Bolstering the Coronavirus Response in the Philippines

11 June 2020

Written by Leah Breen

On January 30, the Philippines reported its first coronavirus case. Fast forward 38 days and the government declared a state of emergency on March 9. Soon afterwards, ThinkWell’s Philippines team dove headfirst into tackling the challenges as the pandemic swept through the country.

Scaling-up testing capacity

In January and February, the country had a single lab that could process coronavirus tests. With a population of over 106 million people, there was an urgent need to expand testing capacity.

As a first step to ramp up testing, the Department of Health (DOH) sought out ThinkWell’s assistance to help maximize the testing capacity of existing independent subnational laboratories. To ensure that the quantity of coronavirus testing labs would align with future demand, ThinkWell’s team provided crucial analytics to estimate testing demand and testing centers’ projected capacity.

Since it was clear that additional labs would soon be needed to process tests, ThinkWell developed a strategy for a coronavirus testing certification process for additional labs. Soon, the DOH was met with an onslaught of certification applications from private health facilities.

We knew that the Philippines would need to think big and act quickly when it came to expanding testing, so we assisted with setting up large testing centers and “pop-up” testing labs. The pop-up labs are compliant with coronavirus testing requirements, and built from the ground-up, in partnership with the private sector, within 10-15 days.

Recognizing that this unprecedented crisis called for novel solutions, ThinkWell joined the Expert Panel for Covid-19 Testing as the technical secretariat to discuss innovations and technologies that can further expand the Philippines’ testing capacity.

By June 2, there were 52 testing facilities in the country that could process over 40,000 tests per day. Less than three months since the government declared a state of emergency, the country was meeting its expanded testing capacity goals. The below two maps reflect the increased number of testing facilities between March and June. The maps were developed by G. Apostol and R. Francisco. The interactive maps are available here.

Developing PhilHealth benefits and policies

During a pandemic, people desperately need health insurance. As part of national efforts to achieve universal health coverage, Filipinos receive health insurance through the government-owned Philippine Health Insurance Corporation (PhilHealth). PhilHealth turned to ThinkWell for support in developing patient benefit policies on coronavirus screening, community isolation, and inpatient care. Applying human-centered design, we developed a Covid-19 patient pathway to guide service delivery methods. PhilHealth is using this pathway to inform the appropriate benefits for Covid-19 patients and to ensure that health facilities are reimbursed for their Covid-19 health services. We also reviewed the implementing rules and regulation for the Bayanihan Act, which mandates that PhilHealth finance various coronavirus-related health services.

Crafting policies on telemedicine use

In the era of social distancing and overwhelmed health systems, telemedicine is in the spotlight. The DOH and the National Privacy Commission are harnessing various telemedicine initiatives in the country, and ThinkWell is reviewing DOH guidelines for scaling-up these initiatives. We are also developing a monitoring and evaluation plan of different telemedicine approaches to assess and improve outcomes and impact.

Improving the supply chain for personal protective equipment

There is still a critical shortfall of personal protective equipment (PPE) among health workers in the Philippines. This was initially due to inadequate PPE projections, disrupted supply chains, and a fragmented response. The DOH requested that ThinkWell model and estimate PPE needs, but we didn’t want to rely on traditional forecasting methods to do so—historical methods would severely underestimate PPE needs during an evolving pandemic. Request-driven procurement, on the other hand, is highly subjective and prone to politicization and disproportionate allocation.

Instead, ThinkWell developed an innovative, human-centered approach to estimating PPE needs. Utilizing a patient journey method, we mapped how Covid-19 patients interact with health workers at various settings and times. For each step in the patient journey pathway, we identified health workers’ specific PPE needs. Our analysis is guiding PPE procurement for all health facilities in the Philippines for the coming months.

The Department of Health has also applied ThinkWell’s human-centered approach to estimate the PPE needs of surgeons and dentists as well as the anticipated supply of life-saving antiviral medications for Covid-19 patients. The Department of Environment and Natural Resources has also harnessed our approach to estimate the amount of PPE waste generated during the pandemic.

Strengthening the coronavirus response in region VI

Region 6 is a nondescript name for an area that covers the idyllic islands of Western Visayas. ThinkWell works with various stakeholders (including regional, provincial, and local health authorities as well as local universities and public health organizations) to document the process of coronavirus response planning and implementation, support the development of local coronavirus response policies, and curate key information for internal and external audiences. So far, ThinkWell has co-developed two policy notes in partnership with University of the Philippines-Visayas. The DOH Center for Health and Development in Region 6, as well as partner provincial health offices in the region, have adopted the recommendations.

Many thanks to the ThinkWell team in the Philippines for leading these efforts: Marife Yap (Senior Technical Advisor), Gelo Apostol (Private Sector Specialist), Ian Nuevo (Health Financing Expert), Jem Sigua (Junior Analyst), PeeWee Wee (Senior Policy Advisor), Lena Alvior (Senior Service Delivery Network Specialist), Camille Samson (SDN Specialist), and Susan Rosales (Administrative and Finance Coordinator).