PNHRS - Philippine National Health Research System

Health is a basic human right guaranteed by our constitution. However, the great disparity in access to and use of health care, resulting in significant differences in health status, between the rich minority and the poor majority of Filipinos constitutes a grave violation of this right for most Filipinos. 

Conventional health status indicators of life expectancy at birth (LEB), infant and child mortality (IMR), and maternal mortality ratio (MMR) show considerable variation when disaggregated according to income groups and geographic location.  Rich urban communities like those in Metro Manila, Cebu, and Davao, with access to modern facilities, have outcomes comparable to those of developed countries – i.e., LEB over 80 years, IMR less than 10, MM less than 15.  In contrast, poor rural communities, such as those in Bicol, the Samar provinces and ARMM, have results that approach those of least developed countries – i.e., LEB under 60 years, IMR over 90, MM over 150.   While not quite as bad as those of least developed countries, urban poor communities have indicators that are from two to five times worse than their neighbors in gated villages.  

These disparities are the result of the following deficiencies in our health system:

• Basic health services as well as tertiary care for the majority of Filipinos are inadequate, fragmented, inefficient, and incomplete.  At least in part due to this, for lowest income groups these services are largely inaccessible and unaffordable.
• The Philippines’ health sector is dominated by commercial interests of a segment of the system that is not really about health outcomes but is primarily about bottom-line profits. 
• Human resources for health are insufficiently educated, inappropriately trained, and poorly motivated to address the health care concerns of most Filipinos in the setting in which they live.  As a result, poorly compensated government health workers are unable to influence behaviors of their high earning private sector counterparts within the change-resistant environments of their respective professional organizations.
• Much of this commercial dominance of our health care system is the result of a failure, so gross as to constitute a default, of public financing for health. The combined weight of the uncoordinated spending for health by the national government, local governments and our national social health insurance program has been so low and so weak that it has driven our health system into a debilitating dependence on out-of-pocket payments by patients.

To address these deficiencies, radical reforms in all components of the Philippine health system are required.  Such reforms must be aimed at achieving UNIVERSAL HEALTH CARE in the country over a reasonable period of time (10-15 years). This means that every Filipino should have access to high quality health care that is efficient, accessible, equitably distributed, adequately funded, fairly financed, and directed in conjunction with an informed and empowered public.  The overarching philosophy is that access to social services is based on needs and not on the capability to pay. This, ultimately, places people at the center of socio-economic development.