National Unified Health Research Agenda (NUHRA): 2011-2016

RESEARCH AGENDA

DIAGNOSTICS GENOMICS/MOLECULAR TECHNOLOGY DRUG DISCOVERY AND DEVELOPMENT HOSPITAL EQUIPMENT AND BIOMEDICAL DEVICES INFORMATION AND COMMUNICATION TECHNOLOGY (ICT) FOR HEALTH FINANCIAL RISK PROTECTION IMPROVING ACCESS TO QUALITY HOSPITALS AND HEALTH CARE FACILITIES IMPROVING PROVISION OF PUBLIC HEALTH SERVICES ENVIRONMENTAL AND CLIMATE CHANGE CONCERNS HEALTH SOCIAL SCIENCES (INCLUDING COMMUNITY DEVELOPMENT)

DIAGNOSTICS

DESCRIPTION:  Development of diagnostic kits for priority infectious diseases and non-communicable diseases for the early detection and/or prediction of disease and mortality, utilizing existing technologies that are off-patent or lapsed technology and/or novel technology. Such technology will also look at genetic or biological markers associated with DM, CVD, and cancer.

Infectious diseases

  1. Dengue and dengue-like illness
  2. Multidrug Resistant/Extensively Drug Resistant Tuberculosis (MDR/ XDR TB)
  3. Drug-Resistant Malaria
  4. Influenza-like illness
  5. Leptospirosis
  6. Sepsis
  7. Human immunodeficiency virus (HIV)
  8. Hepatitis

Non-communicable diseases

  1. Myocardial infarction
  2. Colorectal cancer
  3. Stroke
  4. Diabetes Mellitus
  5. Breast Cancer
  6. Autoimmune/Immunologic diseases or

SPECIFIC TECHNOLOGIES/TOPICS:

Screening/ Confirmatory/ Prognostic

  • Latex agglutination
  • Lateral flow assay
  • Dipstick
  • Isothermal device
  • Biosensors
  • Immunoassay
  • Nucleic Acid Testing – Immunochemistry

Point of care

  • Latex agglutination
  • Lateral flow assay
  • Dipstick
  • Isothermal device
  • Biosensors

GENOMICS/MOLECULAR TECHNOLOGY

DESCRIPTION: Molecular and genomics technologies use the information in the human genome in the design of vaccines, therapeutics, and diagnostic devices or products

  1. Cardiovascular Diseases (CVD)
  2. Infectious Diseases (TB, Dengue, and Influenza)
  3. Cancer
  4. Diabetes
  5. Neurodegenerative Diseases

For cancer:

  1. Breast Cancer
  2. Lung Cancer
  3. Liver Cancer
  4. Cervical Cancer
  5. Colon Cancer

Candidate biomarkers

  1. Cardiovascular disease: CYP3A4, CYP2C9, CYP2B6, P2Y12 (drug resistance markers applicable to other diseases)
  2. Infectious diseases: HLA-A, HLA¬B, etc., dengue serotypes 1-4, pfmdr1
  3. Cancer: TAG72, EGFR, VEGF, ER1, caspase3, CD44, p53
  4. Diabetes: adiponectin, apolipoprotein B, C-reactive protein, ferritin
  5. Neurodegenerative disease: beta amyloid protein, total tau protein,phosphorylated tau

SPECIFIC TECHNOLOGIES/TOPICS

1.  Omics technology

(a) Biomarker identification via: - Genomics

  • Transcriptomics
  • Proteomics
  • Metabolomics

(b) Host-pathogen omics

2. Adult stem cells (mesenchymal/ cord/ induced  pluripotent stem cells)

3. Biologics

  • Vehicles
  • Biologics
  • Small molecules

DRUG DISCOVERY AND DEVELOPMENT

DESCRIPTION:  Researches will aim to discover new drugs which can be developed up to the pre-clinical stage. It will involve the discovery of compounds or molecular drug targets (genomics) that can serve as candidates for drug development.  Drugs will be developed for common infectious diseases and lifestyle related disorders.

RESEARCH TECHNOLOGIES/TOPICS

Pre clinical drug development from natural substances (herbal and marine sources)

RESEARCH AREA: FUNCTIONAL FOODS

DESCRIPTION:  Researches will involve the determination of health benefits and safety assessment of food or food components in reducing risk for disease occurrence, specifically lifestyle related diseases such as CVD, diabetes, and cancer.

RESEARCH TECHNOLOGIES/TOPICS

  • Malunggay
  • Yacon
  • Coconut products (coconut flour, coco sap sugar)
  • Ginger
  • Brown rice
  • Probiotics
  • Sago palm tree

HOSPITAL EQUIPMENT AND BIOMEDICAL DEVICES

DESCRIPTION: Development of affordable, safe and reliable hospital equipment and biomedical devices.

RESEARCH TECHNOLOGIES/TOPICS:

  • Ventilator (Adult / Neonatal)
  • Prosthesis
  • Minimally invasive surgical and rehabilitation equipment
  • LED Operating Room lights
  • Anesthesia machine

INFORMATION AND COMMUNICATION TECHNOLOGY (ICT) FOR HEALTH

DESCRIPTION: Development of user-friendly ICT solutions to accelerate the gathering and processing of health and related information for policymaking, and to deliver quality healthcare services

RESEARCH TECHNOLOGIES/TOPICS:

  • Public Health Surveillance/Health Intelligence Systems
  • Telehealth services and systems
  • Interface for ICT-enabled medical devices
  • ICT-enabled health services

FINANCIAL RISK PROTECTION

 DESCRIPTION: Financial risk reduction means eliminating, if not greatly reducing the amount patients must pay out of pocket to avail health services. The Benefit Delivery Review jointly conducted by DOH and PhilHealth in 2008 highlighted the need to increase enrollment coverage, improve availment of benefits and increase support value in order for the NHIP to provide Filipinos substantial financial risk protection

RESEARCH TECHNOLOGIES/TOPICS:

  • Health Budget Expenditure Studies (Regular and Special Budgets)
  • Evaluation and assessment of existing health budget and expenditures: National vs. Local, and Government of the Philippines (GOP) vs. external budget allocations
  • Analysis of the DOH budget and Health Sector Expenditure using Expenditure Tracking System (ETS) and System of Health Accounts (SHA)
  • Sub-Accounts for Non-Communicable Diseases including trauma
  • Determine the cost of preventive interventions versus cost of care for non-communicable diseases including trauma
  • Assessment and impact studies in enhancing Payment Provider Mechanisms
  • Application of Benefit Delivery Reviews to increase/improve support value, benefits and coverage
  • No Balance Billing Policy: Assessment / evaluation of implementing No Balance
  • Billing in DOH Hospitals
  • Case Mix Implementation: Initial evaluation of 23 case payments in hospitals
  • Out patient benefit mechanisms and monitoring and evaluation systems
  • Effects of increased Sponsored Program (SP) enrollment on the income of private hospitals
  • Assessment of PhilHealth Benefits
  • Assess outpatient benefit package for regular and sponsored programs to support program scale-up or expansion
  •  Legal research to review the NHIP Law audits Implementing Rules and Regulations
  • Entitlements of all Filipinos under Kalusugan Pangkalahatan (KP)
  • Studies related to catastrophic coverage
  • Studies on catastrophic illnesses, prioritization of illnesses, extent of the coverage, and the needed premiums
  • Engaging the private sector for provision of supplemental benefits
  • Role of HMOs and other private insurance in the social health insurance schemes, e.g. role of private sector in providing supplemental package
  • Validating case rates and mechanisms for price setting
  • Studies related to premiums paid for health coverage
  • Effect of increased SP premium of national government on the local government unit’s (LGU)  enrollment of informal poor
  • Funding the premiums of the informal sector (Quintile 2)
  • Effect of increasing the premium for overseas Filipino workers (OFW)
  • Implication of increasing the premium of the poorest sector on the contribution of other PhilHealth Members
  • Capitation estimates of outpatient and inpatient services
  • Studies on improving the NHIP coverage, availment, and support value
  • Investments and resources to implement KP Target Beneficiaries
  • Health-seeking behavior  of families identified aspoorest by the National Household Targetting
  • System-Poverty Reduction (NHTS-PR) of the Department of Social Welfare and Development (DSWD) after being covered by PhilHealth.

IMPROVING ACCESS TO QUALITY HOSPITALS AND HEALTH CARE FACILITIES

DESCRIPTION:  To Improve access to quality hospitals and health facilities, government-owned and operated hospitals and health facilities will be upgraded to expand capacity and provide quality services. The capacity to attend to traumatic injuries and other type of emergencies and manage common causes of morbidity and mortality especially non-communicable diseases and their complications will be enhanced.

RESEARCH TECHNOLOGIES/TOPICS:

  • Responsiveness of health system
  • Determine access and satisfaction levels of clients, especially the poor on health services, facilities,human resource and other resources
  • Public-Private Partnership
  • Determine potential resource, capacities, gaps of private sector to beef-up support for    universal health care (UHC) implementation according to strategic instruments or      goals (e.g., human resource, technology, health facility enhancement)
  • Review and analyze the existing Basic Emergency Obstetric and Newborn Care
  • (BEmONC) and   Comprehensive Emergency Obstetric and Newborn Care (CEmONC) system in terms of facilities, human resource expertise, usage and usefulness
  • Evaluate functionality of each Rural Health Unit (RHU) and Barangay Health Station (BHS) in relation to district hospitals
  • Determine voice of customer
  • What are the actual health needs of  patients suffering from chronic  illnesses such as dialysis?
  • How can patients at risk of nutritional deficiencies be cared for?
  • New and alternative ways of health care delivery
  • How health care can be extended to the settings of home and community particularly for chronic diseases

IMPROVING PROVISION OF PUBLIC HEALTH SERVICES

DESCRIPTION: Although the overall health status of Filipinos has improved, the Philippines is lagging behind in reducing maternal and infant mortality. Disparities in health outcomes are evident across income levels and geographic areas. KP aims to improve provision of public health services to achieve the MDGs

RESEARCH TECHNOLOGIES/TOPICS:

  • Improve design and implementation of public health surveys
  • Establish national demographic health survey (NDHS) with provincial level disaggregation to provide data for managing performance of Province-wide Health System (PWHS)
  •  Local Health Governance
  • Optimal level of devolution to establish effective local health governance
  • Data on geographically isolated disadvantaged area (GIDA)
  • Establish data on GIDA and their performance to provide data for managing inequities
  • Data on urban health
  • Establish data on wealth classification of barangays in cities and their performance to provide data for managing inequities in urban slums (possibly, using the DSWD method)
  • Health Needs and Services for Special Population Groups
  • Occupational Health Services for the Informal Sector
  • Determine appropriate occupational health services for the Informal Sector through the Rural Health Units or Mobile Clinics
  •  Overseas Filipino Workers (OFWs)
  • Provide in-depth data and analysis on the desired and required health services for OFWs
  •  Elderly/Seniors/Garantisadong Pang-matanda
  • Health Promotion for High Risk Individuals
  • Determine impact of health promotion activities for high risks individuals (e.g., smoking, non-communicable diseases, etc.)
  • Models for access
  • Determine models that will increase and sustain access to health services by the urban  poor, people living in GIDAs, indigenous peoples, persons with disabilities, etc.
  • Enhancement of service delivery and referral
  • Problems and successes on the use of sea ambulances and mobile bus clinics in the delivery of  health services
  • Capacitating Human Resources for Health
  • Human Resources for Health (HRH) Master Plan Reformulation
  • Inventory of staff complement and capacities and technology support to implement UHC programs and thrusts.
  • Funding and technical assistance implications
  •  Evaluation of service provision programs e.g., Nurses Assigned in Rural Services (NARS)  project, RNHeals (Registered Nurses for Health Enhancement and Local Service)
  • Strengthen HR commitment to physical therapy (PT) care through annual credentialing and privileging, both permanent and temporary
  • Need to regulate Basic Life  Support (BLS) and Advanced Cardiac Life Support(ACLS) providers and standardize their training
  •  Efficient approach/model for scale up of deployment of community health teams (CHT)
  • Time motion study for CHT to produce output
  • Evaluation of CHT performance and impact on access to health care (safety, accessibility, and affordability )
  • Sustaining CHT mobilization (logistics)
  • Contracting and Procurement
  • Review/assess the implementation of the Procurement Law in DOH.
  • Identify Bottlenecks and challenges
  • Performance and Budget Utilization Reviews
  • Comprehensive report and profile of DOH-Central Office, LGU,CHD, hospital and donor  performance
  • Integrated reports on Monitoring and Evaluation for Effectiveness and Equity (ME3) and  Performance Governance System (PGS) budget (regular, sub-allotment, grants) reviews   and reports

ENVIRONMENTAL AND CLIMATE CHANGE CONCERNS

DESCRIPTION: Disease transmission is affected by environmental health which refers to the control of physical, biological, chemical and socio-cultural factors. Climate change is one of the components of environmental change. In reality, it is just one dimension of change brought by the environment.

RESEARCH TECHNOLOGIES/TOPICS:

  • Studies to develop cost-effective technologies to prevent / control / monitor environmental pollution
  • Developmentof integrated interventional models to reduce prevalence of infectious diseases affected by changes in the environment (e.g., malaria, dengue, leptospirosis, cholera and typhoid,  tuberculosis MDR and XDR)
  • Correlation of climate sensitive diseases to increased temperature, rainfall, and humidity
  • Reduction of prevalence of water and sanitation related diseases

HEALTH SOCIAL SCIENCES (INCLUDING COMMUNITY DEVELOPMENT)

DESCRIPTION: Diseases are not merely products of pathological processes due to infection, stress, etc., but they are also products of the interaction of bio-psychosocial and cultural milieu. Political and policy decisions of the state impact on health of the people. An understanding of the non-biological character of health would deepen the understanding of health and disease, and dynamics of disease

RESEARCH TECHNOLOGIES/TOPICS:

  • Health social science approach in health research and community development to address emerging concerns/issues on sexual and reproductive health, childhood illnesses, chronic illnesses, and  mental health