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What is PRO-Health?

Promoting Rights Organizing for Health is an initiative of the Government Watch and Accountability Research Center on strategic approach to accountability in health. It aims to improve public health governance in ensuring quality reproductive, maternal and newborn, children and adolescents health services accessible to all through organizing, monitoring, coalition-building, advocacy and learning of monitors and accountability frontliners of G-Watch’s local core groups, other partner civil society organizations in collaboration with allied local government units.

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Government Watch (G-Watch) is a national citizen movement that aims to improve governance and deepen democracy through the scaling of accountability and citizen empowerment.

G-Watch has more than two decades of experience in citizen monitoring and action research on transparency, participation and accountability. It is currently present in 12 localities all over the Philippines with partners and allies from civil society, government and international community.

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Action-research incubator

Mission: Promote balanced practitioner-researcher partnerships with public interest groups and reformist policymakers in the global South
Focus: Partner to support relevant applied research proposals and organizational learning strategies
Inspired by dialogue with communities of practice in TPA field
Research lags far behind practice in the TPA
Most available research not so useful for practitioners
Disseminating findings better is not enough
Based at: School of International Service, American University
Project Health Rights Frontliners (HRF): learn with, from and for frontline rights and accountability defenders in identifying and developing innovative solutions to age-old and structural challenges and problems made complicated by climate change, digital age and other changes in context.

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Consolidate and broaden. Consolidate and broaden existing citizen action for accountability to prepare them in further advancing the agenda of transparency, participation and accountability (TPA), this time in health governance;

Develop a reform agenda through multi-level social accountability processes. Identify specific critical and strategic issues on health and come up with a health reform agenda using social accountability;

Build clout and resilience by forming coalitions and alliances, engaging the public and building credibility through evidence and knowledge.

PRO-Health Objectives

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Rationale

Equal access to quality public health care remains a dream for many Filipinos

The effectiveness of the barangay health unit as primary health care provider remains a question

There is a need to provide ample and accurate information on health services and programs to improve awareness and health-seeking behavior among Filipinos

Public health workers are crucial element of a working public health system. The question is how effective and responsive are our public health workers especially at the barangay level.

Health competes with other priorities of political leadership at national and local levels.

Health budget is still not enough to provide accessible and quality health care to the citizens

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Focus policies and programs

Monitoring targets

Barangay/ community health units – facilities, equipment, personnel, services and medicines
Mental health clinics
Procurement and budget
Existing TPA mechanisms – information, participation and accountability

Reproductive Health

First 1000 Days

Mental Health

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Sites and Core Partner Organizations

Pasig
Dumaguete
Lanao del Sur
Puerto Princesa
Naga
Bohol
3 in Visayas with SNPP
3 in Mindanao with SCAP

Naga City Peoples’ Council (NCPC)

Student Council Alliance of the Philippines (SCAP)

Samahan ng Nagkakaisang Pamilya ng Pantawid (SNPP)

Pasig City LGU

College of Maasin

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PRO-Health accomplishments (2023)

Set partnership and learning agenda with 6 G-Watch local core groups, 3 core CSO partners, 1 local government and 1 college’s NSTP/ OJT course to cover 13 local sites
Recruited and capacitated 292 volunteer-monitors
Reviewed around 79 literature, studies, reports and documents; interviewed 22 key informants mostly from government; and conducted 9 focus group discussions with a total of 75 participants from civil society, local and barangay governments, sectoral organizations for a review of evidence and a baselining research on access and quality of health services
Visited and checked at least 230 health units to complete a health unit monitoring tool
Interviewed at least 1,118 citizen feedback respondents using a citizen feedback tool
Interviewed at least 651 health worker respondents using a public health worker entitlement checklist

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Review of evidence and baselining highlights

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Reviewed around 79 literature, studies, reports and documents

Interviewed 22 key informants mostly from government

9 focus group discussions with a total of 75 participants from civil society, local and barangay governments, sectoral organizations

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General health governance and budget�

Though public health governance in the Philippines is devolved, there remains many programs dependent on and big funds concentrated in the DOH.

Most of the critical programs, including reproductive health and First 1000 Days, are being carried out primarily by the local governments cascaded from the national.

With national government agencies (NGAs) as duty bearers, CSOs, NGOs, and COs play a key role in helping link citizens to mechanisms to access their rights and in advocacy to influence policymaking.

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General health governance and budget�

There has been a steady increase in the health budget, especially with the passage of the Sin Tax Law in 2012, but the overall national government budget for RMNCAH programs has been on a downward trajectory for the past years.

There is no mandatory fund allocation for health under the IRA.
Local health budgets and allotments per health program are dependent on the priorities of the LGU.

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RMNCAH access and quality �

Most health services in the Philippines are paid for by out-of-pocket payments even for services with public health benefits
Generally, Reproductive Health and First 1000 Days services are accessible. Mental health programs, however, remain inaccessible

Services, medicines and facilities remain insufficient in some localities
Not all barangays have health centers and consistent quality and accessibility of services and medicines in health centers remains a question

The evidence are mixed when it comes to the impact of 4Ps on health, though clearly there is no evidence on whether 4Ps beneficiaries are accessing quality, timely and appropriate health services

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Challenges and barriers to access and quality

Policy barriers

The stringent and numerous requirements of PhilHealth discouraging people from availing it, barangays not having a clear mandate on health and the continuing dependence of some local governments on the national even with the passage of the Local Government Code and the Mandanas ruling.
No clear program and policy framework for mental health service delivery
Varied practice on contextualized programs for IPs

Communities/ sectors with most limited access

Those living in conflict areas and far flung/ hard-to-reach areas, including members of the IP communities and the poorest
There are gender-based and age-based barriers in the access to health

Public health workers

Public health workers play a crucial role in maternal and children health outcomes, though they face dismal working conditions and suffer from capacity gaps
In general, there is a problem of lack of public health personnel (high turn-over rate as a factor)
Attitude of health workers have been raised as an issue.

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