Many poor or cash-strapped Filipinos with illness or injury died and continue to die for not getting medical attention and treatment on time.

Unfortunately, such preventable deaths happen because of the reality on the ground: poorly equipped barangay health centers, inefficient first line of defense against death from disease and injury, lack of doctors, medicine and medical equipment. Likewise, they don’t operate 24/7.

While it’s laudable that government, through the initiative of Special Assistant to the President Bong Go, started establishing Malasakit Centers in public hospitals — one-stop desks where outpatients can get financial assistance for medical treatment — these are not enough to accommodate all citizens badly needing medical attention.

For one, there are only a limited number of public hospitals and most are located in cities and towns. Data from the Department of Health (DoH) show that there are less than 2,000 public and private hospitals, including infirmaries in the country.

Moreover, not all types of health problems are attended to even by the 90 At Source Ang Processing desks of the Philippine Charity Sweepstakes Office (PCSO) which prioritize cancer and dialysis patients.

Likewise, some hospitals still require part of the bill to be paid in cash even if an indigent patient obtained a “guarantee letter” from the PCSO, Department of Social Welfare and Development (DSWD) or the mayor’s office that promises payment for medical services rendered.

This explains why many patients needing expensive Magnetic Resonance Imaging tests to determine proper treatment for their condition are often left with no recourse but suffer from further deterioration of their condition.

Then there is also the problem posed by the bureaucratic maze in the processing of patient’s request for financial assistance from the PCSO, which is one reason why Malasakit Centers are established in the first place.

While medical assistance fund is available courtesy of the PCSO, DoH and DSWD, every patient or his caregiver waste precious time in queuing and undergoing the procedural vetting of applicants just to qualify for assistance and get a guarantee letter.

Even if Malasakit Centers are established in every hospital in the country, it will still be not enough.

The long lines of outpatients in the receiving areas of the East Avenue Medical Center, the National Kidney Transplant Institute or the Philippine Orthopedic Center every day can attest to the need for more medical facilities.

So, there should also be Malasakit Centers in every 2,600 rural health units and more than 20,200 barangay health stations nationwide.

Many barangay health centers have become so unreliable that some can only provide pain relievers or, ironically, refer indigent patients to a private hospital or pharmacy. Generally, these centers have no doctor or a trained medical staff who can make proper diagnosis, especially during non-office hours and on weekends and holidays.

To make matters worse, the P8.1-billion Health Facilities Enhancement Program (HFEP) of the DoH, meant to build 5,700 units of school-based barangay health stations, is now in limbo after the Commission on Audit (CoA) cited various irregularities in the project.

Among others, CoA said there were unclear contract terms for payment, resulting in either non-start, idle or non-completion of the health stations within the contract time or even duplication in the same barangay.

Moreover, the CoA said the bidding for the construction of 3,200 units was not in accordance with the established procedures, casting doubt on the validity of the bidding process.

According to Health Secretary Francisco Duque, the intention of the program initiated by his predecessor Secretary Janette Garin was “good” but was plagued with faults in the implementation due to poor planning. He said the fate of the program now rests with the CoA.

In addition to irregularities in the construction of health stations, CoA also said the HFEP is plagued with low funding utilization issues.

Under the proposed 2019 budget, funding for the project dropped to P100 million from the P30.3 billion allocated for 2018.

Policy makers must resolve the issue and decide how best to use government resources to deliver the needed health care to our citizens, particularly in the far-flung barangays.

There cannot be inclusive healthcare if medical assistance desk and financial assistance are accessed only through hospitals.

Barangay health stations, provided with medical personnel and adequate stock of medicine, can more effectively reach out to the number of sick and injured citizens who are currently left with no recourse but to either endure the pain or worse, die a slow death.