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Devolution of Health Services

In 1991, the Philippines government devolved basic services including health services to local government units through the Local Government Code of 1991. This led to the management and delivery of health services being transferred from the national Department of Health to provincial, city, and municipal governments in 1992. Several negative effects resulted from this devolution, including a breakdown in management systems, declining hospital utilization, poor staff morale, and infrastructure issues. The findings reveal parallels with international literature on the potential negative effects of decentralization, showing the need for further health sector reforms in the Philippines to address these issues.

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Noelle Fabros
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82 views2 pages

Devolution of Health Services

In 1991, the Philippines government devolved basic services including health services to local government units through the Local Government Code of 1991. This led to the management and delivery of health services being transferred from the national Department of Health to provincial, city, and municipal governments in 1992. Several negative effects resulted from this devolution, including a breakdown in management systems, declining hospital utilization, poor staff morale, and infrastructure issues. The findings reveal parallels with international literature on the potential negative effects of decentralization, showing the need for further health sector reforms in the Philippines to address these issues.

Uploaded by

Noelle Fabros
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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NAME: Noelle Nicole Fabros DATE: 09/11/21

RLE GROUP: A2

Reference:
https://www.researchgate.net/publication/7862492_Overview_of_Devolution_of_Health_Services_in_t
he_Philippines

Summary

In 1991 the Philippines Government introduced a major devolution of national government


services, which included the first wave of health sector reform, through the introduction of the Local
Government Code of 1991. The Code devolved basic services for agriculture extension, forest
management, health services, barangay (township) roads and social welfare to Local Government Units.
The management and delivery of health services in the Philippines was devolved from the National
Department of Health to locally elected provincial, city, and municipal governments in 1992. On the
subject of decentralization, a study of international literature was conducted. In both provinces, rapid
assessments of health management systems were carried out. The rural health information system and
prior consultant reports were used to supplement the data. Quality and coverage of health care have
worsened in some places after devolution was implemented, particularly in rural and remote areas. It
was found that in 1992-1997, system effects included a breakdown in management systems between
levels of government, declining utilization particularly in the hospital sector, poor staff morale, a decline
in maintenance of infrastructure and under financing of operational costs of services. Decentralization
aims to increase middle-level managers' decision-making space, optimize resource allocations from
central to peripheral areas, and improve the efficiency and effectiveness of health-care management.
The findings of the historical review of devolution in the Philippines reveal some parallels with
worldwide literature, which describes certain negative effects of decentralization, and provide
justification for the Philippines to embark on a second wave of reform in order to 'make devolution
work.'

Reflection:

This article attempts to document the Philippine’s experience in health devolution with focus on
the Department of Health’s efforts to make it work. It also aims to draw lessons and insights that are
critical in assessing the country’s decentralization policies and also, in informing future policymaking. In
particular, it highlights the importance of (i) a well-planned and well-designed government policy to
minimize, if not avert, unintended consequences; and (ii) mainstreaming of health policy reforms to
ensure sustainability. It suggests the need to (i) take a closer look at the experience of local government
units (LGUs) that were able to reap the benefits of health devolution and find out how the good
practices can be replicated in other LGUs; and (ii) review and assess the various health reforms and
mechanisms that have been in place to draw lessons and insights that are useful for crafting future
health policies.

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