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

BACKGROUND: The Philippines has, mandatory service policies to address the insufficiency and maldistribution of human resources particularly for health services. Despite being perceived as an appropriate intervention to bridge the aforementioned HRH gaps, the past and present implementations of such programs in the country have never been formally studied.

OBJECTIVE: This paper aimed to present the history of mandatory service programs in the Philippines, look at their natures, and see how their different implementations relate to each other.

METHODOLOGY: Using a qualitative document analysis method, administrative issuances and reports relevant to past and current implementations of mandatory service policies in the Philippines were obtained and reviewed.

RESULTS: Mandatory service programs have been implemented in the country by institutions from both the private and public sectors as early as 1968. The focus of such has been mostly for government positions and specialized professions including physicians and scientists. While extensive efforts have been made through the years, the policies demonstrated fragmentation and recurring gaps in implementation. Such gaps include the lack of enabling policy mechanisms, formal monitoring and evaluation, and program institutionalization.

CONCLUSION: The historical narrative of return service programs in the country is a potential source for the development of an overarching mandatory service policy framework for human resources in the Philippines, one that is specific to the context and setting of the country. By articulating policy issues identified, this paper provided a stepping-off point for future mandatory service program policy planning, implementation, evaluation, and institutionalization in the Philippines.

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: The College of Public Health, University of the Philippines Manila (CPH-UPM) was engaged by the Center for Health Development Calabarzon (CHD 4A) to design, implement and manage the retooling of their personnel following implementation of Executive Order No. 336 on the rationalization of the Philippine government’s executive branch. Objective: To describe the training design and present outputs of the training modules designed for the CHD 4A staff. Methods: We reviewed the project documentation, which included the inception report, minutes of meetings, training modules, and post-training reports. Abstracted information was validated through internal discussion by a core group, which had representatives from the two organizations involved from project inception to close-out. Results: The design, development and implementation of the training were the product of collaborative efforts between CHD 4A and the technical team from the College of Public Health, University of the Philippines Manila. Technical staff of CHD 4A were trained in the competency areas in which gaps between the expected and perceived level of performance across all salary grades were highest: results orientation, planning and organizing, technical expertise, quality service focus, coordination and networking, and managing change. Nine training courses were implemented from May to July 2016, which was attended by 230 participants. All training modules were highly rated by participants (range: 3.60 to 3.85) based on a four-point scale, with 4 as the highest rating and 1 as the lowest. Comparison of pre- and post-tests for the modules on coordination and networking, and managing change showed a statistically significant increase in scores at the conclusion of their respective sessions. Conclusion The design of a training program for an organization’s personnel must be tailor-fit to and answer the needs of its employees. Trainers must be willing to make dynamic changes and adapt to immediate feedback from participants. The implementing party and organization itself must both ensure thorough evaluation of the effects of the training to achieve the organization’s long-term goals.
Staff Development ; Teaching ; Education ; Workforce

On the base of the principle of penetrating moxibustion and in combination with free adjustment devices such as movable U-shaped moxa stick holder and movable clamp, a new type of moxibustion box exerted on the head is designed, with precise positioning and sufficient heat intensity.
Hot Temperature ; Moxibustion ; Temperature ; 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

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. 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.

It has attracted much attention worldwide that the application of artificial intelligence (AI) in primary screening and clinical diagnosis and treatment of eye diseases. In recent years, this technology has also been widely used in various grass-roots eye disease management, effectively improving the current situation of weak eye disease diagnosis ability and shortage of human resources in primary medical institutions. At present, there is no reference standard or guideline for the management mode, implementation content and management method of vision health management based on this technology, which are in urgent need of standardization. The article described the work mode exploration of AI-assisted grass-roots visual health management in Shanghai and shared practical experience. The aim is to provide reference for other provinces in China to carry out relevant work.
Humans ; Artificial Intelligence ; China ; Reference Standards ; Workforce

Objective: A survey was conducted to understand the work conditions, daily living habits and occupational stress of nurses and care workers employed by nursing care medical facilities. Materials and Methods: Self-completion questionnaires were administered to 68 personnel (27 nurses, 41 care workers) aged 38.3 ± 12.5 years. Results: The percentage of nurses who fell under the `good' lifestyle category was zero, while the percentage of those in the `poor' lifestyle category was 66.7%. In comparison, 12.2% of care workers enjoyed a `good' lifestyle, and 56.1% had a `poor' lifestyle. From among all the respondents, 60.2% fell under the `poor' lifestyle category. There were significant differences between nurses and care workers (p<0.01) for two categories, `stress from the work environment' and `subjective level of his/her work aptitude', which are presumably stress factors. Significant differences were also observed between them (p<0.05) for the following two categories, `subjective level of physical burden' and `job satisfaction'. There was no significant difference between the nurses and the care workers with regard to the raw scores recorded for all the categories under `physical and mental reactions caused by stress'. However, the care workers scored 8.1 ± 2.3 points in the `feeling of fatigue' category, and their scores were evaluated as `slightly high' as per the determination criteria. With regard to the stress-relieving factors, no significant differences were noted between the nurses and care workers in terms of the raw scores recorded for any of the categories. The raw scores recorded for the `support from supervisors' category were 7.3 ± 2.0 and 7.1 ± 1.8 points for the nurses and care workers, respectively. These scores were evaluated as `slightly high' according to the determination criteria of the questionnaire on stress. Conclusions: On the basis of the results of this study, it was determined that the work hours per day were longer and the duration of breaks was shorter for the nurses than for the care workers. No significant difference was observed in the daily living habits of the nurses and care workers. The raw scores for the factors (questionnaire items) that were presumed to be the causes of stress were significantly higher for the nurses than for the care workers. Support from supervisors was a stress-relieving factor for both the nurses and care workers.
workforce ; Stress ; Work ; Life Style ; categories