7. Pillars of the Health System

In the late 1980s, the Philippines Department of Health (PDOH), relying on its integrated management information system, detected less than one outbreak per year in a population of more than 60 million people. In 1989, the PDOH designed the National Epidemic Surveillance System, a hospital-based sentinel surveillance system that encompasses both the flow of data and the personnel requirements needed to make the surveillance system work effectively. After the pilot study demonstrated promising results, the PDOH created personnel positions and a supervisory structure for sentinel physicians, nurses, and clerks in regional epidemiology and surveillance units (RESUs) integrated into the public health system. In 1995 alone, the system detected and formally investigated about 80 outbreaks, including 25 bacteriologically confirmed outbreaks of typhoid and 5 of cholera. As the Philippines developed HIV serological and behavioral risk surveillance, the RESU staff members conducted surveys in their communities. By integrating surveillance functions based on the skills of the workforce, PDOH was able to avoid the duplications, inefficiencies, and sustainability problems of multiple vertical systems (White and McDonnell 2000).

Source: DCP2, chapter 53, p. 1004.