THE PHILIPPINE DEPARTMENT OF HEALTH (DOH) INFORMATION SYSTEMS

EFFECTIVITY: STRENGTHENING ITS IMPLEMENTATION IN LOCAL GOVERNMENT

UNITS (LGUs) THROUGH THE HEALTH CARE CENTERS

Gawat, Ron D.

Pangilinan, Juenesse Myrtle V.

Umali, Antonius C.

Villanueva, Arvin Jay C.

ABSTRACT

Health care is one of the primary responsibilities of the State in order to ensure that

citizens have access to health services, without bias to the socio-economic background of

the individual who would need it. The Philippine Health Care system, despite of the

efforts and programs to advance the field through researches and scientific inquiry, is still

lagging behind the ASEAN neighbors as there are apparent lapses in its accessibility (i.e.

in the provinces or barrios). In line to the principle of Universal Health Care to address

such problems and insufficiencies in the status quo, the Department of Health (DOH)

created a framework of Health Information System to expand the access not only to

services available to the patients but also to the information access as well as through

information technology (i.e. Hospital Services Information System, Financial Information

System, Physical Resources Information System and Human Resources Information

System). The development of such framework serves as a guide to integrate data collection, processing, reporting and use of information.

Such regulatory system would provide methodologies and scientific advancement to

influence the flow or process of health information dissemination in a way that is not

costly. The Health Information System is a multi-faceted paradigm to assure that policy-

making process and decision-making is knowledge-based and information-based. This, in the end, would assure that the services which would be formulated, implemented and

assessed would turn to be a sustainable process in improving the local health databases.

This paper would assess the progress of such paradigm in a particular barangay community

(smallest administrative division) as to whether health care centers are well-equipped with

the proper materials, paraphernalia and methodologies in helping the DOH realize the said

framework in the barangays. Also, aside from its realization, this paper would also answer

how it helped the patients to be well-informed aside from just being given proper

medications and check-ups. Through this, the policy would be assessed as to whether it can

be improved, revised or effectuated by seeing different alternatives possible.

CHAPTER I

THE CONTEXT OF THE POLICY ISSUE

Introduction

The health care system of the Republic of the Philippines is of the pillars of the states

national interest as recognized and guaranteed by the 1987 Philippine Constitution: that each and

every person has a right to health. Under Art XIII, Sec. 11; The State shall adopt an integrated

and comprehensive approach to health development which shall endeavour to make essential

goods, health and other social services available to all the people at affordable cost. There shall

be priority for the needs of the underprivileged sick, elderly, disabled, women, and children. The

State shall endeavour to provide free medical care to paupers.

With the passage of time, reforms in regards to the structure of the health care system

have been installed for the past decades like creating vital laws for the strengthening of the health

care system and the devolution of health services to the local government units (LGUs). With the

devolution of the health services from the national to the local level as prescribed under the

provisions of the Local Government Code of 1991, the role nowadays of the Department of

Health (DOH) is to provide coherence and direction in enhancing operational effectiveness of

local health systems towards improved health status in localities1, more of supervisory role in a

sense.

The monitoring and checking of the status of the health care system in the Philippines is a

concern which does not only involve DOH, medical practitioners and patients but also the civil

society as a whole. In line with this, the Department of Health, as the governments main organ

1 Health Support System, Chapter 6, 6.1 Local Health System p. 110, DOH (2013)

to make sure that the countrys health care system is properly aligned with the standards set by

the World Health Organization (WHO), utilized a mechanism which would require data that

shall be used to generate measures/indicators on the health and nutrition status of the population

over a period of time.

The Health Information System, according to studies, is a framework in order to

standardize definitions of health indicators nationwide and for the people to clearly visualize the

existing state of affairs as far as the health care system is concerned. Also, this enables them to

harmonize system of health data generation among different government agencies. During the

Pres. Gloria Arroyo administration, the framework relating to the Health Information System has

been established through the Information System Strategic Plan (ISSP) for 2007-2011. In the

present times, this plan has been fortified under the current administration of Pres. Benigno

Aquino III through the implementation of programs and policies relating to the attainment of

Universal Health Care through Kalusugang Pangkalahatan - Aquino Health Agenda under the

revised ISSP. With the advancement of information and communication technology (ICT), it has

been strategic for the government to use such tool to establish a modern information system that

shall provide evidence for policy and program development; and support for immediate and

efficient provision of health care and management of province-wide health systems.2

The primordial focal points on health information as one of the important tools in

achieving the strategic thrusts relating to:

1. financial risk protection

2. improved access to quality hospitals and health care facilities and attainment of the

health-related MDGs focused on reducing maternal and child mortality, morbidity

and mortality from TB and malaria

2 Philippines - Department of Health Information Systems Strategic Plan 2011-2013 (http://hingx.org/Share/Details/403#)

3. the prevalence of HIV/AIDS in addition to being prepared for emerging disease

trends, and

4. prevention and control of non-communicable diseases3

Thus, decentralization is integral for the barangay health centers to come up with their

strategic plans and methods to provide health services in the local barangay setting. These

centers are vital organs for they are community-based and patient-based institutions. They

are responsible for providing basic health services, first aid treatments, diagnosis of common

diseases and the likes. In the present times, it is mandated that there should be at least one health

care center per barangay or a locality to ensure that people from the community shall have access

to different barangay health services which is primarily aligned with that of the goals and visions

of the DOH.

Statement of the Policy Issue/Problem

Since the policy is already existing, the question that is needed to be asked is whether or

not such framework really does benefit a particular locality, specifically the local barangays in

the provinces, through the health care centers. Since the devolution of the framework is from the

national going to the local level, the researchers would like to focus on the micro-level setting to

clearly see that the Health Information System really does benefit common people in one way or

another. Most of the questions posted are based from the guidelines cited in the Health

Information System Module.

General Problem:

Does the framework encompass the barangay setting, specifically those who have little

access to health facilities in the status quo?

Specific Problems:

1. In what way does the Health Information System help the DOH to improve the

Health Care system existing in the Philippines?

2. How does the DOH maximize the use of information and communication technology

(ICT) for the delivery of health services and management of the information system

in the local level?

3. Are quality services being done by means of proper communication with concerned

agencies?

4. Is there a means for them to communicate?

5. Do they share relevant and up-to-date data and information for the betterment of

health services delivery and databases?

This study was undertaken to foresee as to whether the existing framework of the DOH in

terms of the development of the Health Information System is effective in attaining its goals and

agendas.

Objectives

The objectives of the study are

1. To check the status of the Health Care system by measuring the effectiveness of the

Health Information System in a barangay community.

3 Philippine Health Information System:Review and Assessment, February - July 2007

2. To have a reliable and timely health information system. With that, a paradigm that

produces reliable data and information vital for the improvement of the structure of

the health system in the Philippines.

3. To evaluate the current framework, see the lapses and provide alternative

recommendations for the improvement of it.

Significance of the Study

The vitality of the study is to see that the Health Information System, as a mechanism, is

an effective tool in terms of adhering to the goals of the Department of Health and at the same

time with the World Health Organization standards. Secondly, this would interest people who

would like to research on the status of the Philippine Health Care system through the

implementation of a more stringent and coherent Health Information System which would

benefit the poor. Through the health centers in the local barangays and communities, we can see

as to whether such really has a trickle-down effect to the people who would need the services

mentioned under the framework.

Scope and Limitations of the Study

The study would only focus on the effectiveness of the Health Information System and

how the decentralization of health services in the barangay locality helps the common people to

have broader access through the information system and health databases which are available in

the local health centers.

CHAPTER II

REVIEW OF RELATED LITERATURE

Related Literature

International literature was assessed in topics relating to decentralization, health systems

typology and e-Health system. One yardstick which is being utilized by the DOH is that of the

international standards set by the World Health Organization through the Health Metrics

Network (HMN), which published a manual titled Framework and Standards for Country Health

Information Systems (Second Edition 2008). The rationale behind the publication is to help

countries and other partners improve global health by strengthening the systems that generate

health-related information for evidence-based decision making.3

HMN is one of the multilateral partnerships which aim to at least make a stable

framework for other countries to adopt as the world faces the challenges relating to health

information dissemination and integration in the 21st century. The framework presented on the

HMN were based from the globally accepted set of standards collated from different countries

worldwide. These norms and standards are related but not contained to the collection,

management and synthesis of the health information for the future purposes and studies. It is the

HMN framework which at the end, will be the ultimate paradigm that both members and users

from domestic to international level would most likely use as an example in shaping their Health

Information System. The implementation of the paradigm through research and development

could be made possible by scrutinizing the established policies, programs and actions that have

been made for the strengthening of the current information systems status.

3 Health Metrics Network. Framework and Standards for Country Health Information Systems, World Health

Organization June 2008

Figure 1. The HMN Framework (Source: Framework and Standards for

Country Health Information Systems, World Health Organization June 2008)

In the context of the Philippine setting, the Philippine Constitution is very clear in its

agenda that the right of every citizen to health is a national interest and that as much as possible,

the marginalized sector of the society would be greatly prioritized despite of their financial

incapability for health services. Thus, it is high time that the Philippines must implement what is

in accordance to the Universal Health Care: to provide every Filipinos of the highest possible

quality of health care that is accessible, efficient, equitably distributed, adequately funded, fairly

financed and appropriately used by an informed and empowered public.4

On the conclusion in the manual, national action plans for the health information systems

should include a monitoring and evaluation framework with some specific standards set to be

used to keep track on the status of the health system. The indicators to be chosen must have a

broader scope following the usual model inputs, processes, outputs and outcomes, to be able to

4 Universal Health Care Study Group. Executive Summary (http://www.universalhealthcare.ph/executive-summary/)

foresee the impacts and results that there would be once an effective Health Information System

has been set forth by the agencies concerned.

According to Universal Health Care National Institutes of Health UP Manila, the

inequity in access results from a health system characterized by:

(1) inappropriate governance within the health system

(2) an antiquated and inadequate health information system

(3) ineffective regulation of health goods and services

(4) fragmentation of health service delivery

(5) a dysfunctional health workforce,

(6) and unfair, unjust and inadequate health care financing.5

On the second level, which is the inadequacy of the current Health Information System,

Marcelo and Caero observed that the management of health information in the Philippines is at

best rudimentary and ministerial because data collectors perform their work as a matter of

compliance without regard for the informations usefulness for decision-making at all levels.6

This is founded on the basis that typical health centers sometimes tend to disregard couple of

files and records which were obliterated instead of having been studied or analyzed. In spite of

the present administrations efforts in making the health information system more efficient and

accessible, there is a lack of backbone on how it would be managed at the end as integration of

data and information are becoming less achievable with the lack of clear communications among

the implementing agencies. As prescribed and suggested, the Department of Health needs to

5Ibid.

6 Marcelo, Alvin B and Caero, Julian M. Health Information Systems University of the Philippines Manila National

Telehealth Center 2010

define the health informatics standards that will meet the requirements of the enterprise

architecture. With these standards, implementers will be constrained to operate within a clear

set of rules which, if fully complied, will guarantee inter-operability with similarly compliant

systems. 7

The flaws mentioned in the national framework, logically, also transcends to that of the

local setting (in the barangays) as reviewed in the previous studies. On the study Overview of

Devolution of Health Services in the Philippines by Grundy et.al., they asserted that the aim of

decentralization is to widen decision-making space of middle level managers which are one of

the crucial key players in local setting policymaking process.

Related Studies

According to the National Objectives of Pres. Benigno Aquino IIIs administration for

2011-2016, the goal for making the health information system to be more effective and efficient

is to establish harmonized, quality, relevant, and responsive e-health services to provide the

necessary tools, data, information and knowledge for evidence-based policy and program

development towards the provision of accessible, quality, affordable, efficient and safe health

services and attainment of better health outcomes for all Filipinos.

There are inherent problems nowadays that exist in health information management like

the completeness, accuracy and access to health records and data due to disintegration. With

different separate agencies which hold different kinds of records, decision-making is more or less

hampered and affected as policymakers cannot easily make a conclusion without a clear and

grounded basis for an action plan to be executed.

7 Philippines eHealth Strategic Framework and Plan 2013-2017, Information Management, Department of Health 2010

In the framework of the Philippine government, it is the Philippine Health Information

Systems (PHIS) which shall work in gearing towards integration of data and information systems

using generally accepted management standards and protocols which will enhance health service

statistics reporting from the national to the local level plus the civil society as a whole. This will

also include improvements and scale-up programs for Information Systems (IS) in health centers,

hospitals and other critical information and service delivery centers and support service groups.

In the execution of the strategic goals and targets, the following valued principles shall be

applied as suggested: a) client-focused approach b)collaboration and partnerships and user

involvement c) good governance and performance through judicious and efficient use of

resources, transparency, accountability d)ethics in safeguarding privacy and confidentiality e)

shared learning f)simple and cost effective technology application.

The WHO proposed a framework for improving health systems which consists of 6

building blocks: service delivery; health workforce; information; medical products, vaccines and

technologies; financing and leadership and governance. These building blocks characterize the

well-established and sustainable mechanism for the production (input), analysis (process) and

distribution of updated and reliable information or data (output).

Synthesis

Based from the studies, it has been clear that the current health system status in the

Philippines needs to be checked and analyzed at the same time. Some unwanted reports have

been documented relating to Health Information Systems lacking in terms of responding to the

needs of the Filipino citizens, particularly the poor in the rural areas which tend to become the

victims of such inefficiency and lack of proper action coming from the health service providers

in both levels. For one thing, it must be noted that reforms to improve the health system is a

concern of the Asia-Pacific region, usually focusing to topics which relates to the

decentralization of health services to be passed on the LGUs. As part of that community, the

Philippines must readjust along with its neighboring countries in the ASEAN region.

The current national Health Information System, even with the support and efforts

coming from the government, is still fractured and unsystematic. The internationally accepted

framework is clear in its objectives to help other countries improve their paradigm for health

systems development. Such standards and guidelines in promoting such through implementation

must assure that data and information are consistent, structured and at the same time processed.

These, once converted, will be used as a tool to propose a policy for rectifying the flaws which

will be observed. Actions coming from the government must be consistent and sustainable to

level-up the norms of governance of the health system in the Philippines.

CHAPTER III

THE RESEARCH FRAMEWORK

Theoretical Framework

The WHO Framework has key indicators which serve as an instrument for the

researchers to at least measure the strength of the health information systems in an objective

manner. As indicated on the figure below (Figure 2), there is a need for data and information to

be integrated for the policymakers to use it as a tool to plan and create knowledge on the topic

concerned, with mastery of the issue and convert it into useful information for the public. The

over-all process for health information conversion is vital for the strengthening of the health

information system.

Figure 2. Transforming Data into Information and Evidence Source:

Framework and Standards for Country Health Information Systems, World

Health Organization June 2008)

Figure 3. Domains of the Measurement for Health Information Systems Source: Framework and Standards for Country Health Information Systems,

World Health Organization June 2008)

Conceptual Framework

The researchers used some of the international indicators and standards to check the

status of the Health Information System in the Philippines. It is believed that such indicators are

really an efficient tool in making the study. These indicators would serve as the guiding tool to

assess whether the holistic process of the framework is being followed in the micro-level setting

(in the barangays). It is highly believed that the national framework is useless if its effectiveness

do not even tip to that of the local community, specifically the local health centers which serve as

the most basic health service provider for the people in the barangay community.

The adoption of the framework for health systems development would serve as a guide

to the researchers for the approach to the locus of the study, a barangay community. This is

chosen due to the fact that the barangay is the basic political unit of the country and is much

closer and accessible for the common people, especially the marginalized sector of the society.

Definition of Terms

Devolution - is the process of decentralizing the powers from the national government by

giving the local government units (LGUs) the authority to provide services to their constituents.

In this case, the devolution of the management and delivery of health services from the DOH to

the governments of provinces, cities, municipalities and barangays.

E-Health - defined as a cost-effective and secure use of information and communications

technologies in support of health and health-related fields, including health-care services, health

surveillance, health literature, and health education, knowledge and research. A useful tool in

the present age of information technology for a more efficient health information system

integration.

Health Information System - according to Health Metrics Network, is a public health

surveillance which focuses mainly on defining problems and providing a timely basis for action.

The system is the over-all framework for health information distribution and integration,

sustaining the development of the health system as a whole

CHAPTER IV

METHODOLOGY

This chapter mainly presents the research methodology and sources of data which are

used in conducting the study. It also includes different data treatments on secondary data

available to be employed in this paper.

There is a need to make the available data and records organized to develop a process for

review of relevant studies conducted to obtain necessary information to make judgments with

respect to the indicators as prescribed by the studies mentioned.

Research Design

The researchers would use the qualitative type of research, using the secondary data

sources available and selected health journals. In gathering data available for the independent

variable, the study will simply collect reports from the various relevant institutions regarding the

list of indicators provided in this study. Most are already available online in different databases

and websites.

Study Area

The locus of the study would be in a barangay community. The researchers used the

study of Sumaylo et.al. as a reference wherein the area study is located in Brgy. Dawis, Digos

City, Philippines. The data in the study would be able to determine the different communication

tools that health workers in that area provide to the people in the barangay.

Data Gathering Procedure

Pertinent secondary data which are available was used to be studied and analyzed,

especially those which concerns the current status of the Health Information System of the

country. Reports, journals and studies were also consulted.

The intention of this study is not necessarily to interpret health statistics data coming

from the agencies concerned in the implementation of the countrys health information system

but on how the paradigm would produce relevant data and information that can be useful and at

the same would enable the ability of the system to produce valid, reliable, timely and

reasonably accurate information for use by planners and decision-makers. (Chapter 11, Health

Information System Module)

CHAPTER V

RESULTS AND DISCUSSIONS

Based from the findings, both from the DOH and other independent research institutions,

the countrys health information system is fuelled with problems like the disintegrated data

collection. In the recent study conducted by the Philippine Health Information Network, it

concluded that the Philippine Health Information System does not meet the international

standards. As can be seen in Figure 4, the various sources of health information is one

contributing factor which makes the health information system lacking a framework which shall

guarantee that the parallel duties and responsibilities of different agencies would manage the

integration and coordination of these agencies. This results to the more complex and

disintegrated health information access.

In the study of Sumaylo et.al (2012), they conducted a survey in Barangay Dawis, Digos

City, Philippines regarding the health service in the concerned LGU and its communication

strategy. Barangay Dawis is known home to people coming from different cultures. The place

was originally inhabited by the Indigenous People called Calagan before other settlers came. It

is a coastal area facing Davao Gulf. Its northern boundary is Barangay Aplaya, Digos City

while the southern boundary is the Municipality of Hagonoy in Davao del Sur.8 The respondents

were asked to identify any means wherein local health service officers provide their central

office the proper tools of delivering health care provision by an efficient communication towards

them. As seen, the common communication tool between city health office and the local health

centers is through the submission of monthly reports (See Figure 6). In the following question as

to the effect of the systems framework in the operation of the communication process, 14.29

percent of the respondents said Yes while 85.71 said No.

8Sumaylo, Dennis John F., Escano, Ma. Teresa R., Abio, Doyle Felix T. Needs Assessment of Barangay Health Workers

(BHWs) in Delivering Health Care Provisions in Barangay Dawis, Digos City, Philippines, University of the Philippines

Mindanao 2012

Figure 4. Various Sources of Health Information

Source: Health Metrics Network (2008)

Figure 5. The Map of Barangay Dawis, Digos City, Philippines

Source: Needs Assessment of Barangay Health Workers (BHWs) in Delivering Health Care

Provisions in Barangay Dawis, Digos City, Philippines

Figure 6. Effectiveness of Handling Information Per Organization,

Source: Needs Assessment of Barangay Health Workers (BHWs) in Delivering Health Care

Provisions in Barangay Dawis, Digos City, Philippines

Figure 7. Communication Tools Used by Barangay Health Workers with the

System of Communication

Source: Needs Assessment of Barangay Health Workers (BHWs) in Delivering Health Care

Provisions in Barangay Dawis, Digos City, Philippines

The actual face-to-face interaction among the Barangay Health Center and the Barangay

as Health Worker is part of the tool in transmitting reports because in Brgy. Dawis, the Barangay

Health Center is located near the Barangay Hall. Sending memoranda is not needed anymore

because of the proximity of the Barangay Health Center to that of the City Health Office.

It is usually common that there are some programs and policies crafted by the Barangay

Health Workers designed for the immediate community needs which do not already need an

approval from the City Health Office for them to respond efficiently. This reflects the real

essence of decentralization to have the local level office autonomous in terms of coming up with

their own communication tools which do not already need an approval from higher offices as

long as it is aligned with the guidelines and policies of the Department of Health.

With the current framework on hand, the local health care officers are said to be equipped

with the basic skills needed for their training as volunteers in communications. But despite of

this, improvement in the barangays means to communicate data to offices and to the patients

like the need for the barangay health workers to use the Internet, is an important tool which

would help the existing communication process and delivery of health care provisions. Although

the current face-to-face interaction is really effective in terms of report and information transfer,

the changing times must be considered and alternatives like using ICT must be fully developed

and maximized. The reports from the national objectives and goals of the government to build up

planned actions for the implementation, review and rebuilding the ICT is an integral part for the

health sector. As of today, the projects relating ICT is funded not only by the government but

also by civil groups supporting the development of the Health Information System. The

challenge to the government now is to enhance the systems framework which would provide

clear set-up to fully meet the standards as defined by the Health Metrics Network.

The DOH Central Office focuses only on factual information in delivering health care

provisions. There is a necessity for these health service personnel to go beyond statistics by

means of applying each and every data, information and studies which were given to them on

hand. It is needed due to the mere fact that health personnel must go beyond borders by means of

processing the gathered relevant health information. There is a need for further strategizing in

improving in the means of communication in related fields like strategic communication

planning and message development.

Does the framework encompass the barangay community, specifically those who have little

access to health facilities (in the status quo)?

Based from the findings in Brgy. Dawis, apparently, the framework is encompassing the

barangay setting. Despite of the little resources that the health personnel in the local area

have, utility maximization has been a strategic tool for them to communicate with patients

and provide basic health services towards them.

1. In what way does the Health Information System help the DOH to improve the Health

Care system existing in the Philippines?

Health information system is integral in bridging the gap between the national supervising

agency, local health centers and the people in the barangay. It interconnects these groups,

which enables for the improvement of data collection and processing necessary for future

health cases studies in the barangays to effectuate a better policy to be implemented.

2. How does the DOH maximize the use of information and communication technology

(ICT) for the delivery of health services and management of the information system in the

local level?

There are initiatives nowadays coming from the DOH to maximize its resources for the

improvement of health systems ICT. It would take time for the ICT to be the

mainstream communication tool for integration of data collection, information

dissemination to the patients/clients and output processing of information for further

health studies. As seen in Brgy. Dawis, this still remains a prospect instrument.

3. Are quality services being done by means of proper communication with concerned

agencies?

In the case of Brgy. Dawis, they are able to communicate by transmitting reports to a

supervising agency wherein the barangay is under surveillance. Proximity of these

agencies also helps the fast transmission of data among themselves.

4. Is there a means for them to communicate?

Yes. In the context of the health agencies (both the supervising and the local),

communication within the barangay health center and other agencies exists like

memoranda, monthly reports, semi-annual reports, face-to-face interaction and meetings

takes place so as to consolidate the needs and gains in efficient communication of integral

data and information.

5. Do they share relevant and up-to-date data and information for the betterment of health

services delivery and databases?

Yes. There are communication tools which help for the betterment of the health services

that they provide, which are present in the barangay like (as stated in Figure 7) flyer,

leaflets, posters, brochures, fact sheets, public service announcements, face-to-face

interaction and text messaging.

CHAPTER VI

CONCLUSIONS AND RECOMMENDATIONS

Summary of Findings

Because of the lack of a single framework in the past, Health Information System is

developed in terms of its capacity to build up. The main problem which is apparent even up to

this day is the lack of a unified policy framework which would link parallel systems together

resulting to the fragmentation of the Health Information System. It was this reason that the

Philippine Health Information Network was created through the initiative of the Health Metrics

Network, ensuring that a particular institution/body would do the task to integrate the health

information system. In the present times under the Benigno Aquino III administration, it still is

in the developing stage and is not well-grounded or supported by statutes or political mandates

from the national government. In the case of Brgy. Dawis, this is reflective despite of lack of

financial capability and other means to sustain the needs of the time. But still, even though they

showed strong capability in doing the basic communication strategies, improvement in

consolidating data and information is still needed in the barangay.

The quality of health information is important in terms of achieving results which are

favorable in measure, integrated and at the same time accessible to health officers. The need for

the information communication technology to be developed is necessary. The role of the ICT

does not only help in integrating the data and information of different health care centers but it

also makes the monthly reports from local to national offices more efficient. As seen in the

study, Brgy. Dawis still lacks the ability to strengthen ICT as a tool for health information

processing.

Conclusions

For the past decades, the existence of decentralization has been critiqued for some flaws

which are observable like the inefficiency of the barangay to take decisive actions for some local

service delivery (specifically in health service distribution). This is rooted from policy

institutional, financial binding constraints undergirded by political, economic, social and cultural

factors. (Layag et.al)

There have been variations in regards to the performance of LGUs in terms of attaining

reliable and timely health outputs and outcomes. The case of Brgy. Dawis is not the same as that

to other barangays in the Philippines. In order to help barangays address the pressing problems

and to make use of the available limited resources to consolidate the information system in one

cohesive and structured framework, there have been projects, programs and policies coming

from the LGUs, DOH and NGOs (donor institutions and health advocates); efforts which are

signs that coordination among the different keyplayers in the society helps in building up the

health system of the Philippines nowadays, despite of it being incrementally small.

Checking the status of the Health Information System should not be solely constricted

from the typical keeping of statistical records. The performance and status of the health system

of the Philippines should be able to stand up on its own in terms of the quality of health

databases for the improvement of the health services, which will be processed once the data has

been used efficiently.

Recommendations

Empower LGUs for knowledge-based decision making through Field Health Service

Information System.

In the status quo, it is the FHSIS which is the only direct health information system in

place at the sub-national level. The DOH must exert measures which will promote the

harmonization of the Health Information System in the country in steps like (as stated in the

study of Health Policy Notes by the DOH health policy consultants and officials):7

A. Advocate the use of knowledge based decision making in health among the local chief

executives

The priority of the DOH Central Office going to its subsidiaries is to make the

information system not only information-based but at the same time knowledge-

based. This will enable the health personnel and LGU executive officials to use the tools

available as a means to help alleviate the health system in the particular barangay

community.

B. Capacitate LGUs not only on data collection but information processing and use

As stated, strengthening the multiple stakeholders model will fully maximize and

enhance the development of the health information system and health data processing.

With different stakeholders helping one another for the maximization of the tools, these

would make the health system flexible in responding to the needs of the people.

9 Department of Health (DOH) Health Policy Notes, Volume 2: Issue 3 | Department of Health, Manila, Philippines

C. Streamline the FHSIS indicators and other disease Surveillance Processes

The LGUs must also create their own mechanism to make their own health

information system/framework workable which is not contradictory to the objectives and

goals of the national field office. This would make decentralization truly work and its

essence not being incrementally disregarded.

D. Development of independent systems at the local system.

The priority of different LGUs nationwide is to make the health information

system/health databases to be knowledge-based in order to provide the capability to make

use of the information system for the benefit of the stakeholders in the civil society

(specifically the patients in the local community). This will make equilibrium between data

collection needs and the demand for the execution of policy as based from the data gathered.

This strategy will help the Philippine Health Information System in the local level improve

through efficient communications cum interaction and at the same time developing its

independence in terms of necessary decision-making processes.

The people involved in the policy-making process and the construction of the Health

Information Systems shall make a hypothesis which will be tested through implementation.

However, such may not be that applicable to every local government units as there are clearly

gaps between the accepted theory based from the study and the implementation which shall

be spearheaded.

REFERENCES

Department of Health (DOH) Health Policy Notes, Volume 2: Issue 3 (August 2008) |

Department of Health, Manila, Philippines

Health Metrics Network. Framework and Standards for Country Health Information Systems,

World Health Organization June 2008

Health Support System, Chapter 6, 6.1 Local Health System p. 110, DOH (2013)

Marcelo, Alvin B. and Caero, Julian M. Health Information Systems University of the

Philippines Manila National Telehealth Center 2010

Philippine Health Information System: Review and Assessment, February - July 2007

Philippines - Department of Health Information Systems Strategic Plan 2011-2013

(http://hingx.org/Share/Details/403#)

Philippines eHealth Strategic Framework and Plan 2013-2017, Information Management,

Department of Health 2010

Sumaylo, Dennis John F., Escano, Ma. Teresa R., Abio, Doyle Felix T. Needs Asssessment of

Barangay Health Workers (BHWs) in Delivering Health Care Provisions in Barangay Dawis,

Digos City, Philippines, University of the Philippines Mindanao 2012

Universal Health Care Study Group. Executive Summary

(http://www.universalhealthcare.ph/executive-summary/)