AO Deployment Guidelines For Public Hearing
AO Deployment Guidelines For Public Hearing
AO Deployment Guidelines For Public Hearing
ADMINISTRATIVE ORDER
No. 2013 - ____________
SUBJECT:
I.
RATIONALE
Select cadre of Human Resources for Health (HRH) are being deployed by the Department of
Health to marginalized populations and other areas of need for the purpose of augmentation and
health service delivery. Currently, the department deploys nurses, doctors, midwives, and other
health professionals under the following programs: RN Heals Program, Doctors to the Barrios
Program, Medical Pool Placement Program and Rural Health Team Placement Program. Despite
these endeavors, equity and access to critical health services remains inadequately addressed.
With the commitment to attain universal health care, the HRH must be responsive to the needs of
our country and support the achievement of our MDG targets. This would require the right
quantity, quality and relevance of HRH to our health system needs. Therefore, there is a need to
harmonize the policies and processes for the placement and distribution of health professionals
through the deployment programs.
In order to ensure the success of HRH as a strategy for universal health care, there is a need to
create standard operational and administrative directions for all HRH deployed by DOH.
This Order aims to provide the structure and mechanism for the deployment of HRH managed by
DOH.
II.
OBJECTIVES
General:
To provide policies and guidelines for implementation of the HRH deployment programs for the
purpose of improving access and health service delivery under universal health care.
Specific:
1. To provide guidelines for implementation to program managers and implementers.
SCOPE
This order shall apply to the entire public health sector, DOH bureaus, Centers for Health
Development, hospitals, DOH attached agencies including Philhealth, local government units,
and external development partners that are involved in the deployment of human resources for
health.
This order shall cover the implementation of deployment programs from the pre-recruitment to
program evaluation. This intends to unify existing guidelines for deployment of health
professionals for the purpose of improving access and health service delivery through provision
of HRH.
IV.
DEFINITION OF TERMS
1. Community health team (CHT)- is a group of health volunteers assigned to each barangay/
priority population area led by a midwife that tracks eligible population for public health
services, assist families in assessing and acting on health needs, provides information on
available services in the locality and facilitates the organization of transportation,
communication systems, outreach services and linkages with other providers in the service
delivery network (Barangay health Station, Rural Health Unit, other small private and public
hospitals and facilities).
2. Deployment- means by which select health professionals are physically transferred in areas
of need to complement the existing HRH in health facilities and for effective and efficient
health service delivery.
3. Doctors to the Barrio Program- is a DOH program that deploys doctors to doctor-less
municipal health offices/ rural health offices as prioritized by the program to serve as their
municipal health officers or rural health physicians.
4. DOH retained hospital- refers to government hospitals managed and supervised by the DOH
5. Geographically isolated and disadvantaged area (GIDA)- communities with marginalized
population, physically and socio-economically separated from the mainstream society such
as island municipalities, up-land communities, hard-to reach areas, and conflict-affected
areas
6. Human Resources for Health (HRH) refers to health professionals currently engaged in
actions whose primary intent is to enhance health. They include physicians, nurses,
midwives, dentists, and allied health professions with valid license/registration from the
Philippine Regulatory Commission (PRC). They work in the different domains of the health
system including curative, preventive and rehabilitative care services as well as health
education, promotion and research. Under UHC it is an instrument to ensure that all Filipinos
have access to professional health care providers capable of meeting their health needs at the
appropriate level of care
msp/psd/hhrdb/13-71 (Draft as of August 30, 2013, ver 4)
7. Indigenous cultural communities/indigenous peoples -as defined in Republic Act No. 8371,
otherwise known as "The Indigenous Peoples Rights Act of 1997;"
12. National household targeting system (NHTS) a data bank and an information management
system managed by the Department of Social Welfare and Development (DSWD) that
identifies who and where the poor are. The system generates and maintains the
socioeconomic database of poor households
13. Poor families- refers families whose income fall below the poverty threshold as defined by
the National Economic and Development Authority and/or cannot afford in a sustained
manner to provide their minimum basic needs of food, health, education, housing and other
essential amenities of life
14. Registered Nurses for Health Enhancement and Local Service (RNHeals)-is a DOH
program that deploys registered nurses to government health facilities utilizing training cum
deployment approach.
15. Rural Health Midwife Placement Program- is a DOH program that deploys registered
midwives to RHUs and/or BEmONC facilities particularly in the far flung areas to provide
quality health services with focus on Maternal, Newborn, and Child Health Nutrition.
16. Rural Health Team Placement Program-is a DOH program that recruits and deploys allied
health professionals to complement existing workforce of hospitals and RHUs utilizing
training cum deployment approach. This may include dentists, nurses, pharmacists, medical
technologists, physical and occupational therapists, nutritionist-dieticians, midwives, and
sanitary inspectors.
17. Universal health care (UHC)- a focused approach to health reform implementation ensuring
that all Filipinos especially the poor receive the benefits of health reform
V.
GENERAL GUIDELINES
1. All deployment programs for HRH shall promote improved access to professional health
care providers capable of meeting their health needs at the appropriate level of care
2. The success of the deployment programs shall then be monitored in terms of progress in
health outcomes, attainment of the MDGs, improvement in access to quality health facilities
and services and improvement of local health systems.
3. Deployment programs shall prioritize the poor and marginalized populations.
msp/psd/hhrdb/13-71 (Draft as of August 30, 2013, ver 4)
4. The DOH shall deploy appropriate HRH to either LGU health facilities or DOH- retained
hospitals.
5. The DOH shall engage local health systems and recognize that the LGUs have the primary
mandate to finance and regulate the local health systems including the provision of HRH
6. There shall be coordinated and harmonized participation of stakeholders, public and private
partnership; including academe, professional societies, non-government organizations
aligned to the objectives of the program.
VI.
A. Organizational Structure
HEALTH HUMAN RESOURCE DEVELOPMENT BUREAU
LGU
DOH/ DOH-RETAINED
CENTERS/ HOSPITALS
HOSPITAL
MUNICIPAL/
CITY HEALTH
OFFICE
4. The LGU
a. Establish a functional local health board of which the deployed HRH shall be part
b. Utilize resources including but not limited to the following: internal revenue allotment,
Philhealth capitation fund, reimbursements, users fees and other sources to support
programs, activities, supplies, commodities, and incentives as support to the deployed
HRH
c. Allocate funds for honoraria, remote allowance, and other provisions of under the
Magna Carta for Public Health Workers as may be applicable.
d. Provide appropriate financial and logistic counterparts for the benefit and welfare of
the deployed HRH as stipulated in the governing laws for health workers including
but not limited to transportation, lodging and miscellaneous expenses related to
conduct of their duties.
e. Support learning and development interventions and other related opportunities of
deployed HRH by allowing them to attend such activities and providing needed
allowances
f. Support policies and plans aligned with the implementation of universal health care
and adoption of national health laws.
g. It shall endeavor to hire an adequate number of skilled health professional to attain
ideal ratio or staffing standard as prescribed by DOH
h. Ensure safety of deployed HRH
i. Encourage and support innovative projects for health systems development through
financial and administrative means including provision of incentives
j. Enter into and abide by a standard contract/ Memorandum of Agreement (MOA) with
the DOH
k. Provide feedback to CHDs on the performance of deployed HRH and program
implementation
5. Deployed HRH
a. Ensure client-centered delivery of services
b. Respond effectively and efficiently to the health needs consistent with accepted
standards of care
c. Aggressively promote healthy lifestyle to reduce and prevent non-communicable
diseases
d. Initiate and participate in public health measures to prevent and control of
communicable diseases and adequate surveillance and preparedness for emerging and
re-emerging diseases.
e. Promote inter-agency and inter-sectoral cooperation for health
f. Perform other functions as mandated under the existing pertinent national laws and
protocol (eg. Local Government Code, Hospital Institutional Policies, Civil Service
Code)
g. Enter into and abide by a standard contract/ Memorandum of Agreement (MOA) with
the DOH
h. Provide feedback to CHDs on the performance of recipient LGUs/ hospitals and
program implementation
6. PhilHealth and other development partners
a. Utilize financial instruments and strategies to motivate HRH and promote retention
through grants, incentives, capitation, and other means.
b. Allocate funds for improvement of health facilities and working environment/
conditions of deployed HRH
c. Provide support for the development of HRH and local health systems projects,
scholarships, and research.
3.
4.
5.
LGUs submit requests for additional HRH to CHDs along with necessary
supporting documents
CHDs evaluate and validate:
a. LGUs as qualified recipients
b. LGUs request for additional HRH
CHDs submit a list of qualified recipients to HHRDB
HHRDB evaluates requests and finalizes the list of qualified recipients and
their HRH allocation for feedback to CHD
CHD coordinates results with requesting LGUs
The HHRDB shall open the application for the deployment programs on their
prescribed schedule. Job posting/ publication shall be done through the web page,
school announcements/ publication, contact persons, media, civil service
commission bulletin, as deemed appropriate. It shall include the requirements,
core competencies, and benefit package. The information on where to apply shall
also be included.
A. Hospitals
1. HRH applies to the hospital and undergoes hospital recruitment and selection
process.
2. Hospital endorses qualified HRH to DOH through the CHDs
3. CHDs validate the list of selected applicants and submit to HHRDB
4. For Physicians: HHRDB processes the appointment papers/ contracts of
selected HRH
5. For other HRH: CHD processes the appointment papers/ contracts of selected
HRH
B. RHUs and City Health Offices (CHOs)
1. HRH accomplishes the application form and undergoes recruitment and
selection process of the CHD-HRDU or through its extension offices. All
regional applicants must file a letter of application addressed to the regional
director.
2. CHD-HRDU recommends qualified HRH to the Regional Director
3. CHDs endorses the list of selected applicants to HHRDB
For Doctors: HHRDB processes the appointment papers/ contracts of selected
HRH
For Other HRH: CHD-HRDU processes the appointment papers/ contracts of
selected HRH
Pre-deployment
HHRDB shall conduct pre-deployment orientation for doctors.
CHDs will conduct regional pre-deployment orientation for other HRH to be
deployed in the RHUs and CHOs within their catchment areas. A maximum of 2
week regional orientation or exposure shall be observed provided that the necessary
preparations in the area of deployment and other conditions for deployment have been
met.
Hospitals shall also conduct institutional pre-deployment orientation
Deployment
A. Hospitals
For Physicians:
1. Upon approval of appointment or contract, HHRDB issues a Department
Personnel Order (DPO) relevant to their places of assignment
2. Physicians report to their areas of assignment
3. HRH submits daily report of attendance to Hospitals
4. Hospitals submit the monthly report of attendance to HHRDB
5. HHRDB process payments for deployed HRH
For Other HRH
1.
2.
3.
4.
5.
Retention strategies
The recipient of deployed HRH shall support and endeavor to retain the deployed HRH in
their facility and abide by stipulations of their signed MOAs.
For Hospitals: Within 3 years from the date of initial appointment, shall endeavour to
provide regular items for deployed HRH
For RHUs and CHOs: Within 2 years from date of initial deployment, shall prepare ways and
means for hiring of deployed HRH
In cases, wherein the recipient facility fails to retain the deployed HRH from the national
government, it shall ensure that the loss of the HRH that will not result to the following:
a. Loss of existing PHIC accreditation of health facility
b. Discontinuation of development projects from funding of development partners
c. Compromise of critical health programs related to attainment and sustainability of
HRH
Logistical support, Funding Source, and Budget utilization
a.
The deployment of HRH shall be considered a special program under the HHRDB
b. All direct and incidental expenses related to deployment shall be charged against
DOH funds.
c.
HHRDB shall sub-allot fund to CHDs for the payment of salaries or stipends of other
HRH and other related activities as specified by the program.
d. All direct and incidental expenses for activities conducted by CHD personnel related
to conduct of technical assistance, capacity building, monitoring, and providing
logistical support to deployed HRH shall be charged against CHD funds.
e.
All direct and incidental expenses on activities conducted by HHRDB personnel
related to program implementation and monitoring shall be charged against HHRDB
funds.
f.
Transportation expenses incurred during the initial deployment of HRH to the areas
of assignment and during the termination of the contract or end of appointment shall
be charged to DOH funds. Expenses incurred during attendance to learning and
development activities shall be charged to the sending office unless otherwise
specified by the sponsoring office.
Other special provisions
Recruitment of HRH for deployment programs shall prioritize recipients of national
scholarship programs. After having complied with the minimum requirements,
graduates from the scholarship programs sponsored and managed by DOH shall be
accepted in the HRH deployment programs.
The implementation shall be consistent with the governments commitment to zerocorruption and anchored on participatory governance transparency and accountability
in all levels.
msp/psd/hhrdb/13-71 (Draft as of August 30, 2013, ver 4)
VII.
REPEALING CLAUSE
All other issuances inconsistent with the provisions of this Order are hereby repealed/rescinded
and modified accordingly.
VIII. SEPARABILITY CLAUSE
If for any reason, any part or provision of this Order be declared invalid or unconstitutional, such
shall not affect the other provisions which shall remain in full force and effect.
IX.
EFFECTIVITY DATE
HHRDB
HPDPB
ATC
OSEC
The minimum threshold of 23 doctors, nurses and midwives per 10,000 population that was established by WHO as necessary
to deliver essential maternal and child health services
i