The main objective of the study was to develop and adapt financing strategies and options for the over-all health delivery system of the provision. A situation analysis was done to draw out the problem areas where a health financing design is needed. This situation analysis involved focus group discussions for gathering clients’ perspectives and key informant interviews for gathering providers’ perspectives. The focus group discussions were conducted in 12 municipalities of Surigao del Norte.
Recommendations were: (a) Establishment of an integrated and comprehensive network of health facilities of varying capabilities, prioritization of health services. The LGU should review its priorities and map out strategic areas within which allocations will be prioritized. The design of the health financing system for Surigao del Norte is dependent on an integrated health delivery system within the structure of the District Health System of different local government units (LGUs). Each LGU health district will have a core referral hospital with well-defined catchment areas. The secondary health facilities will offer a variety of health services; (b) Re-prioritization of health services. The LGU should review its priorities and map out strategic areas where allocations should be prioritized; (c) Inter-LGU cost-sharing mechanisms. This involves cost-sharing of expenses wherein the provincial government shoulders the personnel expenses while the municipal government shoulders maintenance and operating expenses; (d) Improvement and implementation of a health insurance scheme, specifically the social insurance scheme under the Philippine Health Insurance Corporation and community-based health insurance schemes like the “tampuhay” and the SURIMAA. Tampuhay is a local version of fund pooling that can be fashioned into a health insurance scheme. In Tampuhay, the mothers of a community agree to contribute a fixed amount to an investment fund. The interest and capital are divided among the participants in time for the fiesta. The SURIMAA, on the other hand, is a mortuary fund; (e) Exploring ways of reducing banking sector interest charges; and (f) Institution of reforms at the provincial level by: asserting the province’s share of the devolution equalization fund to get a bigger share of the cooperative pharmacy and IRA fees; tapping sources of provincial government funds other than the IRA allotment, such as mining fees and the national wealth tax; cost-recovery mechanisms such as procuring drugs in bulk quantities, charging fees for usage of medical supplies in the core referral hospital, and charging consultation fees for off-office hours consultation and for non-emergency cases.
