Background: The Philippines was renowned for its reputation as one of the leading countries in the world, holding notable contributions for supplying the global laborers including occupational therapists alongside other healthcare professionals. The importance of occupational therapists in the healthcare industry was progressively being acknowledged, as they offer rehabilitative care to Filipinos in need within the country. With the continual advancement of knowledge, occupational therapists were fast becoming in-demand professionals locally. However, there appeared to be a dearth of practicing registered occupational therapists in the Philippines, owing to their inclination towards overseas employment as seen by their migration to affluent countries driven by push factors, which are unfavorable circumstances in the place of origin that reinforce migration, and pull factors, which are things that attract the migrant to move to the destination country. Objectives: This study explored the factors influencing the Filipino occupational therapists towards selecting a working environment, prevailing factors that contributed to the decision of Filipino occupational therapists to work overseas, and significant differences between the working conditions domestically and internationally. Methods: The study utilized a qualitative descriptive study to conduct a comprehensive exploration, studying the subtleties and complex nature of Filipino occupational therapists' migration. Researchers conducted semi-structured online interviews with 10 participants currently working as occupational therapists abroad across four countries including Australia, United Kingdom, United Arab Emirates, and United States of America. Thematic analysis was used to analyze the qualitative data, resulting in the identification of seven themes that described the factors on why Filipino occupational therapists went beyond the borders. Results: There are seven themes that describe factors why occupational therapists work abroad. These factors include (a) Labor Provisions, (b) Financial Motivations, (c) Organizational Camaraderie, (d) Presence of Career Progression, (e) Vast Resource Modalities, (f) Individualized Gains, and (g) Political Apathy. Conclusion The study stipulated the parameters aimed at improving occupational therapy working conditions and encouraging proactive initiatives to alleviate the shortage and reverse the brain drain among occupational therapists in the Philippines’ healthcare system.
health workforce

OBJECTIVE: To analyze the long-term trends of the changes in the equity of China's health workforce allocation to provide a reference for the more balanced and orderly development of China's health system. METHODS: The Gini coefficient was used to evaluate the degree of equity in the allocation of health workforce between regions, and the Gini coefficients for the allocation of doctors and nurses based on population and regional gross domestic product (GDP) distribution were calculated respectively. RESULTS: In 2019, the number of licensed (assistant) physicians per 1 000 population in China was 2.77, and the number of registered nurses per 1 000 population was 3.18. The Gini coefficient for the distribution of licensed (assistant) physicians by population was 0.141 in 2002, decreasing to 0.081 by 2014 and then remained stable. The Gini coefficient for the distribution of registered nurses by population was 0.164 in 2002 and decreased to 0.066 in 2018. The Gini coefficient for the distribution of licensed (assistant) physicians by GDP was 0.236 in 2002, decreased to 0.169 in 2013, then increased to 0.183 and remained stable. The Gini coefficient for the distribution of registered nurses by GDP was 0.206 in 2002, decreased to 0.150 in 2013, and then increased each year to 0.180 in 2019. The equity of the allocation of registered nurses by population was worse than the equity of the allocation of licensed (assistant) physicians in 2002, and in 2016, for the first time, exceeded that of licensed (assistant) physicians. CONCLUSION Equity in the allocation of health workforce across China has improved, but the improvement in equity between regions has hit a bottleneck, with health workforce allocation in the western regions still relatively scarce. Although nursing workforce allocation equity caught up with licensed (assistant) physicians, the number of licensed (assistant) physicians is close to that of developed western countries, while there is a large gap in registered nurses. It is recommended that the relevant authorities make good long-term planning for health workforce, further increase the policy for the introduction of health workforce in the western region, and increase the supply of healthcare services in the western region with the help of digital transformation of healthcare and internet healthcare. At the same time, they should further increase investment in resources for higher nursing education and actively plan to cope with the ageing population.
China ; Health Equity ; Health Services ; Health Workforce ; Humans ; Workforce

Background: Philippines is in a constant struggle to address shortage and maldistribution of health professionals, affecting equity in service delivery. The government endeavors to generate adequate supply of health workforce through scholarship and training programs which have been further expanded with the enactment of the Universal Health Care (UHC) Act. This article aimed to give a background for discussion on the application of return service agreement (RSA) provisions in the light of attaining universal health care. Methods: A modified systematic review of literature was conducted guided by the key issues determined by the Department of Health with focus on the extent of scholarship grants and on number of recipients. Results: The Philippine government enacted policy reforms through implementing RSA in response to the progressive decline of the net flow of health professionals. However, the criticisms lie in that RSA is not a long-term solution. With the RSA provisions in the UHC Law, metrics on determining the under-produced and maldistributed professional cadre must be created. These should be responsive in addressing facility-level and health system-level gaps. Conclusion and Recommendation Paucity of current local literature impedes attaining a conclusive body of evidence, therefore, further research is needed. Operationalization of RSA should not be viewed as a singular means to solve the health workforce gaps, but as part of holistic assessment, taking into consideration epidemiological, geographical, political, and social determinants. Stakeholders must ingress in collaborative intersectoral policy actions to warrant bottom-up support. Activities related to mapping, monitoring, and incentivizing medical and health-related professionals must be established to support a system conducive for workforce retention.
Medically Underserved Area ; Health Workforce ; Health Services

Background and Objectives: Reforms in health professions education in the past decade entails the development of effective curricula that impact and improve health outcomes. Along with health professionals, barangay health workers (BHW) are not spared from experiencing curricular mishaps when they undergo trainings for community health work. This article described the process of a participatory approach in curriculum development for BHWs in a local community in the Ilocos Region. Methodology: An exploratory sequential mixed method design was used for this pilot study. The method was framed from six (out of ten) steps in the Research and Development Cycle; these steps were categorized in three phases: 1) needs assessment, 2) participatory curriculum development, and 3) implementation of the curriculum and evaluation. Results: Our findings yielded both qualitative (Phases 1 and 2) and quantitative (Phase 3) data which were analyzed separately and sequentially. Phase 1 revealed findings based on the strengths, weaknesses, opportunities, and threats found in the community's health care context which were used to determine the four potential training topics to develop a curriculum. Phase 2 generated a curriculum on hilot wellness through the participation of the local government and curriculum experts. Phase 3 produced evaluative data on the reaction, learning, and behavior of BHWs towards the implemented curriculum on hilot wellness. Conclusion The participatory curriculum development process entailed the generation and analysis of data from the community that produces a curriculum for the community. This curriculum does not only offer sustainable and longitudinal health care services but is sensitive to the values and culture of the community while considering the notion that learning it not linear. This article demonstrated that a participatory approach in curriculum development within health professions education can be pursued to address the everchanging healthcare needs of local communities.
Health Workforce ; Public Health ; Workforce ; Health Personnel ; Curriculum ; Occupational Health ; Community Health Services

Underlying causes of most nutrition related problems are diverse, including biological, social, cultural, and economic factors. Qualitative approaches complement quantitative methods in identifying the underlying meanings and patterns of relationships involved in managing malnutrition. This study examined perceptions regarding malnutrition among health workers from 7 clinics (community and health clinics) in Tumpat, Kelantan. A total of 18 nurses and 2 doctors, who were involved in monitoring child health and nutrition, were included in the study. These health workers were interviewed using a semi-structured questionnaire adapted from Sastry’s framework on malnutrition (Sastry, 1996). The questionnaire included biological, behavioral and environmental factors that influence child health and nutrition. All the health workers perceived that mothers/caregivers play the main role in improving the health of malnourished children. The quality of childcare was rated as moderately satisfactory by the health workers. Most of the affected families who were given the Food Baskets did not fully use all the items for the malnourished child. Child feeding practice was based on the needs of the whole family rather than according to the target child’s needs. Most of the mothers preferred processed cereals than rice porridge because the former is easier to prepare for the child. Although they were from a low socioeconomic background, most of the mothers were not earning additional income for the family. The qualitative methodology provided information that can be used as a basis for the designing of quantitative questionnaires to assess malnutrition among children. The induction characteristic of qualitative methods was used to gain an understanding of the underlying reasons or phenomena such as behaviours that are directly observable.
Health ; Child ; Malnutrition ; workforce ; Nutritional status

Background. Attrition in residency training can lead to lower workplace morale and increased costs. Finding associated factors can help revise admissions criteria or identify at-risk residents.

Objective. We aimed to determine factors associated with attrition among residents in pediatrics.

Methods. We applied a mixed cross-sectional (survey) and retrospective cohort (records review) study design. Residents who began training in the Philippine General Hospital in 2012-2018 were included. Our primary outcomes were non-completion of training within three years (attrition), completion beyond three years or ongoing training at a delayed year level (off-cycle), and the composite of attrition or off-cycle. Fisher's exact probability test and t-test were used to compare the non-attrition group versus the attrition group, and the non-attrition group versus the attrition or off-cycle group.

Results. The overall attrition rate and off-cycle rate among 162 residents were 7.41% and 4.32%, respectively. The survey response rate was 73.00%. Four factors were significantly associated with attrition: higher age at entry into the program (p = 0.030), advanced degree (p = 0.009), longer interval from internship completion to start of residency training (p = 0.017), and a lower case presentation score (p = 0.048). The proportion of respondents older than 29 years was significantly higher in the attrition group than the non-attrition group (40.00% vs 0.94%, p = 0.031). Higher age at entry was also significantly associated with the composite outcome (attrition or off-cycle).

Conclusion. Older age at entry, advanced degree, a longer interval from internship, and lower-case presentation scores were associated with attrition among residents in pediatrics from a single center.

Rationale: The provision of surgical services in the Philippines is an essential component of our healthcare system. Despite an increasing number of accredited training programs, geographic maldistribution remains a key factor in access to surgical care in the country. This study aimed to describe the geographic distribution of surgeons and anesthesiologists in the Philippines and factors that affect their practice to provide insights into the country's surgical capabilities. Additionally, demographic factors such as workforce density, professional mobility, and economic indicators were explored. The ultimate goal was to establish an updated database for continuous monitoring of surgical manpower, facilitated through the collaboration of the Philippine College of Surgeons (PCS) and the Philippine Society of Anesthesiologists (PSA). Methods: This cross-sectional study, sponsored by the World Surgical Foundation (WSF) and the Philippine College of Surgeons Foundation (PCSF), received exemption from review by the Single Joint Research Ethics Board (SJREB) of the Department of Health. An online survey was distributed to surgeons and anesthesiologists across the Philippines from July 1 to December 31, 2020. Active practitioners in relevant specialties were eligible, excluding retirees. Procedures adhered to ICH-GCP principles, National Ethical Guidelines, and the Data Privacy Act. Additional data, sourced from various outlets, was consolidated, verified and subsequently entered into an electronic data sheet (Google Sheets, Google LLC, Palo Alto CA) to extract descriptive statistics of the surgical and anesthesia workforce at the national and regional levels. Results: Analysis of the data indicates male dominance with a noticeable trend of increasing female participation in surgical training programs, while anesthesiologist gender distribution showed a female preponderance. Maldistribution in manpower persists, influenced by factors such as training programs, medical education, and the availability of secondary and tertiary hospitals, and other socio-economic conditions in the country. The study reveals regional variations in the distribution of surgeons and anesthesiologists in the Philippines, with a notable concentration in urban centers, the highest being in Luzon, particularly in the National Capital Region (NCR). Conclusion The study highlights gender disparities and regional variations in the distribution of surgeons and anesthesiologists in the Philippines, with a significant concentration in Luzon, particularly in the National Capital Region (NCR). Disparities in subspecialty distribution are exacerbated by healthcare education discrepancies and inadequate healthcare infrastructure especially in rural areas. Addressing these challenges requires focused efforts on expanding training programs, recruiting specialists, and ensuring equitable access to surgical care nationwide. Establishing a comprehensive surgical workforce database is essential for informed policymaking, monitoring workforce distribution, and assess service quality to enhance access to surgical services.
Workforce ; Health Resources ; General Surgery ; Anesthesiology

Background: High prevalence of oral health problems persists across all age groups among Filipinos despite the continued endeavors of the government and professional societies. This position statement aimed to generate consensus policy recommendations to protect and promote oral health in the Philippines as an integral part of the healthcare service in light of the Universal Health Care (UHC) Act. Methods: An evidence-based policy brief and presentations of dental and policy experts were used as discussion points in the roundtable discussion conducted by the UP Manila Health Policy Development Hub. Key stakeholders from various sectors were convened to generate inputs for policy actions and amendments to oral health related policies. ools. Results: Thematic analysis of the discussion was organized using the WHO Building Blocks of Health Systems, which yielded practical, accessible, and population-wide interventions (2010). The following issues were highlighted: (a) health service delivery needs strong collaboration of LGUs; (b) insufficient workforce of dental professionals; (c) market availability of sufficiently fluoridated toothpaste per age group; and (d) health financing scheme on oral health services. Conclusion and Recommendations With the shift in the health system landscape brought by the UHC Act, timely and responsive inter-sectoral interventions, focusing on prevention, must be set to attain the target decrease in the prevalence of dental caries. It was also to recommend to (i) engage the academe and training institutions to increase the workforce, (ii) consider adopting international standards on sugar consumption as appropriate, and (iii) ensure sufficient funds for sustainability of oral health programs, particularly school-based caries prevention program starting in pre-schools.
Oral Health ; Public Health Dentistry ; Workforce ; Dentists ; Health Services

Background and Objective: Primary care providers are key players in providing quality care to patients and advancing Universal Health Care (UHC). However, effective and quality healthcare delivery may be affected by inadequate knowledge and failure to adhere to evidence-based guidelines among providers. The Philippine Primary Care Studies (PPCS) is a five-year program that pilot tested interventions aimed at strengthening the primary care system in the country. Evidence-based training modules for healthcare providers were administered in Sorsogon and Bataan from the years 2018 to 2021. Module topics were selected based on common health conditions encountered by providers in rural and remote settings. This program aimed to evaluate the effectiveness of training in increasing provider knowledge. Methods: A series of training workshops were conducted among 184 remote- and 210 rural-based primary care providers [nurses, midwives, barangay or village health workers (BHWs)]. They covered four modules: essential intrapartum and newborn care (EINC), integrated management of childhood illness (IMCI), non-communicable diseases (NCD), and geriatrics. A decision support system (UpToDate) was provided as a supplementary resource for all participants. We administered pre-tests and post-tests consisting of multiple-choice questions on common health conditions. Data was analyzed using paired one-tailed t-test, with an alpha of 0.05. Results: The knowledge of nurses, midwives, and BHWs improved after the training workshops were conducted. The largest increase from pre-test to post-test scores were observed among the midwives, with a mean difference (MD) of 32.9% (95% CI 23.9 to 41.9) on the EINC module, MD of 25.0% (95% CI 16.6 to 33.4) in the geriatrics module, and MD of 13.5% (95% CI 6.9 to 20.1) in the NCDs module. The nurses had the greatest improvement in the IMCI module (MD 10.8%, 95% CI 2.5 to 19.1). The knowledge of BHWs improved in all participated modules, with greatest improvement in the NCD module (MD 9.0%, 95% CI 5.77 to 12.14). Conclusions Primary care workshops, even if conducted as single-sessions and on a short-term basis, are effective in improving short-term knowledge of providers. However, this may not translate to long-term knowledge and application in practice. Furthermore, comparisons across provider categories cannot be made as participant composition for each training workshop varied. Ultimately, this study shows enhancing provider knowledge and competence in primary care will therefore require regular and diverse learning interventions and access to clinical decision support tools.
Capacity Building ; Health Workforce ; Philippines ; Primary Health Care

To examine the relationship lifestyle factors, personal character, mental health status, and job strain a self-administered questionnaire survey was conducted among employees of a leading electrical manufacturing company in Japan. A total of 2, 327 workers (Male=1, 668, Female=659) responded to the survey. We analyzed the relationships of health practices based on such factors as: Free child (FC) from the Egogram, the Working-life satisfaction, and the General Health Questionnaire-28 through Path-analysis techniques.The following results were obtained: The mental health status was significantly affected by such factors as health practices, Working-life satisfaction, personal character (FC), life satisfaction, and age. Health practices and personal character (FC) showed a direct relationship to the mental health status and an indirect relationship to the Working-life satisfaction and life satisfaction. The variances accounting for mental health status were 41.8% in male workers and 43.8% in female workers.Path-analysis data suggested that mental health status was affected about 40% by lifestyle, personal character, Working-life satisfaction, and life satisfaction. It was suggested that there might be important factors affecting mental health status but which are unknown to us by as much as 60% in the present day. These findings suggested the necessity of further investigation of the relationship among lifestyle factors, mental health status, and job strain among employees of a reputable company in the present day.
Mental Health ; life satisfaction ; workforce ; Personality Character ; Life Style