Health status has improved dramatically in the Philippines over the last
forty years: infant mortality has dropped by two thirds, the prevalence of
communicable diseases has fallen and life expectancy has increased to
over 70 years. However, considerable inequities in health care access and
outcomes between socio-economic groups remain.
A major driver of inequity is the high cost of accessing and using health
care. The Philippines has had a national health insurance agency –
PhilHealth – since 1995 and incrementally increased population coverage,
but the limited breadth and depth of coverage has resulted in high-levels
of out of pocket payments. In July 2010 a major reform effort aimed at
achieving ‘universal coverage’ was launched, which focused on increasing
the number of poor families enrolled in PhilHealth, providing a more
comprehensive benefits package and reducing or eliminating co-payments.
Attracting and retaining staff in under-served areas is key challenge. The
Philippines is a major exporter of health workers, yet some rural and poor
areas still face critical shortages. Inefficiency in service delivery persists as
patient referral system and gatekeeping do not work well.
Successive reform efforts in financing, service delivery and regulation
have attempted to tackle these and other inefficiencies and inequalities
in the health system. But implementation has been challenged by the
decentralized environment and the presence of a large private sector, often
creating fragmentation and variation in the quality of services across the
country