The Role of Lgus in Achieving Good Governance in Health Systems

7/31/2019 The Role of Lgus in Achieving Good Governance in Health Systems

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THE ROLE OF LGUs IN ACHIEVING GOOD GOVERNANCE

IN HEALTH SYSTEMS

SLIDE #1

Definition:

Governance is the exercise of political, economic and

administrative authority in the management of resources for

development. It comprises complex mechanisms, processes and

institutions through which citizens and groups articulate their

interests, mediate their differences and exercise their legal rights

and obligations.

SLIDE #3

Good governance on the other hand can be measured through

the following principles:

1.Legitimacy and voice;2.Direction;3.Performance;4.Accountability; and5.Fairness

These principles can be summarized through a quotation from

Andrew Lansley: The government will require accountability atall levels for results, measured in terms of patient outcomes

rather than distorting targets.(SLIDE #4)


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We need to know our target, direct ourselves to the said target,

listen to our stakeholders and direct clientele, perform with

fairness and be accountable to our every move.

As an active partner of the Department of Health in achieving

Universal Health Care or Kalusugang Pangkalahatan, our aim is to

achieve better health outcomes, sustained health financing and

more responsive health system. This aim means that our target is

the poor to have equitable access to quality health care by being

financially protected, could access to quality hospitals and health

care facilities and further to attain the Millennium DevelopmentGoals.

After identifying our target, let us now see and evaluate the

stakeholders and our direct clientele for this aimthat is our

constituents. The targets are in our locality, in our own barangays

and our aim is to let them avail of our services in our own LGUs.

From our own local settings, let us inform, perform and reform (ifpossible) towards the achievement of our goals.

SLIDE #5

Question to ponder... Are our health services in our respective

LGUs enough and responsive to the needs of our constituents?

SLIDE #6

Before answering this question, let us see the Identified Critical

Aspects of Governance that prevent us in achieving the principles

of Good Governance, namely:


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1.Mutual Accountability of all those interested in health;2.Health Legislation and Regulation; and3.Financial Constraints

Mutual Accountability of all those interested in health:

Let us not leave all health concerns and problems to the

Department of Health alone. Since health is everybodys concern,

let us all be accountable to Universal Health Care or Kalusugang

Pangkalahatan. Being mutually accountable means strengthening

our partnerships with those who are also looking forward to ahealthy community, e.g., Civil Society Organizations (CSOs), Non-

Governmental Organizations (NGOs), local & national agencies,

and other concerned agencies.

Health Legislation and Regulation:

This includes issuances not only from the national or regionallevels but most especially those which were issued by the LGUs.

This includes issuances which defined the functions, entitlements,

incentives and regulations which will serve as guide of our

constituents to address equity and ethical issues in the

implementation of health programs, projects and activities.

Financial constraints:

Many LGUs could barely afford to provide basic services, and the

limited amount of health aid provided demands to be spent in

such a way to maximize health returns to promote health


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development. Hence, local officials are challenged to look into

other considerations and options to improve delivery of health

services and facilities.

Going back to the question, Are we providing enough and

responsive health services to our constituents? Yes or No, our

inner answer will boil down to this Kalusugang Pangkalahatan and

the mobilization of our Community Health Teams (CHTs). If our

LGU is one of the poor as enumerated and identified by the

National Household Targeting System (NHTS) courtesy of our

another partner agency, the Department of Social Welfare andDevelopment (DSWD), we should not be alarmed, instead it will

serve as our light going out from the tunnel of poverty.

Since our target in achieving the Aquino Health Agenda/ Universal

Health Care or Kalusugang Pangkalahatan is the poor, let their

responses in the data/information gathering done by our CHTs be

our guide in assessing our local health system. Apparently, thefirst-hand information will be coming from our constituents, thus

they are powerful. Let us then make use of that power by making

them equipped with information. How can our constituents avail

of our local health service when in the first place, they are not

aware of the services that our LGUs offer?

Finally, some basic principles for health program interventions

need to be in place: political will and skill; strong supply

through technical programs and strong demand from citizens

and stakeholders; and integral approach to governance,

financing, operations and capacity-building.


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There is a need to raise awareness of politicians regarding the

importance of good health system governance and performance.

And what we are doing now is a perfect venue to raise ourawareness.

SLIDE #7

Health System Governance Principle

Strategic Vision: LGUs should be mindful of setting the vision firstbefore any plan of action. The historical, cultural and social

complexities in our respective locality should be considered

because this will be where our perspective is grounded.

SLIDE #8

Participation & Accountability:

Participation and consensus orientation: Such broad participation

is built on freedom of association and speech, as well as

capacities to participate constructively. Good governance of the

health system mediates differing interests to reach a broad

consensus on what it is in the best interests of the group and,

where possible, on health policies and procedures. Before any

move to mobilize our Community Health Teams, consultations

with our Local Health Board and other conventions should be

undergone so that no stakeholder and beneficiary will be left

behind.


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SLIDE #9

Responsiveness:

Rule of Law: Legal frameworks pertaining to health should bemade free and enforced impartially, particularly the laws on

human rights related to health. Sometimes, with our eagerness to

implement laws which we think are helpful to our constituents,

we set aside the possibility of violating the basic human rights.

SLIDE #10

Transparency:

Transparency: As a major virtue of which DILG is advocating, the

LGU processes, plans, programs, activities and information should

be directly accessible to those concerned with them, and enough

information is provided to understand and monitor health

concern.

SLIDE #11

As always emphasized, I would like to share with you that

Transparency allows beneficiaries and stakeholders to hold local

officials more accountable. Transparency and more information

can lead to better informed policy-makingbetter health

systemgood governance on health system.


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SLIDE #12

Legal Basis for Inter-LGU Coverage

SEC. 25, LGC of 1991. National Supervision over LocalGovernment Units. - (a) Consistent with the basic policy on localautonomy, the President shall exercise general supervision overlocal government units to ensure that their acts are within thescope of their prescribed powers and functions.

The President shall exercise supervisory authority directly overprovinces, highly urbanized cities, and independent componentcities; through the province with respect to component cities and

municipalities; and through the city and municipality with respectto barangays.

(b) National agencies and offices with project implementationfunctions shall coordinate with one another and with the localgovernment units concerned in the discharge of these functions.They shall ensure the participation of local government units both

in the planning and implementation of said national projects.

SLIDE #13

(c) The President may, upon request of the local government unitconcerned, direct the appropriate national agency to providefinancial, technical, or other forms of assistance to the localgovernment unit. Such assistance shall be extended at no extra

cost to the local government unit concerned.

(d) National agencies and offices including government-owned or

-controlled corporations with field units or branches in a province,

city, or municipality shall furnish the local chief executive


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concerned, for his information and guidance, monthly reports

including duly certified budgetary allocations and expenditures.

SLIDE #14SEC. 16, LGC of 1991. General Welfare. - Every local government

unit shall exercise the powers expressly granted, those

necessarily implied therefrom, as well as powers necessary,

appropriate, or incidental for its efficient and effective

governance, and those which are essential to the promotion of

the general welfare. Within their respective territorial jurisdictions,

local government units shall ensure and support, among otherthings, the preservation and enrichment of culture, promote

health and safety, enhance the right of the people to a balanced

ecology, encourage and support the development of appropriate

and self-reliant scientific and technological capabilities, improve

public morals, enhance economic prosperity and social justice,

promote full employment among their residents, maintain peace

and order, and preserve the comfort and convenience of theirinhabitants.

SLIDE #15

SEC. 17, LGC of 1991. Basic Services and Facilities. - (a) Local

government units shall endeavor to be self-reliant and shall

continue exercising the powers and discharging the duties and

functions currently vested upon them. They shall also discharge

the functions and responsibilities of national agencies and offices

devolved to them pursuant to this Code. Local government units

shall likewise exercise such other powers and discharge such

other functions and responsibilities as are necessary, appropriate,


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or incidental to efficient and effective provision of the basic

services and facilities enumerated herein.

(b) Such basic services and facilities include, but are not limitedto, the following:

(1)For a Barangay:

xxx

(ii) Health and social welfare services which include maintenance

of barangay health center and day-care center;

xxx

SLIDE # 16

(2) For a municipality:

xxx

(iii) Subject to the provisions of Title Five, Book I of this Code,

health services which include the implementation of programs

and projects on primary health care, maternal and child care, and

communicable and non-communicable disease control services;access to secondary and tertiary health services; purchase of

medicines, medical supplies, and equipment needed to carry out

the services herein enumerated;

xxx

(3) For a Province:

xxx

(iv) Subject to the provisions of Title Five, Book I of this Code,

health services which include hospitals and other tertiary health

services;

xxx


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(4) For a City:

All the services and facilities of the municipality and province, and

in addition thereto, the following: xxx

SLIDE #17

SEC. 34, LGC of 1991. Role of People's and Nongovernmental

Organizations. - Local government units shall promote the

establishment and operation of people's and nongovernmental

organizations to become active partners in the pursuit of local

autonomy.

SEC. 35, LGC of 1991. Linkages with People's and Non-Governmental Organizations. - Local government units may enter

into joint ventures and such other cooperative arrangements with

people's and nongovernmental organizations to engage in the

delivery of certain basic services, capability-building and livelihood

projects, and to develop local enterprises designed to improve

productivity and income, diversify agriculture, spur rural

industrialization, promote ecological balance, and enhance theeconomic and social well-being of the people.

SLIDE #18

Thank you!

Documents

The Role of Lgus in Achieving Good Governance in Health Systems