“Prevention is better than cure.” It is an adage that one might find appropriate as we consider the state of our healthcare system and our country’s handling of the COVID-19 crisis. For the 10th iteration of the Interdisciplinary Book Forum, we are once again discussing a book that examines the condition of the Philippines’ healthcare system, Securing a Continuum of Care: The Challenges of a Fragmented Health Sector, written by Carlo Irwin A. Panelo, et al. The forum will be held online on October 27, 2021 (Wednesday) at 3:00PM. Audiences may tune in through our Facebook Live.

Like the featured book of the 8th IBF (Some Days You Can’t Save Them All by Ronnie Baticulon), this title provides timely insights on our country’s healthcare during the pandemic despite being written before it. Securing a Continuum of Care focuses on the effects of the 1992 mandate to devolve the management and delivery of health services from a national level to local government units. While this decentralization may have had good effects, it has caused problems with accessibility especially to the poor. It has also resulted in inconsistent healthcare across the different regions of the country. This was emphasized further by the pandemic and the varied responses of local government units to the crisis.

This relates directly to the Philippines’s longstanding problem with understaffing. We see this manifest now in hospitals closing their COVID wards as the number of infected workers continues to rise, and more personnel resign due to inadequate financial support and overwork in a hazardous environment. There is news of funneling increased POGO taxes to healthcare, but this leaves one to wonder if this and other solutions could have been done earlier to prevent a systemic collapse rather than recover from it. In a fragmented health sector, it is also crucial to ask if these band-aids will be effective across all regions.

Securing a Continuum of Care investigates the multiple deficiencies of our devolved healthcare system and suggests improvements on policies to address them. UP Press Director J. Neil Garcia emphasizes the importance of such a book and a forum during a pandemic: “In many ways the UP Press distinguishes itself as an academic publisher in our country because of the kinds of purposive titles it has been inclined to publish across the decades. Doubtless among them are books that deploy an intersectional and cross-disciplinal approach in unpacking governmental problems and public policy issues, to which they offer helpful new perspectives and solutions. The title we are featuring for this 10th outing of the UPP-Likhaan Interdisciplinary Book Forum focuses on the question of public health, assessing the effect of decentralizing reforms that this sector underwent 25 years ago on the health and wellbeing of the vast majority of Filipinos, who are poor. Written by its authors before the pandemic, this book’s insights on the strengths and weaknesses of our country’s health sector now find renewed currency and relevancy, especially when their overall critique of the decision to restructure and devolve our country’s public health delivery system away from the Department of Health to local government units may need to be revisited and rethought—challenged on one hand, reinvigorated on the other—in view precisely of the difficult situation and systemic national and transnational circumstances that constitute and permeate the ongoing global health crisis.”

A multisectoral approach is paramount to solve our healthcare crisis. Joining us in the 10th IBF are doctors and scholars who are involved in the study, management, and development of healthcare policies: Dr. Ma. Victoria Raquiza, an associate professor at the UP National College of Public Administration and Governance; Dr. Leslie Ann Luces Sedillo, a provincial health officer in Aklan; Dr. Paolo Medina, faculty at the Department of Family and Community Medicine in UP Manila; and Dr. Beverly Lorraine Ho, a director of the Department of Health. Facilitating the discussion is Prof. Gerry Los Baños, deputy director of the UP Press and a professor of English and Creative Writing.

Dr. Panelo expounds on the book’s relevance to our healthcare, then and now: “This is a must-read for those who want to better understand how healthcare is delivered and financed. Taking a serious look at the health system of the Philippines is a must to ensure a more inclusive, responsive and resilient health system for Filipinos.”

Join our discussion on October 27, 3PM. We hope that through this forum, we can encourage more informed decision-making for the country’s healthcare, and ultimately, pave the way for a more robust health service that is accessible to all Filipinos, even when we have recovered from the COVID-19 crisis.


ABOUT THE BOOK

Securing a Continuum of Care: The Challenges of a Fragmented Health Sector offers a timely analysis of how the devolution of health service delivery to local government units (LGUs) has reduced the effectiveness of the health care system in providing a continuum of care for poor Filipinos. The book describes the progress in improving health outcomes during the last twenty-five years, and how national-to-local fragmentation and social determinants have affected the health of Filipinos. The book discusses three structural weaknesses that have prevented earlier reforms from effectively addressing these challenges and thus improving health outcomes. Lastly, the book examines how these structural weaknesses have prevented improvements in health outcomes in the case of eight specific health problems.

With the benefit of long-term hindsight, Securing a Continuum of Care hopes to contribute to the development of new policies and strategies that will address the structural weaknesses of a devolved health sector and, ultimately, improve the health of Filipinos.”


ABOUT THE PANEL

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Beverly Lorraine Ho is the concurrent Director for Health Promotion Bureau and Disease Prevention and Control Bureau at the Department of Health – Philippines.

Immediately prior, she was Chief of Research Division of the Health Policy Development and Planning Bureau where her efforts significantly contributed to the passage of key legislation on sugar-sweetened beverage tax, tobacco tax and universal health care. She has also worked in the Philippine Health Insurance Corporation and the Asian Development Bank.

Bev is a fellow of the Maurice Greenberg World Fellows Program at Yale University, the Equity Initiative and the Atlantic Institute. She holds an MD from the University of the Philippines and an MPH in Health Policy and Management from the Harvard T.H. Chan School of Public Health as a Fulbright Scholar.

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Ma. Victoria (Marivic) Raquiza is Co-Convenor of Social Watch Philippines and is an Associate Professor of the National College of Public Administration and Governance (NCPAG), University of the Philippines Diliman, where she teaches courses on poverty, inequality, the developmental state and governance as well as on social policy. She received her MA degree in Development Studies from the Institute of Social Studies, The Hague, Netherlands and her PhD degree from the City University of Hong Kong. She sits in a number of government inter-agency bodies related to social protection, and is currently a Board Member and Fellow of the Social Weather Stations.

Marivic lived in North Cotabato, Mindanao in the early nineties, working with poor farmers to promote a sustainable rural development program when she was with the Philippine Rural Reconstruction Movement (PRRM). She promoted lifelong learning programs with various stakeholders in Southeast Asia when she was with the Asia South Pacific Bureau for Adult Education as well as the SDGs as an active member of Social Watch Asia.

Marivic was part of a number of official country delegations to different UN conferences particularly focused on social development, the MDGs and later the SDGs and on financing for development. She has published on the themes of social equity, the conditional cash transfer program, on social policy and on the state of poverty and inequality in the Philippines.

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Leslie is a Provincial Health Officer I in the Province of Aklan Aklan. She is also currently an Acting Chief of Hospital of the Provincial Hospital as well as overseeing the operations of the other 7 public hospitals of the province. She is also at the forefront in managing the integration of the preventive and the curative healthcare system of the entire province. Prior to this position, she served as a Municipal Health Officer of Pintuyan, Southern Leyte under the Doctor to the Barrios program of the Department of Health. After three years of professional service in remote and underserved communities, she held the distinction of being the Most Outstanding Doctor to the Barrios in 2010 and she was a recipient of the Outstanding Young Aklanon Award in 2011. With years of experience as a public health and policy specialist, Leslie is now leading the implementation of the universal health care law in her province. Working alongside the local government’s leadership, her mission is to achieve health equity and improve the overall health of all Akeanons, especially the underprivileged and the vulnerable

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Dr. Medina, or “Doc Lopao” as he is more popularly known within his personal and professional circles, is a Community Medicine and Primary Health Care Practitioner-Educator with more than five years’ experience in local health systems development as the Municipal Health Officer of the island municipality of Quezon, Quezon from 2009 to 2014. Since 2015, he has taught his discipline at his alma mater, the University of the Philippines College of Medicine (UPCM), as an Assistant Professor and has been the course coordinator for the UPCM-PGH Internship in Community Medicine since AY 2017-2018 up to the present. In his first year of teaching, he was awarded the UP Medical Alumni Society Outstanding Teacher Award for Clinical Clerks for AY 2015-2016 (LU6) and has also received the said distinction for different UPCM year levels in AY 2018-2019 (LU5 and LU6) and AY 2019-2020 (LU6). Last August 08, 2021, he was recognized as the UPMASA Missouri-Southern Illinois Chapter Outstanding Medical Teacher for Academic Year 2020-2021 at the “Salimbay” 112th UP College of Medicine Commencement Exercises and Philippine General Hospital Closing Ceremonies.

Doc Lopao is also one of the founding partners and founding Vice President of the Alliance for Improving Health Outcomes, Inc. (AIHO), an NGO seeking to “enable people to make health systems work for people” and is presently serving as one of its board of trustees. He is also a founding board member of the Philippine Society of Public Health Physicians (PSPHP).

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Gerry Los Banos is Deputy Director of the UP Press and heads it’s editorial department. He teaches English and Creative Writing with the UP Department of English and Comparative Literature.