SP4PHC in the Philippines

The  Philippines team successfully concluded their country level work on the SP4PHC project in 2023. It was opportunistic that the project started as the universal health care (UHC) law was approved which offered an unprecedented opportunity to make the purchasing of primary health care services more strategic. The law mandated radical structural reforms in the health sector, including universal insurance coverage through PhilHealth and expanded primary health care benefits, among others. SP4PHC provided technical support to the Department of Health and PhilHealth to design and implement the provisions of the UHC law to strengthen purchasing of primary health care services, especially for family planning and maternal, newborn, and child health. While the country is no longer a geographical focus for the donor, the team continues to use its learning and expertise to support health financing reform locally and globally and is contributing to ThinkWell’s learning on gatekeeping and facility autonomy.

Reflections and accomplishments

  • Documented opportunities and barriers associated with the participation of private primary health care facilities in delivering family planning services and liaised with provider organizations such as the Integrated Midwives Association of the Philippines on approaches for attracting more private midwives into PhilHealth’s network.
  • Enabled the Department of Health and PhilHealth to develop policies, like the Special Health Fund (as a mechanism for pooling local health resources) and an expanded primary care benefit (Konsulta), through analytics and technical support.
  • Supported the pilot of Health Care Provider Networks and mapped referrals within the provincial networks to assess which services are available at which facilities. This mapping will be used by the provinces to identify service gaps (and redundancies) and prioritize future investments.
  • Cohosted the Western Visayas UHC Summit, together with the DOH Western Visayas Regional Office and the Asian Development Bank, enabling local chief executives, provincial health officers, and municipal health officers to share insights and best practices in implementing the UHC Law.
  • Provided technical assistance for national policies on scaling up COVID-19 testing, telemedicine, and PhilHealth benefits development; facilitated dialogue between government and the private sector; and produced analytics to guide regional pandemic response to COVID-19.
  • Produced a series of briefs capturing learnings from the implementation of the UHC Law.
  • Partnered with the provinces of Guimaras and Antique to support the implementation sites for the UHC Law reforms by facilitating planning for the integration of facilities into a network, strengthening the managerial capacity of respective provincial health boards and establishing their administrative-financial secretariats, and developing an approach for engaging private providers.

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The Universal Health Care (UHC) Law offered an unprecedented opportunity to make the purchasing of primary health care services more strategic, expanding access and increasing the range of benefits covered by PhilHealth. The Philippines team documented the progress made and key learnings of their two focal provinces through this coffee table book, published in December 2023. This book is not only a celebration of the achievements of UHC in the Philippines, but also a source of inspiration and learning for other countries and regions that are pursuing similar goals.

Financial Integration of Local Health Systems as Envisioned in the UHC Law

One of the key features of the Philippines universal health care (UHC) Law is the restructuring and integration of the financing of province- or city-wide local health systems that will govern health care provider networks comprised of primary to tertiary facilities. In the three years since the law’s enactment, the Department of Health and PhilHealth have released policies to guide the implementation of financial integration. This brief, published in December 2023, explores how the financial integration of local health systems, as mandated in the UHC Law, can improve health financing in the country and provide recommendations for its successful implementation. Our analysis shows that the financial integration of local health systems has the potential to improve the quality of care, but only if several processes are fine-tuned. To achieve this, stakeholders must continue collaborating to model, test, gather evidence, and forge a consensus around continuous improvement, allowing the sector to introduce and institutionalize evidence-based health financing reforms.

Scoping the Digital Landscape of Health Resource Tracking in the Philippines

Timely and informative health resource tracking (HRT)—the production and use of comprehensive information about the allocation, flow, and use of funds in the health system—is essential for guiding health financing policy design, implementation, and evaluation. This case study, released in May 2023, employed a mixed-methods approach. A desk review was initially conducted to understand the existing documented frameworks and policies relating to public financial management (PFM), HRT, and health management information systems in the Philippines. Key informant interviews were subsequently conducted with key stakeholders identified during the document review.

How can lessons from the Covid-19 response strengthen the Philippines’ drive to universal health care?

Reprioritization of government resources for the COVID-19 pandemic slowed down the implementation of the country’s Universal Health Care (UHC) law; however, the pandemic response created an unexpected opportunity to test some of the UHC law’s reforms, especially as health institutions and leaders in the Philippines were challenged to test new strategies to respond to the pandemic. The lessons generated from implementing the reforms at that time can help the government reprioritize and recalibrate the strategies described in the UHC law. This brief, published in July 2022, discusses the pandemic response in the Philippines vis-à-vis the reforms proposed in the UHC law using the control knobs framework of health systems, developed by Roberts et al. (2008).

Three Decades of Devolution in the Philippines: How This Has Shaped Health Financing and Public Financial Management Reforms

Over the past five decades, subnational government units in most countries around the world have assumed some decision-making authority. Public funds, and the efficient management of them, are crucial in ensuring sustainable health financing for achieving UHC. The World Health Organization (WHO) and ThinkWell jointly developed a series of case studies to explore the implications of decentralization for health financing, with a focus on PFM. This case study, published in April 2022, documents health financing and health-related PFM processes in the Philippines.

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SP4PHC aims to improve how governments purchase primary health care services, with a focus on family planning and maternal, newborn, and child health. SP4PHC is supported by a grant from the Bill & Melinda Gates Foundation.