The transition to a province-wide health system (PWHS) in the Philippines holds the potential to transform healthcare delivery across the country, but significant financial and operational challenges are impeding progress.
A recent study by the Philippine Institute for Development Studies (PIDS) examined the experiences of the provinces piloting this PWHS and identified key obstacles that need to be addressed for a successful transition.
PWHS is an essential part of the Universal Health Care (UHC) Act, which aims to unify local healthcare systems into integrated networks that provide continuous, comprehensive care.
The reform seeks to streamline service delivery, optimize financial resources, and ensure accessible healthcare across provincial and municipal boundaries.
Authors Ida Marie Pantig, senior research specialist Pauline Joy Lorenzo and supervising research specialist Tatum Ramos, in the study titled “Transitioning to a Province-Wide Health System: Experience of the Provinces of Bataan and South Cotabato”, detailed the difficulties faced by these provinces in implementing the reform.
Bataan, with a population exceeding 850,000, has struggled with a shortage of healthcare workers. “Recruitment and retention of healthcare personnel remain a major challenge, especially in remote and geographically isolated areas,” the authors said.
The lack of sufficient human resources along with coordination issues among local government units have created significant gaps in service delivery.
“Financial constraints also further intensify these operational challenges,” the authors added. Bataan faces difficulties in allocating sufficient resources to strengthen its healthcare workforce and upgrade facilities.
Meanwhile, South Cotabato faces similar challenges with its nearly one million population. Although it has made progress by establishing a special health fund that pools financial resources from various LGUs, many local leaders remain hesitant to fully commit to this system.
“The issue of cost sharing, decision making on procurement, and prioritization of projects were raised by the mayors during meetings,” the authors said.
Adding to these financial challenges, South Cotabato also received limited technical support from national health authorities. Without adequate guidance, local governments have struggled to manage the complexities of healthcare integration. “This makes it difficult for the province to build infrastructure and develop the workforce needed for a fully functional PWHS,” the authors said.
The study emphasized that clear communication with stakeholders, particularly local executives, is essential to building support for the reform and ensure smooth implementation. Implementing these reforms and providing additional resources to supplement LGU funding is crucial in ensuring the success of the PWHS. Increased national support is also needed to further strengthen local healthcare systems.
Technical assistance from national agencies is a key element that will help provinces manage the complexities of integration. Greater support in financial management and healthcare workforce development is essential for provinces like Bataan and South Cotabato to realize the full potential of the PWHS.
“The transition to the new health system will not materialize without the partnership between the aspiring provinces and various stakeholders that provided technical and financial assistance, including NGAs, NGOs, development agencies, and the private sector,” said the authors.
