Facility Mapping in the Primary

Care Provider Network:

Facility Service Assessment
Setting the Baseline

Hospital (L1/L2/L3)

School
Office
Clinic Dental Clinic
Clinic Medical
Outpatient Clinic
RHU/HC RHU/HC

Diagnostics Birthing Home

Pharmacy
BHS

PRIMARY CARE PROVIDER NETWORK

Objectives
• Assess service capacity of healthcare facilities in the Local Government Unit
• Identify available services of healthcare facilities in the Local Government Unit
• Identify services which the healthcare facilities lack and identify possible facilities
to be partnered with and contracted to provide the services to the population
• Validate referral pathways for primary to tertiary care services
• Account human resource for health in the healthcare facilities, their capacities
and competencies
• Assess infrastructure and equipment in primary care facilities and hospital
facilities based on DOH licensing standards
• Identify gaps on health facility infrastructure and equipment and human resource
for health
• Formulate plans to address the identified gaps on health facilities and service
capacity
Facility Service Capacity Assessment
• Facility Service Capacity Assessment identifies if a facility provides the
required primary health care services in a catchment population. It refers
to the physical presence of the delivery of services, encompassing health
infrastructure, core health personnel, and service utilization.

Output:
- Database of all public and private health facilities, equipment, and medical
transport vehicles with DOH licensing
- Mapping of all health human resource assets and competencies for service
delivery ensuring that all HRH for Konsulta package are licensed and
accredited
- Completion of Service capabilities for expanded primary care and proofs of
adherence to disease-based risk stratification mechanisms
Tools to be used
• Facility Service Assessment Tools (Primary Care facilities and
hospitals)
• Human Resource Complement and Learning and Development
(Training) Profile for Primary Care Facilities
• Infrastructure and Equipment Assessment Tool
Facility Service Assessment Tool
Instructions: Facility Service Assessment – Primary care facilities

• Fill in the Primary Care Facility

Human Resource Complementation
Table in the appropriate column.
• Identify total population and the
number of health care professional
in the facility. Identify if these are
PLGU-, M/CLGU-, DOH- or private-
hired.

• Time allotment for Facility Service

Assessment Tool: 1 hour
Instructions: Facility Service Assessment – Primary care facilities

BHS Referral RHU/ Birthing Referral

Facility Facility/Clinics Facility • Locate the column
/ Infirmary which identifies your
facility—BHS or RHU/
PREGNANCY Birthing
√ History and History and Facility/Clinics/
Physical Physical Infirmary.
Examination Examination
• Please tick (√) on the
X Nutritional BHS A Nutritional
designated column the
Assessment Assessment
services available in
and and
your facility.
Counseling Counseling
Instructions: Facility Service Assessment – Primary
care facilities
• If not available, please put an X and indicate the referral facility where
the services will be obtained on the appropriate column. Referral
facility should be a facility nearest your facility that provides the
service.
• Eg.
BHS Referral Facility RHU/ Birthing Facility/ Referral Facility
Clinics/ Infirmary
PREGNANCY
√ History and Physical History and Physical
Examination Examination
X Nutritional Assessment BHS A Nutritional Assessment
and Counseling and Counseling
Instructions: Facility Service Assessment – Primary
care facilities
• For BHS/ Clinics, besides filling in the column for BHS/ Clinics, go to
the column for RHU/ Birthing Facility/ Infirmary and identify the
facility to where you will refer patients if the services in these facilities
are needed. The identified referral facility may not be or need not be
the RHU but the nearest facility that can provide you the services.
BHS Referral Facility RHU/ Birthing Facility/Clinics/ Referral Facility
• Eg. Infirmary
PREGNANCY
√ History and Physical Examination History and Physical
Examination
Nutritional Assessment and BHS A Nutritional Assessment and
Counseling Counseling
√ Pre-natal Consultation Pre-natal Consultation
STI testing using syndromic Private Medical Clinic A
approach
Mental Health Service RHU A
Screening
Instructions: Facility Service Assessment –
Primary care facilities
• On the section Other Services and Diagnostics, please identify any
facility nearest you which can provide the services to your
constituents. Please identify schedule if possible.
• Eg.
Services Referral Facility (if possible, with schedule)
Bilateral Tubal Ligation Provincial Hospital A (every last Friday of the
month)
Blood transfusion Provincial Hospital A

Diagnostics
Oral Glucose Tolerance Test Private Laboratory A (Mondays – Fridays; 6:00
Am – 5pm)
Bleeding Parameters Private Laboratory A (Mondays – Fridays; 6:00
Am – 5pm)
Instructions: Facility
Service Assessment –
Hospitals

For Hospitals
• Each Section has its instructions.
• For the PRIMARY CARE SERVICES
CHECKLIST, please tick if services are
available and provide the details on
Unit/ Provider providing the services,
schedule of services and schedule of
fees or amount paid if applicable.
 Instructions: Facility Service
Assessment – Hospitals

Units/ Wards
• Please tick if units/ wards are
present in the facility and provide
details on point person and
schedule.
Instructions: Facility
Service Assessment –
Hospitals

Standard Staffing
• Please indicate the number of staff in the
facility and identify under the appropriate
column if PLGU-, C/MLGU-, DOH- or private-
hired.
Specialists
• Please indicate the names of specialists
affiliated in the facility. Please provide
schedule of the specialist during clinic/ office
visit.
Instructions: Facility
Service Assessment –
Hospitals

Laboratory and Diagnostics

• Please tick if laboratory services/
diagnostics are available and provide
details on the schedules of the services
and schedule of fees or amount paid for
the identified services.
Transportation Services
• Please indicate the fees.
 Instructions: Facility Service
Assessment – Hospitals

Specialized Services
• Please tick if the services are
available. Leave this section blank if
not applicable.
Instructions: Facility Service
Assessment – Hospitals
For Specialized Facilities:
• Please check all services, equipment and
specialists that are available in your
facility. Leave this section blank if not
applicable.

• Please fill in Services available which are

not indicated in the first table. Also
include Schedule of identified services and
the schedule of fees.
Human Resource Complement
and Learning and Development
(Training) Profile
Instructions: Human Resource Complement and
Learning and Development (Training) Profile
• Fill in the Human Resource Complement and Learning and
Development (Training) Profile. Identify the total number of plantilla
positions, filled and unfilled plantilla positions and total number of
JO/ contract of services hired.
• List down the names of Personnel in each of the positions. Tick if the
personnel is trained or not on the trainings listed per column.
• Include in the first column plantilla positions even if they are not filled
up. Just leave the following columns blank.
• Include in the profile the JO/contract of service positions on the
appropriate section of the tool.
• Time allotment: 1 hour
Instructions: Human Resource Complement and
Learning and Development (Training) Profile

Fill in the numbers needed

Include unfilled plantilla positions. Leave following columns blank.

Include JO/ contract of service

Infrastructure and Equipment
Assessment Tool
 Instructions: Infrastructure and Equipment
Assessment Tool
• Fill in the Infrastructure and Equipment
Tool for Primary Care Facilities
• Tick the parameters available in your
facility.
• The tool is composed of three parts:
• General Design Parameters and
Systems
• Functional Spaces
• Equipment and Supplies
 Instructions: Infrastructure and Equipment
Assessment Tool
• Fill in the Infrastructure and Equipment
Tool for Primary Care Facilities
• Tick the parameters available in your
facility.
• The tool is composed of three parts:
• General Design Parameters and Systems
• Functional Spaces
• Equipment and Supplies
 Instructions: Infrastructure and Equipment
Assessment Tool
• Fill in the Infrastructure and Equipment
Tool for Primary Care Facilities
• Tick the parameters available in your
facility.
• The tool is composed of three parts:
• General Design Parameters and Systems
• Functional Spaces
• Equipment and Supplies
Consolidation of workshop
output
Instructions
• Group yourselves into clusters which are composed of adjacent areas.
• In a manila paper consolidate selected results of the Facility Service
Capacity Assessment specifically on laboratory services.
• Indicate the facilities (which may include your facility) that will
provide the following services:
• CBC with platelet count Lipid Profile
• Urinalysis Fasting Blood Sugar
• Fecalysis Oral Glucose Tolerance Test
• Sputum Microscopy ECG
• Fecal Occult Blood Chest Xray
• Pap Smear Creatinine and HbA1c
 Instructions
• You may write it in table form, diagram or a drawing.
• Identify referral facilities that are commonly identified by the group.

Main Health CBC/ Urinalysis/ OGTT Lipid Profile Chest Xray ECG
Center Fecalysis/
Sputum
Microscopy/ FBS
A MHC A MHC Private Lab.1 Private Lab. 1 HS Hospital HS Hospital
B MHC B MHC Private Lab.2 Private Lab. 2 HS Hospital HS Hospital
C MHC C MHC BC Hospital BC Hospital HS Hospital HS Hospital
HSHospital Private Lab 2 Private Lab 1 BCHospital

PCP IS IN PCP IS IN
PCP IS IN

A MHC B MHC C MHC

CBC/ Urinalysis/ CBC/ Urinalysis/ CBC/ Urinalysis/
Fecalysis/ Sputum Fecalysis/ Sputum Fecalysis/ Sputum
Microscopy Microscopy Microscopy
Points for Analysis and Discussion
 Points for Analysis and Discussion

❖ Randomly validate the entries in the service assessment tool made by each facility by
looking into the following:

a. Entries that are connected such as maternal and newborn services. Entries for linked
services should match; E.g.
BHS 1
Pregnancy Note: Entries do not match. One cannot provide
X – Labor Watch essential newborn care and initiate
X – Monitoring of vital signs and progress of
breastfeeding if deliveries are not done in the
labor
X – Provision of Mother-friendly practices during
same facility.
labor and delivery
Newborn
√ - Essential Newborn Care
√ - Initiation of Breastfeeding
 Points for Analysis and Discussion

b. Services that can be provided to different population subgroups. Identify the different reasons for such
prioritization; limited supplies (e.g. provision of ferrous sulfate to pregnant women but not for non-pregnant
women), religious/personal beliefs/provider bias (e.g. Provision of FP services to adult women and non-
provision of FP services to adolescent women), etc;

c. Reasons why services are not available. Correlate this to the other tools such as lack of human resource
(human resource complement section), lack of training (training inventory tool), absence/ incomplete/
substandard infrastructure and lack of supplies (infrastructure and supplies assessment tool) and non-practice
of health personnel. E.g.

Cluster 1 Service Training

(IUD) (FPCBT-2 Note: Entries of BHS 1 and 2 on the services (IUD)
IUD) do not match the entries in the training inventory.
BHS 1 x √
BHS 2 √ x
BHS 3 √ √
 Points for Analysis and Discussion

❖Randomly validate and compare services known to be unavailable in a certain facility

with the entries of the identified referral facility. Look out for facilities that may refer
without knowing if the services are available in their identified referral facilities. In the
same manner, there may be facilities that will refer to higher level institutions not
knowing that the services can be accessed in an adjacent same level facility

BHS 1
Adolescent (10 – 19 yo)
X – DMPA Note: Referral facility of BHS 1 for IUD needs to
X – IUD (referred to BHS 2) be corrected because identified referral facility
BHS 2 (BHS 2) does not provide said service.
Adolescent (10 – 19 yo)
√– DMPA
X – IUD
 Points for Analysis and Discussion

❖ Identify to which the primary care facilities refer to for laboratory and imaging
diagnostics. Ask how referral facilities were chosen? Access/distance? Cost
(covered or out-of-pocket, patient’s choice? Point out during the discussion the
implications of having too many identified referral facilities. These would
include process of doing contracting agreements, payment mechanisms, etc.

❖ Take note of clustering practices. Identify its added value such as possibility of
prioritization and ensuring access to adjacent barangays, etc.
 Points for Analysis and Discussion

1. All PCPNs and their partner hospitals shall endeavor to meet access standards
for health facilities including human resource complement, infrastructure,
commodities and supplies. The identified absence/ lack of the minimum
standards such as human resource complement, training needs, infrastructure
and equipment form part of the gaps that need to be addressed in the strategic
local and operational investment plans for health.

2. Gaps that hinder service provision include lack or absence of human resource,
willingness of health provider vs. lack of training, trained health provider vs.
non-performance, and willingness and training vs. lack of supplies.
 Points for Analysis and Discussion

3. Health service providers are used to vertical referrals that may lead to waste of
time, effort and additional out-of-pocket expense from both providers and clients.
Services may be referred to the same level of facility nearest the area/ catchment
population.

4. Commonly identified referral facilities are partners that will be considered for
contracting. Geographical characteristics, road networks, availability of
transportation facilities, availability of health services, completeness of services and
possibility of partnership shall be considered in choosing the referral facilities of the
PCPN.

5. Clustering of adjacent barangays is strategic because it helps maximize resources

and identify priorities in situations where there are limited resources.
 Recommended Action Points

1. Complete Facility and Service Capacity Mapping. Health facility profiling

must be done annually.
2. Validate outputs. Consolidate the absence/ lack of the minimum standards
identified from the tools. Ensure facility readiness through human resource
inventory, training and performance inventory, strategic capacity building
and strategic distribution of supplies and commodities.
3. Identified gaps from the workshop are inputs for strategic and operation
planning especially on major cost drivers (human resource complementation,
capacity building/ training needs, infrastructure/ equipment/ supplies needs).
 Recommended Action Points

4. Create a visual map where facilities and services are available.

5. Information regarding services must be shared among network members.

Constant discussion and consultation in the network must be done.

6. From the tools, draft a directory (consolidation of all facilities, available

services, schedules and contact details) and a navigators’ guide (identifies the
nearest facility that will provide the specific services for its catchment population;
unique in every area).
Maraming Salamat!
Maging maingat at
ligtas!