Philippines Sentrong Sigla Movement

1
Philippines Sentrong Sigla Movement

• Improving the Quality of Health Services in a
  Decentralized Health System
• Lessons Learned from a National Certification
  Program

2
Introduction

• Definition
• SS is a quality improvement initiative through a
  certification/recognition program. Health
  facilities are certified based on a set of
  standards
• SS also promotes continuous quality improvement
  as a complementing strategy

3
Introduction

• Steps in the Certification Process
• Philippines Department of Health (DOH) provides
  copies of quality standards to local government
  units (LGUs)
• LGU facility conducts self assessment
• Mayor/Governor sends letter of intent to
  participate
• DOH SS teams conducts assessment
• LGU facility gets certified, receives SS seal
• Certified facility gets monitored twice a year
  and tries to strive for higher level standards

4
Lessons Learned

• Interest in QI is universal but a supportive
  environment is needed to make it happen
• Everyone likes the idea of QI
• SS provided simple, practical steps to improve
  quality of health services
• SS provided motivation through certification

5
Lessons Learned

• SS became a successful model of how a national
  government can influence local behavior under
  devolution
• Getting LGUs to comply with national standards
  and policies major challenge
• LGUs resent heavy-handed approach
• SS respects local interest and priorities without
  compromising standards of quality

6
Lessons Learned

• Political support is a critical success factor
• Applies both at the national and local level
• Program should have a political value and appeal

7
Lessons Learned

• Champions for quality in health care come from
  many sectors
• Politicians, planners, private sector
  representatives, community influentials
  championed the cause for SS
• Multisectoral interest interest and support
  prodded health workers to take action

8
Lessons Learned

• Development of standards required extensive
  consultations
• Consensus building through consultation
• Bridging gap or balancing between technical
  requirements and realities in the field
  providers perspective and clients perspective

9
Lessons Learned

• Progressive standards are needed to sustain
  interest in SS certification and to provide
  guidance to LGU facilities
• Experience with Baby Friendly Initiative
• CQI interface with static standards

10
Lessons Learned

• Cash incentives maybe counterproductive
• Divert attention away from doing real quality
  improvement work
• Demoralize facilities not given cash incentives
  in spite of being certified
• Not sustainable

11
Lessons Learned

• Credibility of certification depends on quality
  of assessment
• Assessment should be accurate
• Develop further skills of assessors

12
Lessons Learned

• Minimal involvement of private sector reduced
  program impact
• Enhance credibility of certification program if
  private sector is involved

13
Lessons Learned

• Link with Philippine Health Sector Reform (HSR)
  enhances value and sustainability of SS
• Interface with Philippines HSR initiatives
• Adopted by Philippine Health Insurance
  Corporation SS certified facilities are eligible
  to be reimbursed for selected primary health care
  services
• Integrate with HSR