MANUAL OF STANDARDS FOR

PRIMARY CARE FACILITIES

 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

MESSAGE

The passage of the Universal Health Care (UHC) Law is a breakthrough health reform which
ensures that all Filipinos are guaranteed with equitable access to quality and affordable health
care services and are protected against financial risk.

With the revitalized health sector agenda of the Department of Health (DOH) called
FOURmula One Plus for Health (F1 Plus), the Department shall contribute to the aspirations
of the UHC by instituting a primary care-focused health system. This includes the licensing
and implementation of a regulatory system for stand-alone health facilities, including
ambulatory and primary care services.

Our initiatives are motivated by challenges brought about by the non-prioritization of health
in certain communities and difficulties in the access of health services due to geographic
barriers. This is where the DOH hopes to focus and reach-out, in terms of ensuring access to
quality and people-centered health services.

Through the UHC Law, DOH together with the local government units (LGUs) can better
deliver population and individual-based health services to the communities. This will entail
our constant engagement, collaboration, and exchange of information and best practices
within the health care provider networks (HCPNs). This will provide our health care system
with the vehicle to attain the national health goals.

Through the collective efforts with the Philippine Health Insurance Corporation (PHIC),
LGU partners, development partners, and other primary care experts, the DOH issues this
Manual of Standards for Primary Care Facilities to serve as a guide for the licensing and
regulatory system that primary care facilities and HCPNs may refer to for the upgrading
facilities, standard operating procedures, and health promotion and literacy services.

Let us continue to uphold excellence and compassion as we uplift the lives and health of our
people!

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

MESSAGE

With the implementation of the Universal Health Care (UHC) Law, the health sector will be
progressively enabling Filipinos to have better access to health care services and experience a
more responsive health system that protects them from financial hardship. UHC envisions
that every Filipino is assigned to a primary care provider and can access appropriate care
seamlessly within and across healthcare provider networks. As we strive towards a primary-
care focosed health care system, Barangay Health Stations, Rural Health Units, and Urban
Health Centers must be avenues of clinical quality, operational efficiency, and people-
centered processes as the first point of care of every Filipino.

This Manual of Standards for Primary Care Facilities shall serve as a guide for stakeholders
in health facility planning and development for these health facilities. Chapters of the manual
discusses core functions, service capabilities, staffing structure, infrastructure and equipment
requirements, information system, and recommended guide for organizing operational
activities and maintenance, reporting, and safekeeping of medical records.

We encourage all health care workers, local government units, national planners,
development partners, and other public and private stakeholders to take part in striving
towards the realization of the UHC’s vision of providing effective and equitable health
services for all, through the utilization of this Manual. Health facilities are the face and venue
of health care for Juan and Juana, and for a Universal Health Care that is felt by the people,
we must work towards building structures, systems, and people in our health facilities.

LILIBETH C. DAVID, MD, MPH, MPM, CESO I

Undersecretary of Health
Health Facilities and Infrastructure Development Team

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

PREFACE

The Department of Health (DOH) moves towards the achievement of the Universal Health
Care (UHC) that is centered on the health and well-being of people, ensuring an inclusive
health system that is equitable and affordable.

In support of the FOURmula One Plus for Health, the DOH strategic framework to achieve
UHC, the Health Facility Development Bureau (HFDB) upholds the thrust through its
mandate to formulate policies and develop standards for health care facilities.

True to its mandate, the HFDB spearheaded the development of the “Manual of Standards for
the Primary Care Facilities,” in collaboration with the other experts on primary patient care
such as the DOH bureaus and offices, Philippine Health Insurance Corporation (PHIC), Local
Government Unit (LGU) Partners, and various health care workers.

As the DOH advances toward the delivery of improved public health services, it is indeed a
significant step to provide this developmental standard that will serve as guidance for the
Primary Care Facilities in a Primary Care Provider Network, a coordinated group of public,
private or mixed primary care providers which shall serve as the foundation of the health care
provider network.

Correspondingly, it shall serve as a guide for the licensing and regulatory system that will be
instituted for the Primary Care Facilities.

With the issuance of this Manual, the Primary Care Facilities, through the integration of
public and private primary care providers in its primary care provider network, will help
these facilities as primary care gatekeepers, thereby primary care service delivery is improved
and strengthened towards a quality responsive health system.

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

ACKNOWLEDGMENT
The Health Facility Development Bureau the Department of Health (DOH) expresses sincere
appreciation to Dr. Francisco T. Duque, III, Secretary of the Department of Health; Dr.
Lilibeth C. David, Undersecretary of the Department of Health; Dr. Nestor F. Santiago, Jr.,
Assistant Secretary of the Department of Health and Dr. Maria Rosario S. Vergeire, Assistant
Secretary of the Department of Health and Chairperson, Technical Working Group for
Primary Care, for their active supervision and direction in bringing this Manual from concept
to its completion.

We are grateful for the immeasurable support, cooperation, and contribution extended by the
HFDB family, DOH Centers for Health Development (CHD) Directors and Technical Staff;
Provincial Health Officers Association of the Philippines (PHOAP), Association of Health
Officers of Metro-Manila (AHOMM); Association of the Municipal Health Officers of the
Philippines (AMHOP); Philippine Health Insurance Corporation (PHIC) and other health
personnel and experts in primary care.

In the same way, we express our gratitude for the active participation, inputs, comments and
full support of the Central Office Directors, Division Chiefs, Program Managers, and
Technical Personnel of the following Bureaus:

● Health Facilities and Infrastructure Development Team

● Field Implementation and Coordination Team
● Disease Prevention and Control Bureau
● Bureau of Local Health Systems Development
● Health Human Resource Development Bureau
● Health Facilities and Services Regulatory Bureau
● Knowledge Management and Information Technology Service
● Health Promotion and Communication Service
● Health Policy Development and Planning Bureau
● Pharmaceutical Division
● Health Facilities Enhancement Program

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

TABLE OF CONTENTS
Message from the Secretary
Preface
Acknowledgement

Chapter 1: Introduction
1.1. Background
1.2. Purpose and Intent
1.3. Classification of Primary Care Facilities based on Service Capability

Chapter 2: Definition of Terms

Chapter 3: Primary Care Facility Standards based on Service Capability

Chapter 4: Human Resource for Health Complement

Chapter 5: Equipment and Medical Transport Vehicle Requirements

Chapter 6: Essential Infrastructure Requirements and Considerations

6.1. General Design Parameters and Considerations
6.2. Critical Facility Systems
6.3. Implementation
6.4. Schematic Plans and Perspectives

Chapter 7: Health Information System

Chapter 8: A Guide for the Primary Care Facilities

8.1. National Schedule of Public Health Programs
8.2. Guide on Organizing Operational Activities
8.3. Briefer on the Local Government Unit Health Scorecard

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

Chapter 1

INTRODUCTION
1.1. Background
The Manual of Standards for Primary Care Facilities is guided by the following principles
and policies:

● Universal Health Care Act, RA 11223 (2019) – aims to ensure that all Filipinos have
equitable access to quality and affordable health care, goods, and services, as well as
protection against financial risk. The Act encourages the establishment of health care
provider networks, which is a group of primary to tertiary care providers, whether
public or private, offering people-centered and comprehensive care in an integrated
and coordinated manner with the primary care provider acting as the navigator and
coordinator of health care within the network.

● Alma Ata Declaration (1978) – expressed the “need for urgent action by all
governments, all health and development workers, and the world community to
protect and promote the health of all the people of the world. The declaration
identified primary health care as the key to the attainment of the goal of “Health for
All.”

● Local Government Code, RA 7160 (1991) – devolved the delivery of health services
to the different local government units (provinces, cities, municipalities, and
barangays), with the Department of Health providing assistance, policies, guidelines,
and standards for health, as well as tertiary and specialized hospital services.

● DOH Administrative Order No. 67-A, 2001 – provision of assistance in the upgrading
of devolved local health hospitals and rural health units based on the Sentrong Sigla
Standards, PhilHealth accreditation, and DOH Licensing Standards.

● DOH Sentrong Sigla Movement, 2002 – aimed to improve and strengthen the quality
of public health services through its Certification and Recognition Program of the
local government health facilities, including hospitals, urban health centers, rural
health units, and barangay health stations.

1.2. Purpose and Intent

The Manual of Standards shall serve as a guide for the licensing and regulatory system that
will be instituted for Primary Care Facilities. The standards shall also be utilized as a
reference for the contracting agreements between the public primary care facility and the
private service provider that delivers individual-based health services.

The standards shall be used by the public and private health sectors, national agencies, local
government units, development partners, academe and research partners, civil society, and
other relevant stakeholders in the implementation of primary health care.

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

1.3. Classification of Primary Care Facilities based on Service Capability

As defined by the Universal Health Care Act, the Primary Care Facility (PCF) is an
institution that delivers primary care services and shall be licensed or registered by the
Department of Health. These facilities can be public or private and include Urban Health
Centers (UHC), Rural Health Units (RHU), and private medical clinics among others.

Under the PCF are health stations such as the Barangay Health Stations (BHS). The main
functions of the BHS are to augment the UHC or RHU in the provision of primary care
services and to coordinate patient transport to the appropriate referral facility when necessary.
Other examples of health stations are school clinics, occupational health clinics, office
clinics, etc.

1.4. Illustration of Primary Care Facilities in a Primary Care Provider

Network

The illustration shows the coordination of the group of public primary care facilities wherein services may be
outsourced through a contracting agreement between the public primary care facility and the private service
provider that delivers individual-based health services.

1.5. Illustration of Health Facilities in a Health Care Provider Network

The illustration shows the formation of a Health Care Provider Network (HCPN) that ensures integration and
effective and efficient delivery of population-based and individual-based health services. The HCPN is a group
of primary to tertiary care providers, whether public or private, offering people-centered and comprehensive
care in an integrated and coordinated manner with the primary care provider acting as the navigator and
coordinator of health care within the network. The patients needing specialized care shall be referred by the
HCPN to the apex or end-referral hospital.

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

Chapter 2

DEFINITION OF TERMS
A. Health Care Provider Network (HCPN) – a group of primary to tertiary care providers,
whether public or private, offering people-centered and comprehensive care in an
integrated and coordinated manner with the primary care provider acting as the navigator
and coordinator of health care within the network.

B. Primary Care Provider Network (PCPN) – a coordinated group of public, private, or

mixed primary care providers, acting as the foundation of the HCPN.

C. Primary Care Facility – refers to the institution that primarily delivers primary care
services which shall be licensed or registered by the Department of Health.

D. Primary Care – refers to the initial-contact, accessible, continuous, comprehensive, and

coordinated care that is accessible at the time of need including a range of services for all
presenting conditions, and the ability to coordinate referrals to other health care providers
in the health care delivery system, when necessary.

E. Contracting – refers to a process where providers and networks are engaged to commit
and deliver quality health services at agreed cost, cost sharing, and quantity in compliance
with prescribed standards.

F. Population-based Health Services – refer to interventions such as health promotion.

Disease surveillance, and vector control, which have population groups as recipients.

G. Individual-based Health Services – refer to services which can be accessed within a

health facility or remotely that can be definitively traced back to one (1) recipient, has
limited effect at a population level and does not alter the underlying cause or illness such
as ambulatory and inpatient care, medicines, laboratory tests and procedures, among
others

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

Chapter 3

PRIMARY CARE FACILITY STANDARDS BASED ON

SERVICE CAPABILITY
The Primary Care Facility (PCF), such as the Urban Health Center (UHC) and the Rural
Health Unit (RHU), shall take the lead in the delivery of primary care services in its defined
catchment areas. The Health Station, such as the Barangay Health Station, shall augment the
services of the PCF.

Services that are not present in the PCF may be outsourced through a contracting agreement
between the UHC/RHU and the private service provider that delivers the individual-based
health services. This ensures the delivery of a comprehensive health services for the
community.

3.1. Summary of Services

Primary Care Facility

Services (UHC/RHU/Medical Health Station
Clinic)
Defined catchment area Yes No
Medical services Yes Yes
Laboratory services In-house or outsourced No
Imaging services In-house or outsourced No
Pharmaceutical commodities Distribution of selected public
In-house or outsourced
and services health drugs and medicines
Birthing services In-house or outsourced No
Population-based health
Yes (if government) Yes
service
Minor surgeries Yes No
Physical, occupational,
In-house or outsourced No
and/or speech therapy
Patient transport vehicle
Ambulance (dedicated,
Transportation (dedicated, shared, or
shared, or outsourced)
outsourced)
Licensing

Note: laboratory, dental,

and birthing services are
Yes No
covered under the license of
the UHC/RHU when they
are rendered within the
facility

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

3.2. Services in a Primary Care Facility

3.2.1. Population-based Health Services (provided by government PCF)

● Health promotion
● Epidemiologic surveillance
● Health protection (vector control, environmental health, occupational safety, and
food safety measures)
● Emergency preparedness and response

3.2.2. Individual-based Health Services

● Maternal and Newborn Care
1. History tracking
2. Physical examination
3. Antenatal care (screening, immunization, micronutrient supplementation,
preparation of birth plans, counseling on breastfeeding)
4. Assessment and referral of high-risk patients
5. Intrapartum management
6. Essential newborn care
7. Postpartum care, including breastfeeding support
8. Counseling and health promotion
9. Promotion of male involvement in maternal and child care

● Family Planning Services

1. Counseling and provision of family planning services
2. Promotion of male involvement in reproductive health and gender and
development

● Nutrition Services
1. Nutritional status assessment, counseling, and recommendation
2. Provision of micronutrient supplementation
3. Management of mild to moderate malnutrition

● Dental Services
1. Oral and dental health check-up

● Rehabilitation Services
1. Outsourced community-based rehabilitation (physical therapy,
occupational therapy, speech therapy, psychology or psychiatry)
2. Referral to specialists for formal assessment of disability for intervention
and rehabilitation

● Health Assessment and Referral Services

1. Assessment and referral of nicotine addiction level in smokers
2. Assessment and referral of alcoholism problems
3. Assessment and referral of addictive substance abuse

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

● Clinical Laboratory Services

1. Complete blood count with platelet count
2. Urinalysis
3. Fecalysis
4. Fecal occult blood test
5. Lipid profile (total cholesterol, HDL, LDL, triglycerides)
6. Fasting blood sugar
7. Oral glucose tolerance test
8. Sputum microscopy
9. Pap smear
10. Visual inspection with acetic acid test
11. Creatinine
12. Blood typing
13. Dengue rapid test
14. Screening for hepatitis B, syphilis, and HIV
15. Transport of samples for laboratory testing
16. Nucleic acid amplification test (1 in every primary care provider network)

● Diagnostic and Imaging Services

1. Electrocardiogram
2. Diagnostic ultrasound (can be outsourced)
3. Chest X-ray (can be outsourced)

● Pharmaceutical Services
1. Provision of essential drugs and medicines (dispensing, distribution, and
advice) and commodities

3.2.3 Other Services

● Administrative Services
1. Management and maintenance of health records (including management of
electronic medical records and information system)
2. Consolidation and analysis of surveillance reports
3. Issuance of certificates
a. Medical certification
b. Death certification
c. Medico-legal certification
4. Sanitation inspection and issuance of permits
5. Maintenance of equipment and facility

● Supervisory Services
1. Ensures patient navigation in its primary care provider network
2. Supervision of health stations
3. Supervision of health workers
4. Leads the Local Health Board and Nutrition Council
5. Participates in other committees where health is involved

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

3.3. Services in a Health Station

The services offered in a government health station are also offered in a primary care facility.

3.3.1. Population-based Health Services

 Health promotion, communication, and advocacy
 Counseling and psychological services
 Disease prevention

3.3.2. Individual-based Health Services

● Medical Services
1. Screening of illness (e.g. visual acuity, hearing problems), assessment, and
referral of patients to the PCF
2. Developmental and mental health evaluation of children
3. Occupational health screening
4. Physical check-up (including clinical breast examination by a physician or
a trained health staff, eye examination by ophthalmological team under the
supervision of an ophthalmologist)
5. Ensure continuum of care (home-based care, navigation, referral)
6. Case finding, treatment, and monitoring of reportable diseases, including
tuberculosis
7. Trauma, emergency, and transport services

● Reproductive Health Services

1. Provision and counseling on reproductive health services
2. Promotion of male involvement in reproductive health, gender and
development

● First Aid for injuries, poisoning, trauma, envenomation, animal bites, malaria
cases, chemical hazard exposures

● Maternal and Newborn Care

1. Pregnancy tracking
2. Antenatal care (assessment, counseling, immunization, micronutrient
supplementation, preparation of birth plans, counseling on breastfeeding)
3. Referral of high-risk patients to the PCF
4. Postpartum care, including breastfeeding support
5. Promotion of male involvement in maternal and child care

● Nutrition Services
1. Nutritional status assessment and counseling
2. Provision of micronutrient supplementation
3. Promotion of proper nutrition
4. Promotion of healthy lifestyle

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

3.3.3 Other Services

 Administrative Services
1. Management of health records (including management of electronic
medical records and information system)
2. Collection of health data, including disease surveillance data
3. Issuance of certificates
d. Medical certification
e. Death certification
f. Medico-legal certification
4. Monitoring, inspection, and survey of basic sanitation facilities (water,
toilet, garbage segregation and disposal)

● Supervisory Services
1. Supervision of barangay health workers and barangay nutrition scholars
2. Participates in Barangay Nutrition Council and other committees where
health is involved

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

Chapter 4

HUMAN RESOURCE FOR HEALTH COMPLEMENT

Human resource for health (HRH) is an essential component of a functional health system.
As stipulated in the Universal Health Care (UHC) Act, HRH issues shall be comprehensively
addressed through identified mechanisms and tools to ensure that there are enough and
appropriate health worker complement in all levels of the health sector. Furthermore, a
National Health Workforce Support System shall be established to augment the HRH needs
of local public health systems, with priority given to Geographically Isolated and
Disadvantaged Areas (GIDA).

Defining the standards to determine the appropriate staffing and skills mix requirements for
the health workforce in a healthcare setting is an iterative process. Pending the results of the
Workload Indicators of Staffing Needs (WISN) study, the staffing standards is currently
based on the health worker to population ratio, as reflected in the National Objectives for
Health (NOH) 2017-2022:
● One (1) Urban Health Center/Rural Health Unit physician per 20,000 population
● One (1) public health nurse per 10,000 population
● One (1) public health midwife per 5,000 population
● One (1) public health dentist per 50,000 population

The HRH who will deliver the health services may be employed by the primary care facility
or hired through a contracting agreement between the public primary care facility and the
private service provider which delivers individual-based health services.

The staffing requirements for birthing homes and diagnostic facilities that offer clinical,
laboratory, radiology, and other ancillary services shall follow DOH Administrative Order
2012-0012 or the Rules and Regulations Governing the New Classification of Hospitals and
Other Health Facilities in the Philippines.

At the barangay level, each barangay shall have one (1) Barangay Health Worker (BHW) per
20 households. The BHW shall act as the first point of contact between the healthcare system
and the rest of the community. In addition, there shall also be one (1) Barangay Nutrition
Scholar (BNS) per barangay. The BNS shall help identify and monitor malnourished
pregnant and lactating mothers and children and shall promote good nutrition practice.

Lastly, all primary care facility HRH must be PhilHealth members.

4.1. Proposed Units in a Primary Care Facility

The UHC/RHU is expected to lead the Primary Care Provider Network (PCPN) and shall
have two functional units – the Health Service Delivery Unit and the Health System Support
Unit.

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

4.1.1. Health Service Delivery Unit

The UHC/RHU shall perform their primary role of providing population and individual-based
health services through the Health Service Delivery Unit (HSDU). The HSDU shall also
navigate and coordinate referrals to other service providers within the Health Care Provider
Network (HCPN).

The standard operating hours of the primary care facility shall not exceed eight (8) hours a
day or forty (40) hours a week. For practical purposes, this shall be construed that a health
worker shall report to the UHC/RHU from Monday to Friday, 08:00h through 17:00h (with
no noon break) except on public holidays. The facility has the option to extend or modify its
operating hours depending on the need of its catchment area.

The current UHC/RHU is led by a City or Municipal Health Officer (C/MHO) who is
responsible for formulating and implementing the health programs in the whole city or
municipality. The C/MHO also supervises, coordinates, and monitors the operations of the
UHC/RHU. Under the C/MHO is the Rural Health Physician who takes charge of a small
medical team assigned in the RHU and renders preventive and medical services in at least
one (1) barangay.

The HSDU shall have a dedicated Primary Care Physician per 20,000 population and must be
PhilHealth accredited, one (1) public health nurse per 10,000 population, one public health
midwife per 5,000 population, and one (1) sanitation inspector per 20,000 population.

If the primary care facility has a birthing home, it should comply with the licensing
requirements. The other health care workers to comply with the licensing requirements are
the dentist or dental hygienist, medical technologist or laboratory aide, pharmacist or
pharmacy assistant, and ambulance driver. Meanwhile, the social welfare officer shall be
under the supervision of the Local Social Welfare Office.

4.1.2. Health System Support Unit

The other proposed unit is the Health System Support Unit (HSSU) which shall be primarily
responsible for rendering administrative services such as management of logistics,
equipment, and facilities as well as management of health data and records in the UHC/RHU.
The HSSU shall also coordinate with and submit reports to the Provincial Health Office or
their respective Health Care Provider Network. The HSSU shall be composed of an
information technology officer, records officer, administrative assistant, and utility worker.

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

Urban Health Center / Rural Health Unit

City / Municipal Health Officer

Health Service Delivery Unit Health System Support Unit

Primary Care Physician (dedicated) Information Technology Officer
Public Health Nurse Records Officer
Public Health Midwife Administrative Assistant
Sanitation Inspector Utility Worker

4.2. Health Station

The Health Station, such as a Barangay Health Station, is a subunit of the UHC/RHU. The
main functions of the Health Station are to augment the UHC/RHU in the provision of
population-based health services and to coordinate patient transport to the appropriate referral
facility when necessary. The Health Station shall be composed of one (1) nurse, one (1)
midwife, one (1) BHW per 20 households, one (1) BNS per barangay, administrative
assistant, utility worker, and the emergency transport driver. The rural health physician,
dentist or dental hygienist, medical technologist or laboratory aide, and sanitation inspector
from the UHC/RHU shall rotate on scheduled visits to the Health Stations.

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

Chapter 5

EQUIPMENT AND MEDICAL TRANSPORT VEHICLE

REQUIREMENTS

A primary care facility must have the necessary equipment and medical transport vehicle to
support the delivery of health services and to ensure quality of care. Effective equipment
management leads to provision of high quality patient care and saves costs due to repair and
maintenance.

A health facility must have the following equipment in order to function effectively and
deliver the essential health services. A health facility may opt to outsource services in case of
gaps in equipment and medical transport vehicle.

5.1. Primary Care Facility (e.g. Urban Health Center and Rural Health
Unit)

No. Equipment Quantity

1. Bed, plain with mattress, 4 inches thick, with IV stand 1 set
BP apparatus, non-mercurial, with adult and pediatric 1 set
cuff, desk type
2. a. Aneroid 1 piece
b. Digital 1 piece
3. Biosafety cabinet 1 piece
Cervical inspection set or vaginal speculum set 1 set
a. Small 1 piece
4. 2 pieces
b. Medium
c. Large 1 piece
5. Cholesterol meter with strips 1 piece
Dressing set or minor surgery set 1 set
a. Surgical scissors, straight 1 piece
b. Surgical scissors, curved 1 piece
c. Bandage scissors 1 piece
6. 1 piece
d. Pick-up or ovum forceps
e. Mosquito forceps 2 pieces
f. Tissue forceps with teeth 2 pieces
2 pieces
g. Tissue forceps without teeth
EENT diagnostic set 1 set
a. Ophthalmoscope 1 piece
7. 1 piece
b. Otoscope
c. Laryngoscope 1 piece
8. Non-contact thermometer, heavy duty 1 piece
9. Emergency light, battery operated 1 piece
10. Examining light 1 piece

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

No. Equipment Quantity

11. Examining table 1 piece
12. Fetal Doppler 1 piece
13. Foot stool 1 piece
14. Height board 1 piece
Hydrocollator machine with 2 hydrocollator packs 1 set
15.
(optional)
16. Instrument table 1 piece
IUD insertion set 1 set
a. Uterine sound 1 piece
17. 1 piece
b. Tenaculum forceps
c. Ovum forceps 1 piece
Minor surgical set or cut down set 1 set
a. Instrument tray with cover, 18/8, stainless steel, 1 piece
410 mm x 254 mm x 64 mm
b. Mayo scissors straight, 5-3/4” (14.5cm) 1 piece
c. Mosquito hemostatic forceps straight, 5” (12.5 2 pieces
cm), 20 mm jaw with full serrations
d. Mosquito hemostatic forceps straight, 4-3/4” (12 2 pieces
18.
cm), 20 mm jaw with full serrations
1 piece
e. Needle holder, bulldog jaw, 6-1/4” (16 cm)
1 piece
f. Surgical knife handle #3, scalpel 1 piece
g. Surgical knife handle #4, scalpel 1 piece
h. Tissue forceps, 1x2 teeth, 5-3/4” (14.5cm) 2 pieces
i. Bandage scissors
19. Mucus extractor 1 piece
20. Nebulizer 1 piece
21. Resuscitator, manual with bag and mask, adult 1 piece
22. Resuscitator, manual with bag and mask, pediatric 1 piece
23. Revolving stool 1 piece
24. Salter scale 1 piece
25. Safety collector box 1 piece
26. Sharp waste disposal unit 1 piece
27. Snellen’s eye chart or visual acuity test chart 1 piece
28. Stethoscope, adult 1 piece
29. Tape measure 2 pieces
30. Thermometer and hygrometer (2 in 1) 1 piece
31. Thermometer, dial 1 piece
Weighing scale with height measuring stick, heavy duty,
32. 1 piece
adult
33. Weighing scale, digital, infant 1 piece
34. Wheelchair 1 piece
35. Wheeled detachable stretcher 1 piece

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

No. Equipment Quantity

Laboratory Section
36. Cabinet, laboratory 1 piece
Chemistry analyzer for blood chemistry, may be
37. 1 piece
outsourced
38. Clinical centrifuge, 12 placer 1 piece
39. Cholesterol meter with strips 1 piece
40. Differential counter 1 piece
41. Emergency light, battery operated 1 piece
Glucometer, with needle and 100 strips, with expiration
42. 1 piece
of at least 1 year
43. Hemacytometer 1 piece
44. Hemoglobinometer 1 piece
45. Microscope, binocular type 1 piece
46. Non-contact thermometer, heavy duty 1 piece
47. Nucleic acid amplification test machine 1 unit per network
48. Oxygen unit, with humidifier and regulator, min. 5 lbs. 2 units
49. Reagent refrigerator 1 piece
Transport box (if water samples need to be sent to water
50. 1 piece
reference laboratory)
51. Urine analyzer 1 piece
52. Vaccine refrigerator 1 piece
53. Vaccine carrier with cold boxes 1 set
54. Vaccine carrier with foam pads and water packs 1 set
55. Water quality testing kit, gadget, or equipment, for field 1 set
56. Effluent, sewage water quality testing kit (optional) 1 set
57. Sharp waste disposal unit 1 piece
Dental Section
58. Autoclave, 20 L 1 piece
Dental unit and chair with compressor and complete
59. 1 set
accessories, with high and low speed hand pieces
60. Light cure machine 1 piece
Dental prophylaxis instrument set 1 set
a. Universal scaler, non-magnetic hollow handle
b. Perio curette, non-magnetic hollow handle
61.
c. Periodontal probe
d. Gracey curette, set of 6 different tips, non-
magnetic hollow handle
Dental instruments 1 set
a. Mouth mirror
62. b. Cotton plier
c. Explorer
d. Spoon excavator
Basic dental surgery set 1 set
63.
a. Extraction forceps, #16, with cross serration for

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

No. Equipment Quantity

better grip, ergonomic for better comfort designed
instrument
b. Extraction forceps, #17
c. Extraction forceps, #18L
d. Extraction forceps, #18R
e. Extraction forceps, #44
f. Extraction forceps, #69
g. Extraction forceps, #150
h. Extraction forceps, #151
Aspirating syringe, stainless steel, with locking
64.
mechanism
65. Minnesota retractor, stainless steel
Bone file, stainless steel
a. Bone curette, non-magnetic hollow handle
b. Gum separator, non-magnetic hollow handle
c. Seldon, stainless steel
66.
d. Root tip pick, straight, non-magnetic hollow
handle
e. Root tip pick, left, non-magnetic hollow handle
f. Root tip pick, right, non-magnetic hollow handle
67. Blade handle, #3, stainless steel
68. Elevator, #301, non-magnetic hollow handle
69. Elevator, #304, non-magnetic hollow handle
70. Surgical mallet, stainless steel
71. Iris, straight, stainless steel
72. Iris, curved, stainless steel
73. Adson tissue forceps, stainless steel
74. Molt, #9, stainless steel
75. Hemostat mosquito forceps, stainless steel
76. Perisoteal elevator, stainless steel
77. Bone rongeur, stainless steel
78. Allis tissue, stainless steel
79. Needle holder, stainless steel
80. Apical elevator, right, non-magnetic hollow handle
81. Apical elevator, left, non-magnetic hollow handle
82. Cryer, east, non-magnetic hollow handle
83. Cryer, west, non-magnetic hollow handle
84. Pedo forceps, 150, stainless steel
85. Pedo forceps, 151, stainless steel
86. Pedo forceps, 17S, stainless steel
87. Pedo forceps, 16S, stainless steel
88. Pedo forceps, 18R, stainless steel
89. Pedo forceps, 18L, stainless steel

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No. Equipment Quantity

Instrument cassette for sterilization, large, with locking
90.
mechanism
91. Mouth mirror, stainless steel
92. Cotton plier with lock, stainless steel
93. Explorer, stainless steel
94. Spoon excavator, stainless steel
95. Dental suction machine 1 piece
Dental restorative set 1 set
a. Woodson, non-stick, stainless steel
b. Ash, stainless steel
c. Cement spatula, stainless steel
d. Articulating paper forceps, straight, stainless steel
e. Ball burnisher, stainless steel
f. Anterior composite filling instrument, thin, non-
stick, stainless steel
g. Anatomic burnisher, stainless steel
96. h. Posterior occlusal contouring instrument, stainless
steel
i. Matrix band holder, stainless steel
j. Composite burnisher, stainless steel
k. Plugger, stainless steel
l. Mouth mirror with handle #5, stainless steel
m. Cotton plier with lock, stainless steel
n. Explorer, stainless steel
o. Spoon excavator, stainless steel
p. Set of burs, round-10, diamond
97. Dental instrument cabinet 1 piece
98. Instrument table 1 piece
99. Sterilizing unit, table top 1 piece
100. Sharp waste disposal unit 1 piece
Others
101. Electronic medical record system
102. Computer or laptop with internet connection 1 set
103. Printer 1 piece
104. Mobile phone 1 piece
105. Fire extinguisher 1 piece
106. Generator set, 50 KVA 1 set
107. Wall clock 1 piece
108. White board with pens 1 set
Transport
Ambulance
(may be procured by the facility or may be acquired
109. 1 unit
through a contracting agreement with a private service
provider)
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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

5.2. Health Station (e.g. Barangay Health Station)

No. Equipment Quantity

1. Autoclave, 20 L 1 piece
2. BP apparatus, non-mercurial, with adult and pediatric 1 set
cuff, desk type
a. Aneroid 1 piece
b. Digital 2 pieces
3. Cervical inspection set or vaginal speculum set 1 set
a. Small 2 pieces
b. Medium 2 pieces
c. Large 2 pieces
4. Dressing set or minor surgery set 1 set
a. Surgical scissors, straight 2 pieces
b. Surgical scissors, curved 2 pieces
c. Bandage scissors 2 pieces
d. Pick-up or ovum forceps 2 pieces
e. Mosquito forceps 4 pieces
f. Tissue forceps with teeth 4 pieces
4 pieces
g. Tissue forceps without teeth
2 pieces
h. Suture removal scissors
5. Vaccine carrier with cold dog 1 piece
6. Vaccine carrier thermometer 1 piece
7. Digital thermometer, non-contact 3 pieces
8. Digital thermometer 3 pieces
9. Examining light 1 piece
10. Examining table 1 piece
11. Glucometer, with needle and 100 strips, with expiration 3 pieces
of at least 1 year
12. Cholesterol meter 1 piece
13. Instrument table 1 piece
14. IUD insertion set 1 piece
15. Uterine sound 1 piece
a. Tenaculum forceps 1 piece
b. Ovum forceps 1 piece
16. Nebulizer 1 piece
17. Oxygen tank, portable 1 set
18. Oxygen tank with regulator 1 piece
19. Vaccine refrigerator 1 piece
20. Revolving stool 1 piece
21. Salter scale 1 piece
22. Sharp waste disposal unit 1 piece
23. Safety collector box 1 piece
24. Stethoscope, adult 1 piece

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No. Equipment Quantity

25. Stretcher 1 piece
26. Tape measure 2 pieces
27. Weighing scale with height measuring stick, adult 1 piece
28. Wheelchair 1 piece
Others
29. Electronic medical record system
30. Computer or laptop with internet connection 1 set
31. Printer 1 piece
32. Mobile phone 1 piece
33. Fire extinguisher 1 piece
34. Generator set, 50 KVA 1 set
35. Wall clock 1 piece
36. White board with pens 1 set
Transport
37. Patient transport vehicle 1 unit
(shall be utilized during emergency and referral of
patients to other facilities; may be procured by the facility
or may be acquired through a contracting agreement with
a private service provider)

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Chapter 6

ESSENTIAL INFRASTRUCTURE REQUIREMENTS AND

CONSIDERATIONS
Infrastructure planning, design, and construction should take into account factors that would
affect the users, how the structure will be used, and the structure itself. A design is a well
thought of solution to a spatial problem of the past, present, and future. In line with this,
thoughtful considerations should be made in the planning, design, and construction of
facilities. Facility planning and design shall comply with all relevant laws and issuances, as
well as with the guidelines set by the Department of Health (DOH) and other government
offices.

6.1. General Design Parameters and Considerations

After the selection of an appropriate site for the facility, planning and design of the building
shall take into consideration the following, but not limited to:

1. Site conditions and context

1.1. Climate
1.2. Environment
1.3. Topography
1.4. Socio-cultural factors

2. Sustainable and green

2.1. Site sustainability
2.2. Indoor environmental quality
2.3. Energy efficiency
2.4. Water efficiency
2.5. Material sustainability
2.6. Healthcare waste management

3. Resilient strategies for structural and other physical components against

environmental threats
3.1. Typhoon resistant roofing system, doors, and windows
3.2. Flood resistant – higher than the anticipated flood level; at least 600mm
from the finish grade line if the site is not flood prone
3.3. Fire resistant – use of fire resistive building materials

4. Natural light and ventilation

5. Safety and security of occupants and real properties

6. Zoning of spaces in relation to users and services

7. Patient movement and wayfinding

7.1. Clear wayfinding through properly designed and installed signage

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

7.2. Sign board listing facility hours and available services of the health facility,
Citizen’s Charter, and PhilHealth as a provider
8. Appropriate material specifications based on functional requirements

9. Universal design
9.1. Provision of accessible spaces and features compliant to the Accessibility
Law (Batas Pambansa 344) – some of which include but are not limited to,
safety fixture to assist users needing support, as well as appropriate finishes
and materials
9.2. Properly designed ramps and railings.

10. Visual and acoustic privacy

11. Sanitation and Infection control

11.1. Provision of spaces for Water, Sanitation and Hygiene (WASH) such as,
but not limited to, toilets, handwashing facilities, clean up areas, janitor’s
closet, waste holding area, materials recovery facility, and others

12. Support facilities

12.1. Waiting areas
12.2. Toilets
12.3. Handwashing area
12.4. Materials storage areas
12.5. Designated spaces for waste bins
12.6. Waste collection area
12.7 Housekeeping materials area

13. Cultural sensitivity

14. Therapeutic environment theory

14.1. Reduce environmental stressors such as noise, inappropriate lighting levels,
confusing wayfinding, poor indoor air quality, and visual clutter.
14.2. The provision of positive distractions such as access to gardens, views of
nature, restorative areas, art, music, and other elements or activities that
stimulates a positive response from users.
14.3. Enable social support through the provision of spaces where users can
interact with each other.
14.4. Give patients a sense of control on their environment by allowing them to
adjust some of the conditions such as privacy, lighting, and temperature.
The provision of visual anchors for better wayfinding can also contribute to
the patients’ sense of control.

6.2. Critical Facility Systems

1. Water supply system
1.1. To provide safe drinking water, adequate in volume and pressure (compliant
to the minimum pressure as mandated by the National Plumbing Code) of

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

safe water supply for handwashing, personal hygiene, laundry, cleaning, and
food preparation.
1.2. The development of a water safety plan for the facility is recommended. For
normal and emergency conditions, there should be adequate water supply or
water reserve.

1.3. The method of collection, storage, and distribution of emergency water

should depend on the site of the health facility. This would include the
identification of alternate water supply for emergencies and water
interruptions of the regular water supply.

2. Sanitation System and Environmental Management

2.1. Provision of a basic sanitation facility, defined as a toilet facility with a

standard size of septic tank for wastewater treatment. (Code on Sanitation of
the Philippines; DOH AO 2019-0047 National Standard on the Design,
Construction, Operation and Maintenance of Septic Tank System)

2.2. Provision of functional and clean toilets for clients, persons with disabilities,
pregnant and health staff, hand washing area with water and soap. Design
and construction should comply with the requirements of the Code on
Sanitation of the Philippines. It is also recommended that toilets be provided
with a bidet.

2.3. Placenta pit to be provided if birthing services are being offered in the
facility. Construction of the placenta pit shall comply with the conditions as
stipulated in Annex C (Planning and Design Guidelines for Birthing Home)
of DOH AO 2016-0042 (Guidelines in the Application for DOH Permit to
Construct)

2.4. Provision of waste holding area (located outside the building – within the
site).

2.5. Covered garbage containers with color-coded segregation for healthcare

waste management (collection and disposal/treatment).

3. Electrical system
3.1. Electrical and alternative energy sources (e.g. solar panel and generator) to
address fluctuating electricity or power outage and encourage energy
conservation.

3.2. The electrical system should be properly installed and regularly checked and
maintained in coordination with the LGU Engineering Office.

3.3. Health workers are trained on safe handling and basic maintenance of
energy- consuming equipment/appliances in coordination with the LGU
Engineering Office.

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

3.4. Consider the electrical loading and other specifications of medical and non-
medical equipment for appropriate operation.

4. Transportation system
4.1. Ambulance in a primary care facility is shared with its health stations.
4.2. Presence of patient transport vehicles in health stations for emergency
response and referrals.

4.3. The use of the health facility’s transportation shall be governed by local
policy to ensure its 24/7 availability.

4.4. Provision of parking area for ambulance or patient transport vehicle.

4.5. Use of alternative clean energy.

5. Communication system
5.1. Presence of mobile phone and internet connection to assist continuity of care
and electronic medical record.

6. Fire Protection System

6.1. Facility layout and emergency plan visibly posted
6.2. Fire exit/emergency exit signage installed
6.3. Fire extinguishers for fire safety

6.3. Implementation
Technical assistance for the Detailed Architectural and Engineering Designs (DAED) for
primary care facility and health station shall be provided through the concerned DOH –
Center for Health Development.

6.4. Schematic Plans and Perspectives

6.4.1. Health Station (e.g. Barangay Health Station)

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

6.4.2. Health Station (e.g. BHS) plus Birthing Home

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6.4.3. Primary Care Facility (e.g. Rural Health Unit)

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

6.4.4. Primary Care Facility (e.g. RHU) with attached Birthing Home

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

6.4.5. Primary Care Facility (e.g. RHU) with attached Birthing Home and
TB-DOTS

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 MANUAL OF STANDARDS FOR PRIMARY CARE FACILITIES

Chapter 7

HEALTH INFORMATION SYSTEM

 The primary care facility shall maintain an electronic health information system (HIS)
and electronic medical record (EMR). The health facility may engage an EMR provider to
develop their electronic claims system, which shall be certified by PhilHealth.

 Patient privacy and confidentiality shall be upheld at all times in accordance with the RA
10173 or the Data Privacy Act of 2012.

 RA 9165 or the Comprehensive Dangerous Drugs Act of 2002 states that judicial and
medical records of drug dependents under the voluntary submission program shall be
confidential and shall not be used against them for any purpose, except to determine how
many times they voluntarily submitted themselves for confinement, treatment, and
rehabilitation.

 The Field Health Service Information System (FHSIS) shall be used for the reports
consolidated by the program managers. Reports from the primary care facilities shall be
submitted to the DOH Center for Health and Development (CHD) through the Provincial
Health Office (PHO) within the prescribed timeline.

 The health facility shall prepare, review, and submit statistical data and other relevant
reports using the electronic HIS to the PHO, DOH-CHD, PhilHealth, as required.

 For document and record control, a logbook of borrowed records shall be properly filled
out. There shall be a designated records officer or document custodian, a room to secure
the documents, forms, and records, as well as policy and procedure for the retention and
storage of documents.

 There shall be a complete and updated inventory of essential drugs, medicines, and
commodities using stock cards and supply records.

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Chapter 8

A GUIDE FOR THE PRIMARY CARE FACILITIES

8.1. National Schedule of Public Health Programs

(Source: DOH Monthly Health Events)

Month Health Events

 National Deworming Month
 Schistosomiasis Awareness and Mass Drug Administration Month
 Liver Cancer and Viral Hepatitis Awareness Prevention Month
 Zero Waste Month
January
 Autism Consciousness Week (3rd week)
 National Cancer Consciousness Week (3rd week)
 Goiter Awareness Week (4th week)
 World Leprosy Day (last Sunday)
 National Down Syndrome Consciousness Month
 National Health Insurance Month
 Oral Health Month
 Philippine Heart Month
 Mental Retardation Week (February 14-20)
February  National Awareness Week for the Prevention of Sexual Abuse and
Exploitation (2nd week)
 Leprosy Control Week (last week)
 National Rare Disease Week (last week)
 World Cancer Day (February 4)
 International Childhood Cancer Day (February 15)
 Rabies Awareness Month
 Women’s Week (1st week)
March  International Ear Care Day (March 3)
 National Women’s Day (March 8)
 World TB Day (March 24)
 National Hemophilia Awareness Month
 Head and Neck Consciousness Week (last week)
 World Immunization Week (last week)
April
 World Health Day (April 7)
 World Malaria Day (April 25)
 Garantisadong Pambata (regular activity)
 International Thyroid Awareness Week (last week)
May  AIDS Candlelight Memorial Day (3rd Sunday)
 Health Worker's Day (May 7)

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Month Health Events

 World Thyroid Day (May 25)
May
 World No Tobacco Day (May 31)
 Dengue Awareness Month
 National Kidney Month
 National No Smoking Month
 National Safe Kids Week (3rd week)
 National Poison Prevention Week (4th week)
June
 World Blood Donor Day (June 14)
 ASEAN Dengue Day (June 15)
 DOH Anniversary (June 23)
 International Day Against Drug Abuse and Illicit Trafficking (June
26)
 Filariasis Mass Drug Administration Month
 National Blood Donors Month
 National Deworming Month
 National Disaster Resilience Month
July  Nutrition Month
 National Disability Prevention and Rehabilitation Week (3rd week)
 National Allergy Day (July 8)
 World Population Day (July 11)
 World Hepatitis Day (July 28)
 ASEAN Month
 Family Planning Month
 National Adolescent Immunization Month
 National Breastfeeding Awareness Month
 National Lung Month
 Sight Saving Month
 Mother-Baby Friendly Hospital Initiative Week (1st week)
 World Breastfeeding Week (August 1-7)
August
 National Hospital Week (August 6-12)
 ASEAN Week (August 7-13)
 Asthma Week (2nd week)
 Philippine National Research System Week (2nd Week)
 Family Planning Day (August 1)
 White Cane Day (August 1)
 National TB Day (August 19)
 School Based Immunization (Grade 1, 4, and 7)
 Blood Diseases Month
 Generics Awareness Month
September
 National Epilepsy Awareness Week (1st week)
 Obesity Prevention Awareness Week (1st week)

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Month Health Events

 Alzheimer’s Disease Awareness Week (3rd week)
 National Thyroid Cancer Awareness Week (4th week)
 Linggo ng Kabataan (September 25-30)
September  World Suicide Prevention Day (September 10)
 World Contraception Day (September 26)
 World Environmental Health Day (September 26)
 World Rabies Day (September 28)
 Filipino Elderly Week (1st week)
 National Newborn Screening Week (1st week)
 National Mental Health Week (2nd week)
 Bone and Joint Awareness Week (3rd week)
 Health Education Week (3rd week)
 National Attention Deficit / Hyperactivity Disorder Awareness
October Week (3rd week)
 Food Safety Awareness Week (last week)
 World Sight Day (2nd Thursday)
 World Mental Health Day (October 10)
 Global Handwashing Day (October 15)
 World Psoriasis Day (October 29)
 Garantisadong Pambata (regular activity)
 Filariasis Awareness Month
 Malaria Awareness Month
 National Children’s Month
 Traditional and Alternative Health Care Month
 National Skin Disease Detection and Prevention Week (2nd week)
 Drug Abuse Prevention and Control Week (3rd week)
 National Consciousness Week Against Counterfeit Medicine (3rd
week)
 Chronic Obstructive Pulmonary Disease Awareness Day (3rd
Wednesday)
November  World Day of Remembrance for Road Traffic Victims (3rd
Sunday)
 Population and Development Week (November 23-29)
 National Food Fortification Day (November 7)
 World Diabetes Day (November 14)
 World Prematurity Day (November 17)
 World Toilet Day (November 19)
 National Consciousness Day for the Elimination of VAWC
(November 25)
 18 Day Campaign to End Violence Against Women (November 5
– December 12)

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Month Health Events

 Firecrackers Injury Prevention Month
 Linggo ng Kabataan (2nd week)
 Ear, Nose, and Throat Consciousness Week (December 3-9)
December
 World AIDS Day (December 1)
 International Day of Persons with Disabilities (December 3)
 National Health Emergency Preparedness Day (December 6)

8.2. Guide on Organizing Operational Activities

The operational activities of a primary care facility (urban health center or rural health unit)
shall be based on the guidelines and protocols set by the Department of Health. The facility
shall develop policies and systems to ensure proper communication and responsiveness to
clients as directed by the following general guidelines:

1. A Citizen’s Charter on clinic hours and services being offered shall be posted in a
strategic area readable by all clients and service providers.

2. Clients shall be seen by a health staff within 15 minutes of registration or shall follow
the Citizen’s Charter of the facility.

3. “No Noon Break Policy” shall be observed at all times.

4. The facility shall be available to receive patients during evenings and in case of an
emergency to provide initial care and referral to an appropriate health facility when
needed.

5. A functional two-way referral system within the health care provider network shall be
established, with the primary care facility acting as the navigator and coordinator of
care.

6. The primary care facility is mainly responsible for monitoring the population database
and profile within its catchment area and identifying the health facilities and providers
within its network.

7. There shall be an established priority lane for pregnant women, persons with
disabilities, and senior citizens. Priority shall also be given to clients with high-grade
fever, difficulty in breathing, high blood pressure, etc.

8. The whereabouts of personnel shall be posted in a strategic area readable by all staff
in the facility.

8.3. Briefer on the Local Government Unit Health Scorecard

This section on Local Government Unit (LGU) Health Scorecard (HSC) shall only apply to
LGU health facilities. The LGU HSC is a component of the FOURmula One (F1) Plus for

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Health Monitoring and Evaluation (M&E) System. It uses key performance indicators to
monitor and evaluate the performance of the local health system (province-wide and city-
wide).

The LGU HSC enables the tracking of national priorities towards responsive local health
reforms and the identification of critical areas for improvement to achieve better health
outcomes from the local to the national level. The LGU HSC facilitates the reporting of LGU
progress in meeting the national health targets based on the priority programs, projects, and
activities of the Department of Health.

The LGU HSC makes use of directional arrows and color codes to indicate the gaps in the
implementation of health programs. It can also identify localities that perform well and are
deserving of recognition and incentives. The four (4) general purposes of the LGU HSC are:

1. Report to clients
The LGU HSC reports outcomes valuable and relevant to the stakeholders and the
general public.

2. Benchmark performance
The primary concern of the assessment is comparing the province/city-wide health
system performance through internal and external benchmarks. Internal performance
benchmark shall compare the province/city-wide health system performance with its
past performance through the use of directional arrows. External performance
benchmark shall compare the province/city-wide health system performance to the
national target of the same year and to the national baseline through the use of color
codes.

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3. Link to financing
The LGU HSC performance results shall be the general basis of performance-based
financing, allocations, awards, and other grants. Plans and budget allocations should
be consistent with the annual results.

4. Basis for prioritizing actions

According to the LGU HSC color codes, the red performance requires the province or
city to intensify its efforts and resources, revise strategies, set a catch-up plan, and
seek assistance. The yellow means that the province or city needs to maintain progress
geared towards the national target. The green shows that the province or city can
maintain the current level of performance, be a model site for other LGUs, or be a
pilot site for innovative interventions.

The LGU HSC indicators and targets are periodically reviewed to align with the national
health agenda defined through the National Objectives for Health, UHC implementation,
Sustainable Development Goals, and the directives of the current administration. It is also
harmonized with the Field Health Service Information System and the Philippine Health
Information Exchange. Indicators and targets related to Family Health, Non-Communicable
Diseases, Communicable Diseases, Environmental Health, Logistics, Nutrition, among
others, are included in the LGU HSC.

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REFERENCES
 RA 11223, Universal Health Care Act, February 20, 2019
 RA 7160, Local Government Code, 1991
 RA 9502, Cheaper Medicines Act, 2008
 RA 10354, Responsible Parenthood and Reproductive Health Act
 RA 11036, Mental Health Act
 RA 11148, First 1000 days
 RA 7883, Barangay Health Workers’ Benefits and Incentives Act
 RA 11166, AIDS Act
 RA 10173, Data Privacy Act
 RA 11215, Cancer Control Act
 RA 9994, Expanded Senior Citizens Act
 RA 1378, National Plumbing Code of the Philippines and its Implementing Rules and
Regulations, June 18, 1955
 Executive Order 119, 1987, Creation of the District Health Office to absorb the
functions of the District Hospitals, supervision and control over District Hospital,
Municipal Hospitals, Rural Health Units, Barangay Health Stations, and all other
ministry units in the health district
 Executive Order No. 851, 1981, Arrangement of the District Hospitals, Rural Health
Units and Barangay Health Stations into Health Districts
 Presidential Decree (PD) 1096, February 19, 1977, National Building Code of the
Philippines and its Implementing Rules and Regulations
 PD 856, December 23, 1975, Code on Sanitation of the Philippines and its
Implementing Rules and Regulations
 PD 1569, Strengthening Barangay Nutrition Program
 PD 856, The Code on Sanitation of the Philippines
 The Alma-Ata Declaration, 1978
 National Objectives for Health, Philippines 2017-2022, 2018, Department of Health
 DOH Administrative Order No. 67-A, 0029, 2007, Guidelines for Rationalizing the
Health Care Delivery System based on Health Needs
 DOH Administrative Order No. 67-A, 2001, Guidelines for the Provision of Assistance
in the Upgrading of Devolved Local Health Hospitals and Rural Health Units based on
Sentrong Sigla Standards, PhilHealth Accreditation and DOH Licensing Standards
 DOH Administrative Order 2012-0012, 2012, Rules on New Classification of
Hospitals and Other Health Facilities
 DOH Administrative Order 2010-0036, Universal Health Care for All Filipinos or
Kalusugang Pangkalahatan
 DOH Administrative Order No. 2004-0168, National Policy on Health Emergencies
and Disasters
 DOH Administrative Order No. 70-A, 2002, Revised Rules and Regulations Governing
the Registration, Licensure, and Operation of Hospitals and Other Health Facilities in
the Philippines
 DOH Administrative Order 2012-0013, Policy and Guidelines on Logistics
Management in Emergencies and Disasters

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 DOH Department Circular No.2019-0137, Disaster Risk Reduction and Management

in Health (DRRM-H) Planning Guide
 DOH Administrative Order No. 2016-0042 (Annex B), Planning and Design
Guidelines for Hospitals and Other Health Facilities
 DOH Joint DENR-DOH Administrative Order No. 02, Series of 2005, Policies and
Guidelines on Effective and Proper Handling, Collection, Transport, Treatment,
Storage and Disposal of Health Care Wastes
 PhilHealth Circular No. 2019-0003, Expansion of the Primary Care Benefit (EPCB)
 PhilHealth Circular No. 010-2012, Primary Care Benefit Package 1 (PCB1)
 PhilHealth Circular on KONSULTA Package, 2020
 Health Facility Improvement Tool for Water, Sanitation and Hygiene (WASH) in a
Health Care Facility, WHO and UNICEF, 2018
 Manual on Technical Guidelines for Hospitals and Health Facilities Planning and
Design, Department of Health, 1994
 Signage Systems Manual for Hospitals and Offices, Department of Health, 1994
 Health Facilities Maintenance Manual. Department of Health, 1995
 Manual on Healthcare Waste Management 3rd Edition, Department of Health, 2011
 Fire Safety Enforcement Manual, Bureau of Fire Protection, 2012
 The Fire Code of the Philippines and its Implementing Rules and Regulations, Bureau
of Fire Protection, 2009
 Batas Pambansa (BP) 344, July 26, 1982 - Accessibility Law and its Implementing
Rules and Regulations.
 Philhealth Benchbook for Quality Assurance in Healthcare 2006
 Safe Hospitals in Emergencies and Disasters, Philippine Indicators, Department of
Health, Manila, July 2011.
 Safe Management of Wastes from Health Care Activities, WHO Publication 2014
 Philippine Green Building Code, 2015, Department of Public Works and Highways

Related Literature/Publications

 WHO Health Resources Availability Mapping System (HeRAMS), 2012

 WHO Generic Essential Emergency Equipment List at the first referral health facility,
2012
 WHO List of Medical Devices by Health Care Facility, 2010
 WHO- Making Health Systems Work: Towards Better Management in Health
Leadership, 2007
 Partnership for Community Health Development Philippines, Community
Health Service, DOH, 1995
 Primary health care in the Philippines: banking on the barangays, Public Med.gov
 National Library of Medicine National Institutes of Health, 1986
 Supply-Side Readiness of Primary Health Care in the Philippines, World Bank
Group, DOH, and PhilHealth

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