The Philippines is an Island country of Southeast Asia in the western Pacific Ocean. The country has a land area of   (98,171 sq km and a total area of 300,000 sq km water. The islands are of volcanic origin, with the larger ones crossed by mountain ranges. The highest peak is Mount Apo (9,690 ft; 2,954 m) on Mindanao.

Considering the three indicators of health of Philippines, in the year 2017, Philippines -crude birth rate was 16.2 per 1000 people, which was a decrease from the previous year 2016 which was 16.8, in the year 2016, life expectancy was recorded to 69.1 years which is much higher when compared to the year 2015 which recorded life expectancy of 69 years and, in 2018, the IMR for the Philippines was 19.3 deaths per thousand live births which is a decline from the 19.7 in 2017. The directions of these three health indicators show an improvement in the health care of the Philippines. Health care is delivered in three levels which are primary level of health care facilities, a secondary level of health care facilities and tertiary level. It is financed by the government, users, Phil health cover and an employee’s compensation scheme.

 The main health problem that is facing the Philippines is Tuberculosis. However, the government has taken several measures to deal with the situation through programs such as National TB Control Program (NTP), through which the country aims to detect 85% of TB patients and successfully treat at least 90% of them and also encouraging people to go for testing. TB is not only affecting the Philippines but it is a global problem and therefore the US should be concerned about it. In light of the TB problem, I do make the following recommendations to the Philippines, the first country to set up and fund the research centres that will work on drug development and use and effectiveness of chemoprophylaxis in order to find ways to counter drug-resistant tuberculosis. Number two, government to take measure that will prevent the transmission of the disease and lastly, the government should put in place programmatic management which will ensure effective implementation of the strategies.

Introduction

In this research paper, the Philippines is the country that of the choice that I will explore. The Philippines, is an Island country of Southeast Asia in the western Pacific Ocean. It is an archipelago consisting of some 7,100 islands and islets lying about 500 miles off the coast of Vietnam. “Manila is the capital, but nearby Quezon City is the country’s most populous city. The Philippines has many cultural affinities with the West. It is the second-most-populous Asian country with English as an official language and one of only two predominantly Roman Catholic countries in Asia. Despite the prominence of such Anglo-European cultural characteristics, the peoples of the Philippines are Asian in consciousness and aspiration”. (Michael CullinaneGregorio C. BorlazaCarolina G. Hernandez)

The country has a land area of   (98,171 sq km and a total area of 300,000 sq km water. The islands are of volcanic origin, with the larger ones crossed by mountain ranges. The highest peak is Mount Apo (9,690 ft; 2,954 m) on Mindanao.

The Philippines ranked among Asia’s 10 fastest growing economies in 2017. Consumer power, remittances from overseas workers and an influx of call centres had given it that status, raising hopes for easing rampant poverty. Then GDP expansion wobbled in 2018 because of rising prices and lack of new direct investment. The Philippine economy grew 6.2 per cent last year, down from 6.7 per cent in 2017 and 6.9 per cent a year earlier. Inflation dented consumption in late 2018, while factory investors stayed away for lack of infrastructure compared to what’s available elsewhere in Asia (Ralph, 2019).

Having defined and introduced the country where am going to carry out the research, the main area that will focus on is the health sector of the Philippines. In this particular topic, there are several issues that I seek to address; analysis of the health indicators of Philippines, health system of the country, how the health system is financed, comparison of the health system of Philippines and United States of America, major health problems of Philippines and their extent, impact of Philippines health problems in the global world and finally draw the recommendations that seek to improve the health sector of Philippines.

The Philippines Health Indicators

Health indicators are measures that are designed to help analyze the state of health of the country and use it as a proxy for comparison across different geographical locations and develop actionable programs.  In this particular case, I will consider three indicators as discussed below;

Birth rate

The birth rate is the total number of lives births per 1000 in a population in a year. In the year 2017, Philippines -crude birth rate was 16.2 per 1000 people, which was a decrease from the previous year 2016 which was 16.8.  The decline in the birth rates literally means that health problems associated with the Philippines are on the decline due to the fact that, higher birth rates translates to higher health problems amongst the people (Philliphines Statistics Authority, 2017).

Life expectancy

This is the measure assigned to measure the average time an individual is expected to live. Life expectancy in the Philippines is on the rise according to a report released by Kneoma. In the year 2016, life expectancy was recorded to 69.1 years which is much higher when compared to the year 2015 which recorded life expectancy of 69 years. The increase in life expectancy is attributed to a decrease in maternal deaths in the country and increase improvement in maternal health (Knoema, 2016).

 (Knoema, 2016).

Mortality rate

This standard measures that show how many units deaths occur per 1000 people per year. In this particular case, I will use infant mortality because the Infant mortality rate (IMR) is one of the clearest indicators of the socio-economic and health status of a community. This is because, more than any other age-group of a population, infant survival depends on the socioeconomic conditions of their environment. Hence its estimation is important for evaluating and planning public health strategies. In 2018, the IMR for the Philippines was 19.3 deaths per thousand live births which is a decline from the 19.7 in 2017. These simply show an improvement in the social health care system but still much is needed to be done to take the number down.

(Knoema, 2018).

Health care system of the Philippines

Definition and delivery of health care services

Health care system in the Philippines is divided into the following 3  levels; the first level is the PRIMARY LEVEL OF HEALTH CARE FACILITIES – are the rural health units, their sub-centers, chest clinics, malaria eradication units, and schistosomiasis control units operated by the DOH; puericulture centers operated by League of Puericulture Centers; tuberculosis clinics and hospitals of the Philippine Tuberculosis. Then we have Society; private clinics, clinics operated by the Philippine Medical Association; clinics operated by large industrial firms for their employees; community hospitals and health centres operated by the Philippine Medicare Care Commission and other health facilities operated by the voluntary religious and civic group. Second, we have SECONDARY LEVEL OF HEALTH CARE FACILITIES – are the smaller, non-departmentalized hospitals including emergency and regional hospitals. • Services offered to patients with symptomatic stages of the disease, which require moderately specialized knowledge and technical resources for adequate treatment. Lastly, we have a TERTIARY LEVEL OF HEALTH CARE FACILITIES -are the highly technological and sophisticated services offered by medical centres and large hospitals. These are specialized national hospitals. – Services rendered at this level are for clients afflicted with diseases which seriously threaten their health and which require highly technical and specialized knowledge, facilities and personnel to treat effectively.

Financing of health care services

There are numerous ways in which health care is financed in the Philippines. Government health spending is controlled and determined by hundreds of actors (DOH officials, governors, mayors, Phil Health officials) who have direct control over health resources and different mandates and responsibilities. DOH continues to finance the so-called retained hospitals while LGU uses their internal revenue allocations to operate their own health facilities. Both DOH and LGU health facilities, in turn, receive Phil Health reimbursements and, sometimes, external support from donors (mostly in kind). In addition, the facilities may or may not have their own fee or other revenue-generating programs. As a result of all these, planning, coordination, and allocation of available resources are highly inefficient (Department of health Philippines, 2010).

 The following is the percentage share of financing agent in the year 2005, government with 28%, national with 15.8%, local with 12.9%, social insurance 11%, Philhealth 10.7 %, employee’s compensation 0.4%, private sources 59.1%, out-of-pocket 48.4%,private insurance 2.4%, HMOs 3.9%, employer-based plans 3.2%, private schools 1.2% and other sources 1.2% (Department of health Philippines, 2010).

Comparison of healthcare of the Philippines and the United States of America

Considering the delivery of healthcare services, in the United States of America, most health care services are delivered privately even though they are financed publicly. On the side of the Philippines, the private sector offers more health care facilities than the state, with 772 of the 1195 domestic hospitals operated privately in 2015. The largest concentrations are in the National Capital Region, which was home to 48 government and 112 private hospitals that year.

On aspect of the health care coverage, in the year 2014, about 90% of the citizens in the United States of America had health care insurance coverage and universal health care has been rolled out in the United States of America. On the contrary, in December 2012, the government of the Philippines earmarked 85 per cent of the incremental revenues for health. Of this 85 per cent, 80 per cent was intended to be used to provide free health insurance for poor and near-poor families through the National Health Insurance Program managed by PhilHealth, programs intended to speed the progress of the health Millennium Development Goals, and programs to

 Promote health awareness.

Considering the challenges, the main problems that are impediments to the halted care provision in the United States of America is the rising cost of health care due rising of the insurance premiums, shortage of the primary health care professionals which when summed together affects the quality and effectiveness of the health care services ( ROWENA, 2017). On the other side, expansion of coverage to underpopulated and economically disadvantaged areas and the growing prevalence of non-communicable diseases (NCDs) are some of the challenges that are facing the Philippines. Rapid growth in the population is also another challenge facing the Philippines where growth in the population has outstripped medical workforce.

Major Health problem facing People of the Philippines

Tuberculosis burden to the Philippines 

Philippine is experiencing numerous problems in its healthcare system ranging from lack of adequate personnel to cater to the needs of the fast-growing population to unequal access to the health care which especially affects the poor people. However, even though the above problems are affecting health care delivery, would like to concentrate on one major problem that is ravaging the Philippines at an alarming rate. Many Filipinos face diseases such as Tuberculosis, Dengue, Malaria and HIV/AIDS. These diseases pair with protein-energy malnutrition and micronutrient deficiencies that are becoming increasingly common. In the midst of the three diseases, citizens of this country are hardly hit by tuberculosis.

In the Philippines, TB is a major health problem. It is the sixth leading cause of death and illness. In 2011, WHO estimates there are 260 000 incident cases in the country and 28 000 dies in a year as a result of TB? TB prevalence is high among the high-risk groups such as the elderly, urban poor, smokers and those with compromised immune systems such as people living with HIV, malnutrition and diabetes. It is estimated that 10 600 patients have multi-drug resistant TB (MDR-TB) in 2011. This situation leads to substantial socio-economic losses to the country (World Health Organization, 2011). The Philippines is among 8 countries where two-thirds of 2017 TB cases were found, data showed.

Steps to Tuberculosis problem in the Philippines

First, the ministry of health rolled out the program known the National TB Control Program (NTP), through which the country aims to detect 85% of TB patients and successfully treat at least 90% of them. Secondly, has created awareness among the citizens and developed a health program where, persons with signs and symptoms of TB can access free diagnostic test using sputum microscopy and anti-TB drugs from different DOTS facilities such as the rural health units, health centres, private clinics, some hospitals, prison clinics, and other facilities. A treatment partner ensures patient compliance.

 Third, the country has partnered with WHO which provides technical assistance in the following areas; intensifying TB case finding through the CATCH TB Cases Project in Metro Manila and DetecTB in Palawan; strengthening TB laboratories, including use of new TB diagnostic tools; scaling up PMDT (Programmatic Management of Drug-resistant TB), implementing infection control;  finding TB cases actively among close contacts, clinical risk groups and risk populations; improving TB surveillance as well as program monitoring and evaluation; strengthening TB/HIV collaborative work; and building up operational research capacity. Lastly, the government has implemented a strategy that ensures that detainees have access to TB treatment and medical care.

Health threat of the Cancer to the United States of America

Tuberculosis is the world’s biggest infectious killer. An estimated 4,500 people die from TB every day. In 2017, TB caused an estimated 1.3 million deaths among HIV-negative people and an additional 300,000 deaths among HIV+ people. Global estimates show that 10 million people developed TB in 2017 and over 4 million people miss out on TB care and treatment. Additionally, the cases of drug-resistant TB remain a public health crisis. In 2017, there were 558,000 people who developed resistance to rifampicin, the most effective first-line drug against TB. This simply means that TB is not only about the Philippines but rather it is a global issue and therefore needs the attention of other countries (Ana, 2018).

USA is battling with TB too. According to a report released in 2017, eliminating tuberculosis (TB) will require interrupting TB transmission as well as major efforts to address latent TB infection. In 2017, a total of 9,105 TB cases were reported in the United States. This represents a 1.6% decrease from 2016. Consequently, TB was reported in all 50 states where the percentage of TB cases that are drug resistant has remained stable for the last 20 years

It is of great importance for the United States of America to be concerned of TB since it also a health problem that it is battling with. The USA needs to partner with the Philippines  and also with other nations that are experiencing the problem, share the human resources and financial resources that are available in a bid to reduce the prevalence of the disease and also reduce economic impacts the disease has on the economy.

Recommendations

Considering the major health problem that is affecting the Philippines, I do suggest the following strategies and recommendations to the health sector. First and foremost, I recommend the country to set up and fund the research centres that will work on drug development and use and effectiveness of chemoprophylaxis in order to find ways to counter drug-resistant tuberculosis. Secondly, I recommend the government to consider creating awareness among the people so that people can go for testing and ensure that TB is detected at an early stage and be contained. In this case, the government may consider optimizing actions along the patient-initiated pathway and systematic screening pathway. Third, I recommend that the government should employ qualified medical personnel who will offer the right medical treatment to the TB patients and this will help in reducing the size of the latent reservoir.

 Fourth, the government should put in place programmatic management which will ensure effective implementation of the strategies such as education of targeted TB knowledge should be provided for information and imparting skills to healthcare workers, patients, families, visitors, and employees so that they can all understand and be engaged into TB control programme. Lastly, I recommend the government to take measure that will prevent the transmission of the disease such as administrative actions (early identification of suspected cases, rapid isolation and appropriate treatment of infectious patients), engineering and environmental controls (negative-pressure ventilation rooms, high-efficiency particulate air filtration, and ultraviolet germicidal irradiation), and personal protective measures (masks) (Li, Chung, Leung, Nishikiori, Chan, & Yeoh, 2017).