Serving as a panelist for two institutions undergoing Performance Governance System (PGS) assessments—the Local Government Unit (LGU) of Limay and Navotas City Hospital (NavCH)—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 NavCH 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 NavCH, 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 NavCH 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 NavCH, 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 NavCH 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

Author: Dr. Anthony Faraon, ZFF The Challenge Initiative-Philippines Chief of Party

This presentation outlines a tri-sectoral collaboration model in the Philippines designed to strengthen local health leadership and improve health outcomes. It highlights how the Zuellig Family Foundation (ZFF), in partnership with academic institutions and the Department of Health, supports Local Chief Executives and Municipal Health Officers through leadership development, experiential learning, and evidence-based interventions.

ZFF shared these insights at the 18th Association of Pacific Rim Universities Global Health Conference, held at Universiti Malaya in Kuala Lumpur, Malaysia, from October 28–31, 2025, showcasing practical strategies for capacitating local health leaders through tri-sectoral partnerships.

ZFF_APRU ZFFI

The University of the Philippines Manila – College of Public Health (UP-CPH) is a premier academic institution dedicated to training professionals and leaders in public health. For over a decade, it has partnered with the Zuellig Family Foundation (ZFF) to strengthen the capacities of local government leaders in delivering better health services to their communities.

Dr. Ernesto “Jun” Gregorio Jr., Associate Professor and focal person for UP-CPH’s Health Leadership and Governance Program (HLGP), has been part of this collaboration since its early stages. “We were tapped by ZFF in 2013 to become their academic partner for Region 4A (Calabarzon),” he said. “The Department of Health (DOH) was scaling up the HLGP nationwide, and ZFF needed academic institutions to help with implementation. We were endorsed by then DOH Region 4A Director Dr. Ed (Edgardo) Gonzaga, who was also our alumnus.”

Since then, UP-CPH has trained multiple batches of local leaders from municipalities across Cavite, Batangas, Rizal, and Laguna. The goal: to equip mayors, municipal health officers, and other local leaders with the knowledge and tools to improve local health outcomes.

One standout example of success was San Luis, Batangas. “They had creative initiatives like an ‘alkansya’ (“piggy bank”) system for pregnant women, so they could save money during prenatal visits and have funds when they give birth,” Dr. Jun shared. “Even the mayor personally drove the ambulance when no one else could. That level of involvement really made an impact.”

Another remarkable transformation happened in Noveleta, Cavite, a third-class municipality. “From a mostly red scorecard, they improved dramatically in just under two years,” he explained. “They didn’t just improve health indicators—they addressed social determinants of health. They trained out-of-school youth for call center jobs and even accompanied them to Manila for interviews. They boosted income and community pride.”

Noveleta also cleaned up its polluted coastline, previously a garbage site, and revived it into a thriving fishery and tourist area. “They reduced coliform levels, saw fish and even turtles return, and built a fish port,” said Dr. Gregorio. “They showed that improving the environment can uplift public health and the local economy.”

This partnership has not only improved communities—it has also enriched teaching and curriculum at UP-CPH. “The lessons we learned in the field have become part of our coursework. I now use real stories from Noveleta and San Luis in my classes on health promotion and social determinants of health,” Dr. Jun said.

Another product of this partnership is the Roberto R. Romulo Fellowship, which supports emerging leaders from local government units to gain deeper expertise in public health leadership and governance. This fellowship strengthens capacity building by providing additional opportunities for advanced learning and mentorship. The first batch of fellows graduated last March 2025.

The collaboration has even led to new academic programs. “We’re developing a ladderized curriculum—starting with a certificate course in public service, then moving to diploma and eventually a master’s degree,” he said. “This gives local leaders a clear academic path while applying what they learn in real-world settings.”

Beyond programs and training, Dr. Gregorio stressed the value of ZFF’s support: “ZFF provided a platform where theory meets practice. We learn from the mayors just as they learn from us. That two-way exchange has been powerful.”

Looking ahead, he sees room to grow the partnership. “We want to help revise the Barangay Health Leadership and Management Program (BHLMP) and align it with the new DOH initiative, Purok Kalusugan. The indicators need updating to include social and educational determinants.”

Ultimately, Dr. Jun believes that public health must be community-centered and multi-sectoral. “Our health system remains hospital-centric. Strengthening local public health leadership is essential. If we can institutionalize these programs and scale them up, we’ll move closer to achieving real health equity.”

Related articles:

• Sustaining the Legacy: First Batch of Roberto R. Romulo Public Health Leadership and Governance Fellows Graduate
• Health Equity in Focus: UP-CPH and ZFF Lead Webinar on Universal Health Care