A Legacy of Passion and Commitment: Dr. Anna De Guzman Forges on the Right Path for Universal Health Care in Pangasinan

It was in a quiet coastal municipality in Sultan Kudarat where Dr. Anna De Guzman’s passion for medicine and public health began. Her father, who was the town’s rural health physician, exposed her to the plights of their community, “Growing up with my father, I saw the lack of knowledge in handling healthcare and how some patients would need a pump boat and, sometimes, even horses and carabaos to get to where the basic health services were located.” Her father focused on the preventive and promotive side of public health, so that they would know how to manage their healthcare. This experience has inspired Dr. De Guzman to become a doctor. 

After completing her medical degree, Dr. De Guzman planned on specializing in obstetrics and gynecology. “It was influenced by my desire to educate mothers on family planning, caring for their children, and reducing the mortality associated with having multiple children.” However, her path changed when her father became a municipal health officer (MHO) in Region 12 with the Department of Health (DOH). Around the same time, the Philippines’ governance system underwent a devolution that transferred the responsibility of delivering basic health services from the national government to local government units (LGUs). “The advantage of this was that the services were truly localized because the LGU understands the health situation. But what happens if you get an LGU that does not prioritize health?”

Embracing Public Health

Filled with purpose and passion, she went back to her region. A decade may have passed since she was last in the province, but the improvements in public health were limited. Dr. De Guzman quickly realized the pressing need for public health interventions.

Dr. De Guzman also found the time to take a course at the University of the Philippines, where she learned more about community empowerment and engagement. “Through situational gap analysis, we were able to define our objectives and goals and share them with our stakeholders. This included legislative bodies, as they play a crucial role in passing policies. Next, we engaged health workers, aiming to motivate and inspire them to educate the community and prioritize better health outcomes. The focus was really preventive measures, because curative ones would be very expensive; the people in the municipality would not have the means to pay you.” Dr. De Guzman also believed in the spirit of volunteerism, knowing that the volunteers are deeply entrenched in their own communities and understand the plights of their communities personally.

Change Location, Same Passion

The decision to start a family brought Dr. De Guzman to Pangasinan, her husband’s province. Dr. Marlo De Guzman, her husband, requested her transfer to be a Medical Specialist III, assigning her to the Regional Tuberculosis Prevention and Control program. Her work in tuberculosis control marked a significant milestone, as Pangasinan witnessed a notable reduction in tuberculosis-related morbidity and mortality.

Dr. De Guzman led the planning for the Pangasinan local investment plan for health and coached Pangasinan to develop the province-wide investment plan. She realized that by transferring to Pangasinan, Dr. De Guzman was able to make an impact and contribute to achieving various health outcomes in Region 1.

Even with the change of location, Dr. De Guzman’s passion for healthcare for all remained strong. She says, “I have always been passionate about advocating for policies, interventions, and strategies, even before the Universal Health Care (UHC) Law. My background in serving Sultan Kudarat exposed me to poverty, inadequate services, limited education, and cultural disparities. I consistently strive for an improved healthcare system wherever I am assigned. I am deeply committed to my job, driven by a desire to make a meaningful difference, and I feel a moral responsibility to the community.”

Advocating for UHC

Dr. De Guzman’s advocacy for UHC was fueled by the challenges posed by the 1991 devolution. She recognized the need for an integrated health system capable of providing equitable and comprehensive health services. Republic Act No. 11223, the UHC Law, became a cornerstone of her efforts. She states, “The UHC inspires and motivates me to push further. It gives me hope because UHC is reintegrating all localities, municipalities, and cities to provide a wide-reaching health system.” This law signed in 2019, declares all Filipinos as PhilHealth members, ensuring financial protection and access to quality primary health care services. “It is also people-centered, so the healthcare services we have are currently being improved with a focus on people’s needs, not just when they are sick, but also when they are well. If they are very sick, they can be helped to be admitted to different hospitals, with financial protection through PhilHealth.”

This focus on people’s needs and the government’s response is perhaps the strength of the UHC, and Dr. De Guzman hopes it will improve the way Filipinos behavior in seeking healthcare.

Implementing UHC in Pangasinan

In 2022, under the leadership of Governor Ramon Guico III, Pangasinan officially integrated UHC into its health system. Dr. De Guzman played a pivotal role in this transformation, engaging 46 of 47 LGUs in the province. Through extensive consultations and collaborations, she secured the commitment of local chief executives, health workers, and community leaders. This led to establishing the Provincial Health Board and formulating policies and guidelines for the Special Health Fund (SHF). 

The implementation of UHC in Pangasinan has yielded remarkable outcomes. The province now boasts 46 PhilHealth-accredited health facilities, ensuring access to comprehensive primary health care with improved Health outcomes in the heath programs. The maternal mortality rate has significantly decreased and the province’s tuberculosis control program has also seen notable success, removing tuberculosis from the leading causes of morbidity and mortality in the province. Nutrition programs have led to a substantial reduction in malnutrition and stunting among children that Dr. De Guzman was recognized by the National Nutrition Council as the National Outstanding Provincial Nutrition Action Officer in 2022.

Transforming Pangasinan’s Health System with ZFF

The Zuellig Family Foundation (ZFF) has been pivotal in advancing UHC in Pangasinan, supporting Dr. De Guzman and her initiatives. An alumna of ZFF’s Provincial Leadership Governance Program in 2016, she is currently enrolled in the Bayang Malusog Provincial Leadership Development Program as a scholar of DOH Region 1. These programs are important to Dr. De Guzman, especially in her role as President of the Provincial Health Officers Association of the Philippines. Through such programs, ZFF has empowered Dr. De Guzman and her team with the skills and knowledge to navigate complex health challenges and implement effective health strategies. 

These programs have fostered a collaborative approach, bringing together local health officers, public health nurses, and community leaders to work towards common health goals. ZFF’s emphasis on ownership, co-ownership, and co-creation has helped Dr. De Guzman build a robust health system that addresses the unique needs of Pangasinan’s diverse population. The Foundation’s continuous mentorship and capacity-building efforts have enhanced the local health workforce’s technical and managerial capabilities and instilled a strong commitment and passion for achieving UHC.

Challenges and Solutions

Dr. De Guzman’s journey was challenging. The transition to UHC required overcoming political hurdles, cultural barriers, and logistical constraints. However, her strategic approach, rooted in ownership, co-ownership, and co-creation principles, facilitated effective communication and collaboration among stakeholders. The engagement of local health officers, public health nurses, and volunteers was crucial in addressing the unique health needs of diverse communities, including indigenous populations. “We are now at the end of this phase of the acceleration of UHC, and we are now empowered to push for all these strategies in Pangasinan because we have ZFF that continues to help us.”

Legacy and Inspiration

As Pangasinan continues to advance its health system, Dr. De Guzman envisions a future where the province becomes a model of health excellence in the Philippines. The focus is on sustaining and expanding the gains achieved through UHC. This includes continuous capacity building for health workers, enhancing health facilities, and ensuring the financial sustainability of health programs through the SHF. 

Dr. De Guzman’s legacy is one of dedication, passion, and resilience. She embodies the principles of compassionate leadership, emphasizing the importance of integrity, commitment, diligence with focus and a shared vision for better health outcomes. She says, “Leaders should be very passionate and dedicated if they want to effect change. They should be able to communicate their vision and their strategies. You should also be a role model, lead by example, always have integrity, and hold on to your values. I want Pangasinan to remember me as a humble and very committed, passionate leader. Leadership is not about being the best, but it’s about pushing everyone to become better.” 

The story of Dr. Anna De Guzman and the Provincial Health Office of Pangasinan is a testament to the power of visionary leadership in achieving UHC. Through relentless advocacy, strategic planning, and collaborative efforts, they have made significant strides in ensuring that quality health services are accessible to all.