The COVID-19 disruptions wreaked havoc on the country's delivery of basic health services. Primarily affected are the delivery of tuberculosis (TB) and family planning (FP) services across different levels of service delivery. This proposed panel explores the host of factors that contributed to the quick adaptations for some local government units, LGUs. Simultaneously, identify factors that acted as a stumbling block for other units to do the same. Utilizing primary and secondary data from different health units and service delivery partners, this proposed panel will discuss how health service delivery continued, albeit on a scaled-down basis. Four separate papers will discuss the initial evidence on significant factors contributing to scalable and sustainable adaptations, and these are as follows: 1) the stepping up of technology use in service delivery; 2) provision of supportive human resources support; 3)integration of various service components across different programs and health units, and lastly, 4) supportive and consistent health governance policies across different levels of health service delivery.
Technology use and adaptation in TB and FP services during the pandemic
Joselito Sescon, MA, MDE
Institute of Philippine Culture
Ateneo de Manila University
Leslie Advincula-Lopez, PhD
Institute of Philippine Culture
Ateneo de Manila University
Dennis B. Batangan, MD, MSc (Heid)
Institute of Philippine Culture
Ateneo de Manila University
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Technology use and adaptation in TB and FP services is seen through the pandemic disruptions on the demand side and corresponding commodities and healthcare workers’ services on the supply side. Technology use and adaptation is framed and analyzed through the TB and FP program processes and corresponding adjustments to adapt. These process flows are systemic and are continually redesigned to optimize the delivery of services and expected outputs. As observed in the disruptions brought about by the COVID-19, technologies are employed to enable and facilitate the health service delivery processes following the pandemic restrictions and standards.
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Technologies, including a host of digital technologies, are introduced in the adaptations and innovations in the patients’ and clients’ flow, commodity flow, and service delivery. These include digital adherence technologies in monitoring TB and FP patients, online software technologies in FP and TB program monitoring and evaluation, electronic laboratory information systems interoperable with Integrated reporting systems, and web application technologies in training. As necessitated by the situation, there is also a decisive shift to online platforms for consultation, counseling, technical assistance, and training in both the TB and FP programs. The profusion of these technology-enabled adaptations calls for the review and identification of which one has potential for scaling up and replication. Further, we highlight the learnings from the nuanced and textured experience of the health delivery systems that made the shift.
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Technology use and adaptation in TB and FP services is seen through the pandemic disruptions on the demand side and corresponding commodities and healthcare workers’ services on the supply side. Technology use and adaptation is framed and analyzed through the TB and FP program processes and corresponding adjustments to adapt. These process flows are systemic and are continually redesigned to optimize the delivery of services and expected outputs. As observed in the disruptions brought about by the COVID-19, technologies are employed to enable and facilitate the health service delivery processes following the pandemic restrictions and standards.
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Technologies, including a host of digital technologies, are introduced in the adaptations and innovations in the patients’ and clients’ flow, commodity flow, and service delivery. These include digital adherence technologies in monitoring TB and FP patients, online software technologies in FP and TB program monitoring and evaluation, electronic laboratory information systems interoperable with Integrated reporting systems, and web application technologies in training. As necessitated by the situation, there is also a decisive shift to online platforms for consultation, counseling, technical assistance, and training in both the TB and FP programs. The profusion of these technology-enabled adaptations calls for the review and identification of which one has potential for scaling up and replication. Further, we highlight the learnings from the nuanced and textured experience of the health delivery systems that made the shift.
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Supportive human resources in TB and FP services during the pandemic
Leslie Advincula-Lopez, PhD
Institute of Philippine Culture
Ateneo de Manila University
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Jessica Sandra R. Claudio, MA
Institute of Philippine Culture
Ateneo de Manila University
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Haraya Marikit Mendoza
Institute of Philippine Culture
Ateneo de Manila University
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The experience of many health workers across different locations in the country during the COVID-19 pandemic indicates the limits of technological innovations without due emphasis on the corresponding human resource adaptations to minimize disruptions in the delivery of health services. TB, Family Planning, and Adolescent Reproductive Health adjustments focused on four (4) strands. These are 1) work arrangements onsite and offsite with due consideration to the safety of healthcare workers; 2) provision of additional allowance to provide uninterrupted communication between the health workers and the clients, and also among various health workers across various levels of health service delivery; 3) the emphasis on human design in the new technology used for TB and FP services, 4) a blended approach in re-tooling the health workers’ mastery of the new TB and FP strategies implemented during the pandemic.
Integration of health service components: Pandemic and post-pandemic scenarios
Dennis B. Batangan, MD, MSc (Heid)
Institute of Philippine Culture
Ateneo de Manila University
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Jessica Sandra R. Claudio, MA
Institute of Philippine Culture
Ateneo de Manila University
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Haraya Marikit Mendoza
Institute of Philippine Culture
Ateneo de Manila University
Mitigating measures initially done by health programs in response to the COVID-19 pandemic have resulted in more lasting policy and program adaptations that are now being woven into the expected health governance shifts of the health system at the national and local levels. Parallel processes concerning the reconfiguration of program approaches are ongoing and are done in anticipation of the post-pandemic scenarios which must consider the overall framework of the Universal Health Care (UHC) and the stronger push for more local autonomy. Nevertheless, across all these policy and program transitions, key challenges remain such as the sustainability of these institutional adaptations, the harmonization of national and local health system governance, and the call for adaptations to advance the devolution of health services.
Health governance policies: TB and FP services during the pandemic
Leslie Advincula-Lopez, PhD
Institute of Philippine Culture
Ateneo de Manila University
Dennis B. Batangan, MD, MSc (Heid)
Institute of Philippine Culture
Ateneo de Manila University
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Dr. Pilar Berse
Department of Political Science
Ateneo de Manila University
The COVID-19 pandemic created unprecedented challenges to the Philippines’ health sector, particularly on existing health programs under some of the country’s most pressing concerns namely, tuberculosis and family planning. The Philippines ranks highest in terms of tuberculosis among Asian countries (Department of Health, 2021; World Health Organization, 2020) and it is viewed as a public health concern that necessitates the involvement of multiple sectors along the lines of research, public health training, proactive treatment mechanisms, as well as national and international information exchange channels to curb the disease’s spread. Family planning on the other hand, has always been a significant health concern, with high population growth identified as one of the causes of poverty and inequality (Asian Development Bank, 2009) as it threatens to contribute in pushing millions of Filipinos deeper into poverty. What disruptions on the government’s priority programs on tuberculosis and family planning were created by IATF policy issuances particularly on mobility, community quarantines, and cancellation of face to face classes? This research interrogates the tension points at the national or local level between existing health programs on family planning and tuberculosis vis-à-vis selected IATF policies that are meant to address COVID-19 related problems.