Managerial, and Entrepreneurial Approach to
Retaining Medical Professionals in the
Philippines
Many efforts have been made until now to address the shortage of medical professionals.
Philippines rural municipalities have programs to create, attract, and keep the human
resources for health (HRH). These, however, fall short of providing the required number of
skilled and highly motivated HRH needed to satisfy the particular requirements of rural
towns. Actions intended to address HRH difficulties continue to be primarily focused on the
production, recruitment, and retention of sustainable HRH. Specific treatments are also
personalized based on numerous macros, meso, and micro-level environmental elements. The
Philippines' decentralized healthcare system is a significant Meso-level influence. When the
Local Government Code (Republic Act 7160) allowed for the transfer of the health and other
sectors to local government units (LGUs) (i.e., provinces, cities, and municipalities), the
devolution of the public health sector in the Philippines began. This involves giving physical
infrastructure, such as hospitals and health centers, as well as health workers (such as
physicians, nurses, and midwives), to the LGUs. (Tejero et al., 2021) The Internal Revenue
Allotment (IRA), a grant from the federal government to local governments, is how the local
health system is funded. The devolution has given LGUs more discretion over governancerelated decisions. However, there have reportedly been issues with the financial
decentralization methods. According to criticism, cities and barangays are favored over
provinces and municipalities when calculating the IRA because arbitrary percentages are
assigned to each level of local government. The availability and use of resources can be
maximized in an ideal devolved health system, but in practice, many LGUs, particularly rural
municipalities, have limited resources and are financially virtually entirely dependent on the
IRA. Due to their inability to fully provide the pay scales and benefits that are required by
law, rural LGUs find it difficult to attract and keep health workers.
To deal with the shortfall, the health department created programs for health personnel to be
deployed. However, it has been claimed that a number of local government units and LGUs
have become dependent on these deployment programs due to their presence for more than
two decades. Although some deployed health personnel have been maintained by their LGUs
as part of the organic health workforce, this appears to be the exception rather than the rule.
The DTTB program, in place since 1993, intends to draw qualified, dedicated, and
community-oriented medical practitioners to provide healthcare in geographically isolated
and disadvantaged regions (GIDA) around the nation that lack physicians. The doctors get
competitive salaries (the current gross monthly income is about Php 90,000 or USD 1870) for
the two years they work in their designated districts. (WHO, 2021)