Leaving no one behind - Using Digital and Data to Enable Smarter Targeting of Health and Social Services in the Philippines
A blog by Dr. Dennis B. Batangan, Jaztine A. Calderon, Patria D. Garcia, Frontier Tech Implementing Partners.
Pilot: eTriage for social inclusion: navigating out of vulnerability situations
Image by AGBProductions from Pixabay
Surfacing Issues in Health Service Delivery
In the Philippines, local governments are responsible for delivering essential health and social services. A crucial objective of these governmental bodies is to ensure that individuals who are both eligible and in dire need of health or social services can effectively avail of these services.
Despite the overarching goal and mandate of government institutions, the practical implementation and delivery of health and social services are barred by a range of challenges. Issues like siloed health information systems, incomplete databases and registries, incompatible information systems, and difficulties in identity verification contribute to individuals being unable to access the necessary health and social services. Alongside these technical hurdles, there are instances where lack of awareness about the availability of such services compounds the problem. Most often overlooked are health services such as vaccinations and free medicines, and social services such as cash transfers in the aftermath of a typhoon.
Regrettably, those most affected by these issues and challenges belong to the community's marginalised or vulnerable groups. This includes indigenous populations, informal settlers, senior citizens, persons with disabilities, and street dwellers. The convergence of the individual’s vulnerabilities and the roadblocks posed by lack of service access hinder their opportunities and restrict their ability to access fundamental resources such as basic health services and social insurance. The result of these compounding challenges is an unfortunate cycle that further marginalised groups from essential services and opportunities for improved well-being.
‘Leaving No One Behind’
In order to respond to this challenge, the Frontier Technologies pilot - the British Embassy Manila, Pasig City, and Ateneo de Manila University are working together to explore the potential of evidence-based digital solutions to address the vital issues of ensuring equitable access to health services or benefits for vulnerable groups and communities within Pasig City in Metro Manila.
The pilot’s commitment is anchored on the core principle of “Leave no one behind”, a fundamental value of the Sustainable Development Goals (SDGs). With this, the pilot is dedicated to exploring the transformative capabilities of digital technology, with a special emphasis on data analysis. The overarching goal is to create a robust health information system that not only streamlines and enhances data accessibility but also serves as a catalyst for evidence-based decision-making. By achieving this, the pilot seeks to pave the way for enhanced efficiency in health service delivery through improving health information systems and better serving the most vulnerable population.
The ambition of this pilot aligns with the SDGs, giving importance to equitable access to healthcare for all individuals, irrespective of their current circumstances in life. Through the utilisation of digital health tools and improving data-driven decision-making, the Frontier Technology pilot aspires to bridge the existing gaps and ensure vulnerable individuals are afforded equitable access to essential health services and benefits. The initiative embraces innovation, collaboration, and inclusivity, setting a course for a more equitable and sustainable healthcare system in Pasig City.
Vision for Solution
In the conception of this pilot, the British Embassy Manila through the Better Health Programme, has previously worked with Pasig City in developing and setting up a digital patient registry and health information system. This system was designed to support healthcare workers in effectively managing patient health records and utilise data to enhance the quality of patient care and service delivery under the Non-communicable Disease (NCD) Program of Pasig City.
Through their collaborative efforts, the British Embassy Manila and Pasig City established a digital platform that not only facilitated the management of patient records but also played a vital role in informing various aspects of patient care and yielding better health data reports for the city. This encompassed frontline healthcare services such as immunisation programs, primary care, and diagnostic programs, all of which significantly improved through the utilisation of the system.
In the context of the Frontier Technology pilot project, the team sought to build upon this existing work. The goal was to leverage the foundation built by the aforementioned health information system which presents a wealth of data readily available in registries to develop a specialised tool. Specifically, the pilot sought to develop a tool to help those responsible for managing health or social programs in identifying vulnerable individuals who could benefit from targeted support to access specific services or benefits.
At the outset, the envisioned solution for the pilot project was the development of what was referred to as the “eTriage for Social Inclusion: Navigating Out of Vulnerability Situation” or “eTSI NOVuS”. This was poised to play a pivotal role in enhancing the identification and support of vulnerable individuals, aligning with the overarching mission to ensure equitable access to essential health and social programs for all. Moreover, strengthening poverty-targeting systems through digitization will result in a more evidence-based approach to triaging social vulnerabilities which paves the way for cost-cutting strategies and increased impact of social protection programs. Through eTSI NOVuS, Pasig City would be able to map out the subgroups with social vulnerabilities qualified for social protection, such as indigenous people, people with disabilities, and women and children who are victims of violence. The technology allows for a series of vulnerability identifiers and filters to achieve a more even distribution of resources and services creating more room for social development opportunities.
Scoping the Field
To begin this work, the team at Ateneo de Manila University conducted a series of user research interviews with 12 different stakeholders. Among them were 7 policymakers and 5 service providers who play integral roles in the administration and facilitation of health and social services within the city. Through these interviews, the team’s primary objective was to discern and ascertain the essential requirements and priorities of these stakeholders, with a specific focus on the overarching principle of “leaving no one behind.”
Furthermore, the pilot team undertook the task of compiling technical landscape maps. These maps comprehensively charted the processes, systems, and data pathways currently being utilised to support the delivery of health and social benefits in Pasig City. The overarching aim of this scoping activity was to pinpoint noteworthy opportunities for the more effective utilisation of data information resources across the city. Such enhancements would serve to empower service providers and policymakers in their efforts to identify individuals who may be in vulnerable situations and require targeted assistance.
Interview with the Pasig City’s Public Health Nurse and NCD Coordinator
Interview with Pasig City CHAMP Health Facility Nurse and MuPLoMT Systems Administrator
Through the conversations and consultations with key stakeholders, and gathering information on the current health service delivery and health system, the team was able to identify the current challenges in the health system, processes in collaborating with other units and departments in the city, processes in prioritisation of patients and vulnerable individuals, existing health information systems, characteristics and categories of vulnerable groups, and other ways to reach vulnerable groups.
The interviews and consultations uncovered that the City Health Health Department of Pasig City does offer its primary care services to all of its citizens and does extend some of its services to neighbouring municipalities and cities. As one of the most developed cities in the Philippines, Pasig City has already employed several health information systems that help them keep track of patient records and support their health data reporting to the different local and national government agencies. Despite the presence of health information systems, almost every department and unit are working in silos resulting in different approaches in constituent targeting and health and social service delivery. The different departments cater to overlapping categories of clients. The City Health Department provides health services and programs to anyone who needs it. CHAMP, Center for Dialysis, Healthy Lifestyle, Ambulatory Surgery, Maternity Clinic, and Newborn Care of Pasig City, which is under the CHD, caters mostly to senior citizens, persons with disabilities, and indigents and/or urban poor. The City Social Welfare Department (CSWD) caters mostly to indigents, women, and children. The Office for Senior Citizens Affairs (OSCA) office provides services and benefits mainly to senior citizens.
The circumstances of these various groups definitely differ from one another, but the most commonly identified characteristics are that a) they are not able to access social and health programs and benefits out of their own pocket, have limited financial capabilities, b) have multiple comorbidities already and sometimes also have lifestyle-related problems such as being a smoker or alcohol-drinker, and c) are in stressful environments. Some characteristics are manageable and can still change over time; while other characteristics such as age will not.
Targeting the Vulnerable
After completing our analysis, we reflected on what the findings mean for our pilot and our proposed approach. Upon reviewing the potential technical solutions, the eTSI NOVuS initiative will select elements from these options that both advance the current functionality of MuPLoMT. Following a thorough situational analysis and consultation meetings, the following ideas for development has identified the following avenues for enhancing MuPLoMT:
Integration of data related to NHTS (National Household Targeting System)
Incorporating data from the Philippines’ National Household Targeting System (NHTS) into MuPLoMT will furnish users with a streamlined approach to identifying patients requiring heightened assistance from the local government. The proposed tagging or colour-coded system will serve as a visual cue for healthcare providers, aiding them in prioritising individuals based on their specific needs.
For the seamless implementation of this enhancement, the project team will collaborate closely with Pasig City’s City Social Welfare and Development (CSWD) unit. This collaboration is necessary to acquire pertinent information regarding the most recent iteration of Listahanan, Talaan ng Pamilyang Nangangailangan (List of Families in Need), providing information integral to the development of the feature.
Strengthening of the Loss to Follow-Up Feature
To complement the integration of NHTS data into MuPLoMT, the enhancement of the “loss to follow up” feature will offer additional insights regarding patients who could potentially slip through the cracks in day-to-day operations. These patients might have missed their routine check-ups and monitoring appointments at health facilities which is crucial for controlling and preventing NCDs. This advancement directly addresses a critical challenge identified during the situational analysis.
By flagging individuals who haven’t returned for scheduled appointments, this feature prompts healthcare providers to re-engage with patients who might not be fully aware of the scope of benefits and services at their disposal. Through direct communication with these individuals, the city ensures comprehensive outreach to all those who require essential services and benefits, bridging the gap and promoting holistic care.
After testing the assumptions and conducting laid-out activities and experiments in Sprint 1, the project team proceeded to the next sprint of the project focusing on the design and development of the proposed frontier technology. Building upon the findings and results of the consultations and situational analysis with Pasig City LGU and its partners, we will now test a series of assumptions that can significantly elevate the efficiency and effectiveness of developing a frontier technology that aims to enhance the healthcare services and improve the well-being of the citizens of Pasig City LGU. These assumptions that will be tested in the next sprint are rooted in strategically leveraging existing technologies, partnerships, and resources so the project can further enhance healthcare systems and prioritise vulnerable populations.
Within the framework of the eTSI NOVuS project, aimed at enhancing MuPLoMT, the objective is to narrow the divide between vulnerable communities and the available health and social services tailored to their specific requirements in Pasig City. Our primary aim is to devise a user-friendly solution for the City’s Health Department, empowering them to prioritise patient care while also pinpointing individuals who might otherwise be overlooked.
If you’d like to dig in further…
⛴️ Explore the pilot’s profile
