OBJECTIVE

This study analyzed the factors influencing the implementation of the disability benefit package for children with developmental disabilities (CDDs) in the Philippines.

Data collection was done through document review of policy documents and focused group discussions (FGDs). Guided by Walt and Gilson’s policy triangle framework, data were analyzed through content analysis.

Twenty-two (22) policy documents were reviewed and a total of 16 participants joined the FGDs. Facilitators and barriers were identified and categorized through the policy elements: 1) context is anchored by presence of laws and policies but is hindered by issues on politics, governance, and labor force; 2) policy actors are hopeful in the continuous implementation of the policy but there is a lack of participation from all potential policy actors and limitations with human resources; 3) content is sound and comprehensive but there are costing issues and compliance concerns with requirements; and 4) processes emphasize quality assurance and promising initial dissemination efforts but the lack of stakeholder engagement activities and the tediousness of requirements discourage potential service providers.

While the launch of the disability benefit package for CDDs in the Philippines seemed promising, the policy remains underutilized as the identified barriers outweigh the facilitators. Specific recommendations for the improvement and implementation of the benefit package were outlined and framed based on the policy triangle framework.

OBJECTIVE

This study analyzed the factors influencing the implementation of the disability benefit package for children with developmental disabilities (CDDs) in the Philippines.

Data collection was done through document review of policy documents and focused group discussions (FGDs). Guided by Walt and Gilson’s policy triangle framework, data were analyzed through content analysis.

Twenty-two (22) policy documents were reviewed and a total of 16 participants joined the FGDs. Facilitators and barriers were identified and categorized through the policy elements: 1) context is anchored by presence of laws and policies but is hindered by issues on politics, governance, and labor force; 2) policy actors are hopeful in the continuous implementation of the policy but there is a lack of participation from all potential policy actors and limitations with human resources; 3) content is sound and comprehensive but there are costing issues and compliance concerns with requirements; and 4) processes emphasize quality assurance and promising initial dissemination efforts but the lack of stakeholder engagement activities and the tediousness of requirements discourage potential service providers.

While the launch of the disability benefit package for CDDs in the Philippines seemed promising, the policy remains underutilized as the identified barriers outweigh the facilitators. Specific recommendations for the improvement and implementation of the benefit package were outlined and framed based on the policy triangle framework.

BACKGROUND AND OBJECTIVE

Public health nurses (PHNs) perform more than the provision of direct care to clients. They are also expected to perform roles as leaders, managers, and collaborators in different settings, especially in areas where there are no physicians. Their continuous professional development must be facilitated to empower them to lead the delivery of health programs and services in pursuit of universal healthcare. This study aims to determine the perceived competencies of public health nurses and describe their training needs.

A descriptive, cross-sectional study was utilized, where an online survey was administered to PHNs across the Philippines to determine their self-perceived competencies and training needs based on the eight domains of core competencies of public health professionals. Descriptive statistics was used to summarize the data.

A total of 330 PHNs answered the survey. The results showed that at baseline, PHNs perceived themselves to be competent (from most to least) in the following: communication, analytical/assessment, community dimensions of practice, policy development/ program planning, leadership and systems thinking, cultural competency skills, public health science, and financial planning and management. In terms of training needs, the enablers mentioned include a supportive work environment that can provide a work schedule that is inclusive of time for professional development and work-life balance; a learning environment where colleagues and supervisors support the need for training and innovation; strong internet connection; and enough equipment to participate and submit deliverables for courses taken.

Filipino public health nurses perceived themselves to be competent in the areas of communication and community practice, but less competent in public health science, and financial planning and management. Future capacity-building programs must be designed to meet this demand. Furthermore, to make training programs truly responsive to the needs of nurses, steps must be taken to promote capacity-building enablers.

BACKGROUND

Family and Community Medicine is a medical specialty that plays a crucial role in the healthcare system and will be in the best capacity to provide primary care services, coordinate referrals to specialists when needed, and promote continuity of care across different healthcare settings in the implementation of the Universal Health Care Law. These are policy recommendations on how family and community medicine can play a significant role in the successful implementation of the UHC.

Recommendation #1. The undergraduate curriculum in Family and Community Medicine must be competency based.

Recommendation #2. The competency outcome of Family and Community Medicine undergraduate curriculum must be aligned with the need of the Philippine health system in the context of Universal Health Care reform.

Recommendation #3. The process of delivery of Family and Community Medicine undergraduate curriculum must adopt to new technology and teaching innovation.

Recommendation #4. Family and Community Medicine must develop strategies to make it as career choice.

Recommendation #5. Family and Community Medicine must develop and implement an effective and sustainable faculty development program.

Recommendation #6. Family and Community Medicine must be socially accountable to the community it serves.

Recommendation #7. Family and Community Medicine must be one of the major core competencies of a licensed physician ready to practice as primary care provider in the UHC.

Recommendation #8. Early placement for Family and Community Medicine practice must be available for newly licensed physicians.

Recommendation #9. Family and Community Medicine practitioners must be provided with continuing professional education and training to provide quality patient care.

Recommendation #10. Family and Community Medicine postgraduate education and training must adopt to new technology and training innovation.

Recommendation #11. Family and Community Medicine postgraduate training should cover urban and rural community health service.

Recommendation #12. Family and Community Medicine continuing professional education and training programs must meet the prescribed standards.

Recommendation #13. Regulation of Family and Community Medicine practice must be a public-private partnership.

Introduction: Accidents are unpredictable and sometimes unavoidable. Businesses such as shopping complexes need to follow safety protocols to ensure that nobody is hurt. The shopping complex should have preventive measures and an accident management team to offer efficient and timely treatment for these accident victims. Objective: This paper aims to identify problems experienced by the accident management team in dealing with accidents in a shopping complex. The report will also propose and implement solutions to all issues identified. Methods: Two action research cycles were conducted for this paper, with the results of the first action research flowing into the second action research cycle. Reeves et al.’s interprofessional teamwork framework addressed concerns related to teamwork. The data used in this action research came from journal entries, informal and formal one-on-one discussions, and discussions with each department. Results: The workflow for the current post-accident management activities was evaluated. The problems identified were grouped into 5: roles and responsibilities, procedures, knowledge transfer, logistics, and skills. The issues concerning the roles and responsibilities of each team member were addressed by realigning these with their current skills, training, and job description. The remaining and new problems were addressed by developing an accident management policy. Inclusions in the policy are protocols on transporting patients, communication and transportation procedures, letter of authorization (LOA) approval procedures, post-accident evaluation procedures, pre-accident recommendations, policy revision procedures to address organizational changes, changes in the job description or government regulatory mandates, and the evaluation of current skills in case training is needed. Conclusion Accident management requires a coordinated effort amongst all the team members, with members from different social and health specialties. Using Reeves et al.’s interprofessional teamwork framework, the team identified the problems and implemented solutions by realigning the roles and responsibilities of each team member and implementing an accident management policy that can improve preventive measures and improve post-accident responses.
policy development ; accountability ; action research ; risk management

Background: The Universal Health Care (UHC) Act is a landmark legislation that seeks to improve provision of comprehensive health services through the integration of local health systems. The Department of Health (DOH) conducted a series of roundtable discussions to gather stakeholders' inputs and concerns to refine the initial draft of the Implementing Rules and Regulations (IRR) of UHC. Methods: On April 4, 2019, the Department of Health led a roundtable discussion on the Local Health Systems sections of the UHC IRR in collaboration with University of the Philippines Manila. A total of 65 stakeholders from different sectors participated in a semi-structured roundtable event. The proceedings were audio recorded and transcribed. A thematic analysis was done using NVivo 12 software to document gaps and gray areas identified by the participants. Results: Concerns of the participants revolved around the following: role of the private sector in local health systems; the integration of different municipal and other component health systems into a province-wide health system; organizational design of the health systems; pooling and utilization of the Special Health Fund (SHF). Gaps andgray areas were concentrated on the transfer of personnel and other health resources to the province-wide system, the composition of the Provincial Health Board, and the utilization and management of the SHF. Conclusion The roundtable event acquired various perspectives from stakeholders that could help the DOH identify priority action points that could be resolved at the agency level. The identified themes from the study analysis could be of value to decision makers to clarify issues, address policy gaps, and to prioritize future research directions.
Universal Health Care ; Policy Making ; Medical Assistance ; Government Programs ; Health Policy ;

This study investigated the healthcare status of South Korea and member states of the Organization for Economic Cooperation and Development (OECD). By employing the position value for relative comparison index, healthcare status was measured through the following components: demand, supply, accessibility, quality, and cost. Statistical analysis was conducted through the Mann-Kendall test from analyzing trends from 2000 onwards. Results showed that while Korea, on average, scores higher than the OECD average in most of the investigated components, it is below average in certain indexes including primary care and mental health care. Considering the various health issues that have been raised about these indexes, it is important these components be improved upon by policy-makers.
Delivery of Health Care ; Health Policy ; Korea ; Mental Health ; Organisation for Economic Co-Operation and Development ; Primary Health Care

BACKGROUND: The purpose of this study is supposed to figure out the keyword network from 2009 to 2018 with social network analysis and provide the research data that can help the Korea government's policy making on smoking cessation. METHODS: First, frequency analysis on the keyword was performed. After, in this study, I applied three classic centrality measures (degree centrality, betweenness centrality, and eigenvector centrality) with R 3.5.1. Moreover, I visualized the results as the word cloud and keyword network. RESULTS: As a result of network analysis, ‘smoking’ and ‘smoking cessation’ were key words with high frequency, high degree centrality, and betweenness centrality. As a result of looking at trends in keyword, many study had been done on the keyword ‘secondhand smoke’ and ‘adolescent’ from 2009 to 2013, and ‘cigarette graphic warning’ and ‘electronic cigarette’ from 2014 to 2018. CONCLUSION: This study contributes to understand trends on smoking cessation study and seek further study with the keyword network analysis.
Korea ; Policy Making ; Smoke ; Smoking Cessation

BACKGROUND: The objectives of the study are to find out the effect of the implementing reform in three Central Asian countries, identify its impact on health status and health care delivery systems. This study address to identify strong and weak points of the health systems and provide a recommendation for further health care organization. METHODS: A comparative analysis was conducted to evaluate the effects of implemented policy on health care system efficiency and equity. Secondary data were collected on selected health indicators using information from the World Health Organization Global Health Expenditure Database, European Health Information Platform, and World Bank Open Data. RESULTS: In terms of population status, countries achieved relatively good results. Infant mortality and under-5 mortality rate decreased in all countries; also, life expectancy increased, and it was more than 70 years. Regulations of the health systems are still highly centralized, and the Ministry of Health is the main organ responsible for national health policy developing and implementation. Among the three countries, only Kyrgyzstan was successful in introducing a national health system. Distribution of health expenditure between public expenditure and out-of-pocket payments was decreased, and out-of-pocket payments were less the 50% of total health expenditure in all countries, in 2014. CONCLUSION: After independent, all three countries implemented a certain number of the policy reform, mostly it was directed to move away from the old the Soviet system. Subsequent reform should be focused on evidence-based decision making and strengthening of primary health care in terms of new public health concepts.
Asian Continental Ancestry Group ; Decision Making ; Delivery of Health Care ; Global Health ; Health Expenditures ; Health Policy ; Humans ; Infant ; Infant Mortality ; Kazakhstan ; Kyrgyzstan ; Life Expectancy ; Mortality ; Primary Health Care ; Public Health ; Social Control, Formal ; United Nations ; Uzbekistan ; World Health Organization

BACKGROUND: Diabetes is known as one of the most important ambulatory care sensitive conditions. This study purposed to assess the status of continuity of care (COC) and diabetes-related avoidable hospitalizations (DRAHs) of a group of middle- and old-aged patients and to observe the relationship of the two elements by the two age groups. METHODS: This study utilized the National Health Insurance Service's National Sample Cohort data and the subjects are diabetes patients of 45 and over, classified into two groups of ‘middle-aged’(45–64 years) and ‘old-aged’(≥65 years) patients. The dependent variable was DRAHs, which was defined in accordance with the definition of the Organization for Economic Cooperation and Development “Health Care Quality Indicators” project. COC, as an independent variable, is measured by the COC index in this study. Two-part model (multi-variate and multi-level analyses) was utilized. RESULTS: Factors associated with the status and the number of DRAHs differed by each age group. Meanwhile, the two-part model showed that higher COC was associated with a lower risk of preventable hospitalizations in both middle- and old-aged groups. CONCLUSION: Study findings can provide health policy insights and implications in order to strengthen the primary care system for further improvement of diabetes management, especially for middle- and old-aged groups.
Ambulatory Care ; Cohort Studies ; Continuity of Patient Care ; Health Policy ; Hospitalization ; Humans ; National Health Programs ; Organisation for Economic Co-Operation and Development ; Primary Health Care