Top 10 health agendas of the Philippines

For those who may not be aware of the major health issues facing the country, I have made a quick overview of the challenges facing the government and the Department of Health.

Due to space constraints, I have summarized each issue so everyone can have an initial understanding on them:

1. Improve hospitals and health facilities. This is the most basic problem we need to address. If we lack the facilities, the machines, and the medicines, how can we treat our people? To improve this, we not only need to increase the budget of these hospitals; we should also look for capable and visionary hospital directors who will know what to do with the additional money given to the hospital. The hospital director should know how to manage the hospital efficiently, raise funds, and go into public-private partnerships to quickly upgrade the hospital’s capabilities. He/she should know how to work inside the government bureaucracy and be savvy in the political issues in his or her area.

2. Employ more health workers (doctors, nurses, and midwives). We have a surplus of around 200,000 nurses in the country. And yet, we lack the funds to employ the needed health workers in our health facilities. For example, the RN Heals project only asks “volunteer nurses” to help the government in exchange for an allowance. There are pending legislations to increase the budget of health workers. Moreover, we should ensure their safety in their areas of work. Both hospital improvement and employing the necessary health workers go hand in hand.

3. Increase PhilHealth enrollment and improve PhilHealth benefits. This is the flagship program of the Aquino Health Agenda (AHA), which is also called Universal Health Care (Kalusugan Pangkalahatan). The key strategy is to enroll the poorest 10 million families into PhilHealth. This is roughly 50 million Filipinos, half the population, which are earning roughly less than P6,000 a month per family. Indeed, the ugly truth is that half of our people live in poverty. If we can get the necessary funds to enroll these poor Filipinos, then they will at least be partially covered in their hospital expenses. But aside from giving out PhilHealth cards (which is the easy part), the more difficult issues are 1) increasing the public’s awareness on how to use the card and 2) giving substantial health benefits for indigent patients. To know the real state of PhilHealth coverage in the country, one can ask around any government hospital and ask how many of their charity patients are using PhilHealth. And this percentage (still low) will show us how far we are from giving adequate care to our people.

4. Reduce maternal and infant deaths. The Philippines has a high rate of mothers and infants dying. Experts say that the government will find it difficult to attain the Millennium Development Goal for reducing maternal mortality. The current rate is 152 mothers dying per 100,000 live births, and the target is to reduce this number down to 50 mothers dying per 100,000 live births by 2015, which is unlikely to be achieved.

To decrease maternal deaths, the strategies are to: 1) increase the number of mothers undergoing pre-natal checkups to screen for high-risk pregnancies, 2) increase hospital deliveries, 3) encourage mothers to space their pregnancies by three to five years. To reduce infant deaths, the strategies are to 1) increase the number of breastfeeding mothers, 2) increase vaccination coverage, 3) give the proper nutrition to the mother and child.

5. Reduce non-communicable diseases. These so-called lifestyle diseases are the top causes of mortality in the Philippines, and these include heart disease, stroke, diabetes, high blood pressure, high cholesterol, obesity, and kidney diseases. To address these medical conditions, the DOH needs to reduce the very high smoking prevalence in the country (56 percent of Filipino males smoke), increase intake of fruits and vegetables (three out of five Filipinos do not eat enough fruits and vegetables), increase physical activity, and widen the access to cheap medicines.

6. Reduce and prevent cancer cases. Cancer is the third leading cause of death in the country. In my research, the top 4 preventable cancers are cancers of the lung, liver, breast, and cervix. Smoking cessation (lung cancer), hepatitis B vaccination (liver cancer) and early screening and treatments (breast and cervical cancer) can dramatically reduce these cancer cases and deaths.

7. Lower the cost of medicines. The DOH is mandated to promote generic medicines and to monitor the cost of essential medicines.

8. Control dengue outbreaks. Dengue is basically tied up with environmental sanitation. Continue with the health information campaign on dengue prevention. Ensure adequate hospital facilities, personnel, and equipment for dengue patients. Facilitate the production of the dengue vaccine.

9. Reduce diarrhea outbreaks (gastroenteritis, typhoid and cholera). Like dengue, these diseases are related to environmental sanitation. Ensure clean and safe water supply. If this isn’t possible, then we can teach the public to 1) prepare safe drinking water, 2) wash their hands after using the toilet, and 3) dispose of waste products safely.

10. Control the growing HIV-AIDS epidemic. Should HIV positive cases suddenly increase in the Philippines as projected, then that will put a tremendous strain on the health sector. This is because HIV patients can live a long time and will require expensive maintenance medicines. How then can the government sustain such an expense? A strong health information campaign on HIV transmission and safe sex will help.

There are other important health issues like malnutrition, measles outbreaks, potential flu epidemics, road accidents, air pollution, firecracker injuries, rabies, dental health, mental health, newborn care, eye care, ear care, and many others. Each deserves our attention and support.

However, we can start by focusing our efforts on these 10 health issues above. By doing so, we can surely create a substantial impact on improving the health of many Filipinos. –Willie T. Ong, MD (The Philippine Star)