Philippine Health Care Delivery System & DOH Programs - Concept Map
Philippine Health Care Delivery System as the Structural Framework for Community Health Nursing Practice
Related concepts
Structure of the Philippine Health Care System
Sub concepts
- Public (Government) Sector
- Private Sector (For-profit and Non-profit)
- Devolution under RA 7160 (Local Government Code 1991)
- Role of Local Government Units (LGUs)
Relationship to central
Foundational framework defining how health services are organized and delivered
Department of Health (DOH)
Sub concepts
- Central Office Structure
- Centers for Health Development (CHDs)
- DOH-Retained Hospitals and Specialty Centers
- Attached Agencies (PhilHealth, FDA, PITAHC)
- Sentrong Sigla Movement (Quality Assurance Program)
Relationship to central
Lead agency responsible for policy-making, technical authority, and regulation of health system
Levels of Health Care and Referral System
Sub concepts
- Primary Level (BHS, RHU, Health Centers)
- Secondary Level (District and Provincial Hospitals)
- Tertiary Level (Medical Centers, Specialty Hospitals)
- Upward Referral Process
- Downward/Back-Referral Process
- Two-Way Referral Documentation
Relationship to central
Organizational structure determining where clients enter care and how services are coordinated
Primary Health Care (PHC)
Sub concepts
- Alma-Ata Declaration (1978) and LOI 949 (1979)
- PHC Principles (4 As: Accessibility, Availability, Affordability, Acceptability)
- Community Participation as Core Cornerstone
- Intersectoral Coordination
- Appropriate Technology
- Essential Elements of PHC (ELEMENTS Mnemonic)
- PHC Worker Levels (BHWs, Intermediate-level Workers)
Relationship to central
Cornerstone philosophy guiding community health nursing practice and service delivery
Universal Health Care Law (RA 11223)
Sub concepts
- Automatic PhilHealth Enrollment
- Direct and Indirect Contributor Categories
- Population-Based vs Individual-Based Health Services
- Health Care Provider Networks
- Primary Care as Gateway
- Health Technology Assessment (HTA)
- Integration into Province/City-Wide Health Systems
Relationship to central
Landmark legislation reshaping health financing and ensuring equitable access to care
PhilHealth (National Health Insurance Program)
Sub concepts
- RA 7875 (National Health Insurance Act of 1995)
- Inpatient and Outpatient Benefit Packages
- Z-Benefits for Catastrophic Conditions
- Konsulta (Primary Care Benefit Package)
- Maternity Care Packages
- Client Eligibility and Access Navigation
Relationship to central
Social health insurance mechanism providing financial protection and benefit coverage
Field Health Services Information System (FHSIS)
Sub concepts
- Individual Treatment Record (ITR) as Basic Building Block
- Target Client Lists (TCLs) for Program Tracking
- Summary and Monthly Consolidation Tables
- Quarterly and Annual Reports
- Data Utilization for Local and National Planning
Relationship to central
Official DOH recording and reporting system providing data for planning and program management
Roles of the Community Health Nurse
Sub concepts
- Care Provider (Clinical and Community-Based)
- Health Educator (Core PHC Function)
- Manager/Supervisor (RHU Nursing Service, BHWs, Midwives)
- Coordinator/Collaborator (Inter-facility and Intersectoral)
- Recorder/Reporter (FHSIS and Program Records)
- Advocate and Community Organizer (Community Mobilization)
Relationship to central
Specific functions nurses perform within the health care delivery system to operationalize it
Concept connections
- Local Government Code RA 7160Department of Health Role TransformationDevolution shifted DOH from direct service provider to technical and regulatory authority
- Department of HealthCenters for Health DevelopmentCHDs serve as DOH's regional offices coordinating with LGUs on technical matters and standards
- Primary Health CareCommunity ParticipationCommunity participation is the underlying cornerstone and core principle of PHC implementation
- Alma-Ata Declaration 1978Philippine PHC Adoption LOI 949 1979Philippines adopted Alma-Ata principles through Letter of Instruction 949, making PHC official policy
- Primary Health Care Essential ElementsCommunity Health Nurse FunctionsThe eight PHC elements (ELEMENTS mnemonic) guide and structure all CHN interventions in the community
- Universal Health Care Law RA 11223Automatic PhilHealth EnrollmentRA 11223 mandates automatic enrollment of all Filipinos, eliminating voluntary enrollment and employment-based coverage
- RA 11223 Universal Health CarePrimary Care-Led Referral SystemUHC Act reinforces the primary care gateway model where RHU/health center coordinates client care
- PhilHealth National Health Insurance ProgramUniversal Health Care ImplementationPhilHealth is the social health insurance mechanism that operationalizes and finances UHC benefits
- Sentrong Sigla MovementRural Health Unit QualitySentrong Sigla is DOH's quality assurance program that certifies and improves RHU and health center standards
- Levels of Care Primary Secondary TertiaryTwo-Way Referral SystemThe three levels are connected and integrated through upward referral and back-referral mechanisms
- Referral SystemCommunity Health Nurse Coordination RoleCHNs prepare referral forms, facilitate upward referral, and ensure back-referral follow-up and continuity
- Field Health Services Information System FHSISIndividual Treatment Record ITRITR is the basic building block of FHSIS; every client encounter is documented on an ITR
- Target Client Lists TCLProgram Coverage and No-Miss StrategyTCLs track program-specific clients (prenatal, EPI, TB, FP) ensuring comprehensive program coverage
- Community Health Nurse Data Recorder RoleFHSIS Quality and AccuracyCHNs are primary recorders responsible for accurate, complete, timely FHSIS data at the point of service
- FHSIS DataDOH Planning and Program DevelopmentFHSIS data flows upward through municipal, city, and regional levels to inform DOH policy and program decisions
- Rural Health Unit Primary Care GatewayCommunity Health Nurse Multiple RolesRHU is where CHNs operate as care providers, educators, managers, coordinators, and recorders simultaneously
- PHC Accessibility Affordability Availability AcceptabilityRA 11223 Automatic EnrollmentUHC automatic enrollment directly addresses PHC principles by removing financial and eligibility barriers
- Barangay Health Worker BHWCommunity Health Nurse SupervisionCHNs at RHU manage, train, and supervise BHWs who are the first community-level health resource
- Health EducationCommunity Participation and MobilizationHealth education facilitates community understanding and engagement, enabling true participation in PHC
- Intersectoral CoordinationPHC ImplementationPHC recognizes health requires coordination beyond health sector (agriculture, education, water, housing, sanitation)
- Appropriate TechnologyPrimary Health Care SustainabilityPHC uses technology suited to local conditions and resources, ensuring sustainability and community ownership
- Direct Contributors PhilHealthIndirect Contributors PhilHealthRA 11223 classifies Filipinos into two membership categories with different premium arrangements but equal benefits
- Population-Based Health ServicesGovernment FinancingPopulation-based services like surveillance and promotion are government-financed, not PhilHealth-financed
- Individual-Based Health ServicesPhilHealth Benefit PackagesIndividual services like consultations, tests, and medications are covered under PhilHealth benefit packages
- Health Technology Assessment HTAPhilHealth Coverage DecisionsHTA is a mechanism to guide which services and technologies PhilHealth funds based on evidence and feasibility
Diagrams
Philippine Health Care Delivery System: Complete Concept Hierarchy
Comprehensive mind map showing the complete hierarchy of the Philippine health care delivery system, illustrating how the central concept branches into eight major domains: organizational structure, DOH roles, levels of care, primary health care philosophy, universal health care legislation, PhilHealth insurance, health information systems, and community nurse roles. This visual demonstrates the interconnected nature of health system components essential for NLE preparation.
Client Flow Through the Philippine Health Care Delivery System
Flowchart illustrating the two-way referral system and client movement through the Philippine health care delivery system. Shows how clients enter at the primary level (BHS/RHU), how upward referral occurs when capacity is exceeded, the role of secondary and tertiary care, and the critical back-referral process ensuring continuity of care. Includes documentation and FHSIS recording at each level. Essential for understanding practical application of the health system structure in NLE scenarios.
Organizational Hierarchy: DOH Leadership and Devolved Structure
Organizational flowchart depicting the hierarchical structure of the Philippine health care system following devolution under RA 7160. Shows DOH's role as national technical authority and policy-maker, the regional coordination through Centers for Health Development, and the devolved structure where LGUs operate facilities at different levels. Illustrates how responsibility flows from national to local, with the community health nurse positioned as a key implementer at the primary care level (RHU/BHS). Critical for understanding governance and reporting structures tested on the NLE.
Primary Health Care Essential Elements and Community Health Nursing Functions
Flowchart connecting Primary Health Care essential elements (via the ELEMENTS mnemonic) with PHC principles (the 4 As) and showing how community health nurses operationalize PHC through their five core functions: health education, community mobilization, care provision, data collection, and advocacy. Demonstrates the philosophical foundation that guides community health nursing practice and is essential for NLE questions on PHC implementation.
Universal Health Care Implementation and PhilHealth Access Pathways
Flowchart showing the implementation pathways of RA 11223 (Universal Health Care Law), demonstrating automatic enrollment and classification of membership (direct vs. indirect contributors), the distinction between population-based and individual-based services, and how PhilHealth financing works. Illustrates the primary care-led, referral-based system where the RHU/health center serves as the client's gateway. Shows the role of Health Technology Assessment (HTA) in determining coverage and the integration of FHSIS recording. Critical for understanding modern Philippine health financing and NLE questions on UHC implementation.
Field Health Services Information System FHSIS Data Flow and Utilization
Comprehensive flowchart showing the FHSIS data collection process, beginning with the Individual Treatment Record (ITR) as the basic building block and Target Client Lists (TCLs) ensuring no program client is missed. Traces data flow from individual client encounter through RHU consolidation, municipal/city compilation, to DOH analysis and utilization for planning, program evaluation, and policy development. Emphasizes the community health nurse's critical role as primary data recorder and shows how data feeds back to improve service delivery. Essential for understanding health information systems tested on the NLE.
Community Health Nurse Roles and Responsibilities Distribution
Pie chart illustrating the proportional distribution of community health nurse roles and responsibilities within the Philippine health care delivery system. While all roles are essential, health education emerges as the primary (25%) function aligned with PHC philosophy, followed by direct care provision (20%) and management/supervision (13%). Data recording and FHSIS maintenance (15%), coordination/referral functions (15%), and community mobilization/organization (12%) represent equally important supporting roles. This distribution reflects the emphasis on health education as a cornerstone PHC function and helps NLE test-takers understand the priority allocation of nursing time and effort in community settings.