Reflections on Strengthening Local Leadership and Governance Practice
Insights from the Field | by Dr. Anthony Faraon
Serving as a panelist for two institutions undergoing Performance Governance System (PGS) assessments—the Local Government Unit (LGU) of Limay and Navotas City General Hospital (NCGH)—offered me a rare vantage point into how governance, when taken seriously, becomes a living system that shapes culture, performance, and ultimately, the well-being of communities. These experiences, grounded in the work of the Institute for Solidarity in Asia (ISA), provided valuable insights that deeply align with the health governance principles we advance in the Zuellig Family Foundation (ZFF). They affirmed a central truth: governance is essential, and there is a replicable system that helps leaders translate aspirations into measurable progress.
Leadership Ownership as the Foundation
One of the most striking observations from both Limay and NCGH was the strong ownership shown by senior leaders. In Limay, the mayor and department heads demonstrated not only familiarity with their strategies but also a commitment to embedding these into the LGU’s day-to-day governance. In NCGH, the hospital director and management team exhibited similar dedication—an understanding that achieving proficiency under PGS is not merely a compliance exercise but a strategic shift in how the institution envisions its role in delivering quality health services.
This leadership ownership is not symbolic; it is operational. At both institutions, strategies were cascaded down to staff, creating alignment across units and ensuring that the work of frontline personnel was directly tied to broader institutional goals. This echoes one of ZFF’s long-held principles: transformation happens when leaders champion the change and empower others to carry the vision.
The Power of Multisectoral Engagement
Both Limay and NCGH demonstrated the value of multisectoral councils—a core requirement of the PGS. These councils provided governance structures with breadth and diversity, enabling a wider range of stakeholders to co-own the institution’s goals. The councils asked thoughtful questions, brought in external perspectives, and reinforced transparency and accountability.
For ZFF, this reinforces what we have long practiced in our Health Leadership and Governance Program (HLGP): sustainable health outcomes require whole-of-community engagement. The PGS experience affirms that multisectoral structures remain essential—not as peripheral advisory bodies but as strategic partners in steering direction and sustaining momentum.
Integration: A Natural Area for Strengthening
In both Limay and NCGH, one area that emerged as part of their ongoing governance journey is the need to further harmonize the many strategies, programs, and performance requirements that institutions must manage. This is not a shortcoming; rather, it is a common reality for dynamic organizations operating in complex environments. As priorities expand and new mandates are introduced, institutions are continually challenged to ensure that their strategies remain coherent and mutually reinforcing.
Similarly, the refinement of outcome measurement continues to evolve. Both institutions have already established solid foundations for tracking progress, and they are now at the stage of sharpening how these metrics can more clearly reflect the quality and impact of their work. This is a natural progression—moving from counting activities to capturing meaningful changes in the lives of the people they serve.
These insights resonate with what we observe in our work at ZFF: institutions that are growing and maturing often reach a point where aligning strategies and deepening measurement become opportunities for greater clarity and acceleration. Rather than obstacles, they signal that an organization is ready to move to the next level of governance practice.
What This Means for ZFF’s Work
My experience as a panelist affirms that the PGS model has elements that are highly relevant to ZFF’s approach to health governance. Several insights stand out:
- A structured governance framework accelerates transformation. The discipline of strategy maps, scorecards, and accountability mechanisms strengthens institutions’ ability to operationalize reforms—a lesson ZFF can integrate more deliberately in helping LGUs sustain health systems improvements.
- Cascading strategies to frontline workers must be intentional. Just as PGS requires, ZFF can encourage LGUs and health facilities to ensure that midwives, nurses, barangay health workers, and administrative staff all understand how their roles contribute to health outcomes.
- Multisectoral bodies must evolve from being consultative to being strategic partners. The PGS Governance Council offers a model for how ZFF-supported local health boards and local health teams can deepen their engagement, shift from compliance to stewardship, and anchor decisions on evidence.
- Measurement should be simplifiable and meaningful. ZFF’s metrics for health leadership and systems development can benefit from the PGS discipline of focusing on indicators that truly reflect progress and impact.
A Replicable System for Better Governance
What makes the PGS experience compelling is its replicability. While the contexts of Limay and NCGH differ, both institutions benefited from a governance system that is structured, strategic, and grounded in accountability. For ZFF, this reinforces our core belief that effective governance is not accidental—it is built, practiced, and continually refined.
As we continue working with LGUs and health facilities across the country, integrating these insights can help strengthen our approach and deepen the impact of our leadership and systems development programs. The PGS experience is a reminder that governance is not only possible, but transformative, when leaders embrace a clear system and commit to sustaining it.
Photos from: ISA
