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Five-Year Strategic Plan Report
2013-2017 Degenerative Disease Office
This document was prepared by the Development Academy of the Philippines (DAP) for the technical assistance on
the Development of a Strategic Plan Framework and 5-Year Strategic Plan for all the Degenerative Disease
Programs of the Department of Health.
TABLE OF CONTENTS
EXECUTIVE SUMMARY ....................................................................................................... 1
PART I ....................................................................................................................................... 7
INTRODUCTION ..................................................................................................................... 7
THE DDO’S STRATEGIC PLANNING PROCESS ............................................................ 9
The Change Management Framework ............................................................................... 9
CURRENT GAPS AND CHALLENGES ........................................................................... 11
IMPLEMENTING STRUCTURE ....................................................................................... 15
PART II ...................................................................................................................................... 1
DDO STRATEGICPLAN FOR 2013 - 2017 ............................................................................ 1
THE DDO STRATEGY MAP ............................................................................................... 1
Vision and Mission ............................................................................................................. 2
Strategic Objectives ............................................................................................................ 2
Core Values and Norms ...................................................................................................... 4
DDO SCORECARD .............................................................................................................. 6
PART III .................................................................................................................................. 20
DDO PROGRAMS ACTION PLAN (2013-2017) ................................................................. 20
LIFESTYLE-RELATED DISEASES PREVENTION AND CONTROL PROGRAM ..... 20
HEALTH AND WELLNESS PROGRAM FOR PERSONS WITH DISABILITIES ........ 31
VIOLENCE AND INJURY PREVENTION PROGRAM .................................................. 43
PREVENTION OF BLINDNESS PROGRAM ................................................................... 51
HEALTH AND WELL-BEING OF SENIOR CITIZENS PROGRAM ............................. 58
BIBLIOGRAPHY .................................................................................................................... 66
LIST OF FIGURES
Figure 1 Change Management Framework for DDO Strategic Planning Intervention ........... 10
Figure 2 Current NCDPC Organizational Structure ................................................................ 15
Figure 3: Current DDO Organizational Structure ................................................................... 16
Figure 4 Current Management Structure of the LRD Division ............................................... 16
Figure 5: Current Management Structure of Essential NCD Division .................................... 17
Figure 6 Degenerative Disease Office Strategy Map ................................................................ 2
LIST OF TABLES
Table 1 DDO Strategic Objectives ............................................................................................ 3
Table 2 DDO Scorecard on Strategic Objective 1 ..................................................................... 7
Table 3 DDO Scorecard on Strategic Objective 2 ................................................................... 10
Table 4 DDO Scorecard on Strategic Objective 3 ................................................................... 13
Table 5: DDO Scorecard on Strategic Objective 4 .................................................................. 14
Table 6 DDO Scorecard on Strategic Objective 5 ................................................................... 15
Table 7 DDO Scorecard on Strategic Objective 6 ................................................................... 17
Table 8 DDO Scorecard on Strategic Objective 7 ................................................................... 18
Table 9 DDO Scorecard on Strategic Objective 8 ................................................................... 19
Table 10 Key Program Milestones of the LRD Program ........................................................ 24
Table 11 Key Program Milestones of HWPPWD ................................................................... 36
Table 12 Key Program Milestones for VIPP ........................................................................... 47
Table 13: Key Program Milestones of the HWSC Program .................................................... 61
LIST OF ACRONYMS
AO Administrative Order
ASEAN Association of Southeast Asian Nations
BLHD Bureau of Local Health Development
BSC Balanced Scorecard
CAR Cordillera Administrative Region
CBR Community-based Rehabilitation
CHD Center for Health Development
COPD Chronic Obstructive Pulmonary Disease
CPG Clinical Pathway Guidelines
CPH Census of Population and Housing
CRD Chronic Respiratory Disease
CSHD Center for Sustainable Human Development
CVD Cardiovascular Disease
DAP Development Academy of the Philippines
DBM Department of Budget and Management
DDO Degenerative Disease Office
DOH Department of Health
EMS Emergency Medical Services
ETS Electronic Tracking System
FHSIS Field Health Service Information System
GATS Global Adult Tobacco Survey
GYTS Global Youth Tobacco Survey
HFEP Health Facilities Expansion Plan
HPPWD Health Program for People with Disabilities
HPV Human Papilloma Virus
HWSCP Health and Well-being of Senior Citizens Program
ICF International Classification of Functioning, Disability and Health
IEC Information, education, and communication
IRR Implementing Rules and Regulations
KP Kalusugan Pangkalahatan
KPI Key Performance Indicator
LCE Local Chief Executive
LGU Local Government Unit
LRD Lifestyle-related Disease
LRDPCP Lifestyle-related Disease Prevention and Control Program
LRNCD Lifestyle-related Noncommunicable Disease
MDG Millennium Development Goal
MOP Manual of Operations
M&E Monitoring & Evaluation
NAPC National Anti-Poverty Commission
NCD Noncommunicable Diseases
NCDPC National Center for Disease Prevention and Control
NCHFD National Center for Health Facility Development
NCHP National Center for Health Promotion
NCSP National Committee for Sight Preservation
NGO Nongovernment Organization
NHRA National Health Research Agenda
NTG National Treatment Guidelines
OD Organization Development
ONEISS Online National Electronic Injury Surveillance System
OPIF Organizational Performance Indicators Framework
PBP Philippine Blindness Program
PDAO Persons with Disability Affairs Office
PDP Philippine Development Plan
PGS Performance Governance System
PHIC Philippine Health Insurance Corporation
PhilPEN Philippine Package of Essential Noncommunicable Disease
PIPH Province-wide Investment Plan for Health
PIR Program Implementation Review
PNIDMS Philippine Network for Injury Data Management System
PODTP Philippine Organ Donation and Transplantation Program
PRPWD Philippine Registry for People with Disabilities
PWD Persons with Disability
RHU Rural Health Unit
SOP Standard Operating Procedures
UHC Universal Health Care
UP-NIH University of the Philippines—National Institutes of Health
VIA Visual Inspection using Acetic Acid Wash
VIPP Violence and Injury Prevention Program
WHO World Health Organization
WI Work Instruction
1
EXECUTIVE SUMMARY
Background and Rationale
Noncommunicable diseases (NCDs) are a group of conditions that include lifestyle-related
diseases (LRDs) such as cancer, cardiovascular diseases, diabetes mellitus, and chronic
respiratory diseases. They also encompass other degenerative conditions classified as
“essential NCDs” like visual impairment or blindness, some forms of functional disabilities,
and accidents due to violence, injury, etc. Lifestyle-related diseases (LRDs) are noted to share
common risk factors (e.g. tobacco use, unhealthy diet, lack of physical activity, and harmful
use of alcohol) and some of them are associated with essential NCDs (e.g. visual impairment
caused by diabetes mellitus). This relationship among NCDs entails a comprehensive and
integrated approach of prevention, control and treatment.
The Department of Health (DOH) through the Degenerative Disease Office (DDO) of the
National Center for Disease Prevention and Control (NCDPC) is the technical authority
dealing with NCDs in the country. The DDO is mandated to perform the following functions:
1. Develop policies, standards and guidelines for NCD prevention and control;
2. Develop plans, programs and projects to carry out preventive and control strategies
against NCDs;
3. Set health objectives and priorities for NCD prevention and control;
4. Assist and strengthen capacity to measure and analyze the burden of NCD; and
5. Provide monitoring and evaluation schemes to measure interventions in the
prevention and control of NCDs.
By its mandate, the DDO has been at the forefront of country efforts against NCD. It has
spearheaded the development and implementation of various packages of NCD prevention
and control which include relevant administrative policies, clinical practice guidelines, health
promotion and education programs, local health systems strengthening, capacity building,
linkage-building, monitoring and evaluation, among others. While all these have helped
mitigate the impact of NCDs, health statistics in the last decade indicate greater challenge
ahead.
According to the Department of Health (DOH) reports, LRDs particularly diseases of the
heart, cerebrovascular diseases and malignant neoplasms were the top three leading causes of
deaths from year 2000 to 2009. In the same period, chronic lower respiratory tract diseases,
diabetes mellitus, diseases of the kidney, and accidents and injuries were also among the top
ten causes of deaths. Collectively, these account for 70 percent of the mortalities in the
country annually (Villaverde, et. al 2012). As regards disability, the 2010 Census of
Population and Housing (2010 CPH) found that 1.44 million or 1.57% of the 92.1 million
Filipinos have a disability. Meanwhile, the prevalence of visual impairment was 4.62%
based on the 2002 national survey on blindness and low vision. As to violence and injury,
2
about 7,000 Filipinos die each year due to road traffic crashes, and drowning comes as
leading cause of injury and death among children.
The Philippine situation relative to NCDs is not far from global trends. Chronic LRDs posed
as the leading causes of mortality and disability worldwide (WHO, 2011; Mathers CD.,
2006). Projected trends indicate that by 2020, NCDs are expected to account for 73% of
global mortalities and 60% of the disease burden (WHO). As regards persons with disability
(PWD), the 2012 WHO Fact Sheet states that over 1 billion people, or approximately 15% of
the world’s population, have some form of disability; 80% of them live in low-income
countries, wherein majority are poor and cannot access basic services. The same 2012 WHO
Fact Sheet reveals that there are about 285 million people having visual impairment, of
which 39 million are blind and 246 have low vision. Further, based on another WHO Report
(2012), violence and injuries accounted for approximately 1.2 million deaths in the Western
Pacific Region in 2008, which is about one quarter of global death toll from such causes.
The challenge and burden of NCDs has become significant. A WHO Report in 2005
(Preventing Chronic Diseases: A Vital Investment) noted that countries can incur national
income losses as a result of the impact of deaths from NCDs on the labor supply and savings.
Cognizant of the growing magnitude and burden of NCDs, the DDO recognized the need to
broaden the NCD response, intensify efforts and beef up capacities on NCD prevention and
control. This means bracing for greater demand for specialized health services and improving
access to such, higher investment on NCD programs, policy changes, enhancement of
technical and managerial capacities, improvement of operational system and procedures, etc.
Formulation of strategic interventions thus becomes an imperative, so the DDO initiated the
development of a strategic plan to draw its roadmap in the next five years (2013-2017). More
than setting directions, the DDO strategic plan also serves as basis of measuring program
results vis-à-vis desired outcomes and gauging overall DDO performance.
The DDO Strategic Planning Process
The DDO initiated its strategic planning process in 2012 with technical assistance from the
Development Academy of the Philippines (DAP). The process involves three major phases,
to wit: 1) development of the planning framework, 2) development of the 2013-2017 strategic
plan, and 3) institutionalization of the strategic plan.
The first two phases substantially referred from and aligned with the following framework
documents, among others:
1. WHO Global Strategy for the Prevention and Control of NCDs for a more
comprehensive, integrated approach and community-based framework adopted by
DOH in 2008 plus the Manual of Operations developed in 2009;
2. “Better Health for Persons with Disabilities,” Global Health Disability Action Plan
2014-2021 (Draft 1);
3
3. Towards Universal Eye Health: Regional Action Plan for the Western Pacific Region
2014-2019 (Draft Plan);
4. The Organizational Performance Indicators Framework (OPIF) introduced by the
Department of Budget and Management;
5. The Performance Governance System (PGS) adopted by the DOH in 2009 as a
framework to better implement and sustain health reforms;
6. Universal Health Care/ Kalusugan Pangkalahatan (UHC/KP) that has three strategic
thrusts, to wit: (1) financial risk protection through the expansion of the National
Health Insurance Program enrolment and benefit delivery, (2) responsive health
system by way of improvement in health facilities and services, and (3) better public
health interventions to attain the Millennium Development Goals (MDG);
7. The National Objectives for Health 2011-2016; and
8. The NCDPC Strategic Plan (2013-2016).
The last phase ensures that the DDO strategic plan becomes a living document that will guide
the planning, implementation, monitoring, and evaluation of the Office’s performance
through its various programs and projects.
The DDO Strategic Plan
The DDO strategic plan articulates two levels of performance, i.e., organizational and
program levels. The organizational level presents an integrative perspective of the DDO
operations as a whole, that is, a consolidation of performances of each program under the
Office including cross-cutting concerns, and technical and administrative functions. At the
program level, on the other hand, the strategic plan spells out the program-specific
performance targets, key activities and milestones.
The organization-level strategic plan of the DDO benefits from the first phase of the process
since many of the identified needs, gaps and challenges cuts across programs and pertains to
overall DDO function. Following are the aspects of DDO operations, which are deemed
critical to its performance:
1. Advocacy and health promotion – need to harmonize approaches and improve
collaboration with other concerned offices in the DOH and partners at the national
and local levels; need to strengthen advocacy and health promotion programs to
include monitoring and evaluation of their effectiveness
2. Capacity-building – lack of capacity building activities and training programs for
health workers; use of information technology for technical know-how (e.g. online
courses)
4
3. Health systems strengthening – lack of priority and appreciation of NCD programs
by local government units (LGUs), thus minimal resources allocated for NCDs; weak
referral systems in service delivery; inefficient distribution system for medicines and
health products; lack of human resources; inaccessibility of health facilities for
PWDs; lack of community participation
4. Health care financing – primary care facilities lack capacity and requirements
(equipment, personnel) to qualify for Philhealth benefit packages on NCD services;
limited LGU budget (scarcity of resources and low priority for NCDs); need to tap
resources for NCD programs
5. Network building and collaboration – weak collaboration causing overlaps,
duplication of functions, resources not maximized, and policies not localized or
implemented down to community level; need to enhance partnership mechanisms and
corresponding capacities
6. Policy development and regulation – need to amend/update/attune existing policies
with current situation; need to operationalize and localize policies; need to encourage
multi-sectoral participation in policy development and implementation
7. Research, surveillance, monitoring and evaluation (M&E) – need to intensify
research to keep abreast of NCD prevention and control strategies; need to develop
registries, upgrade and integrate database and information systems; lack of M&E
systems to analyze and measure the NCD burden, aid program implementation and
assess performance.
The DDO constructed its strategy map following its mandate, the WHO global strategy on
NCDs, the Global Health Disability Action Plan, the Western Pacific Region Action Plan for
Eye Health, national frameworks, and the aforementioned gaps and challenges. Furthermore,
the Office constructed its strategy map around three core values – integrity, excellence and
compassion - with a vision to be the Center for Excellence in the prevention and control of
NCDs and mission to direct and harmonize all efforts in the prevention and control of NCDs.
To execute its mission and achieve its vision in five years, the DDO identified strategic
objectives (SOs) along five perspectives based on the PGS – resources, organization, internal
processes, people empowerment, and social impact. The SOs are designed to synergize and
complement each other for better health outcomes in a span of five years. They are described
as follows:
Social Impact
o Strategic Objective 1. Reduced morbidity, mortality and disability due to
NCDs – The DDO aims to contribute to the national and global goal of
decreasing the prevalence and burden of NCDs
5
People Empowerment
o Strategic Objective 2. Enhanced capacity of Centers for Health Development
(CHDs) and other stakeholders in NCD prevention and control – DDO intends
to capacitate CHDs and transfer technical know-how to CHD staff as
generalists so that by 2017, CHDs can handle all NCD-related concerns at the
sub-national and local levels.
Internal Processes
o Strategic Objective 3. Ensure the development and implementation of
evidence-based policies, standards and guidelines – The DDO shall not only
create policies but also pursue the implementation of such and periodically
undertake policy review for necessary amendments; doing so also ensures that
clinical practice guidelines, for example, serve as basis for Philhealth claims in
support of health financing
o Strategic Objective 4. Ensure relevant and efficient capability building – The
DDO must ensure that trainings and the like result in enhanced capacities of
individuals and the organization
o Strategic Objective 5. Strengthen collaboration with stakeholders–to maximize
resources, harmonize efforts and ensure multi-sectoral participation
o Strategic Objective 6. Ensure reliable, timely, and complete data and
researches – The DDO must be able to generate necessary and up-to-date
information to aid planning, policy-making, program management,
performance evaluation, clinical management, etc.; comprehensive
information is needed as well in measuring and analyzing the impact of NCDs
and interventions carried out
Organization
o Strategic Objective 7. Guarantee adequate, competent and expert DDO
personnel accountable for NCD programs - DDO aspires to be the technical
authority in the country with in-house experts/specialists in the field of NCDs
who are able to extend technical know-how to its clients, partners and relevant
stakeholders and manage programs toward desired outcomes.
Resources
o Strategic Objective 8. Establish an effective and efficient resource
management system—the DDO shall ensure adequacy and timeliness of
delivery of medicines and health products in health facilities. This also
includes improving systems to expand the absorptive capacity of the DDO viz.
more funds and investments to meet the growing demand for NCD-related
goods and services;
6
At the program level, the DDO strategic plan considers the peculiarities of each program
although the components are basically similar. Each program sets its specific objectives
based on the SOs. Approaches differ since there are program-specific policies, standards and
guidelines. While LRDs programs, for instance, focus on prevention and control activities,
the health program for PWDs look into the accessibility of health services and rehabilitation
centers as well as the provision of “reasonable accommodation”.
In terms of measuring performance, the DDO developed its organization-level scorecard
whereby it defines the key performance indicators (KPIs) for each SO. The KPIs for social
impact are stated as percent reduction in NCD prevalence expressed in terms of mortality,
morbidity and disability. The KPIs for capacity building pertain to number and/or percent of
health facilities, CHDs and LGUs provided with the necessary trainings. The same constructs
of KPIs applies to the other SOs. Annual targets are set with the intention to refine these as
strategies that will evolve over time. Each of the DDO programs likewise defined their KPIs
and targets in the same measurable constructs.
7
PART I
INTRODUCTION
Noncommunicable diseases (NCDs) are a group of conditions that include lifestyle-related
diseases such as cancer, cardiovascular diseases, diabetes mellitus, and chronic respiratory
diseases. They also encompass other degenerative diseases classified as “essential NCDs”
like visual impairment or blindness, some forms of functional disabilities, and accidents due
to violence, injury, etc. LRDs are noted to share common risk factors (e.g. tobacco use,
unhealthy diet, lack of physical activity, and harmful use of alcohol) and some of them are
associated with essential NCDs (e.g. visual impairment caused by diabetes mellitus). This
relationship among NCDs entails a comprehensive and integrated approach of prevention,
control and treatment.
Global trends show that chronic LRDs are the leading causes of mortality and disability
worldwide (WHO, 2011; Mathers CD., 2006) and by 2020, NCDs are expected to account for
73% of global mortalities and 60% of the disease burden (WHO). As regards persons with
disabilities (PWD), the 2012 WHO Fact Sheet states that over 1 billion people, or
approximately 15% of the world’s population, have some form of disability; 80% of them
live in low-income countries, wherein majority are poor and cannot access basic services.
The same 2012 WHO Fact Sheet reveals that there are about 285 million people having
visual impairment, of which 39 million are blind and 246 have low vision. Further, based on
another WHO Report (2012), violence and injuries accounted for approximately 1.2 million
deaths in the Western Pacific Region in 2008, which is about one quarter of global death toll
from such causes.
In the Philippines, health statistics show that seven (7) of the ten (10) leading causes of death
are noncommunicable in etiology in 2007 (NSO). NCDs, specifically diseases of the heart
and vascular system, have replaced the position of infectious diseases such as pneumonia and
tuberculosis as the topmost leading causes of death (DOH, 2009). DOH reported in 2005 that
lifestyle-related noncommunicable diseases (LRNCDs) caused 49.9% total deaths in the
country while almost one-third (30.8%) of all deaths were caused by heart and vascular
diseases (DOH, 2012). Malignant neoplasm, chronic obstructive pulmonary diseases (COPD)
and diabetes mellitus are included among the top list causes of death. On the other hand,
morbidity trends showed that NCDs such as hypertension and heart diseases are leading
causes of illness. The 2010 Census of Population and Housing (2010 CPH) found that 1.44
million or 1.57% of the 92.1 million Filipinos have a disability. Meanwhile, the prevalence of
visual impairment was 4.62% based on the 2002 national survey on blindness and low vision.
As to violence and injury, about 7,000 Filipinos die each year due to road traffic crashes, and
drowning comes as leading cause of injury and death among children.
8
The Philippine government through the Department of Health (DOH)-National Center for
Disease Prevention and Control (NCDPC) has been implementing NCD or degenerative
disease prevention and control programs in decades past. The DDO is mandated to perform
the following functions:
1. Develop policies, standards and guidelines for NCD prevention and control;
2. Develop plans, programs and projects to carry out preventive and control strategies
against NCDs;
3. Set health objectives and priorities for NCD prevention and control;
4. Assist and strengthen capacity to measure and analyze the burden of NCD;
5. Provide monitoring and evaluation schemes to measure interventions in the
prevention and control of NCDs.
By its mandate, the DDO has been at the forefront of country efforts against NCDs. It has
spearheaded the development and implementation of various packages of NCD prevention
and control which include relevant administrative policies, clinical practice guidelines, health
promotion and education programs, local health systems strengthening, capacity building,
linkage-building, monitoring and evaluation, among others.
However, better health outcomes remain a challenge to the Philippine government as
evidenced by the rising prevalence of NCDs. Thus, the health sector launched the Universal
Health Care (UHC) for All Filipinos, also known as Kalusugan Pangkalahatan (KP) to
address the burden of diseases, among others. UHC/KP deliberately focuses on the poor who
are at highest risk for ill-health. It builds on the gains of health reforms and aims to achieve
the following: (1) financial risk protection through the expansion of the National Health
Insurance Program enrolment and benefit delivery, (2) responsive health system by way of
improvement in health facilities and services, and (3) better public health interventions to
attain the Millennium Development Goals (MDG).
The challenge and burden of NCDs has become significant. A WHO Report in 2005
(Preventing Chronic Diseases: A Vital Investment) noted that countries can incur national
income losses as a result of the impact of deaths from NCDs on the labor supply and savings.
Cognizant of the growing magnitude and burden of NCDs, the DDO recognized the need to
broaden the NCD response, intensify efforts and beef up capacities on NCD prevention and
control. This means bracing for greater demand for specialized health services and improving
access to such, higher investment on NCD programs, policy changes, enhancement of
technical and managerial capacities, improvement of operational system and procedures, etc.
Formulation of strategic interventions thus becomes an imperative, so DDO initiated the
development of a strategic plan to draw its roadmap in the next five years (2013-2017). More
than setting directions, the DDO strategic plan also serves as basis of measuring program
results vis-à-vis desired outcomes and gauging overall DDO performance.
The DDO Strategic Plan is conceived to embody both organizational and program objectives.
Its development also gives an opportunity for it to convene the different players in the
prevention and control of NCDs and incorporate their inputs. Through this, the DDO will be
9
able to establish a supportive environment at the national and local levels and forge a more
cohesive multi-sectoral partnership.
Several initiatives guide the development of the DDO strategic plan such as the NCDPC
Strategic Plan (2013-2014), the Organizational Performance Indicators Framework (OPIF)
introduced by the Department of Budget and Management (DBM), and the PGS adopted by
the DOH in 2009.
THE DDO’S STRATEGIC PLANNING PROCESS
In 2012, the DDO contracted the Development Academy of the Philippines (DAP) through
the Center for Sustainable Human Development (CSHD) to provide technical assistance in
the “Development of a Strategic Plan Framework and 5-year Strategic Plan for all
Degenerative Disease Programs.” This project aimed to support the development of the
DDO’s strategy, direction or road map that would lead the office from where it is now to
where it would like to be in the next five (5) years. It aimed to develop a strategic framework
and a five-year strategic plan for all DDO programs namely:
a. Lifestyle-related Disease Programs [Cancer, Diabetes Mellitus, Chronic Respiratory
Diseases(CRD), and Cardiovascular Disease (CVD)]; and
b. Essential Noncommunicable Disease (NCD) Programs [Health and Wellness Program
for Persons with Disabilities, Violence and Injury Prevention Program (VIPP),
Prevention of Blindness Program (PBP), and Health and Wellbeing of Senior Citizens
Program (HWSCP)].
The Change Management Framework
The DDO has taken basic phases in organizational development (OD) to facilitate the crafting
of its strategic directions and align the strategic plan with the NCDPC and DOH. These
phases are the following with the corresponding outputs shown in Figure 1:
1. Creating the climate for change;
2. Engaging and enabling the organization; and
3. Institutionalization and sustainability.
10
The first phase involves establishing a climate for change within the organization, where it
sets perspectives and ownership of change among the management and staff. The second
phase engages and enables the organization to formulate its vision and mission statement,
identify its strategic objectives and scorecards. The last phase ensures that the strategic plan
of the DDO becomes incorporated in the office’s organizational culture. The strategic plan
serves as guide to the staff in planning, implementing, monitoring and evaluating the
performance of the office.
The key activities in the development of the DDO Strategic Plan include the following:
1. Gaps Analysis and Review of Related Literature
2. Series of Stakeholder Consultations
3. Strategic Planning Workshop and Coaching Sessions
The proceedings and outputs of these processes are contained in a separate report which is an
integral part of this Strategic Plan. (Please refer to said report for details).
Figure 1 Change Management Framework for DDO Strategic Planning Intervention
11
CURRENT GAPS AND CHALLENGES
The development of the DDO Strategic Plan through the aforementioned processes revealed
certain gaps and challenges in the management of DDO programs. These serve as basis in the
formulation of the Strategic Plan framework. This section presents a summary of the
identified gaps and challenges. Please refer to the full reports (Policy Analysis and Program
Assessment, Literature Review, and Stakeholder Consultation) for the context and premises.
On Advocacy and Health Promotion
1. Need for harmonized and integrated action plan for NCD prevention and control. The
DDO should work closely with the National Center for Health Promotion (NCHP) to
have a communication plan for all the programs of the DDO to reflect a more holistic
and integrated plan to address both preventive and treatment interventions.
2. Insufficient advocacy campaigns on other NCD programs. Advocacy and health
promotion for other NCD programs still need to be strengthened. Other areas of
concerns such as road traffic accidents, child injuries and violence, poisoning, falls,
burns, and drowning should also be highlighted.
3. Lack of monitoring and evaluation system to assess existing advocacies. Although
there are existing advocacies and campaigns on healthy lifestyle and injury
prevention, the initiatives still need to be assessed to gauge their impacts. There is still
no clear evidence that these advocacy campaigns have involved and mobilized
communities. Due to the lack of monitoring and evaluation tools, health promotion at
the local level could not be verified.
4. Need for coalition-building for other NCD programs. The rest of the essential DDO
programs (PWD, VIPP, PBP, and PODTP) also recognized the need for multi-sectoral
actions to harmonize efforts. There should be more inclusive approaches in
implementing LRD and essential NCD programs to attain social and environmental
support. More involvement of other sectors may result in more support in advocacy.
5. Other advocacy concerns that need to be addressed for NCD programs. With limited
budgets allocated by LGUs to NCD prevention and control programs, there is then a
pressing need for the DDO, in collaboration with the Bureau of Local Health
Development (BLHD) and the CHDs, to convince the local chief executives (LCEs)
to provide additional funding support for NCD programs along with corresponding
local policies to expand health promotion and education activities even at the
community level.
On Capacity Building
1. Lack of capacity building activities for local health workers. Although there were
training programs conducted by the DDO over the past years, the number of training
programs that have been conducted on NCDs is not sufficient.
12
2. Training programs for HL campaign is limited to public health workers. With the
increasing demand for NCD prevention and control, the need to expand and extend
these training programs to other service providers, medical professionals,
nongovernmental organizations (NGOs), private and corporate institutions, and other
community organizations is also increasing.
3. Maximizing technology for capacity development. The DDO, in collaboration with
other offices of the DOH, should develop and promote online courses to maximize
technology for capacity development.
On Health Systems Strengthening
1. NCDs are not a priority program of LGUs. Most LGUs do not consider NCD a
priority program, as manifested by the absence of a specific line item for NCDs in the
local health budgets. The DDO needs to work closely with the BLHD and CHDs to
advocate for local policies that would strengthen the response of LGUs to NCD
prevention and control.
2. Lack of appreciation of PHIL PEN. The implementation of the PHIL PEN is still a
major challenge, as there is still a need to strengthen its appreciation among the
management and staff of the DDO to integrate this service delivery package into their
strategic plans.
3. Weak referral system in service delivery. The DDO shall then facilitate the
development of referral procedures and guidelines to establish an effective public-
private referral system for NCD prevention and control.
4. Need to strengthen efficient distribution system of medicines and health products.
Delays in the supply of some health products (e.g., vaccines) and the absence of big
cold chains in the region and in the provinces were noted.
5. Inaccessibility of rehabilitation centers and other health programs for PWDs. The
DDO, in coordination with the National Center for Health Facility Development
(NCHFD), should ensure that habilitation and rehabilitation services in regional
hospitals to provide easier access and wider options for PWDs.
6. Inadequate human resources at the public health facilities. Scarcity of human
resources in government facilities, from primary care to tertiary levels, was noted to
be a major service gap in NCD program implementation.
7. Lack of community participation in the different program interventions. The
integration of community-level involvement is still lacking in the current
interventions.
On Healthcare Financing
1. Problem on the PHIC primary care benefit package. Most of the primary care
facilities, such as rural health units and barangay health stations are not yet well-
equipped and prepared in terms of human resources and equipment to offer primary
care benefit package.
13
2. Limited budget of LGUs on NCD programs. LGUs have allocated limited budgets to
NCD programs, despite the fact that NCDs are major causes of mortality and
morbidity.
3. Need to tap other funding sources in program implementation. Mobilizing other
sources, not just the public health sources, for program implementation is still lacking
in the current initiatives.
On Network Building and Collaboration
1. Insufficient collaboration. Insufficient collaboration and the overlapping activities of
the DDO and other organizations were identified by the stakeholders as significant
barriers to the effective performance of the programs.
2. Weak collaborative initiatives at the local level. There is a need to localize coalitions
and partnerships to harmonize efforts toward lifestyle-related NCDs even at the
community level.
On Policy Development and Regulation
1. Existing policies not operationalized. With the existing AOs of the programs, there is
a need to ensure the effective and efficient management of the strategies stipulated in
these policy instruments.
2. Policy instrument on multi-sectoral participation is limited to AOs. There is also a
need to strengthen policy instruments (other than AOs) to ensure multi-sectoral
participation in the control and prevention of NCDs.
3. Lack of local policies to support NCD programs. With the situation that LGUs have
their own set of interests, priorities, and agenda separate from the national
government, it is then necessary for the DDO programs, through the CHDs and
BLHD, to build and facilitate a participative mechanism in the health policymaking
process of the local governments.
On Research
1. Lack of research agenda. With the rapid increase of NCDs and essential degenerative
diseases in the country, the DDO should intensify its research component in order to
develop evidence-based policies, standards, and guidelines for the prevention and
control of NCDs.
On Surveillance, Monitoring, and Evaluation
1. Problem on the registries. There is a need to upgrade the system and develop the
information architecture of the DOH’s website.
2. The Unified Registry System is not yet operationalized. The challenge is how this
specific system will be integrated into the national health information system,
especially with the fragmentation issue within the health information systems of
14
DOH. How the unified registry system will be operationalized at the different levels
of facilities and be harmonized and integrated into the other existing information
systems is also a big challenge for the DDO.
3. Lack of effective and consistent M&E systems. There is no standard monitoring tool
currently in place for the CHDs to adopt and utilize.
15
IMPLEMENTING STRUCTURE
The DDO is a sub-organization under the NCDPC, which is one of the bureaus or centers of
the DOH. It is where the NCD programs are lodged. The creation of DDO started with the
passage of Executive Order No. 119, which clustered the offices of Ministry of Health
(MOH) into Public Health Services, Hospital and Facilities Services, Standards and
Regulations, and Management Services. One of the units created under the Office for Public
Health Services was the Noncommunicable Disease Control Service. This unit focused on the
prevention and control of all NCDs as well as the conduct of studies and researches related to
mental illness, other noncommunicable diseases and occupational health.
It is in 1999 under the Executive Order No. 102 when the Office for Public Health Services
became the National Center for Disease Prevention and Control (NCDPC). The
Noncommunicable Disease Control Service was renamed to be Degenerative Disease Office
(DDO). Two divisions were lodged under the DDO: Plans, Program and Project
Development Division; and Technical Assistance and Resource Development Division. Due
to lack of funds, the office could not cover all NCDs. Hence, it was ordered to focus only on
degenerative diseases.
Currently, the DDO is composed of Essential DDO Division and Lifestyle-Related Disease
Division. However, with the existing implementation of the rationalization program of the
department, pursuant to Executive Order No. 366, the DDO management and staff shall brace
themselves with the impending structural implications within the NCDPC. If in any case the
DDO as an office will be affected, the two (2) divisions will be guided by the strategic plan
framework developed for the management of the various NCD programs.
Figure 2 below shows the current organizational structure of the DDO as part of the NCDPC.
Figure 2 Current NCDPC Organizational Structure
Infectious
Disease
Office
Environment
and
Occupational
Health
Office
Director IV
Director III
Family
Health
Office
Degenerative
Disease
Office
Director III
16
Figure 3 shows the current structure of the DDO.
Figure 3: Current DDO Organizational Structure
At the program level, the figures below represent how DDO manages its programs. Figures 4
and 5 show the management structure of the two (2) divisions under DDO, which are subject
to change over time based on DOH thrusts and directives.
Figure 4 Current Management Structure of the LRD Division
Degenerative
Disease Office
Essential DDO
Division
Lifestyle-related
Disease Division
Diabetes Mellitus Prevention and
Control Program
(Supervising Health Program
Officer)
Cardiovascular
Disease
Prevention and
Control Program
(Nurse IV)
Cancer
Prevention and
Control Program
(Nurse IV)
Chronic Respiratory
Diseases Prevention and
Control Program (Supervising
Health Program Officer)
Medical Specialist II Medical Specialist II
Medical Specialist IV
Division Chief
17
Figure 5: Current Management Structure of Essential NCD Division
Medical Specialist IV
Division Chief
Violence and Injury
Prevention Program
Medical
Specialist II
Prevention of Blindness Program
Medical Specialist II
Health Program for Persons with Disabilities
Chief Health
Program Officer
Policy
Capability Building
Coordination, Networking & Information Management
Research and M&E
1
PART II
DDO STRATEGICPLAN FOR 2013 - 2017
This section presents the overall DDO Strategic Plan Framework or Strategy Map and the
DDO Scorecard for each of the strategies. The DDO Scorecard contains the key performance
indicators and targets, and as such, also serves as a tool for monitoring and evaluation (M&E)
of program results (output/outcome/impact) and organizational (DDO) performance per year
and for the duration of the Strategic Plan. The DDO Strategic Plan is linked with the NCDPC
Strategic Plan such that its implementation, monitoring and evaluation are within the purview
of the Center.
THE DDO STRATEGY MAP
The strategy map is a visual framework of the cause and effect relationships among the
components of an organization’s strategy and is used to integrate the four perspectives of a
balanced scorecard (BSC), which are the following: financial; customer; internal; and
learning growth (Kaplan, 2004).
The DDO Strategy Map outlines the vision, mission, and strategic objectives to be attained by
the Office by 2017. The journey towards the pursuit of the DDO vision is organized into the
four basic perspectives of the BSC. In addition, they have also included a 5th
perspective
(Social Impact), which represents the value the DDO envisions to provide society. The DDO
strategy map is aligned and consistent with the DOH strategy map. It has five perspectives or
areas of excellence and eight strategic objectives. The strategic directions of the DDO as
expressed in the strategy map are aligned with the organizational thrusts of the DOH and the
strategic plan of the NCDPC.
2
Figure 6 Degenerative Disease Office Strategy Map
Vision and Mission
The DDO envisions itself to be the Center for Excellence in the prevention and control of
noncommunicable diseases by 2017. As a lead agency of the health sector, the DOH through
the NCDPC-DDO hopes to exemplify excellence in the management of its various programs
to avert and control the spread of NCDs and other degenerative diseases across the country.
In order to attain this vision, the DDO aims to direct and harmonize all efforts in the
prevention and control of noncommunicable diseases in the country. To fulfill its mandate,
the DDO shall lead all stakeholders towards an integrated and comprehensive action in NCD
prevention and control.
Strategic Objectives
Strategic objectives are broadly defined objectives that an organization must achieve to make
its strategy succeed. According to Peter Drucker (1954), strategic objectives are in general
externally focused and fall into eight major classifications (market standing, innovation,
human resources, financial resources, physical resources, productivity, social responsibility,
and profit requirements).
The DDO strategic objectives are grouped and focused on the different perspectives in the
strategy map, leading to the achievement of the Office’s vision. These objectives are as well
aligned to the KP and the MDGs. Table 1 below outlines the eight strategic broad objectives
of the DDO.
3
Table 1 DDO Strategic Objectives
Strategic Perspectives Strategic Objectives
Social Impact 1. Reduced morbidity, mortality, and disability due
to NCDs
People Empowerment 2. Enhanced capacity of CHDs and other
stakeholders in NCD prevention and control
Internal Processes 3. Ensure the development and implementation of
evidence-based policies, standards, and guidelines
4. Ensure relevant and efficient capacity building
5. Strengthen collaboration with stakeholders on
NCD programs
6. Ensure reliable, timely, and complete data and
researches
Organisation 7. Guarantee adequate, competent and expert DDO
personnel accountable for NCD programs
Resources 8. Establish an effective and efficient resource
management system
At the top of the strategy map is its societal goal of reducing morbidity, mortality, and
disability due to noncommunicable diseases. This is aligned to the DOH’s and NCDPC’s
societal goal that are both anchored to the Philippine Development Plan (PDP) and MDGs.
The PDP lays down the broad societal goals and specifies the sectoral goals and priorities of
the government.1
The DDO also intends to enhance the capacity of CHDs and other stakeholders in NCD
prevention and control. This is in line with one of the core functions of the DDO, which is to
assist and strengthen the capacities of CHDs and other stakeholders in implementing NCD
programs. This strategic objective is likewise related with the KP’s strategic thrust of
improving capacity of health workers in providing quality health care services to all Filipinos.
The DDO also aims to ensure the development and implementation of evidence-based
policies, standards, and guidelines. This is to make sure that all Filipinos have access to
health services, essential medicines and technologies of assured quality, availability and
safety.
1 Department of Budget and Management. 2012. Organisational Performance Indicator Framework: A Guide to
Results-Based Budgeting in the Philippines.Malacañang, Manila.
4
The DDO is also mandated to provide access to professional health care providers that are
capable of meeting the needs of all Filipinos with the appropriate level of care. The DDO is
therefore accountable of providing and ensuring relevant and efficient capacity building
program. In the same light, the DDO shall guarantee adequate, competent, and expert DDO
personnel accountable for NCD programs.
The Department (of Health) through its mandate and the Kalusugang Pangkalahatan
acknowledges the importance of stakeholders and maintaining collaboration. The DDO
intends to promote and even strengthen collaboration with stakeholders on NCD programs.
One of the functions of the Department (of Health) is articulating the national health research
agenda. In response to this, the DDO shall ensure reliable, timely, and complete data and
researches by establishing an effective monitoring and surveillance system.
The DDO aims to establish an effective and efficient resource management system within the
organization. This will ensure that services, equipment and products are properly cascaded to
its intended beneficiaries and clients at the regional and local level.
Core Values and Norms
A core value is an important component that governs the behavior of the people in an
organization. At the bottom of the DDO strategy map are the core values the Office would
adhere to in order to achieve its goals and objectives, namely integrity, excellence, and
compassion (see also Box 1).
5
Box 1: DDO Core Values and Norms
Note: Adopted from the NCDPC
Integrity
We comply with all rules and regulations of the government, the
organization and the office
We complete all transactions and documents for clients accurately and
without delay
We do not receive nor ask any gift from clients in return for services
provided
We avoid conflict of interest and political patronage
We practice moral ascendancy in dealings with clients
Compassion
We are equitably sensitive, responsive, and caring to our clients and their
needs
We gladly provide prompt and appropriate service/technical advice to all
clients
We show respect to all clients and co-workers
We deliver rights-based, gender and culture sensitive services in an
enabling environment
Excellence
We formulate evidence-based policies and guidelines
We establish, uphold and maintain quality standards for disease prevention
and control in the country, and in the performance of DDO duties
We encourage initiatives, innovation, and creativity
We recognize outstanding performance through incentives and rewards
6
DDO SCORECARD
The DDO Scorecard translates broad objectives into measurable items and actionable details
to help facilitate strategy execution, monitoring, and evaluation. The DDO scorecard contains
the key performance indicators and targets for each of the strategic objectives.
An indicator is a quantitative or qualitative factor or variable that provides a simple and
reliable means to measure achievement, to reflect changes connected to an intervention, or to
help assess the performance of a development actor.2 A performance indicator is a variable or
quantitative measure used to determine progress toward the achievement of strategic
objectives.
There are 85 key performance indicators (KPIs) in the DDO Scorecard. These KPIs are the
measures to be used to monitor and evaluate the success of the DDO in achieving its
objectives.
Social Impact
At the top of the strategy map is a societal goal that pronounces the intended desirable impact
of DDO programs, projects, and activities to society. The DDO’s societal goal is aligned with
the DOH’s and NCDPC’s societal goals that are both anchored in the PDP and the MDGs. It
is in this light that the DDO aims to contribute to a higher goal that is improving health
outcomes through the reduction of morbidity, mortality, and disability due to NCDs.
Strategic Objective 1. Reduced morbidity, mortality, and disability due to NCDs
General statistical data such as morbidity and mortality rates and prevalence rate on
noncommunicable and lifestyle-related diseases are important in determining the health status
of (certain) populations. The impact of the increase and decrease of these data aids in
monitoring and evaluating health systems.
The table below presents the key performance indicators for the first strategic objective with
2012 as baseline year. Annual targets have not been set for most of the indicators in the LRD
program because the indicators are more focused on the reduction of risk factors, which can
only be manifested in the change of behavior among high-risk individuals and patients. This
can only be measured after considerable years of continuing information, education and
communication activities for healthy lifestyle (e.g. FNRI survey is conducted every 5 years).
2Managing for Development Results (MfDR) Glossary of Terms.
7
Table 2 DDO Scorecard on Strategic Objective 1
STRATEGIC
OBJECTIVE
KEY
PERFORMANCE
INDICATOR
BASELINE TARGETS
2013 2014 2015 2016 2017
1. Reduced
mortality,
morbidity
&
disability
due to
NCDs.
Prevalence of
adults’ current
tobacco use by 2%
per year
28.3%
(both sexes)
NOH,GATS,
2009
- 10%
reduction - -
-
Prevalence of
youths’ current
tobacco use by 2%
per year
13.7%
GYTS 2011 - 10%
reduction - - -
Prevalence rate of
raised blood
pressure
25.3%
(NNHS,
2008) - 22.0% - - -
Prevalence rate of
adults with high
fasting blood sugar
4.8%
(FNRI, 2008) - 4.3% - - -
Prevalence rate of
high total serum
cholesterol among
adults
10.2 %
(NNHS,
2008) - 9.0% - - -
Percent of
overweight and
obese among adults
26.6 %
(NNHS,
2008) - 23.5% - - -
Prevalence of
adults with high
physical inactivity
60.5% - 50.8% - - -
Mean population
intake of salt per
day in grams
3.3%
(NNHS,
2008) - <3.3% - - -
Percent increase in
mean one-day per
capita fruits and
vegetables intake in
grams
54g
(FNRI,2008)
110g
(WHO
Report)
110g (AO)
-
400 gms
133 gms
(AO)
- - -
Percent of women
aged 21-year old
and above screened
No data
available
80% within 5 years
(annual targets to be determined by LGUs)
8
STRATEGIC
OBJECTIVE
KEY
PERFORMANCE
INDICATOR
BASELINE TARGETS
2013 2014 2015 2016 2017
for VIA
Percent of women
positive for VIA
aged 21-year old
and above managed
No data
available - - 100% 100% 100%
Proportion of adults
25 years old and
above screened for
PhilPEN
No data
available - - - 50% -
No. of patients aged
25-year old and
above diagnosed
and managed for
hypertension
No data
available - - - 100% -
No. of patients aged
25-year old and
above diagnosed
and managed for
diabetes
No data
available - - - 100% -
Percent of senior
citizens who have
consulted and
availed health
services
No data
available TBD
Percent of senior
citizens who have
been managed by
health facilities
No data
available TBD
Percent of PWDs
who have availed
health services
No data
available TBD based on the National
Disability Survey 10% 20%
Percent of PWDs
who have availed
rehabilitation and
habilitation services
including assistive
technology
No data
available TBD based on the National
Disability Survey 10% 20%
9
STRATEGIC
OBJECTIVE
KEY
PERFORMANCE
INDICATOR
BASELINE TARGETS
2013 2014 2015 2016 2017
Percent prevalence
of deaths from
violence and injury
No data
available
Set
baselin
e
10% - - -
Percent prevalence
of disability caused
by violence and
injury
No data
available
Set
baselin
e
10% - - -
Prevalence of
bilateral blindness
due to all causes
565,305
(Philippine
National
Survey on
Blindness,
2002)
- - -
522,864
Less than
(<.05)
-
Prevalence of
cataract blindness
350,489
(Philippine
National
Survey on
Blindness,
2002)
320,07
9 280,546 229,154
162,354
(.50%)
Prevalence of
blindness and
visual impairment
due to refractive
errors
58,226
(Philippine
National
Survey on
Blindness,
2002)
- - - 56,469
(10%) -
Prevalence of
blindness and
visual impairment
in children
205,36
(Philippine
National
Survey on
Blindness,
2002)
- - - 110,167
(50%) -
Morbidity rates refer to the number of people within a certain unit of the general population
who have a certain disease or condition. Morbidity rates are used to determine how common
a particular condition is and the likelihood that other members of a population becomes
afflicted.
10
Mortality rate is a measure of the frequency of occurrence of death in a defined population
during a specified interval.3 Mortality rates are used to show the increase and decrease in a
cause of death over a lengthy time period.
Republic Act 72774 defines ‘disability’ as a physical or mental impairment that substantially
limits one or more psychological, physiological or anatomical function of an individual. It is
DDO’s intention to improve the functionality of persons with disabilities and prevent them
from further impairments or disability.
Reduction in morbidity, mortality, and disability data due to essential NCDs and LRDs is a
manifestation of improved access to quality health facilities.
People Empowerment
This strategic perspective pertains to empowering and capacitating DDO target beneficiaries,
which are the Centers for Health Development (CHDs), LGUs and other stakeholders in the
prevention and control of NCDs.
Strategic Objective 2. Enhanced capacity of CHDs and other stakeholders in NCD
prevention and control
The DDO is expected to function as a capacity-builder for CHDs, LGUs, government agencies and
other stakeholders for the effective implementation of essential NCD and LRD programs. These
groups are either directly or indirectly involved with the operation or management of NCD
programs. The DDO aims to enhance capacities of CHDs and other stakeholders in NCD
prevention and control through adoption of policies, creating structures and enabling
mechanisms, and allocating fund for implementation.
The achievement of this strategic objective can be measured using the following indicators
presented in the table below.
Table 3 DDO Scorecard on Strategic Objective 2
STRATEGIC
OBJECTIVE
KEY
PERFORMANCE
INDICATOR
BASELINE TARGETS
2013 2014 2015 2016 2017
2. Enhanced
capacity of
CHDs and
No. of trained
CHDs/DOH
hospitals who
16 CHDs
51 DOH
hospitals
-
1 CHD
20
DOH
- - -
3As defined by the Center for Disease Control (CDC).
4Republic Act 7277. An Act Providing for the Rehabilitation, Self-Development and Self-Reliance of Disabled
Person and their Integration in the Mainstream of Society and for other Purposes. Approved on March 24, 1992.
11
STRATEGIC
OBJECTIVE
KEY
PERFORMANCE
INDICATOR
BASELINE TARGETS
2013 2014 2015 2016 2017
other
stake-
holders in
NCD
prevention
and control
underwent training
on Smoking
Cessation
hospital
s
No. of CHDs able to
roll out training on
Smoking Cessation
16 16 17 17 17 17
No. of trained NGAs
who underwent
training on Smoking
Cessation
1 - 1 21 - -
No. of stakeholders
that adopted LRD
training/training
packages:
Training
institutions
Allied medical,
paramedical,
academic
institutions
Other
stakeholders
(NGAs, NGOs,
private sector)
0
0
0
-
-
-
4
-
1
4
1
1
4
1
1
-
-
-
Percent of LGUs
(cities and
municipalities) that
implemented a
comprehensive
program in the
prevention and
control of LRDs
2,123
RHU 0 10% 15% 20% 25%
No. of CHDs who
conducted PhilPEN
roll-out training
14 3 - - - -
Number of CHDs
trained on HWSCP
No data
available - - 17 - -
Number of CHDs
able to provide
technical assistance
on HWSCP
No data
available - - 17 17 17
12
STRATEGIC
OBJECTIVE
KEY
PERFORMANCE
INDICATOR
BASELINE TARGETS
2013 2014 2015 2016 2017
Percent of
stakeholders trained
on HWSCP
No data
available - - - 50% 80%
Percent of target
LGUs trained by
CHDs
No data
available - - - 25% 50%
Number of CHDs
trained on
HWPPWD
No data
available - - 8 12 17
Number of CHDs
able to provide
technical assistance
on HWPPWD
No data
available - - 8 12 17
Number of
stakeholders trained
on HWPPWD
No data
available - - 5 5 5
Percent of target
LGUs trained on
HWPPWD by CHDs
No data
available - - 10% 20% 30%
Number of CHDs
trained on VIPP
No data
available - 17 - - -
Number of CHDs
able to provide
technical assistance
on VIPP
No data
available - 17 17 17 17
Number of
stakeholders trained
on VIPP
No data
available TBD
Percent of target
LGUs trained on
VIPP by CHDs
No data
available -
10%
(pilot) 30% 50% 80%
Percent of referral
and referring
facilities capacitated
on VIPP
TBD - - 30% 40% 50%
Number of CHDs
trained on PBP
No data
available - 17 - - -
Number of CHDs
able to provide
technical assistance
No data
available - 17 17 17 17
13
STRATEGIC
OBJECTIVE
KEY
PERFORMANCE
INDICATOR
BASELINE TARGETS
2013 2014 2015 2016 2017
on PBP
Percent of health
facilities trained on
the PBP Registry
TBD - 10% 20% 30% 40%
Percent of target
LGUs trained on
PBP by CHDs
No data
available - - 10% 20% -
Internal Processes
Internal processes refer to all activities and key procedures required to deliver the services of
the organization. This strategic perspective focuses on how the DDO can improve as an
office to better perform its functions. It is concerned on the effective management of the
DDO programs in terms of its operations and customer satisfaction.
Strategic Objective 3. Ensure the development and implementation of evidence-based
policies, standards and guidelines
Health information and policy, standards and regulation are among the six strategic
instruments identified by the KP in achieving better health outcomes and responsive health
system for all Filipinos.
The DDO shall ensure that existing evidence-based policies, standards and guidelines are
developed and implemented at the national and local levels. These policies provide
mechanisms for equitable access to health services and technologies of quality. New policies
will be developed based on the identified needs, gaps and challenges.
Table 4 DDO Scorecard on Strategic Objective 3
STRATEGIC
OBJECTIVE
KEY
PERFORMANCE
INDICATOR
BASELINE TARGETS
2013 2014 2015 2016 2017
3. Ensure the
development
and
implement-
tation of
evidence-
based
policies,
standards
No. of evidenced-
based policies,
standards and
guidelines developed
for the LRD Program
- 4 - 1 1
Number of evidence-
based policies,
standards and
guidelines
- - 4 - 1
14
STRATEGIC
OBJECTIVE
KEY
PERFORMANCE
INDICATOR
BASELINE TARGETS
2013 2014 2015 2016 2017
and
guidelines
implemented for
LRD program
Number of evidence-
based policies,
standards and
guidelines developed
for HWSCP
1 - 1 - -
Number of evidence-
based policies,
standards and
guidelines developed
for HWPPWD
1 1 2 2 2 2
Number of evidence-
based policies,
standards and
guidelines developed
for VIPP
0 3 1 - - -
Number of evidence-
based policies,
standards and
guidelines developed
for PBP
0 2 2 - - -
Number of
community eye
health care model
piloted and evaluated
0 1 2 2 2 2
Number of
community model for
PWDs piloted and
evaluated
0 - 1 2 2 2
Strategic Objective 4. Ensure relevant and efficient capacity building
Capacity building is one of the several components of the DDO functions. The program shall
then make sure that capacity building activities will be developed and implemented to
provide technical assistance in the prevention and control of NCDs. This will guarantee
efficiency and quality services to be provided by health service providers at all levels of care.
Table 5: DDO Scorecard on Strategic Objective 4
STRATEGIC
OBJECTIVE
KEY
PERFORMANCE
INDICATOR
BASELINE TARGETS
2013 2014 2015 2016 2017
4. Ensure
relevant &
No. of training
packages developed 0 8 8 9 - -
15
efficient
capability
building
for the LRD
program
No. of trainings
conducted on CRD
and Hospice &
Palliative Care
0 - - - 16 18
No. of LRD training
packages adopted by
training institutions
0 - - 1
- 1
Number of training
programs developed
for HWSCP
0 - - 1 - -
Number of training
programs developed
for HWPPWD
1 1 - 3 - -
Number of training
programs developed
for VIPP
0 - 1 - - -
Number of training
programs developed
for PBP
0 1 - - - -
Strategic Objective 5. Strengthen collaboration with stakeholders on NCD programs
In an environment with limited resources and high expectation of accountability such as the
health sector, collaboration and building networks are vital. The DDO acknowledges the
critical role of stakeholders in implementing NCD programs. This is evident in the policies of
the DDO where networking, inter-organizational linkages and collaboration are identified as
strategic components. The DDO shall broaden the range of their stakeholders and strengthen
collaboration with them on NCD programs.
Table 6 DDO Scorecard on Strategic Objective 5
STRATEGIC
OBJECTIVE
KEY
PERFORMANCE
INDICATOR
BASELINE TARGETS
2013 2014 2015 2016 2017
5. Strengthen
collabora-
tion with
stake-
holders on
NCD
programs
Percent of policies,
guidelines, and
standards developed and
events conducted for the
LRD program in
collaboration with other
stakeholders
No data
available 100% 100% 100% 100% 100%
16
STRATEGIC
OBJECTIVE
KEY
PERFORMANCE
INDICATOR
BASELINE TARGETS
2013 2014 2015 2016 2017
Percent of stakeholders
engaged in the HWSCP TBD 80% 80% 80% 80% 80%
Percent of stakeholders
engaged in the PWD
program
No data
available 10% 20% 30% 40% 50%
Number of government
partners capacitated for
PWD programs
1 1 1 1 1
Percent of stakeholders
engaged in the VIPP
program
0
50%
100%
- - -
Percent of LGUs with
operationalized EMSS 0 -
10%
(pilot) 40% 80% 100%
Percent of stakeholders
engaged in the PBP
program
0 20% 30% 40% 50% 60%
Number of public health
convention/summit/
conference on the
essential DDO
programs conducted
0 - 3 1 3 1
Number of a 5 year
communication/ health
promotion plan
developed by NCHP
with technical
assistance provided by
the Essential DDO
programs
0 3 - - -
Strategic Objective 6. Ensure reliable, timely, and complete data and researches
As a lead agency in the implementation of NCD programs, the DDO shall ensure that health
data and information are readily available and accurate. Reliable and complete data and
information will be critical in monitoring the progress of the interventions. This will also be
used in developing evidenced-based policies and plans of not only the Office, but also of the
various groups and stakeholders involved in the NCD prevention and control.
17
Table 7 DDO Scorecard on Strategic Objective 6
STRATEGIC
OBJECTIVE
KEY
PERFORMANCE
INDICATOR
BASELINE TARGETS
2013 2014 2015 2016 2017
6. Ensure
reliable,
timely, and
complete
data &
researches
No. of researches on
LRD program
completed
No data
available -
1
1 1 2
Percent of health
facilities using
integrated NCD
Registry
2 out of 71
hospitals - - 10% 10% 10%
Number of researches
completed for
HWSCP
No data
available - 1 - 1 -
Number of indicators
for HWSCP included
in the FHSIS, LGU
scorecard or any
appropriate
mechanism
0 - -
1
indicator
(FHSIS)
1 indicator
(LGU
scorecard)
-
Number of functional
database registries
operationalized
(PRPWD, PBP
Registry, PNIDMS,
ONEISS)
0 4 - - - -
Number of research
proposals by essential
DDO programs
included in the
national research
agenda
0 3 3 3 3 3
Number of researches
completed for
essential DDO
programs
0 - 1 1 1 1
Percent of needed
data used for policy
making and program
development
available to all
stakeholders
0 100% 100% 100% 100% 100%
18
STRATEGIC
OBJECTIVE
KEY
PERFORMANCE
INDICATOR
BASELINE TARGETS
2013 2014 2015 2016 2017
Number of indicators
for essential DDO
programs included in
the FHSIS, LGU
scorecard or any
appropriate
mechanism
0 - -
4
indicators
(FHSIS)
4
indicators
(LGU
scorecard)
-
Organization
This perspective is focused on DDO as an organization, which deploys health experts and
professionals to perform the functions of the Office.
Strategic Objective 7. Guarantee adequate, competent and expert DDO personnel
accountable for NCD programs
Given the mandate of DDO as technical assistance provider to prevent and control the surge
of NCDs and other degenerative diseases, the DDO is expected to deploy adequate,
competent and expert managers and staff accountable to NCD programs. The DDO
management shall work to instill a sense of responsibility in the mindset of program
managers and staff to ensure that the DDO programs are effective and responsive to the needs
of its clients.
Table 8 DDO Scorecard on Strategic Objective 7
STRATEGIC
OBJECTIVE
KEY
PERFORMANCE
INDICATOR
BASELINE TARGETS
2013 2014 2015 2016 2017
7. Guarantee
adequate,
competent
and expert
DDO
personnel
accountabl
e for NCD
programs
No. of personnel who
attended relevant
local training courses,
seminars, and
workshops (training
outside programs e.g.
managerial,
leadership training
courses)
No data
available - 5 5 5 5
No. of personnel who
attended international
training courses,
seminars, and
workshops
No data
available - 1 1 1 1
19
STRATEGIC
OBJECTIVE
KEY
PERFORMANCE
INDICATOR
BASELINE TARGETS
2013 2014 2015 2016 2017
Percent of personnel
who attended relevant
local or international
training courses,
seminars, and
workshops (technical
competencies)
No data
available - 100% 100% 100% 100%
Resources
The core function of DDO to provide technical assistance in the prevention and control of
NCDs entails effective and efficient management of its resources to ensure that health
services, equipment and products are properly downloaded to its clients at the regional and
local level.
Strategic Objective 8. Ensure an effective and efficient resource management system
The DDO aims to install an effective and efficient resource management system within the
organization to monitor utilization and distribution of its resources.
Table 9 DDO Scorecard on Strategic Objective 8
STRATEGIC
OBJECTIVE
KEY
PERFORMANCE
INDICATOR
BASELINE TARGETS
2013 2014 2015 2016 2017
8. Ensure an
effective
and
efficient
resource
manageme
nt system
Utilization rate of
DDO yearly budget 80%
(2012) 80% 80% 80% 80% 80%
Distribution rate of
commodities 95% (2013) - 95% 95% 95% 95%
20
PART III
DDO PROGRAMS ACTION PLAN (2013-2017)
This section presents in detail the Strategic or Medium-Term Action Plan for each of the
DDO programs. It includes a description of the program, the strategic objectives and
components affected by the program, key activities, and milestones vis-à-vis program-
specific components. Also contained in this Part are the Program-level Scorecards deemed to
contribute to the overall DDO Scorecard discussed in the preceding section.
LIFESTYLE-RELATED DISEASES PREVENTION AND CONTROL
PROGRAM
(LRDPCP)
Lifestyle-related diseases (LRDs) refer to chronic, noncommunicable diseases particularly
cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes. These diseases
are collectively known as LRDs because these diseases have common risk factors, which are
to a large extent related to unhealthy lifestyle.5
LRDs remain to be included in the top causes of mortality—CVD as the 1st, Cancer as 3rd
,
CLRD or COPD as 7th
and DM as the 8th
(PHS, 2009). In addition, Hypertension ranks 3rd
among the top ten causes of morbidity (FHSIS, 2011).
The top ten leading causes of mortality by sites are cancer of the breast, colon/rectum,
prostate and cervix ranking 2nd, 3rd, 5th, and 7th respectively. These diseases are to a large
extent related to unhealthy lifestyle and share common modifiable risk factors namely
tobacco use, unhealthy diet, physical inactivity and alcohol use.
The Smoking Cessation Program is one of the interventions being implemented on LRD. The
Smoking Cessation Program aims to promote and advocate smoking cessation in the
Philippines by providing smoking cessation services to current smokers who want to quit
smoking.
The most popular advocacy campaign for NCDs is the National Healthy Lifestyle Campaign
or better known as the “Mag HL Tayo,” which was launched in 2003 and was taken as one of
DOH’s priorities. The campaign promotes the following messages: don’t smoke; regular
exercise; eat a healthy diet; watch your weight; manage stress; and regular health check-up.
The DOH re-launched the campaign in 2009 as “HL to the Max.” Among the target
audiences of this campaign are executives and employees of local government units,
legislators and politicians, and the media.
5Department of Health. N.d.National Objectives for Health 2005-2010.
21
The challenge now for the LRD program is monitoring and verifying the implementation and
success of the various campaigns on lifestyle-related diseases at the local level. Another
challenge for the LRD program is the implementation of the Philippine Package of Essential
NCD Interventions (PhilPEN). The PhilPEN is an adoption of the WHO guidelines in
managing noncommunicable diseases in low resource settings. There is still a need to
strengthen appreciation on the PhilPEN. There is no monitoring mechanism in place to track
its implementation.
Program Description
To reduce mortality and morbidity from LRDs and its complications, the program, through
the CHDs, aims to develop an integrated, comprehensive and community based approach to
create policies, standards and increase awareness, information and continuing education of
health personnel, high-risk individuals and patients.
The program utilizes early detection through risk assessment and screening at the primary,
secondary, and tertiary levels of health care with the appropriate medical/therapeutic
management, rehabilitation and palliative care at both hospitals and community levels.
Program Objectives
The Lifestyle-Related Diseases Prevention and Control Program has the following objectives
categorized under the different strategic components:
Strategic Component: POLICY, STANDARDS AND REGULATIONS
OBJECTIVE 1: To develop evidence-based plans, programs, policies and standards
for LRDs
OBJECTIVE 2: To ensure health regulatory mechanisms for safe and quality health
care
OBJECTIVE 3: To ensure universal access to essential medicines
The program shall develop evidence-based plans, programs, policies and standards for LRDs.
These policies, standards and guidelines will ensure access to health services and medicines
of quality.
The LRD program shall ensure access to safe and quality health care to health service
beneficiaries by establishing regulatory mechanisms in service delivery.
Key Activities:
1. Development of service packages and national clinical pathway guidelines
for NCDs;
22
2. Development of an Administrative Order for chronic respiratory disease
that shall include a review of the WHO PEN;
3. Development of cancer guidelines for hospice and palliative care;
4. Development of a national treatment guidelines on LRD; and
5. Drafting of the Strategic Plan for 2016-2020 for the LRD Program.
Strategic Component: HUMAN RESOURCES FOR HEALTH
OBJECTIVE 4: To capacitate the CHDs and other stakeholders (LGUs) in the
management of LRD programs
The LRD program intends to capacitate its stakeholders specifically the CHDs and LGUs in
managing various LRD programs. One of the functions of the DDO is to capacitate its
stakeholders and other national government agencies in implementing health programs,
services.
Key Activities:
1. Finalization and pilot testing of the training module on Visual Inspection
using Acetic (VIA) Acid Wash;
2. Conduct of various training on the following: Training of Trainers on VIA;
Training on VIA for health service providers, Training on Smoking
Cessation, and Training on PEN;
3. Dissemination of the National Treatment Guidelines on LRD;
4. Integration of the PhilPEN to allied health professionals;
5. Development of training modules for hospice and palliative care; and
6. Development of training modules on Chronic Respiratory Disease.
Strategic Component: HEALTH INFORMATION
OBJECTIVE 5: To provide health information that is valid and accessible
Health information is essential in the formulation of evidence-based policies and program
development. The LRD program intends to provide health information that is valid and
accessible and at the same time to be able to contribute to the DOHs existing health
information systems. At the same time, health information are used in monitoring and
evaluating programs.
Key Activities:
1. Development of a monitoring plan for the different LRDs and come up
with an integrated plan that will be used to monitor implementation of the
LRD Program;
2. Development of LRD Reporting Forms;
3. Conduct of consultative workshop with stakeholders on the
implementation of PEN, Smoking Cessation Program, and VIA;
23
4. Conduct of an LRD PIR and Planning Workshop; and
5. Monitoring of VIA training and other programs being implemented by the
LRD Program.
Strategic Component: GOVERNANCE FOR HEALTH
OBJECTIVE 6: To strengthen governance structures through localization of LRD
programs
Localization of LRD programs and other health programs are one of the goals not only of the
DDO but of the Department of Health as well. The local government units together with the
CHDs are the ones implementing the different LRD programs at the local level. They are
expected to promote and advocate healthy lifestyle to their respective constituents. More
importantly, they are to educate the population on healthy living.
Key Activities:
1. Conduct of continuous promotional activities for the Belly Gud campaign;
2. Celebration of Cervical Cancer Awareness Month with a kick-off activity
in selected CHDs yearly;
3. Convene a Fitness Camp for DOH employees and other national
government agencies;
4. Convene an ASEAN Regional Forum;
5. Convene a yearly Lay Forum on Lifestyle-Related Diseases; and
6. Convene a Convention on NCD Public Health;
Strategic Component: HEALTH FINANCING
OBJECTIVE 7: To ensure the development of health financing and provider payment
scheme mechanisms for LRDs.
The program shall initiate and push for the development of health financing and provider
payment scheme mechanisms for LRDs to enhance access of patients to healthcare services
and facilities.
Key Activity:
1. Coordination with PhilHealth on the implementation of the Primary Care
Benefit Package.
24
Key Program Milestones
The table below presents the key milestones of the LRD program as identified from 2013
until 2017:
Table 10 Key Program Milestones of the LRD Program
YEAR PROGRAM
COMPONENTS PROGRAM MILESTONES
2013
Policy/Standards/
Guidelines Development
Developed Service Packages and
National Clinical Pathway Guidelines
for NCDs (UP-NIH)
IEC Material Development
Conceptualized content and format of
IEC Materials on LRD
Conceptualized content and format of
VIA Training Module
Health Promotion,
Education and Advocacy
Conducted Belly Gud for Health:
Executive Edition
Conducted Cervical Cancer
Awareness Month Kick-off Activity
in Selected CHDs
Convened a Fitness Camp for DOH
Employees and National
Government Agencies
Convened an ASEAN Regional
Forum
Capability Building Finalized and Pilot Tested Visual
Inspection using Acetic Acid Wash
Training Module
Conducted Training of Trainers on
VIA
Visual Inspection with Acetic Acid
(VIA) Training for Health Service
Providers
Service Delivery School – based HPV Vaccination
Project
Monitoring/Evaluation Developed monitoring plan for LRDs
Developed LRD Reporting Forms
Consultative Workshop on PEN,
Smoking Cessation, and VIA
Research Support to LIFECARE Study
25
YEAR PROGRAM
COMPONENTS PROGRAM MILESTONES
2014
Policy/Standards/
Guidelines Development Developed AO for CRD (Review of
WHO PEN on CRD)
Developed Cancer Guidelines for
Hospice and Palliative Care
Developed National Treatment
Guidelines on LRD
IEC Material Development
Developed LRD Communication
Plan & Conceptualization of IEC
Materials
Enhanced Smoking Cessation
Training Manual
Printed LRD IEC materials (TCL,
risk assessment form etc.)
Health Promotion,
Education and Advocacy
Belly Gud for Health to NGAs
Lay Forum on LRDs
Breast Cancer Awareness Month
Conducted Cervical Awareness
Month Kick-off activity in selected
RHUs
NCD Public Health Convention
Capability Building Training of Trainers on VIA
Conducted Training on Smoking
Cessation
Service Delivery Evaluated School-based HPV
Vaccination Project 1
Monitoring/Evaluation Integrated Monitoring of LRDP
Implementation
LRD PIR & Planning Workshop
Research National Nutrition and Health Survey
Support to LIFECARE
Financing Coordinated with PhilHealth
regarding Primary Care Benefit
Implementation
2015
Health Promotion,
Advocacy, Education, and
Communication
Belly Gud for Health to NGAs
Developed CRD Training
Modules
Breast Cancer Awareness
Month
Conducted Cervical Awareness
Month Kick-off activity in selected
RHUs
Conducted Hypertension and
26
YEAR PROGRAM
COMPONENTS PROGRAM MILESTONES
Diabetes Awareness Week Kick-off
activity in selected RHUs
Reproduced Smoking Cessation
Manual
Convened Lay Forum on LRDs
Capability Building Disseminated AO for CRD
Disseminated National Treatment
Guidelines on LRD
PhilPEN Integrated to Allied Health
Professionals
Developed Training Modules for
Hospice and Palliative Care
Pilot Tested Training Module for
Hospice and Palliative Care
Monitoring/Evaluation Integrated Monitoring of LRDP
Implementation
Consultative and Planning Workshop
on LRDs
2016
Policy/Standards/
Guidelines Development Strategic Plan 2016 – 2020
Health Promotion,
Advocacy, Education, and
Communication
Breast Cancer Awareness Month
Conducted Cervical Awareness
Month Kick-off activity in selected
RHUs
Conducted Hypertension and
Diabetes Awareness Week Kick-off
activity in selected RHUs
Capability Building Conducted Training for Hospice and
Palliative Care
27
LR
D P
rog
ram
SC
OR
EC
AR
D
PR
OG
RA
M
TIT
LE
: L
ifes
tyle
-Rel
ate
d
Dis
ease
s
Pro
gra
m
TA
RG
ET
S
20
17
- - - - - - - - -
80
% w
ith
in 5
yea
rs
(an
nu
al t
arg
ets
to b
e d
eter
min
ed b
y L
GU
s)
10
0%
20
16
- - - - - - - - -
10
0%
20
15
- - - - - - - - -
10
0%
20
14
10
%
red
uct
ion
10
%
red
uct
ion
22
.0%
-
20
13
- - - - - - - - - -
BA
SE
LIN
E
28.3
% (
both
sexes
)
NO
H,G
AT
S,2
009
13
.7%
GY
TS
20
11
25
.3%
(NN
HS
, 2
00
8)
4.8
%
(FN
RI,
20
08
)
10
.2 %
(NN
HS
, 2
00
8)
26
.6 %
(NN
HS
, 2
00
8)
60
.5%
3.3
%
(NN
HS
, 2
00
8)
54
g (
FN
RI,
200
8)
11
0g
(WH
O R
epo
rt)
11
0g
(A
O)
No
dat
a
avai
lab
le
KE
Y P
ER
FO
RM
AN
CE
IND
ICA
TO
R
Pre
val
ence
of
adu
lts’
curr
ent
tob
acco
use
by
2%
per
yea
r
Pre
val
ence
of
yo
uth
s’
curr
ent
tob
acco
use
by
2%
per
yea
r
Pre
val
ence
rat
e o
f ra
ised
blo
od
pre
ssu
re
Pre
val
ence
rat
e o
f ad
ult
s
wit
h h
igh
fas
tin
g b
lood
sug
ar
Pre
val
ence
rat
e o
f h
igh
tota
l se
rum
ch
ole
ster
ol
amo
ng
ad
ult
s
Per
cen
t o
f ov
erw
eig
ht
and
ob
ese
amo
ng
ad
ult
s
Pre
val
ence
of
adu
lts
wit
h
hig
h p
hy
sica
l in
acti
vit
y
Mea
n p
opu
lati
on
in
tak
e o
f
salt
per
day
in
gra
ms
Per
cen
t in
crea
se i
n m
ean
on
e-d
ay p
er c
apit
a fr
uit
s
and
veg
etab
les
inta
ke
in
gra
ms
Per
cen
t o
f w
om
en a
ged
21
-yea
r o
ld a
nd
ab
ov
e
scre
ened
for
VIA
Per
cen
t o
f w
om
en p
osi
tiv
e
for
VIA
ag
ed 2
1-y
ear
old
and
abo
ve
man
aged
ST
RA
TE
GIC
OB
JE
CT
IVE
1.
Red
uce
d m
ort
ali
ty,
mo
rbid
ity
& d
isa
bil
ity
du
e to
NC
Ds.
(S
oci
al
Imp
act
)
28
TA
RG
ET
S
20
17
- - - - 17
-
4V
IA
1 n
urs
ing
1
20
16
50
%
10
0%
10
0%
- 17
-
4V
IA
1 n
urs
ing
1
20
15
- - - - 17
21
4 V
IA
1
20
14
- - -
1 C
HD
20
DO
H
ho
spit
als
17
1
4V
IA
1 n
urs
ing
1
20
13
- - -
16
-
BA
SE
LIN
E
No
dat
a
avai
lab
le
No
dat
a
avai
lab
le
No
dat
a
avai
lab
le
16
CH
Ds
51
DO
H
ho
spit
als
16
(to
be
chec
ked
)
1 0 0 0
KE
Y P
ER
FO
RM
AN
CE
IND
ICA
TO
R
Pro
po
rtio
n o
f ad
ult
s 2
5
yea
rs o
ld a
nd
abo
ve
scre
ened
for
Ph
ilP
EN
No
. o
f p
atie
nts
ag
ed 2
5-
yea
r o
ld a
nd
ab
ov
e
dia
gn
ose
d a
nd
man
aged
fo
r
hy
per
ten
sion
No
. o
f p
atie
nts
ag
ed 2
5-
yea
r o
ld a
nd
ab
ov
e
dia
gn
ose
d a
nd
man
aged
fo
r
dia
bet
es
No
. o
f tr
ained
CH
Ds/
DO
H
ho
spit
als
wh
o u
nd
erw
ent
trai
nin
g o
n S
mo
kin
g
Ces
sati
on
No
. o
f C
HD
s ab
le t
o r
oll
ou
t tr
ain
ing o
n S
mo
kin
g
Ces
sati
on
No
. o
f tr
ained
NG
As
wh
o
un
der
wen
t tr
ain
ing
on
Sm
ok
ing
Ces
sati
on
No
. o
f st
akeh
old
ers
that
ado
pte
d L
RD
tra
inin
g/t
rain
ing
pac
kag
es:
T
rain
ing
in
stit
uti
on
s
A
llie
d m
edic
al,
par
amed
ical
, a
cad
emic
inst
itu
tio
ns
Oth
er s
tak
eho
lder
s (N
GA
s,
NG
Os,
pri
vat
e se
cto
r)
ST
RA
TE
GIC
OB
JE
CT
IVE
2.
En
ha
nce
d c
ap
aci
ty
of
CH
Ds
& o
ther
sta
keh
old
ers
in N
CD
pre
ven
tio
n &
co
ntr
ol
29
TA
RG
ET
S
20
17
25
%
- 1
(PE
N
up
dat
e)
1 (
LR
D)
-
9 (
CR
D)
9
(Ho
spic
e)
1P
EN
(Med
icin
e)
20
16
20
%
- 1
(Rev
ised
AO
on
LR
D)
-
8 (
CR
D)
8
(Ho
spic
e)
-
20
15
15
%
- -
1 (
CR
D P
EN
)
1 (
H&
P C
are
Gu
idel
ines
)
1 (
CP
G)
1 (
NT
G)
9 -
1 P
EN
(Nu
rsin
g)
20
14
10
%
- 4
(H&
P C
are
Gu
idel
ines
;
CP
G;
NT
G;
AO
on
CR
D
8 - -
20
13
0
3 8 - -
BA
SE
LIN
E
2,1
23
RH
U
14
0
0 -
KE
Y P
ER
FO
RM
AN
CE
IND
ICA
TO
R
Per
cen
t o
f L
GU
s (c
itie
s
and
mun
icip
alit
ies)
th
at
imp
lem
ente
d a
com
pre
hen
siv
e p
rog
ram
in
the
pre
ven
tio
n a
nd
con
tro
l
of
LR
Ds
No
. o
f C
HD
s w
ho
con
du
cted
Ph
ilP
EN
ro
ll-
ou
t tr
ain
ing
No
. o
f ev
iden
ced
-bas
ed
po
lici
es,
stan
dar
ds
and
gu
idel
ines
dev
elop
ed f
or
the
LR
D P
rog
ram
Nu
mb
er o
f ev
iden
ce-b
ased
po
lici
es,
stan
dar
ds
and
gu
idel
ines
im
ple
men
ted
for
LR
D p
rog
ram
No
. o
f tr
ain
ing
pac
kag
es
dev
elo
ped
for
the L
RD
pro
gra
m
No
. o
f tr
ain
ing
s co
nd
uct
ed
on
CR
D a
nd
Ho
spic
e &
Pal
liat
ive
Car
e
No
. o
f L
RD
tra
inin
g
pac
kag
es a
dop
ted
by
trai
nin
g i
nst
itu
tio
ns
ST
RA
TE
GIC
OB
JE
CT
IVE
3.
En
sure
th
e
dev
elo
pm
ent
an
d
imp
lem
en
tati
on
of
evid
ence
-ba
sed
po
lici
es,
sta
nd
ard
s
an
d g
uid
elin
es
4.
En
sure
rele
va
nt
&
effi
cien
t ca
pa
bil
ity
bu
ild
ing
30
TA
RG
ET
S
20
17
10
0%
2
10
%
20
16
10
0%
1
10
%
20
15
10
0%
1
10
%
20
14
10
0%
1
10
%
20
13
10
0%
BA
SE
LIN
E
0
KE
Y P
ER
FO
RM
AN
CE
IND
ICA
TO
R
Per
cen
t o
f po
lici
es,
gu
idel
ines
, an
d s
tan
dar
ds
dev
elo
ped
an
d e
ven
ts
con
du
cted
in
co
llab
ora
tio
n
wit
h o
ther
sta
keh
old
ers
No
. o
f re
sear
ches
on
LR
D
com
ple
ted
Per
cen
t o
f h
ealt
h f
acil
itie
s
usi
ng
in
teg
rate
d N
CD
Reg
istr
y
ST
RA
TE
GIC
OB
JE
CT
IVE
5.
Str
eng
then
coll
ab
ora
tio
n w
ith
sta
keh
old
ers
on
NC
D
pro
gra
ms
6.
En
sure
reli
ab
le,
tim
ely
,
an
d c
om
ple
te d
ata
&
rese
arc
hes
31
HEALTH AND WELLNESS PROGRAM FOR PERSONS
WITH DISABILITIES
(HWPPWD)
The International Classification of Functioning, Disability and Health (ICF) refers to
disability as “an umbrella term covering impairments, activity limitations, and participation
restrictions. An impairment is a problem in body function or structure; an activity limitation
is a difficulty encountered by an individual in executing a task or action; while a participation
restriction is a problem experienced by an individual in involvement in life situations”
(WHO, 2013). The ICF’s definition of disability denotes a negative interaction between a
person (with a health condition) and his or her contextual factors (environmental and personal
factors). A comprehensive approach in interventions is then necessary for persons with
disabilities (PWDs) as it entails actions beyond the context of health, but more on helping
them to overcome difficulties by removing environmental and social barriers (WHO, 2013).
The WHO fact sheet (2012) reveals that over 1 billion people, or approximately 15% of the
world’s population, have some form of disability. About 110 to 190 million people 15 years
and older have significant difficulties in functioning. Moreover, the rapid spread of chronic
diseases and population ageing contribute to the increasing rates of disability. About 80% of
the world’s PWDs live in low-income countries, wherein majority are poor and cannot access
basic services. With their conditions, PWDs need greater attention and considerations in
terms of health needs, without discrimination. However, reports show that PWDs have less
access to health services and therefore have greater unmet needs.
In the country, the results of the 2010 Census of Population and Housing (CPH, 2010) show
that of the household population of 92.1 million, 1,443 thousand persons, or 1.57%, have a
disability. Region IV-A, with 193 thousand PWDs, was recorded to have the highest number
of PWD among the 17 regions, while the Cordillera Administrative Region (CAR) had the
lowest number with 26 thousand PWDs. There were more males, who accounted for 50.9%
of the total PWD in 2010, compared to females, with 49.1% with disability. For every five (5)
PWD, one (18.9%) was aged 0 to 14 years, three (59.0%) were in the working age group (15-
64 years old), and one (22.1%) was aged 65 years and above (NSO, 2013).
The mandate of the DOH to come up with a national health program for PWD was based on
Republic Act No. 7277, “An Act Providing for the Rehabilitation and Self-Reliance of
Disabled Persons and Their Integration into the Mainstream of Society and for Other
Purposes” or otherwise known as “The Magna Carta for Disabled Persons”. This document
stipulated that the DOH is required to: (1) institute a national health program for PWDs, (2)
establish medical rehabilitation centers in provincial hospitals, and (3) adopt an integrated
and comprehensive program to the Health Development of PWD, which shall make essential
health services available to them at affordable cost (DOH, 2011).
In line with the Implementing Rules and Regulations (IRR) of RA 7277, the DOH needs to
address the health concern of PWDs. In response to this, the DOH issued AO no. 2006-0003,
32
which specifically provides the strategic framework and operational guidelines for the
implementation of Health Programs for PWDs.
However, in the implementation of the program in the past years, there were operational
issues and gaps identified that need to be addressed. These include the following: there is a
need to strengthen multi-sectoral action to harmonize efforts of stakeholders; unclear
delineation of roles and responsibilities of concerned agencies; lack of capacity building
activities for local health workers (e.g. sensitivity training, CBR, etc.); PWD is not a priority
program at the national and local levels thus inadequate funding; inaccessibility of health
facilities for PWDs; lack of human resources in handling the program; and the need to update
and upgrade the database for PWDs (Philippine Registry for People with Disabilities).
Considering all these situations, there is a need to revisit AO no. 2006-0003 to align the
current needs and challenges of the PWD health program with the thrusts and goals of KP
and UHC.
To be consistent with the Global Health Disability Action Plan (2014-2021), the development
of the strategies and approaches of the HWPPWD should also consider “prevention-related
activities focused on early identification and intervention to prevent the development of
secondary or co-morbid health conditions that are often associated with disability, prevention
of the development of new impairments and prevention of existing impairments becoming
worse through improving access to health care and population-based public health
programmes, and barrier removal” (WHO, 2013).
Program Description
The Health and Wellness Program for PWDs is designed to promote the highest attainable
standards of health of PWDs and prevent them from developing health conditions associated
with disability. This involves the development of policies, standards and guidelines, service
packages, health promotion packages, generation of data, capacity development and
rehabilitation interventions to ensure that PWDs have full access to health services at all
levels of care. It also fosters a multi-sectoral approach towards a disability inclusive health
agenda in order to achieve health and well-being of PWDs and promote and protect their
human rights and fundamental freedom and that of their caregivers and personal assistants.
Program Objectives
The Health and Wellness Program for PWDs aims to accomplish the following objectives
under the following strategic components:
33
Strategic Component: SERVICE DELIVERY
OBJECTIVE 1: To address barriers, and improve access of PWDs to health care
services and programs
OBJECTIVE 2: To ensure the accessibility, availability and affordability of
habilitation and rehabilitation services for PWDs, including children
with disabilities
The program shall work to ensure that quality health services and care are accorded to PWDs
on an equal basis with others. It shall improve general and specialized health services that
will provide necessary adjustments appropriate to accommodate the special needs of PWDs.
These services shall lead to the full enjoyment of PWDs of all human rights and fundamental
freedom.
The program shall ensure that habilitation and rehabilitation services are readily accessible,
available and affordable to PWDs and children with disabilities even in local areas. These
services intend to enable PWDs at the earliest possible stage to develop their skills and
abilities, and maintain maximum independence in order to improve their functionalities at
home and as they move and participate in the community. It shall work to promote
availability of community-based rehabilitation programs, including the use of assistive
devices, technologies and special programs designed for PWDs.
Key Activities:
1. Development of a 5-year package of health promotion activities for PWDs
in coordination with NCHP and relevant stakeholders;
2. Coordination with concerned DOH offices and other relevant partners to
come-up with a national plan to upgrade regional/provincial hospitals
rehabilitation centers for inclusion in the Health Facility Expansion Plan
(HFEP) of the DOH and/or any other system wide mechanism; and
3. Provide technical assistance to LGUs and other stakeholders in the scaling
up of model communities for PWDs.
34
Strategic Components: POLICY, STANDARDS AND REGULATION
HEALTH FINANCING
OBJECTIVE 3: To ensure the development and implementation of policies and
guidelines, health service packages, including financing and provider
payment schemes for health services of PWDs
The program aims to set standards, guidelines and policies in providing health services for
PWDs. This will guarantee efficiency and effectiveness, quality and affordability of these
services even in rural settings.
Key Activities:
1. Amendment of the Administrative Order No. 2006-0003 “Strategic
Framework and Operational Guidelines for the Implementation of Health
Programs for Persons with Disabilities (PWDs)”;
2. Development of service packages for PWDs specifically for disability due
to chronic illness, learning disability and cerebral palsy;
3. Advocacy for the development of financing and provider payment scheme
for health services of PWDs;
4. Development of a Manual of Operations for HWPPWD;
5. Provision of technical assistance to LGUs and other stakeholders in the
development of model communities for PWDs; and
a. Development of a policy promoting and advocating a non-handicapping
environment by ensuring that all government health facilities follow the
specifications for universal design for all its equipment, apparatuses and
facilities.
Strategic Component: HUMAN RESOURCES FOR HEALTH
OBJECTIVE 4: To enhance capacity of health providers and stakeholders in
improving the health status of PWDs
As part of the key functions of the DDO as a technical assistance provider, the program
intends to develop the skills and capacity of health providers including the stakeholders to
provide quality and effective health services for PWDs. This includes ensuring that health
providers at all levels are well-trained, gender sensitive and committed to accommodate the
special needs of PWDs.
35
Key Activities:
1. Development of the following training programs: establishing or
implementing health programs for PWDs (HWPPWD) in local
communities; community-based rehabilitation services and sensitivity
training; and home care and peer counseling for PWDs; and
2. Capacitate CHDs/LGUs/other stakeholders on implementation of CBRS,
sensitivity training, peer counseling, training for homecare and on the
PRPWD.
Strategic Component: GOVERNANCE FOR HEALTH
OBJECTIVE 5: To strengthen collaboration and synergy with stakeholders to
improve response to the health services for PWDs through regular
dialogues and interactions
To align the program with the interventions of other groups, the program shall regularly
network and collaborate with various stakeholders to synergize efforts and resources towards
the improvement of health services for PWDs. This will be done by establishing regular
dialogues and interactions with the association and groups of PWDs, as well as NGOs and
private sector working to improve the functionalities of PWDs.
Key Activities:
1. Enhancement of multi-sectoral action through regular dialogues and
meetings with various stakeholders;
2. Support the capacity of government partners for PWD affairs particularly
National Anti-Poverty Commission/ Persons with Disability Affairs
Office; and
3. Conduct of Public Health Convention on Health Program for PWDs.
Strategic Component: HEALTH INFORMATION
OBJECTIVE 6: To facilitate the collection, analysis and dissemination of reliable,
timely, complete and internationally comparable data and researches
on health-related issues of PWDs in order to develop and implement
evidence-based policies
As a lead agency for the health sector, the DOH through the program shall provide reliable,
timely and complete data and analysis about the health status of PWDs. It shall promote and
develop researches and studies to enhance and update information on health-related concerns
and issues of PWDs. This will guide various stakeholders in the development and
36
implementation of evidence-based policies and effective programs and interventions that suit
the special needs of PWDs.
Key Activities:
1. Conduct of National Disability Survey;
2. Ensure functional PRPWD;
3. Identification of a 5-year research agenda;
4. Inclusion of indicators in the FHSIS, LGU scorecard or any appropriate
mechanism in coordination with other DOH offices (e.g. PWDs availing of
various health services, rehabilitation and habilitation services including
assistive devices/technology); and
5. Conduct of regular monitoring and evaluation for the different activities
implemented by the program.
Key Program Milestones
The table below presents the key milestones of the HWPPWD as identified from 2013 until
2017:
Table 11 Key Program Milestones of HWPPWD
YEAR PROGRAM MILESTONES
2013 Amended AO 2006-0003 for PWD
Developed service packages for PWDs specifically for
disability due to chronic illness, learning disability, and
cerebral palsy.
Advocated for the development of financing and provider
payment scheme for health services of PWDs.
Finalized training program on community-based rehabilitation
services and sensitivity training.
Functional PRPWD
Capacitated CHDs/LGUs/stakeholders on the use of PRPWD
Enhanced capacity of government partners for PWD affairs
particularly NAPC/PDAO
Enhanced multi-sectoral action with stakeholders through
regular dialogues and meetings.
Identified a 5 year research agenda
Coordinated with NCHP and relevant stakeholders
for the development of a 5 year package of health promotion
activities for PWDs
2014 Conducted National Disability Survey
Started the development of a Manual of Operations for
HWPPWD
37
YEAR PROGRAM MILESTONES
Initiated the development of a training program for
establishing/implementing HWPPWD in local communities
Initiated the development of a training program/manual for
home care and peer counseling for PWDs
Coordinated with other DOH offices for the inclusion of
indicators in the FHSIS, LGU scorecard or any appropriate
mechanism
Coordinated with NCHFD to come-up with a national plan
to upgrade regional/provincial hospitals rehabilitation
centers for inclusion in the HFEP of the DOH and/or any
other system wide mechanism.
Provided technical assistance to LGUs and other
stakeholders in the development of model communities for
PWDs.
Capacitated CHDs/LGUs/other stakeholders on
implementation of CBRS, sensitivity training and on the
PRPWD
Conducted 1st Public Health Convention on Health
Program for PWDs
Developed policy promoting and advocating a non-
handicapping environment by ensuring that all government
health facilities follow the specifications for universal
design for all of its structures, equipment, and apparatuses
and to ensure reasonable accommodations for PWDs
Conducted Monitoring and Evaluation of the following :
Implementation of service packages for PWDs specifically
for disability due to chronic illness, learning disability, and
cerebral palsy.
An enhanced multi-sectoral action with stakeholders
A functional PRPWD
An enhanced capacity of government partners for PWD
affairs particularly NAPC/PDAO
Inclusion and implementation of 2014 research agenda to
the NHRA
Health promotion activities for PWDs
2015 Finalized Manual of Operations for HWPPWD and training
programs for HWPPWD, home care and peer counseling.
Capacitated CHDs/LGUs/other stakeholders on
implementation of HPPWD, CBRS, sensitivity training, peer
counseling, and training for homecare and on the PRPWD
Provided technical assistance to LGUs and other stakeholders
in the scaling up of model communities for PWDs.
Conducted Monitoring and Evaluation of the following:
Implementation of the service packages for PWDs
specifically for disability due to chronic illness, learning
disability, and cerebral palsy.
Training programs for CBRS, sensitivity training, , PRPWD
38
YEAR PROGRAM MILESTONES
Inclusion of indicators in the FHSIS, LGUs scorecard or any
appropriate mechanism
An enhanced multi-sectoral action with stakeholders
A functional PRPWD
An enhanced capacity of government partners for PWD
affairs particularly NAPC/PDAO
Inclusion and implementation of 2015 research agenda to
the NHRA
Health promotion activities for PWDs
Inclusion of the National Plan to upgrade regional/provincial
hospitals rehabilitation centers in the Health Facilities
Expansion Plan of the DOH and /or other system wide
mechanisms.
2016 Conducted 2nd Public Health Convention on Health Program
for PWDs
Capacitated CHDs/LGUs/other stakeholders on
implementation of HWPPWD, CBRS, sensitivity training, peer
counseling, training of homecare and on the PRPWD.
Conducted Monitoring and Evaluation of the following:
Implementation of service packages for PWDs specifically
for disability due to chronic illness, learning disability, and
cerebral palsy.
Training programs for HWPPWD, CBRS, sensitivity
training, peer counseling, and home care and PRPWD.
Inclusion of indicators in the FHSIS, LGUs scorecard or any
appropriate mechanism
An enhanced multi-sectoral action with stakeholders
A functional PRPWD
An enhanced capacity of government partners for PWD
affairs particularly PDAO
Inclusion and implementation of 2016 research agenda to
the NHRA
Health promotion activities for PWDs
Implementation of Plan to upgrade regional/provincial
hospitals rehabilitation centers included in the Health
Facilities Expansion Plan of the DOH and/or other system
wide mechanisms.
2017 Reviewed Health Program for PWD
Developed 5 year strategic plan for 2018-2022
Conducted Monitoring and Evaluation of implementation of:
Implementation of service packages for PWDs specifically
for disability due to chronic illness, learning disability, and
cerebral palsy.
Training programs for HWPPWD, CBRS, sensitivity
training, peer counseling, and home care.
Inclusion of indicators in the FHSIS, LGUs scorecard or any
appropriate mechanism
39
YEAR PROGRAM MILESTONES
An enhanced multi-sectoral action with stakeholders
A functional PRPWD
An enhanced capacity of government partners for PWD
affairs particularly PDAO
Inclusion and implementation of 2017 research agenda to
the NHRA
Health promotion activities for PWDs
Implementation of National Plan to upgrade
regional/provincial hospitals rehabilitation centers included
in the Health Facilities Expansion Plan of the DOH and or
other system wide mechanisms.
40
HW
PP
D S
CO
RE
CA
RD
PR
OG
RA
M T
ITL
E:
Hea
lth
an
d W
elln
ess
Pro
gra
m f
or
Per
son
s w
ith
Dis
ab
ilit
y
TA
RG
ET
S
20
17
20
%
20
%
17
17
5
30
%
20
16
10
%
10
%
12
12
5
20
%
20
15
TB
D b
ased
on
Nat
ion
al
Dis
abil
ity
Su
rvey
TB
D b
ased
on
Nat
ion
al
Dis
abil
ity
Su
rvey
8
8
5
10
%
20
14
- - - -
20
13
- - - -
BA
SE
LIN
E
No
dat
a
avai
lab
le
No
dat
a
avai
lab
le
No
dat
a
avai
lab
le
No
dat
a
avai
lab
le
No
dat
a
avai
lab
le
No
dat
a
avai
lab
le
KE
Y P
ER
FO
RM
AN
CE
IND
ICA
TO
R
Per
cen
t o
f P
WD
s w
ho
hav
e av
aile
d o
f h
ealt
h
serv
ices
Per
cen
t o
f P
WD
s w
ho
hav
e av
aile
d r
ehab
ilit
atio
n
and
hab
ilit
atio
n s
erv
ices
incl
ud
ing
ass
isti
ve
tech
no
logy
Nu
mb
er o
f C
HD
s tr
ain
ed
on
th
e fo
llo
win
g:
sen
siti
vit
y t
rain
ing
, C
BR
,
ho
mec
are,
pee
r
cou
nse
lin
g,
PR
PW
D
Nu
mb
er o
f C
HD
s ab
le t
o
pro
vid
e te
chn
ical
assi
stan
ce:
sen
siti
vit
y
trai
nin
g,
CB
R,
ho
mec
are,
pee
r co
un
seli
ng
, P
RP
WD
Nu
mb
er o
f st
akeh
old
ers
trai
ned
(se
nsi
tiv
ity
trai
nin
g,
CB
R,
ho
mec
are,
pee
r co
un
seli
ng
, P
RP
WD
)
Nu
mb
er o
f ta
rget
LG
Us
trai
ned
by C
HD
s
ST
RA
TE
GIC
OB
JE
CT
IVE
1.
Red
uce
d m
ort
ali
ty,
mo
rbid
ity
& d
isa
bil
ity
du
e to
NC
Ds.
(S
oci
al
Imp
act
)
2.
En
ha
nce
d c
ap
aci
ty
of
CH
Ds
& o
ther
sta
keh
old
ers
in N
CD
pre
ven
tio
n &
co
ntr
ol
41
TA
RG
ET
S
20
17
2
2 -
50
%
- -
20
16
2
2 -
40
%
1
1
20
15
2
2
3
30
%
1 -
20
14
2
1 -
20
%
1
1
20
13
1 - 1
10
%
1 -
BA
SE
LIN
E
1
0
1
No
dat
a
avai
lab
le
1
0
KE
Y P
ER
FO
RM
AN
CE
IND
ICA
TO
R
Nu
mb
er o
f ev
iden
ce-b
ased
po
lici
es,
stan
dar
ds
and
gu
idel
ines
dev
elop
ed (
e.g
.
AO
am
end
ed;
MO
P a
nd
serv
ice
pac
kag
es d
evel
op
ed;
Hea
lth
ben
efit
pac
kag
es
dev
elo
ped
in
coo
rdin
atio
n
wit
h P
hil
hea
lth
an
d o
ther
con
cern
ed a
gen
cies
)
Nu
mb
er o
f m
od
el
com
mu
nit
ies
for
PW
Ds
pil
ote
d a
nd e
val
uat
ed
Nu
mb
er o
f T
rain
ing
pro
gra
ms
dev
elo
ped
(e.
g.
com
mu
nit
y
bas
ed r
ehab
ilit
atio
n s
erv
ices
and
sen
siti
vit
y t
rain
ing
s
fin
aliz
ed
Per
cen
t o
f st
akeh
old
ers
eng
aged
in
th
e P
WD
pro
gra
m
Nu
mb
er o
f g
ov
ernm
ent
par
tner
s c
apac
itat
ed f
or
PW
D p
rog
ram
s
Nu
mb
er o
f P
ub
lic
Hea
lth
Co
nv
enti
on
on
Hea
lth
Pro
gra
m f
or
PW
Ds
con
du
cted
ST
RA
TE
GIC
OB
JE
CT
IVE
3.
En
sure
th
e
dev
elo
pm
ent
an
d
imp
lem
en
tati
on
of
evid
ence
-ba
sed
po
lici
es,
sta
nd
ard
s
an
d g
uid
elin
es
4.
En
sure
rele
va
nt
&
effi
cien
t ca
pa
bil
ity
bu
ild
ing
5.
Str
eng
then
coll
ab
ora
tio
n w
ith
sta
keh
old
ers
on
NC
D
pro
gra
ms
42
TA
RG
ET
S
20
17
- - 1
10
0%
-
20
16
- - 1
10
0%
-
20
15
- - 1
10
0%
2
20
14
- - 1
10
0%
-
20
13
1
1
1 - -
BA
SE
LIN
E
0
0
0
0
0
KE
Y P
ER
FO
RM
AN
CE
IND
ICA
TO
R
Nu
mb
er o
f a
5 y
ear
com
mu
nic
atio
n/
hea
lth
pro
mo
tion
pla
n d
evel
op
ed
by
NC
HP
wit
h t
ech
nic
al
assi
stan
ce p
rov
ided
by
th
e
pro
gra
m
Nu
mb
er o
f F
un
ctio
nal
PR
PW
D o
per
atio
nal
ized
Nu
mb
er o
f re
sear
ch
pro
po
sals
in
clu
ded
in
th
e
nat
ion
al r
esea
rch
ag
end
a
Per
cen
t o
f n
eed
ed d
ata
use
d f
or
po
licy
mak
ing
and
pro
gra
m d
evel
op
men
t
avai
lab
le
Per
cen
tag
e o
f in
dic
ato
rs
incl
ud
ed i
n t
he
FH
SIS
,
LG
Us
sco
reca
rd o
r an
y
app
rop
riat
e m
ech
anis
m
ST
RA
TE
GIC
OB
JE
CT
IVE
6.
En
sure
reli
ab
le,
tim
ely
,
an
d c
om
ple
te d
ata
&
rese
arc
hes
43
VIOLENCE AND INJURY PREVENTION PROGRAM
(VIPP)
Violence and injuries in the Western Pacific Region accounted for an estimated 1.2 million
deaths in 2008 representing about one quarter of the global death toll from such causes
(WHO, 2012). In the same year, around 350,000 people died on roads, 142,000 from falls and
100,000 from drowning. The remaining number of deaths due to violence and injuries is
attributed to suicide and other intentional and unintentional injuries.
In the Philippines, the Online National Electronic Injury Surveillance System (ONEISS)
recorded a total of 11,264 injuries in the first quarter of 2013. Reports came from 70
government and private hospitals, which account for 3.8% of the 1,821 total number of
hospitals in the country. More than half (60%) of the total reported cases of injuries occurred
among 20-59 age group. Injuries among children (aged 0-19) accounted for 36.3% of the total
reported cases including the 7.6% cases involving children less than 5 years of age. Injury
cases among older persons (60 years and over) accounted for 5.4%. The mean age is 27.3
while the median is 24 years old (DOH).
In response to these injury and violence problems, the DOH has issued the Administrative
Order 2007-0010, which serves as the implementing mechanism of the Violence and Injury
Prevention Program. The program is mandated to design, coordinate and integrate activities,
plans, and programs of various stakeholders into an effective and efficient system. As the
focal agency with respect to violence and injury prevention, the DOH shall also develop
national action plans and injury surveillance systems, strengthen pre-hospital and hospital
trauma care system, institutionalize capacity and human resources in injury and violence
prevention, and implement awareness campaigns on road safety and violence.
The implementation of the program shall address gaps and operational issues primarily on
advocacy and health promotion, and networking and collaboration. In addition to the
continuing efforts on fireworks-related injuries prevention, it is also necessary for the
program to focus on other areas such as interpersonal violence-related injuries and work-
related injuries prevention. The VIPP, similarly, needs to harmonize its works with internal
and external stakeholders; address the need to build the capacities of local health workers on
program management as well as pre-hospital care; and update and upgrade data registries
such as ONEISS and Philippine Network for Injury Data Management System (PNIDMS).
Program Description
The program is designed to reduce mortality, morbidity, and disability due to violence and
injuries in the following key areas of concern:
1. Road traffic injuries;
2. Burns and fireworks-related injuries;
44
3. Drowning;
4. Falls;
5. Sports and recreational injuries;
6. Interpersonal violence-related injuries including Violence Against Women and
Children (VAWC) and bullying;
7. Animal bites and stings;
8. Self-harm;
9. Occupational or work-related injuries;
10. Poisoning and drug toxicity.
Program Objectives
The Violence and Injury Prevention Program aims to accomplish the following objectives
under the following strategic components:
Strategic Component: SERVICE DELIVERY
OBJECTIVE 1: To reduce the number of deaths from violence and injury (in the
following areas: burns, falls, road traffic, chemical, thermal,
drowning, poisoning, and firecrackers)
OBJECTIVE 2: To reduce disability caused by violence and injury
The program shall work towards the reduction of mortality rate from violence and injury in
specified areas through institutionalization of systems and procedures of services at the
community level.
The program shall ensure that there are care and services provided to prevent and mitigate the
consequences of violence and injury and thereby disability.
Strategic Component: HUMAN RESOURCES FOR HEALTH
OBJECTIVE 3: To enhance capacity of CHDs and other stakeholders in the
prevention of injury and violence
As part of the key functions of the DDO as a technical assistance provider, the program
intends to develop and enhance the skills and capacity of healthcare providers at the local and
national level including the stakeholders in providing sufficient and relevant knowledge on
the prevention of violence and injury.
45
Key Activities:
1. Development of training modules on Emergency Services Prior to
Prehospital Care;
2. Development of training modules on Prehospital Emergency Medical
Services; and
3. Capacitate CHDs/LGUs/other stakeholders on VIPP.
Strategic Components: POLICY, STANDARDS AND REGULATION
OBJECTIVE 4: To develop and implement evidence-based policies, standards and
guidelines in the prevention of injury and violence
The program shall provide sectoral and community-based interventions through the
development and implementation of necessary policy instruments, standards and guidelines.
Key Activities:
1. Revision of the Administrative Order;
2. Development of guidelines for the establishment of emergency services
prior to hospital care;
3. Advocate passage of EMSS bill; and
4. Development of a Manual of Operations for Violence and Injury
Prevention Program.
Strategic Component: HEALTH FINANCING
OBJECTIVE 5: To advocate for alternative health financing schemes for trauma care
Financing schemes affect the efficiency with which the health care system produces and
supplies health care services. The program aims to promote to health financing institutions,
financial intermediaries, and insurance companies, the development and implementation of
an equitable financing scheme that would be beneficial to victims of violence and injury.
Key Activities:
1. Coordination with PHILHEALTH on the development of a financial
package for trauma care.
46
Strategic Component: GOVERNANCE FOR HEALTH
OBJECTIVE 6: To promote a culture of safety in key settings such as home, schools,
workplaces, and communities
OBJECTIVE 7: To strengthen collaboration with stakeholders in the prevention of
injury and violence
The program will advocate for health and safety at home, schools, workplaces, and
communities. It shall take a critical role of coordinating with stakeholders in promoting
mainstream environments, which are culturally competent.
The DDO shall promote partnership with various stakeholders to build alliances and networks
and ensure implementation of activities related to injury and violence prevention. The DDO
shall also initiate an alliance building through formal and informal instruments with
stakeholders to ascertain their commitment in implementing action plans and programs and in
mobilizing all available resources.
Key Activities:
1. Enhancement of multi-sectoral action through the establishment of an
alliance on VIPP;
2. Conduct of National Conference on VIPP; and
3. Coordination with the National Center for Health Promotion in the
development of advocacy campaigns on VIPP.
Strategic Component: HEALTH INFORMATION
OBJECTIVE 8: To ensure reliable, timely and complete data and researches on
violence and injury.
As a lead agency for the health sector, the DOH through the program shall promote and
develop researches and studies to enhance and update information on violence and injuries.
This will guide the DDO and various stakeholders in the development and implementation of
evidence-based policies and effective programs and interventions on violence and injuries.
Key Activities:
1. Operationalization of the Philippine Network for Injury Data Management
System;
2. Upgrade Online National Electronic Injury Surveillance System;
3. Identification of a 5-year research agenda;
47
4. Conduct study on the Determination on the Incidence of Injuries for
Vehicular Crashes in the Philippines; and
5. Conduct of regular monitoring and evaluation for the different activities
implemented by the program.
Key Program Milestones
The table below presents the key milestones of the VIPP as identified from 2013 until 2017:
Table 12 Key Program Milestones for VIPP
YEAR PROGRAM MILESTONES
2013 Revised AO for VIPP
Delineated functions between HEMS & DDO
Reviewed related (existing) policies, research
Strengthened collaboration with partner agencies in
operationalizing the PNIDMS
Established alliance on VIPP
Upgraded ONEISS
Drafted guidelines for the establishment of emergency services
prior to hospital care (MOP and SOP)
Conducted study on the Determination on the Incidence of
Injuries for Vehicular Crashes in the Philippines
Identified 5 year research / policy agenda
Conducted Users’ Conference on ONEISS
Strengthened the alliance on VIPP
Advocated passage of EMSS bill
Finalized training modules on Emergency Medical Services
Prior to Prehospital Care
2014 Developed MOP/training manual for VIPP
Piloted Emergency Services at the local level
Drafted training modules on Emergency Medical Services
Prior to Prehospital Care
Enhanced guidelines for the establishment of Emergency
Services prior to hospital care
Capacitated CHDs/LGUs/other stakeholders
Coordinated with PHILHEALTH on the development of a
financial package for trauma care
Conducted Users’ Conference on ONEISS
Operationalized PNIDMS
Conducted National Conference on VIPP
Coordinated with NCHP in the development of advocacy
campaigns on VIPP Ensured the conduct of research/policy
agenda for 2014
Conducted monitoring and evaluation on the program
implementation
48
YEAR PROGRAM MILESTONES
2015 Continued capability building for CHDs/LGUs/other
stakeholders
Finalized guidelines for the establishment of emergency
services prior to hospital care
Enhanced PNIDMS (different dept. / organizations)
Conducted Users’ Conference on ONEISS
Conducted National Conference on VIPP
Ensured the conduct of research/policy agenda for 2015
Conducted monitoring and evaluation on the program
implementation
2016 Continued capability building for CHDs/LGUs/other
stakeholders
Conducted National Conference on VIPP
Conducted Users’ Conference on ONEISS
Operationalized EMSS
Evaluated status of PNIDMS
Ensured the conduct of research/policy agenda for 2016
Conducted monitoring and evaluation on the program
implementation
2017 Reviewed VIPP Program
Developed 5 year strategic plan (2018-2022)
Conducted Users’ Conference on ONEISS
Conducted National Conference on VIPP
Ensured the conduct of research/policy agenda for 2017
Conducted monitoring and evaluation on the program
implementation
49
VIP
P S
CO
RE
CA
RD
PR
OG
RA
M T
ITL
E:
Vio
len
ce a
nd
In
jury
Pre
ven
tion
Pro
gra
m
TA
RG
ET
S
20
17
- - - 17
To
be
det
erm
ined
80
%
50
%
-
20
16
- - - 17
50
%
40
%
-
20
15
- - - 17
30
%
30
%
-
20
14
10
%
10
%
17
17
10
%
(pil
ot)
- 1
20
13
Set
bas
elin
e
Set
bas
elin
e
- 3
BA
SE
LIN
E
No
dat
a
avai
lab
le
No
dat
a
avai
lab
le
No
dat
a
avai
lab
le
No
dat
a
avai
lab
le
No
dat
a
avai
lab
le
No
dat
a
avai
lab
le
TB
D
0
KE
Y P
ER
FO
RM
AN
CE
IND
ICA
TO
R
Per
cen
t p
rev
alen
ce o
f
dea
ths
fro
m v
iole
nce
an
d
inju
ry
Per
cen
t p
rev
alen
ce o
f
dis
abil
ity
cau
sed
by
vio
len
ce a
nd
in
jury
Nu
mb
er o
f C
HD
s tr
ain
ed
on
VIP
P
Nu
mb
er o
f C
HD
s ab
le t
o
pro
vid
e te
chn
ical
assi
stan
ce o
n V
IPP
Nu
mb
er o
f st
akeh
old
ers
trai
ned
on V
IPP
Per
cen
t o
f ta
rget
LG
Us
trai
ned
on V
IPP
by
CH
Ds
Per
cen
tag
e o
f re
ferr
al a
nd
refe
rrin
g f
acil
itie
s
cap
acit
ated
on
VIP
P
Nu
mb
er o
f ev
iden
ce-b
ased
po
lici
es,
stan
dar
ds
and
gu
idel
ines
dev
elop
ed f
or
VIP
P
ST
RA
TE
GIC
OB
JE
CT
IVE
1.
Red
uce
d m
ort
ali
ty,
mo
rbid
ity
& d
isa
bil
ity
du
e to
NC
Ds.
(S
oci
al
Imp
act
)
2.
En
ha
nce
d c
ap
aci
ty
of
CH
Ds
& o
ther
sta
keh
old
ers
in N
CD
pre
ven
tio
n &
co
ntr
ol
3.
En
sure
th
e
dev
elo
pm
ent
an
d
imp
lem
en
tati
on
of
evid
ence
-ba
sed
po
lici
es,
sta
nd
ard
s
an
d g
uid
elin
es
50
TA
RG
ET
S
20
17
- -
10
0%
1 - 1
1
1
20
16
- -
80
%
1 - 1
1
1
10
0%
20
15
- -
40
%
1 - 1
1
1
50
%
20
14
1
10
0%
10
%
(pil
ot)
1 - 1
1
1 -
20
13
-
50
%
- - 1 - 1 -
BA
SE
LIN
E
0
0
0
0
0
0
0
0
0
KE
Y P
ER
FO
RM
AN
CE
IND
ICA
TO
R
Nu
mb
er o
f tr
ain
ing
pro
gra
ms
dev
elop
ed
Per
cen
t o
f st
akeh
old
ers
eng
aged
in
th
e V
IPP
pro
gra
m
Per
cen
tag
e o
f L
GU
s w
ith
op
erat
ion
aliz
ed E
MS
S
Nu
mb
er o
f co
nfe
ren
ce o
n
VIP
P c
on
du
cted
Nu
mb
er o
f fu
nct
ion
al
PN
IDM
S o
per
atio
nal
ized
Nu
mb
er o
f en
han
ced
ver
sio
n o
f P
NID
MS
Nu
mb
er o
f re
sear
ch
pro
po
sals
in
clu
ded
in
th
e
nat
ion
al r
esea
rch
ag
end
a
Nu
mb
er o
f re
sear
ches
com
ple
ted
Per
cen
t o
f n
eed
ed d
ata
use
d
for
po
licy
mak
ing
and
pro
gra
m d
evel
op
men
t
avai
lab
le
ST
RA
TE
GIC
OB
JE
CT
IVE
4.
En
sure
rele
va
nt
&
effi
cien
t ca
pa
bil
ity
bu
ild
ing
5.
Str
eng
then
coll
ab
ora
tio
n w
ith
sta
keh
old
ers
on
NC
D
pro
gra
ms
6.
En
sure
reli
ab
le,
tim
ely
, a
nd
co
mp
lete
da
ta &
res
earc
hes
51
PREVENTION OF BLINDNESS PROGRAM
(PBP)
The WHO fact sheet (2012) revealed that globally there are about 285 million people who are
visually impaired, of which 39 million are blind and 246 have low vision. The major causes
of visual impairment are uncorrected refractive errors such as myopia, hyperopia or
astigmatism (43%), cataract (33%) and glaucoma (2%). About 90% of the visually impaired
people come from developing countries. In 2010, 82% of those blind and 65% of those with
moderate and severe blindness were older than 50 years of age. There are about 19 million
children who are visually impaired, of which 12 million are caused by refractive errors, a
condition that could be easily diagnosed and corrected (WHO, 2012).
In the Philippines, the prevalence of visual impairment was 4.62% based on the 2002 national
survey on blindness and low vision. Among the 17 regions, Region 2 (7.75%) was recorded
to have the highest prevalence of visual impairment while CARAGA has the lowest at 1.67%.
The age groups 60 to 74 have the highest prevalence rates while those aged 0-20 have the
lowest prevalence rates. It was also recorded that errors of refraction is the leading cause of
visual impairment and of bilateral and monocular low vision while cataract is the leading
cause of bilateral and monocular blindness. Childhood blindness (with age group 0-19) has
prevalence rate of 0.06% (DOH, 2011).
To eliminate this growing public health problem, the DOH came up with a national health
program for the prevention of blindness. Guidelines for the operation of the program are
stipulated in Administrative Order No. 179 s.2004. This Administrative Order covers all
health and health-related professionals and offices involved in blindness prevention.
Similarly, the AO specified that the program is guided by the following approach: (1)
Strengthen partnership among and with stakeholder to eliminate avoidable blindness in the
Philippines; (2) Empower communities to take proactive roles in the promotion of eye health
and prevention of blindness; (3) Provide access to quality eye care services for all; and (4)
Work towards poverty alleviation through preservation and restoration of sight to indigent
Filipinos.
The PBP, in general, is working towards the reduction of avoidable visual impairment and
ensuring access to low vision and rehabilitation services for the visually impaired. This is
aligned with the Regional Action Plan for the Western Pacific Region (2014-2019). However,
in the implementation of the program, it was identified that there is a need to strengthen
information and education, and intersectoral collaboration on eye health care promotion and
visual impairment prevention. The PBP, likewise, needs to address the lack of information
management system for the CHDs and hospital to use. Preventive interventions are the core
of the program but this must be specified in AO 179 s.2004. With all these, revisiting the AO
might be necessary to further align the initiatives that the program has already started and
current needs and challenges with the thrusts of the KP and the WHO standards.
52
The Prevention of Blindness Program is a comprehensive eye and visual health program
designed to effectively control diseases causing avoidable blindness, capacity enhancement
of government health facilities, provision of capable public health oriented eye care
professionals and strategic partnerships. With the central feature of facilities and
infrastructure enhancement of government facilities, at national and local government level to
provide quality eye care services, referral systems connecting all health facilities from
community level up to tertiary level facilities will be established to ensure adequate
intervention for all eye diseases and conditions.
The Prevention of Blindness Program aims to accomplish the following objectives under the
following strategic components:
Strategic Component: SERVICE DELIVERY
OBJECTIVE 1: To reduce the current prevalence of bilateral blindness
OBJECTIVE 2: To reduce the prevalence of cataract blindness
OBJECTIVE 3: To reduce blindness and visual impairment due to refractive errors
OBJECTIVE 4: To reduce the prevalence of blindness and visual impairment in
children
The program shall oversee the implementation of program plans and activities on blindness
prevention. It shall ensure eye care services are readily accessible, available at the local level
to reduce avoidable visual impairment as public health problem.
Strategic Component: HUMAN RESOURCES FOR HEALTH
OBJECTIVE 5: To enhance capacity of CHDs and other stakeholders on blindness
prevention
This component ensures the provision of training for health coordinators and health workers
at national and local levels. It will also ensure the availability of and access to training
programs by program implementers.
Key Activities:
1. Development of training modules on PBP; and
2. Capacitate CHDs/LGUs/other stakeholders on PBP.
Program Description
Program Objectives
53
Strategic Component: POLICY, STANDARDS AND REGULATION
DEVELOPMENT
OBJECTIVE 6: To develop and implement evidence-based policies, standards, and
guidelines on blindness prevention
In partnership with the local government units and stakeholders, the program shall develop,
implement, and monitor national and sub-national policies, standards, and guidelines for
integration and provision of services at the community level.
Key Activities:
1. Amendment of Administrative Order;
2. Model Building on Integrated Eye Health Care;
3. Development of a Manual of Operations on PBP; and
4. Development of guidelines on service delivery and clinical pathway.
Strategic Component: HEALTH FINACING
OBJECTIVE 7: To ensure the development of health financing and provider payment
scheme mechanisms for the prevention of blindness
The DDO shall review the current approaches to financing eye-health care and recommend a
more responsive eye-health care financing scheme.
Key Activities:
1. Advocacy for the development of PhilHealth package for eye health care.
Strategic Component: GOVERNANCE FOR HEALTH
OBJECTIVE 8: To strengthen collaboration with stakeholders on blindness
prevention
To ensure that services are available at the local level, the program shall maintain partnership
with different stakeholders for the delivery of appropriate eye health care services at
affordable cost especially to the indigent sector.
Key Activities:
1. Establishment of a coalition on PBP;
2. Enhancement of multi-sectoral action through regular dialogues and
meetings with various stakeholders;
54
3. Conduct of PBP Summit; and
4. Provision of technical assistance to the NCHP for the development of
health promotion activities for PBP.
Strategic Component: HEALTH INFORMATION
OBJECTIVE 9: To ensure reliable, timely, and complete data and researches on
blindness prevention
The conduct of studies and researches play an essential role in public health information and
education, policy formulation, planning and implementation. Thus, the DDO shall encourage
and support the conduct of researches on blindness and blindness prevention. This includes
studies on the socioeconomic impact of blindness, the cost–effectiveness of eye-health
interventions, and the financial benefits of early prevention of blindness and visual
impairment. The program shall also ensure the development and dissemination of clinical
practice guidelines for eye health.
Key Activities:
1. Identification of a 5-year research agenda;
2. Inclusion of indicators in the FHSIS, LGU scorecard or any appropriate
mechanism in coordination with other DOH offices;
3. Establishment of functional PBP Registry; and
4. Conduct of regular monitoring and evaluation for the different activities
implemented by the program.
The table below presents the key milestones of the PBP as identified from 2013 until 2017:
TABLE 1: KEY PROGRAM MILESTONES OF PBP
YEAR PROGRAM MILESTONES
2013 Amended AO for PBP
Distinct functions between National Committee
for Sight Preservation (NCSP) & other partners
Review related (existing) policies, research
Operationalized PBP Registry
Pilot tested; trained
Developed guidelines on service delivery and clinical
pathway
Identified 5 year research / policy agenda
Key Program Milestones
55
YEAR PROGRAM MILESTONES
Capacitated CHDs/LGUs/other stakeholders
Developed Training Modules on PBP
Pilot area testing (training module)
CHD orientation and planning
PBP registry
Formed a coalition for PBP
Provided technical assistance to the NCHP for the
development of Health promotion activities for PBP
Drafted MOP on PBP
Model Building on Integrated Eye Health Care
2014 Advocated for the development of PhilHealth package for
eye health care (e.g. diabetic retinopathy and childhood
blindness)
Capacitated CHDs/LGUs/other stakeholders
Developed indicators for the inclusion in LGUs scorecard
or any appropriate mechanism
Enhanced capacity of the referral and referring facilities
Coordination with HFEP
Development of guidelines on referral system (Included
in CPG)
Evaluated Model Building on Integrated Eye Health Care
Strengthened the PBP Coalition
Enhanced PBP Registry (upgrading, training)
Conducted PBP Summit / conference
Rolled out model on integrated eye healthcare
Conducted M & E
2015 Enhanced capacity of the referral and referring facilities
Enhanced PBP Registry
Continued capability building for CHDs/LGUs/other
stakeholders
Up scaling of Model on Integrated Eye Health Care
Conducted Monitoring and Evaluation
2016 Enhanced capacity of the referral and referring facilities
Enhanced PBP Registry
Continued capability building for CHDs/LGUs/other
stakeholders
Up scaling of Model on Integrated Eye Health Care
Conducted PBP Summit / conference
Conducted Monitoring and Evaluation
Evaluate status of PBP Registry
2017 Enhanced capacity of the referral and referring facilities
Reviewed PBP Program
Conducted Monitoring and Evaluation
Developed 5 year strategic plan (2018-2022)
56
PB
P S
CO
RE
CA
RD
PR
OG
RA
M T
ITL
E:
Pre
ven
tion
of
Bli
nd
nes
s P
rogra
m
TA
RG
ET
S
20
17
- - - - - 17
40
%
- -
20
16
52
2,8
64
Les
s th
an
(<.0
5)
16
2,3
54
(.5
0%
)
56
,46
9
(10
%)
11
0,1
67
(50
%)
- 17
30
%
20
%
-
20
15
-
22
9,1
54
- - - 17
20
%
10
%
-
20
14
-
28
0,5
46
- - 17
17
10
%
- 2
20
13
-
32
0,0
79
- - - - - - 2
BA
SE
LIN
E
56
5,3
05
35
0,4
89
58
,22
6
20
5,3
6
No
dat
a
avai
lab
le
No
dat
a
avai
lab
le
TB
D
No
dat
a
avai
lab
le
0
KE
Y P
ER
FO
RM
AN
CE
IND
ICA
TO
R
Pre
val
ence
of
bil
ater
al
bli
nd
nes
s d
ue
to a
ll c
ause
s
Pre
val
ence
of
cata
ract
bli
nd
nes
s
Pre
val
ence
of
bli
nd
nes
s
and
vis
ual
im
pai
rmen
t du
e
to r
efra
ctiv
e er
rors
Pre
val
ence
of
bli
nd
nes
s
and
vis
ual
im
pai
rmen
t in
chil
dre
n
Nu
mb
er o
f C
HD
s tr
ain
ed
on
PB
P
Nu
mb
er o
f C
HD
s ab
le t
o
pro
vid
e te
chn
ical
assi
stan
ce o
n P
BP
Per
cen
t o
f h
ealt
h f
acili
tie
s
trai
ned
on
th
e P
BP
Reg
istr
y
Per
cen
t o
f ta
rget
LG
Us
trai
ned
on P
BP
by
CH
Ds
Nu
mb
er o
f ev
iden
ce-
bas
ed p
olic
ies,
sta
nd
ard
s
and
gu
idel
ines
dev
elo
ped
for
PB
P
ST
RA
TE
GIC
OB
JE
CT
IVE
1.
Red
uce
d m
ort
ali
ty,
mo
rbid
ity
& d
isa
bil
ity
du
e to
NC
Ds.
(S
oci
al
Imp
act
)
2.
En
ha
nce
d c
ap
aci
ty
of
CH
Ds
& o
ther
sta
keh
old
ers
in N
CD
pre
ven
tio
n &
co
ntr
ol
3.
En
sure
th
e
dev
elo
pm
ent
an
d
imp
lem
en
tati
on
of
evid
ence
-ba
sed
po
lici
es,
sta
nd
ard
s
an
d g
uid
elin
es
57
TA
RG
ET
S
20
17
2 -
60
%
- - 1
10
0%
20
16
2 -
50
%
1 - 1
10
0%
20
15
2 -
40
%
- - 1
10
0%
20
14
2 -
30
%
1 - 1
10
0%
20
13
1
1
20
%
- 1 -
10
0%
BA
SE
LIN
E
0
0
0
0 0
0
0
KE
Y P
ER
FO
RM
AN
CE
IND
ICA
TO
R
Nu
mb
er o
f co
mm
un
ity
eye
hea
lth
car
e m
od
el p
ilote
d
and
eva
luat
ed
Nu
mb
er o
f Tr
ain
ing
pro
gram
s d
evel
op
ed
Per
cen
t o
f st
akeh
old
ers
eng
aged
in
th
e P
BP
pro
gra
m
Nu
mb
er o
f
sum
mit
/co
nfe
ren
ce o
n P
BP
con
du
cted
Nu
mb
er o
f F
un
ctio
nal
P
BP
Reg
istr
y o
per
atio
nal
ized
Nu
mb
er o
f re
sear
ch
pro
po
sals
in
clu
ded
in
th
e
nat
ion
al r
esea
rch
ag
end
a
Per
cen
t o
f n
eed
ed d
ata
use
d
for
po
licy
mak
ing
and
pro
gra
m d
evel
op
men
t
avai
lab
le
ST
RA
TE
GIC
OB
JE
CT
IVE
4.
En
sure
rele
va
nt
&
effi
cien
t ca
pa
bil
ity
bu
ild
ing
5.
Str
eng
then
coll
ab
ora
tio
n w
ith
sta
keh
old
ers
on
NC
D
pro
gra
ms
6.
En
sure
reli
ab
le,
tim
ely
, a
nd
co
mp
lete
da
ta &
res
earc
hes
58
HEALTH AND WELL-BEING OF SENIOR CITIZENS
PROGRAM
(HWSCP)
According to the WHO (2012), the percentage of the population that are aged 60 years and
above has rapidly increased worldwide and is projected to increase even more in the coming
years. The top five leading cause of death from this age group, according to the WHO (2010),
are the following: ischaemic heart disease; cerebrovascular disease; chronic obstructive
pulmonary diseases; lower respiratory infections; and trachea, lung and bronchus cancers.
In 2010, the National Statistics Office reported that 6.8 percent of the 92,337,852 population
are senior citizens or persons aged 60 years and over. Females were accounted to be 55.8%,
while males comprised 44.02%.
The growing community of our most vulnerable citizens is most susceptible to health
concerns. The leading cause of morbidity among senior citizens is lung illness followed by
acute diarrhea and tuberculosis. Disorder of the heart remains to be the leading cause of
mortality, with pneumonia and nutritional deficiency ranking among the top.
The Health and Well-being of Senior Citizens Program encompasses the development of
research-based programs implementing integrated geriatric health package, innovative
delivery of services in all levels of care, and community-based health care services, including
vaccination, towards promoting healthy ageing.
The Health and Well-being of Senior Citizens Program has the following objectives
categorized under the different strategic components:
Program Description
Program Objectives
59
Strategic Component: SERVICE DELIVERY
OBJECTIVE 1: To promote better health for senior citizens through focused service
delivery packages and integrated continuum of quality care in various
settings
The program shall ensure that senior citizens have access to essential geriatric packages and
health services for wellness, prevention, treatment, and rehabilitation from the national to the
local levels.
Key Activities:
1. Conduct of annual monitoring of provisioned free vaccines (pneumococcal and
influenza)
Strategic Component: HEALTH FINANCING
OBJECTIVE 2: To achieve equitable health financing to develop, implement, sustain,
monitor and continuously improve quality health programs accessible
to senior citizens
The HWSCP shall ensure that health financing schemes and other funding support will be
promoted in all concerned government agencies and other private stakeholders to provide
programs that are accessible to senior citizens.
Key Activities:
1. Conduct of a Stakeholders Consultation Meeting on benefits and privileges
of the senior citizens annually in order to assess and discuss current needs
of the elderly
Strategic Component: POLICY, STANDARDS AND REGULATIONS
OBJECTIVE 3: To develop patient-centered and environment standards to ensure
safety and accessibility of all health facilities for the senior citizens
The program shall make sure that patient-centered and environment standards will be
developed to ensure safety and accessibility of all health facilities for senior citizens. These
standards shall be developed to promote healthy ageing across life course and prevent
functional decline disease among senior citizens.
Key Activities:
1. Finalization of the National Policy and Operational Guidelines on Health
and Well-Being of Senior Citizens
60
Strategic Component: HEALTH HUMAN RESOURCE
OBJECTIVE 4: To capacitate CHDs and other stakeholders in managing and implementing
health programs for senior citizens
The program shall ensure that health care providers in both national and local government are
able to effectively provide support and technical assistance in implementing services for
senior citizens.
Key Activities:
1. Conduct of a Training Development and Needs Assessment in order to
assess the current capacities and training needs of staff;
2. Development of a Training Module and Manual of Operations(MOP) on
Health and Well-Being of Filipino Senior Citizens; and
3. Conduct of trainings to CHDs on health and well-being of Filipino senior
citizens and MOP
Strategic Component: HEALTH INFORMATION
OBJECTIVE 5: To establish and maintain complete, up to date, and reliable data on
senior citizens to be used in developing evidence-based policies
The program intends to establish and maintain a repository of data and management system
on evidence-based policies and research and other information on senior-citizens.
Key Activities:
1. Conduct of a profiling of senior citizens in order to have baseline
information; and
2. Conduct of an annual research on the situation and current trends on senior
citizens.
61
Strategic Component: GOVERNANCE FOR HEALTH
OBJECTIVE 6: To strengthen coordination and collaboration among government
agencies, NGOs, partner agencies, and other stakeholders involved in
the implementation of programs for senior citizens
Coordination and collaboration with the local government units and other stakeholders shall
be ensured for an effective and efficient implementation of health services at the hospital and
community level.
Key Activities:
1. Annual conduct of a Wellness Camp for Senior Citizens;
2. Conduct of Orientation on the Senior Citizen Program; and
3. Conduct of regular stakeholders consultation meetings to discuss how to
better implement programs and services for the senior citizens.
The table below presents the key milestones of the LRD program as identified from 2013
until 2017:
Table 13: Key Program Milestones of the HWSC Program
YEAR PROGRAM
COMPONENTS PROGRAM MILESTONES
2013 Service Delivery Monitored provisioned free vaccines
(pneumococcal and influenza)
Convened Wellness Camp for Senior
Citizens
Health Financing Conducted Stakeholders Consultation
Meeting on Benefits and Privileges
Under AO 2012-0007
Policy, Standards and
Guidelines Finalization of the National Policy
and Operational Guidelines on Health
& Well-being of Filipino Senior
Citizens
Governance for Health Conducted orientation on the SC
program
Convened stakeholders consultation
meeting on benefits and privileges
Key Program Milestones
62
YEAR PROGRAM
COMPONENTS PROGRAM MILESTONES
Conducted Walk for Life 2013 for the
Elderly Filipino Week
2014 Service Delivery Monitored provisioned free vaccines
(pneumococcal and influenza)
Convened Wellness Camp for Senior
Citizens
Health Financing Conducted Stakeholders Consultation
Meeting on Benefits and Privileges
Under AO 2012-0007
Health Human Resource Conducted TDNA
Development of Training Module and
MOP on Health & Wellbeing of
Filipino Senior Citizens. (E.g.,
community hospitals and other
stakeholders)
Health Information Contracted out the conduct of
profiling of senior citizens
Governance for Health Convened stakeholders consultation
meeting on benefits and privileges
Conducted Walk for Life 2014 for the
Elderly Filipino Week
2015 Service Delivery Monitored provisioned free vaccines
(pneumococcal and influenza)
Health Financing Conducted Stakeholders Consultation
Meeting on Benefits and Privileges
Under AO 2012-0007
Health Information Conducted research on senior citizens
Governance for Health Convened stakeholders consultation
meeting on benefits and privileges
Conducted Walk for Life 2014 for the
Elderly Filipino Week
2016 Service Delivery Monitored provisioned free vaccines
(pneumococcal and influenza)
Convened Wellness Camp for Senior
Citizens
Health Financing Conducted Stakeholders Consultation
Meeting on Benefits and Privileges
Under AO 2012-0007
Health Human Resource Conducted regional training on
Health & Wellbeing of Filipino
Senior Citizens. (E.g., community
hospitals and other stakeholders)
Conducted national training on
Health & Wellbeing of Filipino
63
YEAR PROGRAM
COMPONENTS PROGRAM MILESTONES
Senior Citizens. (E.g., community
hospitals and other stakeholders)
Health Information Conducted research on senior citizens
Governance for Health Convened stakeholders consultation
meeting on benefits and privileges
Conducted Walk for Life 2016 for the
Elderly Filipino Week
2017 Service Delivery Monitored provisioned free vaccines
(pneumococcal and influenza)
Convened Wellness Camp for Senior
Citizens
Health Financing Conducted Stakeholders Consultation
Meeting on Benefits and Privileges
Under AO 2012-0007
Health Human Resource Conducted national training on
Health & Wellbeing of Filipino
Senior Citizens. (E.g., community
hospitals and other stakeholders)
Health Information Conducted research on senior citizens
Governance for Health Conducted a Regional Stakeholders
Consultation Meeting on Benefits and
Privileges
Conducted Walk for Life 2017 for the
Elderly Filipino Week
64
HW
SC
P S
CO
RE
CA
RD
PR
OG
RA
M T
ITL
E:
Hea
lth
an
d W
ell-
bei
ng f
or
Sen
ior
Cit
izen
s P
rogram
TA
RG
ET
S
20
17
To
be
det
erm
ined
To
be
det
erm
ined
- 17
80
%
50
%
-
20
16
- 17
50
%
25
%
-
20
15
17
17
- - -
20
14
- - - - 1
20
13
- - - - -
BA
SE
LIN
E
No
dat
a
avai
lab
le
No
dat
a
avai
lab
le
No
dat
a
avai
lab
le
No
dat
a
avai
lab
le
No
dat
a
avai
lab
le
No
dat
a
avai
lab
le
1
KE
Y P
ER
FO
RM
AN
CE
IND
ICA
TO
R
Per
cen
t o
f S
Cs
wh
o
con
sult
ed a
nd a
vai
led
hea
lth
ser
vic
es
Per
cen
t o
f S
Cs
wh
o h
ave
bee
n m
anag
ed b
y h
ealt
h
faci
liti
es
Nu
mb
er o
f C
HD
s tr
ain
ed
on
SC
pro
gra
ms
Nu
mb
er o
f C
HD
s ab
le t
o
pro
vid
e te
chn
ical
assi
stan
ce o
n S
C p
rog
ram
s
Per
cen
t o
f st
akeh
old
ers
trai
ned
on S
C p
rog
ram
s
Per
cen
t o
f ta
rget
LG
Us
trai
ned
by C
HD
s
Nu
mb
er o
f ev
iden
ce-b
ased
po
lici
es,
stan
dar
ds
and
gu
idel
ines
dev
elop
ed (
e.g
.
AO
am
end
ed;
MO
P a
nd
serv
ice
pac
kag
es
dev
elo
ped
; H
ealt
h b
enef
it
pac
kag
es d
evel
op
ed i
n
coo
rdin
atio
n w
ith
Ph
ilh
ealt
h a
nd
oth
er
con
cern
ed a
gen
cies
)
ST
RA
TE
GIC
OB
JE
CT
IVE
1.
Red
uce
d m
ort
ali
ty,
mo
rbid
ity
& d
isa
bil
ity
du
e to
NC
Ds.
(S
oci
al
Imp
act
)
2.
En
ha
nce
d c
ap
aci
ty
of
CH
Ds
& o
ther
sta
keh
old
ers
in N
CD
pre
ven
tio
n &
co
ntr
ol
3.
En
sure
th
e
dev
elo
pm
ent
an
d
imp
lem
en
tati
on
of
evid
ence
-ba
sed
po
lici
es,
sta
nd
ard
s
an
d g
uid
elin
es
65
TA
RG
ET
S
20
17
-
80
%
- -
20
16
-
80
%
1
1 i
nd
icat
or
(LG
U
sco
reca
rd)
20
15
1
80
%
-
1 i
nd
icat
or
(FH
SIS
)
20
14
-
80
%
1 -
20
13
-
80
%
- -
BA
SE
LIN
E
0
TB
D
No
dat
a
avai
lab
le
0
KE
Y P
ER
FO
RM
AN
CE
IND
ICA
TO
R
Nu
mb
er o
f T
rain
ing
pro
gra
ms
dev
elop
ed o
n S
C
Per
cen
t o
f st
akeh
old
ers
eng
aged
in
th
e S
C p
rog
ram
Nu
mb
er o
f re
sear
ches
com
ple
ted
Nu
mb
er o
f in
dic
ato
rs
incl
ud
ed i
n t
he
FH
SIS
,
LG
Us
sco
reca
rd o
r an
y
app
rop
riat
e m
ech
anis
m
ST
RA
TE
GIC
OB
JE
CT
IVE
4.
En
sure
rele
va
nt
&
effi
cien
t ca
pa
bil
ity
bu
ild
ing
5.
Str
eng
then
coll
ab
ora
tio
n w
ith
sta
keh
old
ers
on
NC
D
pro
gra
ms
6.
En
sure
reli
ab
le,
tim
ely
, a
nd
co
mp
lete
da
ta &
res
earc
hes
66
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df
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