The implementation of the Universal Health Care (UHC) law in Sorsogon started right after Gov. Francis Joseph “Chiz” Escudero took oath in 2019 as the governor of the province. In August 2019 an Executive Order creating a technical working group (TWG) was issued, designating Dr. Edgar F. Garcia as the UHC Executive Director. One of its mandates is to ensure that the province is included as one of the pilot implementation sites for UHC in the Philippines. From August 2019 onwards, the TWG started the preparation for the requirements to be qualified as an advanced implementation and integration site. As one of the pilot areas, the province of Sorsogon leads in the preparation and compliance in the country. Consequently, on October 7, 2019, the UHC in Sorsogon was launched with representatives from the Department of Health (DOH), Philippine Health Insurance Corporation (Philhealth) and other relevant agencies to witness as guests.
The provincial government, with the leadership of the UHC TWG had made several initiatives in the span of three years of governance. They were able to register 601,000 individuals (out of the 845,000 population) in the e-Konsulta of PhilHealth. The e-Konsulta package is a primary health care intervention to all citizens registered in Philhealth. The target is for all Sorsoganons to be enrolled as members of PhilHealth, regardless of the capacity to pay (indigent or not) and whether direct or indirect payer. The UHC TWG is continuously looking for the remaining 200,000 to achieve 100% enrollment. Another feat is that Sorsogon is the first province in the country that has its whole public health facilities, including 19 rural health units (RHUs) and City Health offices and nine government hospitals, to be accredited by E-Konsulta of Philhealth. Several facilities are newly renovated (one district and four medicare hospitals), several ongoing infrastructure projects (provincial and two district hospitals), new equipment procured (x-ray and ultrasound machines, hospital beds, operating tables and ambulances), and all nine government hospitals are recommended for ISO Certification. In addition, the digitalization of hospital and medical records are developed in partnership with the DBP MEDIX. The Electronic Health Records (EHRs) were developed to be shared with all the health facilities included in the e-Konsulta network. The patient’s EHR can be shared wherever he/she goes provided that the primary healthcare facility is a member of the network. This would minimize the patient from going back and forth to get his/her medical records since this can easily be accessed through the EMR.
Strong political will is a major factor that compelled all the LGUs to readily signify their cooperation and participation in the province-wide health system. Gov. Chiz Escudero, a former Senator, was able to convince and get the commitment and support of the local chief executives (LCEs). He facilitated and easily coordinated with the different involved agencies particularly on the initial data and information needed during the preparatory stage. The presence of the Sorsogon UHC Office, with dedicated personnel and ably headed by Dr. Garcia, who will work and focus mainly in the preparation and implementation of the UHC is another enabling mechanism.
In March 2020, the national health emergency brought about by the COVID-19 pandemic caused the interruption in the UHC preparatory activities. There are still additional documents needed to be prepared by the province in compliance with the maturity tool of the DOH. However, the province has to temporarily suspend these activities to prioritize pandemic response.
Sorsogon’s vision for UHC is “Healthy Sorsoganon” while the mission to attain the vision is “to strengthen the health system of Sorsogon”. In order to achieve that, the UHC TWG focused and adopted the World Health Organization(WHO) advocacy on improving the six building blocks for an effective health system. They are as follows:
Leadership and governance – This involves ensuring strategic policy frameworks exist and are combined with effective oversight, coalition building, regulation, attention to system-design and accountability.
Health workforce – There should be enough qualified health workers that will manage the health system based on DOH standards. A well-performing health workforce is one that works in ways that are responsive, fair and efficient. To date, the gap is still wide on the number of health workers needed
Health information systems – A well-functioning health information system is one that ensures the production, analysis, dissemination and use of reliable and timely information on health determinants, health system performance and health status. With the onset of internet connectivity, paperless transactions are encouraged. Submission of reports should be done electronically, especially the sharing of EMRs of patients. This is to fast track everything and to make the bureaucracy more efficient.
Medical products, vaccines and technologies – Basically this is on the supply chain management. All basic and emergency medicines of assured quality, safety, efficacy and cost effectiveness should be available in the health facilities
Service delivery – Good health services are those which deliver effective, safe, quality personal and non-personal health interventions to those that need them, when and where needed with minimum waste of resources. This includes a referral system, health promotion, and health literacy of the citizens.
Financing – A good health financing system raises adequate funds for health in ways that ensure people can use needed services. With the full integration of the provincial health system, there will be a special health fund coming from DOH, Philhealth and other donors. The management of the utilization of the Special Health fund should be responsive to the health needs of the citizenry.
Essentially, these are the ongoing activities towards the full implementation of the UHC law in the province. Presently, it is working on fulfilling the requirements on the six basic blocks of the WHO. In terms of the documents required by the DOH in compliance with the building blocks, Sorsogon is almost 60% compliant. Once fulfilled, the province becomes ready to implement the UHC law. The law says that preparation should begin by 2019 and the full managerial integration by 2022. But the province is aiming to achieve full managerial and financial integration this year. If this would be realized, by 2022, Sorsogon can already begin the full implementation of the UHC law.
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