Overview
The Department of Health (DoH) is the governing agency of health. Health care is divided into public and private sectors. For the public sector, Local Government Units (LGU) and the Center for Health Development (CHD) are in charge of health care in the various regions in the country. There are mandated health care providers for the different areas of the country. For municipalities, there must be Rural Health Units present, which cover primary health care needs. For cities, there must be hospitals available for primary health care needs. For the provinces, a secondary hospital must be available. In the private sector, private companies and the Philippine Health Insurance Company (Phil Health) are in charge of the health care. These are divided into the profit and non-profit sections. Aside from Phil Health, there are also private health insurance companies that help in reducing health-care related costs.
What happens if you need to see a doctor?
As there are various health care institutions in the country, seeing a doctor would vary in terms of your geographical location. When in the municipality, you would consult with the general practitioner (GP). If needed, the GP will refer the patient to a hospital that is nearest to their location for further consultation. When in the city, they would consult with their GP or family doctor. If needed, they would be referred to specialized doctors, for further consultation. Consultation fees vary per health care professional.
For diabetes, the consulting doctor would refer the patient to a diabetologist or endocrinologist. Diabetologists and endocrinologists are mostly present in the city proper, so if you live in a municipality you have to travel to the nearest city to consult with your diabetes doctor, which might be a long way.
Who decides what doctors can prescribe?
The Food and Drug Administration (FDA) is the government agency solely in charge of approving various foods and drugs that are introduced into the country. The doctors are free to choose which of the FDA approved drugs can be prescribed to the patient.
Practically, what is it like to live with type 1 diabetes in the Philippines?
Living with type 1 diabetes in the country is costly. Every item needed for maintenance of diabetes must be purchased since none of the items are covered by any health-insurance company. There are various brands of glucose monitors and insulin present in the country. Insulin pumps are also available but the cost cannot be afforded by the average-income family. Insulin can be bought over the counter in drugstores and pharmacies, or in diabetes-related institutions such as Institute for Studies in Diabetes Foundation, Inc. (ISDFI) and Juvenile Diabetes Research Foundation (JDRF).
Laboratory procedures are normally done every 3 months, and these have to be paid solely by the patient. Some diabetics would opt to undergo only the HbA1c test once a year due to the cost of laboratory procedures. For guidance in managing diabetes, aside from a diabetologist or endocrinologist there are also dieticians and diabetes educators who are available for consultation regarding diabetes-related concerns.
Due to misconceptions regarding diabetes, which is brought about by the media, and lack of diabetes-related health care professionals in each province, there are a lot of patients left in the dark about everything related to diabetes. Alternative medications or herbal alternatives are also hugely marketed in the country and is less costly than the medications present. Thus, there are patients that would alternate taking these herbal alternatives with their medications or replace the insulin with the herbal alternatives altogether.
What about getting admitted to hospital?
Admission to the hospital must be recommended by the attending doctor. Admission cost would vary in the ward that you requested or assigned in. Health insurance companies can provide discounts to the cost of admission depending on the services that are to be done for the patient.
How does diabetes care vary throughout the Philippines?
There is adequate diabetes care management in the big cities, such as Manila, Cebu, and Davao. There are also specific private clinics dedicated to diabetes care available and these private clinics have at least a diabetes doctor, a dietician, and a diabetes educator. For the rest of the cities in the country, at least a diabetes doctor is present. For those living in municipalities, they have to be referred to a diabetes doctor in the nearest city. Large areas of the Philippines do not have daily access to any pharmaceuticals.
Diabetes doctors, whether diabetologists or endocrinologists, have limited time for consultation. Aside from attending to numerous patients, they also often go either out of the country or out of town to attend conventions and conferences related to diabetes at least once every 2 months. Diabetes educators are also limited in the country. Most of the diabetes educators are present in the main cities in the country. Most of them are also affiliated with pharmaceutical companies such as, Abott, Eli-Lilly, etc.
Thank you to Francesca Isabel Villanueva who helped us immensely with this information about diabetes in the Philippines.
Last updated 2016
