dm2021 0434

Republic of the Philippines
Department of Health
OFFICE OF THE SECRETARY
11 October 2021
DEPARTMENT MEMORANDUM
No. 2021 -
FOR: ALL UNDERSECRETARIES, ASSISTANT SECRETARIES,

DIRECTORS OF BUREAUS AND SERVICES, DIRECTORS OF
CENTERS FOR HEALTH DEVELOPMENT, AND OTHERS
CONCERNED
SUBJECT: Directions for the Development of 2023-2025 Local Investment Plans for
Health and 2023 Annual Operational Plans
The Year 2022 and the 2022 Annual Operational Plan (AOP) mark the end of the 2020-2022
Local Investment Planning for Health period. It
is expected to be a milestone year it ushers in as
a new era in health sector development, with the implementation of Executive Order No. 138 on
full devolution. The EO particularly calls the Department of Health (DOH) and other national
agenciesto review their respective mandates and to develop and implement Devolution Transition
Plans (DTPs) for the next 3 years, in pursuit of full devolution of functions to the LGU, as
enshrined in Sections 3 and 17 of Republic Act 7160 or the Local Government Code (LGC) of
1991.
The implementation of the adjusted national tax allocations of LGUs also starts in Fiscal Year
2022, in the light of the Supreme Court Ruling on the Mandanas-Garcia ruling on the just share
of LGUs in the national taxes. This increase will empower LGUs to provide and effectively
discharge devolved duties and functions under RA 7160.
Alongside this are the continuing efforts on COVID-19 response and management, the many
health policy changes with the RA11223 or the Universal Health Care (UHC) Act, and the initial
progress of the UHC Integration Sites.
It is in the above context that LGUs, Provinces, Highly Urbanized Cities (HUC), Independent
Component Cities (ICC), Municipalities and Component Cities (CC) will develop their respective
Local Investment Plans for Health for 2023-2025.
Administrative Order (AO) 2020-0022 on Guidelines on the Development of Local Investment

Plans for Health and AO 2020-0018 on Guidelines on Contracting Province-wide and City-wide
Health Systems shall guide the LIPH and AOP processes. AO 2020-0022 prescribes that the LIPH
serve as the Strategic Plan for the implementation of UHC Act and the integration of Province-
wide and City-wide health systems. It calls for Provinces, HUCs, ICCs, Municipalities and CCs
to formulate their respective investment plans for health. It also recommends that the LIPH,
through the AOPs, shall be the basis of financial and non-financial grants from the DOH per
Section 22 of the UHC Act. AO 2020-0018, on the other hand, gives guidance on the execution
of Terms of Partnership to engage Local Government Units for UHC implementation.
The directions for the development of LGU 2023-2025 LIPH and 2023 AOP shall adopt the
guidelines, provisions, procedures and processes as outlined in AO 2020-0022 and AO 2020-
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i
0018, with this Department Memorandum providing additional details for specific processes
and procedures.
A. Directions for the development of the 2023-2025 LIPH

Processes Additional provisions to AO 2020-0022
1. Call to plan a. The Center for Health Development (CHD) shall initiate the call
for LGUs to
formulate their LIPH.
b. The Provinces/HUCs/ICCs may initiate the call for their
respective component LGUs to formulate their LIPHs before the
CHD call.
c. Starting with the 2023-2025 LIPH period, municipalities and CCs
shall develop their respective Investment Plans for Health.
2. Levels of health |a. Barangay planning;
planning =
in
The significance of the role of Barangays the local health
system was highlighted during the COVID pandemic.
go Municipalities and Component Cities planning;
Health facility planning;
Sub-provincial health system planning;
slepo
Province/HUC/ICC- wide planning.

3. Organization of A Barangay Planning Team shall also be organized and be
LGU Planning composed of, but not limited to:
Teams «
Barangay Kagawad for Health, Barangay Health Worker;
Barangay Nutrition Scholar, CSO/PO representative,
Barangay Captain
=
Midwife, NDP (as applicable)
b. Prescribed composition of Province/HUC/ICC/Municipality/CC
Planning Teams is in AO 2020-0022 (VLA).
4. Local health Participation in local consultations and planning workshops and
planning consultation with key stakeholders shall be encouraged throughout
a. Consultations the LIPH/AOP processes, in particular:
i. DOH Representatives, CHD Program Managers, CHD and LGU
Budget Officers and Accountants, Chiefs of LGU and DOH-
retained hospitals, PhilHealth representatives, among others;
ii. Representatives from other government agencies, representatives
of legislators, IP Mandatory Representatives (IPMR)/IP CSOs,
development partners, representative of the private sector, other

champions in
health development work
b. Situational The following shall be used as additional inputs to the Situational
analysis Analysis:
i. AO 2020-0037: Guidelines on Implementation of the Local
Health Systems Maturity Levels as reference document, among
others;
ii. Human Resource for Health (HRH) Plan, Information,
Communication and Technology (ICT) Plan, Health Promotion
Framework, Local Health Facility Development Plan (HFDP),
Province Physical Framework Development Plan (PPFDP);
iii. Program/disease-specific strategic plans;
iv. Gender and Development (GAD) Plan.
v. Description and analysis of health, and health-related threats and
situations, and health systems problems/concems, shall make use
of the 6 building blocks of health systems;
vi. For UHC Integration Sites (UHC-IS), this shall include analysis
of the
results of the Local Health System Maturity Level (LHS
ML) National Baseline Assessment or Monitoring Report.
c. Identification of The DOH DTPs from the National Program Managers (NPMs)
gaps, LGU shall serve as the DOH Menu of Assistance to be used as key
investment reference/basis for LGU planning.
needs, strategies ii. NPMs shall provide these through their CHD counterparts prior to
and cost the start of the LGU planning. CHDs shall also provide their
requirements respective Menu of Assistance.
ili. The LIPH shall list 3-year strategies instead of Programs, Projects
and Activities (PPAs). These strategies are to be detailed into
specific PPAs in the AOPs.
iv. The process of costing identifies and estimates resource
requirements needed to produce the expected output/outcome.
These include infrastructure and equipment, personnel,
technologies, training needs, medicines, supplies, among others.
For UHC-IS, the LHS ML Technical Assistance Plan shall serve
as an additional reference.
vi. Tools developed/to be developed by other DOH offices for
planning, calculation of needs and projections may be used, such
as:
* Commodities calculator of the Disease Prevention and
Control Bureau;
=
Philippine Health Facility Development Plan (PHFDP)-LIPH
calculator of the Health Facility Development Bureau;
= Human Resource for Health (HRH) Masterplan;
= Others
vii. Barangays shall submit and endorse their health plansto
Mun/CC/HUC/ICC Health Office. Mun/CC Health Offices shall
the
submit and endorse their LIPHs to the PHO.

5. Review and Development Partners, working in the regions, may be invited to
appraisal be members of the CHD Appraisal Committee.
Review of Municipality/Component City (Mun/CC) Investment
Plans for Health:
=
Review shall be done by the Mun/CC Health Office and the
DOH Representative.
i. Barangays shall submit Barangay Plans to Mun/CC Health
Office. Barangays may opt to use other planning forms and
not the LIPH Forms.
ii. Mun/CC Health Office shall review the barangay health plans
with the DOH Representative and identify strategies/PPAs
to
from the barangay plans incorporate in the Mun/CC IPH;
the process of review is done during the consolidation and/or
planning meetings. The Mun/CC may use the LIPH Appraisal
Checklist as a guide in the review of the barangay plans.
iti. Mun/CC shall use the LIPH Forms. The Mun/CC Health
Officer shall endorse the Mun/CC IPH to the PHO.
5. Review and iv. Province Planning Team shall review the Mun/CC IPHs with
appraisal the PDOHO and identify strategies/PPAs, from the Mun/CC
IPHs, which may be included in the Province-wide IPH. The
process of review is done during the consolidation and/or
planning activities. The Province Planning Team may use the
LIPH Appraisal Checklist as a review tool for the Mun/CC
IPHs.
The Province Planning Team and Program Managers together
with the PDOHO shall review the consolidated Province-wide
plan.
Review of HUC/ICC Barangay Plans:
1 Barangays shall submit Barangay Health Plans to the
HUC/ICC Health Office. The Barangay may opt to use other
planning forms and not the LIPH Forms.
ii. HUC/ICC Team shall review the Barangay health plans with
the CDOHO/DOH Representative and identify
strategies/PPAs from the Barangay health plans to be included
in the HUC/ICC-wide IPH. The process of review is done
during the consolidation and/or planning activities. The
HUC/ICC Planning Team may use the LIPH Appraisal
Checklist as a guide to review barangay plans.
iii. The HUC/ICC Planning Team and Program Managers
together with the CDOHO shall review the consolidated city-
wide plan.
. P/CDOHO:s shall submit to CHD the result of their review,
together with the LIPHs of Provinces/HUCs/ICCs, which have
reached the passing score for CHD appraisal.
. The review and appraisal process of Province/HUC/ICC-wide
IPHs described in the AO 2020-0022 (VI.B.3) shall apply.
6. Concurrence of Following the process in AO 2020-0022 (VI1.B.4), the
the LIPH Province/HUC/ICC incorporates the recommendations of the
CHD Appraisal Team, finalizes the LIPH and submits to the
Provincial/City Health Board (P/CHB) for approval.
. The P/CHB shall endorse the approved LIPH to the CHD for
concurrence.
. The accomplished LIPH Appraisal Checklist with the CHD
Director's signature shall be the key evidence/document for the
concurrence of the LIPH.
. CHDs shall submit to BLHSD, through the Field Implementation
and Coordination Team (FICT), a copy of the approved and
concurred Province/HUC/ICC-wide LIPHs, consisting of the
following:
i Narrative section,
ii. Cost matrices,
iii. Annexes
iv. Accomplished appraisal checklist duly signed by the CHD
Director.
The LIPH Forms are contained in Annex B.
B. Directions for the development of 2023 AOP
Processes Particulars
1. Translation of The 2023 AOP shall be formulated at the same time as the 2023-
the LIPH into the 2025 LIPH and shall follow the same process of development.
AQP Strategies in the Year 1 of the LIPH are translated into specific
PPAs in the 2023 AOP.
LGUs are strongly enjoined to. encode the 2023 AOP into the
LIPH Information System (LIPH-IS) to facilitate the review and
consolidation at the Province/HUC/ICC-wide level. Directions for
the LIPH-IS shall be contained in a separate issuance.
Aligning DOH LGU AOPs shall be considered in the DOH and CHD budget
plans and proposals through the submission of advanced copies during
budgets to the DOH and CHD budget preparation. Advanced copies of AOPs
AOPs are termed as LGU investment needs.
a. LGU id. Timelines and details on submission of LGU investment needs
submission are in Annex A.

of investment iii. LGU investment needs shall follow categories listed in AO 2020-
needs to 0022 (VL.E.1) but may be revised/updated as deemed necessary.
CHDs iv. Review process of LGU investment needs:
= The LIPH-IS may be used for the review of LGU investment
needs.
* The PHO first reviews the investment needs of Mun/CC.
= In the same manner, the HUC/ICC Health Office first reviews
the investment needs of Barangays.
®
LGUs and health facilities concerned are notified by the
system of comments received and are able to revise their
respective investment needs accordingly.
Province/HUC/ICC Health Offices submit to CHDs the
consolidated and validated Province/HUC/ICC-wide investment
needs generated by the LIPH-IS.
vi. Province/HUC/ICC Health Offices shall be responsible to submit
and endorse the Province/HUC/ICC-wide investment needs,
along with the AOP Situational and Gap Analysis Summary, to
the CHD. (See Annex C.1)
b. CHD review Timelines and details on the CHD review of LGU investment
of LGU needs are in Annex A.
investment ii. The CHD Program Managers shall review the LGU investment
needs needs, validated by the Province/HUC/ICC Health Office, of their
respective programs;
ii. CHD PMs shall check the investment needs against the
DTPs/DOH Menu of Assistance and note items which are not
provided by the DOH and those with possible duplication of
funding; CHD PMs are enjoined to coordinate with their NPMs
for priority directions and updates on the DTPs/DOH Menu of
Assistance.
iv. CHD PMs shall incorporate prioritized and validated LGU
investment needs in the CHD Budget Proposal, and present to the
Regional Development Council.
CHD:s shall ensure that Regional Development Council (RDC)-
endorsed proposal is consistent/aligned with LGU investment
needs in LIPH/AOP.
vi. CHD:s shall submit the validated LGU investment needs
consisting of the following to BLHSD, through the FICT:
a. Endorsement from CHD Director
b. AOP Situational and Gap Analysis Summary
c. Forms 3, 3.1, 3.2, 3.3 and 3.4 for all LGUs
d. Regional Summary of LGU investment needs
b. Central Timelines and details on CO review of LGU investment needs are
Office review in Annex A.
of LGU ii. BLHSD shall share the link to the submitted LGU investment
investment needs and Regional Summaries to NPMs.
needs iii. NPMs shall be given access to the LIPH-IS, and may give
it
remarks on what can/cannot cover. The LGU and CHD
concerned are notified of NPM comments, and LGU or health
facility concerned may revise accordingly.
iv. The NPMs shall review the Regional Summaries of LGU
investment needs submitted and validated by CHDs;
NPMs shall consider the LGU investment needs as input to
program planning and budgeting. NPMs shall incorporate
prioritized and validated LGU investment needs in their
respective Budget Proposals.
3. Feedback to Feedback for LGUs from CHD and NPMs shall be organized by
Provinces/HUCs/ the Planning Officer together with the CHD PMs.
ICCs Feedback may be provided through the following means:
i. Through the remarks feature of the LIPH-IS;
ii. After the review of the LGU investment needs;
iii. After the CHD appraisal.
It is recommended that feedback include:
i. Appropriateness of interventions/PPAs based on the LGU’s
situational analysis/current situation;
ii. LGU investment needs incorporated in the DOH budget
proposal;
iti. Dis-aggregation of assistance by LGU based on the approved
NEP or GAA, which may be provided by the CHD PMs,
not furnished by the NPMs.
if
4. Review and Submission of the 2023 AOP shall consist of the following:
Appraisal i. AOP Situational Gap Analysis Summary
ii. AOP Cost matrices
iii. The narrative section of the 2023-2025 LIPH shall likewise
serve as the narrative section for the 2023 AOP.
AOP Forms are contained in Annex C.
The AOP Cost matrices shall be generated from the LIPH IS.
Appraisal of Year 1 AOP (2023)
the LIPH.
is carried with the appraisal of
Separate narrative sections of the AOP shall be required for Year

2 AOP (2024) and Year 3 AOP (2025).
5. Concurrence of Concurrence of the Year 1 AOP (2023) is carried with the
the AOP concurrence of the LIPH.
The accomplished AOP Appraisal Checklist with the CHD
Director's signature shall be the key evidence/document for the
concurrence of the AOP.
6. Execution of a. The TOP shall be executed between the DOH and the
Terms of Province/HUC/ICC only.
Partnership b. Please refer to AO 2020-0018 for the details.
(TOP) c. A separate 2023 TOP template shall be issued.
7. Monitoring a. Regional Monitoring Team:
* Monitoring i. Role: Monitor the Province/HUC/ICC LIPH and AOP plan
Teams development process and plan implementation
ii. Composition:
* LIPH Coordinator, Planning Office representative, CHD
Program representative/s, CHD Finance representative,
DOH Rep Coordinator, CHD Hospital Point-person, invite
DPs working in the region and Other stakeholders; opt for
inter-LGU monitoring;
Province//HUC/ICC Monitoring Team:
i. Role: Monitor LIPH and AOP plan development process and
plan implementation of the Province/HUC/ICC and
component LGUs
ii. Composition:
= Health Officer, PDOHO/CDOHO (DMO V), AMHOP
Rep, Program Manager representative/s, LGU Planning
Office representative, LGU Finance representative, LGU
Hospital representative, invite DP and other stakeholders
C. Monitoring shall follow AO 2020-0022 (VLD).
C. Roles of key stakeholders

Players Additional Roles
1. BLHSD a. Develop and update the LIPH-IS according to planning
requirements of the DOH, CHD and Province/HUC/ICC
b. Incorporate the use of the LIPH-IS in the LIPH/AOP process flow
c. Provide access to LIPH-IS to key stakeholders
d. Develop the LIPH Handbook as guide for the LGUs in LIPH
development
HPDPB Provide directions, updates and feedback to CHDs on the
following:
i. Development, use and implementation of DTPs, further
implementation of the EO 138 on full devolution, and health
financing;
ii. Budget proposal submitted to the DBM, NEP, budget
allocation
Provide copy of the above and other relevant documents to CHDs
in a timely manner.
National Provide program directions and DOH DTPs/Menu of Assistance
Program to CHD PMs prior to the start of LGU planning for LGU
Managers guidance in plan development;
Provide CHD/LGU allocation of assistance, as applicable;
Access the LGU investment needs through the LIPH Information
System to view, review and consider these as bases for allocation
of assistance and preparation of their respective budget proposals
CHD LIPH Convene and coordinate LIPH activities in the region, under the
Coordinators direction of the Assistant CHD Director;
Players Additional Roles
b. Orient CHD staff, LGUs and key partners in the region on
updates on the LIPH and AOP processes, inparticular, the LIPH-
IS, DTPs, LIPH Handbook and new issuances
5. CHD Planning Work together with the LIPH Coordinator inthe provision of
Officer technical assistance on planning and in the other LIPH and AOP
processes to LGUs, other CHD staff and stakeholders.
6. CHD Program a. Provide technical guidance to LGUs in planning workshops and
Managers appraisal, including program directions, DOH DTPs/Menu of
Assistance, and specific LGU allocation, if available, for LGU
guidance in plan development,
b. Access the LIPH Information System to view, review and
validate the LGU Investment Needs and use as bases for
allocation of assistance and preparation of their respective budget
proposals
c. Access the LIPH Information System and/or use generated forms
from the system for the review and appraisal of LGU
LIPHs/AOPs
d. Coordinate with the LIPH Coordinator and Planning Officer for a
harmonized plan development in the CHD
e. Coordinate with NPMs for directions, specific technical
assistance, CHD and LGU allocations, feedback on LGU
investment needs
5. DOH a. Provide TA to LGUs in the development of LIPHs, AOPs and
Representatives LGU investment needs, with guidance from the LIPH
Coordinator;
b. Review and validate LIPHs, AOPs and LGU investment needs;
c. Participate in appraisal activities;
d. Access the LIPH Information System to view, review and
validate the LGU Investment Needs;
e. Assist the PCHB, through the P/CHO in ensuring the horizontal
alignment of the LIPH/AOP with local development plans, such
as Local Development Investment Program (LDIP)/
Comprehensive Development Plan (CDP)/Annual Investment
Program (AIP), and others.
6. Development Selected Development Partners may be invited to participate in the
Partners appraisal of LIPHs and AOPs as a member of the CHD Appraisal
Team.
D. MOH-BARMM
LIPH and AOP 1. The LIPH/AOP development shall be led by the MOH-
development BARMM Assistant Secretary.
2. The LIPH/AOP of BARMM LGUs shall support the 10-point
Priority Agenda of the BARMM Government.
3. In the light of their devolved set-up, BARMM LGUs may
follow a different process on plan development and review and
appraisal of plans, as the MOH-BARMM see fit, in consultation
with the LGUs.
4. Technically, program plan development and review shall be
done in coordination with NPMs
directions and priority thriists.
to ensure aligned with national
The MOH-BARMM Appraisal Team shall consist of the Chief
of Technical Services, Planning Officer, LIPH Coordinator,
Cluster Heads
The accomplished LIPH Appraisal Checklist with the signature
of the MOH-BARMM Minister, or his authorized
representative, shall be the key evidence/document for the
concurrence of the LIPH.
MOH-BARMM shall submit to BLHSD, through the Field
Implementation and Coordination Team (FICT), a copy of the
approved and concurred Province/HUC/ICC-wide LIPHs,
consisting of the following:
a. Narrative section,
b. Cost matrices,
c. Annexes
d. Accomplished appraisal checklist duly signed by the MOH-
BARMM Minister or his authorized representative.
E. Priorities and other directions

Priorities Directions
1. Orientation and In light of the continuing COVID-19 pandemic and under the new
planning normal, activities may be conducted through online platforms. Face-
workshops to-face orientation and planning workshops may be conducted,
depending on the existing quarantine status/alert levels of the
LGUs/Region, and with strict adherence to minimum public health
standards.
2. Executive Order a. The LIPH and the AOP shall outline the strategies and activities
No. 138 of the LGU to be undertaken to fully support the objectives and
goals of EO 138, particularly on full devolution of health
services and functions.
b. The LGUs shall use the DOH DTP as a key guide in local health
planning and advocacy for full devolution of health services and
functions.
3. COVID-19 and Inclusion of COVID-19 and Emerging and Re-emerging Infectious
EREID Diseases (EREID) response/control/interventions
4. LIPH Information |a. The LIPH IS was launched in June 2021 to support LGUs in the
System (LIPH IS) development, consolidation, review and appraisal and analysis
of LGU LIPHs and AOPs. Encoding of the 2022 AOP of
Provinces, HUCs, ICCs and health units and facilities into the
system was initiated soon after.
LGUs are strongly enjoined to use the LIPH IS for the
development, encoding, integration and consolidation, review
and appraisal of LIPHs and AOPs:
i. LIPH 2023-2025, AOP 2023 and LGU investment
needs; and
ii. Succeeding LIPHs and AOPs
CHD: in coordination with LGUs shall agree with the level of
users/levels of encoding: (CHD-level; Province/HUC/ICC level;
Municipality/Component City level; Facility level; Others)
Review and vetting/validation in the IS shall follow the
LIPH/AOP process. CHDs in coordination with LGUs shall
agree on how the review and appraisal will be conducted, and
dates/schedules, provided these are within the prescribed
LIPH/AOP process and timelines;
. Generally, the review process follows the process below:
i. The PHO reviews the investment needs/plans of Mur/CC;
ii. In the same manner, the HUC/ICC Health Office reviews the
investment needs/plans of its Barangays;
iii. The CHD review and validate investment needs/plans
reviewed by PFHUC/ICC HO;
iv. In the same manner, NPMs review investment needs/plans
have been reviewed and vetted by CHDs.
v. LGUs and health facilities concerned are notified by the
system of comments received and are able to revise their
respective investment needs/plans accordingly;
. The LIPH IS is a tool to support the LIPH and AOP processes; it
is not designed to replace the key planning activities and key
LIPH principles/ guidelines (consultation, participation,
inclusivity, prioritization, analysis, others);
. Guidelines on the LIPH IS will be issued separately.
5. Seal of Good “Complete and concurred LIPH and AOP” is included as one of
Local Governance the indicators in the DILG’s SGLG. “Complete” means that all
(SGLG) of the LIPH sections as indicated in the LIPH Content Outline are
Department of present. “Concurred” means the LIPH has passed through the
CHD appraisal
Interior and Local process, has been enhanced and finalized, and
Government endorsed by the P/CHB to the CHD. The accomplished
(DILG) LIPH/AOP Appraisal Checklist with the CHD Director's
signature shall be the key evidence/document for the
concurrence of the LIPH/AOP.
. For 2021 SGLG, the results of the 2019 LGU Health Scorecard
shall be used. Hence, all declared concurred plans (with the
corresponding MOV as above) for those years as per LGU Health
Scorecard Results shall be subject to validation of the DILG
SGLG Team.
6. LIPH Handbook The LIPH Handbook edition 2021 shall update the LIPH
edition 2021 Handbook issued in 2015.
. The handbook, along with this DM and the AO 2020-0022 on
development of LIPH, and the AO 2020-0018 on Contracting,
will be the toolkits and guides for the CHDs and LGUs in the
development of LIPHs and AOPs.
The Handbook is generic, i.e. will not apply for a specific LIPH
period but is designed to provide general directions on LGU
strategic investment and operational planning for health.
. The handbook is not designed as an instruction manual/textbook
on basic planning, as these are available through other means.
7. Directions for The LIPHs and AOPs of UHC-IS shall reflect the provision of
UHC-IS TA according to the needs and gaps identified in the LHS ML
Assessment.
. The LIPH and AOP shall be used as a reference by the UHC-IS
in the preparation of Work and Financial Plans for the Special
Health Fund.
Specific directions for UHC-IS are to be issued separately.
10
8. Policy on plan- In the light of the LIPH as basis/reference for technical
sharing assistance from the DOH, development partners and other
stakeholders, copies of LIPHs and AOPs may be shared, upon
request.
. Requests shall specify the reason and the specific use for the
plans.
Requesting parties shall be advised that plans are to be used for
the specific purpose and may not be shared or forwarded to
other partners.
Specific data requests shall be referred to the concerned CHDs
and LGUs.
CHDs and all other concerned offices are directed to provide technical assistance to Provinces/
HUCs, ICCs, Municipalities and Component Cities in the development and submission of their
2023-2025 LIPHs, 2023 AOPs and 2023 LGU investment needs in the prescribed forms and
timelines. (Please see Annexes.)
For compliance.
By Authority of the Secretary
—
of Health:
KENNETH G. , MD, MPHM, CESO III

Assistant Secretary of Health
Health Policy and Systems Development Team
11
LIST OF ANNEXES:
Annex A LIPH and AOP Development Timelines, Roles and Responsibilities
Annex B LIPH Forms

1. LIPH Content Qutline
2. LIPH Form 1: 2023-2025 LIPH summary of investment cost by building
block, fund source and year
3. LIPH Form 2: Cost assumptions by building block, strategies, resource
requirements and fund source (LIPH Mother Plan)
4. LIPH Appraisal Checklist
5. List of Strategies
Annex C AOP Forms for Year 1 (2023)

1. AQP Situational and Gap Analysis Summary
2. AOP Form 1: Summary of Investment Cost by Health Systems Building
Block and Fund Source
3. AQP Form 2: Cost Assumptions by HS Building Block, PPAs, Quarter and
Fund Source (Mother Plan)
AOP Form 3: Summary of LGU Investment Needs
AOP Form 3.1: LGU Investment Needs for Health Facility Development.
Information Communication and Technology and Operations
Cost
AQP Form 3.2: LGU Investment Needs for Human Resources for Health
AOP Form 3.3: LGU Investment Needs for Commodities
AOP Form 3.4: LGU Investment Needs for Other Technical Assistance
SewNo
AOP Form 4: Regional Summary of LGU Investment Needs

0. LGU Investment Needs Categories
ANNEX A
LIPH 2023-2025 and 2023 AOP Development Process, Timelines and Responsibilities
Reference
Timeline to AQ Activity Documents / Output Responsible Office/Person
M aterials needed
2020-0022
Department
October Orientation of CHD/MOH-BARMM LIPH Memorandum Orientation and Planning Bureau of Local Health Systems Development
2021 Coordinators and Planning Team Other relevant Workshop Schedules (BLHSD)
documents
= CHD Director/MOH-BARMM Minister or
Nm
Rep
Call to pl
October
VLB.1.
an:
LGU Orientation on 2023-2025 LIPH and
Orientation and Planning
*
*
CHD/MOH-BARMM LIPH Coordinator
CHD/MOH-BARMM Planning Officer
2021
= Other relevant Workshop P Schedul
Schedules
2023 AOP development
P » DOH Representatives
P
documents .
s.
Province/HUC/ICC/Municipal/ CC Health
Officers
VIB.2. Local Health Planning (at different levels): Previous LIPH,
a. Situational Analysis AOPs, Other Draft 2023-2025 LIPH *
Province/HUC/ICC/Municipal/ CC Health
b. Identification of gaps, LGU investment health-related Draft 2023 LGU investment Officers/Chiefs of Hospital
needs, strategies and cost requirements local plans needs & Situational and Gap » DOH Representatives
vs. DOH DTP, DOH menu and LGU Health Analysis Summary of * CHD/MOH-BARMM LIPH Coordinator
program standards, directions (VL.E.1) Scorecard, Province/HUC/ICC/Munici « CHD/MOH-BARMM Program Managers
i. Invitation to representatives of FHSIS, other pal/ Component City/Health « CHD/MOH-BARMM Planning Officer
legislators, other champions in program and Units and Facilities
health development works in local health facility
consultation/planning activities statistics and
October — LIPH-IS: Start of encoding of AOP Cost updates
December Matrices in into the system Devolution
2021 Transition Plans
(DTPY/DOH
Menu of
Assistance
Other relevant
documents
Barangay’ 2023 Consolidated » Province/HUC/ICC/Municipal/ CC Health
VLE.L Province/HUC/ICC Planning Team Mun/CC LGU Province/HUC/ 1CC-wide Officers
consolidation of 2023 LGU investment investment needs Investment Needs (AOP Forms +
Province/HUC/ICC Planning Team
needs DTPs/DOH Menu 3:31,3.2,3.3.3.4) & = DOH Representatives
Situational and Gap Analysis
.
of Assistance
Summary
ANNEX A
Reference
Timeline to AO
Documents/
Activity
Materials
.
needed Output Responsible Office/Person
20290-0022
Dissemination of guidelines for 2023 HPDPB
January Budget Proposal, BD Forms, and DBM BP
2022 Forms based on DBM National Budget Call
(NOTE: Calendar may vary depending on
the DBM Budget Call) 2023
VIE.1. a. Submission of 2023 Consolidated DOH Rep reviewed and Province/HUC/ICC/Municipal/ CC Health
Province/HUC/ICC-wide Investment Province/HUC/ validated 2023 Consolidated Officers
Needs to the Province/HUC/ICC DOH ICC-wide Province/HUC/ICC-wide
Representative Investment Needs Investment Needs Province/HUC/ICC DOH Representative
& Situational and
b. Review and validation by Gap Analysis
Province/HUC/ICC DOH Summary
Representative
c. Submission to CHD/MOH-BARMM
LIPH-IS: System-generated forms
February VIE.2. CHD/MOH-BARMM review of 2023 DOH Rep 2023 Province/HUC/ICC-
2022 Province/HUC/ICC-wide LGU investment reviewed and wide LGU investment needs
needs: validated 2023 (System-generated forms)
a. Distribution to CHD/MOH-BARMM Consolidated CHD/MOH-BARMM LIPH Coordinator
Program Managers Province/
HUC/CC-wide Draft CHD/MOH-BARMM
b. Review, inclusion/consideration in Investment Needs Budget Proposal CHD/MOH-BARMM Program Managers
CHD/MOH-BARMM Budget Proposal DTPs/DOH Menu incorporating LGU CHD/MOH-BARMM Planning Officer
of Assistance investment needs
NPM directions
c. Regional consolidation and submission and updates CHD Director/MOH- CHD/MOH-BARMM LIPH Coordinator
to Central Office (BLHSD) BARMM Minister or Rep CHD/MOH-BARMM Planning Officer
(February 14) endorsement of 2023 CHD/MOH-BARMM Program Managers
Province/HUC/ICC-wide CHD Director/MOH-BARMM Minister or
d. Regional Development Council (RDC) investment needs & Rep
Consultation of CHD/MOH-BARMMs Regional Summary (AQP
per DBM Calendar (on CHD/MOH- Form 4)
BARMM Budget Proposal with
incorporated LGU needs)
ANNEX A
Reference
Timeline to AO Documents/
Activity Output Responsible Office/Person
2020-0022 Materials needed
February VLE3. Central Office review of 2023 Regional
2022 Province/HUC/ICC-wide investment needs: Summaries of
a. Distribution to National Program 2023 Bureau of Local Health Systems
Managers (NPM) of LGU investment Province/HUC/IC Development
needs and Regional Summaries (AOP C-wide LGU
Form 4) investment needs
NPMs review and (System- Draft Budget Proposals National Program Managers
inclusion/consideration of LGU generated forms)
investment needs in the Office/Program
Budget Proposal
Endorsement of the Regional (RDC-endorsed Health Policy Development and Planning
Development Council of the CHD/MOH-BARMM budget Bureau
CHD/MOH-BARMM Budget Proposal proposals)
(incorporating LGU Investment Needs)
to DOH thru HPDPB (Note: Timely
submission of RDC-endorsed Budget
Proposals is essential for consideration
in the Central Office Budget Proposal
timelines and deadline to DBM) DOH Budget Deliberation CHD/MOH-BARMM Program Managers
February CHD/MOH-BARMM to incorporate (BD) Forms CHD/MOH-BARMM Planning Officer
LGU investment needs in the BD Forms
and submit to HPDPB and concerned
offices (following the Guidelines on
Budget Proposal Preparation)
March HPDPB to forward RDC-endorsed
Health Policy Development and Planning
CHD/MOH-BARMM budget proposals
Bureau
and BD Forms to National Program
Managers for consideration in the
Office/Program Budget Proposal
March NPM review of RDC-endorsed
National Program Managers
CHD/MOH-BARMM budget proposals
and BD Forms vis-a-vis Office/Program
Budget Proposal that incorporated the
LGU Investment Needs (as per letter b
above)
ANNEX A
Reference
D /
Timeline to AO Activity rocumens. Output Responsible Office/Person
Ma ded
2020-0022
June-July VL E3. g. Feedback of National Program
2022 Managers BP Form C
i. To HPDPB of specific items (DBM Budget Preparation National Program Managers
included in the Program Budget Form C: Summary of RDC
Proposal thru accomplishment of Inputs and
BP Form C (Feedback on RDC- Recommendations on
endorsed proposals) Agency New and Expanded
ii. To CHD/MOH-BARMM of the Programs and Projects) National Program Managers
LGU Investment Needs included of Health Policy Development and Planning
the Program Budget Proposal Bureau
h. National Program Managers to submit
BP Form C to HPDPB. HPDPB to
consolidate and submit to DBM
June — July VILE3. Feedback to LGUs:
2022 * Feedback to CHD/MOH-BARMM Signed Consolidated BP
Program Managers of items included in Form C & comparative
Health Policy Development and Planning
Office/Program Budget Proposal thru
Bureau
the final consolidated BP Form C along
with comparative of original proposal
to DBM and 2023 NEP
pA
(NOTE: Upon release of 2023 NEF)
LGU-disaggregated
VIEA4. » Consolidation of feedback from consolidated feedback from program
e
¥ onagers
National and CHD/MOH-BARMM NPMs and CHD/MOH-
Program Managers BARMM PMs to LGUs
July 2022 Provision of copy of DOH-endorsed 2023
Budget Proposal and Approved NEP to
HPDPB
CHDs/MOH-BARMM
(NOTE: Upon release of 2023 NEP)
June-July VIEA4. LGU
revision and updating of 2023-2025 Review/feedback Local Government Units
2022 LIPH and 2023 AOPs based on review of NEP Revised 2023 AOP (ALL CHD/MOH-BARMM LIPH Coordinator
CHD/MOH-BARMM and NPMs, and forms) DOH Representatives (all levels)
approved 2023 NEP
ANNEX A
oe
Reference
NE
Timeline os
Activity
Documents/
Output Responsible Office/Person
:
Materials needed
July- VIB3 Review and Appraisal of 2023-2025 LIPH LGU Planning Team
September (and 2023 AQP) Revised 2023 Accomplished 2023-2025 LGU Program Managers
2022 a. Review by the Province/HUC/ICC AOP (ALL forms) LIPH Appraisal Checklist Province/HUC/ICC DOH Representatives
Planning Team and Provincial/City
DOH Representatives CHD/MOH-BARMM Appraisal Team
b. CHD/MOH-BARMM appraisal
NOTE: AOP appraisal is carried with the
LIPH appraisal
October — VI.B4. Enhancement and finalization of 2023-2025 Accomplished * 2023-2025 LIPH Final Province/HUC/ICC Health Officer
December LIPH and 2023 AOP 2023-2025 LIPH Enhanced version Province/HUC/ICC DOH Representative
2022 Appraisal «=
LIPH Appraisal
Concurrence of 2023-2025 LIPH with the Checklist Checklist signed by the CHD Director/MOH-BARMM Minister or
2023A0P CHD Director/MOH- Rep
BARMM Minister or LIPH Coordinator
Submission of concurred copy of 2023-2025 Rep
LIPH, Appraisal Checklist and 2023 AOP to =
2023 AOP Final
BLHSD (December 15) Enhanced version
VI.C.2. Execution of 2023 TOP between TOP Template Signed 2023 Terms of CHD/MOH-BARMM LIPH Coordinator,
October
2022- CHD/MOH-BARMM and 2023 AOP Final Partnership (TOP) Legal Officer, CHD Director/MOH-
Province/HUC/ICC Enhanced version BARMM Minister or Rep
January
Province/HUC/ICC Local Chief Executive,
}
he
2023
Health Officer
October VLB.1. Call to
plan for 2024 AOP Department Bureau of Local Health Systems
2022 - Orientation Memorandum Development
January Local Health Planning LGU Planning Centers for Health Development
2023 documents as Local Government Units
above Stakeholders
2023 VIC. 2023 AOP Implementation Concurred 2023 AQP Monitoring Report
VID. Monitoring of Plan Implementation AOP Fund Utilization Report
Evidences of
implementation
ANNEX B.1
2023-2025 LIPH CONTENT OUTLINE
Executive Summary
L Plan development
a. Membership of the LIPH Planning Team (AO 2020-0022 VLA)
b. Plan development process (AO 2020-0022 VIB.)
Consideration and consolidation of health situation and needs of different levels, and
different population groups; incorporation of Barangay Health Plans into Municipal
and Component City Investment Plan for Health; incorporation of Municipal and
Component City [PH into the Province-wide IPH; OR barangay health plans into the
HUC/ICC-wide IPH
Where available, consideration of health needs/activities in Ancestral Domain
Sustainable Development and Protection Plan (ADSDPP)/Ancestral Domain
Investment Plan for Health (ADIPH)
Consideration of other plans such as but not limited to: DRRM-H Plan, Health Facility
Development Plan, Human Resources for Health Plan, ICT Development Plan,
Devolution Transition Plan, GAD Plan
Consultation with/involvement of key stakeholders, Civil Society Organizations
(CSOs)/Non-Government Organizations (NGOs), IP Mandatory Representatives,
representatives of legislators, special population groups, others
Review of the LIPH/previous AOPs including monitoring reports; program strategic
plans; and other LGU health or health-related plans
II. Health situation of the Province/City (AO 2020-0022 VI.B.2.a)

a. Description and analysis of health, and health-related threats and situations, and health
systems problems/concerns, according to the WHO building blocks of health systems,
namely: Leadership and Governance; Financing; Health Workforce; Information;
Supply Chain and Logistics Management and Health Regulation; and Service Delivery
1. Brief discussion on health status of IPs/ICCs, GIDA, Urban Poor and other
vulnerable populations, as applicable
2. Comparison against standards such as NOH, Flplus for Health and LGU Health
Scorecard
3. Gaps/Status of:
e Human resources for health, infrastructure and equipment, service capabilities
of health facilities and services, status of licensing (DOH) and accreditation
(PhilHealth) of health facilities and services, and management support systems
such as human resources for health management and development, information
management, procurement and supply chain management, quality
assurance/improvement, referral system, DRRM-H system, epidemiologic
surveillance system, and proactive and effective health promotion programs
4. Status of P/CWHS integration
IIL. Local priorities/Major thrusts of the LIPH
a. Consistency with gaps/problems/needs identified, and aligned with the UHC Act, F1
Plus for Health, NOH
b. Readiness/Achievement of Province/City-wide integration of the local health systems
c. Recovery and resilience plans
Iv. Monitoring & Evaluation (AO 2020-0022 VI. D.)

a. LIPH/AOP Monitoring Team and other stakeholders involved
b. M&E process/activities
e Systems or program-based Program Implementation Review (PIR), Program and
Budget Utilization Review (PBUR), LGU Scorecard, progress monitoring report,
others
e Tracking of physical accomplishment of PPAs; DOH assistance received; and LGU
counterpart
e Submission of Fund Utilization Reports for transferred funds
Cost Matrices
Cost matrices shall contain strategies that will address gaps/problems/concerns and
priorities based on Situational analysis, Baseline Assessments, DOH Menu of Assistance,
Devolution Transition Plan and GAD plan related to health
LIPH Form Summary of Investment Cost by Health Systems Building Block And
1:
Fund Source
LIPH Form 2: Cost Assumptions by HS Building Block, Strategies, and Fund Source
VIL Other Attachments (As applicable)

Heal
AEX BZ
PH Form 3
2023-2025 LPH SUMMARY OF INVESTNENT COST BY BUILDING BLOC. FUND SOURCE AND YEAR
REGION
PROVINCEMUCACC:
CTY
uc:
MUNICIPALITY/CONPONENT
Fre¥y
FUND SOURCES PHP) (2)
LOCAL GOVERNMENT UNT LGU) "DEPARTMENT OF HEALTH (00H)
PROVHCEHUCACE LGU MUNGIPALITY/COMPONENT OITY LGU. CENTRAL OFFICE Ho
T
HEALTH SERVICE
DELIVERY
HEALTH VIORF ORCE
HEALTH D8 RATION
SUPPLY CHANG
MAAGEMENT
HEALTHREGUATION
5 FINATCING,
EADERSHP
GOVERNANCE
A
SOURCE PhP) Dy
Source asa
Percentage of Grand Tous
NOTES:
Total per Building Block 0 Include the Uhuded
{1 Hoatth Systems Busking Blocks:
§ Healt Service Oebvery: Meath Workforce Heath information Syste; Supply Cham & Logstes 1h and Healt Reguabon {Mecca products, vaccines and technokoqy. Financing Leadership and Govemance
(2) Fund Soxroes - Vehichwhal fice wit be able fa fund he vestment:
§ LGU - Local Goverrroent Urets Province MUCAKC LGU (Genera Fund 30d Trust Fund for
Special Heath Fund); Handcppsk/Camponent Coy LGU (General Fund and Trust Fund fr Healt), Barangay LGU
§ DOM - Cental Off

or Cerurs kr Heath
§ Others - Other Fund Soteces, ch 25 Official Deveicpment Assistance (sg. UN Agencies, developmen parters) othe national agencies; HGOSCSOs: pvate and other seckrs
§ Unturded «No ring source hs been cisatied
3) Total per Gus Block Sum of al Adin sources fo a parncsar Bukdng Block
{4)% of Bukiog Bock Io te Grand Tol

19) Remurks - odes or comments; may specry Other nd saxrees
AiEXE 2
PH Form 1
2023-228 LIPH SUMMARY OF INVESTMENT COST BY BUALDING BLOCK, FUND SOURCE AND YEAR
REGION:
PROVINCEMYCACC:
GUMCIPALIYICOMPOHENT CITY:
wer. wna
FUND SOURCES
Ph) (3
LOCAL GOVERNMENT UHI (GL) EPARTUENT OF HEALTH DOK)
PROVINCEMUCACE LGU ULPECIOAL

ITYICOUPONENT CITY LGU CENTRAL OFFICE
Genenat
Province
Fund
1
KEALTH SERVICE
HEALTH V/ORRFORCE
FEALTH IB ORATION
TEN
SUPPLY CHATS
LUPAGELSENT
HEALTH REGULATION
FRAC
LEAGERSHP ND
Percentage of Grand Tots
Unfunded:
SOURCE (Pre)
Source srs
of Grand Tou!
NOTES:
Tota) por Butging Block Io nciude Unfunded te
1) HoltSystems Buking Blocks
§ Hoa Service Dedvery.
Heal Vioriorce, Health Inrmabon System, Sipety Chan & Logshcs 12 snd Hea Regutston (1edcal products, vacenes and echndlogy); Franc. Lesdersh snd Govemance.
2) Fund Sources - Vituchvweat ofc wl bs aie © hid De ester.
§
§
LGU - Local Goverment Urey
DOH - Cenal Ofice cr Centers or Hows Development,
MCG LGU (General Fund nd Trust Fuad ko HeoTSpecal Hea Fura, Muncoakt Campanent Cty LGR (General Fund and Trust
Fu Kr Healt): Barangay LGU
§ Qthern -
Or Fused Souroes. such Offcsal
a
Development Assistance (eg. UN Agencies, deveicpment parners]. over atonal
agences, 1GOSKC SOs; rivals and other sectors
4 Unfunded to hocking source Kas been Kenified
3) Toll per Buiding Bock - Sum of a nig sss
ki 8 parr
Budi Block
4) % of Buk Block
he
Grand Total
{5)Remrks Noles or corments. may speci Othe fund sources.

«
LIPH Form 2
LIFH
ASSUMPTIONS
PROVINCE/HUCHCC:
MUNICIPALITY/COMPONENT
CY:
MAJOR/SUB-PROGRAM
STRATEGY
1.
1:
Procurement of
Procurement
Procurement
Procurement
TEGY 2:
CITY:
2023-2026
Bullding Block:
STRATEGIES
for Year
for Year 2
for Year 3
for Year
ear
for Year 3
2
1
1
i
BY
{i
_
1
BUILDING BLOCK, STRATEGIE
1:
Performancs
Indicator
Cars
District
Municipality!
Component
CityfBarangay
“
lame of
Health Facility 5)
2024 2025
Resource Requirements {PhP}
Particulars
@
Expense
Category
Total ESTIMATED
Cast
General
Fund
for,"
Local
ProvincefHUCACC LGU
Government
General
Fund
Fund Sources (PhP)
Units (LGU)
Mun/CC LGU
nist Fund
for Health
@®
Barangay
Others
Unfunded
{PhP)
©
REMARKS
10)
TEGY 3:
Advocacy/Awareness/ Health Promotion
and Health Promotion Year 1

J
1 Sub-Total Year 1
1 Sub-Tots! Year 2
1 Sub-Total Year 3 (PhP}
Total for Major/Sub-Program 1 (PhP)
TEGY 1:
of
Procurgsment for Year 1

Procurement for Year 2
Procurement for
Year 3
1
ST
i Building Block:
STRATEGIES
oo
Performance
Indicator
i
ASSUMPTIONS BY BUILDING BLOCK, STRATEGIES, RESOURCE REQUIREMENTS AND FUND
Cre
CityBarangay
.
SOURCE (LIPH MOTHER PLAN}
Name of
eat .
Facility
vo
Resaurce Requirements (PhP)

o
Province/HUCACC
L
LGU
cal
Fund Sources (PhP)
Government Units (LGU)
Mun/CC LGU
&
Unfunded
ned
n
rears
Expense Total ESTIMATED Others
. 0)
|,
Particulars @
Category Cost Trust Fund] Barangay CO GHD
General General |Tiust Fund
“ “ @ Func Fund for Health
TEGY 2:
1. Ti for Year 1
ear
3. T for Year3
2
STRATEGY 3:
Advocacy/Awareness! Health Promotion
1. Advocacy campaigns for Year 1
2. Advocacy for Year 2
3, Advocacy campaigns for Year 3
2 Sub-Total Year 1
2 Sub-Total Year 2
2 Sub-Total Year 3 (PhP)
3-year Total for Major/Stub-Program 2 (PhP)

including Unfunded
SO Sub-Total Year 1
SD Sub-Total Year 2 (PhP)
Sub-Total Year 3
3.year TOTAL
for Service Delivery (PhF)
«
{4)
ProgramProject!
Activities (PPA)
(Buliing Bloc)
Construction;
Establishing
| macs”
District ay pal
City!
i
Barangay
Name
Health
Faciy
of
QO [G2
Target
3
{1) Health Systems Building Block: Service Delivery; Health Workforce; Health Information Systems; Supply Chain
+ Strategies - Identified priority interventions that address health needs and health inequities, such as:
Repair/renovation/expansion of health faciities;
at
&
Total
fot
Logistics Mgt
Itams
cnption
Resource Requirements (PhP)
Expense
Catogary
URCost
systems; Monitoring; Policy development; Sectaral eallaboration/partnerships: Advocacy/awarenesstealth promotion campaigns; Research and development; Others
« Objective ~ Desired outcome in 3 years for the Strategy
(2) Performance Indicator for the Strategy - Measurable valuefperformance measurement to evaluate the success of a strategyfintervention
Qa <r,
(3) District - The legislative district where the Strategy will be appliediconducted. In a province, this excludes the legislative districts covered by the HUG/GC which wil be reflected in the
Municipality/Component
(5) Name of
City/Barangay - Specific area where the Strategy wilt be applied/conducted, indicale if area covers GIDA/IPAUrban poor and other vulnerable population
Health Facility - The exact name of the facility where the Strategy wil be appliediconducied
{6) Target - Quantiiable physical targetigoaliobjective in relation to the performance indicator of a particular stralegy
{7) Resource Requirement Inputs needed to conductipraduce the PPA

—
§ Items Description - specific description of the items/units to be costed {eg. Capsules, tablets, meals, activity cost etc}
Toul Cost|
10 |
1{Unit Cast x
PhP}
and Health Regulation {Medicat products, vaccines and technology);
Procurementirepair of equipment; Hiring of health workforce; Retention of health workforce; Capacity bulkiing/development;
conn
Fund
ProvinceMUCACC
TSF
Financing;
HUCACC's respective plans

for
| MSHE
LGU
Leadership &
Total
Procurement/provisian of commodities, medical supplies;

Fund
Govemance
Fund Source (PhP)
MuniCC LGU
cone |tetrons
for Health
Total
BLGU co CHD Others Unfunded Remarks
§ Expense Category: PS, MOOE, (Infrastructure, Equipment, Motor Vehicle, Others)

CO
§ Unit Cost - Estimated Cost to proguce/conduct the PIP/A

§ Quantity - Total Number of the Unils to be costed
{8) Fund Source — Whichwhat office will be able to
fund the Strategy output:
§ LGU Local Govemment Units: Province/HUCACC LGU (General Fund and Trust Fund for Health/Special Health Fund), Municipality/Component City LGU (General Fund and Trust Fund
-
for
Health); Barangay LGU
Trust Fund - Fund which accounts for tha
receipts by any agency of govemment or
by a public officer acting as a trustee, agen,
or administrator for the fulfilment of some obligations
General Fuad - Fund which is available far any purpose and is
composed of
all receipts and revenues which are not otherwise accruing to
other funds
Special Health Fund - financial resources
pool of
at
the PICWHS intended to
finance population-based and individual health services, health system operating cos!s, capital investments, and remuneration of additional health workers and incentives for all health workers.
§ -
DOH or Centers for Health Development;
Central Office
and other sectors
§ Others - Other Fund, Sources such as Official Development Assistance (eg. UN Agencies, development partners); other national agencies; NGOS/CSOs; private
(9) Unfunded - No funding source has been identified
{10) Remarks - Notes or comments; may specify Other fund sources
ANNEX B.4
LIPH APPRAISAL CHECKLIST
Review of LIPH 2023-2025
Province/City:
INSTRUCTIONS:
1. Only plans with COMPLETE contents! parts shall be reviewed. The Completeness of the Document parameter has no score points. These are pre-requisites before proceeding to the other parameters.
2. If required data/ information is found in the expected section/ part of the LIPH, put the score under the Actual Score column based on the maximum score indicated under the Points column.
3. Indicate comments/ revisions needed in the Remarks/ Recommendations column. Shaded areas
are not to be filled-up.
4. Indicate the total Score and compute for the Percentage. Check the appropriate Over-all Result at the end of the checklist.
5. The LGU and PDOHO review result/document is to be used for the next round’ level ofreview/ appraisal.
6. The Appraisal Checklist provides the minimum criteria. Additional criteria/documents/cvidences may be required by the Appraisal Team, as deemed necessary.
LGU AND P/CDOHO REVIEW CHD APPRAISAL

MEANS
FANS OF
PARAMETERS FOR EVALUATION DETAILS Points RETAOTRS]
VERIFICATION . Remarks/
Actual Score Recommendation Actual Score
Recommendations
J. COMPLETENESS OF THE DOCUMENT NO SCORE NO SCORE
Indicate the presence of: Indicate (+) Indicate {+)
Executive Summary Executive Summary Section
[. Plan development Plan Development Section
IL. 1lealth situation of the Province/City Health Situation Section
11. Local priorities/Major thrusts of the LIPH Local Priorities Section
IV. Monitoring & Evaluation M&E Section
V. Cost Matrices
A. Content/Parts
a. LIPH Form 1: Summary of Investment Cost by Health
Systems Building Block and Fund Source Accomplished Form
b. LIPH Form 2: Cost Assumptions by Health Systems Building
Block, Strategies and Fund Source Accomplished Form
VI. Other attachments, specify: Documents Attached
1. Data are entered in the appropriate columns Accomplished Form
2. Entries correspond to the appropriate data required
B. Properly Filled-up Forms

If
(cg. the column requires funds, amount in PhP should be lished F Form
A ceomplished
entered;
if column requires quantity, numbers are entered etc)
3. Columns and rows which need data entries are filled up
lished
A complished Fi borm
(No empty column/rows unless filling-up is not appplicable)
C. Endorsement of Reviewed LIPH from
LGU Planning Team to CHD
|. Endorsement Letter/Email from PHO/CHO Letter or email
D. LIPH Information System Encoded LIPH in the LIPH-IS Generated Forms from the System
1 of
PARAMETERS FOR EVALUATION MEANS OF
iA ou
DETAILS . Points Lica iirg
VERIFICATION Remarks/
Actual Score Recommendation Actual Score .
Recommendations
iT. PLAN DEVELOPMENT PROCESS 30
A. OrganizationPa of Planning Team
©
[. Organized LGU Planning Team

as per AQ 2020-0022
EUT Personnel Utder’SU
2
I Incorporation of lower level plans

a. Consulation/workshop/meetings documentation
For theprovince:
a. incorporation of Barangay llealth Plans into the Municipal!
b. Elements of lower level plans reflected!
Component City LIPH
included
meine in the Prow/HUC/ICC plan
B. Consideration health situation and b. Incorporation of Municipal and Component City Health
pl
of
3
needs different
different levels Plans into the Province-wide LIPH;
into
of Province-wide LIPH;
eds
level the
c. Actual Mun/CC IPH, Brey. Health Plans and

other Plans as bases
For the HUC/ICC:
NOTE:
of 1 City submittedThese
. plans do not need to be
.
Health the HUC/ICC
.
I
ncoporation Barangay
angay Health PI; Plans
inta -
to DOH BLHSD.
wide AQP
Consideration of other plans such as but not limited to:

a) DRRM-H Plan
©)
Health Facility Development Plan
Elements of these plans reflected/included in the
c) Human Resources for Health Plan 6
ProviHUC/CC
Tov I plan
d) ICT Development Plan
e) Devolution Transition Plan
0) GAD plan
2. When available, considerationof health needs contained in
the Ancestral Domain Investment Plan for Health (ADIPH) /
Auncestral Domain Sustainable Development and Protection Plan| Elements of these plans reflected/included in the
5
(ADSDPP) Prov/HUC/ICC plan
NOTE: If not available, item should not be part of the
denominator.
I. Non-health sector, specify:
Consulation/workshop/meetings documentation
2
2. Special population groups, eg. GIDA, Indigenous Peoples,
Urban Poor, PWDs, seniors, other vulnerable/marginalized
C. Consultation with/ involvement of key groups, specify:
Consulation/workshop/meetings documentation 2
ri
stakeholders
3. Plan harmonization, integration, and synchronization by

.
‘Consulation/workshop/meetings documentation
.
2
LGU, DOH-CHD and
other partners
4. Office of the District Representative/Legislator/s Consulation/workshop/meetings documentation 1
1. RevisiVReview of processes, outputs and outcomes of the a. Planning workshops, PIR documentation
4
D. Review of previous LIPH/AOP period [previous LIPH/AOP period b. AOP monitoring Report
and other LGU plans 2. Other LGU plans revie specify:
o S
reviewed, specify:
Planning workshops, PIR documentation 2
2of
MEANS | OF
PARAMETERS FOR EVALUATION DETAILS Points REMATR3;
Actual Score Recommendation Actua) Score .
Recommendations
HI. TECHNICAL CONTENT
With reference to LIPH Content Outline
PartII. Health Situation of the Pravince/City Cited/indicated: 50
A. Description and analysis of health and 1. Health, health systems and health-related threats/canceras and [Citation of latest status,
reports, records, sex-
health-related threats and situations, and [situations backed up by appropriate data/evidence disaggregated data with verifiable & validated
health sources such as FHSIS, LGU scorecard,
surveillance unit reports, annual statistical reports,
5
AOP monitoring report, health indices, emerging
and re-emerging diseases (if any), hospital
reports, cquity statistics, best practices, non-health
sources, others
Citation of latest status, reports, records, sex-
disaggregated data with verifiable & validated
data sources such as FHSIS, LGU scorecard,
2. Health status of IP/ICCs, GIDA, Urban Poor and other surveillance unit reports, annual statistical reports,
AOP monitoring report, health indices, emerging 4
vulucrable populations, as applicable
and re-emerging diseases (if any), hospital
reports, equity statistics, best practices, non-health
sources, others
3. Status/Gaps on: a. Citation of latest status, reports, records, sex-
2
a. Human resources for
health disaggregated data with verifiable & validated
b. Infrastructure and equipment data sources, if
any, such as LHS ML Monitoring 2
c. Service capabilities (status of DOH licensing and PhiiHeath [results (if applicable), annual statistical reports,
2
accreditation) of health facilities and services health indices, non-heaith sources, others
d. Management support systems: b. Brief namative on the status of each
1. Human resources for health management and 2
management system
2. Information management/EMR 2
3. Procurement and supply chain management 2
4. Referral system 2
5. DRRM-H system 2
6. Epidemiologic surveillance system 2
7. Proactive and effective health promotion programs! 2
4. Status of P/CWHS . .
integration (as
|
applicable)
a. Citation of latest report, any if
b. Brief namative on PACWHS integration
5
5. Levels of analysis:
a. Clear and logical description of data/information a. Citation of latest statistics 3
b.C omparison against standards, trends, benchmarks, targets
Citation of latest NOH, F1 plus and LGU HSC
1. National Objectives for Health 3
targets vis-a-vis latest health situation
2 LGU Health Scorecard 3
Causes/Tactors for the high/fow/equal rend
LL
c. Causes and contributing factors identified
ji j
compared to standards/benchmarks 3
Narmative on how the

d. Linking related gaps with health outcomes and indicators £aps identified will affect 3
nd
of
the health outcomes indicators
Part Local Prioritics/Major Thrusts of the LIPH Cited/findicated:
8
111.
1.Local Priorities/Major Thrusts consistent with gaps

7
I.
problems/concems identified in the Health Sitwation Section List of Local Prioritics/Major Thrusts
Co Co
A. Goals and objectives, priorities/thrusts,
targets and indicators for
the three year 2. Integrati
2.
1
Integration of Health Systems
. as priority (as applicable)
.
4
3. Aligned with/contribute to Universal §lealth Care Act,
[period a. Specific contributions cited
Fourmula One Plus for Health, National Objectives for Health, |b,Specific provisions of UHC Act, F1 Plus, ete 7
Sustainable Development Goals, Ambisyon Natin 2040 that the priorities/thrusts are aligned with
3of
PARAMETERS FOR EVALUATION DETAILS Ce
MEANS OF
VERIFICATION
Paints
LGU AND P/CDOHO REVIEW
Actual Score
Rema .
Recommendation
CHD APPRAISAL
Actual Score
Remarks/
.
Recommendations
Part IV Monitoring & Evaluation Citedfindicated: 10
of LIPH/AOP Monitoring Team EQ, Personnel Order, other issuance
et
A. M&E Process 1.a. Organization 3
ME ’
stakeholders ion-PHO/CHO staff) in
of other stakeholders not included in the
List
Monitoring team that the LGU plans to invite
3
2.2. M&E process/activitics (cg. systems or program-based, PIR,

PBUR, quarterly or semi-annual AQP monitoring, progress
3
monitoring report), specify:
List of M&E activities and coverage lo be
2.b, Coverage of Monitoring ac s include: conducted with target timelines

i. Status of physical accomplishment
LGU counterpart in the AIP
3
iii. DOH assistance
iv. Other areas, specify:
Part V. Cost Matrices Cited/indicated; 52
i
Forms reflecting:
1. Address gaps/problems/concems and priorities based on Suategics addressing gaps/problems/concerns
A. Strategies
Ta
.
6
situational analysis and Baseline Assessments
,
identified the
Situational Analysis are
from
© A
reflected in the Forms
Forms reflecting strategies that are

2. Strategies listed realistic, reasonable and implementable in |-based on SA
6
time frame given doable within three years
-appropriate to the area
3. Strategies are aligned with the Devolution Transition .

otAssistance Accomplished Forms
.
3
Plan/DOH Menu
Forms indicating that all strategies have
1.
Strategies are costed 4

corressponding costs
Lo reasonable, and appropriate Forms indicating strategies costed based on Menu
2. Costing arc of =~.
.
realistic,
. .
of strategies Co |
4
:
10 locality
Assistance, population projection, previous
year's allocation, site of PPA
Forms indicating that all strategies have
B. Costing of interventions
corresponding fund source as follows:
3. Fund sourcing of activities realistic, reasonable and -DOH fund source based on mens
:
-Outside the menu to be funded by LGU or other 4
appropriate
sources
Strategies with no specific source will fall under
Unfunded
4. Strategies/activitics for GIDA barangays costed
NOTE: If
not applicable, item should not be part of the Forms reflecting strategies for GIDA 2
denominator.
C. Costing of interventions (con't)

Strategics/activitics from ADIPH/ADSDPP costed
NOTE: If not available, item should not be part of the
.
Torus reflecting strategies/actvities from
.
oe 2
ADIPH/ADSDPP
denominator.
4 of
MEANS
A OF
PARAMETERS FOR EVALUATION DETAILS - . Points REMORSE]
Actual Score Recommendation Actual Score .
Recommendations
1. Specified reflected the LGU
in
LGU o
CTPA c
Proves IUCACO, ComprehensieeDevelopment Pan Of the CDP/ ELA LDIP/ ATP reflecting the
:
[COPY
D. LGU ownership of and accountability
LDIP AIP
i ¥ ’ EL
counterpart fund of LGU on AOP Year | |
for health operations and reforms
ee
2. Health budget for Year I
mem
is higher than the previous year's
-
-
Accomplished Forms (LGU Counterpart) vs.
—
5
AOP LGU share in 2022 AOP
E. Special Health Fund (SHE), if
Strategies to be funded through SHE Accomplished Forms 3
applicable
M&E
&
strategies costed are consistent with the planned M&E5
strategios costed consistent plano
with
T.
— 2
the
F. M&E component 2. Budget allocation

Forms reflecting the M&E activities
.
as per Part 2
3. TimeTines/schiedule
1Vof the Content Outline 2
TOTAL 160
Percentage 100% 100%
L RESULT OF LGU AND 0 85%
or Better PASSED For CHD Appraisal
O
PROVINCE/CITY DOH OFFICE 0 75-84% PASSED with minor correction, For Enhancement
REVIEW 0 75% and Below LIPH For Revision, PDOHO/CHD to provide special Technical Assistance
Other Comments:
REVIEW TEAM: Date of Review:
PHO/CHO name, signature DOH Representative nae, signature Name, signature, position
Name, signature, position Name, signature, position Name, signature, position
0 85% or Better PASSED 0 For CHD Concurrence

11. RESULT OF CHD APPRAISAL 0 75-84% PASSED with minor correction, For Enhancement
0 75% and Below LIPH For Revision, PDOHO/CHD to provide special Technical Assistance
Other Comments:
CHD APPRAISAL TEAM: Date of Appraisal:
Asst. CHD Director name, signature LHS Division Chief name, signature LIPH Coordinator name, signature
Program Manager name, signature Program Manager name, signature DOH Representative name, signature
Name, signature, position Name, signature, position Naune, signature, position
111. CHD CONCURRENCE

Name and Signature of Director IV Date
5 of
ANNEX B.5
List of Key/Major Generic Strategies to Implement Programs
Construction
WN
Repair/ renovation expansion of Health Facilities
Procurement/repair of equipment
Hiring of HRH
NAR
Retention of HRH (Existing)
Capacity Building/ Development
Procurement/provision (commodities, medical supplies)
PO Establishment and Maintenance of knowledge management/data/information systems
AD
Establishment and Functionality of Management Systems
sm
=O . Monitoring
. Policy Development
be
WN
. Sectoral Collaboration/ Partnerships
be
. Advocacy/Awareness/ Health Promotion Campaigns
— nop
. Research and development
. Others, specify
ANNEX C.1
AOP SITUATIONAL AND GAP ANALYSIS SUMMARY
AOP Year:
Region:
Province/HUC/ICC:
Municipality/Component City:
-
Identified PRIORITY Health Contributing Factor/s Reference Forms
lems/I (Underlying direct or indirect factor/s influencing/affecting (Cite where PPAs that will address the identified
neern:
I rom
Lor roblems/ s/Conce ros of a particular health problem that need to be addressed to gaps/problems/issues/concerns WILL be found: AOP Form
-
solve the problem) 2,3.1,32,33,34)
’
# Morbidity and Mortality, gaps in addressing health

problems of vulnerable groups (GIDA, Indigenous Cultural
Communities/Indigenous Peoples and Urban Poor), and
Other priority gaps/concems which have a major impact on
health systems
NOTE:
The Situational and Gap Analysis presents the whole picture of the LGU (Province/Highly Urbanized City/Independent Component City/Component
City/Municipality) health and health system situation. It summarizes the narrative of the Health Situationer, according to the WHO building blocks of health
systems, namely: Leadership and Governance; Financing; Health Workforce; Information; Medical Products, Vaccines and Technology; and Service Delivery.
The purpose of this table is to link the identified PRIORITY gaps/problems/issues/concerns and contributing factors with the appropriate strategies and
corresponding investment needs, strategies/interventions/activities foundin AOP Forms 2, 3.1, 3.2, 3.3, 3.4. Per AO 2020-0022, strategies/interventions/activities
shall be identified based on gaps and priorities. Thus, using a health systems approach, investment needs, strategies/interventions/activities will be more targeted
and responsive.
Annex C.2
AQP Form 1, Summary of Investment Cost by Health Systems Building Block and Fund Source
Region: REGION A
ProvincefHUCHCC: PROVINCE Y
AQPCY: 2023
Fund Sources (PhP) i

Total per Building
Health Systems Building Blocks % of Building
Block {including
LGU LGY Black to Grand Remarks
Unfunded)
Trust Fund for Trust Fund for Central Office Total
General Fund General Fund (PRP)
Nosth/SHF Health
1. Health Service
Health Information
.
Supply Chain & Logistics Management

.
and Health Regulation
5.
5.
Total per Fund Source (including
Unfunded) (PhP)
a Percentage of Total
{1) Health Systems Building Blacks:

§ Health Service Delivery; Health Workforce; Health Information System; Supply Chain & Logistics Mt and Health Regulation (Medical products, vaccines and technalogy); Financing; Leadership and Govemance
{2} Fund Sources — WhichAwhat office will be able to fund the investment:
§ LGU - Local Govemment Units: ProvinceHUC/ICC LGU {General Fund and Trust Fund for Health/Special Health Fund); Municipality/Component City LGU (General Fund and Trust Fund for Health); Barangay LGU
Trust Fund - Fund which accounts for the receipts by any agency of govemment or by a public officer acting as a trustee, agent, or administrator for the fulfilment of some obligations
General Fund - Fund which is available for any purpose and is composed of all receipts and revenues which are not otherwise accruing to
other funds
Special Health Fund - poo! of financial resources at the PACWHS intended to finance population-based and individual health services, health system operating costs, capital investments, and remuneration of additional health workers and incentives fot all health workers
§ DOH - Central Office ar Centers for Health Development;
§ Others - Other Fund Sources, such as Official Development Assistance (eg. UN Agencies, development partners}; other national agencies; NGOsICSOs; private and other sectors
(3) Unfunded - No funding source has been identified
(4) Total per Building Block - Sum of all funding sources for a particular Building Block including Unfunded
(5) % of Building Blocktothe Grand Total
(6) Remarks - Notes or comments; may specify Other fund sources
Annex C.3
AOP Form 2. Cost Assumption by HS Building Block, PPAs, Quarter and Fund Source (AOP Mother Plan)
Region: REGION A
PravinceHUCACC: PROVINCE Y
Municipality/Componen
Resource Requirements Fund Source

Municipality!
festa
Program/Project! Province/HUCACT LGU Mun/CC LGU
Performance Component
o
Activities (PPA) District ° Total Mems Expense
{Building Block)
eater pon
Boramnay lt Target Description Catogory
.
Unit Cost
"
Quantty
Quantity) General
Trust Fund
General Trust Fund
CHD Others Unfunded Remarks
for Total Total
(PhP) Fund Fund for Health
Health/SHF
for Major!
1
Strategy 1
Sub-total for Major!

2
‘otal for {Building
Target Resource Requirements (PhP) Fund Source {PhP}
ProgramProjocti
Activities (PPA) [oo District
Hunicpalty!
ol
Name
Health
of
at
ale Total Items Expense
U0
Total Cost
(Unit Cost x
Provinge/HUCNICC LGU MuniCC LGY
|LT)
Indicator @ Unit Cost Quant
FEY Unfunded
U™
{Building Block) Target Description Catogory Quantity) TUS FUNG BLGU CO CHD Others Remarks
Bamngay gamer | conerat TustFung
EP) run Chun forbeatn
TO
{1) Health Systems Buikding Block: Service Delivery; Health Workforce; Health Information Systems; Supply Chain & Logistics Mgt and Health Regulation (Medical products, vaccines and technology); Financing; Leadership & Govemance
« Strategies - Identified priority interventions that address health needs and health inequities, such as:
« Construction; Repairirenavation/expansion of health facilites; Procurementirepair of equipment: Hiring of health workforce: Retention of health warkfarce; Capacity buiding/development; Procurement/provision of commodities, medical supplies;
+ Establishing systems; Monitoring; Policy development; Sectoral collaboration/partnerships; Advecacy/awareness/health promotion campaigns; Research and development; Others
« Objective— Desired outcome in 3 years for the Strategy
{2) Performance Indicator for the Strategy - Measurable value/performance measurement to evaluate the success of a strategy/intervention
{3) District - The legistative district where the Strategy will be appliediconducted. In a province, this excludes the legisiative districts covered by the HUCACC which wil be reflected in the HUCACC's respective plans
{4) Municipality/Companent City/Barangay - Specific area where the Strategy will be applied/conducted, indicate if area cavers GIDAAIP/Urbar poor and other vulnerable population
(5) Name of Health Facility - The exact name of the facility where the Strategy will be appliediconducted
(6) Target - Quantifiable physical target/goal/objective in
refation to lhe performance indicalor of a particular strategy
(7) Resource Requirement - Inputs needed to conduct/produce the PPA

§ Items Description - specific description of the items/units to be costed (eg. Capsules, tablets, meals, activity cost etc)
§ Expense Category: PS, MOOE, CO (Infrastructure, Equipment, Motor Vehicle, Qlhers)
§ Unit Cost - Estimated Cost to produce/canduct the P/P/A
§ Quanity - Total Number of the Units to be costed
(8) Fund Source — WhichAwhat office will be able to fund the Strategy output:
§ LGU -
Local Govemment Units: Province UCACC LGU (General Fund and Trust Fund for Health/Special Health Fund), Municipality/Component City LGU (General Fund and Trust Fund for Health); Barangay LGU
Trust Fund - Fund which accounts for the receipts by any agency govemment or of by
a public officer acting as a trustee, agent, or administrator for the fulfillment of some obligations
General Fund - Fund which is available for any purpose and is
composed of all receipts and revenues which are not otherwise accruing to other funds
Special Health Fund - pool of financial resources at the
intended P/GWHS
to
finance population-based and individual health services, health system operating costs. capital investments, and remuneration of additional health workers and incentives for all
heallh workers:
§ DOH - Centers for Health Development;
Central Office or
§ Others - Other Fund, Sources such as Official Development Assistance (eg. UN Agencies, development partners); other nalional agencies; NGOS/CSOs; privale and other sectors
{9) Unfunded - No funding source has been identified
{10) Remarks - Notes or comments; may specify Other fund sources
~~
Annex C.4
AOP Form 3. SUMMARY OF LGU INVESTMENT NEEDS
Region: REGION A
Province/HUCRCC: PROVINCE Y
AOP Year: 2023
Cost per Fund Source (PhP)

LOCAL GOVERNMENT UNITS (LGU) DOH
Categories of Investment Province/HUCACC LGU Mun/CC LGU
Unfunded Total Remarks
Nesds Others
|Central Office CHD
Trust Fuad for
Total General Fund
TrustFund for Total
Barangay
General Fund Health
HealthiSHF
. Health Facility Development

New Construction
LGU Hospital
b. RHY
BHS
Other facilities (please specify)
LGU Hospital
b. RHU
BHS
.
Equipment
.
LGU Hospital
RHU
.
BHS

Vehicle
LGU Hospita!
.
RHU
BHS

per
Cost Fund Source (PhP)
nvestmen it
{
Categories of
leads
ProvincalHUCICG LGU MuniCC LGU
rs
Trust Fund for Trust Fund for Barangay [Central Office CHD
General Fund Total General Fund Total
Health/SHF Health
operations cost)
LGU Hospital
.
RHU
BHS
Technology
.
LGU Hospital
.
REY
8HS
Total
*Human Resource for Health
HRH Deployment
indicate the quantity

amount per cadre.
a. Physician (specify)
b. Nurse
¢. Midwife
d. Medical Technologist
e. Dentist
f. Phamacist
g. Nutritionist-Diefician
h. Physical Therapist
i. , please
a. Need for New Plantilla

items (itemized)
b. Existing Plantilla Items

{Lumped)
¢. Request for New Job
Order/Casual {Lumped
d. Existing Job Order/Casual

{Lumped)
Sub-Total
Categories of Investment Province HUGACC LGU Mun/CC LGU
Needs ers
Trust Fund for Barangay |Central Office CHD
Trust Fund for Total
General Fund Total General Fund
Health/SHF Health
. Commodities
(DrugsiVaccines/Med.
Supplies)
drugs/ vaccine under each
Commodities cited in this

template are EXAMPLES only.
Responsible Parenting
Health
DMPA
b. Pills
Condoms
,
Sub-dermal Implant
Health
. Flouride
b. Lidocaine
Nutrition
Micronutrient powder
b. Vitamin A
fron
National Immunization
PV
OPV
c. DPT-HEPB-HIB
d. MR
Elimination of Infectious Diseases
Control and Eliminalion
Schistosomiasis
~~
per
Cost Fund Source (PhP)
Categories of Investment P
-
rovince/HUCNCC
UCNC LGU Mun/CC LGU
Needs
Trust Fund for Barangay |Central Office] CHD
© ln/SHE Health
Filariasis
Rabies Prevention ant Control
Diseases
Prevention ang Control

Iv/STI Prevention and Control
Other Infectious Diseases
Noncommunicable Diseases
Hypertension
Diabetes
Mental Health
Health
Health Emergency Management
Commodities
Cost per Fund Source (Ph
Categories of Investment
Province/HUCICC LGU Mun{CC LGU
—
.
Needs Unfunded Total Remarks
Trust Fund for TFUStFund for Barangay
gay Centr
tral Office CHD
General Fund Total General Fund Total
HaalthiSHF Health
Other Technical Assistance
Leadership and Governance
ICCAPS, Urban Poor
advocacy and recognition

those with exemplary practices
activities
measurement and
HUCs/ICCs
for
Documentation of best practices

Others
B. Financing
. Health Workforce
D. Information
E. Supply Chain and
Logistics Management &
Regulation
F. Service Delivery
{Programs indicated are not
exhaustive)
Parenting
of Infectious Diseases
Prevention and
Diseases
per
Cost Fund Source
Categories of Investment -
Province/HUCNCC LGU Mun/CC LGU
Needs Otters
Trust Fund for Barangay
gay Central Office
ic CHD
Health/SHF Health
8B
Prevention and Control
HIV/STI Prevention and Control
Noncommunicable Diseases
Management
Annex C.5
AOP Form 3.1. LGU Investment Need for Health Facility Development, information & Communication
Technology and Operations Cost
Region: REGION A
Province/H PROVINCE
Municipalit
AQPCY: 2023
Facility Investment Need (PhP) Cost per Fund Source (PhP)
Municipality! Name of Province HUCACC LGU Mun/CC LGU

District Project Motor Total Cost!
City! Category Health Medical Unfunded Remarks
Companent
Barangay Facility
Description Infrastructure
Equipment Vehicle er Facility Barangay
Central
CHD
Others
General Trust Fund for
Total
General Trust Fund for Total
Office
Fund HeatthiSHF Fund Health
|. Health Facility Development

A. Construction Completion/
II. taformation and Communication Te
Operations Cost - costs to to cover day-to-day requirements of facilities to carry out thelr regular operationssuch as water utilities, electricity, regular office supplies, rents, gasoline, other maintenance and operating expenses
per
Annex C.6
AOP Form 3.2. LGU Investment Need for Human Resource for Health
Region: REGION A
Province/HUC/I PROVINCE Y
Municipality!
AQP CY: 023
Cost Fund Source

LOCAL GOVERNMENT UNITS
Province/HUC/ICC LGU Mun/CC LGU

Municipality!
Name of Health Salary Total Salaries
District Component City! HRH/ Cadre Unfunded Remarks
Facility Grade and Benefits Others
Barangay General
Trust Fund
General Trust Fund Barangay co CHD (PhP)
for Total Total
Fund oe ait Fund for Health
I. HRH
a. Physician
(specify)
b. Nurse
c. Midwife
d. Medical
Technologist
€. Dentist
f, Pharmacist
g
Dietician
Therapist
i. Other
HRH, please
spely
Sub-total
Il. LGU
a. Need for New Plantilla ltems*
b. Plantilla tems
for New Job Order/Casual
d. Job Order/Casual
Sub-total
otal
NOTES
Column $ to include Unfunded
Annex C.7
AOP Form 3.3. LGU Investment Need for Commodities
Region: REGION A
Province/HUCACC: PROVINCE
Municipality!
Component City:
ACP CY: 2023
Cost per Fund Source (PhP}

Municipality! Total Cost LOCAL GOVERNMENT UNITS OOH
Nara of Estimated Unit (Unit Cost x
Commodities Component Target Province/HUCACC LGU MuniCC LGU Remarks
District Health Items Description Quantity Others Unfunded
City! Population Cast {PhP} Quantity)
Fachity Trust Fund for Barangay [Central Office CHD
(PhP) General Trust Fund for Genera)
Barangay Total Total
Fund Heatth/SHF Fund Health
Sub Program 1
Commodities 1
Commodities 2
Commodities 1
Commodities 2
Program 2
Commodities 1
Commodities 2
Commodities 1
Commodities 2
Annex C.8
AOP Form 3.4. LGU Invastmant Nead for Other Technical

Assistance
Reglon: REGION A
Province/HUC/CC: PROVINCE Y
Municipality!
Component City: -
AOP CY: 2023
Resource (PhP) Fund Source

LOCAL GOVERNMENT UNITS {LGU) DOK
Municipality! Total Cost
Activitles Provinca/HUCACC LGU MuniCC LGU
i
Component Items {Unit Costx Unfunded Remarks
|
i
Unit Cost Quantity Central
Barangay Description Quant)
(PHP)
Generar
Fund
TREN]
or
General
Fund
Trust und
for Health
Total
Barangay Office
CHD Phe)
A. Leadership and
Govemnance
Sub-total Leadership and Governance
2
1
Health
Information
E.Supply Chain & Logistics
Management {Health
Regulation)
2
Sub-total Supply Chain & {Health
i
1
Annex C.9
Form 4. REGIONAL SUMMARY OF LGU INVESTMENT NEEDS
Consolidation of AOP Form 3 of Provinces, HUC, ICC in the Region.

details, please refer to Form 3 of Provinces, HUCs, ICCs.
For
Region: REGION A
Year: 2023

Provinces/HUCsACCs LGU Mun/CC LGU
c ategories Invest i
Investment Needs GRAND TOTAL
‘es
of of
Unfunded REMARKS
Trust Fund Others (PhP)
Trust Fund Barangay Central Office CHD {PoP)
General Fund for Health/ Total General Fund Total
for Health
SHF
Health Facility Development
New Construction
a. LGU Hospital
b. RHU
¢. BHS
d. Other facilities (please specify}
Repair/improvement/Upgrading
a. LGU Hospital
b. RHU
¢. BHS
d. Other faciliies (please specify}
Equipment
a. LGU Hospital
b. RHU
¢.BHS
d. Other facilities {please specify}
Motor Vehicle
a. LGU Hospital
b. RHU
¢. BHS
d. Other facilities {please specify)

JO
Cost per Fund Source {PhP}
Provinces/HUCs/ICCs LGU Mun/CC LGU
Categories
tes
of of Investment Needs
4 GRAND TOTAL
Unfunded REMARKS
Trust Fund Barangay Central Office CHD (PhP)
General Fund for Health! Total General Fund Total
for Health
SHE
a. LGU Hospital
b. RHU
¢.BHS
d. Other facilities (please specify}
Sub-Total
ICT Equipment
a. LGU Hospital
b. RHU
c. BHS
d. Other facilities (please specify)
Sub-Total
Human Resource for Health

Physician (specify)
Nurse
Midwife
Medical Technologist
Dentist
Pharmacist
Nutritionist-Dietician
Physical Therapist
Other HRH, please specify
positions
¢. new {Lumped
Sub-Total
LOCAL GOVERNMENT UNITS (LGU,

of Investment GRAND TOTAL
Categories
ategol
9 nvestmen Needs Unfunded REMARKS
Trust Fund Others (PHP)
Trust Fund Barangay Central Office CHD (PhP)
General Fund for Health! Total General Fund Total
for Health
SHF
Commodities (Drugs/Vaccines/Med.
)
Family Health, Nutrition and Responsible Parenting
Family Pianning & Reproductive Health
a. DMPA
b. Pills
¢. Condoms
d. Sub-dermal Implant
Oral Health
a. flouride
b. Lidocaine
Nutrition
a. Micronutrient powder
b. Vitamin A
c. ron
Others
a. IPv
b, OPV
¢. DPT-HEPB-HIB
d.MR
€. Others

Malaria Control and Elimination
Schistosomiasis
Leprosy
Filariasis
Rabies Prevention and Control
Prevention and Control of Infectious
TB
~~
pi
a
Provinces/HUCs/ICCs LGU MuniCC LGU
Categories
ategories of of Investment
Investment Need:
Needs
Unfunded REMARKS
Trust Fund Others
Barangay Central Office) CHD (PhP)
General Fund for Health! Total |General Fund Total
SHF
Dengue Prevention and Control

HIVIST| Prevention and Control

Non-communicable Diseases
Hypertension
Diabetes
Mental Health
CVD
Cancer
Environmental and Occupational Health

Other Commodities
Sub-Total
T Assistance
A. Leadership and Govemance
ystems integration activities
LIPH/AQOP development, planning and

monitoring, advocacy tof consultation with key
stakeholders, program implementation review
GIDA, ICC/IPS, Urban Poor activities/projects
LGU Health Scorecard activities including
advocacy and recognition of those with

exemplary practices
Leadership and Governance strengthening activities

Categories of Investment Needs GRAND TOTAL
REMARKS
Unfunded
Trust Fund Barangay Central Office, CHD {PhP)
General Fund for Health/ Total General Fund Total
for Health
SHF
Data collection for health equity

measurement and intervention for
HUCsACCs
Barangay Health Workers (BHWS) activities

Documentation of best practices
Others
B. Financing
C. Health Workforce
D. information
E. Supply Chain and Logistics Management

& Health Regulation
F. Service Delivery
Family Health, Nutrition and Responsible
Parenting
Rabies Prevention and Control
Prevention and controf of (nfectious Diseases
TB
Dengue Prevention and Control

HIVISTI Prevention and Control
Non-communicable Diseases
Environmental and Occupational Health
Others (specify)
Total
ota
NOTES
Column M to include Unfunded
ANNEX C.10
LGU Investment Needs Categories
LGU Investment Needs Categories Definition/Inclusion

Facility Development & ICT
3.1 Health Needs/requirements for
= Infrastructure — construction, repair, rehab, upgrading
of facilities
= Medical Equipment —specific equipment needed for
the facility
= Motor Vehicle — ambulance, patient transport
= [Information and Communications Technology —
hardware and software
3.2 Human Resource for Health (HRH) Specific HRH cadre needed/requested and existing
3.3 Commodities Various commodities such as drugs, vaccines and their
corresponding medical supplies
3.4 Other Technical Assistance Capacity-building, advocacy and health promotion,
workshops, consultations, monitoring and evaluation,
creating and implementing systems and tools

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Republic of the Philippines

FOR: ALL UNDERSECRETARIES, ASSISTANT SECRETARIES,

Administrative Order (AO) 2020-0022 on Guidelines on the Development of Local Investment

A. Directions for the development of the 2023-2025 LIPH

Province/HUC/ICC- wide planning.

development partners, representative of the private sector, other

submit and endorse their LIPHs to the PHO.

submission are in Annex A.

Separate narrative sections of the AOP shall be required for Year

C. Roles of key stakeholders

E. Priorities and other directions

KENNETH G. , MD, MPHM, CESO III

Annex B LIPH Forms

Annex C AOP Forms for Year 1 (2023)

AOP Form 4: Regional Summary of LGU Investment Needs

II. Health situation of the Province/City (AO 2020-0022 VI.B.2.a)

Iv. Monitoring & Evaluation (AO 2020-0022 VI. D.)

VIL Other Attachments (As applicable)

LOCAL GOVERNMENT UNT LGU) "DEPARTMENT OF HEALTH (00H)

PROVHCEHUCACE LGU MUNGIPALITY/COMPONENT OITY LGU. CENTRAL OFFICE Ho

HEALTH VIORF ORCE

§ DOM - Cental Off

{4)% of Bukiog Bock Io te Grand Tol

PROVINCEMUCACE LGU ULPECIOAL

Percentage of Grand Tots

{5)Remrks Noles or corments. may speci Othe fund sources.

and Health Promotion Year 1

and Health Promotion Year 2

Procurgsment for Year 1

ASSUMPTIONS BY BUILDING BLOCK, STRATEGIES, RESOURCE REQUIREMENTS AND FUND

Resaurce Requirements (PhP)

Government Units (LGU)

“ “ @ Func Fund for Health

1. Advocacy campaigns for Year 1

2. Advocacy for Year 2

3, Advocacy campaigns for Year 3

3-year Total for Major/Stub-Program 2 (PhP)

{7) Resource Requirement Inputs needed to conductipraduce the PPA

and Health Regulation {Medicat products, vaccines and technology);

HUCACC's respective plans

Procurement/provisian of commodities, medical supplies;

§ Expense Category: PS, MOOE, (Infrastructure, Equipment, Motor Vehicle, Others)

§ Unit Cost - Estimated Cost to proguce/conduct the PIP/A

LGU AND P/CDOHO REVIEW CHD APPRAISAL

B. Properly Filled-up Forms

[. Organized LGU Planning Team

I Incorporation of lower level plans

c. Actual Mun/CC IPH, Brey. Health Plans and

Consideration of other plans such as but not limited to:

3. Plan harmonization, integration, and synchronization by

Narmative on how the

1.Local Priorities/Major Thrusts consistent with gaps

of LIPH/AOP Monitoring Team EQ, Personnel Order, other issuance

2.2. M&E process/activitics (cg. systems or program-based, PIR,

2.b, Coverage of Monitoring ac s include: conducted with target timelines

Part V. Cost Matrices Cited/indicated; 52

reflected in the Forms

Forms reflecting strategies that are

3. Strategies are aligned with the Devolution Transition .