The Fourmula One for Health (DOH)

The Fourmula One for Health: The Road Map for Health Sector Reforms in the Philippines 2005 – 2010

What is FOURmula ONE for Health?: Defining the Road Map for Reforms FOURmula ONE for Health is the implementation framework for health sector reforms in the Philippines for the medium term covering 2005-2010. It is designed to implement critical health interventions as a single package, backed by effective management infrastructure and financing arrangements. This document provides the road map towards achieving the strategic health sector reform goals and objectives of FOURmula ONE for Health from the national down to the local levels. FOURmula ONE for Health engages the entire health sector, including the public and private sectors, national agencies and local government units, external development agencies, and civil society to get involved in the implementation of health reforms. It is an invitation to join the collective race against fragmentation of the health system of the country, against the inequity of healthcare and the impoverishing effects of ill-health. With a robust and united health sector, we can win the race towards better health and a brighter future for generations to come.

Starting the Race with the End in Mind: Fourmula One for Health Goals and Objectives Over-all Goals The implementation of FOURmula ONE for Health is directed towards achieving the following end goals, in consonance with the health system goals identified by the World Health Organization, the Millennium Development Goals, and the Medium Term Philippine Development Plan: ∗ better health outcomes; * More responsive health system; and * More equitable healthcare financing.

General Objective FOURmula ONE for Health is aimed at achieving critical reforms with speed, precision and effective coordination directed at improving the quality, efficiency, effectiveness and equity of the Philippine health system in a manner that is felt and appreciated by Filipinos, especially the poor. Specific Objectives: Fourmula One for Health will strive, within the medium term, to: * Secure more, better and sustained financing for health; * Assure the quality and affordability of health goods and services; * Ensure access to and availability of essential and basic health packages; and * Improve performance of the health system

Carrying out the Game Plan: Winning Strategies to Attain FOURmula ONE for Health ComponentSpecific Objectives F1 Component No. 1: HEALTH FINANCING     

Mobilizing resources from extra budgetary sources Coordinating local and national health spending Focusing direct subsidies to priority programs Adopting a performance based financing system Expanding the national health insurance program

Objective: The objective of financing reforms under FOURmula ONE for Health is to secure more, better and sustained investments in health to provide equity and improve health outcomes, especially for the poor.

F1 Component No.2: HEALTH REGULATION  Harmonizing licensing, accreditation and certification  Issuance of quality seals  Assuring the availability of low-priced quality essential medicines commonly used by the poor

Objective: The main objective of health regulation under FOURmula ONE for Health is assuring access to quality and affordable health products, devices, facilities and services, especially those commonly used by the poor. F1 Component No. 3: HEALTH SERVICE DELIVERY  ensuring the availability of providers of basic and essential health services in localities  designating providers of specific and specialized services in localities  intensifying public health programs in targeted localities Objective: FOURmula ONE for Health interventions in service delivery are aimed at improving the accessibility and availability of basic and essential health care for all, particularly the poor. This shall cover all public and private facilities and services

F1 Component No.4: GOOD GOVERNANCE IN HEALTH  establishing FOUR-IN-ONE advanced implementation sites  developing on LGU FOURmula ONE for Health Scorecard  institutionalizing a FOURmula ONE for Health Expanded Professional Career Track Objective: The objective of good governance in health is to improve health systems performance at the national and local levels. FOURmula ONE for Health will introduce interventions to improve governance in local health systems, improve coordination across local health systems, enhance effective private-public partnership, and improve national capacities to manage the health sector.

Defining the Rules of Engagement: Seven (7) General Guidelines for Health Reform Implementation F1 Rule No.1: FOURmula ONE for Health will organize the critical reform initiatives into four implementation components, namely, Financing, Regulation, Service Delivery and Governance. F1 Rule No. 2: The implementation of FOURmula ONE for Health will focus on a few manageable and critical interventions. Such interventions will be identified using the a criteria

F1 Rule No. 3: The reforms will be implemented under a sector-wide approach, which encompasses a management perspective that covers the entire health sector and an investment portfolio that encompasses all sources. F1 Rule No. 4: The National Health Insurance Program (NHIP) will serve as the main lever to effect desired changes and outcomes in each of the four implementation components, where the main functions of the NHIP including enrollment, accreditation, benefit delivery, provider payment and investment are employed to leverage the attainment of the targets for each of the reform components. F1 Rule No. 5: The functional and financial management arrangements will be defined in terms of specific offices having clear mandates, performance targets and support systems, within well-defined time frames in the implementation of reforms within each component. F1 Rule No. 6: The functional clustering of teams and assignment of specific Team Leaders shall facilitate implementation, monitoring and supervision in a coordinative manner and shall not, in any way, prejudice the corporate nature of the DOH-attached agencies nor the autonomy of Local Government Units. F1 Rule No. 7: The selection of FOUR-in-ONE Convergence Sites will be governed by the following criteria: •

Willingness of the LGU to participate in the FOURmula ONE for Health implementation, in terms of willingness to provide the requisite counterpart resources, and willingness to enter into formal national government to local government, inter-local government and government to private sector networking, partnership and resource sharing arrangements;

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Presence of local initiatives or start-up activities relevant to FOURmula ONE strategies, to include, but not limited to: development of inter-local health zones, enrollment of indigents into the social health insurance system, improvement in drug management systems, among others;

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Relatively high feasibility of success and sustainability, to include factors such as capacity to enter into loans, capacity to absorb investments and sustain the reform process, etc.; and

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Availability of funds from GOP and external sources for capital investment requirements.

Working Like Clockwork: Setting F1 Targets and Timetable of Implementation Two (2) Major Phases of F1 Reforms: The FOURmula ONE for Health timetable shall be divided into two major phases: 1.

The Immediate term - covers the period between to December 2005 corresponding to the project preparation phase of the HSRA projects funded by various funding agencies in support of reforms in the DOH, PhilHealth and the existing 16 convergence sites; and

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The Medium term - covering the years 2006-2010, this corresponds to the fiveyear horizon of actual implementation of F1 reforms at the national and local levels.

Reaching the Finish Line: Setting new F1 Targets and Objectives As previously emphasized, working on reforms for the health sector will never be done in a single medium term. It is a long-term, dynamic and iterative process such that reaching the FOURmula ONE finish line means starting on a new track all over again. Components and strategies may be added, refocused or redirected as we go along but the basic reform areas will remain. It is the intention of the FOURmula ONE for Health to put the building blocks in place now and trigger more reforms in the future.