Navigating Health Financing Challenges with Bayang Malusog: Insights from Quezon and Aklan

On July 18, 2024, the Zuellig Family Foundation (ZFF) held its second Bayang Malusog Community of Practice (CoP) session. This event focused on sharing good practices and finding innovative solutions for financial sustainability within Universal Health Care (UHC) implementation. 

During the two-hour session, Dr. Kristine Villaseñor, the Provincial Health Officer of Quezon Province, shared how they have integrated financial management into their system as a Primary Care Provider Network (PCPN) sandbox site of the Department of Health (DOH). J-Lorenz Dionisio, UHC Focal Person for Aklan, talked about their governance model for managing the Special Health Fund. Aklan is one of the four Health Care Provider Network (HCPN) demonstration sites of DOH, alongside Benguet, Laguna, and Sarangani.

Quezon’s Financial Integration and Challenges

In Quezon, the journey towards effective health financing has been marked by both progress and hurdles. Dr. Villaseñor highlighted the opening of their Special Health Fund (SHF) Depository account as a key achievement. This step, led by the UHC Coordinator and the Provincial DOH Office (PDOHO), ensures that funds are properly managed and allocated. One of their notable practices is the collaboration between the Planning and Research Unit and other provincial units, which has been crucial in maintaining compliance with health policies.

Mayors or their representatives are active members of the Provincial Health Board (PHB), which strengthens the governance structure. Additionally, the Konsulta Operational Management Group has been working hard to intensify the Konsulta program. Despite these efforts, challenges remain. The primary source of the SHF is the Konsulta frontload, supplemented by funding from DOH and various tranches. However, frequent system downtimes, inadequate hardware, and slow internet have hindered progress. Monitoring the Konsulta program has also been difficult.

To address these issues, Quezon plans to continue the Konsulta Network Sandbox and develop QuezonHealthCare.com, an online platform for better health service management. They are also working on guidelines for the allocation and utilization of funds within the SHF.

Aklan’s District Health System and Governance Model

Meanwhile, Aklan’s approach to health financing is centered around the establishment of a functional Aklan District Health System. J-Lorenz Dionisio explained their goal of creating six District Health Systems (DHS) to streamline healthcare delivery and improve access to services.  

The organization of these DHS and their respective management teams is ongoing. Aklan has been drafting a Memorandum of Agreement (MOA) for provincial and municipal collaboration, including a policy on sharing resources. They are expanding their Management Support Unit (MSU) to support district operations and have been hiring additional accountants and district health managers.

The MSU assists the Provincial Health Office of Aklan implement the updated health care Konsulta package for the province having been selected as an HCPN demonstration site. They are also working on a draft manual for the HCPN referral system to ensure responsiveness within each district.

The Provincial Governor convenes Aklan’s expanded PHB regularly, with all the mayors, Provincial and Municipal Health Officers present or represented. ZFF’s Provincial and Municipal Leadership and Governance Programs assisted the local government units to align with the #oneAklan vision for health.

Collaborative Efforts and Future Directions

Both Quezon and Aklan are navigating the complexities of health financing with determination and innovative solutions. Through the Bayang Malusog CoP virtual sessions and the Bayang Malusog Exchange (BMEx) online platform, accessible at https://healthinnovex.org, they continue to share insights and strategies, supporting each other in their journey towards achieving their UHC goals.

Dr. Kathrine Flores of the DOH – Bureau of Local Health Systems Development said, “It is important for us to document this journey and share experiences with each other so that we know what we can replicate to our locality.” Alongside Quezon and Aklan are Apayao, Baguio City, Benguet, Biliran, La Union, Laguna, Northern Samar comprising the first batch of the Bayang Malusog CoP. The next virtual session is in September.