December 15, 2022 — “The production of healthcare workers is being driven by global demand rather than local health care system needs.”
This is according to Dr. Kenneth G. Ronquillo, Department of Health (DOH) Undersecretary for Health Policy and Infrastructure Development, during a lecture on the situation, issues, and challenges of the Philippine human resources for health (HRH) at the National Policy Dialogue on Supporting Health Workers held on Nov. 11, 2022.
Dr. Ronquillo stated that based on the data of the Commission on Higher Education, the number of enrollees in specific health professions averaged 217,753 for the past 10 years. Of these, only 22% had graduated, and board passers were only about 16% of all enrollees. This issue of high attrition in HRH stems from different factors related to uncoordinated and ineffective regulation of health workforce production.
He emphasized that the health education market is primarily dominated by private higher education institutions which impose high costs on health sciences education. Such high investment in education is said to be the reason for the desire of the HRH for higher returns on investments and fair or higher paying jobs, which if not satisfied, promotes the option for migration.
Other push factors are a western-oriented health education curriculum, promotion of clinical services and practices in urban areas and abroad, lack of collaborative planning, and implementation of policies in the production of HRH.
Nursing education seems to be the most sought-after health course in the country, resulting in uneven production of other needed categories. Also, the implementation of return service obligations that come with government-funded education is not strictly regulated and monitored.
The Philippines is lagging in terms of salary, with other countries being able to pay as much as six-digit compensations.
As of June 2022 there were 819,099 registered health professionals of which there were 39% practicing in public and private health facilities in the country and as many as 60% in unspecified areas, which are not yet captured by the existing DOH HR information system.
He added that due to the COVID-19 pandemic lockdowns, the Department of Migrant Workers recorded only 11,415 health professional migrants in 2021, which is relatively small compared to previous years.
“The Philippines is lagging behind in terms of salary, with other countries being able to pay as much as six-digit compensations. More so, there is a big difference of about 40 to 65% between the public and private sectors. Even within the public sector, the salary for those serving in sixth-class municipalities is far from the national rate because of existing policies,” said Dr. Ronquillo.
There are limited learning and development opportunities for both public and private health workers. Most of the training is out-of-pocket since there is no legal basis that provides for such a benefit.
He added that another challenge is the inability to provide job security considering the limited number of available plantilla or regular positions and resorting to hiring through job order contracts that do not guarantee benefits, creditable length of service, opportunities for training and the issue of varied granting of benefits and incentives in the Magna Carta for Public Health Workers.
“We recognize that the healthcare workforce is fundamental in building strong and resilient health systems at all levels that will ensure universal health coverage and achieve the highest attainable standards of health. However, for this to be realized, there must be adequate investment in all stages of the HRH, from production, recruitment, and hiring, up to retention in the country.”
Charmaine Lingdas
