The Province of Kalinga proudly graduated from the Roberto R. Romulo (RRR) Fellowship for Public Health Leadership and Governance last March 2025, joining Aklan, Davao de Oro, and Dinagat Islands in completing a year-long journey of transformative leadership. The program, led by the Zuellig Family Foundation (ZFF) in partnership with the University of the Philippines (UP) College of Public Health and the UP National College of Public Administration and Governance, helped local leaders sharpen their governance skills and tackle real health system challenges.

“Our leadership journey has not been easy—it mirrors the long and winding road of achieving Universal Health Care,” said Kalinga Governor James Edduba. “But along the way, we’ve seen real progress, and we celebrate both the small and big wins.”

Governor Edduba’s fellowship journey focused on three critical areas: reducing maternal deaths, improving emergency response, and strengthening mental health programs. His team finalized a province-wide referral manual and mobilized Community Health Action Teams (CHATs) to serve as on-the-ground health coordinators. “We capacitated our health workers to identify knowledge gaps and improve services where it matters most,” he explained.

To address the rise in road traffic injuries, Kalinga established an emergency response team and developed a province-wide accident reporting system. “Before, reports were fragmented. Now we use standard forms for all vehicular incidents—this allows us to make better, evidence-based decisions,” he said.

For mental health, the province passed an executive order mandating government offices to support mental health initiatives. A technical working group was formed to lead suicide prevention efforts, ensure data privacy, and guide media reporting. “We’re building systems to support the mental wellness of our people,” Gov. Edduba added.

Partnerships have been key to Kalinga’s progress. The province secured over 200 million pesos in medical assistance and signed agreements with apex hospitals to expand access to specialized care. “We engaged nearby provinces, private clinics, and national agencies. Our success is built on collaboration,” said the governor.

Governor Edduba’s commitment to health leadership started long before the RRR Fellowship. “When I was still Mayor, my nephew got sick and was sent to the ICU. I remember praying in the chapel beside him, promising I’d do everything in my power to improve health in our province. That moment changed me,” he shared.

Now, with better systems in place and a stronger network of partners, Kalinga is more equipped than ever to continue its health reform journey. As Governor Edduba said, “No single leader can do it all. But together, we can truly do great things.”

“Health is not just the government’s job—it’s everybody’s concern.” – Hon. Nilo Demerey, Jr., Dinagat Islands Governor

The province of Dinagat Islands graduated from the Roberto R. Romulo (RRR) Fellowship for Public Health Leadership and Governance last March 2025, joining three other provinces—Aklan, Davao de Oro, and Kalinga—in celebrating the end of a year-long journey to improve local health systems. With the support of the Zuellig Family Foundation (ZFF), in partnership with the University of the Philippines (UP) College of Public Health and the UP National College of Public Administration and Governance, the RRR Fellowship equipped local leaders with the tools to transform their health governance and make Universal Health Care (UHC) a reality in their communities.

 
Governor Nilo Demerey, Jr. led the province’s efforts with bold ideas and concrete actions. “Our province, though small, has faced significant challenges,” he said. “But with the right leadership, collaboration, and innovative strategies, we have made great progress in ensuring better health care for our people.”

Dinagat tackled major health concerns, including malnutrition, maternal deaths, low immunization coverage, and lack of access to hospital services. In 2024, stunting stood at 11.6% and wasting at 2.5%. There were also three maternal deaths recorded in the first quarter of 2025. In response, Governor Demerey’s team introduced several programs—most notably, a zero-billing policy on health services.

Under the fellowship program, the province launched the Remedy Aksyon Center to handle emergencies across all 100 barangays. They also expanded the Provincial Health Board and rolled out the Senior Citizen Health and Wellness Caravan, door-to-door healthcare services, and weekend medical missions. The province also distributed Remedy Cards—smart IDs with QR codes—to track every resident’s health history and services received. “We realized that those who need health care most are the ones who can’t reach hospitals,” Governor Demerey shared. 

Dinagat also invested in nutrition-sensitive policies, making backyard gardening a requirement for government aid. The province is also enrolled in ZFF’s Nutrition Leadership and Equity Acceleration Program (NutriLEAP) to further improve its nutrition governance and address malnutrition more effectively. 

Thanks to the RRR Fellowship, Governor Demerey said Dinagat’s health governance matured significantly. “This program helped us implement evidence-based policies that are practical and impactful,” he said. “We’ve moved from being a 4th class to a 2nd class province.”

“The public health tradition is not just about policies and programs,” Governor Demerey said in closing. “It is about commitment, collaboration, and compassion.”

Davao de Oro joined Aklan, Dinagat Islands, and Kalinga in celebrating a key achievement last March 2025—the successful completion of the Roberto R. Romulo (RRR) Fellowship for Public Health Leadership and Governance, a program led by the Zuellig Family Foundation (ZFF) in partnership with the University of the Philippines (UP) College of Public Health and the UP National College of Public Administration and Governance.

For Davao de Oro Governor Dorothy Gonzaga, the year-long fellowship was a transformational journey. “Coming from the judiciary and only entering politics in 2022, I never imagined how complex the health system really is,” she said. “This program helped me understand the power of leadership in turning health challenges into opportunities.”

Davao de Oro faced five key health concerns:

1. Child immunization coverage remains critically low. Only 63% of children were fully immunized in 2024—far below the national target of 95%. This gap leaves many children vulnerable to preventable diseases.
2. Teenage pregnancy continues to rise. In 2024, the rate reached 51 per 1,000 adolescents, which is significantly higher than both national and global benchmarks. 
3. The province’s hospitals are overwhelmed. The four provincial hospitals have a 315% occupancy rate, far above the ideal 80–85%, putting strain on both patients and health workers.
4. The province struggles with limited funding to properly manage its hospital system. To address this, the provincial government has proposed the renationalization of one hospital to improve funding and governance. 
5. Enrollment in the PhilHealth Konsulta program is still low. Only 8.4% of residents have had their first patient encounter, showing the need for stronger public awareness and engagement.

Despite the gaps, the province has made important strides. It tapped Barangay Volunteer Sanitation Inspectors to improve sanitation monitoring and prevent disease outbreaks at the community level. An information system was also developed that profiles and helps track Barangay Health Workers. 

The KoboCollect digital tool is being used to collect and manage data on water, sanitation, and hygiene. A provincial communication plan was also rolled out to improve field registration for primary health services.

In terms of services, the province exceeded national targets in prenatal care coverage, skilled birth attendance, and family planning. “These wins give us confidence that we’re on the right path,” she said.

The RRR Fellowship emphasized Bridging Leadership—the idea that real change happens when leaders bring people together. “I learned I can’t do it alone,” Governor Gonzaga reflected. “We need our mayors, health workers, and citizens to co-create solutions.”

Governor Gonzaga credits the Fellowship for sharpening her sense of purpose as a public servant. “I now see health not just as a service, but as a platform for empowerment and equity.”

Aklan proudly marked the end of a transformative journey. Alongside Davao de Oro, Dinagat Islands, and Kalinga, the province graduated from the Zuellig Family Foundation’s (ZFF) Roberto R. Romulo (RRR) Fellowship for Public Health Leadership and Governance in March 2025.

The RRR Fellowship, named after ZFF’s founding chair and in partnership with the University of the Philippines (UP) College of Public Health and the UP National College of Public Administration and Governance, aimed to equip governors and local health leaders with skills to solve real-life health problems.

For Aklan Governor Jose Enrique Miraflores, this was a year of action, collaboration, and meaningful progress for the province. The Fellowship builds on the province’s involvement in ZFF’s other health leadership programs, which helped strengthen the local health system and prepared Aklan’s leaders for deeper, systems-oriented reform.

 

From the start, Governor Miraflores made it clear: implementing Universal Health Care (UHC) was his top priority. As one of the pilot areas for the Healthcare Provider Network (HCPN), Aklan was determined to improve health services for every Aklanon. All 18 primary care facilities in the province are now fully licensed by the Department of Health (DOH)—a first in Western Visayas.

This success came from strong local unity. “All the mayors of the 17 municipalities, kahit ‘kalaban’ pa namin na mayors, they grasped what we need to do,” he remarked. “It’s not only my job to implement UHC. Dapat sama-sama kaming lahat.”

Governor Miraflores also shared the province’s top health challenges. These included:

• Delays in PhilHealth contracting: Even with all the preparation and local budget support, national delays in PhilHealth’s processes held back fund releases and service contracting.

• Slow first patient encounter (FPE) rates: Although 400,000 Aklanons are registered with PhilHealth, only 12% have completed their first patient encounter—still far from the target of 50%.

• Digital health systems: While many primary care facilities now use electronic medical records (EMRs), Aklan’s hospitals still lack full digital systems.

• Lack of health workers: Aklan needs more doctors, nurses, and midwives. The province is now drafting a plan to address this.
• Rising mental health cases: Aklan has the highest suicide rate in Western Visayas. Mental health became Governor Miraflores’ focus during his Deep Dive, a guided community immersion, under the Fellowship.

Despite the challenges, Aklan has achieved impressive results:

• Successfully negotiated with PhilHealth to become an HCPN demonstration site.
• All LGUs contribute 1% of their development fund to the Special Health Fund.
• Six district health managers hired to lead health services in identified clusters.
• Strong partnership with the Sangguniang Panlalawigan, which passed the Aklan HCPN ordinance.
• Digital health partnerships that led to an increase in PhilHealth reimbursements—from Php 104,000 in 2022 to Php 66 million in 2024.
• For mental health, Aklan passed a provincial ordinance and encouraged municipalities to adopt it. In one inspiring case, a troubled child received help and is now serving as a barangay health worker.

Governor Miraflores emphasized the value of data in decision-making: “Kailangan talaga data-driven. Before we decide on things, we need to see the data first so we can learn what we need to do.”

He also credited his training under ZFF’s Bridging Leadership approach, which focuses on personal ownership, co-ownership with stakeholders, and co-creation of solutions. “Hindi ako doktor, but I have to understand what’s happening in our health issues. I shared this mindset with our mayors. That’s why it wasn’t hard to convince them to collaborate.”

As he closed his RRR Fellowship journey, Governor Miraflores reflected on the long-term impact of their work: “Since I became a leader, this is what I always say: ‘What we do in life echoes in eternity.’ This is not only about legacy. It’s about what we do now that will benefit future generations.”

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