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FOURmula One for Health (F1) was adopted as the implementation framework for health sector reforms

for the medium term period, through Administrative Order No. 2005-0023 dated August 30, 2005. It is
designed to implement critical health interventions supported by effective management infrastructure and
financing arrangements. Its implementation is geared towards achieving health systems goals of the World
Health Organization, the Millennium Development Goals (MDGs), and the Medium-Term Philippine
Development Plan (MTPDP) for (a) better health outcomes; (b) more responsive health system; and (c)
more equitable health financing.

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.

Come join the ride!

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:

∗ Βetter 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

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F1 Primer

HEALTH FINANCING

Relevant Issuances Manuals, Documents and Reports TA Activities/Calendar of Events


F1 Team / Fellows / Support Team /
Plans / PPAs Presentation Materials
Consultants

Goal:

Increased, better and sustained financing for health

Strategies:

a. Mobilizing resources from extra budgetary sources


b. Coordinating local and national health spending
c. Focusing direct subsidies to priority program
d. Adopting a performance based financing system
e. Expanding the national health insurance program

ACCOMPLISHMENT

A. National Financing Reforms

1. Developed Health Sector Expenditure Framework


2. Developed a proposal for restructuring of DOH budget
3. Secured financing for critical F1 PPAs within the DOH budget (National Sector Support for
Health Reform Program)

B. National Health Insurance Program

1. Membership: 15.98 members


2. Claims paid: P328M for 44,000 claims
3. Increased benefit packages: for HIV/AIDS, newborn care, 3rd normal spontaneous
delivery, malaria, and SARS
4. Budget support for the national counterpart premium of the Sponsored Program from
World Bank's National Sector Support for Health Reform Project amounting to at least
US$110M
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FOURMULA ONE FOR HEALTH ACCOMPLISHMENT F.Y. 2006

HEALTH SERVICE DELIVERY

Relevant Issuances Manuals, Documents and Reports TA Activities/Calendar of Events


F1 Team / Fellows / Support Team /
Plans / PPAs Presentation Materials
Consultants

Goal:

Ensuring the accessibility and availability of basic and essential health care

Strategies:

a. Ensuring availability of providers of essential health services in localities


b. Designation of providers of specific and special services in localities
c. Intensified public health programs in targeted localities

ACCOMPLISHMENT

1. Monitoring and Evaluation for Health Service Delivery Scorecard


2. Malaria free Benguet, Cavite and Masbate
3. Global Fund for AIDS, TB and Malaria (GFATM) Round 6 for HIV/AIDS
4. Consultant for Performance-based resource allocation
5. MDG - MDR protocol, expansion of WHSMP in Surigao, Benguet and Sorsogon
* MMR Survey
" Child Survival Operational Manual
6. Hospital/Facility Rationalization and Development Plan
7. Full GOP support for MDA of filariasis and schistosomiasis

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FOURMULA ONE FOR HEALTH ACCOMPLISHMENT F.Y. 2006

HEALTH REGULATION

Relevant Issuances Manuals, Documents and Reports TA Activities/Calendar of Events


F1 Team / Fellows / Support Team /
Plans / PPAs Presentation Materials
Consultants

Goal:
Assuring the quality and affordability of health goods and services

Strategies:

a. On the supply side, systems and processes for licensing, accreditation and certification shall be harmonized
and streamlined
b. On the demand side, a “seal of approval system” on health products, devices, services or facilities shall be
developed
c. Consistent with the over-all financing strategy of FOURmula One for Health, cost recovery with income retention
and
other revenue-generating mechanisms shall be pursued to ensure financial sustainability
d. The availability of low-priced, quality essential medicines shall be assured

ACCOMPLISHMENT

1. Upgrading, Harmonizing and Streamlining of Regulatory Processes


* Establishment of a unified regulatory process
- One-stop-shop or Central Regulatory Hub: Draft D.O. for the implementation of One-stop-shop licensing
for health facilities with ancillary service
- Issuance of Automatic Renewal and Principal Certificates of Product Registration, simplifying the rules
and expediting the registration of pharmaceutical products requiring CPRs
* Automation of regulatory systems and processes - on-going development of software for the International
Drug Test Operation and Management Information System (IDTOMIS)
- continued operation of the DOH-LIS
- on-going/commissioning test for the Regulatory Information System (RSYS) of the BHDT
- BFAD automation project supported by the E-government now in the Systems/Software/Web Development
and Implementation expected to minimize red tape/graft and corruption

2. Seal of approval in the context of ASEAN harmonization


* Publication of Phil. National Standards for Medical Device, Equipment Based on International Standards
(IEC/ISO/IBSS, WHO)
* Finalized/approved Joint Memo Circular No.2 s.2006 on Harmonization of Sentrong Sigla Certification
Standards and Philippine Health Insurance Corporation
* Finalized the Draft on Quality Standards List (QSL) and Facility Self-Assessment (FSAC) for Phase 2
level 2 and Technical Assistance Package for Phase 2 Level 2

3. Improving availability of and access to low priced medicines for the poor
* A total of 7,437 BnBs established/functional nationwide, in partnership with the Kabalikat and Botika Binhi
and the National Pharmaceutical Foundation
* Continuous price monitoring of 37 Essential Drug from leading private drugstore chains, pharmacies of
leading private hospitals and government medical centers nationwide

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FOURMULA ONE FOR HEALTH ACCOMPLISHMENT F.Y. 2006

GOOD GOVERNANCE

Relevant Issuances Manuals, Documents and Reports TA Activities/Calendar of Events


F1 Team / Fellows / Support Team /
Plans / PPAs Presentation Materials
Consultants
Goal:
To improve local health system governance and coordination, enhance public-private partnership and improving
central capacities to manage the health sector

Strategies:

a. Establishing FOUR-IN-ONE advanced implementation sites


b. Developing an LGU FOURmula ONE for Health Scorecard
c. Institutionalizing a FOURmula ONE for Health Expanded Professional Career Track

ACCOMPLISHMENTS

A. SMCT
1. Finalized critical Flagship Programs, Projects and Activities (PPAs)
2. Issued necessary policy/legislative instruments (through the accomplishment of policy matrix)
3. Firmed-up F1 structures - DOH Execom, PSDT, FICTs, HSR-TCG, F1 Fellows
4. Undertook National Investment Planning to determine cost requirements and TA needs to implement F1 PPAs
5. Started the development of M/E framework
6. Developed a Health Human Resource Master Plan and a DOH Rationalization program
7. Adopted SDAH through joint planning, monitoring process with development partners.
8. Mobilized a total of US$545.1M resources from different dev't partners.
9. Local Health Systems Development:
* firmed up commitments from the 16 F1 sites chief executives
* finalized and reviewed 16 PIPHs through the Joint Appraisal Committee (JAC)
* scaled-up advocacy for health reforms in coordination with FICTs
* started with the documentation of good practices in preparation to roll out planning
B. IMST
1. Financial Management
* Redefinition of Finance Service functions
* Rationalization of Financial Management and Support Center (FMSC)
* Improvement of Internal Control including:
- revision of delegated approving authorities for various financial transactions
- streamlined operations, implementing centralized cash advance, guarantee deposits
for fuel and lubricants, payroll integration of regular employees, check vs. direct credit
to ATM of employees, remittances, payment for utilities, asset management, E-NGAS
roll out

2. Procurement and Logistics Management


* Capacity building activities for staff and other concerned personnel
* Application of the Agency Performance Indicators (API) System to gauge compliance of
DOH Central Office to RA 9184
* Implemented DOH procurement plan
* Implemented suppliers registration systems

3. Internal Audit
* PAGC's recognition to the DOH for ranking first among 70 agencies in terms of
compliance to the requirements of the IDAP for the 1st semester 2006
* Continuous implementation of DOH Integrity Development Program (Prevention,
Education, Deterrence, Strategic partnership)

4. Information Management
* Developed 8 new computerized systems: UMIS, FHIS, DOH Alert System, Web-based
Public Assistance Information System (WBPAIS), Political Profiling System, Suppliers
Registry System, Web-enabled Price Monitoring System, Web-enabled Stock Inventory
System
* Implemented 2 systems: Rural Health Unit Management Information System
(RHUMIS) and Filariasis Health Information System (FHIS)
* Conducted Users' Orientation and Training on HOMIS, UMIS, Radiation Facilities
System, WBPAIS, DTOMIS, ENGAS
* Monitored system implementation (HOMIS and Health Care Equipment Information
System)
* Conducted application system and technical trainings for users/ICT staff on HOMIS,
Systems Maintenance and Web Development
* Maintained 13 application systems
* Provided TA or support to various systems/projects/programs

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FOURMULA ONE FOR HEALTH ACCOMPLISHMENT F.Y. 2006

F1-LGU REPLICATION:

Issuances:
* Administrative Order (AO):

Health Financing
AO 2006-0022 Guidelines for Establishment of Performance-Based Budget for Public Health
AO 2006-0023 Implementing Guidelines on Financing F1 for Health Investments and Budget Reforms
AO 2006-0027 Implementing Guidelines for Performance-Based Budgeting for DOH Retained Hospitals
Health Regulation
AO 2006-0033 Guidelines for the DOH-PITC Expanded Drug Access Pilot Program using Convenience Stores as BNB Express Outlets
Amendment to AO 2006-0033 entitled: Guidelines for the DOH-PITC Expanded Drug Access Pilot Program using Convenience Stores as
AO 2006-0033-A
BNB Express Outlets
Health Service Delivery
AO 2006-0008 Guidelines of Public-Private Collaboration in Delivery of Health Services including Family Planning for Women of Reproductive Age
AO 2006-0029 Guidelines for Rationalizing the Health Care Delivery System based on Health Needs
Good Governance
AO 2006-0006 Implementation Guidelines of the Technical Assistance Packages in Support to ARMM Strategy for Health Improvement (ASHI)
Incentive Scheme Framework for Enhancing Inter-LGU Aug. 3, 2006 Coordination in Health through Inter-Local Health Zones (ILHZ)
AO 2006-0017
and Ensuring their Sustainable Operations
AO 2006-0020 Guidelines for Evaluation of Consumer Participation Strategies in Fourmula One for Health
AO 2006-0025 Guidelines in Establishing the Health Commodities July 25, 2006 Reference Specification Information System (HCRSIS)
AO 2005-0023 Implementing Guidelines for FOURmula One for Health as Framework for Health Reforms
AO 2006-1133 Designation of Fellows for the Implementation of Formula One for Health
Guidelines for Operationalizing the Competency- Sept. 6, 2006 Based Human Resources for Health Management and Development
AO 2006-0031
(HRHMD) Systems

* Department Personnel Order (DPO):

Good Governance
Creation of TWG to formulate a Policy for Establishing a Collaborative Partnership between the National Cooperative Sector and the
2006-2403
DOH in support to F1 Implementation
2005-1862 FOURmula ONE for Health Functional Management Arrangements
2006-1133A Amendment to Department Personnel Order No. 2006-1133, Designation of Fellows for the Implementation of Formula One for Health

Plans: Programs, Projects and Activities

National Investment Plan for Health (NIPH)


Health Financing:
1. Budget Reforms of DOH and attached agencies
- Development of Health Sector Experience Framework (HSEF)
- Establishment of a system for budget allocation, utilization and performance monitor in g

2. Expansion of the National Health Insurance Program (NHIP)


- Securing NG counterparts
- Advocacy to increase membership and allocation
- Expansion of benefits

Health Regulation:
1. Upgrading, Harmonizing and Streamlining of Regulatory Processes
2. Seal of approval in the context of ASEAN harmonization
3. Improving availability of and access to low priced medicines for the poor
Health Service Delivery:
1. Public Health Program Development
- Disease free zone initiatives – Malaria, Filariasis, Schistosomiasis, Rabies and Leprosy
- Intensified disease prevention and control of the following diseases:
a. Vaccine preventable diseases
b. TB
c. HIV/AIDS
d. Emerging/Re-emerging infections

- Maternal and child health


a. Finalize/work for the approval of policy that all pregnant women must deliver in health facilities
b. Monitor implementation of policy in item #1
c. Strengthen advocacy, promotion and support to breastfeeding
d. Strengthen support to Maternal/Child Nutrition to include:
* Micronutrient supplementation
* Food fortification g. Policies/standards/guidelines on IMCI

- Healthy lifestyle and risk management

2. Health Facilities Development Program: national/local-public/private


- Updating the hospital development plan and monitoring its implementation
- Rationalization of health facilities including facility mapping for BEMOCs and CEMOCs
- Upgrading of national health facilities
- Rationalizing services in the facilities
- Integrating wellness services in hospitals

3. Strengthening Surveillance and Epidemic Management System


- Creation and strengthening of epidemic and surveillance units at all government levels,
(PESU, MESU, CESU)
- Linkage with private sector

4. Strengthening of disaster preparedness and response system

5. Health Promotion
- Review of health promotion interventions and technology upgrade
- Incorporation of health promotion in service packages
- Integration of patient education in Clinical Practice Guidelines
- Proposed creation of health promotion foundation
Good Governance:
1. Sectoral Management
* Local Health Systems Development
* National Human Resource for Health Program
* Sectoral Development Approach for Health
* Philippine Health Information System

2. Internal Management
* Public Finance Management
* Procurement and Logistics Management
* Internal Audit

Provincial Investment Plan for Health (PIHP)


Health Financing:
1. Expansion of the National Health Insurance Program (NHIP)
- Universal coverage
- Enrollment of the poor
- Enrollment of the informal sector (advocacy, other initiatives)
- PHIC accreditation/rational use of PHIC reimbursement
- Local Government Premium Counterpart secured
Health Regulation:
1. Implement/Enforce health and health-related laws
- Milk Code
- Asin Law
- Others
- Localization of IEC messages

2. Advocate for the legislation of health-related laws at the local level


3. Carry out decentralized regulatory functions
4. Improve access to low-cost quality drugs/commodities
- Botika sa Barangay
- Botika ng Bayan
- Health Plus
Health Service Delivery:
1. Public Health Program Development
- Disease free zone initiatives – Malaria, Filariasis, Schistosomiasis, Rabies and Leprosy
- Intensified disease prevention and control of the following diseases:
a. Vaccine preventable diseases
b. TB
c. HIV/AIDS
d. Emerging/Re-emerging infections

- Maternal and child health


a. Implement the policy that all pregnancies be labeled as high risk therefore aim to deliver all pregnant
women in health facilities
* Facility mapping to ensure accessibility of all pregnant women to BEMOC/CEMOC
* Upgrading of BEMOCs/CEMOCs civil works/equipment/human and material resources
* Ensure organization of Women’s Health Teams to assist pregnant women formulate a birth plan

b. Formulate and implement a CSR strategy


c. Formulate and implement other reproductive health programs as deemed needed at the local level
d. Implement breastfeeding program
e. Implement Maternal/Child Nutrition programs to include:
* Micronutrient supplementation
* Food fortification
- Implement the Integrated Management of Childhood Diseases (IMCI)
- Healthy lifestyle and risk management

2. Health Facilities Development Program:


National/local-public/private
- Rationalization of local health facilities to include facility mapping for BEMOCs & CEMOCs
- Upgrading of local health facilities – civil works/equipment/goods
- Health human resource-provision/Capacity building
- Rationalizing services in the facilities
- Integrating wellness services in local hospitals

3. Strengthening Surveillance and Epidemic Management System


- Creation and strengthening of epidemic and surveillance units (PESU, ILHZ, MESU)
- Setting up of surveillance systems
- Linkage with private sector

4. Strengthening of disaster preparedness and response system

5. Health Promotion
- Advocacy/BCC
- Localization of IEC messages
- Reproduction of localized IEC messages
Good Governance:
1. LGU Sectoral Management
* Local Health Systems Development
* Sub-national Human Resource Strengthening
* Sectoral Development Approach for Health as the management approach to health reforms
* LGU Scorecards Development/implementation
* Local Health Information System development/utilization

2. Internal Management
* Finance Management
* Procurement Management
* Logistics Management
* Internal Audit