Philippines 08

8/2/2019 Philippines 08

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354 | COUNTRY HEALTH INFORMATION PROFILES

PHILIPPINES

1. CONTEXT

1.1 Demographics

The Philippines consists of 7107 islands, with a land area of 300 000 square kilometers. Itspopulation, as of 1 August 2007, was placed at 88 574 614, giving a population density of 295per square kilometre Among the 14 regions of the country, Calabarzon (Region IV-A) had thelargest population, with 11.7 million, followed by National Capital Region (NCR), with 11.6million and Central Luzon (Region III), with 9.7 million. These three regions comprised morethan one-third (37.3%) of the Philippine population.

Based on the 2000 census figure of 76.5 million, the average annual population growth rate of2% for the period from 2000 to 2007 is the lowest recorded for the Philippines since the 1960s. The country's population is predominantly young, with the 0-14 year age group representing

33.8% and those aged 65 years and above comprising 4.4%. There is an almost equal number ofmales and females. The crude birth rate stands at 20.5 per 1000 population and the crude deathrate at 4.8 per 1000 population. Overall life expectancy is 67 years, 64 years for males and 70years for females.

1.2 Political situation

The Philippines is a democratic and republican state subscribing to the presidential form ofgovernment, with three branches: the executive, legislative and judicial branches. The countryhas a unitary form of government and a multiparty political system. Executive power is vested inthe President, who is the head of state and commander-in-chief of the armed forces. TheCabinet members are the heads of agencies and assist the President in drafting executive laws,policies and programmes of government. The Constitution ensures direct election by the peoplefor all elective positions from the President down to the members of the barangaycouncils.

In 1991, the Local Government Code transferred some of the powers of the nationalGovernment to local government officials. The code devolved basic services, including health,giving responsibility to local government units. The country is made up of political localgovernment units (LGUs) of provinces, cities, municipalities and barangays. A local chiefexecutive heads each LGU. Administrative autonomy enables the LGUs to raise local revenues,to borrow and to determine types of local expenditure, including expenditures on health care.

1.3 Socioeconomic situation

The Philippine economy in 2007 was at its strongest, with the gross domestic product (GDP) realgrowth rate for the year averaging 7.3%, the highest in 31 years. The economy continued to keeppace with population growth in the fourth quarter of 2007, as per capita GDP grew from 3.4% to5.3%.

The challenge for the Government is to enable these economic gains to be felt by the poorersectors of society. The 2006 official poverty statistics revealed an increase of 2.5 percentagepoints to 26.9% from 24.45 in 2003, meaning a total of 4.7 million poor families in 2006compared with the 4.0 million estimated in 2003. In terms of population, the number of poorFilipinos reached 27.6 million in 2006, 16% more than the 23.8 million estimated in 2003, whilefood-poor individuals increased to 12.2 million, 14% more than in 2003. In the presence of thecountrys gains in economic growth, the Government's move to realign the national budgettowards social services is a good opportunity to focus on the education and health needs of thepopulation in tandem with an effective population management programme.


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COUNTRY HEALTH INFORMATION PROFILES |355

The gender gap appears to be in favour of girls as far as participation in basic education,technical-vocational education and training and higher education are concerned. There is a needfor the Government and other education stakeholders to look more seriously at the lowcompletion and retention rates among boys in the school system. Although indicators to reflectgender equality, such as the country' Gender Development Index (GDI) and GenderEmpowerment Measure (GEM) reflect gains, these do not necessarily translate into positivemeasurable changes in the roles of and status of women, given the continuing incidence of

violence against women, the predominance of female child-abuse victims, the trafficking ofwomen and children for sexual exploitation and female forced labour, among others.

The slow decline in maternal mortality means that the country is unlikely to meet the MillenniumDevelopment Goal maternal mortality target or 80% access to reproductive health services by2015. The reasons include the inadequate access to integrated reproductive health services, suchas contraceptives, family planning and responsible-parenthood education, by women, includingpoor adolescents, and men.

1.4 Vulnerabilities and hazards

There is constant concern about the Philippines' high population growth rate and it being alimiting factor for broad-based growth and reduction of poverty.

There is a hidden threat from HIV and AIDS; although prevalence is still below 0.1% of thepopulation, there was a 20% increase in the number of reported cases from 2004 to 2006.

Due to its geographical location, the country faces various natural disasters, such as typhoons,landslides, volcanic eruptions and earthquakes.

2. HEALTH SITUATION AND TREND

2.1 Communicable and noncommunicable diseases, healthrisk factors and transition

Tuberculosis continues to affect a sizeable segment of the population, although, in recent years,effective case-finding, disease management using the directly observed treatment short-course

(DOTS) strategy, and partnership with the private sector have made inroads into the preventionand control of the disease.

Mosquito-borne diseases, such as malaria, dengue and filariasis, are an ever-present danger inendemic areas. Although malaria is no longer a leading cause of death, it remains among theleading causes of morbidity in the country, particularly in rural areas. High-risk groups includeupland subsistence farmers, forest-related workers, indigenous peoples and settlers in frontierareas and migrant agricultural workers.

Dengue fever also remains a threat, with cyclical outbreaks every three to five years. Early in2008, there was a resurgence in the number of cases.

The increase in life expectancy, rapid urbanization and lifestyle trends have resulted in changes inthe health profile. Four of the most prominent noncommunicable diseases are linked by

common preventable risk factors related to lifestyle. These are cardiovascular diseases, cancer,chronic obstructive pulmonary diseases and diabetes. In a study conducted by the Food andNutrition Research Institute in 2003, it was found that 90% of Filipinos have one or more ofthese risk factors: smoking, obesity, hypertension, high blood sugar and abnormal bloodcholesterol levels. Among the risk factors found, smoking was the most common risk factor, with 12.1% of women and 56.3% of men smokers. Obesity based on waist-hip ratio is morecommon than obesity measured by BMI. Prevalence of obesity and overweight using the hip-to-weight ratio is 12.1% for men and 54.8% for women.


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2.2 Outbreaks of communicable diseases

A total of 7880 dengue cases were admitted to various sentinel hospitals nationwide from January 1 to March 29, 2008, 20.6% higher than during the same time period in 2007(6532). Cases had exceeded and reached the alert threshold in weeks 1, 8 and 9 and went abovethe epidemic threshold on the 2nd to 7th week. Ages of cases ranged from


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Undernutrition remains a challenge in the country. Only 68% of children under five have thenormal weight for age using the National Center for Health Statistics/WHO Standards. In 2005,the prevalence of underweight pre-school children (0-5 years) was 24.6%, 26.3% were stunted,4.8% were wasted and 2.0% were overweight. In its State of the worlds children 2004. The UnitedNations Childrens Fund (UNICEF) reported that 20% of infants have a low birth weight, whileaccording to the 2003 NDHS, 13% are babies of low birth weight.

Exclusive breast-feeding is on the decline, with only 33.5% of children exclusively breast-fed upto the age of six months.

Other nutritional challenges faced by the Filipino child include:

anaemiawith prevalence rates among children aged 6-12 months and 6-11 years of age stillincreasing, and presently at the high levels of 66% and 37.4%, respectively;

vitamin A deficiencythe level among children aged six months to five years increased from35% in 1993 to 40% in 2003;

iodine deficiencythere are an estimated 1.5 million schoolchildren aged 6-12 years who areat risk of mental retardation due to iodine deficiency.

2.5 Burden of disease

Tuberculosis is still among the leading causes of morbidity and mortality in the Philippines; thecountry as has the 8th highest TB incidence in the world and the 3 rd highest in the Western PacificRegion. The burden of disease of TB is disproportionately high for the poor, elderly and malepopulation, although death is highest among older persons. Since TB principally affects theproductive age group, it is estimated that the country loses some Php 26 billion (US$ 540 millionannually due to premature deaths from TB.

Environmental-related health risks have been cited as a significant problem, with air pollution, water pollution, sanitation and unhygienic practices contributing to an estimated 22% of thereported disease cases and nearly 6% of reported deaths, costing Php 14.3 billion (US$ 287million) per year in lost income and medical expenses.

3. HEALTH SYSTEM

3.1 Ministry of Health's mission, vision and objectives

The Department of Health's vision is to be "The leader of health for all in the Philippines". Itsmission is to "guarantee equitable, sustainable and quality health for all Filipinos, especially thepoor, and to lead the quest for excellence in health".

The goals of the health department align with the WHO health systems framework. Betterhealth for the entire population is the primary goal. This means making the health status of thepeople as good as possible over the entire life cycle. The second goal is related to how the healthsystem performs in meeting peoples expectations and satisfaction with the services it provides.

Equitable health care financing is the third goal because health and illness involves large andunexpected costs that may result in poverty for many people.

The strategic thrusts to achieve the three primary health goals mentioned above are anchored inthe current programme of health reforms, labelled Fourmula One for Health. It is designed toundertake critical reforms with speed, precision and effective coordination, with the end goal ofimproving the efficiency, effectiveness and equity of the Philippine health system. Vital reformsare organized into four major implementation components: health financing; health regulation;health service delivery; and good governance in health. Implementation will focus on fourgeneral objectives: (1) health financing, the general objective of which is to secure increased,


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better and sustained investments in health to provide equity and improve health outcomes,especially for the poor; (2) health regulation, which aims to assure access to quality and affordablehealth products, devices, facilities and services, especially those commonly used by the poor;(3) health service delivery, where health interventions are aimed at improving the accessibility andavailability of social and essential health care for all, particularly the poor; and (4) goodgovernance in health, aimed at improving health systems performance at the national and locallevels.

3.2 Organization of health services and delivery systems

With the devolution of health services to LGUs under the Local Government Code of 1991,fragmentation of services became evident. Service provision is regarded as dual, consisting ofboth the public and private sector. The public sector has three largely independent segments orsets of providers: (1) national government providers, which include, among others, hospitals runby national government agencies (e.g., hospitals of the Department of Health and theDepartment of National Defense), central and regional offices of the Department of Health;(2) provincial government providers, which include provincial hospitals, provincial blood banksand the Provincial Health Office; and (3) local (municipal or city) government providers,including rural health units or RHUs, city health centres and barangayhealth stations or BHSs.Each BHSs is staffed by a midwife, and each RHU by a doctor, a nurse and midwives.

The Department of Health's role now focuses on regulation, technical guidelines/orientation,planning, evaluation, and inspection, while the provincial government is responsible forprovincial and municipal hospitals, health centres and health posts, although funding flows donot exactly match responsibility. The municipal government-level role is not well defined andcapacity is reportedly weak.

With the decentralization of service delivery, local chief executives became core players in thehealth sector. The number of actors involved multiplied and hence the need for coordination andpolicy monitoring. On health financing, for instance, the Department of Health and the CentralGovernment are no longer in control of resource allocation. The need for better coordinationand a better working relationship with the local government units and other stakeholders is wellrecognized.

Private providers are predominantly located in highly urbanized areas. The private sectorconsists of a wide range of privately operated facilities, such as pharmacies, physicians in solo orgroup practices, small hospitals and maternity centres, diagnostic centres, employer-basedoutpatient facilities, secondary and tertiary hospitals, traditional birth attendants and indigenoushealers.

Ongoing reforms in health service delivery are aimed at improving the accessibility andavailability of basic and essential health care for all, particularly the poor. Public primary healthfacilities are perceived as being low quality, hence they are frequently bypassed. Clients aredissatisfied due to long waiting times; perceived inferior medicines and supplies; poor diagnosis,resulting in repeated visits; and the perceived lack of medical and people skills of the personnelavailable, especially in rural areas. The result is that secondary and tertiary facilities are inundatedwith patients needing primary health care. Since public primary facilities are more accessible tohouseholds and are mostly visited by the poor, improving the quality of those servicesparticularly demanded by the poor would improve their health. Furthermore, referralmechanisms among different health facilities across local government units need to bestrengthened.

Pharmaceutical challenges remain due to asymmetric information, income distribution and theinadequacy of the regulatory system. This stems from various factors such as massive campaignsand lucrative incentives from multinational drug firms, prolonged patent rights cases and a lackof appropriate public understanding regarding generics.


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3.3 Health policy, planning and regulatory framework

The Government's policy to achieve improvements in health includes a perspective on theintegral value of health for any nation, the coordination of resources from all sectors, the right toaccess quality care, and the presence of socioeconomic fundamentals. While the Governmentprovides the leadership and stewardship to ensure that all efforts in the health sector lead to acommon goal, greater support to local health systems development and emphasis on strong

management and administrative support systems at all levels of governance is critical. Bettercoordination between national policies and external development partner priorities would alsoplay a major role in fostering the harmonization of resources for health.

The Department of Health remains inadequate in regulating the quality of health services in thecountry. This is attributed to the immense gaps in health regulations caused by the lack ofspecific legal mandates, inadequate expertise, an inadequate number of health regulation officers,a lack of expertise and infrastructure in specialized services and laboratory facilities, and weakhealth regulatory systems and processes.

3.4 Health care financing

The financial burden on individual families remains high. The latest (2005) national healthaccounts show that the most common source of funds for health in the country today is still out-

of-pocket payments (around 49%). Paying for health care is an issue because of its povertyimpacts. Under the current health care financing arrangements, low-income families are pushedinto poverty due to payments for health care. Almost 80% of total health expenditure is spenton personal health care services. In contrast, only 11% is used for public health care services. About 10% is used for the administrative spending needed to run the entire health system.These are signs that the Philippines is not spending enough or effectively for health.

Health care financing resources are spent largely on hospital-based curative services and notenough on preventive and promotive health services, and subsidies for health services are poorlytargeted. The large hospitals in Metropolitan Manila and other urban areas get the biggest shareof spending, while non-hospital health services face difficulties in getting adequate funding.

Meanwhile, the national health insurance programme has seen only a relatively slow and cautiousincrease in its share of total health expenditure. Possible reasons for this include its low benefit

package and the fact that coverage of the informal economy has not increased. The limitedfinancial protection of the national health insurance programme, PhilHealth, is closely related toits benefit coverage and provider payment system. As physicians provide more services and raiseprices under the current fee-for-service system, medical care expenses increase rapidly. However,PhilHealth pays only up to the rather low benefit ceiling and patients pay the rest of theexpenses. At the same time, physicians have the freedom to bill without fee regulation.Discussions are now ongoing to explore the feasibility of extending benefit coverage by raisingthe benefit ceiling.

Public health facilities are funded through a mix of public subsidies, such as Philhealthreimbursements, user fees and, to a limited extent, private health insurers. At the primary carelevel, public subsidies and Philhealth capitation allocations are funding services for both insuredand non-insured members and for both public health and personal care. At the hospital level, the

mix of funding is not well understood by regulators. Moreover, several schemes may be workingat the same time, depending of local priorities and management styles. Drugs are mainlypurchased out-of-pocket from private for-profit retailers. The Government has recentlyintroduced thousands of non-profit community outlets, but their impact on access and the costssupported by patients remains to be seen.

In response to these issues, the Government is finalizing its health care financing strategy toimprove health care financing polices that would realistically enhance access, equity andeffectiveness in resource mobilization and allocation, as well as the use of health services.


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3.5 Human resources for health

In 2004, there was one physician for every 880 people, one nurse for every 235, one dentist forevery 1800, and one pharmacist for every 1664. However, these ratios have most likely changed,especially with the exodus of nurses in the past five years. The country is purportedly theleading exporter of nurses to the world and the second major exporter of physicians. Prevailingchallenges include unmanaged immigration of Filipino health workers; a weak and inadequate

human resources for health (HRH) information system; and an existing distribution imbalance,among others. Responses to HRH issues in the past have often been stopgap measures. Inaddition, the interventions of the agencies concerned have not always been well coordinated.

In order to address such complex and multi-faceted issues, a comprehensive approach is needed. A master plan for human resources for health has been developed and implementation ofactivities is underway. A high-level coordinating body and multisectoral working group wasestablished in 2006 to mobilize political commitment, donor/partner support and the fundingneeded to accomplish the priority activities of the master plan. Called the Human Resources forHealth (HRH) Network, this group was able to successfully convene a policy forum to advocatetheir policy agenda, which aims to resolve issues related to production, entry and retention ofhealth professionals, as well as their exit and re-entry.

Strategic thrusts for 2005-2010 include development of HRH policies and strategies to addressout-migration; sustaining incentive mechanisms for HRH distribution and complementation inunderserved areas; and making education, training and skills development more appropriate tolocal needs. The strategies that are being undertaken include, among others, theinstitutionalization of the health human resource management and development system;improvement of the technical competence and relevant skills of health professionals througheducation and training; provision of targeted and performance-linked compensation benefits;strengthening of the coordination mechanism between the education sector, regulatory agenciesand HRH users; and installation of and HRH information system.

3.6 Partnerships

The attainment of national health goals has significantly progressed given the well-defined,commonly-shared vision and framework for health (now called FOURmula ONE).Department of Health experience has shown that better harmonization of efforts among the various stakeholders at all levels is critical. Currently, assistance for the health sector comesmainly in the form of grants, loans and technical assistance. A sectorwide development approachfor health (SDAH) between government and partners is being initiated to maximize investments,minimize duplication of initiatives and generate the necessary resources for the health sector. TheDepartment of Health is also working closely with international organizations and globalinitiatives to strengthen implementation of priority health programmes.

3.7 Challenges to health system strengthening

The publicly funded health system has been undergoing a major reform programme since 1999. At the broadest level, this has included a review of the Department of Healths primaryfunctions, roles and responsibilities and the suitability of the existing organizational structure tosupport these at both the strategic and service-delivery level. Introducing and pilot-testing the

different concepts and strategies of heath sector reform in selected provinces has showcasedsome gains in health systems development. However, one of the gaps then was the absence of acomprehensive operational framework to implement the reform strategies. Thus, theFOURmula ONE framework was launched in August 2005 to set the direction andimplementation arrangements for strengthening the way health care is delivered, governed,regulated and financed.

FOURmula ONE is now on its third year of implementation and both the Department of Healthand the LGUs are being challenged with operational issues, such as procurement. In addition,the health care delivery system has yet to address some major issues and challenges including,


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among others: the absence of data disaggregated at provincial/municipal level (for baseline andmonitoring); the absence of a workable means of identification of the poor for targeted healthinterventions; the minimal involvement of the private sector in the delivery of public healthprogrammes; the still excessive reliance on the use of high-end hospital services rather thanprimary care; the slow improvement in maternal mortality reduction; and population growth.Issues such as geographic inequity, where people who live in rural and isolated communitiesreceive less and lower quality health services, and socioeconomic inequity, where the poor do not

receive health services due to inaccessibility and/or unaffordability, continue to abound in thecountry.

More specific issues like out-migration of skilled health workers, low salaries/wages and lack ofincentives and poor work environments, including shortages of basic medical equipment andsupplies, continue to contribute to the worsening shortage of workers in rural areas, where healthneeds are greatest. Hospitals, both public and private, all over the country lament the loss ofsenior experienced nurses and doctors. The University of the Philippines-Philippine GeneralHospital (UP-PGH), the largest hospital in the country, loses 300 to 500 nurses of their 2000nurse workforce every year. Midwives, the front liners in providing health services, are alsoseeking jobs as caregivers in other countries in need.

There is a lack of reliable, disaggregated and integrated health and health-related data, evidence

and information, and inability to use health information to ensure knowledge-based policies andprogrammes remains a major challenge. There is also low investment in health research anddevelopment systems, as well as in information management systems.

In the area of health care financing, the following challenges remain: high out-of pocketspending; inadequate government spending on health; low spending for cost-effective publichealth interventions; low social health insurance benefit spending; and identification of the truepoor for social health insurance (sponsored programme).

The high cost of drugs and medicines also remains a major challenge, as prices range from twotimes to as much as 30 times higher than in other neighbouring Asian countries. To date, theCheaper Medicines Bill, which aims to effectively reduce the cost of medicines in the country, isyet to be signed by the President of the Philippines.

The devolution of health services created new challenges for the Government in overseeing thatlocal actions are in accordance with national policies and goals. Good governance in health atthe local levels, particularly in improving transparency and accountability in finance andprocurement, and logistics management remains a big challenge. With FOURmula ONE,systems of accountability and transparency are being established to minimize unscrupulousbehaviour, thereby ensuring efficient use of available resources for health.

4. LISTING OF MAJOR INFORMATION SOURCES AND

DATABASES

Title 1 : National Statistics Office.Web address : http://www.nso.gov.ph/

Title 2 : 2007 Government of the Philippines year-end reportWeb address : http://www.gov.ph/faqs/yearend_reports.asp

Title 3 : Philippine environment monitor 2006. The World Bank Group. June 2007Web address : http://www.worldbank.org.ph/pem

Title 4 : National Epidemiology CenterOperator Department of Health, PhilippinesWeb address : http://www2.doh.gov.ph/nec/

Title 5 : 2007 Philippines Development Forum8-9 March 2007, Cebu City, Philippines.


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Title 6 : 2005-2010 National Objectives for HealthOperator : Department of Health, PhilippinesWeb address : http://www2.doh.gov.ph/nec/

Title 7 : National Nutrition and Health Survey (NNHeS): Atherosclerosis-related diseaseand risk factors

Authors : Antonio Dans, Dante Morales, Felicidad Velandria, Teresa Abola,

Artemio Roxas Jr., Felix Eduardo Punzalan, Rosa Allyn Gy,Elizabeth Paz-Pacheco, Lourdes Amarillo and Maria Vanessa VillaruzSpecification : Philippine Journal of Internal Medicine, 43:103-115, May-June 2005.

Title 8 : Philippine nutrition facts and figures 2005Operator : Food and Nutrition Research Institute.

Department of Science and TechnologyTaguig, Metro Manila

5. ADDRESSES

DEPARTMENT OF HEALTH

Office Address : San Lazaro Compound, Tayuman,Sta. Cruz, Manila

Official Email Address : [email protected] : (632) 743-8301Fax : (632) 743-1829Website : http://www.doh.gov.ph

WHOREPRESENTATIVE IN THE PHILIPPINES

Office Address : 2nd Floor, Bldg 9, Department of HealthSan Lazaro Compound, Tayuman, Sta. Cruz, Manila

Postal Address : P.O. Box 2932, ManilaOfficial Email Address : [email protected] : (632) 338-7479/ 338-8605Fax : (632) 731-3914


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6. ORGANIZATIONAL CHART: Department of Health


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Year Source

Demographics

1 300.00 2006 1

2 88 574.61 2007 2

3 2.04 2000-07 2

4

11.47 a 11.64 a 11.29 a 2005 3

22.28 a 22.70 a 21.87 a 2005 3

4.40 a 4.02 a 4.78 a 2005 3

5 64.00 2007 est 4

6 20.50 2004 7

7 4.80 2004 7

8 1.73 2005 6

9

67.00 64.00 a 70.00 a 2004 7

10.60 12.10 2002 11

10 3.18 2005-15 6

11 92.60 1995-2005 8

12 1 461.33 2007 9

13 8.10 2007 9

14 0.77 2005 8

15 30.20 2003 10

16

17

36 24 12 2004 7

45 350 416 2007 17

34 22 12 2006 5

2 218 b 84 1 374 2006 5

2 517 2006 16

35 405 122 2006 22

63 41 22 2006 5

11 374 c 5 869 c 5 505 c 2006 5

Leprosy

Malaria

Plague


- 514 years

- 65 years and above

COUNTRY HEALTH INFORMATION PROFILE

INDICATORS DATA

Area (1 000 km2)

Female

WESTERN PACIFIC REGION HEALTH DATABANK, 2008 Revision

Total Male

Estimated population ('000s)

Annual population growth rate (%)

Percentage of population

- 04 years

Rate of natural increase of population (% per annum)

Urban population (%)

Crude birth rate (per 1000 population)

Crude death rate (per 1000 population)

Life expectancy (years)

- at birth

- Healthy Life Expectancy (HALE) at age 60

Socioeconomic indicators

Total fertility rate (women aged 1549 years)

Adult literacy rate (%)

Proportion of vehicles using unleaded gasoline (%)

Health care waste generation (metric tons per year)

Typhoid fever

Selected communicable diseases

Per capita GDP at current market prices (US$)

Environmental indicators

- Type B

- Type C

Female

Total Urban

Human development index

Rate of growth of per capita GDP (%)

Dengue/DHF

Gonorrhoea

- Unspecified

Cholera

Encephalitis

Rural

Number of deaths

FemaleMaleTotal

Number of new cases

Total Male

Syphilis

Communicable and noncommunicable diseases

Hepatitis viral

- Type E

- Type A

PHILIPPINES


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PHILIPPINES

Year Source

18 690 566 b 348 992 328 956 2006 5

19 3 538 2 069 1 469 2004 7

20

147 305 2006 16

85 740 ... 2006 16

21

106 884 d 51 980 d 54 864 d 42 686 22 551 20 135C: 2005

D: 200412, 7

14 043 d 14 043 d 4 254 55 4 199C: 2005

D: 200412, 7

8 585 d 4 737 d 3 848 d 2 230 1 234 996C: 2005

D: 200412, 7

7 277 d 7 277 d 1 111 1 111C: 2005

D: 200412, 7

992 d 647 d 345 d 452 307 145C: 2005

D: 200412, 7

4 202 d 2 243 d 1 959 d 2 460 1 234 1 226C: 2005

D: 200412, 7

4 113 d 2 140 d 1 973 d 1 927 1 201 726C: 2005

D: 200412, 7

7 629d

5 660d

1 969d

. . .

C: 2005

D: 2004 12, 7

3 932 d 2 368 d 1 564 d 1 439 811 628C: 2005

D: 200412, 7

17 238 d 13 273 d 3 965 d 7 240 5 446 1 794C: 2005

D: 200412, 7

22

54 045 30 598 23 447 2004 7

28 663 18 571 10 092 2004 7

43 077 24 322 18 755 2004 7

15 617 8 614 7 003 2004 7

13 915 7 065 6 850 2004 7

2 183 930 1 253 2004 7

23 16 552 7 970 8 582 2004 7

24 1 104 799 305 2004 7

25

12 646 11 613 1 033 2004 7

6 976 5 312 1 664 2004 7

1 818 1 400 418 2004 7

26

670 231 342 989 327 242 828.80 794.50 767.20 2006 5

572 259 295 827 276 432 707.70 685.30 648.10 2006 5537 100 265 320 271 780 689.90 614.60 637.20 2006 5

404 141 177 059 227 082 522.80 410.20 532.40 2006 5

337 275 161 446 175 829 435.00 374.00 412.20 2006 5

130 608 82 969 47 639 169.90 192.20 111.70 2006 5

38 482 17 946 20 536 49.30 41.60 48.10 2006 5

25 400 12 675 12 725 32.50 29.40 29.80 2006 5

22 284 12 128 10 156 27.60 28.10 23.80 2006 5

15 279 8 076 7 203 19.60 18.70 17.00 2006 5

1. ALRI and Pneumonia

Circulatory

- Cerebrovascular diseases

- Liver

- All forms

- Leukaemia

- Lip, oral cavity and pharynx

- Trachea, bronchus, and lung

7. Diseases of the Heart

INDICATORS DATA

Tuberculosis

Mental disorders

Male Female

- New pulmonary tuberculosis (smear-positive)

Cancers

All cancers (malignant neoplasms only)

- Hypertension

All circulatory system diseases

- Acute myocardial infarction

Number of deaths

Male

All types

- Homicide and violence

- Motor and other vehicular accidents

Female

Number of cases

Male

- Occupational injuries

- Suicide

COUNTRY HEALTH INFORMATION PROFILES| 365

3. Bronchitis/Bronciolitis

2. Acute Watery Diarrhea

10. Dengue Fever

Female

6. TB Respiratory

8. Acute Febrile Illness

9. Malaria

Rate per 100 000 population

Total

4. Hypertension

5. Influenza

- Ischaemic heart disease

Number of new cases

Leading causes of mortality and morbidity

Total Male

- Stomach

- Breast

Female TotalTotal

Leading causes of morbidity (inpatient care)

Injuries

- Rheumatic fever and rheumatic heart diseases

Diabetes mellitus

- Colon and rectum

- Cervix

- Oesophagus

Communicable and noncommunicable diseases

Diarrhoeal diseases

Acute respiratory infections


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PHILIPPINES

Year Source

27

70 861 40 361 30 500 85.72 96.99 74.30 2004 7

51 680 28 930 22 750 62.52 69.52 55.42 2004 7

40 524 21 395 19 129 49.02 51.42 46.60 2004 7

34 483 28 041 6 442 41.30 67.39 15.69 2004 7

32 098 15 822 16 276 38.83 38.02 39.65 2004 7

25 870 17 841 8 029 31.30 42.87 19.56 2004 7

21 278 10 916 10 362 25.74 26.23 25.24 2004 7

18 975 13 084 5 891 22.95 31.44 14.35 2004 7

16 552 7 970 8 582 20.02 19.15 20.91 2004 7

13 180 7 809 5 371 15.94 18.77 13.08 2004 7

28 35.90 2006 13

29 36.00 2007 16

30 43.90 2003 14

31 12.00 2006 13

32 54.80 2003 15

33

90.00 2007 16

87.00 2007 16

87.00 2007 16

88.00 2007 16

34

152 2004 7

317 2004 7

35

172 2007 16

39 2007 16

530 2007 16

..

121 2007 16

17 2007 16

0 0 0 2007 16

1 261 2007 16

3. Malignant Neoplasm

Leading causes of mortality

Total


Total Male

2. Vascular System Diseases

Number of deathsNumber of cases

Female

Total

DATA

Number of deaths Rate per 100 000 population

Male Female

MaleMaternal, child and infant diseases

1. Heart Diseases

6. Tuberculosis, all form

INDICATORS

Male FemaleTotal Male Female Total

Female

- Pertussis (whooping cough)

- Rubella

- Congenital rubella syndrome

- Sepsis

- Mumps

- Hib meningitis

- Poliomyelitis

- Eclampsia

- Haemorrhage

- Abortion

Selected diseases under the WHO-EPI

- Obstructed labour

- Measles

Percentage of pregnant women with anaemia

Percentage of pregnant women immunized with tetanus toxoid (TT2)

8. Chronic lower respiratory diseasesw

9. Diabetes Mellitus

Immunization coverage for infants (%)

- POL3

- BCG

- DTP3

- Diphtheria

Percentage of newborn infants weighing at least 2500 g at birth

4. Accidents

10. Certain conditions originating in the perinatal period

Percentage of women in the reproductive age group using modern

contraceptive methods

7. Ill-defined and unknown causes of mortality

5. Pneumonia

Neonatal mortality rate (per 1000 live births)

Maternal causes

- Hepatitis B III

- Total Tetanus

- Neonatal tetanus


14/16

PHILIPPINES

Year Source

36

37

Public health facilities 682 37 400 2006 19

21 10 374 2006 19

713 e 22 023 2006 19

2 293 2006 17

Private health facilities 1 068 36 519 2006 19

38

3 911.61 2006p 20

3.30 2006p 20

45.34 2006p 20

1 549.17 2006p 20

39.60 2006p 20

6.40 2006p 20

8.33 2006p 20

60.40 2006p 20

51.31 2006p 20

39

Year Source

40

Physicians - Number 93 862 2004 21

- Rate per 1000 population 1.14 2004 21

Dentists - Number 45 903 2004 21


Pharmacists - Number 49 667 2004 21


Nurses - Number 352 398 2004 21


Midwives - Number 136 036 2004 21


Paramedical staff - Number

- Rate per 1000 population

Community health workers - Number

- Rate per 1000 population

41 Physicians

Dentists

Exchange rate in US$ of local currency is: 1 US$ =

- external resources for health as % of general government expenditure

on health

Number of beds


Rural

Pu

blic

DATA

Ur

ban

Number

DATA

Human resources for health

Health insurance coverage as % of total population

Private

M

ale

Female

Total

INDICATOR

Private health expenditure

- private expenditure on health as % of total expenditure on health

External source of government health expenditure

Health facilities

INDICATORS

- general government expenditure on health as % of total expenditure on

health

Total health expenditure

- total expenditure on health as % of GDP

- amount (in million US$)

- general government expenditure on health as % of total general

government expenditure

- amount (in million US$)

- General hospitals

- Specialized hospitals

- District/first-level referral hospitals

- Primary health care centres

- per capita total expenditure on health (in US$)

Government expenditure on health

Health care financing

- Outpatient clinics

Facilities with HIV testing and counseling services

Health infrastructure

- Hospitals

Annual number of

graduates


15/16

PHILIPPINES

Year Source

41 Pharmacists

Nurses

Midwives

Paramedical staff

Community health workers

42 Physicians

Dentists

Pharmacists

Nurses

Midwives

Paramedical staff

Community health workers

Year Source

43 27.60 2003 14

44 24.00 2006 13

45 32.00 2006 13

46 92.00 2007 16

47 162.00 2006 13

48 63.70 2006 13

20.30 2006 13

42.40 2006 13

49 50.60 2006 13

50 4.80 2006 13

51 Antenatal care coverage - At least one visit

- At least four visits 59.00 2006 5

52 15.70 2006 5

53

54 0.02 2007 18

55

56 410.00 2006 16

57 0.14 2006 16

58 17.00 2006 22

59 85.00 2006 22

60 432.00 2006 16

61 45.00 2006 16

62 77.00 2006 16

63 82.00 2005 16

64 93.00 96.00 88.00 2006 23

65 78.00 81.00 72.00 2006 23

66

DATA

Proportion of population in malaria-risk areas using effective malaria

prevention measures

Health-related Millennium Development Goals (MDGs) Female

Proportion of tuberculosis cases detected under directly observed

treatment short-course (DOTS)


Tuberculosis death rate per 100 000 population

Total

Male

HIV prevalence among population aged 15-24 years

Estimated HIV prevalence in adultsf

Proportion of population using an improved sanitation facility

Proportion of population using an improved drinking water source

Malaria death rate per 100 000 population

Unmet need for family planning

INDICATORS

INDICATORS

Total

DATA

Private

Male

Urban

Rural

Public

Female

Under-five mortality rate (per 1000 live births)

- Percentage of deliveries at home by skilled health personnel (as % of

otal deliveries)

Infant mortality rate (per 1000 live births)

Annual number of

graduates

Workforce losses/ Attrition

Adolescent birth rate

Total Urban Rural

Proportion of population with access to affordable essential drugs

on a sustainable basis

Contraceptive prevalence rate

Proportion of tuberculosis cases cured under directly observed

treatment short-course (DOTS)

Proportion of population in malaria-risk areas using effective malaria

treatment measures

Tuberculosis prevalence rate per 100 000 population

Maternal mortality ratio (per 100 000 live births)

Prevalence of underweight children under five years of age

Proportion of 1 year-old children immunised against measles

Proportion of births attended by skilled health personnel

- Percentage of deliveries in health facilities (as % of total deliveries)

Malaria incidence rate per 100 000 population

Percentage of people with advanced HIV infection receiving ART


16/16

PHILIPPINES

p

est

NR

a

b

c

d

e

f

1

2

3

4

5

6

7

8

9

10

1112

13

14

15

16

17

18

19

20

21

22

23


World Health Organization and United Nations Children's Fund Joint Monitoring Programme for Water Supply and Sanitation (JMP). Progress on Drinking Water and Sanitation:

Special focus on Sanitation . UNICEF, New York and WHO, Geneva, 2008. [http://www.wssinfo.org/en/40_mdg2008.html]

WHO Regional Office for the Western Pacific, data received from technical units.

National Epidemiology Center, Department of Health, Philippines.

2007 Estimation Workshop and Concensus Meeting, National Epidemiology Unit, Department of Health, Philippines.

National Malaria Control Program, Department of Health, Philippipnes.

Professional Regulation Commission. Philippines

Official Website of the Republic of the Philippines [http://www.gov.ph/]

2007 Census of Pouplation, National Statistics Office Presss Release. [http://www.census.gov.ph/data/pressrelease/2008/pr0830tx.html]

Projected Population by Five-Year Age Group and by Sex, by Five Yr. Interval, Medium Assumption.National Statistics Office. [http://www.census.gov.ph/data/sectordata/poproj07.txt]

United Nations, Department of Economic and Social Affairs, Population Division (2007). World Population 2006. Wallchart (United Nations publication, Sales No. E.08.XIII.3).

Field Health Service Information System. Department of Health, Philippines.

NSO Quick Stat Index Page. National Statistics Office, Philippines. Feb. 2008.

National Statistical Coordination Boardm, Philippines.

Bureau of Health Facilities and Services, Department of Health

World Health Organization - National health accounts series [http://www.who.int/entity/nha/country/MYS.pdf]

Sources:

Not relevant

Not included in the official list of MDG indicators

Human Development Report 2007/2008: Fighting climate change: Human solidarity in a divided world . United Nations Development Programme, New York USA 2007.

Provisional

Estimate

2004 Philippine Health Statistics, National Statistics Office. Philippines, 2004.

Estimated figure

Notes:

Data not available

[http://hdr.undp.org/en/reports/global/hdr2007-2008/]

District hospital can be general or special

Revised data

Totals may not tally due to some reported cases with no gender breakdown

Figure includes paratyphoid fever

2006 Family Planning Survey, National Statistics Office, Philippines.

2003 National Demographic Health Survey, National Statistics Office, P hilippines.

Land Transportation Office. Department of Transportation and Communication, Philippines.

World health report 2004. Changing history. Geneva, World Health Organization, 2004.2005 Philippine Cancer Facts and Figures, by the Philippine Cancer Society, Rizal Medical center and Department of Health.

Sixth National Nutrition Survey, National Nutrition Council, Department of Health, Philippines, 2003.

Documents

Philippines 08