MPH 504 Week 4 Country Health Profile Example

Country Health Profile: The Philippines, Read Against Vietnam and the United States, With Attention to Who Pays for Care and Where the Data Come From

Student Name

Chamberlain University

MPH 504: Cultural Competency and Global Public Health

Instructor Name

Month Day, Year

Country Health Profile: The Philippines, Read Against Vietnam and the United States, With Attention to Who Pays for Care and Where the Data Come From

Why This Country

The Philippines is an archipelago of more than 7,000 islands with a population of about 115.8 million in 2024 (World Bank, 2026). It is the country of birth of a large share of the patients I manage in a county TB program, and the previous week's analysis placed its TB incidence far above both of its comparison countries. A profile of its health system explains why that burden persists and what any program working with Filipino communities, at home or abroad, has to take into account. The profile reads the Philippines against Vietnam, a neighbor with a similar income level, and the United States, where I practice, so that each indicator has a stated reference.

Indicators Chosen and Why

Twelve indicators are reported, chosen to cover four questions: how long and how well people live, how mothers and children fare, what the health system has to work with and who pays. A profile with fifty indicators says less than one with a dozen that are chosen for a reason. Each figure is the latest year available in the World Bank's World Development Indicators, which draw on WHO, UNICEF and UN agency estimates, so the three countries are measured in the same way.

Table 1

Selected Health Indicators for the Philippines, Vietnam and the United States

Note. Note. World Bank (2026), World Development Indicators; latest year shown where it differs.

Length and Quality of Life

Life expectancy in the Philippines, 69.9 years, is nearly five years below Vietnam's, although the two countries spend almost the same amount per person on health. The gap points to differences in how spending is organized and in the burden of infectious disease, including TB, rather than to the total amount spent alone.

Mothers and Children

Child survival has improved, but the Philippines lags its neighbor. Under-five mortality of 26.5 per 1,000 is about one and a half times Vietnam's, and neonatal deaths make up about half of under-five deaths, which points to care around birth. Maternal mortality of 84 per 100,000 live births is the indicator most out of step with Vietnam. Stunting affects about a quarter of children under five, a sign of chronic undernutrition that also raises the risk of TB later in life. Measles immunization, at 80%, is well below the level needed to prevent outbreaks. Part of the reason lies in the 2017 controversy over a dengue vaccine, after which the share of Filipinos who strongly agreed that vaccines are important fell from 93% in 2015 to 32% in 2018 (Larson et al., 2019). A measles epidemic followed in 2019.

What the Health System Has to Work With

The Philippines trains many nurses but has fewer than one physician per 1,000 people, and a large share of its nurses emigrate to work abroad, including to the United States. Health services were devolved to provinces, cities and municipalities under the Local Government Code of 1991, so primary care and public health programs depend heavily on local government budgets and priorities, which vary widely (Dayrit et al., 2018). The Universal Health Care Act of 2019 automatically enrolled all Filipinos in the national health insurance program, PhilHealth, and set out to integrate local health systems into province-wide networks, but implementation is still uneven.

Who Pays

The most important single figure in the profile may be the out-of-pocket share. In 2023, households paid 44.4% of current health spending directly, four times the U.S. share. High out-of-pocket spending delays care and pushes families into poverty. Even with free TB drugs, more than four in ten households affected by TB spent over a fifth of a year's income on the illness (Florentino et al., 2022). PhilHealth coverage reaches the whole population on paper but covers mainly inpatient care, so outpatient visits, medicines bought at private pharmacies and the costs of travel and lost work remain with households.

Using the Country's Own Sources

The country's own statistics agency publishes national health accounts that differ in detail from the international figures. The Philippine Statistics Authority (2023) reported total health expenditure of 5.5% of GDP in 2022 and a household out-of-pocket share of 44.7%. The World Bank figure for current health spending in 2022 is 5.2%. The difference is not an error: total health expenditure includes capital spending such as new hospitals, while current health spending excludes it. A profile that mixed the two would appear to show a change that did not happen. National sources add detail that international databases lack, such as spending by region, but each figure has to be used with its own definition.

Gaps in the Data

Several indicators are modeled rather than counted. Maternal mortality is estimated because many deaths, especially at home, are not recorded with a cause, and the modeled series has been revised as new data came in. Stunting depends on national nutrition surveys that are several years apart. TB incidence carries a wide uncertainty interval, as the previous week showed. These gaps are greatest in remote island provinces, which are also where care is hardest to reach, so national averages probably flatter the places with the least access.

What the Profile Means for Practice

For a county TB program in the United States, three points from this profile matter. Patients born in the Philippines are likely to have grown up with costly outpatient care and may expect to pay, so stating clearly that testing and treatment are free removes one barrier. Many will have received BCG as infants, given the country's long vaccination program, and the recent loss of vaccine confidence means that conversations about tests and medicines should invite questions rather than assume trust. And because many Filipino nurses work in U.S. health care, the community includes health workers who can be partners in reaching others.

References

Dayrit, M. M., Lagrada, L. P., Picazo, O. F., Pons, M. C., & Villaverde, M. C. (2018). The Philippines health system review (Health Systems in Transition, Vol. 8, No. 2). World Health Organization Regional Office for South-East Asia. https://apps.who.int/iris/handle/10665/274579

Florentino, J. L., Arao, R. M. L., Garfin, A. M. C., Gaviola, D. M. G., Tan, C. R., Yadav, R. P., Hiatt, T., Morishita, F., Siroka, A., Yamanaka, T., & Nishikiori, N. (2022). Expansion of social protection is necessary towards zero catastrophic costs due to TB: The first national TB patient cost survey in the Philippines. PLOS ONE, 17(2), e0264689. https://doi.org/10.1371/journal.pone.0264689

Larson, H. J., Hartigan-Go, K., & de Figueiredo, A. (2019). Vaccine confidence plummets in the Philippines following dengue vaccine scare: Why it matters to pandemic preparedness. Human Vaccines & Immunotherapeutics, 15(3), 625-627. https://doi.org/10.1080/21645515.2018.1522468

Philippine Statistics Authority. (2023). 2022 Philippine national health accounts. https://psa.gov.ph/statistics/pnha

World Bank. (2026). World development indicators [Data set]. https://databank.worldbank.org/source/world-development-indicators