(YEARENDER) Health dept creates ways to achieve ‘health for all’

The Department of Health (DOH) has begun laying the foundation to achieve President Rodrigo Duterte's mission of giving every Filipino, especially the poor, access to quality health care services.

Following her appointment as health secretary last July 4, Dr. Paulyn Jean Rosell-Ubial pledged to work towards a health system that is responsive to the needs of the people, particularly the poorest of the poor, vowing that the delivery of health services will not be tainted by corruption.

"The poor are the ones who suffer whenever corruption exists in the government," Ubial said as she accepted the post from her predecessor.

Shortly afterwards, she directed regional directors to ensure that all hospital staff in DOH facilities nationwide exercise frugal spending practices while maximizing the delivery of health services. She however emphasized that there should never be any limitation if the spending is for the benefit of the poorest of the poor.

One of Ubial's first initiatives was to launch the Duterte administration's Philippine Health Agenda (2016-2022). The agenda tasks the health department to bring together key stakeholders to work towards improving the people's access to health services while reducing out-of-pocket costs.

For starters, the DOH tried to reach the country's poorest 20 million -- through house-to-house visits conducted by health department personnel -- to inform them that they could get free check-ups in government health facilities under the Tamang Serbisyo Para sa Kalusugan ng Pamilya (TSeKaP) service package.

TSeKaP encourages poor families to seek early treatment for their illnesses in government hospitals since as indigents, they are automatically covered by PhilHealth (thanks to sin tax revenues) and need not pay anything under the No Balance Billing (NBB) policy. This means that they could get surgical operations and medicines for free.

Ubial said she has also been negotiating with PhilHealth to cover even the transportation fares of patients to encourage them to go to hospitals.

"No out-of-pocket expenditures for the poor - that is my dream," she said.

As of the first week of November, more than 50 percent of the targeted 20 million poor identified by the regional health offices have availed of the TSeKaP package, reported Ubial, who said official figures will be released early next year.

Among those who took advantage of the TSeKaP package were prisoners visited by the health chief at the Correctional Institution for Women in Mandaluyong.

The inmates were provided complete physical examinations, including screening for tuberculosis, HIV, hypertension and diabetes, while those 60 years and above were given anti-flu and pneumococcal vaccines.

Just before going on Christmas break, the Senate scrapped the "No PhilHealth ID, No benefits" policy to guarantee universal health coverage. In this light, an additional PHP3 billion was appropriated for health coverage.

This development guarantees that the remaining eight million Filipinos not covered by PhilHealth are granted access to health services. The eight million covers those in the informal economy, as well as street families and children difficult to trace because they have no permanent address.

The drug menace

Ubial meanwhile recalled that when President Duterte first interviewed her back in May, the first thing he said was, "Dra., I hate drugs."

"So, I would like all of us in the Department of Health to remember that and to put that to heart because we will support the President in ridding this country of the drug menace," she said.

As the country witnessed the surrender of 983,233 drug suspects -- of which 908,596 were drug users and 74,637 were pushers -- to authorities since the launch of Oplan Tokhang in July, the health department took it upon itself to find ways to help them.

Given the huge number of surrenderers, Ubial described the country's drug problem as "a public health emergency", and saw the need to double the capacity of the country's rehabilitation centers and the personnel who will man them.

Last Nov. 29, it opened the first phase of the Mega Drug Treatment and Rehabilitation Center in Fort Magsaysay, Nueva Ecija. The project, a donation of Chinese real estate billionaire and philanthropist Huang Rulun, involves the construction of 172 buildings on an 11-hectare tract of land in the military camp to accommodate 10,000 drug dependents. As of late November, it was ready to take in 500 drug users.

Pointing out that drug addicts are not the enemy because they are only victims of drug pushers, Ubial vowed to help them. "Talagang tutulungan po natin sila. (We will certainly help them.) This initiative will not only benefit the well-being of these drug victims whom we want to reach out to and help, but will also be for the change that we envision for our country," she said.

The health secretary also helped the local government units (LGUs), particularly barangay, municipal and city officials, handle the community-based rehabilitation program -- estimated to cover more than 90 percent of drug users -- in coordination with non-governmental organizations (NGOs), inter-faith groups and volunteers.

Last Dec. 20, the DOH, together with the Department of Interior and Local Government (DILG), likewise signed a memorandum of agreement with Alliance Global Group, Inc. for a new drug rehabilitation facility that will be built on a 6,853-sq. meter land inside Camp Bagong Diwa in Taguig City.

The HIV scare

Equally urgent was the need for the DOH to address the alarming rise in the country's HIV cases, which has reached 38,114 in October 2016 from January 1984. This year, roughly 26 new HIV infections every day were reported for a total of 7,756 cases. More than half of the figure or 19,578 belong to the 25-34 age group, and 27 percent or 10,279, to the 15-24 age group.

During the commemoration of World AIDS Day on Dec. 1, Ubial appealed for collective and relentless efforts to make the sector most vulnerable to HIV -- including the youth -- keenly aware of how the deadly disease is spread and how to protect themselves, the need for them to get tested, and the treatment available to them.

She noted that her department is continuously offering free and confidential HIV testing in Social Hygiene Clinics run by LGUs and in 26 HIV Treatment Hubs nationwide and is seriously considering the recommendation of the World Health Organization (WHO) on self-testing to improve HIV testing rates and prevent treatment delays.

According to the department, 15,035 people living with HIV are on antiretroviral treatment, which is given free for life to those registered in HIV Treatment Hubs across the country.

Ubial further called for "real collaboration" with other government agencies, such as the Department of Education, as well as community-based organizations, to reach the young population and give them correct information on HIV and its consequences and how to stop its spread.

The DOH floated the idea of distributing condoms in school clinics to reach those who are sexually active at a young age, stirring up a controversy. Defending its proposal, the department said it is in no way promoting premarital sex among youths but is merely protecting them from the lethal disease. The education department is still studying the proposal.

Zika and pregnant women

Tackling mosquito-borne diseases became a bigger challenge for the department this year with the confirmation of 52 Zika infections, 33 of which were recorded in the National Capital Region, Calabarzon, Western Visayas, and Central Visayas. According to the DOH, the patients' ages ranged from seven to 59 years. Of the total, 34 are female, and three of them are pregnant -- one each from Quezon City, Cebu, and BiAan in Laguna. A 16-year-old from Las PiAas City, who was diagnosed with Zika on the third trimester of her pregnancy, has recently given birth to a healthy and normal baby boy while the woman from Cebu is due to give birth this January.

Since Zika has been linked to microcephaly among babies born to women who acquired the virus while they were pregnant, the DOH will continue to monitor the pregnant women and their babies until two years after childbirth. So far, ultrasound tests have shown that the women's babies appear to be normal.

To coordinate its anti-Zika campaign, the department held a national summit last Oct. 28, inviting representatives of government agencies, private sector, academe, the business and medical community, international partners and civil society to discuss with them the DOH's Zika Action Plan.

The health department also continued the dengue vaccination for children, carrying out the second round last October. The school-based immunization, launched in April to protect children from dengue hemorrhagic fever, vaccinated 81,665 Grade 4 pupils aged 9 years old and above enrolled in public schools in Central Luzon, Calabarzon and the National Capital Region (NCR) as of April 11, 2016. The third and final round will be conducted in April next year.

In the meantime, the department continued to appeal to the public to get rid of mosquito-breeding places and protect themselves by using mosquito repellant.

Infant survival

Furthermore, the DOH continued to strengthen its infant and maternal health care program. Last Nov. 25, the department and PhilHealth launched benefit packages that would address the high rate of death among premature and small newborns. According to the department, nearly half of the children who die before their fifth birthday are newborns. Of these babies, 60 percent die as a result of prematurity and low birth weight.

Newborn deaths due to complications from prematurity and low birth weight can be prevented through adequate prenatal care, sufficient intake of nutritious food during pregnancy, managing complications before childbirth, and early breastfeeding, Ubial explained.

"The cost of saving preterm and small babies has been economically catastrophic for many families, both rich and poor. True to the tenets of the Philippine Health Agenda, it is very timely that we address the financial protection of these families and universal health care for their newborns," she said. The benefit packages, designed with the support of the UNICEF, will potentially reach 300,000 premature and small newborns every year.

Brain and mental health

In celebration of Brain Attack Awareness Week and in partnership with the Stroke Society of the Philippines, the DOH launched in August a medical assistance program that will make the stroke medicine, Alteplase, available to the public for free in 26 government hospitals nationwide. The medicine, when given within three hours after a patient suffers a stroke, improves the patient's chance of survival, reduces disability, and shortens hospital stay and rehabilitation. While Alteplase is only available initially in 26 government hospitals, among them the East Avenue Medical Center, Philippine Heart Center and the Philippine General Hospital, Ubial has instructed these hospitals to explore partnerships with private hospitals to enable the latter's patients to also avail of Alteplase, free of charge.

Meanwhile, the DOH has found that some two million to three million suffer from serious mental illness in the country, and that nearly one in every 100 households has a member with a mental disability.

Confronting mental health issues, Ubial said in October that she has signed an administrative order that contains a comprehensive framework on how the department's mental health program will be implemented at all levels of the health system across the country.

This, she said, is in line with the Duterte administration's plan to offer community-based mental health care. The department has also sought a PHP220 million budget allocation to support its mental health program for 2017.

The DOH has also partnered with the Natasha Goulborn Foundation (NGF) and Globe Telecoms in launching the hotline (02) 804-HOPE (4673) and 0917 558 HOPE (4673) last July 7 to offer a phone-based suicide prevention and counseling service.

It has likewise supported the passing of Senator Risa Hontiveros' bill on mental health filed at the Senate, and had a tie-up with the Department of Education in piloting the "Wellness Emotional Resilience for Filipino Youth" in the Mimaropa region.

Anti-smoking initiatives

In its battle against diseases caused by smoking, the department this year finally succeeded in implementing the Graphic Health Warning Law.

Last Nov. 4, cigarette packs bearing pictures of the devastating effects of smoking on the body hit the stores. Anti-smoking advocates hope this would deter smokers and potential smokers from reaching for cigarettes.

Furthermore, in an effort to protect non-smokers from second-hand smoke, the DOH came up with a proposed executive order that would prohibit smoking in public places -- both indoor and outdoor. The proposed EO is still waiting for the President's signature.

'Iwas paputok'

As 2016 comes to an end, the DOH again finds itself facing the yearly challenge of convincing merrymakers to shun firecrackers.

Early this month, the department directly engaged children in the campaign by telling students of the Felipe Calderon Integrated School and the Jacinto Zamora Elementary School, both in Manila, that they can still welcome the New Year with a bang -- not by lighting firecrackers but by shaking and beating anything that produces a loud sound.

The health department tried to have a proposed executive order on the regulated use of firecrackers signed by the President, who however decided to postpone it until September next year in consideration of those whose livelihood depends on the manufacture of firecrackers.

The DOH meanwhile suggested that each LGU hold a community fireworks display, as a way of reducing the individual lighting of firecrackers. However, only Marikina City has expressed support for the proposal.

So far, 90 firecracker-related injuries have been recorded on Dec. 21-28, with Manila, Quezon City and Mandaluyong leading the count in the NCR. Based on regions, the NCR was the topnotcher, with Western Visayas and Calabarzon at its heels. As in last year, the 'piccolo' remains the number one culprit, followed by the improvised cannon known as 'boga', 'whistle bomb', 'kwitis', 'luces' and other firecrackers.

Health department officials have made sure that all government hospitals and health facilities are ready, putting them under Code White, which requires them to be on standby to respond to emergencies during the holidays.

The foundation has been laid to achieve the new administration's health agenda, with every effort directed toward attaining the best health outcome for every Filipino while keeping costs to a minimum.

The results remain to be seen. But as Secretary Ubial always says when she reminds the public that health is everyone's concern, "Let us work together towards this vision of 'All for Health towards Health for All'."

Source: Philippines News Agency

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