Health Manpower Sharing Pacific

Health Human
Resource Sharing
Quality Health Care
Through Coordination
Pacific Inter Local Health Zone,

Province of Southern Leyte

Health Human Resource Sharing:
Quality Health Care Through Coordination
TABLE OF CONTENTS
Message 5
Acknowledgements 6
Summary 7
Project Rationale:
Less Human Resources Mean Poorer Health 8
Project History and Objectives:
Reviving an Ailing Hospital 9
Project Results:
Sharing Multiplies Health Human Resources 10
Key Steps in Implementation:
Putting Strategies into Effective Action 11
Analysis and Lessons Learned:
Keeping Things Simple Works 16
Annexes:
Annex A – Result of Legal Query made to the
Civil Service Commission 20
Annex B – Executive Order authorizing MHOs
to practice at the ADH 22
Annex C – Sample Certificate of Authority Letter from LCE 23
Annex D – Board Resolution with guidelines on MHO duties 24
Annex E – Executive Order authorizing Anesthesiologist
and Specialist from SLPH 26
Annex F – Board Resolution requesting DOH to authorize
the conduct of elective cases at the ADH 27
Annex G – Board Resolution requesting EVRMC
to share its Specialist with the ADH 28

FOREWORD

Replication Technical Working Group

Undersecretary MARIO C. VILLAVERDE, Sectoral Management Coordination
Team (SMCT) and Policy Support Development Team (PSDT) for Service Delivery
Asst. Secretary NEMESIO T. GAKO, SMCT and PSDT for Service Delivery
Director LILIBETH C. DAVID, Bureau of Local Health Development (BLHD)
Director JUANITO D. TALEON, former OIC-BLHD, Director III-CALABARZON
Director EDGARDO M. GONZAGA, CHD for Eastern Visayas
Documentation Team
Ms. Ramila Geganto
Dr. Verna Fernandez
Dr. paula Paz Sydiongco
Technical and Editorial team
DOH CO Replication Team:

Ms. Erlinda E. Domingo, BLHD
Ms. Rosalinda S. Guerrero, BLHD
Ms. Ma. Rosario S. Torralba, BLHD
Ms. Irene V. Hizon, BLHD
Ms. Rosa G. Gonzales, HPDPB
Ms. Adelaida P. Mendoza, HPDPB
Dr. Juanita H. Fandinño, HHRDB
Ms. Carole A. Bandahala, NCDPC
CHD-Eastern Visayas Replication Team:

Dr. Paula Paz Sydiongco
Dr. Imelda Ramos
Dr. Verna Fernandez
Dr. Exuperia Sabalberino
Ms. Jocelyn Garcia
GTZ
Ms. Deborah Carmina Sarmiento
Dr. Carmelita Canila
Consultants:
Ms. Josefa Carandang
Ms. Deborah Carmina Sarmiento
Dr. Carmelita Canila
Dr. Michael Adelhart
Ms. Enya Devanadera

MESSAGE
The Health Human Resource sharing is an initial step to solve the downgrading of
Anahawan District Hospital, the core referral hospital of the Pacific Inter Local Health
Zone. It was found out to be effective and the mayors allowed their Municipal Health
Officers to render services in the provincially owned district hospital through a letter of
authority.
We believe that Human Resource Sharing at the Anahawan District Hospital is a showcase
of unity, sacrifice, willingness of our doctors, nurses, midwives, and the rest of the health
care providers who despite the lack of material resources and the social pressure to look
for greener pasture abroad, remain with us and perform the best that they can to alleviate
suffering and restore health among Southern Leyteños in the Pacific municipalities.
This sharing of health human resource improved the quality of curative services provided
by the Anahawan District Hospital. This also initiated an exemplary Bayanihan Spirit and
commitment of the LGUs and stakeholders of Southern Leyte for the common good of our
people.Thus, this simple initiative has created great satisfaction among health workers as
well as the community.
May this simple innovation of Pacific Inter-Local Health Zone inspire other health workers
& LGUs to pursue betterment of health services in their locality.
DR. JOSE LITO P. TRUMATA

Provincial Health Officer II
Province of Southern Leyte

ACKNOWLEDGMENT
We salute our doctors at the Rural Health Units (RHUs) of the Pacific Inter-Local Health Zone
for heeding the call of their vocation and extending their duty even beyond bounds of their
territorial responsibilities. Thank you for offering your services unmindful of the additional
burden and responsibilities.
Our deepest gratitude to the Local Chief Executives and Local Government Units of the
Pacific towns for sharing their resources with the provincial LGU to enable the Anahawan
District Hospital to continue providing its quality services.
Our special thanks to our development partner, German Development Cooperation (GTZ),
and the Department of Health-Eastern Visayas for their unwavering support of our effort
to organize and systematize our health-care system so we could provide our constituents
better health services.
Pacific Inter Local Health Zone of Southern Leyte would like to thank the following
institutions/individuals who were instrumental in making health human resource sharing in
the Pacific a success:
Anahawan District Hospital

Center for Health Development – Eastern Visayas
Eastern Visayas Regional Medical Center
German Development Cooperation
Pacific Inter Local Health Zone Board
Pacific Inter Local Health Zone Technical Management Committee
PhilHealth – Eastern Visayas
Provincial Accounting and Treasurer’s Office,
Provincial Office of Southern Leyte
Salvacion Oppus Yñiguez Memorial Provincial Hospital
DR. ERNESTO J. CAHOY

Chief of Hospital – ADH
TMC-Chairman PILHZ

Summary
The Anahawan District Hospital (ADH) is the core referral government hospital in the Pacific
Inter Local Health Zone in Southern Leyte. Like in many other hospitals across the country, it
experienced being hard-pressed to provide quality health services to its client communities
mainly because of inadequate human resources, especially doctors. Patients often had to be
referred or transferred to other hospital facilities that were two to three hours away. Mayors
also found themselves providing more financial assistance to indigent patients either from their
own pockets or thru the LGU’s Assistance to Individuals in Crisis Situation (AICS) funds. Yet even
as both the community and local government were increasing their expenditures for health, the
quality of health services remained poor.
In response to this situation, the dynamic Board and Technical Management Committee of the
Pacific Inter Local Health Zone developed and implemented some health human-resource (HR)
sharing strategies, prioritizing the issue of lack of medical doctors in the search for an immediate
solution. There was strong commitment from the local chief executives of the provincial
government and the six municipalities making up the Pacific ILHZ to work together to resolve their
common problem. Their efforts have not been for naught, and have resulted in the availability of
more medical personnel to provide quality health services, increased community access to better
hospital services, the provision of incentives to doctors, and a proud and empowered hospital
staff.
The Pacific ILHZ experience is a good example of how LGUs and other health stakeholders can
work together, tapping the limited resources available to them, in addressing health-care gaps
caused by shortages in medical personnel in their locality. In light of the Human Resource (HR)
crisis that the Philippine health sector is facing, such initiatives are welcome. Although these are
temporary, stop-gap solutions, they are doable and can easily be applied by LGUs. The practice
also lends some insights to health stakeholders at the national level who are looking at improving
governance and coordination in among local health systems as one of the objectives of Fourmula
One.

Project Rationale
Less Human Resources
Means Poorer Health
The Anahawan District Hospital is the core referral government hospital in the Pacific Inter
Local Health Zone (Pacific ILHZ), providing hospital services to a catchment population of
just over 100,000. Before the devolution in 1991, the hospital had excelled in the delivery of
quality health care. Given limited government resources after the devolution, however, it
became difficult to support hospital operations. There was insufficient supply of medicines,
lack of hospital facilities/systems development, and inadequate medical staff—there were
not enough doctors rendering services in the hospital, while the medical staff lacked training
and capacity development.
Like in many other hospitals across the country, the low income and slow promotion
among the hospital’s doctors, compounded with the partial implementation of Magna
Carta benefits, had caused physicians to search for greener pastures, which only further
demoralized those left behind. Because of the subsequent lack of quality health care, the
DOH licensure and Philhealth accreditation downgraded the Anahawan District Hospital
from secondary to primary level in 2004. This meant that the hospital could no longer provide
residents of the Pacific towns with secondary-level health care such as surgery, X-ray, and
laboratory services. Furthermore, Philhealth members could no longer avail of their benefits
at the ADH, which was the nearest hospital to their homes. Patients had to be transferred
to other hospitals, and that translated to their having to spend more time and resources
seeking medical treatment in Sogod, Maasin, or Tacloban City, thereby increasing their out-
of-pocket expenditures for health care.
____________________________________________________________________________________________________________________
1
FOURmula One for Health is a reform mechanism in improving health system performance, ensuring access
and availability, assuring quality and increased financing for a better health outcomes, more responsive health
system and equitable health care financing.
2
Republic Act No. 7305, also known as the Magna Carta Of Public Health Workers, aims to (a) promote and
improve the social and economic well-being of the health workers, their living and working, conditions and
terms of employment; (b) develop their skills and capabilities in order that they will be more responsive and
better equipped to deliver health projects and programs; and (c) encourage those with proper qualifications and
excellent abilities to join and remain in government service.

Another result was the mayors’ reluctance to enroll more indigent households in Philhealth
since they could not maximize their in-patient Philhealth benefits. Mayors also had to
provide more financial assistance to indigent patients either from their own pockets or thru
the LGU’s Assistance to Individuals in Crisis Situation (AICS) funds. This meant higher LGU
expenditure.
The provincial LGU, however, could not offer a bigger budget to improve ADH operations.
In the meantime, the local governments and the people were spending more and more for
quality healthcare.
Project History and Objectives

Reviving an Ailing Hospital
In December 2003, the Pacific Inter Local Health Zone (Pacific ILHZ) was organized through
a Memorandum of Agreement (MOA) among six municipalities (Saint Bernard, San Juan,
Anahawan, Hinundayan, Hinunangan and Silago), the Provincial LGU of Southern Leyte, the
Department of Health, PhilHealth, and the German Technical Cooperation (GTZ), with the
goal of strengthening the District Health System.
Even then, it was very clear that the Anahawan District Hospital had human resource-
management gaps and issues that needed to be addressed if the hospital’s service delivery
were to improve. The Pacific ILHZ stakeholders thus got together and agreed to strategize
to improve the hospital’s human resource-development system. The lack of medical doctors
and the absence of an anesthesiologist were prioritized to be given immediate solutions
since these were perceived to be major threats to the delivery of quality health service in the
district, especially to the marginalized groups.
The Pacific ILHZ stakeholders then set deceivingly simple project objectives, with the hope
that these would eventually improve total health care:
• To augment the number of doctors at Anahawan District Hospital
• To provide attractive incentive packages for the doctors
_____________________________________________________________________________________________________________________
3
There is difficulty in attracting doctors to work in remote areas. Doctors prefer to work as private
practitioners or in the Rural Health Units (RHUs) because of the higher income offered by these options.

Project Results
Sharing Multiplies Health
Human Resources
The sharing of health human resources proved to be the right prescription for
the Pacific ILHZ’s health care system. Among the benefits reaped so far:
• There are now more medical personnel to provide quality health services:
1. The MHOs of the six PILHZ LGUs go on duty at ADH and at the Hinunangan Community
Hospital.
2. Two doctors -- a senior resident physician in obstetrics-gynecology and a pathologist
-- from the Eastern Visayas Regional Medical Center in Tacloban City are now fielded
at the ADH.
3. After the two doctors of Eastern Visayas Regional Medical Center ended their contracts,
five doctors applied at ADH and are now on regular duty. Two are pediatricians and
three are general practitioners. No one among them, however, is a surgeon. To ensure
continuity of service delivery to patients, the PILHZ TMC passed a resolution and was
approved by the PILHZ Board to allow MHOs skilled in surgery to perform emergency
operations, such as caesarean section, appendectomy, and herniorraphy, anytime
these are needed, with the consent of the Chief of Hospital.
• The MHOs and doctors now enjoy monthly additional incentives:

1. MHO – Philhealth professional fee, plus additional PhP1,500/24-hour duty
2. Doctors – PhP5,000/month
And by addressing the health human resource concerns, bigger results were achieved:
• People’s increased access to hospital care

In 2005, the hospital occupancy rate was 45.76%. Three years later, this increased to
64.79%, largely because ADH could now provide patients with secondary-level health
care services, such as OB-Gyne and Surgery -- the most common hospital services needed
by the community. Philhealth members were also encouraged to patronize the hospital
because they could now avail of their benefits there.
10
• Reduction in the out-of-pocket expenditures of patients

With the regular availability of skilled physicians, clients are saved from
traveling 100 to 200 kilometers to the next health facility, thereby reducing their
transportation expenses just to avail of health services.
• Increased hospital income and improved hospital stature

The hospital income in 2004 was PhP1,137,395.60 and grew to PhP1,862,466.03
a year later. In 2008, ADH posted an income of PhP2,637,086.60.
In 2004, the Anahawan District Hospital was downgraded from secondary to primary
level of care. With the initiative on human resource sharing, it was upgraded back
to secondary level of care by the DOH and PhilHealth. The hospital can now perform
emergency and elective surgery. At present, ADH is doing tertiary level of care in
diagnostic and laboratory services.
Anahawan District
• Longer physician retention and improved referral system Hospital staff in
The additional incentives, while modest, are very much appreciated by the doctors action
who have been inspired by these in continuing their services at the ADH. With doctors’
services assured, the hospital can now better accommodate patients referred to it by
the RHUs and BHSs.
• Proud and empowered hospital staff

The hospital staff are now proud and confident to encourage clients to access the
hospital services. The human resource-sharing scheme has also improved the MHOs’
capacity and skills in hospital work. In addition, it gave the ADH Senior Resident
Physician an opportunity to train in the OB-Gyne Services.
Key Steps in Implementation

Putting Strategies into Effective Action
1. Recognizing the problem and identifying options given available resources
A Technical Management Committee (TMC) oversees the Pacific ILHZ’s day-to day
operations and meets every month. The problem of lack of doctors (and its adverse effects)
11
in the hospital was discussed in several meetings, during which TMC members brainstormed
on health human resources in the area that could be available to them. Among the potential
manpower they thought of tapping were
-- doctors from the Eastern Visayas Regional Medical Center (EVRMC) in Tacloban
City;
-- doctors from the Salvacion Oppus Yñiguez Memorial Hospital (SOYMPH); and
-- MHOs of the six LGUs of the Pacific ILHZ.
There were five options considered:
• Allow the MHOs to practice at the ADH and at the Hinunangan Community Hospital,
a smaller hospital in the district that also lacked doctors;
• Share the anesthesiologist/specialist from Salvacion Oppus Yñiguez Memorial
Hospital with the ADH or sharing of specialist between ILHZs;
• Secure services of Specialists from the Eastern Visayas Regional Medical Center
through their Residency Dispersal Program;
• Fill up vacant medical positions; and
• Upgrade the entry position of medical doctors from Medical Officer 3 to Medical
Officer 4.
Of the five options, only the second was not actively pursued. The ADH was hoping to
upgrade its Medical Officer 3 staff to Medical Officer 4 if the doctor had finished residency
training.
2. Identifying health human resource sharing strategies that are doable and
realistic
It was decided that pooling and sharing of health human resources was necessary to ensure
continuity of quality health care-service delivery. In March 2004, the Pacific ILHZ Board
approved the guidelines on human resource pooling with several Board Resolutions and
Executive Orders. The following sub-steps provide details on the health human resource
sharing strategies that the Pacific ILHZ conceptualized and how it was able to implement
these. Replicating LGUs should adapt these strategies to their own context, prioritizing
those that they feel will address the problems that pose the most threats to their delivery of
quality health care.
12
2.1. Securing authorization for the MHOs to practice in the hospital
The Pacific ILHZ was encouraged to adopt the scheme for MHOs to work at the ADH given
the latter’s experience in working in hospitals, and the fact that they had special training in
surgery.
Through the Local Health Board, mayors posed a question on the legality of MHOs rendering
services in a government hospital on official time, as they are employed by the municipal
LGU. A legal query to the Civil Service Commission (CSC) was made and it was confirmed that
MHOs could go on hospital duty, provided that they did so without additional compensation.
(See Annex A for the Result of the CSC Query)
An Executive Order (EO) was issued by the Provincial Governor authorizing the MHOs of the
municipalities covered by the Pacific ILHZ to practice in the Anahawan District Hospital and
Hinunangan Community Hospital on official time, provided that the MHOs had an official
authorization from their respective municipal government to function as such. (See Annex B for
a copy of the EO and Annex C for a sample authorization letter of an LCE authorizing the MHO
to render service).
The rendering of MHO services were also subjected to some guidelines that were developed
in a participatory manner, and captured and institutionalized through a PILHZ Board
Resolution. (See Annex D for Board Resolution with guidelines)
To date, there has been no adverse effect of the practice of MHOs in the hospital vis-à-vis the
RHUs’ primary/public health-care functions. This is because the RHUs are aware and support
this practice and “pitch in” when the MHOs are away.
2.2. Ensuring the availability of anesthesia services at the hospital
Because OB-Gyne and Surgery were one of the most common hospital services needed by
the community, it was important for the ADH be able to provide reliable anesthesia services.
The provincial government thus issued an Executive Order and Board Resolution (see Annex
E and F) authorizing an anesthesiologist and specialist from Southern Leyte Provincial
Hospital (SLPH) to render duty in the Anahawan District Hospital, subject to schedules and
guidelines agreed upon with the ADH chief and the Provincial Health Officer. The doctors’
services are often requested for elective surgeries at the ADH.
13
2.3. Participating in a hospital dispersal program
The ADH also decided to participate in the Residency Dispersal

Program being offered at the EVRMC, which would enable medical
specialists from the EVRMC to work at the ADH for six months as part
of a prescribed residency training course by the DOH. (See Annex G
for Board Resolution on this).
The doctors, a senior resident physician in obstetrics-gynecology and a

pathologist, have continued to work at the ADH (after their six-month
training course) and have now been absorbed by the hospital as regular
staff.
Anahawan Chief of
Hospital Dr. Ernesto By partnering with a nearby hospital and being open to receive assistance from outside
Cahoy endorsing his
medical staff, the ADH was also able to build the capacities of its own staff, i.e. the senior
patient to Dr. Coraza,
MHO of San Juan, and resident physician of the ADH had an opportunity to train in OB-Gyne services through a
hospital nurse, Fe peer-to-peer learning process with the fielded physician from the EVRMC.
Abuyog
3. Sustaining quality healthcare by pooling financial resources and providing
incentives
The Pacific ILHZ had to ensure that the mechanisms it had put in place would be sustained
and truly implemented at the ADH. This meant providing incentives and an encouraging
environment for the medical staff to work in, as well as having the sufficient budget to make
these possible.
The Pacific ILHZ made use of its existing financial system, the Common Health Trust Fund
(CHTF), in providing monetary incentives to medical staff. As a mechanism for pooling
financial resources, the CHTF received annual contributions from its six municipal LGUs and
from the provincial LGU.
Starting 2005, the Pacific ILHZ Board provided a monthly incentive of PhP3,000 to each
resident physician of Anahawan District and the Hinunangan Community Hospitals. The
incentive was raised to PhP5,000 in 2008. The Pacific ILHZ has made sure that such incentive
packages are always included in their Annual Work and Financial Plan.
14
The doctors from the SLPH and EVRMC are also supported and encouraged in other ways:
• SOYMPH doctors can claim Travel Expense Vouchers from the provincial LGU;
• They are provided with food and quarters by the hospital;
• They can claim PhilHealth professional fees if clients are PhilHealth members; and
• They can charge paying patients professional fees based on PhilHealth guidelines.
Having a Common Health Trust Fund in place is not a prerequisite for human-resource
sharing. Replicating LGUs may use other mechanisms to pool/pay for incentives, building
on their own existing financial systems and policies, and designating responsible staff to
manage such mechanisms. In the case of the Pacific ILHZ, the leadership skills and integrity
of both the CHTF Fund Custodian and the TMC Chairman (who also happens to be the ADH
chief) was important to ensure transparency throughout the program’s implementation.
4. Monitoring resources and schedules
Simple monitoring of the health human resource-sharing schemes is done through the
regular meetings and correspondences done by the Pacific ILHZ on various health matters.
It includes:
• Ensuring LGUs make their annual contributions to the CHTF;

• Ensuring that doctors’/nurses’ incentives are paid fully on a timely basis. This
is currently being done on a quarterly basis to lessen administrative payment
processes; and
• Planning and agreeing on doctors’ monthly schedules. As much as possible,
schedules for the upcoming month are determined during the current month.
The regular monthly meetings of the Pacific ILHZ provide a venue to discuss and
agree on the schedules.
_____________________________________________________________________________________________________________________
4
The CHTF is used to finance the Pacific ILHZ’s Annual Work and Financial Plan, as approved by its board.
The fund is lodged at the Provincial Treasurers Office in a separate book of account (ILHZ CHTF Trust
Fund), and is managed by a designated Fund Custodian. The Chairman of the Pacific ILHZ’s Technical
Management Committee acts as co-signatory for cash advances and other financial transactions.
15
The table below provides a summary of the Pacific ILHZ’s experience as guide for LGUs that
may be interested in replicating some or all aspects of the practice.
Analysis and Lessons Learned

Keeping Things Simple Works
For the Pacific ILHZ, prioritizing and zeroing in on health human resource issues helped
significantly to improve its overall health care-service delivery in just a few years time.
Success factors in health human resource sharing

• Reliable management structure and financial system that facilitated project
implementation
A functional and pro-active ILHZ that met regularly provided a venue for collective
16
discussion and decision at both the technical and political levels. As well, the Common
Health Trust Fund was an effective mechanism to pool, allocate and disburse financial
resources.
• Keen participation and commitment from all stakeholders

The strong political will of LCEs enabled quick and effective decisions, i.e. increasing
LGU contributions to the CHTF, to be made. Also, the presence of dedicated staff
such as the District Nurse Supervisor and DOH Representative in providing technical
assistance to the LGUs facilitated the timely pooling and disbursement of funds. The
dedication of the Technical Management Committee and medical staff who render
services—the MHOs, Specialists, etc.—have also been invaluable.
• Realistic and innovative strategies implemented

The Pacific ILHZ worked with what it had. It built on existing resources and its
strengths, and developed and implemented strategies that were simple yet effective.
The doctors’ incentives may not be a very large amount and the situation at the ADH is
still far from the ideal, but the benefit of improved health services because of human-
resource sharing is already being reaped by the community.
• Opportunity for hospital staff development harnessed as a longer-term solution

Having trained medical personnel from other hospitals render duty at ADH was not
just about having more doctors to service patients. It was also about building the
capacities of the existing staff. The fielded doctors and specialists brought with
them not only their technical expertise, but also their rich personal experiences from
working with other medical practitioners from other hospitals. In addition, the ADH
encouraged its staff to undergo in-service training at the EVRMC when possible.
(Some MHOs were also able to enhance their hospital work skills through this in-
service training program.)
It is thus important to note that health human-resource sharing can either be a permanent
or remedial/temporary measure that LGUs/ILHZs adopt when confronted with doctor
shortages. In any case, investing to build staff capacity will always be beneficial in the
medium- to long-term.
17
Related policy concerns

Meeting the objectives of the health reform agenda
Fourmula One looks into improved governance and coordination in and among local health
systems as one area of health reform. The establishment and functionality of Inter-Local
Health Zones—where there is coordination among local governments, NGOs, NGAs, donor
agencies, and other stakeholders involved in health—is a key achievement toward the
realization of this reform. Resource sharing, whether financial, equipment, human resource,
logistics, etc., is a concrete manifestation of effective coordination toward common health
goals, one of which is improved total health care. Such has been the success of the Pacific
ILHZ, despite the fact that its initial objectives were to simply ensure there were doctors to
provide health care/services at the core referral hospital.
Looking at the broader issue of the HR crisis in the health sector
The Philippine health sector has long been confronted with shortages in medical personnel.
Stories of doctors leaving the country to become nurses in other countries are quite
common. Though efficiency gains in organizing HR is most welcome, LGUs and other health
stakeholders must not lose sight of underlying problems. This is related to the insight that
health human resource sharing, as practiced by the Pacific ILHZ, may be a temporary or
stop-gap solution. At present, the sector is faced with the reality of limited LGU budgets
and salaries. Still, this also presents an opportunity for hospitals to discuss and look at other
options, such as corporatization of local facilities.
Replicating the practice
An LGU or group of LGUs, i.e. an ILHZ, with the following characteristics is in the best position
to replicate this practice:
• Has a population with limited access to hospital care services due to lack of doctors;
• Confident that the support and commitment of the Local Chief Executive(s) and
health workers can be obtained. A formal ILHZ with a sound Technical Management
Committee, or similar management structure, can facilitate the sharing mechanism.
18
Yet even without one, a group of mayors/governor can still implement provided they
are willing and they have a venue to discuss issues and solutions.
• Has or is able to establish a Common Health Trust Fund, or other financial system/
mechanism to pay for the incentives of doctors and other medical staff; and
• Allows MHOs who have the skills, experience, and are willing to work in the hospital.
Training in hospital work for MHOs should be provided if they lack the capacity.
Who to contact if interested in replication
Name: Dr. Ernesto J. Cahoy

Position: Chief of Hospital
Organization: Anahawan District Hospital
Contact Details: 053- 581-0093
19
Annex A
Result of Legal Query made to
the Civil Service Commission
20
21
Annex B
Executive Order authorizing MHOs
to practice at the ADH
22
Annex C
Sample Certificate of Authority Letter from LCE
23
Annex D
Board Resolution with guidelines
on MHO duties
24
25
Annex E
Executive Order authorizing Anesthesiologist
and Specialist from SLPH
26
Annex F
Board Resolution requesting DOH
to authorize the conduct of elective cases at ADH
27
Annex G
Board Resolution requesting EVRMC
to share its Specialist with ADH
28

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Health Human

Pacific Inter Local Health Zone,

Replication Technical Working Group

Technical and Editorial team

DOH CO Replication Team:

CHD-Eastern Visayas Replication Team:

DR. JOSE LITO P. TRUMATA

Anahawan District Hospital

DR. ERNESTO J. CAHOY

Project History and Objectives

• The MHOs and doctors now enjoy monthly additional incentives:

• People’s increased access to hospital care

• Reduction in the out-of-pocket expenditures of patients

• Increased hospital income and improved hospital stature

• Proud and empowered hospital staff

Key Steps in Implementation

There were five options considered:

2.1. Securing authorization for the MHOs to practice in the hospital

2.2. Ensuring the availability of anesthesia services at the hospital

2.3. Participating in a hospital dispersal program

The ADH also decided to participate in the Residency Dispersal

The doctors, a senior resident physician in obstetrics-gynecology and a

4. Monitoring resources and schedules

• Ensuring LGUs make their annual contributions to the CHTF;

Analysis and Lessons Learned

Success factors in health human resource sharing

• Keen participation and commitment from all stakeholders

• Realistic and innovative strategies implemented

• Opportunity for hospital staff development harnessed as a longer-term solution

Related policy concerns

Looking at the broader issue of the HR crisis in the health sector

Replicating the practice

Who to contact if interested in replication

Name: Dr. Ernesto J. Cahoy

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