Disability Benefit Package for Children with Developmental Disabilities in the Philippines: A Policy Analysis

Abstract

Background: Sustainable development goal declarations influenced various countries across the globe to create and reform laws and policies to achieve universal health care (UHC). To improve access to the health of children with developmental disabilities (CDDs), PhilHealth launched the Z benefit package for CDDs, which offers subsidized rehabilitation assessments and interventions from contracted healthcare institutions. However, this policy remains underutilized. Research Objectives: This study aimed to analyze the factors that influence the implementation of the disability benefits package for CDDs in the Philippines. Specifically, to 1) describe the current context, policy actors, content, and process of the disability benefits package for CDDs; 2) explore perspectives of policy actors towards implementation of the disability benefits package and their critiques on the context, content, and process of the policy; and 3) identify the facilitators and barriers that influence the implementation of the disability benefits package for CDDs. Methodology: The study used a case study design which entailed the collection of data through document review of policy documents and focused group discussions (FGDs) among selected policy actors (i.e., rehabilitation professionals, representatives from professional organizations, administrative heads of institutions, parents of CDDs). Guided by Walt and Gilson’s policy triangle framework (Walt and Gilson, 1994), data were analyzed through content analysis via a deductive approach. Results: Twenty-two (22) policy documents were retrieved in the document review and a total of 16 participants joined the FGDs. Facilitators and barriers were identified and categorized through the policy elements: 1) context is anchored through the presence of laws and policies supporting the advocacy of early intervention and access to therapy services of CDDs but is hindered by issues on politics, governance and labor force; 2) policy actors (service providers and beneficiaries) are hopeful in the continuous implementation of the Z benefit package nationwide and share the advocacy for CDDs but is hindered by the limited participation of all potential policy actors and limitations with human resources; 3) content is sound and comprehensive but concerns on costing and complying with required resources hinder translation to implementation and lack of certain protocols posit threat on adaptability and sustainability; and 4) processes involved in implementation emphasize quality assurance and initial dissemination efforts were effective during launch but the lack of activities to continuously engage potential service providers and the tediousness of overall process limits participation of service providers both from the public and private sectors. Conclusion: While the launch of the disability benefits package for CDDs in the Philippines seemed promising, the policy remains underutilized as the identified barriers outweigh the facilitators of each policy element. Thus, recommendations for policy reform, education, and research were derived to improve future policy implementation.