Host: Dr. Catherine Chung, ZFF Portfolio Director
Dr. Leslie Luces-Sedillo, Provincial Health Officer II, Aklan
Languages: English, Filipino
From policy to practice, Dr. Leslie Luces-Sedillo, provincial health officer II of Aklan, walked us through the unique process of building a health care provider network in her province.
Dr. Cathy: Hi. This is Dr. Catherine Chung, ZFF Director for Local Health System and with us today is Dr. Leslie Luces-Sedillo, provincial health officer II of Aklan. Hi, Dr. Leslie. Good afternoon.
Dr. Leslie: Magandang hapon. It’s good to see you, Dr. Cathy.
Dr. Cathy: Our topic for today is relevant to the goal of Universal Health Care Law na napirmahan noong 2019. In particular, we will talk about how to set up a health care provider network that is mandated by the law. The UHC Law defines a health care provider network as a group of primary–so, from the rural health units–to tertiary health care providers, offering people-centered and comprehensive care in an integrated and coordinated manner. The Department of Health has set the standards and guidelines for the formation of health care provider networks, but what does the process look in practice?
Dr. Leslie: For Aklan, the health care provider network or HCPN is operationalized in our province through the institutionalization of our district health system. We have six districts here in Aklan and each district is composed of several primary care facilities and one district hospital. We are now in the process of crafting our manual of operations to guide the flow of referrals from one facility to another in each district and so, the direction of our province is that each primary care facility will be licensed and each identified district hospital are all upgraded to level I hospital. Furthermore, there will also be a governing body in each district wherein the mayor will be the chairperson and it will be co-chaired by the chief of the district hospital in that district.
Then, there will also be an organization or a body wherein we call a support unit, which will be composed of our development management officers and district health managers assigned in that district.
What is also unique in Aklan is that to save some place sa huge part in the operations of our hospitals, we have our economic enterprise which handles our jetty port and some of our hospitals. A huge percentage of the income from our jetty port sustains the operations of our hospitals. So, every time na bumibisita po kayo sa Boracay, you’re supporting the improvement of our hospitals.
Dr. Cathy: Dr. Leslie, hindi ba ‘yong six district health system mo, it is not the original six district health system. Bakit nagkaroon ng iteration?
Dr. Leslie: Well, as you’ve mentioned Doc, we reorganized again our district health system. It’s essentially ‘yong reason nito when we crafted the district health system is that para ‘yong mga tao within that district will have easy access to the health facilities within their areas. So, we look into on how we divided the areas, especially in the municipalities kung saan po mas malapit ‘yong mga barangays sa pinakamalapit na primary care facilities. For example, in our municipality which is Nabas, the northern part of Nabas ay malapit po doon sa isang district hospital which is located up north and ‘yong southern part of Nabas is more accessible in another district hospital in another district naman. That’s why, when we check again, when we met again with the mayors and through the provincial health board, it was discussed again that we’ll have to separate this municipality into two districts. Operationally, it’s more challenging for the municipality, but for the Aklanons, or for those that are staying Nabas, it would be easier for them and more accessible if we arrange it in such a way that we are looking after their access. That’s why, there are some reconfigurations, and even in some districts wherein there are no district hospitals, there were agreements within the district to construct a new hospital. Iyon ‘yong mga magagandang developments that I’m proud to share because really in every district, it’s very unique. But what’s similar is that all are collaborating, all are cooperating, especially our leaders in health and they are in one page as to the direction when we presented this district health plan with them.
Dr. Cathy: Sa mga PHOs talagang dapat pag-isipan at pag-usapan ‘yong bubuuing district health system or inter-local health zone, depende sa context ng province kasi importante ito as a foundation to the establishment of the health care provider network. May isa pang follow-up question doon, Dr. Leslie, on that note. I think mayroon isang unique sa Aklan sa kaniyang district health system. Kasi noong una, alam ko mayroong part ng Antique na municipalities or barangays na part ng inyong district health system. Baka pwede mo rin i-share iyon?
Dr. Leslie: That’s true. Although, it’s difficult to operationalize, again at the end of the day, what we wanted is better access for every Filipino. There is one area or a town in another province na dito po sa Aklan sila talaga pumupunta, or they are seeking their health care services here in Aklan dahil po mas malapit po sila sa amin in terms of transportation. Kaya po, we decided that part of re-constructing our district health system is involving, or including municipalities of other provinces. Again, it’s in the works on how we will operationalize it, but it’s the direction that we are taking, not just in Antique, but also in Capiz because there is also one area in Capiz or another town in Capiz wherein their constituents are also accessing our health services. This will be challenging in terms of health financing as to how we are able to share resources but for now, this is what we’ve planned so that our Aklanons or even non-Aklanons can access health care easily and have better access to our health facilities.
Dr. Cathy: Laliman natin ‘yong discussion, Dr. Leslie. Isa-isahin natin kung nasaan na talaga si Aklan ngayon in terms of the health care provider network. So, let’s start with your facilities–kung nasaan na ba kayo in terms of licensing, in setting up of your network with your private sector. Can you tell us more about that, Dr. Leslie?
Dr. Leslie: Currently, we are in the process of profiling our health facilities. Very important ito kasi ito ‘yong bahay na kailangan natin ma-upgrade. So, we are profiling the health facilities to document the services that are available in each facility. Ang reason for this is that this aid us in whatever gaps in services that each facility needs to allocate budget on in the next few years. As I’ve mentioned, we are targeting that our primary care facility will be licensed by next year and we are also targeting yearly upgrades for our district hospitals.
As of now, we still need to build approximately 200 barangay health stations, and 11 primary care facilities and we need to expand our district hospitals. The health facility enhancement program or the HFEP of the Department of Health plays a huge part in realizing this goal.
Dr. Cathy: Alam ko, Dr. Leslie, kasama rin ‘yong private sector doon sa inyong na-identify sa district health system. Per district, parang mayroong isang private sector na tutulong sa inyo. Baka pwede mo pang i-share about that, Dr. Leslie?
Dr. Leslie: One of the plans that we are having is that we are engaging the Aklan Medical Society. We are engaging them through dialogues. Once we’ve established the system already, then we will be asking for help from them as to the specialists; dahil po very important po ito dahil those that are seeking help in our health facilities, once na hindi na po ito kaya ng ating primary care facilities, they will be referred to our specialists or to our hospitals and again, for easy referral and to facilitate a better system, we are looking at partnering with our private doctors, especially in the Aklan Medical society to realize again this goal so that everything will be interconnected and even the financing side will also be incorporated in this partnership.
Dr. Cathy: Ang goal ninyo ba, Dr. Leslie, is mixed health care provider network? Hindi ba sa law, ang sinasabi niya ay pwedeng government or public-public or pwedeng mix, public-private and private-private, pero dito parang mix ‘yong plano ng Aklan?
Dr. Leslie: Eventually, Doc, we would really need to partner with the private sector kasi hindi lang naman ito kaya lahat ng government so, we really need help from our partners in the private sector, most especially tapping our special T-doctors and once we’ve established our system, as I’ve mentioned, we will be really outsourcing some of the services, specialized services to these private partners.
Dr. Cathy: Para sa mga listeners natin, pwede mo i-outsource or i-MOA (memorandum of agreement) ‘yong x-ray, pwedeng mga laboratories and pati nga mga pharmacies, hindi ba, Dr. Leslie? ‘Yong mga private pharmacies?
Dr. Leslie: Yes. Pwedeng-pwede talaga kasi as of now, syempre we cannot really fast-track the structures of our primary care facilities. It entails a lot of investments and so, the easier way is really to outsource these services that are not currently available lalo na ‘yong mga laboratories. Kailangan kasi niyan–of course, you’ll have to procure your laboratory equipment’s. You’ll have to hire med techs and mahirap po ito as of this time na madaliin po natin, but in the meantime that we are still establishing the structure; we are investing in the infrastructure; we are hiring more manpower, the easier way to go is really to partner with them, with our laboratories. As you’ve mentioned, ‘yong mga x-ray, our hospitals with x-ray facilities and actually, even transport services Dr. Cathy, if they don’t have an ambulance that is licensed, even this can be outsourced para at least, while we are waiting to really have all these services within our primary care facilities, in the meantime, we can really outsource and the Department of Health is even advocating also for this partnership with our private sector.
Dr. Cathy: Now, we go to the health workers naman, Dr. Leslie. Alam natin, ‘yong establishment ng isang health care provider network ay hindi lang structure ‘yong importante doon or ‘yong kailangan doon. Kailangan din ng mga tao. Baka gusto mo kaming i-update regarding the health workers’ preparation naman ng Aklan?
Dr. Leslie: Mahirap i-operationalize ang isang primary care facility na walang tao at even ‘yong at the minimum requirements of a primary care facility, that’s already a lot and even in the current devolution transition plan, ang dami pong mga recommendations to add on to our organizational structure and this puts a toll on our municipalities; and in our discussions with the mayors and the MHOs, this is really one of their clamors that, “Doc, hindi po namin kaya ito na maibigay lahat nang ito in just a short period of time.” And so, again really financing is a problem, but of course, as you’ve mentioned, doc. Very important ‘yong how we take care of the people who is caring for others. We understand this. We feel this, especially during the pandemic dahil po sila po talaga ‘yong mga soldiers and the frontline workers that really battled COVID. They were there at the front lines and so, it’s also a time to really appreciate them and really give proper compensation. One off the discussions is also pushing for the full implementation of the Magna Carta for health workers and of course, even if it’s difficult, we are also prioritizing and lobbying for positions for our health workers in the municipalities as well as the hospitals; dahil as I’ve mentioned earlier, hindi tatakbo ‘yong mga health facilities if there is no one who will man these facilities in the respective municipalities and hospitals.
Dr. Cathy: Yes, and early on naging witness ako noon prinesent mo ‘yong mga kailangan talaga na HHR or health human resource sa mga munisipyo. Wala pa nga ‘yong mga hospitals diyan. So, talagang marami kailangan. Siguro ‘yong follow-up question ko doon, may target dates ba, for example, itong issue or challenge on HRH ay ma-address natin with the municipalities, Dr. Leslie?
Dr. Leslie: Well, it’s a constant dialogue. We will be discussing this in the succeeding health boards dahil napakaimportante po itong pag-usapan. But then again, we will always go back to the available resources that we have in our municipalities and our province. Again, we will have to be reasonable as well as to what we are asking because hindi lang naman health kung baga, ang binabudgetan ng munisipyo at ng probinsya. There are also other sectors that need also attention and budget and so, slowly we are elevating these concerns and we are actually waiting for the right time as well to really push for this, when the finances are stable kasi as of this time, with the Mandanas Ruling, we understand that the IRA is kung baga, mas konti po in the next two and that is a challenge, as well for us.
Dr. Cathy: Yes, lalo na ngayon na nasa new normal with COVID pa, but at least, you have your initiatives and plans na for the province of Aklan and naging witness ako doon, na talagang maganda ‘yong relationship ninyo with the Association of the Municipal Health Officers (MHOs) at regular ‘yong mga meetings sa FB ninyo. Palagi kong nakikita iyon. Just like the rest of the country, ‘yong health human resource talaga ay isang challenge in the implementation of UHC. Ganoon din sa establishment ng health care provider network.
Dr. Leslie: I would like to add, Dr. Cathy, I just remembered na in our current executive meeting the other day, we will be implementing the upgrading of the salary grade of our nurses in the hospitals. ‘Yong Nurse I kasi po ay nasa salary grade XI iyan and starting January, we will be implementing the new proposal which is the Nurse I will be salary grade XV and the Nurse II will be elevated to salary grade XVI. So, that is a huge help to our manpower, especially our nurses. We are very thankful also to the finance team of the province and of course, to the governor for really making sure that this will be implemented next year. Matutuwa po ‘yong mga nurses namin po dito.
Dr. Cathy: Yes, sigurado matutuwa sila syempre, ang laki noong increase ng kanilang salaries and deserve naman nila iyan dahil nga sa talagang dedication and sa dami rin kanilang mga ginagawa sa health programs natin, especially sa hospitals and sa rural health unit.
Dr. Cathy: And that marks the end of the first part of our three-part episode on the health care provider network with Dr. Leslie. But we still have two more episodes with her so don’t miss them. Wishing all of you good health. Thank you for listening.
Dr. Leslie Luces-Sedillo, provincial health officer II of Aklan, shared how the province is working on its health information system, financing mechanisms, and primary health care system. She also gave tips on how to win the cooperation of mayors in building a province-wide health system.
Dr. Cathy: Hi. This is Dr. Catherine Chung, ZFF director for the Local Health System. Welcome to the second part of our three-part episode on the health care provider network with Dr. Leslie Luces-Sedillo, provincial health officer II of Aklan.
Dr. Cathy: Dito naman, Dr. Leslie, pwede mo ba kaming makuwentuhan regarding the health information system in preparation to the health care provider network? Hindi ba kasi ang goal talaga is to really have an integrated health information system from the grounds up to the hospitals?
Dr. Leslie: Yes, Dr. Cathy. Ever since kasi problema talaga ito. Magpapakunsulta ka sa RHU, kukunan ka ng data then, i-refer ka sa ospital, kukunan ka ulit ng data. So, parang ang hirap. Why not really merge with all these information systems to make the transaction seamless and faster? So, we are thankful that the Department of Health has made electronic information systems for hospitals as well as at the level of primary care facilities, to RHUs so, i-ClinicSys for municipalities, and iHOMIS (Integrated Hospital Operations and Management Information System) hospitals. For the province of Aklan, in the past few years with concentrated on making iHOMIS functional. As of now, talagang nagagamit na po ’yong IHOMIS. Malaking tulong po ito sa mga hospitals to fast-track the transactions at the same time, even the PhilHealth reimbursements. Now, we are focusing our efforts on the implementation of iClinicSys. We have currently organized a team to oversee this. We did a full assessment of all facilities and we identified the number of computers, printers, servers, and manpower needed for its full operation. So, we are hoping and also, DOH will be providing us assistance in terms of providing this hardware like the printers, and computers, but I think, the province will also invest in this. Kailangan kasi may anim na computers bawat primary care facility para bawat station, computerized na siya. Hindi ka na paulit-ulit. Hindi na siya by paper and then, you can generate data in the fastest possible time and you can also submit it to PhilHealth easier. Then, later on, ‘yong fusion ng iHOMIS and iClinicSys na once each of these systems are in place. It will be a long journey, but again, we need to start somewhere and that’s where we are as of this time for our health information system.
Dr. Cathy: Maganda ‘yong nag-needs assessment na ang Aklan at sinasabi ni Dr. Leslie anim na computers ang kailangan. Baka may mga listeners tayo, Dr. Leslie, na mga private sector or ibang groups na makapag-provide nito sa Aklan. Iyon lang, malaking cost na iyan at napakalaking bagay pag nabigyan ‘yong mga rural health units natin.
Dr. Leslie: And we appreciate really the help of DOH sa regional office because talagang bumababa sila sa amin and they have committed to go to each municipality so that they can train the health workers on how to use the system. The Internet system will also be available in our health facilities.
Dr. Cathy: Yes, kasi ang daming GIDA (geographically isolated and disadvantaged areas) areas din sa Aklan. May mga areas na wala talagang signal and tingin ko, may napuntahan na rin kami dati noong pumunta diyan sa isang barangay or city na wala talagang signal. Mahihirapan ipadala sa PhilHealth lalo na kung kailangan ng reimbursement doon sa payment. So, importante iyon, ‘yong hardware, software, Internet at syempre ‘yong taong gagawa at mag-operationalize ng health information system. May laptop ka nga, wala namang taong marunong. So, importante na…
Dr. Leslie: Na-train.
Dr. Cathy: Kasama rin iyon sa plans ng mga municipalities at kasama rin dun sa pinondohan nila and may support ang ating Department of Health. Nababanggit na natin itong kaperahan, Dr. Leslie. How about ‘yong financing mechanism; kasi nasabi mo na rin, in development fund, may kasunduan na rin ba ‘yong mga munisipyo ninyo sa Aklan para masimulan itong special health fund or pooling of funds?
Dr. Leslie: Yes. Alam mo pag usaping pera, it’s challenging, Dr. Cathy, but what we are doing here in Aklan, we are currently in the process of finalizing our memorandum of agreement on the pooling of funds from our municipalities and of course, si province din po mag-share. So, as part of our special health funds, what we are doing is that in the MOA, each municipality and the province will be sharing 10% of their development fund to be used as an operation funds for the districts. So, iyon po ‘yong medyo unique po namin na strategy dito sa Aklan to ensure that there are really funds for health. Hindi po ba ‘yong development fund is can be used naman as to any development projects and including health. So, if talagang naka-stipulate na 10% of that will be for health, so that will be sustained. It will be every year that the province will have this pool of funds that we can really use to upgrade our health facilities to hire more manpower and general operations in health. Malaking tulong po ito once this will be operationalized and this will be signed by our municipalities. So, on the works lang po kami as to finalizing it. I think, in the next health work, we will be presenting this again to the body for approval.
Dr. Cathy: In relation to that, dahil nga pipirma nga ‘yong mga munisipyo, itutuloy na natin sa follow-up question. Importante ‘yong kaperahan, ‘yong pirma nila sa MOA, pagbibigay ng 10% na development fund doon sa sisimulan na special health fund. Kumusta naman ‘yong partnership with your municipalities? Kasi dapat pumirma talaga sila lahat to signify their commitment or terms of partnership sa probinsya. Ito ay nasa batas to signify and nagko-commit sila to a province-wide health system with Universal Health Care Law.
Dr. Leslie: Yes, Dr. Cathy. Very important iyon kasi again, this is a financial resources and nag-aagawan lahat para makakuha ng part ng IRA, ‘yong funds ng munisipyo at ng probinsya and so, there were series of discussions. We’ve talked with MHOs. We’ve talked with the mayors during their League of Municipal Mayors Meeting. We’ve talked with the municipal budget officers. Hindi siya madali. It was a series of discussions and meetings with them so as to fine-tune the memorandum of agreement and we have a legal team on board which is part of our local health board. Kaya po sila din po ‘yong tumutulong sa amin in finalizing this. So, a lot of behind the scene work is being done; a lot of rehashing and editing is being done so as to finalize this agreement. Pag na-approved po ito and everyone will sign the agreement, sa totoo lang, this will be a huge development for Aklan dahil malaking concern kasi po on where we are going to source funds to finance all these things that we want to do for Universal Health Care and if we have these funds really allotted for them, per district, it will also help to build the relationships because sila within the district, we will be planning on how they will utilize this fund. Hindi po kami makikialam sa kanilang pera. They will actually be planning and deciding on how they can use the budget. Of course, according to the guidelines set by the Department of Health. So, iyon po, Dr. Cathy. I’m really hoping that this will be successful and everyone, well so far, there were verbal agreements already coming from the mayors, from the MHOs as to these agreements. So, hopefully, there will be – ma-sign na siya para at least, it will be really sealed agreement from everybody.
Dr. Cathy: Dr. Leslie, hindi ba alam natin sa isang probinsya, hindi naman lahat iyan makakasama sa isang political party? Alam naman natin that’s a reality. Dito sa sinasabi mo, nagkakaroon ng series of dialogues and then, nag-signify naman sila ng commitment. Baka madagdagan mo pa ‘yong tips naman sa ating mga provincial health officers na nakikinig para mas makuha ‘yong commitment ng mga mayors?
Dr. Leslie: Piling-pili po ‘yong mga meetings that we are attend – kumbaga, pinipili namin kung saan na meeting kami pupunta to lobby for this. Medyo crucial na mga usapin lalo na sa pera. So, during we’ve found that very important ‘yong meeting ng mga mayors during their League of Municipal Mayors. They are regularly meeting up. Well, we, here in Aklan po, madalas po ‘yong meetings nila and doon po kami pumapasok dahil at least, it’s just that team, ‘yong audience namin. Wala nang ibang tao. It’s just the mayors. So, mas directed, mas focused po ‘yong discussion, especially if naka-agenda po sa kanila. Sinasabihan po namin ‘yong kanilang GAD (gender and development) that we will be talking about the sharing and the pooling of funds and so, mas directed po ‘yong discussions, less distractions–rather than doing it in a bigger group. Mas mahirap po iyon and also, if mahirap pa rin in that level, we will go to every municipality, we will visit the mayors in their offices and really share ito, kunwari, hindi sila naka-attend, they were prior commitments and they were not able to make it during meetings, we will visit the offices of the mayors and we will personally lobby to them para at least, naintindihan po nila kung ano po ‘yong mga current concerns that needs to be on their table and needs other decision-making, also. It’s more personal atake po on this very important concerns na kailangan po natin i-lobby lalo na finances.
Dr. Cathy: Maganda ‘yong naging strategy ng team nina Dr. Leslie aside sa maraming pag-uusap talaga. Ang dami na rin na-mention ni Dr. Leslie kaninang mga challenges niya with regards to the implementation of UHC in general and also, sa HCPN or the health care provider network establishment. Baka mayroon ka pang other challenges na naiisip mo, Dr. Leslie, and paano mo iyon na-overcome with your team?
Dr. Leslie: Even before kasi Doc, ang passage of the Universal Health Care Law, kakaumpisa na rin ‘yong Aklan in re-organizing our health care provider network way back pa. So, but one of the challenges really was when pandemic hit us, so parang tumigil lahat, nandoon sana ‘yong momentum to do all of these activities to fully implement ‘yong UHC, but here comes the pandemic and everyone and everything was stopped and put on hold. Lahat ng resources; lahat ng plans and efforts were channeled in COVID operations. So, I think that was a huge challenge for us kasi alam mo iyon, nandoon ka sa momentum, tumigil ulit and then, you have to shift again your focus in another area which is COVID operations, but now, medyo nag-stabiliz na ‘yong ating COVID. We are again going back on track where we left off in the implementation. Siguro, paulit-ulit natin itong na-mention ‘yong finances. Mayroon talaga naman mahirap talaga ‘yong financial resources lalo na we went through a huge challenge of the pandemic. So, talagang na-drain ‘yong resources. I’m sure other provinces can relate to this–an added burden which is because of the Mandanas Garcia Ruling, we will have a lower IRA in the next two years and this will definitely have a huge impact in our UHC targets because again, syempre kailangan ng malaking investment in health so that in the next few years when we have lower IRA, syempre we cannot fully allocate our budget to these health needs. I think, those are the challenges for now, major challenges. But again, we are finding ways and means through partnerships, private partnerships to help us with the needs and the gaps that we have para at least, hindi tayo nakatengga kahit konti ‘yong IRA in the next two years. We will find other means to support the health system.
Dr. Cathy: Alam din namin, Dr. Leslie, ‘yong ating probinsya has been strengthening its primary health care system and then, sa iyo nga namin nakita ‘yong isang comprehensive primary health care facility ni-represent mo iyan noong 2019. Iyan ‘yong ini-envision natin sa ating mga rural health units. Why is this important in setting up a health care provider network? Nasaan na si Aklan ngayon since noon 2019 na na-discuss natin iyan sa isang provincial health board, Dr. Leslie?
Dr. Leslie: Alam mo, sobrang importante ‘yong ating strengthening ng primary care system. Ito ‘yong heart ng entire health care system. It is the initial point of contact of our patients and our clients. So, when we facilitate a good gatekeeping mechanism, ‘yong bawat tao, each person will be directed to the proper health facility that can cater to the health services that they need at that time. In effect, with proper gatekeeping and with the strengthening of our primary care facilities, our hospitals would be decongested and our hospital beds will be allocated and made available for those that really need this for the patients that need secondary and tertiary levels of care. Kaya, Dr. Cathy, talagang we’re really emphasizing down to the municipal level to the mayors na importante ito. We really need to invest in this. We really need to expand our primary care facilities because there is no Universal Health Care without primary health care.
Dr. Cathy: That’s the real foundation of UHC. Kailan ninyo target, Dr. Leslie, na ma-license lahat ng itong primary care facilities natin sa Aklan?
Dr. Leslie: Well, we really aim to have it license all of our primary health care facilities by next year. So, we’re really hoping to reach the target. Currently naman, mine-mentor and kino-coach sila ng ating mga DMOs on the ground and we are thankful that they are really hands-on with this. Talagang tinututukan natin ito and we’re hoping that we can reach the target that by next year, we can have a more comprehensive primary care facility and in partnership of course with PhilHealth, through their financing mechanism din. You know, PhilHealth is very supportive here in Aklan; with constant dialogue and discussions with them, balitaktakan ng mga concerns and problems on the ground. They’re very fast in addressing this and fixing the system. Sana po tuloy-tuloy po ‘yong ganoon partnership and even down to the level ng ating mga primary care facility, they can fast-track also the reimbursements that is needed also for our primary care facility. If mayroon na kasi tayong kunsulta package, malaking tulong po iyon sa mga tao because there are free services that will be provided; free medicines that will really be provided. Kaya po, binabalanse po natin iyon, that the health facility and the municipality will also have stable finances, but at the same time, they’re able to provide these free services also to their communities.
Dr. Cathy: And that’s it for part two of our three-part episode with Dr. Leslie. Don’t miss the last part, where she will share tips on onboarding a new governor and takeaways on the implementation of Universal Health Care. Wishing all of you good health, and thank you for listening.
Learn from the experience of Dr. Leslie Luces-Sedillo, provincial health officer II of Aklan, in onboarding a new governor in line with the implementation of Universal Health Care.
Dr. Cathy: Hi. This is Dr. Catherine Chung, ZFF director for the Local Health System. Welcome to the last part of our three-part episode on the health care provider network with Dr. Leslie. Today’s questions will surely solicit a lot of learning so let’s get things started.
Dr. Cathy: Alam natin na ang Aklan ngayon ay may bagong governor, siguro ang tanong ko lang is the former Governor Joven Miraflores was often described as a hands-on leader. What active roles did he play to get to where you are right now in the health care provider network or the UHC attainment as a whole Dr. Leslie?
Dr. Leslie: Alam mo, we are really lucky to have former Governor Joeben Miraflores as our leader, most especially during the trying times of the pandemic. You know, he is really a bridging leader by heart and he has developed these adaptive leadership skills through the coaching and mentoring of the ZFF team. Governor Joeben as a visionary leader makes sure that all his plans that he co-planned with his team and co-created with us become really a reality. So, his secret is he frequently engages with the municipal mayors and the MHOs, especially when major decision-making is on the table and he will even go out of his way to find private partners to help us finance our projects. Also, he is a very good listener. He listens to expert opinions, but at the same time, he also listens to the voices of the people on the ground. I will never forget the time when he did his deep dive into one of the farthest municipalities in Buruanga, the team together with him, visited a family of a mother who died because of childbirth and he intently listened to the difficult journey of the mother through the storytelling of the husband and through those stories, he looked at how the mother really suffered because of the situation at that time and so, he visited all the facilities that the mother went to in order to really see first-hand the gaps on the ground and after that experience of the deep dive, every time that we will have meetings with him, he will always reference back to that glaring inequity problem that he saw first-hand and he would challenge us to take part in solution building in this health concerns. Ganoon po si former Governor Miraflores and we are really thankful to really be working with him as our leader.
Dr. Cathy: Na-experience rin namin iyan. He’s really a good listener and nag-collaborate talaga siya sa mga kasama niya sa Aklan. Naging witness ako ng mga provincial health board meetings ng Aklan at talagang ang dami kasama, ang daming nag-attend and talagang dini-discuss with his leadership ‘yong mga issues and challenges and syempre, ‘yong mga kailangan gawin sa probinsya. Ngayon, Dr. Leslie, nabanggit ko na may bago na tayong governor. Can you describe how you and your health team are adjusting under the new provincial leadership and please give us idea on how you are on boarding him? Alam kasi natin baka ‘yong mga ibang listeners natin, ‘yong mga PHOs may ganitong experience din tulad ng Aklan.
Dr. Leslie: Alam mo, ang swerte ng Aklan because I think the transition was so smooth. What’s good is the new governor has sustained all the efforts and the gains of the previous administration. So, our new governor is also a graduate of the Municipal Leadership and Governance Program or MLGP of ZFF, and similar to his father, he is also a very good bridging leader. Again, still, health is a priority of the new administration and in fact, on his first day of office, he visited us in our office and asked us personally for updates on our ongoing programs and kung ano ‘yong mga plano for our health system reforms in the succeeding years. So, you can really see his dedication and his commitment to further the gains of what we already did in the past few years and he is pushing for more reforms and for more innovations as his term unfolds. So, we are really looking forward to working closely with the new governor.
Dr. Cathy: Aside sa na-mention mo, Dr. Leslie, ‘yong working closely with the governor, may additional tips ka pa ba sa mga PHOs natin lalo na kung bago ‘yong kanilang mga governor?
Dr. Leslie: I think, it’s really basic. Constant communication is really the key to a good working relationship between the governor and us in the health sector. So, what we would always do is we would regularly give him updates on important developments and the current situation of the areas that he wants to be monitored and through the conduct of the regular provincial health board meeting. It’s an important avenue where the governor can hear concerns from the municipalities and the hospitals; and so, that’s an avenue where we co-create policies and strategies to address the issues that are raised during the session.
Dr. Cathy: Ang swerte talaga ng Aklan and we are excited to meet the governor sa kaniyang session sa October and kasama ‘yong team ni Dr. Leslie.
We are nearing the end of our program today. Dr. Leslie, please share with us your most important learning in UHC from the law’s enactment in 2019 to the start of your province’s implementation, until now.
Dr. Leslie: Alam mo, Universal Health Care implementation is really doable naman, but it just needs a lot of behind the scene work. It entails a lot of collaborative work and relationship-building amongst our fellow health workers. Importante iyon, hindi ba, Dr. Cathy, the adaptive part.
Dr. Cathy: Yes.
Dr. Leslie: Sobrang mahalaga iyon. Of course, collaborating with the crucial stakeholders to move forward with our UHC agenda. So, there are a lot of challenges to be hurdled and finances to be put in place so that our goals will be met and we really need to communicate and share a common understanding in this collaborative work.
Dr. Cathy: Seeing that you are doing a great job in implementing UHC in the province, is there any additional assistance you still hope to get from the government, Dr. Leslie?
Dr. Leslie: In terms of additional assistance, Dr. Cathy, We’ve raised this to them that we are asking for their help with their health facilities enhancement program or HFEP to sustain their assistance with us in establishing our health facilities, and our health infrastructures. As I’ve mentioned earlier, we still need to construct 200 BHS, 11 primary care facilities and we need to expand our hospitals so that they become level I facilities. Hindi po namin kaya po iyon, ‘yong probinsya at ng mga munisipyo to really finance all of these infrastructures. Talagang mahirap po dahil this entails a lot of investments and kaya po, humihingi po talaga kami ng help with them to really help us with financing all of these health facilities and aside from infrastructures support, we would also need assistance and guidance and policy support in moving forward ‘yong health financing part naman, Dr. Cathy, specifically in operationalizing the special health fund dahil I think, in the works naman na po ito, but I think in the next few months, we will have more news as to how we really can handle, or ano pa bang funds that we can pool so that our special health fund can be operationalized.
Dr. Cathy: I-emphasize natin 200 BHS at 11 primary care facilities. Baka marinig ito ng marami at masuportahan si Aklan ng DOH.
Sa mga listeners natin, kailangan ni Aklan ng 200 BHS at 11 primary care facilities. Marami iyan, Dr. Leslie.
Dr. Leslie: Yes, sobrang dami.
Dr. Cathy: Syempre, responsive na mga hospitals.
Dr. Leslie: Dapat. The mandate really is one BHS per barangay, hindi ba, Dr. Cathy?
Dr. Cathy: Oo.
Dr. Leslie: If we want to achieve that mandate, then we really need all the help that we can get in establishing and building all these health facilities.
Dr. Cathy: How about from non-government organizations like ZFF, mayroon ka pa bang assistance na kailangan ng probinsya ng Aklan at ano iyon mga assistance na iyon?
Dr. Leslie: Sobrang helpful ng ZFF, alam mo iyan, from the very start and we are very thankful for our collaboration since 2016 from PLGP, nag-move forward na tayo hanggang ngayon. Across the years, including pandemic–challenging times– the ZFF team has really invested a great foundation in building up our municipal and provincial health leaders, and because of this investment, it has really translated into better health outcomes here in the province of Aklan. Now that we are jumpstarting again, Universal Health Care implementation, of course, we would still need your guidance and support, most especially in operationalizing our district health system and to achieve our UHC goals, and of course, there are some mayors na bago and since we feel that the MLGP and the bridging leadership program is really very important sa ating mga leaders kaya po, we are again asking support from you to help us train our health leaders, our mayors on this. Kaya po, malaking tulong po iyon sa probinsya ng Aklan.
Dr. Cathy: Thank you very much for your valuable insights, Dr. Leslie.
Dr. Leslie: Nice talking to you, Dr. Cathy. Maraming salamat for your time. Dr. Cathy: And that wraps up our three-part episode on the health care provider network with Dr. Leslie. In future episodes, we will talk more about Universal Health Care. So, don’t miss them. Again, this is Doc Cathy, wishing you good health. Thank you for listening.