Office and Public Health Office; inventory of facilities and equipment and identify gaps and their cost; enhancing private sector partnership and competitiveness of the provincial health system to attract more qualified and committed health personnel and more patients (Corporatization); secure funding from the government, foreign grants, loans, and other sources of funds; strengthen inter-local health zones to enhance referrals and cooperation from municipal mayors and congressmen; strengthen cooperation of RHUs and MHOs in case monitoring; improve the physical structures of hospitals, create ISO committees, hire qualified personnel with good incentives and retain them; and create TEAMS to implement and monitor the system.
With the tiered referral system involving the BHS, District/Primary Care Facilities, and the strategically located four provincial hospitals, travel time of the patients in emergency cases will now be reduced to 30 minutes before getting medical care instead of many hours of long travel going direct to VSMMC in the city, where not a few will become more serious or die along the way because of stress and delay in treatment.
Indeed there is now a clear-cut understanding of where the province is and where it is going as far as health service delivery is concerned.
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