Governance in Primary Care Systems: Experiences and Lessons from Urban, Rural, and Remote Settings in the Philippines

Authors

  • Nannette Bernal-Sundiang Philippine Primary Care Studies, University of the Philippines Diliman, Quezon City
  • Regine Ynez H. De Mesa Philippine Primary Care Studies, University of the Philippines Diliman, Quezon City
  • Jose Rafael A. Marfori Philippine Primary Care Studies, University of the Philippines Diliman, Quezon City; College of Medicine, University of the Philippines Manila; Philippine General Hospital, University of the Philippines Manila
  • Noleen Marie C. Fabian Philippine Primary Care Studies, University of the Philippines Diliman, Quezon City
  • Ysabela T. Calderon Philippine Primary Care Studies, University of the Philippines Diliman, Quezon City
  • Leonila F. Dans Philippine Primary Care Studies, University of the Philippines Diliman, Quezon City; College of Medicine, University of the Philippines Manila
  • Mia P. Rey Philippine Primary Care Studies, University of the Philippines Diliman, Quezon City; Cesar E.A. Virata School of Business, University of the Philippines Diliman, Quezon City
  • Josephine T. Sanchez Philippine Primary Care Studies, University of the Philippines Diliman, Quezon City
  • Cara Lois T. Galingana Philippine Primary Care Studies, University of the Philippines Diliman, Quezon City
  • Jesusa T. Catabui Philippine Primary Care Studies, University of the Philippines Diliman, Quezon City; University of the Philippines Health Service Diliman, Quezon City
  • Ramon Pedro P. Paterno Philippine Primary Care Studies, University of the Philippines Diliman, Quezon City; Universal Health Care Study Group
  • Edna Estefania A. Co Philippine Primary Care Studies, University of the Philippines Diliman, Quezon City; National College of Public Administration and Governance, University of the Philippines Diliman, Quezon City; UP-CIFAL Philippines, Quezon City
  • Antonio Miguel L. Dans Philippine Primary Care Studies, University of the Philippines Diliman, Quezon City; College of Medicine, University of the Philippines Manila

DOI:

https://doi.org/10.47895/amp.vi0.4834

Keywords:

governance, primary care, universal healthcare, health systems, interventions, participant observation

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.

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Published

2023-03-28

Issue

Vol. 57 No. 3 (2023)

Section

Articles

How to Cite

1.
Governance in Primary Care Systems: Experiences and Lessons from Urban, Rural, and Remote Settings in the Philippines. Acta Med Philipp [Internet]. 2023 Mar. 28 [cited 2025 Apr. 15];57(3). Available from: https://actamedicaphilippina.upm.edu.ph/index.php/acta/article/view/4834

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