By Francis Allan L. Angelo
Investments in health care will help boost the economy amid the COVID-19 pandemic, according to an official of the National Economic and Development Authority (NEDA).
In an interview with Daily Guardian on Air via Aksyon Radyo-Iloilo on Friday, NEDA-6 assistant regional director Arecio Casing Jr. said improving the health system in the local level will give the public confidence to go out again from their homes, thereby kickstarting the local economy.
“If we have a very good health care system, people will be confident to go out once more and economic activity will resume. That will bode well for our local economy,” Casing said.
Casing made the statement in the context of the Regional Recovery Plan (RRP) 2020-2023 which NEDA crafted to guide local government units (LGUs) and regional line agencies.
The plan required some PhP393.355 billion that must be invested from 2020-23 so that Western Visayas can rebound from the effects of the pandemic.
Based on the plan, the economic sector would require the largest allocation of PhP253.318 billion or 64.40 percent of the total, which include the Agriculture and Fisheries and Industry and Services sectors.
The Social Services thematic area has the second biggest investment requirement at PhP73.080 billion or 18.58 percent covering the following sectors of health, education and training, social protection and housing.
A total of PhP32.363 billion is allocated for infrastructure and transport (8.23 %), PhP31.987 billion for governance (8.13%), and PhP2.607 billion for environment (0.66 %).
The funds will be sourced from the regular and re-aligned budgets of the regional line agencies and local government units.
DISRUPTION
Based on the RRP, the COVID-19 pandemic has severely disrupted the performance of the health sector.
Implementation of essential health programs, the universal health care, health promotion programs, mental health and the PhilHealth programs were hampered resulting in poor accomplishment in some health indicators and non-implementation or delayed implementation of these health programs.
While the region has managed to address the absence of COVID-19 laboratories and isolation facilities, lack of health professionals and other frontliners, and inadequacy of emergency supplies and medical logistics, the pandemic disrupted basic health services in various areas.
“The imposition of enhanced community quarantines in the region in response to COVID-19 pandemic has disrupted the routine operations of health programs and other essential health services in all levels, primary health care setting and hospital operations. Support systems and interventions were prioritized for COVID-19 prevention, detection, isolation and management which resulted in compromise and displacement of health service delivery for non-COVID programs,” the RRP read.
With the restrictions on the mobility of people and limited public transportation facilities, there was a decrease in the pre-natal, post-natal and immunization services and on tuberculosis treatment.
The RRP also noted an increase in the prevalence of raised blood pressure which could be attributed to the anxiety and fear of COVID-19.
But the good news is that the prevalence of tobacco use decreased, which could be an indicator that people prioritize buying food items rather than non-food products during the pandemic.
The document also cited limited access to primary health care and non-COVID related health programs.
Delivery of primary health care services was disrupted, further limiting access of vulnerable population such as senior citizens, immune-compromised individuals, women, children, persons deprived of liberty (PDL), persons with disabilities (PWDs) and members of indigenous people (IPs) and internally displaced persons (IDPs), etc.
This was brought about by the temporary closure of out-patient departments of hospitals, animal bite centers, HIV treatment facilities, family planning clinics, immunization clinics, newborn screening (NBS) continuity services, maternal and child health services, TB programmatic management of drug-resistant (PMDT) clinics, diabetic/hypertensive clinics, among others.
Border and travel restrictions also hampered the preventive and screening diagnostics such as TB testing, NBS confirmatory testing, HIV testing, non-communicable diseases workups/refill of maintenance medications, etc.
“This resulted to the inadequacy of DOH-centrally procured logistics at the regional level like essential medicines, e.g., antiretroviral therapy (ART), TB drugs, drugs for anti-hypertensive, anti-diabetics, vaccines and paraphernalia, micronutrient supplements, and the like. With no available air, sea and land transportation, the distribution of logistics to local government units, hospitals and other health service implementers was also delayed,” it added.
Moreover, the financial support for non-COVID services was limited since the budget support was prioritized to COVID-19 related activities, logistics, and human resources for health.
Financial support for non-COVID services was limited since budget support was prioritized to COVID-19 related activities, logistics and human resource for health.
It is expected that there will be an increase in the volume of infectious waste materials such as disposable masks from households and health care facilities due to the rising number of COVID-19 patients.
Also, solid wastes from packaging materials of establishments will increase due to the surge in the delivery of food and other essential products/supplies. These require strict implementation of infection prevention and control.
The lack of facilities for proper management of remains of persons with COVID or similar symptoms is also a challenge.
While there are many funeral parlors, there are only a handful of crematoriums in Western Visayas.
“In Iloilo City there is only one crematorium, which is privately-owned and managed while Bacolod City has three private crematoriums. As a rule, remains of persons who have manifested similar symptoms, with or without confirmatory results, have to be cremated.”
In compliance with the national government’s standards in the management of the dead on COVID-19, public and private health facilities, in coordination with the LGUs and the relatives of the deceased will facilitate the cremation of the body of COVID-19 patients within 12 hours after death.
Health facilities/centers will ensure that the bodies would be properly stored in a morgue, inside a freezer, while awaiting cremation, to prevent untimely decomposition and the spread of pathogens.
MENTAL HEALTH AND HOSPITAL COST
The pandemic also revealed the inadequate mental health and psychosocial support service (MHPSS) providers.
“The COVID-19 pandemic has created a situation where one has no longer a sense of control resulting to increased anxiety among the population. People fear of infection, loss of employment, and the lack or limited financial capacity in providing essential needs such as food and medicines. Quarantine protocols will be more challenging for some segments of populations such as adolescents, elderly, immune-compromised, pregnant women, children and those with existing health problems. Psychosocial stressors and social stigma could affect the mental and psychosocial well-being of individuals, families and communities. It is thus essential that psychosocial health support is in place to protect the mental health and psychosocial well-being of individuals especially those COVID-19 positive cases,” the RRP added.
The Department of Health (DOH) in Western Visayas has trained 89 personnel to provide MHPSS to various provinces and cities. Moreover, there are 387 Municipal Health Officers, nurses and other health care workers trained in Mental Health Gap Action Program (mhGAP) who can provide basic mental health care services.
“With rising cases of COVID-19, more trained mental health and psychosocial support service personnel are needed to address mental health problems. Moreover, mental health services should be accessible to the population,” it added.
COVID-19 patients also had to deal with the high cost of hospitalization.
Hospital expenses of COVID-19 positive indigent patients were partially covered by PhilHealth Insurance while those who are not indigents can avail of a case-to-case scheme.
The package for mild pneumonia in the elderly or those with co-morbidities amounts to PhP43,997; moderate pneumonia, PhP143,267; severe pneumonia, PhP333,519; and critical pneumonia, PhP786,384.
Case rate covers mandatory services, such as hospital accommodation, laboratory, supplies, equipment, and professional fee, among others, both for public and private hospitals.
The Western Visayas Medical Center (WVMC), a sub-national laboratory accredited by the DOH and PhilHealth, can cover the testing expenses of probable or confirmed COVID-19 cases.
PhilHealth can provide the members with these benefits, especially during the pandemic. For those who are not yet members or have gaps in paying their contributions, automatic membership and even automatic eligibility of the PhilHealth benefits are still assured.
These supports, however, just cover a fraction of the expenses one incurred when hospitalized with COVID-19. Already, hospitalization costs for COVID-19 patients run to hundreds of thousands of pesos, especially with prolonged recovery period in the hospitals.
