The Philippine health system reform has consistently been on the forefront of the Global Health Dialogue, and significant reform initiatives have been taken from 1991 onwards. The past two decades of reforms have primarily concentrated on installing local governance structures to manage health service delivery, effectively re-shaping the role of the Department of Health (DoH) as regulator, provider of technical assistance and overall steward of the system, and putting in-place the NHIP as a major purchaser of services. The Philippines reform process builds on previous gains and corrects deficits in the system as they become better understood. However, there are still persistent barriers to health care despite a long series of reforms. The third phase of this EU project presents an opportunity to ensure that the foundations of Universal Health Care (UHC) are strongly laid down and that they endure changes in Philippine politics and remain the centerpiece goal of the health sector and the Philippine government at large. EPOS has adopted the sustainable health systems framework as an approach to deliver technical assistance (TA) to partners. As a main knob to support the health sector reform process, EPOS is supporting the DoH to find new local health system management models to improve service delivery.
This TA forms part of the national development approach and ties in with the poverty alleviation approaches of the government. The TA is lodged within the current health system reform agenda and is expected to facilitate achievement of results, not as a parallel mechanism that shadows the work of government, but as a provider of technical expertise and adviser to the reform process. The TA is oriented towards five key result areas and foci of TA intervention: Strengthening the service delivery system; Strengthening the institutional capacity of the PhilHealth to become the primary payer in the health system; Improving the governance of the health sector; Enhancing the regulatory capacity for provision of quality services, medicines and supplies; Ensuring equitable distribution of human resources for health (HRH). Our approach focuses on making sure that priorities that have been laid down and is being pursued for the next few years will become steps and lessons to ensure future long-term values. The ultimate goal is to achieve a well-functioning health system that can result in greater equity in health and also sustain its performance through the years, and it will require trial and tests and application of lessons learned in other contexts to the Filipino health care system. Whilst not one size fits all, the quest for health systems sustainability and responsiveness to local needs is universal, and there are experiences to share world-wide. Local health system development is the primary connection point of the TA to the overall health system reform initiative as it cuts across the different components of reform. The TA supports modifications of local health systems management that departs from the traditional model from when decentralisation and reforms were first rolled out. It intends to create lasting solutions to persistent logistical problems that plague local health systems and at the same time adapt to changing contexts and incorporate national and global experiences. While each reform component is addressed at the local governance level, parallel measures take place at the national level to institutionalize reform.