Improving access to healthcare in the Philippines

Decision-makers challenge

The Universal Health Care (UHC) Act, signed into law in 2019, is a whole-of-government commitment to revitalizing the Philippine healthcare system, ensuring primary healthcare is accessible to all Filipinos, regardless of financial status.

To navigate this massive undertaking, decision-makers must rely on timely and relevant data to ensure quality implementation. The Department of Health (DOH) needs a system to track progress and empower leaders to make informed decisions that will directly impact the health and well-being of millions. 

Through continuous monitoring and evaluation, the DOH can identify and address challenges swiftly, ensuring resources are allocated where they are needed most.

Impact opportunity

Our partnership with the DOH will provide a measurement strategy for the country’s Universal Health Care (UHC) policy, which aims to allow all Filipinos to access healthcare services without financial risks.

Results from the national UHC survey will offer valuable insights for the DOH to identify gaps in healthcare access, affordability, and quality on the patient and health facility level. It will also highlight areas for improvement in the healthcare system, such as reducing out-of-pocket costs, improving the quality of care, and ensuring that healthcare services are available where they are most needed.

Our approach

The survey collected data across all active UHC integration sites (UHC-IS) from facilities, healthcare workers, and patients on their experience of UHC policies to date. It also collected data on healthcare access, affordability, and quality, on the current status of UHC implementation, and on the experiences of healthcare workers. The results of this survey will offer insights into the status of healthcare for Filipinos and health facilities in the country. The recommendations will enable evidence-based policy implementation toward achieving accessible and equitable healthcare for all.

The UHC survey is powered by IDinsight’s DataDelta team. DataDelta deploys sampling innovations, highly-trained data collection teams, and custom-built software to provide decision-makers with top-quality survey data at scale when they need it.

The results

The UHC study found insights across a broad group of topic areas on both the implementation of UHC, and Filipinos’ experience with the healthcare system.

We found that several implementation areas have been progressing well. Registration to the Philippine Health Insurance Corporation (PhilHealth) has been steadily increasing year-on year (15.2% of patients interviewed, vs <6% in previous years). 71.3% of facilities in active integration sites have been accredited to provide a comprehensive outpatient benefit package called Konsultasyong Sulit Tama (Konsulta). Additionally, referral networks and changes to staffing structure have been partially implemented.

However, there are still key gaps that need addressing for UHC to be fully functional:

• PhilHealth processes for both patients and facilities have been inefficient, leading to lagging registration and utilization rates, and delays in capitation payments
• There are gaps in service availability of the Konsulta package among community-level primary care facilities (PCFs)
• Healthcare workers (HCWs) are understaffed and have high turnover rates

Beyond implementation, we also looked into the experience that patients in active UHC-IS to understand how Filipinos interact with the new health system:

1. Only 24.1% of Filipinos in active UHC-IS are aware of UHC, and even less so are aware of the Konsulta program.
2. General and preventive check-ups are still infrequent, with patients reporting that they have forgone, reduced, or delayed care. Patients frequently bypass the primary care system. 
3. Incidents of out-of-pocket payments and catastrophic health expenditures happen most among private hospital inpatients.

In partnership with DOH-PMSMD, the results were also circulated and presented to different government stakeholders in various settings such as:

1. Writeshops with internal DOH bureaus, including Health Human Resources Development Bureau (HHRDB), Health Policy Development and Planning Bureau (HPDPB), Bureau of Local Health Systems Development (BLHSD), etc., to develop plans and strategies based on insights from the survey,
2. Presentation to the Executive Committee, including the Secretary of Health, and the Managing Committee, composed of directors from all bureaus of DOH,
3. Presentation to the Interagency Committee on Health and Nutrition Statistics, the committee that handles national statistics on health and nutrition, and
4. Presentation to the Interagency Committee on UHC