LEARNING OBJECTIVES At the end of the course the participants shall be able to: 1.

Define what is Disaster Risk Reduction and Management in Health (DRRM-H);

2.

Discuss the policies and framework in DRRM-H, namely: a. Sendai Framework b. Philippine Disaster Risk Reduction and Management Act of 2010, RA 10121 c. Universal Health Care Act of 2018, 11223 d. FOURmula One Plus e. National Objectives for Health 2017-2022 f. DRRM-H Framework

3.

Demonstrate an understanding of the 5K Approach.

DRRM-H Planning Guide: Module 1 [Introduction to Disaster Risk Reduction and Management in Health]

Disaster Risk Reduction and Management in Health (DRRM-H)

The Philippine Health Agenda Guarantee 2 ensures that health services delivered through Service Delivery Networks (SDNs) are available 24/7 even during disasters. This warrants uninterrupted health services to avert preventable morbidities and mortalities as well as ensure that no outbreaks occur secondary to disasters. In the delivery of these services, gender-sensitive, culturally-appropriate, inclusive approaches are considered. These goals are consistent with national and international policies such as the Sendai Framework for Action, Republic Act 10121 or the Philippine Disaster Risk Reduction and Management Act of 2010, the Philippine Health Agenda, National Objectives for Health and the Fourmula One

Plus. In order to realize these goals, it is imperative that Disaster Risk Reduction and Management in Health (DRRM-H) be institutionalized at all levels of governance.

Disaster Risk Reduction and Management in Health is an integrated, systems-based,

multi-

sectoral process that utilizes policies, plans, programs, strategies to reduce health risks due to disasters and emergencies, improve preparedness for adverse effects and lessen adverse impacts of hazards to address the needs of affected population with emphasis on the vulnerable groups.

Sendai Framework The Sendai Framework for Disaster Risk Reduction 2015–2030 (SFDRR) was born from the need to ensure DRR policy reflects our evolved understanding of the complexity of disaster risk in the twentyfirst century (Aitsi-Selmi, et. al., 2015). It was found that economic loss related to disasters was estimated to have exceeded USD 1.3 trillion over the 2000-2012 period, and 700,000 lives were lost during the same time period, and more than 1.5 billion were affected by disaster in various ways. To develop the framework (UNISDR 2013). the UNISDR or United Nations Office for Disaster Risk Reduction organized and facilitated several global, regional, national, and intergovernmental negotiations and technical meet-

ings in the period preceding the World Conference on Disaster Risk Reduction (WCDRR) 2015. SCOPE: Applies to the risk of small-scale and large-scale, frequent and infrequent, sudden and slowonset disasters.

DRRM-H Planning Guide: Module 1 [Introduction to Disaster Risk Reduction and Management in Health]

The Sendai Framework have seven global targets: 1.

Substantially reduce global disaster mortality by 2030, aiming to lower average per 100,000 global mortality rare in the decade 2020-2030 compared to the period 2005-2015.

2.

Substantially reduce the number of affected people globally by 2030, aiming to lower average global figure per 100,000 in the decade 2020-2030 compared to the period 2005-2015.

3.

Reduce direct disaster economic loss in relation to global gross domestic product (GDP) by 2030.

4.

Substantially reduce disaster damage to critical infrastructure and disruption of basic services, among them health and educational facilities, including through developing their resilience by

2030. 5.

Substantially increase the number of countries with national and local disaster risk reduction strategies by 2020.

6.

Substantially enhance international cooperation to developing countries through adequate and sustainable support to complement their national actions for implementation of this Framework by 2030.

7.

Substantially increase the availability of and access to multi-hazard early warning systems and disaster risk information and assessments to the people by 2030.

(UNDRR, 2019)

It also have Four Priorities for Action, namely: 1. Understanding disaster risk 2. Strengthening disaster risk governance to manage disaster risk 3. Investing in disaster risk reduction for resilience 4. Enhancing disaster preparedness for effective response and to “Build Back Better” in recovery, rehabilitation and reconstruction As a way to streamline regional and international cooperation, the Sendai Framework requests regional and international organizations to support countries and other stakeholders in the implementation of this framework, including the development of relevant sector policies and standards, monitoring

mechanisms and the strengthening of capacities. Expected Outcome: Substantial reduction of disaster risk and losses in lives, livelihoods and health in the economic, physical, social, cultural, and environmental, asse

Philippine Disaster Risk Reduction and Management Act of 2010, RA 10121 RA 10121: “An act strengthening the Philippine Disaster Risk Reduction and Management System, providing for the National Disaster Risk Reduction and Management Framework and institutionalizing

the National Disaster Risk Reduction and Management Plan, appropriating funds therefor and for other purposes.” (NDRRMC, 2010)

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This act changed the policy environment and the way the country deals with disasters from mere response to preparedness. It provides a comprehensive, all-hazard, multi-sectoral, inter-agency, and community-based approach to disaster risk management through the formulation of the National Disaster Risk Management Framework. This law also promotes the development of capacities in disaster management at the individual, organizational, and institutional levels. A very important feature of this law is its call for the mainstreaming of disaster risk reduction in physical and land-use planning, budget, infrastructure, education, health, environment, housing, and other sectors. RA 10121 also recognizes local risk patterns and trends and decen-

tralization of resources and responsibilities and thus encourages the participation of NGOs, private sectors, community-based organizations, and community members in disaster management. It inhibits the full participation of the Local Government Units (LGUs) and communities in governance. The approach tends to be “response-oriented” or “reactive.” This is evidenced by the widespread emphasis on post-

disaster relief and short-term preparedness, such as forecasting and evacuation, rather than on mitigation and post- disaster support for economic recovery. (Official Gazette of the Republic of the Philippines, 2010)

Universal Health Care Act of 2018, 11223 RA 11223: “An act instituting universal health care for all Filipinos, prescribing reforms in the health care system, and appropriating funds therefor” (Official Gazette of the Republic of the Philippines, 2019) The Universal Health Care Act is the first of its type in the Western Pacific region, this is s particu-

larly remarkable considering the strong presence of the private sector in the Filipino health system existing in parallel with a fragmented and devolved government health service. The Act prescribes system reforms in accordance with the multiple financing and service delivery mechanisms at work in the Philippines. From a technical perspective, the major reforms of the Act will consolidate existing yet fragmented financial flows, increase the fiscal space for benefit delivery, improve the governance and performance of devolved local health systems and institutionalize support mechanisms such as health technology assessment and health promotion. In the first half of 2019, the Department of Health and the Philippine Health Insurance Corporation will produce the operational guidelines on how to carry out the provisions of the Act; and WHO will contribute what it can, where appropriate. Since the issuance of the Universal Health Care Act, the HEMB has given importance to the following deliverables: 1.

Development of health service package for emergencies;

2.

Development of an SDN model in emergencies and disasters; and

3.

Development of HEMB package of TA services for the CHDs and LGUs.

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FOURmula One Plus Fourmula One (F1) for Health is the implementing framework for health reforms (The FOURmula One Plus for Health (F1Plus for Health) is the blueprint of the health sector plans and commitments for

the medium term) 2017-2022 as the medium-term strategic framework which expands the four pillars of health reform and highlights greater focus on performance accountability towards the Filipino people Under the Fourmula One Plus for Health the Department of Health organizes its health sector initiatives into 4 Pillars namely: 1. Financing 2. Service Delivery 3. Regulation 4. Governance

Each of these components have been operationalized into flagship programs, projects and activities for implementation at the national as well as local levels.

The F1Plus for Health Strategy Map Logical Framework: The FOURmula One Plus for Health (F1Plus for Health) is the blueprint of the health sector plans and commitments for the medium term. Multi-sectoral collaborations: The overarching goal of providing the Universal Health Care (UHC) can on-

ly be achieved through the collective efforts of all stakeholders. This framework is also aligned to the following: Philippine Development Plans, Sustainable Development Goals 2030, and the long-term vision of Filipinos embodied in the Ambisyon Natin 2040 . COURSE DRRM-H Planning Guide: Module 1 [Introduction to Disaster Risk Reduction and Management in

● The f1plus for health strategy map serves as our logical framework, it is the blueprint of the health sector plans and commitments for the medium term. ● This presents the primary strategies and the desired outcome in line with the four pillars of: governance, financing, service delivery, regulation, and a cross-cutting initiative on performance accountability. ● But while DOH assumes the role of a national health policymaker and regulatory institution, it recognizes the contribution of other stakeholders in shaping the health of the population. the overarching goal of providing Universal Health Care (UHC) can only be achieved through the collective efforts of all stakeholders. To ensure the accessibility of essential quality health services at appropriate levels of health care.

Key Strategies: 1.

Access to quality essential health products and services.

2.

Ensure equitable access to health facilities.

3.

Ensure equitable distribution of HRH.

4.

Engage service delivery networks (SDNs).

SERVICE DELIVERY is … 

Where we shall ensure equitable access and distribution to quality essential health products, services, facilities, and distribution of human resources for health.



Access to quality essential health products and services will be done through a comprehensive essential health service package, that will be available in strategic locations.



HRH requirements will be more strategically mapped and planned for, while the DOH will also be engaging other government agencies in order to ensure adequate production of HRH, both in quality and quantity.



Further, HRH distribution will be made more equitable, by providing competitive compensation and better working conditions especially in underserved areas that need HRH the most.



Facilities and practitioners will now also be organized into service delivery networks, providing strategic and well-defined catchment areas.

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

These SDNS will utilize gatekeeping mechanisms and two-way referral mechanisms in order to ensure appropriate and efficient service delivery.



Imagine a High-speed trains, known for being fast and on time. it also ensures the comfort and well -being of all its passengers. Try to consider in emergency/ disaster, how fast and on timely can we deliver our service, how well do we considers the overall wellbeing of our victims/responders.

PRIORITY ACTION POINTS 1.

F1 Plus for Health Strategic Commitments and Milestones.

2.

Advance implementation sites for SDN Establishments.

3.

Closing the gaps in human resources for health and health facilities in 4th-6th class municipalities.

In our plans and program implementation, this should be top on our concern and focus, contributing and attaining our commitments, high involvement of advance implementation sites and the vulnerable in the implementation of our programs.

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National Objectives for Health The National Objectives for Health (NOH) 2017-2022 serves as the medium-term

roadmap

Philippines

towards

achieving

universal health care (UHC). It specifies the objectives, strategies and targets of the Department of Health (DOH) FOURmula One Plus for Health (F1 Plus for Health) built along the health system pillars of financing, service delivery, regulation, governance and performance accountability. This ultimately leads to the three major goals that the Philippine Health Agenda aspires for: (1) better health outcomes with no major disparity among population groups; (2) financial risk protection

for

all

especially

the

poor,

marginalized and vulnerable; and (3) a responsive health system which makes Filipinos

feel

respected,

valued

and

empowered.

General Objective: Access to essential quality health products and services ensured at appropriate levels of care. Specific Objective: Access to quality essential health products and services increased.

Sub-pillar and Key Interventions: Intensified strategies to reduce public health threats through resilient health systems and provision of essential health goods and services during times of disaster and emergencies. Indicator 33: Target = 100% - percent of disaster affected area with no reported outbreaks (disaggregated by locus, e.g. within/ outside evacuation centers) ● Strategic Objective: The DOH will work towards a resilient health system --- It will adopt a holistic, comprehensive and community-centered approach – the Kaligtasang pangKalusugan sa Kalamidad sa Kamay ng Komunidad (5K) or the “disaster health safety in the hands of the community” approach to ensure continued provision of quality care even in disasters and emergency situations.

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●LGUs will be capacitated to enable communities to be the prime mover of Disaster Risk Reduction and Management in Health (DRRM-H), which will be institutionalized in all levels of governance by:

(1)

developing and implementing DRRM-H plans

(2)

organizing trained and equipped health emergency response teams

(3)

ensuring availability and accessibility of health

emergency commodities, and (4)

ensuring functionality of Operation Centers (OPCEN).

● The DOH will ensure that its programs and interventions will be directed towards the following: (1) reducing vulnerabilities and enhancing capacities of communities; (2) building and strengthening capacities of communities to anticipate, cope and recover from the negative impacts of emergencies and disasters; (3) supporting life preservation and addressing basic subsistence needs of affected population; and (4) helping restore and improve facilities, livelihood and living conditions and organizational capacities of affected communities, in line with “building back better.”  The National Disaster and Epidemic Management Systems will be enhanced by strengthening

epidemiology and surveillance units especially in provinces, cities, municipalities and barangays. The private sector will be engaged in surveillance and response. Remember: 

The health system will be resilient only when there is continuity in the delivery of health services in emergencies and disasters, and when the number of preventable morbidities and mortalities is reduced, thus, averting emergency and disaster-related outbreaks.



Through the NOH, the Department of Health hopes to ensure uniform understanding of the F1 Plus

for Health and guide agencies, local government units (LGUs) and other stakeholders in translating medium-term health policy directions, strategies and benchmarks into concrete programs and projects that will allow all Filipinos, especially the poor, to readily access and use affordable quality care, and thereby boosting universal healthcare.

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Building a Disaster-Resilient Philippines

5K approach or the Kaligtasang pangKalusugan sa Kalamidad sa Kamay ng Komunidad (Health Disaster Safety in the Hands of the Community) will guide planned at all levels of governance to formulate disaster risk reduction measures of the four thematic areas. This approach will help achieve the goals of the Philippine Health Agenda through institutionalizing DRRM-H in the health system. The 5K Approach is in line with the National Disaster Risk Reduction Management Framework’s (NDRRMF) vision of the country to have a safer, adaptive and disaster-resilient Filipino communities toward sustainable development. Health Resilience ● Capacity of a health system to absorb, adapt and transform when exposed to a shock such as pandemics, natural disasters or armed conflict and still retain the same control on its structure and functions. (Blanchet, 2017) The Bureau works intensely to obtain the 5K vision, in the long run, ensures a healthy and resilient people

and communities through focusing our efforts in Disaster Risk Reduction and Management in Health.

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DRRM-H Framework

Uninterrupted health service delivery during emergencies and disasters

Averted preventable morbidities and mortalities and other health effects secondary to emergencies and disasters

No outbreaks secondary to emergencies and disasters

DRRM-H institutionalization and strengthen institutional capacity on DRRM-H

DRRM-H Plan

Health Emergency Response Teams

Health Emergency Commodities

Functional Emergency Operational Center

Governance

Health Service Delivery

Resource Mobilization and Management

Information and Knowledge Management

Increased investment in Disaster Risk Reduction and Management in Health

In this framework it shows that through increase investments in the health system (health human resource, commodities, equipment, there will be enhancement in the process in governance, service delivery, resource mobilization and management and information and knowledge management.) this

shall workout the establishment of outputs such as the DRRM-H Plan, Health Emergency Response Teams, Health Emergency Commodities and functional Emergency OpCen, preparing the health system and community in anticipating emergencies and disasters, and shall become operational whenever necessary, vital in response operations (provision of essential public / medical health services).

Improvements and development of this system shall capacitate us become more resilient contributing to outcomes of uninterrupted health service delivery during E/D, averting preventable morbidities and mortalities and other health effects brought about by E/D and ensuring that no outbreaks secondary to e/d would take place.

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DRRM-H Institutionalization is the establishment of a functional DRRM-H system at all levels of governance which includes key indicators that translate to health resilience CRITERIA

All LGUs with Disaster Risk Reduction and Management in Health (DRRM-H) System Institutionalized means the availability of ALL of the following:

Health Emergency Response Teams

DRRM-H Plans

Health Emergency Commodities

Functional Emergency Operations Center

Approved

Trained

Available

Coordination

Updated

Organized

Accessible

Communication Command and Control

Disseminated Tested Funded DRRM-H Medium Term Strategies 2020-2022 Support Disaster Risk Reduction and Management in Health (DRRM-H) Institutionalization  Develop responsive policies,

plans, and guidelines  Establish/improve training

systems  Intensify promotion and

advocacy activities

Support the enhancement of response capacities  Strengthen response teams’

competencies (knowledge, skills, attitude, practices)  Improve logistics systems,

health infrastructure/ technology  Improve provision of essential

Support knowledge management for effective disaster risk governance  Develop/enhance information

management system  Crystalize good practices and

lessons learned through monitoring and evaluation  Translate knowledge to policy

and practice through research

health services in emergency and disaster  Build/strengthen partnerships

3 Medium Strategies:

1.

Preparedness

2.

Response

3.

OpCen

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Role of the Different Key Players on DRRM-H Institutionalization

HEMB and CHDs are facilitators as enablers and orchestrators Roles of a Facilitator for Disaster Resilience ●Connect external resources and local community

●Empower local community to be self-sufficient

●Provide proper knowledge, experiences and tools

●Help local leaders learn a standardized but effective way to improve disaster resilience

●Help local leaders implement what they learned

●Share experiences and lessons learned with communities in other areas

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SUMMARY 

Disaster Risk Reduction and Management in Health is an integrated, systems-based, and multisectoral process of utilizing policies, plans, programs, and strategies to reduce health risks due to

disasters and emergencies, improve preparedness for adverse effects, and lessen adverse impacts of hazards to address the needs of affected population with emphasis on the vulnerable groups. 

The first global policy framework that was adapted by the UN for post-2015 global agenda is the Sendai Framework. It was born from the need to ensure that disaster risk reduction policy reflects an evolved understanding of the complexity of disaster risk in the 21st century.



Philippine laws such as the Philippine Disaster Risk Reduction and Management Act of 2010 and the Universal Health Care Act of 2018 promote capacity-development in disaster management, and

guarantee access to quality and affordable healthcare for all Filipinos—among other provisions. 

In line with the National Objectives for Health, the three major goals that the Philippine Health Agenda aspires for: (1) better health outcomes with no major disparity among population groups; (2) financial risk protection for all, especially the poor, marginalized and vulnerable; and (3) a responsive health system which makes Filipinos feel respected, valued and empowered.



The DRRM-H Framework states that by increasing the investments through governance, proper health service delivery, resource mobilization and management, information and knowledge man-

agement, it will produce a proper DRRM-H plan, health emergency response teams, health emergency commodities, and functional emergency operations center, respectively.

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This course material was produced in 2019 by the “Development of eLearning Modules for the Department of Health”

project implemented by the University of the Philippines Open University and funded by the Department of Health Health Human Resource Development Bureau.

PRODUCTION TEAM Course Package Developer: Queenie R. Ridulme Rita C. Ramos Online Pedagogy Expert: Myra D. Oruga Resource Person: Dr. Maridith Afuang

Online Learning Object Specialist: Rhea Ariele Pascua Rachel Anne Joyce Sales Scriptwriter: Rhea Ariele Pascua Rachel Anne Joyce Sales Style Editor: Rhea Ariele Pascua Rachel Anne Joyce Sales

DRRM-H Planning Guide: Module 1 [Introduction to Disaster Risk Reduction and Management in Health]