22 tnrnslates to the fact lhnl c1lrnost half of health expendjturcs is out-of-pocket; jn olher words, lhe "financial burden on individual families is heavy, leaving access to care highly inequitab le" (NSCB, 2002). The severely lim. ited heullh budget is,ilso the biggest hind. ranee to the fu!J implementatio n of we Jl-n1eaning policies such as national heallh insurance. · There n. re a number of lnws that impacl on people's beallh directly (such as the salt iodization law and food fortificalion law) and indirect ly sucb as Lhoi,;e Ulat affect their purchasing power (mi11 imum wage, e. 'f()ctllded value-added lax, encccgy law, etc. ), family aod social rchitionships (e. g., laws protecting women and children). environment, and access Lo education and employment opportu njties. There are also laws that affect the delivery of health services--tbe Loca J Goven1ment Code, National Healtl1 Insurance Act and the professional practice acts of U1e differe. nt professions (mtrsing, mich,~fcry and medkine). HEALTH CARE DELIVERY SYSTEM A health care delivery system is the totality of usocietal services and actj vities designed to protector restore the health ofindividu::i]s, families, groups and com. 1ntm it:ies (Bant,1, 1986 in Cookfair. 1996:66). II includes both govenw1eul and non-gover nment hea 11-h facilities Q1ospitals, clinics, diagnostic. : centers, health centers), programs, services and activities (preventive, promotive, curative alld rehabilitative). Preventiv e health care is a major concern of the government-owned health centers wbj Je curative c;ire is pro"idccl by hospitals, both government and private. · The health care delivery system is affected by po Jicies sucl, as RA 9439 and RA 9502 (refer to Annex A2 for a listing of laws that impact on people' healtl1 and the health care delivery system) Public health Public health is generally regarded as a responsibility of government. One of the most guoted definitions of public health is that of Winslow (1920): '. 'Public health is the science and art of prev~nting disease, prolonging life, and promoti ng hew. th and efficiency through organized community effort; for the sanitati. on of the environment ; the con1rol of communicab le infections; the education of the individu al in persona J hygiene; the organization of medical and nursing services for Lbe early di. ignos is and preventive treatmentofdi. ~ea se; and, the de Yelopment of the social machinery to ensure everyone a standard of living adequate for the maintenance of health, so OL·ganizing these benefits as to enable every citizen to realize his birthright of health and longevity" (Hanlon and Pickett, 1979:4). Today public health could be defined in terms of its three c Qce functions : assessment, policy development and assurance. Assessme11t is the regular collection and analysis of healtl1 d,1ta. These data are used for program plannin~ and policy developruent. Policy deuelopmenl involves advocacy and politfoal action to develop policies in various levels of decision making. Assurance is makingsurethathea lth serv;ces are effective, available and accessible to the people (Iostitl Lte of Medicine, 1988 in Clark, 2008:87-88). Related to the core functions of public health there are ten essentia l hea Jth services (ASTON in Lundy and Janes: 2001: 875) which are: (1) monitoring l1ealtb status to identify community health problems; (2) cliagnosing and i. twcstigaii ng healt11 pi·oblems and hazards in lhe community ; (3) informfog, educating and empo=ering people 