Early Response to COVID-19 in the Philippines

Low- and middle-income countries (LMICs) with weak health systems are especially vulnerable during the COVID-19 pandemic. In this paper, we describe the challenges and early response of the Philippine Government, focusing on travel restrictions, community interventions, risk communication and testing, from 30 January 2020 when the first case was reported, to 21 March 2020. Our narrative provides a better understanding of the specific limitations of the Philippines and other LMICs, which could serve as basis for future action to improve national strategies for current and future public health outbreaks and emergencies

COVID-19 Vaccine Brand Hesitancy and Other Challenges to Vaccination in the Philippines

Effective and safe COVID-19 vaccines have been developed at a rapid and unprecedented pace to control the spread of the virus, and prevent hospitalisations and deaths. However, COVID-19 vaccine uptake is challenged by vaccine hesitancy and anti-vaccination sentiments, a global shortage of vaccine supply, and inequitable vaccine distribution especially among low- and middle-income countries including the Philippines. In this paper, we explored vaccination narratives and challenges experienced and observed by Filipinos during the early vaccination period. We interviewed 35 individuals from a subsample of 1,599 survey respondents 18 years and older in the Philippines. The interviews were conducted in Filipino, Cebuano, and/or English via online platforms such as Zoom or via phone call. All interviews were recorded, transcribed verbatim, translated, and analysed using inductive content analysis. To highlight the complex reasons for delaying and/or refusing COVID-19 vaccines, we embedded our findings within the social ecological model. Our analysis showed that individual perceptions play a major role in the decision to vaccinate. Such perceptions are shaped by exposure to (mis)information amplified by the media, the community, and the health system. Social networks may either positively or negatively impact vaccination uptake, depending on their views on vaccines. Political issues contribute to vaccine brand hesitancy, resulting in vaccination delays and refusals. Perceptions about the inefficiency and inflexibility of the system also create additional barriers to the vaccine rollout in the country, especially among vulnerable and marginalised groups. Recognising and addressing concerns at all levels are needed to improve COVID-19 vaccination uptake and reach. Strengthening health literacy is a critical tool to combat misinformation that undermines vaccine confidence. Vaccination systems must also consider the needs of marginalised and vulnerable groups to ensure their access to vaccines. In all these efforts to improve vaccine uptake, governments will need to engage with communities to ‘co-create’ solutions

Public Trust and the COVID-19 Vaccination Campaign: Lessons from the Philippines as it Emerges from the Dengvaxia Controversy

While the entire world prepares and begins to roll out COVID-19 vaccines, the Philippines is still reeling from the consequences of the Dengvaxia controversy in 2016. Those highly political events led to the erosion of public trust in leaders and a significant damage to vaccine confidence in the country, now potentially impacting the uptake of COVID-19 vaccines. We discuss how public trust and confidence can be rehabilitated through accountability, transparency, and proper communication from the most trusted sources of the population. We also highlight key lessons for policymakers and leaders on allowing science to take the front seat, and politics behind, for the safety and well-being of the people during this public health crisis

COVID-19 vaccine brand hesitancy and other challenges to vaccination in the Philippines

Effective and safe COVID-19 vaccines have been developed at a rapid and unprecedented pace to control the spread of the virus, and prevent hospitalisations and deaths. However, COVID-19 vaccine uptake is challenged by vaccine hesitancy and anti-vaccination sentiments, a global shortage of vaccine supply, and inequitable vaccine distribution especially among low- and middle-income countries including the Philippines. In this paper, we explored vaccination narratives and challenges experienced and observed by Filipinos during the early vaccination period. We interviewed 35 individuals from a subsample of 1,599 survey respondents 18 years and older in the Philippines. The interviews were conducted in Filipino, Cebuano, and/or English via online platforms such as Zoom or via phone call. All interviews were recorded, transcribed verbatim, translated, and analysed using inductive content analysis. To highlight the complex reasons for delaying and/or refusing COVID-19 vaccines, we embedded our findings within the social ecological model. Our analysis showed that individual perceptions play a major role in the decision to vaccinate. Such perceptions are shaped by exposure to (mis)information amplified by the media, the community, and the health system. Social networks may either positively or negatively impact vaccination uptake, depending on their views on vaccines. Political issues contribute to vaccine brand hesitancy, resulting in vaccination delays and refusals. Perceptions about the inefficiency and inflexibility of the system also create additional barriers to the vaccine rollout in the country, especially among vulnerable and marginalised groups. Recognising and addressing concerns at all levels are needed to improve COVID-19 vaccination uptake and reach. Strengthening health literacy is a critical tool to combat misinformation that undermines vaccine confidence. Vaccination systems must also consider the needs of marginalised and vulnerable groups to ensure their access to vaccines. In all these efforts to improve vaccine uptake, governments will need to engage with communities to ‘co-create’ solutions

Soil-Transmitted Helminthiasis and Schistosomiasis in Children of Poor Families in Leyte, Philippines: Lessons for Disease Prevention and Control

Objective Neglected tropical diseases (NTDs) continue to be a public health problem in the Philippines. We assessed the association of soil-transmitted helminthiasis (STH) and schistosomiasis with selected health-related and socioeconomic variables in four villages in Leyte, Philippines. Methods Stool specimens from 418 adults and 533 of their children from 209 families were examined through the Kato-Katz technique. Results STH and schistosomiasis were present in 64.6% and 12.5%, respectively, of study participants. Analysis through the generalized linear mixed model revealed a number of associations between infection in parents and their children. Findings indicate that years of disease prevention and control efforts in these areas have been unable to bring down prevalence in children and their parents. Eliminating NTDs as public health problems will require a systems thinking approach beyond implementation of vertical control programs alone

The 2019 Philippine UHC Act, Pandemic Management and Implementation Implications in a Post-COVID-19 World: A Content Analysis

The 2019 Philippine Universal Health Care Act (Republic Act 11223) was set for implementation in January 2020 when disruptions brought on by the pandemic occurred. Will the provisions of the new UHC Act for an improved health system enable agile responses to forthcoming shocks, such as this COVID-19 pandemic? A content analysis of the 2019 Philippine UHC Act can identify neglected and leverage areas for systems’ improvement in a post-pandemic world. While content or document analysis is commonly undertaken as part of scoping or systematic reviews of a qualitative nature, quantitative analyses using a two-way mixed effects, consistency, multiple raters type of intraclass correlation coefficient (ICC) were applied to check for reliability and consistency of agreement among the study participants in the manual tagging of UHC components in the legislation. The intraclass correlation reflected the individuals’ consistency of agreement with significant reliability (0.939, p \u3c 0.001). The assessment highlighted a centralized approach to implementation, which can set aside the crucial collaborations and partnerships demonstrated and developed during the pandemic. The financing for local governments was strengthened with a new ruling that could alter UHC integration tendencies. A smarter allocation of tax-based financing sources, along with strengthened information and communications systems, can confront issues of trust and accountability, amidst the varying capacities of agents and systems

Educating a New Generation of Doctors to Improve the Health of Populations in Low- and Middle-Income Countries

Francesca Celletti and colleagues from WHO argue that a transformation in the scale-up of medical education in low- and middle-income countries is needed, and detail what this might look like

Top 10 public health challenges to track in 2023: Shifting focus beyond a global pandemic

The year 2022 saw COVID-19 as the primary public health concern, with vaccine rollout and mandates at the forefront. Other viral infectious diseases, such as Monkeypox and Ebola, emerged as public health concerns. Climate change and political conflicts significantly impacted global health, increasing the demand for humanitarian assistance and protection. In 2023, it remains crucial to identify global and public health priority areas to coordinate and implement effective solutions. Through discussions with public health practitioners and researchers, we have identified key priority areas for 2023, namely, health systems, the mental health crisis, substance abuse, infectious diseases, malnutrition and food insecurity, sexual and reproductive health challenges, environmental pollution, the climate crisis, cancer, and diabetes. These priority areas highlight shared concerns that should be addressed to facilitate proactive and innovative health interventions and practices. To achieve universal healthcare targets for 2030, prioritization, financial investment, international cooperation, and collaboration in addressing these global health challenges are crucial. This requires coordination among public health decision-makers, the private health sector, and opinion leaders to implement country-specific healthcare financing and food security measures. Research, scientific knowledge, and technical capacities must be leveraged to produce sustainable interventions that effectively reduce health disparities and improve health system responsiveness to prevent these challenges from progressing to public health emergencies

The Philippines Health System Review

The Asia Pacific Observatory on Health Systems and Policies (‎‎the APO)‎‎ is a collaborative partnership of interested governments, international agencies, foundations, and researchers that promotes evidence-informed health systems policy regionally and in all countries in the Asia Pacific region. The APO collaboratively identifies priority health system issues across the Asia Pacific region; develops and synthesizes relevant research to support and inform countries\u27 evidence-based policy development; and builds country and regional health systems research and evidence-informed policy capacity