DOH should take over health systems not LGUs – Health chief

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Metro Manila (CNN Philippines, February 12) — The Health chief said he will propose the transfer of control of health services from the local governments to the Health Department due to the rising number of measles cases and low coverage of immunization in the country. 

Department of Health (DOH) Secretary Francisco Duque suggested to revisit the Local Government Code of the country, that says health systems and facilities should be under the jurisdiction of the local government units (LGUs). This after a measles outbreak was declared in multiple regions in the country, amounting to more than 4,300 cases with 70 confirmed deaths. 

"Time has come to revisit the wisdom of having devolved the health systems to the LGUs, " Duque told CNN Philippines' The Source.

Duque said the need for coordination from the Health Department to the LGUs causes delay in the implementation of health services. He added that not every local government prioritizes health services which contributed to the low coverage of the country's immunization program.  

"One of the weaknesses, hindi namin macontrol yung sense of priority that local chief executive ought to have over their health system. If it's not their priority then that is also explaining why (there is low coverage)," Duque said. 

Asked on whether the secretary is up to the challenge of taking on more work by overseeing all health systems in local governments, Duque said he is prepared to take control and to prioritize the people's health. 

"The job is going to be more effective than difficult, nothing is easy, everything is difficult, but it's the health outcomes that are our priority," he said.

Over the past four years, the number of unvaccinated children continued to rise. In 2015, there were 583,203 children that were unvaccinated. This number shot to 712,669 in 2016, 855,039 in 2017 and it rose to 960, 457 in the third quarter of 2018. 

A child is marked as unvaccinated if he or she has not received any vaccine, if he or she has been scheduled for vaccination but did not show up or if the child received only one dose of vaccination and did not return for subsequent doses. 

From nine months old a child can receive a vaccine followed by a second dose at 12 months old, Duque explained. Should the child receive the first dose of vaccination much later such as when they are one year of age, they can receive the second dose after three months. 

The health chief said they met with the Department of Education, the Department of Interior Local Government and the Social Welfare Department to conduct vaccination programs in several schools and communities. 

He said they plan to conduct house-to-house visits to vaccinate children from six to 59 months old. They will also coordinate with different schools to vaccinate students from kindergarten to 6th grade. The immunization campaign will focus on measles vaccination for students and polio vaccines due to a resurgence of the disease in some countries.

The coverage of the country's immunization program also suffered a decline from 70% in 2015 to 68 % in 2016 and 67% in 2017. The coverage of the program dropped significantly in 2018 with 40%. The World Health Organization said a country must achieve 95% coverage to effectively prevent the spread of diseases.   

Duque said he is unaware of the reason behind the steep decline of vaccination coverage during the aforementioned years. However, after speaking to some parents, he attributed the lost of trust and confidence in vaccinations to fear of the adverse effects of vaccination similar to the alleged side effects of the dengue immunization program or dengvaxia in 2014.  

Parents also cited lack of free time and inaccessibility of some health centers, Duque added. 

The Health Department declared a measles outbreak in Metro Manila, Central Luzon, CALABARZON, Western Visayas and Central Visayas. The DOH is currently monitoring the Autonomous Region of Muslim Mindanao, Region 9 and Region 11 for possible outbreaks.