Measuring the Capacity to Combat Illicit Tobacco Trade In 160 Countries

Background Illicit trade of tobacco negatively affects countries’ tobacco control efforts. It leads to lower tobacco prices and makes tobacco products more accessible to vulnerable populations. In this study, we constructed an illicit tobacco trade index, which measures the structural and institutional capabilities of 160 countries in addressing illicit tobacco trade. We collected the most recent and best available data on general governance, tobacco control policies, and trade and customs practices. Results Singapore, New Zealand, Finland and Sweden lead countries with the most favorable illicit tobacco trade score. We observed a positive relationship between illicit tobacco trade scores and Gross National Income (GNI) per capita and a negative relationship with the share of illicit tobacco trade to total tobacco consumption. Conclusions The capability to combat illicit trade varies across countries. However, on average, low and middle-income countries (LMICs) are less capable of addressing illicit tobacco trade as suggested by the lower illicit tobacco trade index score. The lower index score in low and middle-income countries was mainly driven by low scores in tobacco control policies and trade and customs practices and conditions. Our study reinforces the importance for LMICs to adopt the WHO’s Protocol to Eliminate Illicit Tobacco Trade Products, particularly committing to treaty obligations and investing on track and trace system and other customs reforms

Trends in National-Level Governance and Implementation of the Philippines\u27 Responsible Parenthood and Reproductive Health Law from 2014 to 2020

In 2012; the Philippines passed the Responsible Parenthood and Family Planning Law; a landmark legislation billed as a multisectoral and rights-based approach to further sustainable human development. This article is part of the first comprehensive evaluation of the implementation of the law by national-level actors. This evaluation is intended to assess the progress of implementers in the conduct of mandates; roles; and responsibilities described in the law and its implementing guidelines. Interviews with key national government officials and data from official documents and literature revealed 3 major trends in governance and implementation from 2014 to 2020. First; despite being a multisectoral policy; performance was siloed within individual units of implementing agencies; with limited interagency coordination. Second; although the law explicitly called for interventions to invest in human capital and address socioeconomic disparities for sustainable human development; performance focused on biomedical and health interventions; particularly in the area of family planning. Third; national-level governance for reproductive health interventions concentrated on programmatic and operational concerns. Overall; this case in the Philippines illustrates that fragmented implementation has contributed to the slow improvement of reproductive health outcomes. This study highlights the challenges of governance and multisectoral coordination to implement multidimensional interventions in a low- and middle-income country; and it provides potential areas for political and administrative reform in reproductive health governance in the Philippines. By creating a common narrative and onboarding multiple sectors; officials can better identify and address structural determinants with holistic policy solutions to improve reproductive health outcomes

Multisector Strategy in Addressing Noncommunicable Diseases in the Philippines

This report is a continuation of the discussion paper of the Philippine Institute for Development Studies entitled "Inequalities in Noncommunicable Diseases in the Philippines". The first technical paper is an analysis of the current status and social determinants of noncommunicable diseases (NCD). This report, on the other hand, focuses on potential NCD prevention and control strategies of the Department of Health (DOH) with wider multisector involvement.This report is divided into five chapters. Chapters I and II discuss the current status of noncommunicable diseases and existing policies and programs of the DOH. Chapter III introduces the potential roadmap of the NCD prevention and control program of the DOH. Chapter IV defines the roles and responsibilities of different bureaus within the health sector. Chapter V outlines the potential framework of the multisector strategy of the DOH

Who Provides Good Quality Prenatal Care in the Philippines?

This paper attempts to illustrate the quality of prenatal care services provided by different health care providers. Section I presents the introduction and overview of the study. Section II discusses important information gathered during literature review which was organized into prenatal care and its benefits, recommended practice and discussion of quality of prenatal services. Sections III and IV present the detailed objectives and methodology adapted in the study. Section V discusses the results of the analysis. Lastly, Section V and VI present the discussions and policy recommendations. Results of the study include women who are older, poorer, and with lower educational attainment received poorer quality of prenatal care compared to women who are younger, richer, and better educated. Multiparous women also received poorer quality of prenatal care. Among the health care providers, doctors provide very good quality of prenatal care while majority of midwives and nurses provide fair quality of prenatal care. Not surprisingly, majority of the traditional birth attendants provide poor quality of prenatal care

The Impact of COVID-19 on Hospital Admissions for Twelve High-Burden Diseases and Five Common Procedures in the Philippines: A National Health Insurance Database Study 2019-2020

Background The Philippines has the highest cumulative COVID-19 cases and deaths in the Western-Pacific. To explore the broader health impacts of the pandemic, we assessed the magnitude and duration of changes in hospital admissions for 12 high-burden diseases and the utilization of five common procedures by lockdown stringency, hospital level, and equity in patient access. Methods Our analysis used Philippine social health insurance data filed by 1,295 hospitals in 2019 and 2020. We calculated three descriptive statistics of percent change comparing 2020 to the same periods in 2019: (1) year-onyear, (2) same-month-prior-year, and (3) lockdown periods. Findings Disease admissions declined (-54%) while procedures increased (13%) in 2020 versus 2019. The increase in procedures was caused by hemodialysis surpassing its 2019 utilization levels in 2020 by 25%, overshadowing declines for C-section (-5%) and vaginal delivery (-18%). Comparing months in 2020 to the same months in 2019, the declines in admissions and procedures occurred at pandemic onset (March-April 2020), with some recovery starting May, but were generally not reversed by the end of 2020. Non-urgent procedures and respiratory diseases faced the largest declines in April 2020 versus April 2019 (range: -60% to -70%), followed by diseases requiring regular follow-up (-50% to -56%), then urgent conditions (-4% to -40%). During the strictest (April-May 2020) and relaxed (May-December 2020) lockdown periods compared to the same periods in 2019, the declines among the poorest (-21%, -39%) were three-times greater than in direct contributors (-7%, -12%) and two-times more in the south (-16%, -32%) than the richer north (-8%, -10%). Year-on-year admission declines across the 12 diseases and procedures (except for hemodialysis) was highest for level three hospitals. Compared to public hospitals, private hospitals had smaller year-on-year declines for procedures, because of increases in utilization in lower level private hospitals. Interpretation COVID-19’s prolonged impact on the utilization of hospital services in the Philippines suggests a looming public health crisis in countries with frail health systems. Through the periodic waves of COVID-19 and lockdowns, policymakers must employ a whole-of-health strategy considering all conditions, service delivery networks, and access for the most vulnerable. Funding Open Philanthropy

Improvement of the Implementation Procedures and Management Systems for the Health Facilities Enhancement Grant of the DOH

One of the major challenges in the Philippine health sector is to secure adequacy of appropriate health facilities. To address this problem, the Health Facilities Enhancement Program (HFEP) was implemented by the Department of Health (DOH) in 2007. Specifically, HFEP aims to improve facilities such as health centers and barangay health stations to sufficiently provide for emergency and primary care services. It also aims to upgrade government hospitals. This study examines the implementation of the program and probes at the rationale for the selection of facilities for upgrading. It lays out policy options to improve equity and efficiency in allocation of funds

Profile of Private Hospitals in the Philippines

As a recognition of the valuable role of private sector in the healthcare delivery system, this paper attempts to collate vital information on private hospitals in the Philippines. This paper looks at the different characteristics and structures of private hospitals sector with regard to geographical distribution, services, financing, human resource, and other information needed by policymakers, investors, and other interested stakeholders. To better understand the current health care delivery system in the country, other sections compare private hospitals vis-a-vis government-owned facilities

Inequities in Noncommunicable Diseases

This report presents the findings of the research conducted by the Philippine Institute for Development Studies (PIDS) on leading noncommunicable diseases (NCDs). With the collaborative efforts of the World Health Organization (WHO) and Food and Nutrition Research Institute (FNRI), this research project was conducted to supplement the Department of Health's (DOH) initiative in crafting a national strategy in the prevention and control of noncommunicable diseases.This study presents evidences on mortality, morbidity, some social determinants, and inequities. Different secondary data sets like the National Nutrition Survey, National Demographic and Health Survey, Death Registry from the National Statistics Office, Family Income and Expenditure Survey and other information obtained from other studies were analyzed to come up with a unified and comprehensive study that depicts the true picture of NCDs epidemic in the country

Furthering the implementation of AEC blueprint measures

The study identifies outstanding issues and bottlenecks and provides recommendations to facilitate the Philippines' full compliance to its commitments to the ASEAN Economic Community (AEC). Various in-depth interviews and surveys were conducted with concerned stakeholders from government agencies and the private sector to bring to fore the issues and bottlenecks for policymakers' action. Although its focus is mainly on services and investment liberalization, this study also tracks policy changes in trade facilitation, nontariff measures, standards and conformance, and mutual recognition arrangements after the release of the 2010/2011 AEC Scorecard Reports

What Drives Hospitals to Expand? A Case of Private Hospitals in Palawan, Philippines

This comprehensive study aims to determine the different factors that motivate private hospitals in rural areas to expand their operation. The study was conducted in seven private hospitals in Palawan, Philippines. The study used key informant interviews to gather data on operations, finances, and other concerns affecting the viability and sustainability of the private hospitals covered. The results reveal that financing, government policies, human resources, and organizational issues, if addressed by the government, could serve as positive incentives to hospital owners and decision makers to further engage in the provision of health care services in rural areas. The results could provide useful information to policy makers in assessing the impact of existing government hospital regulations. Moreover, the study may also provide some insights on how the private sector can be harnessed to invest in health care, especially in rural and poor areas in the country