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South Cotabato’s ‘convergence’ approach to primary health care

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Medicine Cabinet

HEALTH is on the top of the list of South Cotabato’s convergence approach in the responsive delivery of social services.

“We realized that if we wanted to go down to the villages… we had to do it together and help each other. That was when we decided to adopt the convergence approach in delivering social services to our people,” said South Cotabato Governor Daisy Avance Fuentes when she spoke during the 2018 Health for Juan and Juana: Moving Forward with the Philippine Health Agenda forum.

Ms. Fuentes stressed that a functional local health board is crucial. The Provincial Health Board of South Cotabato is composed of the Governor, the Chairperson of the Sangguniang Panlalawigan Committee on Health, a representative of the Department of Health (DoH) Regional Office, and an NGO partner.

In one of the board’s regular meetings, Ms. Fuentes and her team found out that they were not getting the feedback needed to respond to the health needs of their constituents. As a result, there were many gaps in the province’s health service delivery network. “This was because we were all bureaucrats in the regional and provincial government.”

She proceeded to enroll in the DoH and Zuellig Family Foundation’s Provincial Leadership and Governance Program (PLGP) which aims to bridge leadership towards an improved and integrated provincial health system. “The program gave me a deeper understanding of the challenges in the health system, as well as empathy for our health workers and my constituents.”

Ms. Fuentes noted that the national government mandates local government units (LGUs) to ensure poor patients in hospitals have no out-of-pocket expenses and benefit from PhilHealth’s No Balance Billing policy. “But this is not possible if LGUs rely only on PhilHealth reimbursements because we pay for indigent patients admitted in both public and private hospitals.”

To address this gap, the South Cotabato provincial government established a trust fund for the purchase of medicines and medical, laboratory, and radiology supplies of South Cotabato Provincial Hospital, Norala District Hospital, and Polomolok Municipal Hospital. Funding comes from contributions of the three provincial hospitals, which allot 25% of their total income to the trust fund.

“Even if we procure by bulk on a semestral or quarterly basis, many of the supplies we purchase do not arrive on time. With the trust fund, our provincial hospitals have an alternative means to procure supplies in a timely manner.”

The South Cotabato provincial government also signed a Memorandum of Agreement with all pharmacies and drugstores in the province and Davao from which the provincial government can purchase medicines and hospital supplies.

Moreover, the provincial government has partnered with the Mahintana Foundation, a local NGO that operates a chain of community drugstores. One of these is the Health Plus Shop-in-a-Shop (HPSiS), a public-private partnership (PPP) between Mahintana Foundation and the South Cotabato provincial government aimed at improving poor patients’ access to quality and affordable medicines in public hospitals.

“Whatever medicines the provincial government cannot supply in time, HPSiS addresses the gap. We pay them every 15 days, and 70% of their net profit goes back to the provincial government,” Ms. Fuentes explained. HPSiS is a 2015 Galing Pook awardee and one of the 2017 10 Best PPP Stories of the Department of Interior and Local Government.

Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines (PHAP). Medicine Cabinet is a weekly PHAP column that aims to promote awareness on public health and health care-related issues. PHAP and its member companies represent the research-based pharmaceutical and health care industry.

medicinecabinet@phap.org.ph