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Background
Public investment in health and effective and responsive use of health budget are crucial in ensuring equal access to quality healthcare.
Though there has been a steady increase in the health budget in the past decade from Php55B in 2013 to Php263B in 2022, this is mainly due to the additional revenues generated through Sin Tax, and not exactly indicative of the increasing prioritization for health in the general budget. Whether the drastic increase of 378% in the health budget in the last decade has led to an improved access and quality of public health services remains a big question.
Public health continues to be under-prioritized and bolder policy and governance actions are needed to ensure that every Filipino gets accessible and quality healthcare given the importance of health in development and progress.
It is estimated that children and adolescents comprise 39.8 percent of the population as of 2020. Women of reproductive age (15 to 49 years old) comprise 51.9 percent (27.85 million) of the 53.65 million female household population in 2020. The Philippine Development Plan (PDP) for 2023-2028 states that undernutrition in the Philippines is declining, albeit at a slow rate. The Department of Health DOH has made recent statements pertaining to “persistent malnutrition” in the Philippines, noting that the stunting rate among children 0 to 23 months had plateaued over the last ten years.
Yet, programs for mothers, children and youth such as the First 1000 Days and mental health are not among those with the biggest allocation in the national health budget. Meanwhile, according to the 2021 Annual Report on the Responsible Parenthood and Reproductive Health (RPRH) Act, the overall national government budget for reproductive health programs has been on a downward trajectory in previous years.
Furthermore, there is no mandatory fund allocation for health under the National Tax Allotment (NTA, formerly Internal Revenue Allotment) of local governments. Local health budgets and allotments per health program are dependent on the priorities of local government units, particularly the local chief executives.
The proposed budget for the National Health Insurance Program (PhilHealth) for 2024 has increased in light of the Universal Health Care (UHC) Law or Republic Act 11223 where PhilHealth is tasked “to provide health insurance coverage and ensure affordable, acceptable, available, and accessible health care services for all Filipinos.” However, the country remains far from achieving universal healthcare. According to a 2017 study on health financing, most health services in the Philippines are paid for by out-of-pocket payments even for services with public health benefits.
Finally, the recent TPA Now! paper of G-Watch entitled The Importance of Accountability in Fiscal Reforms: Learning from G-Watch’s Multi-Level Monitoring of Health Budget from Sin Tax shows that the increase in health budget due to Sin Tax is “not accompanied by strengthened anti-corruption safeguards,” with weak “government’s systems for monitoring, oversight and public disclosure of where that increased spending actually goes.”
Transparency, participation and accountability in health is crucial given that the health budget remains insufficient to ensure universal healthcare and because of reports of corruption and inefficiencies in health service delivery. In particular, in recent years, there have been reports of irregularities in the Philippine Health Insurance Corporation (PhilHealth) and the procurement of health services especially during the COVID-19 pandemic. There is also the every day accounts of inefficiencies in health service delivery, and inaccessibility of public health services due to palakasan and nepotism.
The recent paper of Accountability Research Center entitled Activating Spaces, Scaling Up Voices: Community-based Monitoring and Planning of Health Services in Maharashtra, India shows that elevating resource issues on health service delivery confronted at the community level to the national has the potential of addressing systemic barriers that can improve the situation across localities. This makes multi-level engagement the includes national budget monitoring crucial in improving health governance as a whole. The same paper also brings up key ways and means by which community monitoring can be strategic in addressing people's health issues and concerns.
Activities profile and objectives
This February 2024, G-Watch is back with its annual awareness-raising campaign for the strengthening of public accountability entitled Ako, Ikaw, Tayo May Pananagutan, this time focusing on health budget. With the theme “Budget sa Kalusugan, Pangalagaan,” this simultaneous events in G-Watch sites all over the country will take up ways and means by which the health budget can be made more transparent, participatory and accountable. It will do so by convening G-Watchers and accountability frontliners and key actors and stakeholders in health governance.
This is in line with G-Watch’s latest initiative called Promoting Rights Organizing in Health PRO-Health) with Accountability Research Center, the Pasig City local government and other civil society groups. PRO-Health aims to strengthen transparency, participation and accountability in public health governance by building coalitions and alliances among citizens, groups, communities and government allies around health rights, and by facilitating learning and problem-solving among accountability frontliners, rights defenders and allied government champions to come up with pro-people and bottom-up solutions to systemic barriers and hurdles to reproductive, maternal, newborn and adolescent health services.
As part of the Ako, Ikaw, Tayo May Pananagutan activity, G-Watch Center and ARC will be hosting a 2-day “Briefing-Orientation Seminar on Health Budget Monitoring” targeting participants from PRO-Health allied organizations and G-Watch partners and volunteers based in Metro Manila who will form part of PRO-Health national monitoring of the health budget and procurement.
The briefing-orientation seminar shall aim to:
For more information:
Email: government_watch [at] yahoo.com
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Website: www.g-watch.org
Facebook: @gwatch.ph
Twitter: @gwatch_ph