Seven years after the Universal Health Care Act’s passage, Dr. Anthony Faraon, Chief of Party of The Challenge Initiative (TCI)-Philippines at Zuellig Family Foundation, argues that the real challenge is no longer about passing new laws but understanding why existing policies falter at the local level. Drawing from the Jesse M. Robredo Foundation’s GoodGov Exchange Round Table Discussion last July 30, 2026, he emphasizes that meaningful reform requires bridging the gap between national mandates and the on-the-ground realities of local governments, health workers, and the Filipino families they serve.

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I went to the GoodGov Exchange Round Table Discussion expecting to give a short presentation on strengthening local health systems. I ended up learning as much from the conversation that followed.

Around the table were eight members of the House of Representatives, many of them relatively young legislators. Earlier that morning, they had heard from the Department of Health about two persistent challenges: health facilities and our health workforce. My task was to share what we at Zuellig Family Foundation (ZFF) have learned from working with local governments, and what these experiences might mean for Universal Health Care (UHC).

I presented familiar realities: fragmented services, shortage of health workers, financing constraints, weak referral systems, and the different capacities of local government units (LGUs) to implement national policies.

But the more interesting part came after the slides.

The discussion moved from UHC implementation to malnutrition, the health workforce, hospitals and primary care, medicines and new technologies, and even whether some devolved health services should be returned to the national government.

Different issues, but one question kept coming back: Why do good policies sometimes struggle when they reach the ground?

Photo above: Dr. Faraon shares lessons from the ZFF’s work with LGUs on strengthening health systems.

Seven years of UHC: what have we learned?

The UHC Act gave the country a strong framework for reform. Seven years after its passage, however, implementation remains uneven.

We see this in our work with LGUs. Some local governments have moved much further in integrating their health systems, strengthening primary care, using data, and mobilizing resources. Others continue to struggle with workforce shortage, financing, referrals, and governance.

Perhaps the UHC conversation now needs to move beyond asking, “What new law do we need?” We should also ask, “What have we learned from implementing the law we already have?”

There may be provisions Congress needs to revisit. But any amendments should be informed by what governors, mayors, health officers, frontline workers, and patients are actually experiencing.

Sometimes the problem is the law. Sometimes it is the implementing rules or financing. And sometimes local institutions simply do not yet have the capacity to do what national policy expects of them.

Knowing the difference matters.

The learning crisis may begin before school

One discussion that particularly stayed with me was malnutrition.

Despite the First 1,000 Days Law, stunting remains disturbingly high. Recent national data cited by the Second Congressional Commission on Education (EDCOM 2) showed that 25.3 percent of Filipino children under five are stunted, roughly one in four, and that the rate had increased for the first time in a decade.

This should concern not only those working in health and nutrition. It should concern everyone working in education.

EDCOM 2 has highlighted how poor nutrition in early childhood affects children’s readiness and ability to learn. We often discuss the learning crisis in terms of classrooms, teachers, textbooks, and curriculum. All are important. But some children arrive at school already disadvantaged by what happened, or failed to happen, during pregnancy and their first two years of life.

Health, nutrition, and education cannot be treated as separate problems when they converge in the same child.

Photo above: A rural health unit staff member conducts a check-up on an infant, a critical primary care service for early detection of malnutrition and other health issues.

We don’t just need more health workers

The usual health workforce conversation focuses on numbers: How many doctors, nurses, and midwives do we lack?

But our discussion went further. We also need to ask where health workers are located, whether their competencies match population needs, what they are legally allowed to do, and whether our different professional laws work together as a coherent health workforce policy.

The laws governing medicine, nursing, midwifery, and other professions were enacted at different times and developed largely within their respective professions. Perhaps it is time to examine them together.

Could a comprehensive review, or even an omnibus health workforce framework, address outdated or conflicting provisions and clarify task sharing, career pathways, deployment, and emerging roles in primary care?

This is not about lowering professional standards. It is about asking whether our regulatory framework still matches the health system we are trying to build.

Hospitals matter, but so does what happens before the hospital

There will always be pressure to build and upgrade hospitals. Understandably so. People can see a new hospital and immediately recognize the government’s investment in health.

But UHC cannot be built around hospitals alone.

For most Filipinos, the health system should begin much closer to home: the health center, barangay health station, or primary care provider.

That is where children should receive vaccines, women should have access to family planning and maternal care, hypertension and diabetes should be detected early, malnutrition should be identified, and common illnesses should be managed before they become emergencies.

So yes, let us continue improving hospitals. But we should be equally serious about strengthening the front door of the health system.

A new facility without enough health workers, medicines, diagnostics, information systems, or a working referral network is not yet a functioning primary care system.

Photo above: Barangay health workers assist with patient registration at a primary care facility.

Innovation must eventually reach the patient

Our conversation on medicines raised another difficult question: How can Filipinos gain earlier access to innovative medicines and technologies while ensuring rational use, affordability, and value for limited public resources?

We need to look at the whole pathway: FDA regulation, health technology assessment, formulary decisions, procurement, financing, and ultimately whether the medicine reaches the patient.

Innovation and rational use need not be opposing goals. We need institutions capable of evaluating new technologies rigorously but efficiently. When something provides meaningful benefit and value, the health system should be able to make it accessible beyond those who can afford to pay out of pocket.

Congress can help by looking at where existing processes have become unnecessarily slow, fragmented, duplicative, or no longer fit for purpose.

National or local?

At one point, we discussed whether provincial hospitals and other devolved health services should simply be returned to the national government.

I understand the attraction. LGUs vary enormously in resources and management capacity.

But simply changing who owns a hospital will not automatically solve weak financing, management, or accountability.

Perhaps the better question is: What should the national government do, what should LGUs do, and what should they do together?

The UHC Act points toward integration, pooled financing, provider networks, and shared accountability. Before reversing devolution, we should understand why these mechanisms have not worked as well or as quickly as intended.

Photo above: Participants of the July 30 GoodGov Exchange round table discussion pose following a productive exchange on UHC implementation.

Where reform becomes real

I left the session encouraged, not because we agreed on everything. We didn’t. That was precisely what made the exchange worthwhile.

The legislators asked practical questions. They challenged assumptions. More importantly, they seemed interested not only in what another law could mandate, but in what happens after Congress passes one.

From years of working with local governments, we know that the better-performing LGUs are not necessarily the wealthiest. What often distinguishes them is committed leadership, functioning institutions, good use of data, strong partnerships, and the ability to translate resources into services people actually experience.

Congress has an important role in creating the laws, budgets, and incentives that make this possible. But local governments also have something valuable to offer Congress: evidence from implementation.

Perhaps we need more conversations where those two worlds meet.

Because Filipinos do not experience Universal Health Care through the text of a law.

They experience it when the health center is open, when a health worker is available, when a child receives the right nutrition and vaccines, when medicines are in stock, when referrals actually work, and when getting sick does not push a family into poverty.

That is where health reform becomes real.

Baguio City health leaders met with national agencies and the Zuellig Family Foundation (ZFF) on February 19, 2026 to reinforce the financial foundation of its local health system. The technical coaching session, under ZFF’s Bayang Malusog Leadership and Governance Program (BMLGP) aimed to sharpen the city’s strategy for health financing and integrated care under the Universal Health Care (UHC) Act.

Representatives from the Department of Health-Cordillera Administrative Region (DOH-CAR), the Philippine Health Insurance Corporation (PhilHealth), and the Baguio City local government reviewed the city’s progress and readiness for integrated care delivery.

Related articles:

• ZFF Strengthens Primary Care to Advance UHC in Benguet and Baguio City
• Baguio City Advance Universal Health Plans

Building an Integrated Health System

Since establishing its Health Care Provider Network (HCPN) in 2021, Baguio City has built a more coordinated local health system that connects primary care facilities, hospitals, and specialized services.

City leaders highlighted key integration milestones during the session:

• Joining the PhilHealth Primary Care Provider Network Sandbox Program
• Holding two HCPN summits to align public and private health providers
• Creating a Patient Navigation and Referral System to streamline patient movement between facilities

These initiatives directly support the UHC goal: ensuring residents receive continuous, coordinated, and quality care.

Maximizing Health Financing Opportunities

A major focus of the coaching session was improving the management of PhilHealth claims, a vital revenue source for local health facilities.

Data presented showed that about 64% of the city’s health facility claims received payment, totaling approximately Php 3.18 million disbursed from 2022 to 2026. Facilities like the Irisan Health Center demonstrated how effective claims management can strengthen facility operations and expand community health services.

PhilHealth representatives stressed that robust claims management ensures local health services fully utilize national financing mechanisms.

Strengthening the Special Health Fund

The session also tackled the Special Health Fund (SHF), which pools resources to support integrated health service delivery under UHC.

Baguio City reported a Php 200 million allocation to the SHF for 2026, demonstrating its commitment to strengthening the local health system. Participants agreed they must translate these resources into tangible service improvements. Priorities include accelerating procurement processes, strengthening financial planning, and improving coordination across implementing units.

Leadership and Governance for Health

The activity underscored the need for strong leadership and collaboration to advance health reforms.

PhilHealth Senior Vice President Renato Limsiaco provided direct technical guidance to Baguio City’s health leaders, sharing insights on optimizing financing systems and preparing for provider network contracting under UHC.

This engagement also reflects the leadership development work of ZFF through BMLGP, which helps local governments strengthen governance, improve health financing, and build more responsive health systems.

Moving Forward

As Baguio City advances its UHC reforms, local leaders identified these key next steps:

• Strengthen coordination across city departments and the Local Health Board
• Operationalize the SHF manual and financing protocols
• Resolve procurement and information technology bottlenecks
• Prepare for provider network contracting under integrated health care delivery

With strong partnerships and continued leadership development, Baguio City is well-positioned to further strengthen its local health system. By reinforcing both leadership and financing systems, the city is laying the groundwork for a future where every resident can access the care they need, when and where they need it.

Banner photo: Dr. Celia Brillantes, Baguio City Health Officer

Authors: Joan Kidatan, ZFF Local Health Systems Provincial Associate for Baguio City; Krizzia Esperanza, ZFF Corporate Communications Associate

During Module 1 of the Bayang Malusog Leadership and Governance Program (BMLGP) held on November 27–28, 2025, representatives from the municipalities of Kibungan and Kapangan in Benguet—including Kapangan Mayor Harris Dizon—came together to reflect on their leadership journeys and shape a shared vision for Universal Health Care (UHC).

By the end of the module, both groups had crafted messages that captured their hopes for their people: “Maksil ya maketing ay i-Kibungan” (Healthy and resilient people of Kibungan) and “Misyon man-aabat para sin salun-at for a healthier Kapangan” (Our mission for health—together for a healthier Kapangan).

Reflections Rooted in Community

The reflections from the group grew naturally from the Day 1 sessions, where participants explored their values, motivations, and lived experiences through the three-step Bridging Leadership framework of Ownership, Co-Ownership, and Co-Creation.

As part of the Ownership process, the group examined their “why” as leaders—what shaped them, what drives them, and how their stories connect to the health of their communities.

This grounding in personal purpose set the tone for the collective work that followed.

Bryan Alacdis, Kibinungan Municipal Accountant, explained that in their town, support for each other is deeply woven into their way of life. “Our main [quality in Kibungan] is we support each other. Awan ti milak-laksid, awan ti maibat-bati. (No one is left out, no one is left behind.)”

Dizon also connected their collective effort to a familiar cultural symbol in Benguet, the grand march, a traditional dance that brings people together across social, political, and religious lines. 

In the same way, leaders from both municipalities recognized that UHC is a shared movement—everyone stepping in rhythm, carrying their role, and supporting one another.

Co-Ownership, Co-Creation, and Action Planning

On the second day, the groups moved from personal awareness to shared responsibility. Guided by the Zuellig Family Foundation’s Local Health System and BMLGP team, they practiced trust-building, stakeholder mapping, and open dialogue—activities that helped them understand the bigger system they are part of.

With this stronger sense of co-ownership, the teams drafted action plans aligned with the Benguet UHC Roadmap. These plans focused on strengthening primary care, improving coordination between offices, supporting health financing, and making sure resources are used wisely and transparently.

The two-day module ended with a meaningful moment. Participants recited the Pledge of Commitment as Bridging Leaders, affirming their promise to lead with compassion, integrity, and shared responsibility. Afterward, they joined in the grand march—a symbol of unity, community spirit, and moving forward together.

Like the grand march, the UHC journey in Benguet is a collective movement. With visions strengthened by both personal purpose and shared commitment, Kibungan and Kapangan now step forward in rhythm, carrying with them a shared hope for a healthier and stronger Benguet.

The Zuellig Family Foundation (ZFF), together with the Department of Health-Cordillera Administrative Region (DOH-CAR) and the City Government of Baguio, hosted a two-day City Health System Strengthening Program (CHSSP) workshop on November 20–21, 2025 at Mines View Park Hotel, Baguio City. The activity, part of the Bayang Malusog Leadership and Governance Program, brought the Baguio Local Health Board and health leaders from the City Camp and Irisan District Health Centers into one space to reflect on the city’s health challenges and opportunities.

Baguio’s Health Situation: Key Points

The workshop began with a grounding on Baguio’s 2024 health situation—a clear picture of both progress and continuing gaps. The leading causes of illness (acute respiratory infections, dental cavities, and hypertension) and the main causes of death (vascular diseases, cancer, and heart disease) showed the city’s dual burden of infectious and lifestyle-related conditions.

Dr. Celia Flor Brillantes, City Health Officer, added other important concerns. Maternal deaths remain high; antenatal care and full immunization percentages are still below national targets; and procurement delays have limited the availability of medicines for people with hypertension and diabetes. Partnerships—such as Abbott’s support for viral load testing—continue to enhance HIV services, but mental health cases increased sharply from 241 in 2023 to 525 in 2024, pointing to urgent psychosocial needs.

The city also faces staffing gaps, with 11 more health workers needed across facilities. Accreditation efforts under the Yaman at Kalusugan Para sa Pamilyang Pilipino (YAKAP) Program continue, supported by better population registration. The Mines View Health Center is preparing for accreditation by the end of the year.

Workshop Learning Sessions

Given this context, participants joined sessions on Universal Health Care (UHC), PhilHealth benefits, systems thinking, visioning, and ZFF’s Bridging Leadership Framework. Resource persons from DOH-CAR, PhilHealth, the Baguio Health Services Office (HSO), and ZFF guided the discussions, which helped deepen appreciation for shared leadership and collective action.

Throughout the workshop, health leaders shared reflections that captured the spirit of the program.

“Change does not happen overnight, but we can always start with our own,” said Dr. Vanessa Fagcangan of the Irisan District Health Center.

Dr. Ma. Lourdes Pakoy of the HSO spoke about the need to widen their perspective: “Ang lawak pala ng kailangan naming punan. Even with UHC, the problem of strengthening primary care facilities is still the same today. We really need to step up and unite.”

Meanwhile, Dr. Nelson Hora of the City Camp District Health Center emphasized adaptability in a changing health landscape: “We are in a changing world… you always have to grow your capital. Invest in your expertise. Kung ano ang meron ka, pagyamanin mo para madali mong i-offer.”

The workshop closed with a renewed sense of co-ownership—the third and last phase of ZFF’s Bridging Leadership Framework—between the Baguio Health Services Office and the Local Health Board. Both teams committed to addressing health inequities through coordinated leadership and stronger engagement with communities and partners.

ZFF and its partners continue to nurture health leaders who demonstrate technical skill, grounded leadership, and a shared commitment to strengthen Baguio’s health system—one collaborative step at a time.

Author: Joan Kidatan, ZFF Bayang Malusog Leadership and Governance Program Associate

This policy brief advocates for strengthening Bataan’s barangay-based incentive program as a strategy to mitigate the rising burden of non-communicable diseases (NCDs), emphasizing the importance of bolstering primary care to enhance early detection and treatment, thereby freeing resources for broader community development and improving the province’s Human Development Index (HDI).

The study introduces the Barangay Leadership Management Program (BLMP) in Dinalupihan, Bataan, demonstrating its role in enhancing health leadership and management capacity at the barangay level to bolster primary care and integrate health services effectively.