Health Service Delivery Network

Goal of Universal Health Care Healthy individuals

Healthy families
Healthy communities

-improve health outcomes

-provide financial risk protection
-provide quality access to health services
Health Systems and facilities
-national
-international
-LGUs: P-C-M
-GO / OGO
-NGOs
-other stakeholders
Model of health care services Outputs
-changes in
health status

Health care systems

-public
-private
Health care
-indigenous
services
-voluntary
-curative
-preventive
Inputs -promotive
-health status -rehabilitative
-health problems
-resources
The WHO Health Systems Framework
Levels of Health Care

Tertiary
Secondary
Primary
 Referral System
 Tertiary Facility

 Secondary Facility

 Primary Facility- Rural Health Unit /Clinics

Village Health Stations

BHS
 Health Care Providers

Length of Cost of
Training Training
P h y s i c i a n s

Paramedics/Allied Health

Community Health Workers

Availability Accessibility # of People

Served
 Guiding principles
1. Universal health care targets and
outcomes shall guide the goals and
objectives of Service Delivery -other local government units
Network(SDN) -other stakeholders

2. Local Government Units have

control over its health system GO GO
and may enter into a form of NGO others NGO others
agreement with other LGUs for
purpose of coordinating or RHU RHU
consolidating efforts, services
and resources.
 0 DOH
Guiding principles 3 hospitals
ITRMC
3. SDN is an instrument to improve, MMMHMC
strengthen service delivery and 0
ensure continuity of services. 2 Provincial Hospitals
District Hospitals
City Hospitals
PGH 0 Municipal Hospitals
1
Kidney Center- Heart Center- Lung Center RHUs
4. All hospitals and health Rehabilitation Center
facilities shall be part of
referral network. Dialysis Centers Laboratories
 Guidelines in establishing the service delivery network
1. SDN refers to the network of facilities and
providers within the province or city-wide
health systems
-offering a package of health care services in an
integrated and coordinated manner similar
to the local health referral system.

2. SDN shall ensure access to quality care for every family in

the province/city for: Health
-health interventions, Primary Health Care and Primary Care system
-emergency, medical/surgical intervention in general hospitals
-referral links to specialty hospitals and other health facilities
family
3. SDN may be initiated or composed by both public private
public and private hospitals and other health
facilities. others

4. The different levels of care as to type of health facility

and services in an SDN are described as follows:
4. a. level of care:
-population health interventions
-primary health care(health promotion
and preventive health care)
-primary care
First contact of care that offers basic health services including
emergency service and provision of normal deliveries.
Health Facilities Services available
-population health care
-Rural Health Units with
-health promotion
a network of Barangay -counselling
Health Stations -immunization
-Primary care facilities -check ups/screening services
-laboratory exams
-Private clinics and -facility-based deliveries
infirmaries including -treatment and other services
birthing homes
4. b. Level of care: emergency. medical, surgical intervention
-accessed through a general hospital that provides for all kinds of illnesses,
diseases, injuries or deformities or through a specialty hospital that
specializes in a particular disease or condition or in one type of patient
Health facility:
-General hospitals
(level 1, 2, 3)
-Specialty hospitals
Services available:
-clinical services on Medicine: Family
Health, Pedia, Internal Medicine,
OB-Gyne and Surgery
-emergency services
-out-patient services
-specialty services: organ/age group
4.c. level of care: other special care
Provides continuing care and follow-through consultations on a short
or long-term basis.
Services available:
Health facility:
Other health facilities incl: -long-term rehabilitation care
-custodial psychiatric care (mental dse/disorders/impairments)
-drug abuse/rehab centers -clinical laboratories, radiology,
-sanitaria nuclear medicine
-diagnostic/therapeutic -CT scan, mammography
facility
-trauma facility
-specialized outpatient care
-ambulatory surgical clinic, -other specialized services: dialysis,
dialysis clinic, oncology center ambulatory surgical
etc.
Service delivery network in action
1. patient to RHU……….to the network
…to the provincial ….to ITRMC
hospital

2. Home visit….referred to RHU…to the network

….to Philippine
Orthopedic
Center

…to Rural
Health Unit
Service delivery network in action
3. police/traffic aide vehicular/road accident…….network

Provincial
hospital
ITRMC

4. after HIV advocacy….HIV test…..referral…tx hub

SLH SLH
ITRMC RITM
RITM
Service delivery network in action
5. Immunization Animal
bite DOH for vaccine supplies
center
…if necessary, hospital for
appropriate wound care
RHU
City-Mun
6. disease surveillance hospital
Dengue case District
-RHU report RHU
hosp
-hospital report
-radio
DOH
-social media Private Prov’l
-barangay report Hosp hosp
-tsismis etc DOH
hosp
Each family connected to the health system

Health
system

family
• Key characteristics of good service delivery
Good service delivery is a vital element of any health
system.
Service delivery is a fundamental input to population
health status, along with other factors, including
social determinants of health.
The network of service delivery should have the
following key characteristics. 5. Quality
6. Person-centered
1. Comprehensiveness
7. Coordination
2. Accessibility
8. Accountability and efficiency
3. Coverage ..
4. Continuity
• Key characteristics of good service delivery
1. Comprehensiveness: A comprehensive range of health services is
provided, appropriate to the needs of the target population, including:
-preventive
-curative
-palliative
-rehabilitative services and
-health promotion activities
• Key characteristics of good service delivery
1. Comprehensiveness:
2. Accessibility: Services are directly and
permanently accessible with no undue barriers of
cost, language, culture, or geography.
Health services are close to the people, with a routine
point of entry to the service network at primary care
level (not at the specialist or hospital level).
Services may be provided in the home,
the community, workplace, or health facilities
as appropriate.

Company clinic
School clinic
• Key characteristics of good service delivery
1. Comprehensiveness
2. Accessibility
3. Coverage: Service delivery is designed so that all people in a defined
target population are covered, i.e. the sick and the healthy, all income
groups and all social groups.
• Key characteristics of good service
delivery
1. Comprehensiveness
2. Accessibility
3. Coverage
4. Continuity: Service delivery is organized to
provide an individual with continuity of care
across the network of services, health
conditions, levels of care, and over the
lifecycle.

..a two-way referral system

Key characteristics of good service -licensing
delivery -accreditation
1. Comprehensiveness -certification
2. Accessibility
3. Coverage
4. Continuity
5. Quality: Health services are of high quality,
i.e. they are effective, safe, centered on the
patient’s needs and given in a timely fashion.
Key characteristics of good service delivery
1. Comprehensiveness
2. Accessibility
3. Coverage
4. Continuity
5. Quality: Health
6. Person-centeredness: Services are organized
around the person, not the disease or the financing.
Users perceive health services to be responsive and
acceptable to them.
There is participation from the target population in
service delivery design and assessment.
People are partners in their own health care.
Key characteristics of good service delivery
1. Comprehensiveness
2. Accessibility
3. Coverage
4. Continuity
5. Quality: Health
6. Person-centered
7.Coordination: Local area health service
networks are actively coordinated, across
types of provider, types of care, levels of -functional 2-way referral system
service delivery, and for both routine and
emergency preparedness. -functional Local Health Boards
The patient’s primary care provider
facilitates the route through the needed
services, and works in collaboration with
other levels and types of provider.
Coordination also takes place with other
sectors (e.g. social services) and partners
(e.g. community organizations).
Key characteristics of good service delivery
1. Comprehensiveness
2. Accessibility
3. Coverage
4. Continuity
5. Quality: Health
6. Person-centered
7. Coordination
8. Accountability and efficiency: Health
services are well managed so as to achieve the
core elements described above with a minimum
wastage of resources.
Managers are allocated the necessary authority
to achieve planned objectives and held
accountable for overall performance and
results.
Assessment includes appropriate
mechanisms for the participation of the target
population and civil society.
 Birthing Metro Manila
Station hospitals
Rural
Private -other regions
Health hospitals
Unit 1-2
DOH-
Private
Tertiary
hospitals
Health
Mun.-City
hospitals Prov’l for all
others
hospital
District
hospital
end