Prevention may be the cure

THE SHIFT TO primary health care remains one of the top aspirations of the Department of Health (DoH). But for now, this will unfortunately remain as a longterm dream, said DoH Assistant Secretary Dr. Enrique Tayag at a health conference on May 18 at the Asian Development Bank (ADB) office in Ortigas. He said primary health care is not an overnight project, and it entails time, work, and cooperation of stakeholders. “The aspiration is to move the outpatients from the hospitals and so the GPs ( general practitioners) can come in at the prevention phase,” said Mr. Tayag, emphasizing the importance of prevention rather than cure in the conference called “Health for Juan and Juana: Moving Forward with the Philippine Health Agenda,” organized by the Pharmaceutical and Healthcare Association of the Philippines (PHAP). The World Health Organization defines “primary health care” as a concept “based on the principles of equity, participation, intersectoral action, appropriate technology, and a central role played by the health system.” It is the first-contact care that is accessible among the people within their community.

GPs — medical doctors without specializations — are one of the cornerstones of primary health care. But in this country of more than 100 million people, there are only 13,000 GPs.

“Human resources is the heart and soul of universal and primary health care,” said Dr. Pedro Paterno, a member of the Universal Health Care Study Group of the University of the Philippines Manila, and one of the key resource persons at the forum. He said that to ensure primary care in the Philippines, the government should allocate P1,760 per person in 2018. By then, our estimated population will be 105 million.

In her pre-taped video message about the achievements of the current administration, DoH Secretary Dr. Paulyn Jean Rosell-Ubial said the funds backing PhilHealth, which currently covers 92 million Filipinos, are increasing because of the sin tax law. In 2015, the PhilHealth budget was P86.97 billion, in 2016 it went up to P122.6 billion, and this year it is P155.4 billion.

According to Department of Budget and Management Secretary Benjamin Diokno, 40% of the P3.35 trillion national budget will be allocated for social services, including health. This is in line with the government’s goal of reducing poverty by 1.25% to 1.5% annually, to reduce the poverty rate to 13% from 15% in 2022. He added that for fiscal year 2017, P158.3 billion will be used for hospital, outpatient, and public health services, which is an increase of 19.2% from 2016.

But while the budget allocations for health are increasing, fewer medical experts become GPs or even stay in the Philippines. Dr. Eduardo Banzon, the principal health specialist of the ADB, said “we are not being creative” with the human sources we have. He said the government should create an environment that favors would-be GPs to pursue and practice primary health care, especially in provinces and remote areas. As so many Filipino students are taking up nursing, he suggested “promoting the nurses to more than just assistants” so we could add more medical practitioners to the country’s roster of experts. This way, we can maximize our human labor force.

An advantage for the country’s growing economy is that the work force is young. Department of Finance Secretary Carlos Dominguez III said in a video message played in the forum that we should maintain our demographic sweet spot — a time when youth accounts for an increasing larger proportion of the population. The country’s median age is 23 years old. But he said the challenge is how to utilize our young workers, how to educate them on the importance of their health, noting that we don’t have the luxury of time.

Among the health problems of the youth are the increasing rate of teenage pregnancy and the increasing number of teenage smokers. According to the World Health Organization’s Youth and Tobacco in the Western Pacific Region: Global Youth Tobacco Survey 2005-2014 report, 13.7% of Filipinos aged 13 to 15 — more than one in every eight teens — use tobacco products. Meanwhile, the Philippines is the only country in Asia where the number of teenage mothers is going up.

For Mr. Diokno, our demographic sweet spot is crucial and must be prioritized in what is otherwise an aging world. “We must mold our young population into an agile and competent work force,” he said, adding that this, together with providing accessible and quality health care system in the Philippines, should be maintained as the agenda of the government.