Chapter 1 | Introduction

A. Background 

Access to essential medicines is a critical component of achieving universal health coverage (UHC), which aims to provide equitable healthcare access without causing financial hardship (Bigdeli et al., 2015). In line with UHC goals, the Department of Health - Pharmaceutical Division (DOH-PD) introduced the Philippine Medicines Policy (PMP) for 2022-2030. This policy provides a national framework that guides efforts to improve medicine access in the Philippines. The PMP is structured around six pillars, represented by the acronym ACCESS (Department of Health, 2022):

A

Assurance of Safety, efficacy and quality

C

Collaboration on availability and affordability

C

Commitment to the rational use of medicines

E

Effective networking, partnerships and governance

S

Sustainable financing for medicines

S

Strengthening health systems 

This framework is built upon the DOH-PD's three fundamental pillars: (1) medicine availability, (2) medicine accessibility, and (3) the rational use of medicines (RUM). By addressing these critical aspects, the PMP aims to improve healthcare outcomes and support the broader goals of UHC in the country.

To support the PMP, the DOH-PD uses various health information systems (HIS) and data collection tools essential for monitoring and evaluating progress. These include the Electronic Drug Price Monitoring System (EDPMS), Drug Price Watch (DPW), Drug Price Reference Index (DPRI), Pharmaceutical Management Information System (PMIS), Pharmacovigilance Information Monitoring System (PViMS), electronic Philippine National Formulary (ePNF), and the Philippine Essential Medical Devices List (PEMDL). Despite these tools, challenges remain in effectively monitoring and evaluating ongoing policies and programs, underscoring the need for better data collection and management.

In response, EpiMetrics, Inc., in collaboration with the DOH-PD and the Asian Development Bank (ADB), developed a Theory of Change and Monitoring & Evaluation (M&E) Framework to better connect pharmaceutical interventions with health system goals. As part of this effort, a pilot data collection program for priority indicators is underway. This initiative aims to improve the DOH-PD's ability to monitor progress, identify gaps, and ultimately enhance access to essential medicines, aligning with the national goal of UHC.

Defining Medicine Access

Access to healthcare is a multi-faceted concept that encompasses several dimensions. As conceived by Penchansky & Thomas (1981), “access reflects the fit between the patient and the healthcare system.” Guided by this concept, the dimensions specific to medicine access are defined accordingly:

In line with the PMP, the end-goal of medicine availability and accessibility is to guarantee equitable and timely access to affordable and quality medicines at all points of healthcare for all Filipinos. On the other hand, the WHO (2005) defines the rational use of medicines (RUM) as “a situation where patients receive medications appropriate for their clinical needs, in doses that meet their individual requirements, for an adequate period of time and at the lowest possible cost to them and their communities.” According to the PMP, this pillar aims to strengthen the role of the DOH and other stakeholders in promoting the RUM.

B. Purpose and Objectives of the Field Guide

Purpose

The Field Guide serves as a comprehensive resource for the DOH-PD, providing essential tools and guidance to optimize data collection and management; therefore, ensuring the effectiveness of its monitoring and evaluation framework. By offering clear protocols, comprehensive training, ethical guidelines, and resource planning assistance, the Field Guide empowers you to collect accurate, reliable, and ethically sound data, ultimately supporting informed decision-making and evidence-informed policy development and actions.

Objectives

The Field Guide aims to optimize data collection and management for the DOH-PD's monitoring and evaluation framework. Specifically, it will provide you with:

1. Clear guidelines and protocols for data collection and management;

2. Comprehensive training on study and sampling design, indicators for measurement, and data collection methods;

3. Essential tools for efficient data gathering;

4. Guidelines to ensure responsible and ethical data collection practices; and

5. Field data collection and resource planning.

C. Who are the intended users of the Field Guide?

This Field Guide is designed for the use of monitoring and evaluation (M&E) officers, National Drug Policy Compliance Officers (NDPCO), and Public Health Pharmacists (PHP) who play a crucial role in the data collection process for the DOH-PD's M&E framework. 

1. Data Collection: You will be responsible for gathering data on various aspects of the pharmaceutical sector, such as drug availability, affordability, and usage patterns.

2. Data Entry and Management: You will input collected data into the standardized data collection tools, ensuring accuracy and consistency.

3. Coordination with Stakeholders: You will need to coordinate with healthcare professionals, patients, and other stakeholders to seek permission, to gather data, and to ensure the accuracy of information.

4. Adherence to Guidelines: You must adhere to the guidelines and protocols outlined in the Field Guide to ensure the quality and reliability of data.

5. Feedback and Reporting: You are encouraged to provide feedback on the data collection and management process to contribute to the ongoing improvement of the agency's monitoring and evaluation efforts.

D. What is the scope of the Field Guide?

The Field Guide provides a comprehensive framework for data collection and management, essential for the DOH-PD's monitoring and evaluation efforts. It outlines detailed processes and protocols, covering topics such as the M&E framework, indicators, study and sampling design, data collection methods, techniques, and tools, and ethical considerations. Additionally, the Field Guide offers guidance on data storage, backup, retention, and security. While data analysis and reporting are not within the scope of the Field Guide, it provides a solid foundation for these subsequent tasks. 

E. How to navigate the Field Guide?

Practical Tips to Navigate the Field Guide

To enhance your experience with this Field Guide, consider the following strategies:

1. Comprehensive Review: For a thorough understanding of the entire data collection process, read this Field Guide from beginning to end. This approach provides context and ensures familiarity with all aspects of monitoring and evaluation. This is especially recommended during initial reading.

2. Task-Specific Navigation: To focus on particular data collection processes:

   1. Consult the Table of Contents and the List of Tables and Figures to locate specific sections or information efficiently; 

   2. For clarity and consistency, refer to the Acronyms page for definitions of terms used throughout this document;

   3. Utilize the search function to find relevant pages, especially when looking for information related to specific keywords or topics; and

   4. Carefully review the chosen sections, including associated links and references.

3. Indicator-Based Reference: When seeking information on specific indicators for monitoring and evaluation:

   1. Refer to the Detailed Description of Indicators in Appendix H for in-depth information on specific indicators; and

   2. Each indicator has a unique identification number (UID). Use the table below to quickly reference the list of indicators (Table 1.2).

4. Ongoing Support: Keep the Field Guide accessible throughout the data collection process and regularly review relevant sections to reinforce best practices and maintain data quality. 

Quick Reference Guide

For quick reference, please consult the following frequently asked questions (FAQs) (Table 1.3):