Strengthening Local Capacity for Health Equity Reform in the Philippines

The Province of Capiz, located primarily on the island of Panay in the Visayan Islands, is composed of 16 municipalities and one city with a total of 472 barangays. With a population of more than 650,000, it has the highest poverty levels (59.7%) in the Western Visayas. More than 70% of the inhabitants are engaged in farming and/or fishing.

There are eight government and three private hospitals in the Province of Capiz. Of the eight government hospitals, one is classified as provincial, four as district, and three as community hospitals. As mandated in the Local Government Code of 1991, the management of the government hospitals was devolved to the local government units; however, the resources (human and financial) necessary to operate the hospitals were not devolved at the same time. This, combined with the absence of a comprehensive health program and an existing budget deficit, put a strain on the kind and quality of the health services currently available to the people of Capiz and on the ability of officials to develop strategies to improve the delivery of basic health care services. 

In order to address these issues, the Province of Capiz and the City of Roxas intensified their efforts to initiate reforms to improve health care services through an integrated health delivery system. The challenge, they recognized, was to mobilize and maximize resources for the efficient delivery of health services on a sustainable basis. As an initial result of these efforts, national government agencies, donor agencies, and the private sector have committed resources and technical support services to assist local officials in accomplishing their goals. The Gerry Roxas Foundation leads the private/not for profit sectors’ participation by supporting the capacity building program for hospital and rural health workers and barangay health workers. It is also responsible for mobilizing private sector volunteers to augment and act as an auxiliary to the formal health services in the Province.

The Capiz Integrated Health Services Development Program was launched in March 2000, and a memorandum of agreement (MOA) signed between the various stakeholders. The overall goal of this program is to establish areas for convergence of health services and cooperation among the stakeholders in the health sector through integration of all health care programs for a more efficient, effective and comprehensive health care delivery system. The primary objectives of this program are five-fold:

o        To organize local health zones involving the hospitals, local government units, and the private sector with each local health zone working together through the Capiz Integrated Health Services Council to address specific problems within their zones;

o        To institutionalize a rational and efficient referral system between the different levels of health care providers;

o        To promote setting up of alternative community-based health financing mechanisms in order to provide health insurance coverage for the majority of the Capiceños;

o        To upgrade hospital services and facilities to cater to the needs of more affluent patients thereby increasing revenues to subsidize indigent patients.

This program is currently ongoing, and the CSIH Strengthening Local Capacity for Health Equity Reform in the Philippines project will build upon it to provide strengthened capacity for resource allocation decision-making for equitable health care services planning and delivery.

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