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Figure 1. Philippines Health System Organization.
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Under the decentralized, or devolved, health system, technical assistance, policies, and guidelines for malaria control disseminate from the National Department of Health (DOH) to the Provincial Health Offices via Regional Centers for Health Development (CHD) and DOH representatives positioned in extension offices at the provincial level. Information and technical assistance is further propagated by provincial health office staff who conduct trainings and oversee malaria control activities at the municipal and barangay levels with the participation of DOH representatives. While some funding does flow downward from national, every government unit is expected to provide financial support for malaria activities occurring at its respective level. The Provincial Health Office serves as point of entry for external funding organizations, including Global Fund.
doi:10.1371/journal.pone.0073352.g001
Figure 2. Malaria Burden Stratification in 2005 and 2011.
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Malaria burden across provinces in the Philippines are stratified based on the number of indigenous cases reported each year. Between 2005 and 2011, malaria cases have declined in many provinces. In the selected case study provinces, cases have declined in Apayao, Benguet, and Laguna. Cavite are Benguet are certified to be malaria-free according to the Philippines subnational malaria elimination certification standards.
doi:10.1371/journal.pone.0073352.g002
Figure 3. Malaria Cases for Selected Provinces of the Philippines.
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The number of indigenous and imported (when available) cases for each selected province is displayed, along with key programmatic events.
Notes: (A) imported cases are not available; 100% long-lasting insecticide net (LLIN) coverage is defined as one net per 2.5 persons. (B) Imported cases are largely undocumented for this time period; the program was devolved to Local Government Units (LGUs) in 2006. (C) Cases from 1986-1999 were from both P. vivax and P. falciparum; all cases from 1999-2001 were from P. vivax. (D) Three cases occurred from July 2003-August 2004 that cannot be attributed to a single year and thus are not included; data are not available for 1996-1998, 2005, and 2007-2011. LGU = Local Government Unit.
doi:10.1371/journal.pone.0073352.g003
Figure 4. Malaria Program Expenditures for Selected Provinces of the Philippines.
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Total program expenditures by type of activity are displayed for each selected province for selected years, along with the number of indigenous and imported (when available) cases. The percent allocation for the two largest spending categories are given next to each bar.
Notes: M/M&E = Management and Monitoring and Evaluation; IEC = Information and education campaign; Prev/Vector = Prevention and vector control; Diag/Treat = Diagnosis and treatment.
doi:10.1371/journal.pone.0073352.g004
Figure 5. Staffing Ratios by Indigenous Caseload.
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Staffing ratios are calculated by dividing the raw count of personnel by the full-time equivalent (FTE) of the sum of all personnel time spent on malaria (i.e. staffing ratio = number of reported people working on malaria / number needed if all employees were working full time). A staffing ratio is calculated for each province-year observation and plotted according to the logged number of indigenous cases if the number of cases is greater than zero. For province-years where zero indigenous cases are recorded, points are plotted on the vertical axis itself.
doi:10.1371/journal.pone.0073352.g005
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