WORLD EDUCATION CONNECT MULTIDISCIPLINARY E-PUBLICATION
Vol. V Issue IX (September 2025)
International Circulation
This is an open-access, peer-reviewed, and refereed international publication in online & printed versions that features research papers, abstracts, theses, dissertations, and journals. It is registered to the ISSN National Center of the Philippines, and ISSN International Center, the Global Index for Continuing Resources with ISSN (Online) 2799-0842 and ISSN (Print) 2799-130X.
World Education Connect Multidisciplinary e-Publication, Vol. V, Issue IX (September 2025), pp.247-249
Nolito V. Eviota Jr., RN, RM, LPT
MAN (Master of Arts in Nursing), UPHSD Student, Metro Manila
Abstract
Underserved municipalities often juggle thin staffing, long travel distances, and patchy referral pathways—conditions that quietly shape the quality of everyday care. This rapid situational analysis looks at Sablayan and Sta. Cruz in Occidental Mindoro to make sense of what’s working, what’s missing, and what’s doable now. Using a desk review of recent Philippine health sector directives and global guidance on rural workforce retention, alongside a structured synthesis using the Donabedian (structure–process–outcome) lens, we outline a practical bundle of human resource for health (HRH) strategies for primary-care–led networks. Findings center on three themes: persistent maldistribution and unstable staffing; capability and support gaps that affect safety and continuity; and retention levers—education pipelines, incentives, and supportive supervision—that are most promising when deployed together. We close with a locally grounded, 12‑month action menu that favors team-based deployment, “grow-your-own” scholarship pathways, task-sharing, and simple enablement tools (connectivity, e‑referrals, and routine coaching). The analysis is meant to be immediately useful to local leaders who must balance policy ambition with everyday realities.
Keywords: Human resources for health (HRH), Rural workforce retention, Primary care–led networks, Donabedian framework (structure–process–outcome), Occidental Mindoro (Sablayan & Sta. Cruz)
Introduction
The availability of qualified medical professionals who are prepared to remain and work securely is a determining factor in the caliber of care provided in rural and remote regions. There is data from around the world indicating that rural retention is improved by bundled measures such as education pipelines, fair incentives, career development, and supporting circumstances. There is a movement underway in the Philippines toward primary-care-driven networks and more stringent quality standards, which is being led by universal health care (UHC) reforms. Implementation, on the other hand, is hampered by local governments that are limited in their resources, delays in the recruitment process, uneven working conditions, and external migration. This document transforms suggestions into a practical, locality-sensitive action plan to solve these difficulties.
Methods
We conducted a rapid desk review (July–September 2025) of: (1) World Health Organization guidance on rural and remote retention; (2) peer‑reviewed Philippine analyses of workforce issues under UHC; and (3) national policy directives that shape HRH planning and primary-care networks. We mapped insights against a Donabedian framework to keep a line of sight between HRH actions (structure), everyday clinical/managerial routines (process), and patient‑relevant outcomes (outcome). We prioritized strategies with near‑term feasibility for Sablayan and Sta. Cruz.
No human participants were engaged; ethical approval was not required for this literature‑based analysis. An anti‑plagiarism and copyright declaration accompanies this manuscript and was observed throughout drafting.
Results
The municipalities of Sablayan and Sta. Cruz rely heavily on small teams at rural health units (RHUs) and barangay health stations, making service continuity fragile. Global guidance suggests bundled strategies for retention, including education pipelines, fair financial incentives, safe housing, career ladders, and supportive workplaces, to strengthen stay-rates and improve service performance in rural areas. However, tight coordination between local budgets, provincial HRH planning, and national deployment is required.
Service quality weakens when frontline teams lack timely mentoring, protected learning hours, or basic support tools. The 2023-2028 national health sector strategy emphasizes worker protection and institutional strengthening, which can be localized through regular case reviews, on-site mentorship, and quality huddles tied to RHU metrics. WHO promotes role optimization, enabling nurses, midwives, and barangay workers to safely deliver routine care through task-sharing and targeted upskilling.
Philippine evidence suggests three effective retention levers: scholarships and return-service placements, structured onboarding, and tackling daily frictions like training costs, insecure contracts, and stalled career progression. These strategies are crucial for the municipalities' success in ensuring service continuity and addressing challenges in the health system. onboarding for networked care, and LGU-backed incentives such as housing, hardship allowances, and predictable rotations anchored in the current health strategy (Google Sites).
Discussion
The proposed HRH plan for municipalities should focus on simple, compounding moves over grand designs. It consists of four parts: 1) Growing the education pipeline by launching locality-tied scholarships for priority cadres, coordinated with provincial placement planning, and pairing them with early, community-based rotations. 2) Deploying team-based primary care by staffing Rural Health Units (RHUs) to a minimum team standard, using weekly micro huddles and monthly quality reviews to keep processes tight. 3) Binding (retaining with dignity) by offering a mix of incentives, such as liveable housing or commuting support, hardship pay, time-bound contract conversion to permanent posts, and a transparent, merit-based progression path. 4) Enabling (making good work easy) by ensuring reliable connectivity at RHUs, basic teleconsult links for specialty advice, e referral templates, and a lightweight HRH dashboard.
This literature-informed, context-applied analysis cannot quantify effect sizes or confirm cost effectiveness for Sablayan and Sta. Cruz, and Philippine policy instruments may evolve, which may update feasibility assumptions over time. Despite these limitations, the convergence between global guidance and Philippine evidence is strong enough to inform near-term action.
Conclusion
Quality in rural settings rises when workforce strategies are bundled, not piecemeal. For Sablayan and Sta. Cruz, the most practical path is to grow talent locally, deploy stable team‑based primary care, bind people with fair and humane conditions, and enable them with simple tools. That combination is doable, evidence‑sound, and aligned with current Philippine policy direction.
References
Pepito, V. C. F., Loreche, A. M., Legaspi, R. S., Guinaran, R. C., Capeding, T. P. J. Z., Ong, M. M., & Dayrit, M. M. (2025). Health workforce issues and recommended practices in the implementation of Universal Health Coverage in the Philippines: A qualitative study. Human Resources for Health, 23, 21. https://doi.org/10.1186/s12960-025-00988-3. (PMC)
World Health Organization. (2021). WHO guideline on health workforce development, attraction, recruitment and retention in rural and remote areas. Geneva: WHO. (NCBI)
Department of Health (Philippines). (2022). Administrative Order No. 2022‑0038: Health Sector Strategy for 2023–2028. Manila: DOH. (Google Sites)
DOI 10.5281/zenodo.17232039
