Measuring our UHC progress

WHERE is the Philippines now in its journey to Universal Health Care (UHC)? This was the critical question that Dr. Gundo Aurel Weiler, Country Representative of the World Health Organization (WHO), answered during the recent “Health for Juan and Juana: Moving Forward with the Philippine Health Agenda” forum.
“What cannot be measured cannot be managed, so it’s important that we measure our progress in UHC. We want to know whether we are on track to hit our targets. We also want to see how other countries are doing… to learn from them, especially those that are doing better than us,” said Dr. Weiler, a physician and medical sociologist who has worked as a public health advocate in the Philippines for many years. Indeed, as the WHO points out, performance measurement offers policymakers a major opportunity to secure health system improvement and accountability. It can also improve the quality of decisions made by all stakeholders within the health system.
Dr. Weiler stressed the need to ensure that all people and communities receive quality health services without suffering financial hardship. He cited a pre-2012 data from the Philippine Family Income and Expenditure Survey (FIES), which showed that 6.3% of Filipinos spend more than 10% of their household budget for health. For comparison, this figure is 3.7% for Australia, 6.2% for Japan, 9.8% for Vietnam, 13.5% for South Korea, and 17.7% for China.
“Spending 25% of the household budget [for health] is considered the threshold for potentially catastrophic expenditure because this is when people start to borrow money and sell their assets,” said Dr. Weiler.
To measure the coverage of essential health services, public health experts use tracer indicators, such as infectious diseases (e.g. HIV), reproductive health/family planning, non-communicable diseases (e.g. hypertension), and service capacity.
“The coverage of HIV antiretroviral treatment in the Philippines is 32%,” Dr. Weiler said. Our country currently lags behind Mongolia (33%), Malaysia (37%), Lao PDR (41%), Vietnam (47%), and Cambodia (80%). The globally agreed target for HIV antiretroviral treatment coverage is 80%, with the global average at 53% and regional average 55%.
In terms of meeting Family Planning (FP) needs, the Philippines scored 51%, which is lower than our Asian neighbors: Cambodia (56%), Lao PDR (61%), Mongolia (68%), and Vietnam (70%). The global average is 77% while the regional average is almost 90%.
For blood pressure control, the Philippines scored 77%, which is not far from the global average of 78% and regional average of 81%, Dr. Weiler noted. One aspect of service capacity is international health regulation compliance, which measures the health system’s ability to provide emergency services, he explained. “Under this category, the Philippines’ score of 84% compares favorably with the global average of 73% and regional average of 79%.”
Overall, the Philippines scored a UHC Composite Index of 58%. The global average is 64% while the regional average is 75%. “The Philippines is moving in the right direction,” Dr. Weiler concluded.
The Health for Juan and Juana Forum, with theme “Making Universal Healthcare Happen,” aimed to deepen engagements and strengthen collaborations to come closer to the attainment of UHC, realizing that the nation’s social and economic progress depend on a healthy citizenry. Those aspirations remain.

Reference:
1. Peter C. Smith, Elias Mossialos and Irene Papanicolas. “Performance measurement for health system improvement: experiences, challenges and prospects.” 2008 WHO European Ministerial Conference on Health Systems. http://www.who.int/management/district/ performance/PerformanceMeasurementHealthSystemImprovement2.pdf. Accessed June 7, 2018

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.