The European Union financed Philippine Health Sector Reform Contract (PHSRC) 2014-2018, drawn up under a budget support mechanism, amounted to EUR 30 million and was intended to improve the country's financial capability to achieve health sector policy objectives, governance in the health sector and delivery of health services.
As a complementary measure to the non-earmarked budget support, the PHSRC-TA had been put in place to supply the Department of Health (DOH) agencies, including the Food and Drug Administration (FDA) and the Philippine Health Insurance Corporation (PhilHealth), with expert inputs with particular focus on expanding financial risk protection and improving access to quality health service delivery. Implementation of the PHSRC TA program was contracted to a consortium led by EPOS Health Management which had set up a TA team of three key experts (coming from the technical fields of Health Systems, Human Resources for Health, Pharmacy) and a national long-term specialist in Health Financing & Health Insurance, housed in the key agencies of the government to manage implementation under the following Key Result Areas (KRA):
KRA 1: Strengthened health service delivery systems, notably with respect to functioning referral networks, quality of services and equitable access to essential medicines.
KRA 2: Adequate supply and equitable distribution of human resources for health.
KRA 3: Increased utilization of the National Health Insurance System and increased and more efficient public financing for the poor.
KRA 4: Strengthened regulatory capacity of government to ensure quality of services, medicines and supplies.
KRA 5: Strengthened capacity in implementation, monitoring and evaluation of policies and reforms, particularly with regard to improving equitable access, quality and efficient management of the sector.
Good governance of the TA process (budget management, Terms of Reference definition, recruitment of experts, briefing of experts, implementation, supervision and approval process of final product) was maintained through a consultative tripartite process. The parties included were the counterpart agency (DOH), the financing agency (EUD) and the implementation agency (EPOS).
By the end date of the PHSRC TA programme in November 2018, a total of 9,406 person days of international and national experts had been delivered under 96 different TORs with varying complexity and scope.
Identification of TA within the five KRAs was de facto demand (DOH) driven, with technical inputs during the TOR development and refinement by the four EPOS key experts. This ensured DOH ownership and alignment with national policy priorities also during time of political change.
Examples of flagship TA / TOR delivered:
Piloting and institutionalization of a Medical Residency Rotation scheme for postgraduate medical education (Internal Medicine, Surgery, Pediatrics, Obs & Gyn).
Establishing a Center of Excellence for Family Medicine (service delivery and training of postgraduate family medicine practitioners.
Piloting and support the scale-up of a national outpatient-based voluntary medical drug treatment pathway for Methamphetamine users.
Research on effect of gate keeping to contain escalating claims submission by hospitals to PhilHealth.
Reviewing PhilHealth Inpatient case rates and initiating move towards DRG based reimbursement.
Developing a road map for the national roll-out of electronic medical records.
Reviewing and updating of various government orders on topics such as access of residents in geographical disadvantaged and isolated area to health service.
Updating the National Health Enterprise Architecture integrating PhilHealth and DOH and information requirements.
Developing interoperability platforms for harmonized data analytics and solutions such as user driven dashboard visualization.
Upon request by Counterparts, the EPOS experts provided support (lectures, presentations, expert panel discussions, policy dialogue) to various high level bodies such as Executive and Management Committee meetings, DOH National Staff Meetings, Health Partner Meetings, Universities and Private Entities (with strict enforcement of our internal conflict of interest policy).