Primary health care for noncommunicable diseases in the Philippines: An exploratory mixed-method study in select local government units

Abstract

Background: Primary health care (PHC) is an important strategy in the prevention and control of noncommunicable diseases (NCD). Over the last ten years, the Philippine health sector has attempted to strengthen service delivery and health financing for PHC to address NCDs. This study aimed to describe and identify the challenges and best practices for NCD services in select local government units (LGUs) in the Philippines.

Methodology: Using a sequential exploratory mixed-method design, surveys were conducted to determine the subnational PHC capacity for NCDs in 12 LGUs and 24 public primary care facilities. This was followed by semistructured interviews with 23 health administrators and PCF staff from different provinces of the country. LGUs were purposively sampled to represent different levels of urbanization and levels of income.

Results: The Philippines' PHC capacity was inadequate for its rising incidence of NCDs. Barriers were numerous: absence of multisectoral plans and integrated approaches, inadequate health budgets despite multiple overlapping financing sources, and lack of health human resources and training opportunities for NCDs. Enablers included the rare case of synergistic leadership across government administrative levels and the augmentation of financing by the national government.

Conclusions: Facilitating Philippine leadership away from vertical approaches to PHC requires technical guidance from the national government to curate a menu of cost-effective interventions across the life course as well as capacity-building for local executives and health staff to determine appropriate implementation strategies.