Governance in primary care systems: Experiences and lessons from urban, rural, and remote settings in the Philippines
doi.org/10.47895/amp.vi0.4834
- Author:
Nannette Bernal-Sundiang
1
;
Regine Ynez H. De Mesa
1
;
Jose Rafael A. Marfori
1
,
2
,
3
;
Noleen Marie C. Fabian
1
;
Ysabela T. Calderon
1
;
Leonila F. Dans
1
,
2
;
Mia P. Rey
1
,
4
;
Josephine T. Sanchez
1
;
Cara Lois T. Galingana
1
;
Jesusa T. Catabui
1
,
5
;
Ramon Pedro P. Paterno
1
,
6
;
Edna Estefania A. Co
1
,
7
,
8
;
Antonio Miguel L. Dans
1
,
2
Author Information
1. Philippine Primary Care Studies, University of the Philippines Diliman, Quezon City
2. College of Medicine, University of the Philippines Manila
3. Philippine General Hospital, University of the Philippines Manila
4. Cesar E.A. Virata School of Business, University of the Philippines Diliman, Quezon City
5. University of the Philippines Health Service Diliman, Quezon City
6. Universal Health Care Study Group
7. National College of Public Administration and Governance, University of the Philippines Diliman, Quezon City
8. UP-CIFAL Philippines, Quezon City
- Publication Type:Journal Article
- Keywords:
governance;
participant observation
- MeSH:
primary care;
universal healthcare;
health systems;
interventions
- From:
Acta Medica Philippina
2023;57(3):5-16
- CountryPhilippines
- Language:English
-
Abstract:
Methods:Data on governance issues were obtained from participant observation and regular meetings facilitated over one year. Conducted across urban, rural, and remote settings, the present study outlines experience-near insights throughout a hierarchy of system implementers—from those in positions of authority to frontline workers. These insights were thematically analyzed and organized following the Health System Dynamics Framework.
Results:This study identified six governance challenges: 1) establishing a health information system; 2) engaging leaders, healthcare staff, and communities; 3) assuring efficient financing; 4) assuring health workforce sufficiency; 5) addressing legal challenges; and 6) planning evaluation and monitoring. To address these challenges, this study forwards systemic solutions to advance effective governance and improve healthcare performance.
Conclusion:A renewed approach to strengthening primary care systems is fundamental to achieving universal
healthcare. This entails good governance that develops strategies, equips people with tools for proper implementation, and provides data for evidence-based policies. The experiences outlined in the present study envisions guiding policymakers toward improving health outcomes in a devolved setting.
- Full text:666.pdf
