Philippines: Health Sector Development Program

Sovereign Project | 33278-013

Latest Project Documents

Project Data Sheets (PDS) contain summary information on the project or program. Because the PDS is a work in progress, some information may not be included in its initial version but will be added as it becomes available. Information about proposed projects is tentative and indicative.

The Public Communications Policy (PCP) recognizes that transparency and accountability are essential to development effectiveness. It establishes the disclosure requirements for documents and information ADB produces or requires to be produced.

The Accountability Mechanism provides a forum where people adversely affected by ADB-assisted projects can voice and seek solutions to their problems and report alleged noncompliance of ADB's operational policies and procedures.

In preparing any country program or strategy, financing any project, or by making any designation of, or reference to, a particular territory or geographic area in this document, the Asian Development Bank does not intend to make any judgments as to the legal or other status of any territory or area.

Project Name Health Sector Development Program
Project Number 33278-013
Country Philippines
Project Status Closed
Project Type / Modality of Assistance Loan
Source of Funding / Amount
Loan 2136-PHI: Health Sector Development Program
Ordinary capital resources US$ 200.00 million
Loan 2137-PHI: Health Sector Development
Ordinary capital resources US$ 13.00 million
Strategic Agendas Inclusive economic growth
Drivers of Change Governance and capacity development
Sector / Subsector

Health - Health sector development and reform

Gender Equity and Mainstreaming Gender equity
Description Improving the health status of the poor in selected provinces (convergence sites) through better access to quality health services. The program will support the implementation of health sector reforms described in the Health Sector Reform Agenda of the Department of Health. The project will help selected LGUs develop a comprehensive and integrated local health system, in accordance with DOH policy and priorities but addressing local needs through adequate local solutions. The program will also help DOH and its regional offices (Centers for Health Development) better fulfill their role and functions in the context of devolution, and provide adequate support to LGUs in improving health services delivery.
Project Rationale and Linkage to Country/Regional Strategy To be determined.
Impact Improve health status of the population, especially of the poor and achievement of health related Millenium Development Goals (MDGs).
Project Outcome
Description of Outcome Increase utilization of affordable and financially sustainable quality health services by the poor based on progressive implementation of the Health Sector Reform Agenda.
Progress Toward Outcome There was a steep increase in the use of health services, in both project and control sites. This is confirmed by field visits during the project completion review mission which noted that newly expanded or constructed hospitals were already overcrowded.
Implementation Progress
Description of Project Outputs

A. Health Financing Reform - Financial sustainability of the national health insurance improved and insurance coverage of the poor extended.

B. Hospital Reform - Improved governance, operational efficiency, and service provision of public hospitals

C. Public Health Reform - Increased utilization of cost-effective public health programs and primary health care services

D. Regulatory Reform - Improved quality, accessibility, and safety of health care-related products, facilities, and services

E. Local Health System Reform - Rational delivery of local health services through formation of interlocal health zones (ILHZs) and private sector partnerships

F. Health Sector Governance - Increased public accountability and improved organizational effectiveness of health service providers

Status of Implementation Progress (Outputs, Activities, and Issues)

The project consisted of six outputs implemented through two funding streams. DOH financed consultancy and capacity building activities and investment to support the health sector reform agenda. MDFO financed civil works activities undertaken by participating provinces in terms of upgrading health facilities.

(i) Health Financing Reform the project developed and implemented both at national and local level an increase in membership coverage and utilization of PhilHealth benefits, information campaign, especially targeting the poor. At project completion there was (i) an increase in the health budget of participating provinces, however only a minimum increase in the percentage share of the provincial budget; (ii) an increased awareness in the National Health Insurance Program among the households in the participating provinces; and (iii) although there was a decrease in the number in PhilHealth sponsored membership but the percentage coverage vis-a-vis population of poor households exceeded 100% in the participating provinces. Utilization of benefits remains an issue.

(ii) Hospital Reform HSDP supported the construction and upgrading of health facilities. At completion, (i) the project upgraded 8 health facilities. 5 in Ilocos Norte (Nueva Era RHU, Dingras RHU, Dingras District Hospital; Bangui District Hospital; Gen. Roque B. Ablan Sr. Memorial Hospital and 3 in Oriental Mindoro (Pinamalayan District Hospital, Roxas District Hospital Oriental Mindoro Provincial Hospital), consisting of 4 district hospitals, 2 rural health units, and 2 provincial hospitals, and 3 DOH retained hospitals(Batangas Medical Center, Batangas, Mariano Marcos Memorial Hospital and Medical Center, Ilocos Norte and Veterans Regional Hospital, Nueva Vizcaya. Cvil works included construction of obstetric ward, emergency room, private wing, and others, and are fully operational. However, there are design problems in terms of space, location of services, and also quality problems of fixtures, floors and doors. Overall quality of civil works appears good; (ii) procured various medical equipment amounting to $2.2 million for the 3 DOH retained hospital to improve the quality of maternal and child health services and emergency care, and enhance hospital operations. There was no change in the proportion of public hospitals with existing governing boards, however there was an increase in public hospitals with existing policy on hospital autonomy. With regard to the proportion of public hospitals/municipalities with a management information system (MIS), the project achieved an increase but lower than expected. It was however noted that RHUs and CHOs have an existing Field Health Service Information System that function as the MIS.

(iii) Public Health Reform the project reviewed, developed and implemented social marketing and advocacy plans. It has also developed guidelines for planning and managing health programs for indigenous communities. It was noted that the proportion of LGU spending on health allocated to public health reform programs and activities, showed a decrease or no change at all; some eligible RHU staff were trained on management guidelines while a number of all eligible hospital staff were trained on clinical procedure guidelines (CPGs).

(iv) Regulatory Reform - HSDP supported the approval of DOH AO No 2011-09 (National Pharmacovigilance Program) which outlines the general and specific guidelines on the implementation arrangements, identification of concerned government agencies to be involved and their respective responsibilities. It also facilitated the localization of some regulatory laws such as health codes, facility based delivery, newborn screening and accreditation of health facilities at LGU level. At completion, PhilHealth accreditation for OPB, MCP and TB-DOTS of sample RHUs increased.

(v) Local Health System Reform there was limited progress achieved under this component. The basic overall functionality of ILHZs in the project provinces existed only in name where structural pre-requisites dominated over functional components. The indicator on ILHZs having a formal referral system is the same from 2007 to 2011. There was an increase in the public-private partnerships in project provinces.

(vi) Health Sector Governance HSDP supported the development of two resource and learning centers in DOH. The Resource Center for Health Systems Development (RCHSD) has been operational since 2009 as the main resource center. It initiated various capacity building and knowledge sharing activities such as health expenditure tracking system, burden of illness and economic evaluation of diseases, standards of health and human rights-based approach, and performance governance system to strengthen capacity to support health sector reform implementation. It was noted that policies on accountability were already built in other agencies' guidelines such as Commission on Audit and Civil Service Commission. On the development of HSIS, there was no change for both the project and control provinces but both achieved the target of having at least one HSIS developed to improve the reliability of health data .

Geographical Location To be determined.
Safeguard Categories
Environment B
Involuntary Resettlement
Indigenous Peoples
Summary of Environmental and Social Aspects
Environmental Aspects
Involuntary Resettlement
Indigenous Peoples
Stakeholder Communication, Participation, and Consultation
During Project Design Key stakeholders were consulted during the project preparation phase.
During Project Implementation Key stakeholders including government offices, development partners, and CSOs participate through health partners meetings, JAPI and other sector coordinating activities led by DOH
Business Opportunities
Consulting Services To be determined
Procurement To be determined.
Responsible ADB Officer Gerard Servais
Responsible ADB Department Southeast Asia Department
Responsible ADB Division Human and Social Development Division, SERD
Executing Agencies
Department of Finance
Margarito B. Teves
DOF Building
Bangko Sentral ng Pilipinas Complex
Roxas Blvd., Manila, Philippines
Concept Clearance 02 Mar 2003
Fact Finding 01 Apr 2004 to 07 May 2004
MRM 01 Oct 2004
Approval 15 Dec 2004
Last Review Mission -
PDS Creation Date 30 Nov 2006
Last PDS Update 26 Sep 2013

Loan 2136-PHI

Approval Signing Date Effectivity Date Closing
Original Revised Actual
15 Dec 2004 10 Jan 2005 12 Jan 2005 30 Jun 2007 - 30 Jun 2007
Financing Plan Loan Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 200.00 Cumulative Contract Awards
ADB 200.00 15 Dec 2004 200.00 0.00 100%
Counterpart 0.00 Cumulative Disbursements
Cofinancing 0.00 15 Dec 2004 200.00 0.00 100%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating Satisfactory Satisfactory - Satisfactory - Satisfactory

Loan 2137-PHI

Approval Signing Date Effectivity Date Closing
Original Revised Actual
15 Dec 2004 10 Jan 2005 12 Jan 2005 31 Dec 2011 30 Sep 2012 16 May 2013
Financing Plan Loan Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 13.00 Cumulative Contract Awards
ADB 13.00 15 Dec 2004 11.95 0.00 95%
Counterpart 0.00 Cumulative Disbursements
Cofinancing 0.00 15 Dec 2004 12.60 0.00 100%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating Satisfactory Satisfactory - Satisfactory - Satisfactory
Title Document Type Document Date
Health Sector Development Program Project/Program Completion Reports Aug 2014
Health Sector Development Project Project/Program Administration Manual Jun 2007
Health Sector Development Program Progress Reports on Tranche Releases Nov 2006
Health Sector Development Program Reports and Recommendations of the President Nov 2004

Evaluation Documents

See also: Independent Evaluation

No documents found.

The Public Communications Policy (PCP) establishes the disclosure requirements for documents and information ADB produces or requires to be produced in its operations to facilitate stakeholder participation in ADB's decision-making. For more information, refer to the Safeguard Policy Statement, Operations Manual F1, and Operations Manual L3.

Requests for information may also be directed to the InfoUnit.