1. Philippines Sentrong Sigla Movement
Improving the Quality of Health Services in a Decentralized Health System:
Lessons Learned from a National Certification Program
Philippines Sentrong Sigla Movement

2. Introduction Definition
SS is a quality improvement initiative through a certification/recognition program. Health facilities are certified based on a set of standards
SS also promotes continuous quality improvement as a complementing strategy

3. Introduction Steps in the Certification Process
Philippines Department of Health (DOH) provides copies of quality standards to local government units (LGUs)
LGU facility conducts self assessment
Mayor/Governor sends letter of intent to participate
DOH SS teams conducts assessment
LGU facility gets certified, receives SS seal
Certified facility gets monitored twice a year and tries to strive for higher level standards

4. Lessons Learned
Interest in QI is universal but a supportive environment is needed to make it happen
Everyone likes the idea of QI
SS provided simple, practical steps to improve quality of health services
SS provided motivation through certification

5. Lessons Learned
SS became a successful model of how a national government can influence local behavior under devolution
Getting LGUs to comply with national standards and policies: major challenge
LGUs resent “heavy-handed approach”
SS respects local interest and priorities without compromising standards of quality

6. Lessons Learned Political support is a critical success factor
Applies both at the national and local level
Program should have a political value and appeal

7. Lessons Learned
Champions for quality in health care come from many sectors
Politicians, planners, private sector representatives, community influentials championed the cause for SS
Multisectoral interest interest and support prodded health workers to take action

8. Lessons Learned
Development of standards required extensive consultations
Consensus building through consultation
Bridging gap or balancing between technical requirements and realities in the field: provider’s perspective and client’s perspective

9. Lessons Learned
Progressive standards are needed to sustain interest in SS certification and to provide guidance to LGU facilities
Experience with Baby Friendly Initiative
CQI interface with “static” standards

10. Lessons Learned Cash incentives maybe counterproductive
Divert attention away from doing real quality improvement work
Demoralize facilities not given cash incentives in spite of being certified
Not sustainable

11. Lessons Learned
Credibility of certification depends on quality of assessment
Assessment should be accurate
Develop further skills of assessors

12. Lessons Learned
Minimal involvement of private sector reduced program impact
Enhance credibility of certification program if private sector is involved

13. Lessons Learned
Link with Philippine Health Sector Reform (HSR) enhances value and sustainability of SS
Interface with Philippines’ HSR initiatives
Adopted by Philippine Health Insurance Corporation: SS certified facilities are eligible to be reimbursed for selected primary health care services
Integrate with HSR