Law Summary
Objective
- To provide the foundation and purpose for Department of Health (DOH) support in Urban Health System Development (UHSD).
- To define directions and framework for UHSD implementation in the Philippines.
Scope
- Applies to the entire health sector involved in UHSD, including DOH, Centers for Health Development (CHD), DOH-retained hospitals and attached agencies.
- Includes city governments, national and city Official Development Assistance (ODA) partners.
- Serves as a guide for technical assistance to City Health Offices developing urban health systems.
Goals and Objectives of UHSD
Goals:
- Improve health system outcomes: better health, equitable healthcare financing, responsiveness, and client satisfaction.
- Influence social determinants of health, focusing on urban poor and slum populations.
- Reduce health inequities pronounced in urban settings.
General Objective:
- Address urban health challenges.
Specific Objectives:
- Raise awareness on urban health issues.
- Initiate inter-sectoral approaches.
- Guide local government units (LGUs) in sustainable urban health responses.
Definition of Terms
- Urban Areas: Based on population density, barangay size, economic establishments, and administrative classification.
- City Classification: Highly Urbanized, Independent Component, and Component Cities defined by population, income, and administrative independence.
- Rapid Urbanization: Autonomous socio-economic-political-cultural process resulting in increased urban density.
- Urban Health System: All entities and processes in urban settings protecting or improving population health.
- Social Determinants of Health: Critical societal factors impacting health, such as education, housing, sanitation.
- Equity in Health: Universal access to highest health standards without social discrimination.
- Health Inequity: Systematic health disparities among social groups.
- Slum: Low-income settlements characterized by poor housing, lack of services, overcrowding, insecurity, and poverty.
General Principles
- Healthy Urbanization: Promotes public health amid rapid urban growth.
- Inter-Sectoral Action: Collaborations beyond health sector to address social determinants.
- Inter-City Coordination: Resource sharing and collaboration across neighboring cities.
- Social Cohesion: Strengthening community groups for effective policy representation.
- Community Participation: Active involvement of communities in health initiatives, from planning to sustaining.
- Empowerment: Enabling communities to control decisions affecting their wellbeing.
Components of UHSD in the Philippines
Programs and Strategies:
- Healthy Cities Initiatives (HCI): Continuous improvement of urban environments and community support.
- Reaching Every Depressed Barangay (RED): Community-led approach to address health needs in depressed barangays.
- Environmentally Sustainable and Healthy Urban Transport (ESHUT): Urban transport planning promoting health, safety, and environmental protection.
Planning Tools and Framework:
- Urban Health Equity Assessment and Response Tool (Urban HEART): Evidence-based tool to identify health inequities for targeted intervention.
- City-wide Investment Planning for Health (CIPH): Framework for mobilizing city resources and partnerships to meet health goals.
Capability Building:
- Short Course on Urban Health Equity (SCUHE): Six-month course to equip practitioners and policymakers with equity-focused urban health approaches.
General Guidelines
- National programs must tailor strategies for urban health and integrate them into city-level investment plans.
- Emphasize equity performance and inter-sectoral coordination in program designs.
- Generate data to provide evidence for policies addressing urban poor and vulnerable groups.
- Foster social cohesion, community participation, and empowerment in interventions.
- Collaborate with other sectors to address social determinants comprehensively.
- Use UHSD frameworks (HCI, RED, ESHUT) to guide program interventions.
- Utilize Urban HEART findings for situational analysis and planning, particularly in Highly Urbanized Cities.
- Include equity-focused interventions in CIPHs and Annual Operation Plans (AOPs).
- Encourage national program managers to enhance UHSD expertise through capacity building.
Implementing Mechanisms
- The Bureau of Local Health Development (BLHD) responsible for UHSD policies, systems, and capacity building.
- DOH offices to integrate UHSD standards and strategies in national programs.
- CHDs to develop capacities, assist cities in system development, and appraise investment plans.
- A National Technical Working Group to guide UHSD development nationwide.
Roles and Responsibilities
Bureau of Local Health Development (BLHD):
- Issue policies and provide guidance on UHSD.
- Direct CHDs in technical assistance and capacity development.
- Provide funding support for CIPH and SCUHE.
- Serve as secretariat to the National UHSD Technical Working Group.
Centers for Health Development (CHDs):
- Lead collaboration with cities on urban health initiatives.
- Advocate and orient cities on UHSD and CIPH.
- Provide technical assistance and appraise city plans.
- Support regional UHS initiatives and ensure alignment with national policy.
City Health Office (CHO):
- Lead local UHS initiatives and planning under city government authority.
- Coordinate with city departments and LGUs affecting health.
- Monitor health outcomes impact.
- Facilitate inter-sectoral and inter-LGU coordination.
- Align local initiatives with national policies.
Repealing Clause
- Supersedes all previous issuances inconsistent with this Order.
Effectivity
- The Order takes effect immediately upon issuance on July 12, 2011.