250313 Health reform and epidemics: Antibiotic access and drug resistance in the Philippines

Monday, October 31, 2011: 1:42 PM

Paul Kadetz, PhD, MPH, MSN , Department of International Development, University of Oxford, Oxford, United Kingdom
Devolution of health care to the local community level since 1991 has resulted in markedly increased health disparity in the Philippines. The decentralization of administrative duties without the parallel decentralization of medical resources is believed to have contributed to this disparity. In particular, access to pharmaceuticals has been severely compromised at the local level.

In order to determine the effect of the reduction of access to pharmaceuticals on local level health care and community health, qualitative semi-structured interviews (n=100) recruited from convenience and snowball sampling in three different Philippine municipalities were conducted at the local level of both rural and municipal health units. Quantitative epidemiologic analysis of the incidence and prevalence of antibiotic resistance from municipal health units and provincial hospital records were compared.

Findings include the increased cost and decreased physical availability of pharmaceuticals has resulted in a lack of essential drugs and antibiotics and a rationing of antibiotics with markedly reduced dosing from municipal and local health units of one to two days; with an infeasible expectation that patients would purchase pharmaceuticals after the initial 1-2 day samples were exhausted. Quantitative data analysis reveals that the current policy of sample dosing in some municipal health units is increasing vulnerability to population drug resistance. A critical analysis of current public health policies contributing to these issues are reviewed.

Learning Areas:
Administration, management, leadership
Protection of the public in relation to communicable diseases including prevention or control
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
Identify how health reform in the Philippine context (devolution) has compromised access to pharmaceuticals Explain how access to antibiotics is leading to drug resistence Analyze the cultural and social factors leading to antibiotic resistence in the Philippines

Keywords: Access and Services, Health Reform

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the sole author and researcher of this research
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.