FEBRUARY 2021

DISCUSSION PAPER SERIES NO. 2021-07

Process Evaluation of the Department

of Health Human Resources for Health
Deployment Program

Michael R.M. Abrigo, Gina A. Opiniano, and Zhandra C. Tam

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Process Evaluation of the Department of Health Human
Resources for Health Deployment Program

Michael R.M. Abrigo

Gina A. Opiniano
Zhandra C. Tam

PHILIPPINE INSTITUTE FOR DEVELOPMENT STUDIES

February 2021

1
Abstract

The Philippine national government, through the Department of Health (DOH), has a long
tradition of augmenting the supply of health care workers in underserved areas. Even with the
adoption of the Local Government Code in 1991, which shifts the mandate of DOH from being
sole provider of health services to provider of technical services for health, the DOH continues
to deploy health care professionals throughout the country. Over the last decade, the national
health resources for health (HRH) deployment program has expanded from a relatively small
program with a budgetary support of less than PhP200 million that deployed less than 500
health professionals in 2010 to a massive program of about PhP10 billion that deployed almost
30,000 health care workers in 2020. This process evaluation aims to assess the DOH-HRH
deployment program design and logic, and document its implementation vis-à-vis its stated
design. We find that while the program has many advantages over individual local governments
in reallocating HRH across geographic boundaries, there are both design and implementation
challenges that may negatively impact on the experiences of deployed health care workers,
which, in turn, may reflect negatively on the program. We provide some actionable
recommendations specific to these issues to improve the program.

Keywords: Health resources for health, Deployment program, Process evaluation

Disclaimer: This article/report reflects the points of view and thoughts of the authors’, and the
information, conclusions, and recommendations presented are not to be misconstrued as those
of the Department of Health (DOH). Furthermore, this article or report has not yet been
accepted by the DOH at the time of writing. The material presented here, however, is done in
the spirit of promoting open access and meaningful dialogue for policy/plan/program
improvement, and the responsibility for its interpretation and use lies with the reader.

Role of funder: We would like to express our gratitude to the Department of Health for their
support in the funding of the study and sharing of data for analyses. For this assessment, the
funders had no role in study design, data analysis, interpretation of results, or preparation of
this discussion paper.

2
Table of Contents
1. Introduction ........................................................................................................................5
1.1. Background ........................................................................................................... 5
1.2. Objectives.............................................................................................................. 6
1.3. Limitations ............................................................................................................. 6
2. Review of Literature ...........................................................................................................7
3. Overview of DOH-HRH deployment program ................................................................10
3.1. Key policies ......................................................................................................... 10
3.2. Program design ................................................................................................... 10
3.3. Program statistics ................................................................................................ 14
3.4. Previous evaluations ........................................................................................... 15
4. Methodology .....................................................................................................................17
4.1. Results Framework ............................................................................................. 18
4.2. Data collection methods ...................................................................................... 19
5. Results and Discussion ..................................................................................................20
5.1. Program design and logic.................................................................................... 20
5.2. Program implementation ..................................................................................... 26
6. Summary and Recommendations ..................................................................................38
6.1. Summary ............................................................................................................. 38
6.2. Recommendations .............................................................................................. 39
Appendix .............................................................................................................................43

List of Tables
Table 1. Summary of WHO evidence-based recommendations ............................................................. 8
Table 2. Quality standard, compensation and functions by deployment program .............................. 13
Table 3. Number of DOH-deployed health workers, 2010-2020 .......................................................... 15
Table 4. Number of deployed health workers by region and profession, May 2020 ........................... 16
Table 5. Share of program recipient-local governments (%): Philippines, 2016-2018 ......................... 21
Table 6. Recruitment success rate (%) by region and selected cadre: Philippines, May 2020 ............. 22
Table 7. Basic daily pay: Deployed DOH-HRH and comparable quality standard (QS), 2018 ............... 23
Table 8. Student willingness-to-accept deployment by professional field ........................................... 24
Table 9. Source of information on the DOH-HRH deployment program by selected characteristics .. 28
Table 10. Average working hours by activity type, and number of patients per week ........................ 30
Table 11. Deployment experience ........................................................................................................ 32
Table 12. Program benefits receipt frequency and satisfaction by profession .................................... 33
Table 13. Percentile self-rating by selected characteristics .................................................................. 36

List of Figures
Figure 1. DOH-HRH deployment program implementing structure ..................................................... 11
Figure 2. Results Framework of the DOH-HRH Deployment Program.................................................. 18
Figure 3.Willingness to be absorbed by local governments by profession .......................................... 25
Figure 4. Share (%) of alumni who attended PDOS by selected characteristics ................................... 29
Figure 5. Attrition rate by selected characteristics ............................................................................... 37
Figure 6. Absorption rate by selected characteristics........................................................................... 38

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List of Appendix
Appendix A. Interview Guide for Program Managers ........................................................................... 43
Appendix B. Interview Guide for Deployed Health Care Worker ......................................................... 46
Appendix C. Interview Guide for Local Chief Executives ...................................................................... 48
Appendix D. HRH Deployment Program Alumni Survey ....................................................................... 50
Appendix E. HRH Deployment Program Student Survey ...................................................................... 63

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 Process evaluation of the Department of Health Human Resources
for Health Deployment Program

Michael R.M. Abrigo, Gina A. Opiniano, and Zhandra C. Tam1

1. Introduction

The supply of human resources for health (HRH) is critical in the delivery of health care goods
and services. In the Philippines, while the supply of HRH appears to be sufficient at the national
scale, recent analysis by Abrigo and Ortiz (2019) of more finely disaggregated data shows that
less than a quarter of cities and municipalities in the country have HRH densities above the 41
physicians, nurses, and midwives per 10,000 population recommended by the World Health
Organization [WHO] (2016), leaving at least three-quarters of cities and municipalities with
potentially insufficient number of health care workers to provide health care services.

The Philippines has a long history of recruiting health care workers from areas with relatively
more abundant supply in order to be deployed and augment the supply of health care workers
in underserved areas. Despite this tradition, very few studies have documented and assessed its
implementation. This study aims to contribute to the literature by providing a process
evaluation of the current Department of Health (DOH) national health care worker deployment
program. As such, it aims to provide context and study background on future assessments of
the impact of this program.

The DOH-HRH deployment program may have particular advantages over individual local
governments to reallocate HRH across geographic boundaries mainly through the provision of
program benefits. However, as pointed out by Araujo and Maeda (2013), the challenge is not
only to identify effective interventions to entice health care workers to practice their profession
in underserved areas, but to choose the combination of interventions that may realistically be
implemented. This involves recognizing that health professionals may have different
preferences, and should not be treated as one homogenous population.

1.1. Background

The Department of Health has been recruiting health professionals to augment the supply of
health care workers in underserved areas for over four decades. In 1974, the DOH introduced
the Rural Health Practice Program that requires physicians and nurses to practice in rural areas
as prerequisite for the issuance of professional licenses. This was then changed into a voluntary
program in 1986, and was the precursor of the current Rural Health Team Placement Program.
Alongside this was the development of the Medical Pool Placement Program that allows hiring
of physicians on a temporary basis to augment the HRH in hospitals.

With the enactment of the Local Government Code in 1991 and the subsequent adoption of
Executive Order 102 in 1999, the DOH was effectively transformed from being the sole
provider of health services in the public sector to being a provider of specific health services

1
Fellow II, Consultant, and Research Analyst II, respectively, at the Philippine Institute for Development Studies.
The authors acknowledge the able research assistance by Ms. Sherryl Yee. The authors are grateful for insightful
comments by participants in the PIDS Research Workshop series where a preliminary version of the report was
presented. All remaining errors are by the authors.

5
and of technical services for health. In the early years of decentralization, DOH introduced the
Doctors to the Barrios (DTTB) Program, a national physician deployment program that aims
to address the shortage of medical doctors in rural areas.

A DOH survey in 1992 found that 271 municipalities in the Philippines had no physicians,
which became the impetus for the creation of the DTTB program (Leonardia, et. al., 2012).
Despite this innovation, however, a recent estimate by Abrigo and Ortiz (2019) shows that in
2015 less than a quarter of cities and municipalities in the country have HRH densities higher
than the recommended threshold by the WHO. They further noted that while the country
produces a substantial number of health professionals – with HRH to population densities
exceeding internationally set thresholds at the national level – different push and pull factors
that affect the locational decision of health professionals have resulted in increasing spatial
concentration of health care workers, primarily in more developed regions.2

The DOH-HRH deployment program aims to address this market failure by recruiting health
care workers in regions with relatively abundant supply to be deployed in areas with “missing
markets” for health care workers. The DOH-HRH program also addresses informational
challenges by exposing deployed health care workers to working conditions in communities,
thereby bridging information gaps between potential workers, i.e., health professionals, and the
realities in places of work, i.e., in community health settings.

Since the introduction of the DTTB program, the DOH has expanded its HRH deployment
program to include midwifery and nursing professionals, and to practically all health and allied
health professions in more recent years. From being a relatively small program with a budget
of less than PhP200 million in 2010, the DOH deployment program has grown to a PhP10
billion-worth program in 2020.

1.2. Objectives

This study aims to evaluate the design and implementation of the DOH Human Resource for
Health (HRH) Deployment Program. More specifically, this process evaluation seeks to (1)
assess the program design and logic of the DOH-HRH deployment program, (2) document its
actual implementation, including perceptions of stakeholders, bottlenecks in implementation,
and deviations from program design, and (3) provide actionable recommendations to improve
its design and implementation. This process evaluation is intended to provide context and study
background for an impact evaluation of the DOH-HRH deployment program.

1.3. Limitations

While we aim to fully document the implementation of the DOH-HRH deployment program,
we focus our attention on the three largest subprograms by number of professionals deployed,
namely, midwives, nurses, and physicians. Further, we limit our analysis to the implementation
of the program within five years after DOH Administrative Order (AO) 2014-0025, which is
the latest in a series of DOH-AOs that provide guidelines on the implementation of the DOH-
HRH deployment program.

2
See Abrigo and Ortiz (2019) for a more extensive discussion on the demographic distribution, and more
recent stock and flow estimates of health care workers in the Philippines.

6
2. Review of Literature

The spatial imbalance of health professionals between and within countries is a “worldwide,
longstanding and serious problem” (Dussault and Franceschini, 2006). Despite this recognition
and the critical role that health workers play in the delivery of health services, little is known
about their geographic availability and accessibility (Guagliardo, 2004).

Several “pull” and “push” factors, including individual and community characteristics, work
environment, financial incentives, and education system, have been identified in the literature
to influence the locational decision of health professionals (Dussault and Franceschini, 2006;
Lehmann, et. al., 2008; Wilson, et. al., 2009; Barnighausen and Bloom, 2009; Araujo and
Maeda, 2013; McPake, et. al., 2014). However, much of the literature are focused on English-
speaking industrialized economies and largely on only a subset of the available HRH cadres,
particularly on physicians (Dolea, et. al., 2010; Mandeville, et. al., 2014).

The World Health Organization (2010) reviewed several interventions and their likely impacts
to improve retention of health workers in remote and rural areas based on experiences around
the world (see Table 1 for summary). Many of the studies that were included in their review
were observational and did not use a control group, and were therefore considered of “low”
quality. The recommendations were rated as “strong” if the intervention is likely to be
successful in a wide variety of settings, and otherwise as “conditional” if the intervention
requires “careful consideration of contextual issues and prerequisites” for implementation to
be successful. Interventions that provide personal and professional support, targeted admission
for students with rural backgrounds, and include rural health topics in curricula were rated as
“strong” recommendations.

In the Philippines, while there have been a number of studies that document profiles of health
workers in the country (e.g., Reyes and Picazo, 1990; WHO, 2013), research on factors that
affect their location decision remains scant. Much of the studies in this area focus on factors
relating to decisions to migrate (e.g., Astor, et. al., 2005; Lorenzo, et. al., 2007; Alonso-
Garbayo and Maben, 2009), and rarely on intentions to locate domestically. Some exceptions
include Abrigo and Ortiz (2019) and Leonardia, et. al. (2012) that both studied local location
choice decisions among health workers in the country.

Abrigo and Ortiz (2019) estimated propensity models of location choice decision among
physician, nurses and midwives using observed counts of health workers by municipality and
city. Their revealed preference approach captures the contribution of locational factors on the
decision of health workers on where to practice their professions. They found that physicians,
nurses and midwives are more likely to locate in areas where their earnings potential may be
highest. Unlike in other studies, however, they found that health workers from ethnolinguistic
minorities are less likely than other health workers in the same profession to work in areas with
high ethnolinguistic concentration. Leonardia, et. al. (2012), on the other hand, uses a revealed
preferences approach, wherein they directly asked physicians their motivations to participate
in the country’s national rural physician deployment program. They found that physicians who
joined the Doctors to the Barrios program were largely driven by return service obligations
(53.5%), opportunity to serve rural populations (23.9%), and interest in public health and
community medicine (18.3%).

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Table 1. Summary of WHO evidence-based recommendations
Evidence Recommendation
Category Recommendation
quality strength
Education Use targeted admission policies to enroll students with a rural background in Moderate Strong
education programs for various health disciplines, in order to increase the
likelihood of graduates choosing to practice in rural areas.
Locate health professional schools, campuses and family medicine residency programs Low Conditional
outside of capitals and other major cities, as graduates of these schools and programs
are more likely to work in rural areas.
Expose undergraduate students of various health disciplines to rural community Very low Conditional
experiences and clinical rotations as these can have a positive influence on attracting
and recruiting health workers to rural areas
Revise undergraduate and postgraduate curricula to include rural health topics so as to Low Strong
enhance the competencies of health professionals working in rural areas, and thereby
increase their job satisfaction and retention.
Design continuing education and professional development programs that meet the Low Conditional
needs of rural health workers and that are accessible from where they live and work, so
as to support their retention.
Regulatory Introduce and regulate enhanced scopes of practice in rural and remote areas to Very low Conditional
interventions increase the potential for job satisfaction, thereby assisting recruitment and retention.
Introduce different types of health workers with appropriate training and regulation for Low Conditional
rural practice in order to increase the number of health workers practicing in rural and
remote areas.
Ensure compulsory service requirements in rural and remote areas are accompanied Low Conditional
with appropriate support and incentives so as to increase recruitment and subsequent
retention of health professionals in these areas.
Provide scholarships, bursaries or other education subsidies with enforceable Low Conditional
agreements of return of service in rural or remote areas to increase recruitment of
health workers in these areas.

8
Table 1. Summary of WHO evidence-based recommendations (continued)
Evidence Recommendation
Category Recommendation
quality strength
Financial incentives Use a combination of fiscally sustainable financial incentives such as hardship allowances, grants Low Conditional
for housing, free transportation, paid vacations, etc., sufficient enough to outweigh the
opportunity costs associated with working in rural areas, as perceived by health workers, to
improve rural retention
Personal and Improve living conditions for health workers and their families and invest in infrastructure and Low Strong
professional support services (sanitation, electricity, telecommunications, schools etc.) as these factors have a
significant influence on a health worker’s decision to locate to and remain in rural areas.
Provide a good and safe working environment, including appropriate equipment and supplies, Low Strong
supportive supervision and mentoring, in order to make these posts professionally attractive,
and thereby increase the recruitment and retention of health workers in remote and rural areas.
Identify and implement appropriate outreach activities to facilitate cooperation between health Low Strong
workers from better served areas and those in underserved areas, and, where feasible, use
telehealth to provide additional support to health workers in remote and rural areas.
Develop and support career development programs and provide senior posts in rural areas so Low Strong
that health workers can move up the career path as a result of experience, education and
training, without necessarily leaving rural areas.
Support the development of professional networks, rural health professional Low Strong
associations, rural health journals etc. in order to improve the morale and status of
rural providers and reduce feelings of professional isolation.
Adopt public recognition measures such as rural health days, awards and titles at local, Low Strong
national and international levels to lift the profile of working in rural areas as these
create the conditions to improve intrinsic motivation and thereby contribute to the
retention of rural health workers.
Source: WHO (2010)

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3. Overview of DOH-HRH deployment program

3.1. Key policies

Prior to the 1991 Local Government Code (Republic Act [RA] 7160), the Department of Health
(DOH) is the sole provider of health services in the Philippines. During this period, the DOH
has already been deploying health care workers to underserved areas on a temporary basis. In
1974, the DOH introduced the Rural Health Practice Program which requires rural health
practice as pre-requisite for the issuance of medical and nursing license. This was then changed
in 1986 into a voluntary program that focused on community health and development. The
Medical Pool Placement Program, on the other hand, allows the hiring of physicians on a
temporary basis to augment the human resources in hospitals, including provincial and district
hospitals that send their resident physicians to training.

Since 1991, however, much of health services, including primary health care service and the
operation of health facilities except apex hospitals, were delegated to local governments under
RA 7160. The DOH’s new roles were reaffirmed in 1999, by virtue of Executive Order 102,
which mandates the DOH to be provider of specific health services and of technical services
for health, including to local governments.

In the early years of decentralization, local governments in rural areas faced tight budgets and
had difficulties recruiting local health personnel (Dussault and Franceschini, 2006). A survey
in 1992 found that 271 municipalities had no physicians, which prompted the DOH to
implement the Doctors to the Barrios (DTTB) program in the succeeding year (Leonardia, et.
al., 2012). The DTTB program aims to provide quality health care service in depressed,
marginalized, and underserved areas across the country. Since the introduction of the DTTB
program, several other health worker deployment programs were added, including those for
midwives, nurses, dentists, medical technologists, nutrition-dieticians, and physical therapists.

In 2018, the Philippine government enacted the Universal Health Care (UHC) Act (R.A.
11223) that automatically enrolls every Filipino citizen in the National Health Insurance
Program. Under the UHC Act, the Commission on Higher Education and the DOH are
mandated to expand scholarship grants for allied and health-related undergraduate and graduate
programs. Recipients of these government-funded scholarship programs are then required to
provide return service in priority areas for at least three years, with compensation, under the
DOH. The UHCT Act also mandates the creation of a National Health Workforce System
(NHWS) to help local public health systems address their human resource need. Similar to
prior national health worker deployment programs, the DOH is mandated to deploy health
workers in the NHWS.

3.2. Program design

While the thrust of the DOH human resource for health (HRH) deployment program has
generally remained the same over the past three decades, the design of the program has
undergone several iterations with the issuance of updated DOH guidelines governing its
implementation. In this section, we present the current design of the program as provided for
in DOH Administrative Order (AO) No. 2014-0025, and the latest applicable DOH issuance.
We limit our discussion to those relating to deployment in local governments.

10
 3.2.1. Organization

The DOH-HRH deployment program is managed by the Health Human Resource Development
Bureau (HHRDB), which directly supervises its implementation by DOH Regional Offices
(DOH-ROs). The DOH-HHRDB provides overall administration, including policy
formulation, slot allocation, coordination, and monitoring, of the HRH deployment programs.
The DOH-ROs, on the other hand, serves as a conduit between the central administration of
the DOH-HRH deployment program and the recipient local governments and health facilities.
The DOH-ROs coordinate, endorse, and facilitate the deployment of HRH to their areas of
assignment. They also conduct pre-deployment orientation of the HRH. Except for physicians
deployed under the DTTB program, all deployed HRH are hired through the DOH-ROs. Figure
1 summarizes the implementing structure of the DOH-HRH deployment program.

3.2.2. Site selection

Following DOH-AO 2014-025, the selection of priority areas and the number and type of health
workers for deployment is determined by DOH based on the following criteria:

1. Population of recipient or catchment area of the health facility

2. Geographic location and socio-economic classification of area
3. Gaps in current HRH vis-à-vis recommended HRH to population ratio
4. Accreditation status of health facility
5. National priority health facilities for upgrading of infrastructure and services to support
achievement of health-related Millennium Development Goals
6. Need for specialized care or services as mandated by law

Figure 1. DOH-HRH deployment program implementing structure

DOH-HHRDB Overall management

and supervision

Hiring, direct supervision

DOH-Regional Offices
and support*

DOH/DOH-retained centers/hospitals Local Government Units

Hospitals
Program recipients

Health Offices

*Excluding DTTB program.

Source: Adapted from DOH Administrative Order No. 2014-0025.

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For the DTTB program, the HHRDB requires requesting local governments to submit a matrix
of health personnel and a resolution justifying the need for DTTB deployment. The request of
local governments needs to be recommended by the provincial DOH office and the DOH-RO.

Operationalization of the priority areas have evolved over the years. In 2015, the priority areas
include doctorless cities and municipalities, 5th and 6th class municipalities, and national
priority areas under several initiatives, such as municipalities included in the 44 Focus
Geographical Areas (FGAs), Accelerated Sustainable Anti-Poverty Program, Whole of Nation
Initiative, and Bottom-up Budgeting. In 2018, the focus was to provide one health worker per
barangay, geographically isolated and disadvantaged areas, identified municipalities with
indigenous people, 4th to 6th class municipalities, and other national priority areas, including
those in the 44 FGAs, 36 focus areas of the 2017-2022 Philippine Plan of Action for Nutrition,
and areas with DOH pharmaceutical programs.

3.2.3. HRH selection

The selection of HRH follows the usual hiring and selection process in government. The
HHRDB and DOH-ROs post call for hiring, which include the requirements, core
competencies and benefits, as well as information on the application process, for each program.
Applicants accomplish the requirements and submit it to DOH-ROs or to its extension offices.

Except for applications to the DTTB program that is processed by HHRDB, the selection and
recruitment for the HRH deployment programs are through the DOH-ROs. The DOH-ROs
endorse selected applicants to HHRDB, where either the HHRDB or DOH-ROs process the
appointment documents of selected HRHs as appropriate.

Applicants are generally required to be board-certified for their respective profession. Table 2
summarizes the quality standard, offered compensation, and brief description of possible tasks
of recruited HRH for a selection of the DOH deployment programs.

3.2.4. Deployment process

The on-boarding of health workers in the DOH-HRH deployment programs start with a pre-
deployment orientation seminar by the DOH-ROs. DTTB physicians across the country have
additional centralized orientation conducted by the HHRDB. These pre-deployment
orientations are then followed by a location-specific orientation conducted by the PDOHO.

Deployment of health workers commences with the issuance of the HHRDB or the DOH-RO
of a Department Personnel Order or a Regional Personnel Order, respectively, and endorsement
to the deployed workers’ place of assignment. The deployed health worker may then report to
his/her place of assignment to perform the tasks required of him/her.

12
Table 2. Quality standard, compensation and functions by deployment program
Salary Grade
Position Quality standard Brief functions
(PhP/month)
Medical Officer Doctor of Medicine; R.A. 1080 (Board) eligibility 23 Provide direct medical services
IV (PhP75,359)
Rural Health Doctor of Medicine; R.A. 1080 (Board) eligibility 24 Provide direct medical services
Physician (PhP85,074)
Dentist II Doctor of Dental Medicine or Dental Surgery; Board 17 Provide preventive dental health services
eligibility; Relevant experience and training (PhP38,464)
Nurse II Bachelor of Science (B.S.) in Nursing; Board eligibility; 15 Conduct health education, provide nursing services, and
Relevant experience and training (PhP32,053) serve as navigator in facility
Nurse II* B.S. in Nursing; Board eligibility; Relevant experience 15 Manage health-related information systems and logistics
and training (PhP32,053) (Public Health Associates [PHA]); Provide program
support based on needs (non-PHA)
Medical Tech- B.S. in Medical Technology or in Public Health; Board 15 Provide laboratory services
nologist II eligibility; Relevant experience and training (PhP32,053)
Pharmacist II B.S. in Pharmacy; Board eligibility; Relevant experience 15 Manage the pharmaceutical supply chain of primary
and training (PhP32,053) healthcare services
Nutritionist- B.S. in Nutrition and Dietetics; Board eligibility; 15 Implement nutrition program
Dietician II Relevant experience and training (PhP32,053)
Midwife II Completion of midwifery course; Board eligibility; 11 Conduct health education, home visits, and provide
Relevant experience and training (PhP22,316) midwifery services
Notes: Monthly basic compensations are as of 2020 based on the 2019 Salary Standardization Law (R.A. 11466). Values are gross of taxes and other contributions, and net
of statutory benefits or premium payment. Experience and training requirement include one year of relevant experience and four hours of relevant training, unless
otherwise stated. NS – not specified. *Charged under Maintenance and Other Operating Expense.
Sources: 2019 DOH-HHRDB Memorandum and DOH Department Memorandum 2018-034.

13
 3.2.5. Benefits

The monthly compensation by HRH employed under the DOH-HRH deployment programs are
summarized in Table 2. Prior to June 2019, except for DTTB physicians, all deployed health
workers under the DOH-HRH deployment program were hired under contracts of service, and
therefore no employer-employee relationship existed between the hired health workers and the
DOH. Beginning in 2019, all health workers, except for those hired as Public Health
Associates, are hired as contractual employees under personnel services, and are therefore
eligible for statutory benefits, including basic pay, personnel economic relief allowance,
representation allowance, subsistence allowance, and hazard pay, if applicable. Those under
contract of service, on the other hand, are provided a five percent premium to their basic pay.

In addition to specified monthly compensation, under DOH Department Order 2018-0009, the
provincial DOH office (PDOHO) or the integrated provincial health office are tasked to lobby
for supplementary incentives to support deployed health workers, including the following:

1. Funds, logistics and materials for health-related programs or projects

2. Monthly allowance or honorarium
3. Meal or meal allowance during their tour of duty
4. Transportation or transportation allowance to cover field assignments and travels on
official business
5. Communication allowance
6. Modest board and lodging, whenever necessary
7. Learning and development opportunities

Further, under DOH-AO 2014-0025, the DOH, through the HHRDB and DOH-ROs, are tasked
to provide learning and development interventions to deployed health workers based on their
learning needs. The recipient local governments, on the other hand, are tasked to cover the
transportation and living allowances of deployed health workers who are attending capacity
building activities.

DTTB physicians may also earn a master’s degree in Public Management major in Health
Systems and Development (MPM-HSD) from the Development Academy of the Philippines
(DAP). The DAP MPM-HSD is a 38-unit inter-disciplinary program designed for the DTTB
program. Classes are held for two weeks every six months over the duration of physicians’
DTTB assignment.

3.2.6. Retention and absorption

In DOH-AO 2014-0025, recipient local governments of the DOH-HRH deployment program

are tasked to “support and endeavor to retain”, and to “implement ways and means to hire”
deployed health workers.

3.3. Program statistics

Over the last decade, the DOH-HRH deployment program has ballooned from a relatively small
program with a budgetary support of less than PhP200 million in 2010 to about PhP10 billion
in 2020. This represents a substantial increase from less than one percent of new DOH
appropriations in 2010 to about 10 percent in 2020.

14
This increase in budgetary support has allowed the DOH-HRH deployment program to expand
substantially, sending 439 individuals, composed of 248 physicians and 191 midwives, in 2010
to almost 30,000 individuals, composed of physicians, dentists, nurses, pharmacists, medical
technologists, nutritionist-dieticians, midwives, physical therapists, and public health
associates, in 2020. Table 3 summarizes the number of deployed cadres by type and year
between 2010 and 2020.

Focusing on the most recent available data (see Table 4), when disaggregated by region of
deployment assignment, Bicol Region (9.1%), Eastern Visayas (8.6%) and Central Visayas
(8.0%) were the greatest recipients by share of all deployed health workers in 2020. There are
however important differences across deployed health professions. CALABARZON, for
example, received the highest number (12.7%) of all deployed physicians, while Eastern
Visayas was the deployment site of the largest number of nurses (13.7%) in 2020.

3.4. Previous evaluations

Despite almost three decades of program implementation, the evidence based on the DOH-
HRH deployment program remains thin. A few exceptions include Leonardia, et. al. (2012),
Andaya (2011) and Politico (2011), and Lawas, et. al. (2016) that evaluated the implementation
of the DTTB program and the Medical Pool Placement and Utilization Program (MPPUP),
respectively, and Avancena, et. al. (2019) that conducted a cost-benefit analysis of the DTTB
program.

Avancena, et. al. (2019) developed a mathematical model that they calibrated using parameters
from the literature and expert opinion applied to hypothetical cohort of children in two
provinces and in a representative rural municipality. Based on the analysis of two health
conditions, namely, pediatric pneumonia and diarrhea, they concluded that the DTTB is cost-
effective, and that their estimates likely underestimate the benefits from the program.

Table 3. Number of DOH-deployed health workers, 2010-2020

2010 2012 2014 2016 2018 2020
Physician 248 393 458 537 456 724
DTTB 67 235 320 407 311 371
MPPUP 181 158 138 35 37 30
Others … … … 95 108 323
Dentist … … … 267 278 201
Nurse … 10,000 11,292 16,703 17,856 18,628
Pharmacist … … … … 276 303
Medical Technologist … … … 441 655 589
Nutritionist-Dietician … … … … 153 189
Midwife 191 2,391 2,700 4,205 5,022 4,519
Physical Therapist … … … … … 65
Public Health Associate* … … … 1,681 3,821 3,286
All cadres 439 12,784 14,450 23,834 28,517 28,504
Notes: DTTB – Doctors to the Barrios; MPPUP – Medical Pool Placement and Utilization program; *Includes
unclassified health workers under the Universal Health Care-Implementers Deployment Program.
Source: DOH-HHRDB.

15
 Table 4. Number of deployed health workers by region and profession, May 2020
Medical Public
Techno- Nutritionist- Physical Health All
Physician Dentist Nurse Pharmacist logist Dietician Midwife Therapist Associate cadres
National Capital Region 23 5 328 21 11 2 85 0 466 941
Caraga 46 4 509 11 22 8 130 6 212 948
Ilocos Region 36 23 1,083 21 49 2 213 1 206 1,634
Cagayan Valley 43 7 1,183 17 24 2 260 3 189 1,728
Central Luzon 57 17 1,150 21 22 3 97 7 453 1,827
CALABARZON 92 15 1,619 17 51 6 142 4 198 2,144
MIMAROPA 51 10 462 11 22 6 183 4 100 849
Bicol Region 32 17 1,666 9 5 17 600 1 206 2,553
Western Visayas 59 16 634 18 42 10 272 16 276 1,343
Central Visayas 36 23 1,565 12 78 21 390 2 126 2,253
Eastern Visayas 50 29 1,712 16 39 4 398 5 166 2,419
Zamboanga Peninsula 30 5 916 15 49 16 320 3 115 1,469
Northern Mindanao 57 4 1,154 16 26 15 338 5 75 1,690
Davao Region 44 6 770 14 43 2 259 2 138 1,278
Soccsksargen 17 6 1,027 58 49 47 467 3 146 1,820
Caraga 22 4 920 14 35 5 210 4 123 1,337
Bangsamoro ARMM 30 20 1,413 5 19 25 157 5 276 1,950
Philippines 725 211 18,111 296 586 191 4,521 71 3,471 28,183
Note: Aggregate values may be slightly different to those in Table 3 because of difference in recording period.
Source: DOH-HHRDB.

16
Leonardia, et. al. (2012), using self-administered questionnaire and face-to-face interviews,
found that physicians who joined the DTTB program as part of a return service obligation
reported having less satisfaction, while those who were motivated by interests in public health
care reported being more satisfied with their deployment experience. Further, they documented
that physicians who received their medical training from institutions in the National Capital
Region perceived that there were fewer options for them in their place of assignment, and were
more critical of the compensation that they received. Leonardia, et. al. (2012) report that among
the 452 deployed DTTB physicians between 1993 and 2011 only 18% were absorbed by the
local government where they had been deployed. They concluded that inadequate local
government support and local politics were the most critical factor that determine the retention
among deployed DTTB physicians.

Andaya (2011) surveyed 73 deployed DTTB physicians in 2011 to assess the fidelity of DTTB
program implementation to its operational guidelines, particularly with respect to issues faced
by deployed physicians. She found that a substantial proportion of deployed physicians had
little (13%) to no familiarity (16%) with the rationale behind and the objectives of the DTTB
program. Her study noted several deviations from the DTTB program operational guidelines,
including on the provision of additional incentives by the local governments (e.g., honoraria,
subsidized board and lodging, etc.), place of residence during deployment by DTTB
physicians, social preparation and orientation conducted by DOH, and monitoring and
evaluation by DOH-ROs.

Politico (2011) employed a mixed design approach to assess the implementation and
sustainability of the DTTB program. She found that deployed DTTB physicians have low
awareness of the DTTB program’s goals. Further, she found that retention rate is relatively low
only at 18% among deployed DTTB physicians between 1993 and 2009. Among the 65
currently deployed physicians who were surveyed, only 23% had stated intentions to continue
working in their host LGU, while a predominant 53% were planning to enter medical residency
programs. About a quarter of those surveyed mentioned staying in government health service
(14%) or having other career plans (10%). Politico (2011) concludes that the low retention may
be related to overall job satisfaction, stress at work, LGU support, and support and supervision
from DOH. She also highlighted other issues with the program, including (1) inequitable
geographic distribution of DTTB physicians, (2) non-adherence to deployment and allocation
process, (3) non-documentation of program impacts.

Lawas, et. al. (2016), also using self-administered questionnaires and face-to-face interviews,
evaluated the MPPUP. They found that hospitals request for additional health workers either
to address the need of health facilities with expanded capacity but without increased plantilla
positions, or of rural and remote facilities that have difficulties attracting and retaining health
workers. They documented that while deployed physicians expected to provide only patient
care services, they were, however, given administrative responsibilities, training functions, and
research and other outreach activities. The concluded that the MPPUP was beneficial to
hospitals, and that MPPUP physicians have high degree of satisfaction.

4. Methodology

This study is a process evaluation of the DOH-HRH deployment program, where we document
the actual implementation of the program, and assess its conformity with its original design.

17
We also assessed the plausibility of some of the key assumptions required by the program’s
results framework.

4.1. Results Framework

This process evaluation is anchored on the results framework of the program. A results
framework summarizes the logical causal pathways from inputs and processes employed by
the program to produce outputs, which, in turn, result in the program goals. It describes how
the intervention, in this case the DOH-HRH deployment program, is conceptualized to deliver
its intended results. Figure 2 presents the DOH-HRH deployment program results framework
which was developed based on DOH-AO 2014-0025 and RA 11223. This results framework is
effectively the analytic framework followed in this study.

Figure 2. Results Framework of the DOH-HRH Deployment Program

•Program budget
•Health professionals
Input •Operational guidelines

•Site selection and social preparation

•Search, selection and hiring of health professionals
•Orientation of health workers
Process •Deployment of health workers

•Delivery of health care goods and services by qualified health

professionals
Output •Integration of deployed health professionals into the community

•Improved acccess to quality and affordable health care goods and

Intermediate services
Outcome

•Improved population health

Final Outcome

Source: Authors’ elaboration based on DOH Administrative Order No. 2014-0025.

18
The overarching goal of the DOH-HRH deployment program is to improve health outcomes
among the population. This may be attained through the program by deploying and integrating
qualified health personnel, especially in underserved areas, which, in turn, will result in the
improved delivery of health care goods and services. The deployment of health care workers
requires financial, human resource, and policy support to be able to conduct the many different
processes involved to successfully deploy health care workers, including selection of sites for
deployment and their social preparation; search, selection and hiring of qualified health
personnel; orientation of selected HRH prior to deployment; and eventual deployment in
selected sites.

These individual steps have implied assumptions. For example, program budgets need to be
sufficient to cover program costs and made available in a timely manner. Hiring of HRH for
deployment requires a pool of available and willing health workers. Local governments, on the
other hand, are assumed to have resources, e.g., health facilities, and medical equipment and
supplies, to allow the deployed HRH to perform their duties. Local governments are also
assumed to be willing and have the capacity to absorb deployed HRH when their contracts
under the DOH-HRH deployment program expires to ensure continuous delivery of health care
services to the community.

4.2. Data collection methods

This study employs a mixed-method approach that includes the review and analysis of
secondary data (e.g., program documents, and official statistics), and of primary data collected
through key informant interviews (KIIs) and focus group discussions (FGDs), and through an
online survey of program alumni and of medical, nursing and midwifery students.

We conducted a desk review of DOH-HRH deployment program documents, including policies

and guidelines, budgetary allocations, and monitoring statistics, to (a) document the official
design and intentions of the program, (b) map out the roles and responsibilities of key
stakeholders as provided for in government policies, and (c) assess potential challenges and
bottlenecks as may be identified from monitoring statistics. Insights from the desk review are
then used to inform the guide questions used in KIIs and FGDs, and the online alumni and
student surveys.

The KIIs and FGDs were designed to provide an in-depth discussion with program managers,
deployed HRH, and recipient-government local executives to capture their views and
experiences with regard the deployment program. Discussions with recipient-government local
executives focus on their view of the program design and logic, their experience of the
deployment process, and their recommendations to improve the program. Discussions with
currently and previously deployed HRH, on the other hand, also touched on program benefits,
while those with program managers included topics on administration and financing, and
sustainability in addition to those previously mentioned. A copy of the KII and FGD guide
questions are provide as appendices to this report.

The KIIs and FGDs were conducted either through face-to-face or online meetings with
respondents. In addition to FGDs with program managers in DOH-CO in the National Capital
Region, discussions and interviews were conducted with program managers, deployed health
care workers, and local government representatives in Cagayan Valley, Central Visayas, and
Davao Region. Each session usually ran for around 1.5 to 2 hours, depending on the number
of respondents. The KIIs and FGDs were audio-recorded with the consent of the participants.

19
Finally, we also conducted an online survey of HRH deployment program alumni to capture
the experiences of a broader set of respondents, as well as to assess their willingness to accept
absorption by their host local governments. We adopted the questionnaire by Leonardia, et. al.
(2012) to capture the experience of program alumni during their deployment. An online student
survey, on the other hand, was conducted to capture the willingness of future potential HRH
pool to be deployed in underserved areas. The questionnaires are provided as appendices.

5. Results and Discussion

This section presents the results of the analysis conducted from data collected in the different
activities outlined in the previous section. The discussion is separated into two subsections.
The first subsection discusses the assessment on program design and logic, which focuses on
the reasonableness of the different program components based on a design standpoint.
Attention was given to whether the implied assumptions in each of the steps are plausible in
actuality based on information in the literature and available statistics. The second subsection,
on the other hand, discusses the implementation of the program as experienced by program
managers, deployed healthcare workers, and local government representatives. The analyses in
this subsection are drawn mainly from the KII, FGDs, and online surveys conducted.

5.1. Program design and logic

This subsection looks at the plausibility of the program based on a design standpoint. The
different program components are assessed based on whether implicit assumptions are likely
to be met in reality based on indications from available data and the literature on the topic.

5.1.1. Organization

The DOH-HHRDB provides overall management of the DOH-HRH deployment program,

while the DOH-ROs provide direct supervision and support to the program. This set-up may
be optimal for the program given that information on public sector HRH gaps and on HRH
supply availability, and budgetary support are more abundant at this level of organization.
Further, central and regional government offices may have more extensive reach to disseminate
information. These together allow the DOH-HHRDB and DOH-ROs to advertise job postings
more widely, receive greater number of applications, and re-allocate health workers from areas
with relatively more abundant supply to areas where supply may be more limited. In Abrigo
and Ortiz (2019), for example, they noted that majority of physicians (59.9%), dentists (67.3%),
pharmacists (53.7%), and nutritionist-dieticians (56.5%) reside in the National Capital Region,
Central Luzon or CALABARZON. Because of the informational and financial resources
available to the national and regional organizations of the DOH, they may have comparative
advantage relative to local governments that have more limited financial resource and network
to perform the same requirements.

20
 5.1.2. Site selection

The DOH-HRH deployment program was envisioned to augment the supply of healthcare
workers in underserved areas with the priority areas identified by the DOH, which may change
from year to year. Based on the 2018 DOH-HRH deployment guidelines, the prioritization
criteria may be too broad, thereby potentially diluting the potential benefits of the program by
allowing deployment in areas where there may be sufficient supply of health care workers. For
example, under the 2018 guidelines, the DOH-HRH deployment program may deploy in any
one of the following: in 687 fourth to sixth class municipalities; in 1,045 municipalities
included in the 44 Focus Group Areas of the DOH; in 57 cities and 804 municipalities in the
2017-2022 Philippine Plan of Action for Nutrition; and in 87 cities and 1,167 municipalities
with geographically isolated and disadvantaged areas. For reference, the country has 146 cities
and 1,488 municipalities.

Table 5. Share of program recipient-local governments (%): Philippines, 2016-2018

Physician
Nurse Midwife
Any DTTB MPPUP Others
All local governments 35.1 25.0 1.0 12.0 100.0 94.2

A. By local government income class

First Class 30.5 19.5 1.8 12.2 100.0 92.7
Second Class 34.0 22.0 0.5 14.0 100.0 95.5
Third Class 36.0 24.7 1.0 14.3 100.0 93.7
Fourth Class 34.4 24.3 0.5 11.7 100.0 95.7
Fifth Class 38.5 32.5 1.1 8.5 100.0 94.7
Sixth Class 63.0 59.3 0.0 3.7 100.0 85.2

B. By 2015 poverty incidence

< 10% 19.5 4.5 2.5 16.0 100.0 90.5
10% to < 20% 34.7 20.0 1.0 16.2 100.0 95.3
20% to < 30% 42.9 32.6 1.6 13.9 100.0 96.8
30% to < 40% 36.5 31.4 0.0 7.5 100.0 97.3
40% to < 50% 35.2 30.0 0.9 7.0 100.0 97.8
> 50% 37.0 29.5 0.0 8.5 100.0 84.0

C. By 2010 HRH-to-population ratio

> 1:5,000 30.7 14.4 2.5 16.9 100.0 94.8
1:10,000 to < 1:5,000 28.5 19.5 0.0 12.5 100.0 100.0
< 1:10,000 37.8 29.7 0.7 10.3 100.0 92.8
Notes: DTTB – Doctors to the Barrios; MPPUP – Medical Pool Placement and Utilization Program.
Sources: Values are based on DOH-HHRDB program monitoring data. Municipal- and city-level poverty
incidence are based on Philippine Statistics Authority (2019a) small area estimates. HRH-to-population ratio
are based on the composite of physicians, nurses, and midwives calculated from the 2010 Census of
Population and Housing (National Statistics Office, 2012).

21
Indeed, examination of the place of deployment of physicians, nurses and midwives between
2016 and 2018 show that the DOH-HRH deployment program has deployed in first to third
income class local governments, in areas with relatively low poverty incidence, and in areas
with relatively high HRH-to-population ratio (see Table 5).

5.1.3. Health worker selection

Requiring applicants to the DOH-HRH deployment to have professional board certification

ensures that health workers who will be hired have the requisite training and skills to perform
their duties in the community. Additional benefits may be had by selecting and hiring from a
large pool of applicants whereby board-certified candidates may be further screened and ranked
based on their qualifications, including additional training, and the duration and quality of their
relevant experiences. A high recruitment-success rate may suggest high demand for slots
among the DOH-HRH deployment programs.

Table 6. Recruitment success rate (%) by region and selected cadre: Philippines, May 2020
Medical Nutri-
Phar- Techno- tionist-
Dentist Nurse macist logist Dietician Midwife
National Capital Region 100 100 100 100 100 100
CAR 100 94 65 100 100 88
Ilocos Region 96 85 100 100 100 96
Cagayan Valley 54 98 100 100 100 99
Central Luzon 100 100 100 100 100 100
CALABARZON 83 84 113 121 200 93
MIMAROPA 100 95 100 100 100 96
Bicol Region 94 96 75 63 74 99
Western Visayas 94 79 100 98 91 97
Central Visayas 110 100 100 100 100 100
Eastern Visayas 193 92 100 93 100 97
Zamboanga Peninsula 71 90 100 100 100 100
Northern Mindanao 57 87 89 104 83 97
Davao Region 67 83 117 100 100 97
SOCCSKSARGEN 67 91 100 73 100 100
Caraga 50 92 100 100 71 100
Bangsamoro ARMM 100 95 100 100 100 199
Philippines 95 92 98 98 96 100
Notes: Values are based on DOH-HHRDB program monitoring data. CAR – Cordillera Autonomous Region;
CALABARZON – Cavite, Laguna, Batangas, Rizal and Quezon (Region IV-A); MIMAROPA – Mindoro,
Marinduque, Romblon and Palawan (Region IV-B); SOCCSKSARGEN – South Cotabato, Cotabato, Sultan
Kudarat, Sarangani and General Santos (Region XII); ARMM – Autonomous Region in Muslim Mindanao.
Recruitment success rate is calculated as the ratio of filled relative to available slots.

Table 6 shows the recruitment success rate, calculated as the share of filled relative to available
slots, by region and selected deployment programs as of May 2020. It shows that demand for
slots by health care workers in the DOH-HRH deployment are relatively robust, with national
recruitment success rate ranging from 92% for nurses and 100% for midwives. When

22
disaggregated by region, the National Capital Region, Central Luzon, and Central Visayas have
recruitment success rates of at least 100%, suggesting that the slots are either fully or over-
subscribed. In some regions and professions, however, the recruitment success rates are
relatively low, such as for dentists in Cagayan Valley, Caraga, and Northern Mindanao, where
the recruitment success rate is below 60%, suggesting that there may be low demand for slots
in those areas. This may be correlated with the spatial distribution of dentists in the country.
Based on data from the 2015 Census of Population (PSA, 2016), only five percent of all dentists
reside in these three regions.

5.1.4. Benefits

The DOH-HRH deployment program generally uses financial incentives to counterbalance the
perceived and actual opportunity costs associated with working in underserved areas. As
classified by WHO (2010), however, financial incentives may not necessarily work in all
contexts. While the opportunity costs from working in underserved areas may not be readily
calculated from available data, comparison of offered basic pay by the DOH-HRH deployment
program and national average wages may provide indications of benefits associated with
employment options for health care workers.

As shown in Table 7, health workers employed under the DOH-HRH deployment program
receive a premium of at least 35% (for dentists) and up to 140% (for rural health, i.e., DTTB,
physicians) of median wages for each profession. In all of these selected programs, the offered
basic wages by the different DOH-HRH deployment programs are above the 75th percentile of
basic wage rates of health workers in the same profession.

Table 7. Basic daily pay: Deployed DOH-HRH and comparable quality standard (QS), 2018
Offered basic pay Daily basic pay (Comparable QS)
Salary Daily 25-th 50-th 75-th
Grade basic pay percentile percentile percentile
Rural Health Physician 24 3,332 920 1,363 1,923
Medical Officer IV 23 2,982 920 1,363 1,923
Dentist II 17 1,581 769 1,166 1,363
Nurse II 15 1,319 491 600 818
Medical Technologist II 15 1,319 500 700 850
Nutritionist-Dietician II 15 1,319 500 636 954
Pharmacist II 15 1,319 350 636 962
Midwife II 11 917 500 600 800
Notes and Sources: Daily basic pay is based on 2018 values. DOH-HRH deployment program basic pay are
based on DOH Department Memorandum 2018-034 and Executive Order 201, series of 2016, modifying the
salary schedule for government personnel. Daily basic pay for comparable quality standards are based on
estimates from the October 2018 round of the Labor Force Survey by the PSA (2019b).

Despite this apparent premium provided by the DOH-HRH deployment program, the
recruitment success rates presented in Table 8 suggests that there may be other factors that are
important for health workers in deciding to work in underserved areas.

In order to identify potential program levers to entice health care workers to be deployed in
underserved areas, we conducted an online willingness to accept experiment with Medicine,

23
 Nursing and Midwifery students. Each student is presented a set of five alternative employment
options which they are asked to rank. Four of the options provide different benefits for
accepting deployment in an underserved rural community. These benefits are based on those
already provided in some of the DOH-HRH deployment programs. The last of the options is
an outside-value option wherein they will not accept to be employed in an HRH deployment
program, and instead work elsewhere. Each survey participant is provided three sets of such
options to be ranked. The sets are randomly assigned, and each of the options within sets are
randomized for each respondent. Table 8 presents the results of the willingness-to-accept
experiment with parameters estimated using ranked-ordered logistic regression.

The results of the willingness-to-accept experiment show differences in the preferences among
students, who are presumably the future pool of healthcare workers in the DOH-HRH
deployment program, across fields. Future physicians are more likely to accept deployment
with at least 150% premium in wages, and have some control over their place of assignment.
Nurses, on other hand, are more likely to accept deployment with at least 100% premium on
wages, housing and travel allowance, control over their place of assignment, and training
aligned with their continuing professional development (CPD). Midwives, on the other hand,
are more likely to respond to provision of CPD-related trainings.

Table 8. Student willingness-to-accept deployment by professional field

Medicine Nursing Midwifery
Monthly compensation: Base is national average wage rate
50% higher than national average (=1) -0.383 0.013 -1.634
(1.231) (0.065) (0.842)
100% higher than national average (=1) 0.287 0.510*** 0.102
(0.830) (3.093) (0.061)
150% higher than national average (=1) 1.098*** 0.615*** 0.964
(2.878) (3.707) (1.063)
200% higher than national average (=1) 1.086** 0.745*** 0.740
(2.338) (4.343) (0.546)
Allowance
With housing and travel allowance (=1) 0.212 0.212* 0.738
(1.228) (1.672) (1.044)
Deployment site selection: Base is no choice on selection
Limited choice of site (=1) 0.637*** 0.220* -0.312
(2.653) (1.746) (0.428)
Choice to be indicated in application (=1) 0.965*** 0.714*** -0.054
(2.851) (5.190) (0.077)
Training: Base is no free training
Training aligned with CPD (=1) 0.257 0.505*** 0.962***
(0.998) (3.727) (7.163)

Number of Observations 195 795 60

Bayesian Information Criterion 369 1437 113
Notes: Values in parentheses are standard errors clustered by respondent-experiment set pair. *, **, and ***
indicate statistical significance at the 10-, 5- and 1-% alpha-levels, respectively. CPD – Continuing Professional
Development. Source: Authors’ calculations.

24
 5.1.5. Retention and absorption

Interviews with program managers indicate that the longer-term goal of the DOH-HRH
deployment program is for local governments to be able to employ and retain their own team
of health care workers to provide health care services in the community. The DOH-HRH
deployment program is seen only as a stopgap measure to allow the continuous provision of
services in underserved areas in the near-term. However, the policy on the deployment program
is relatively weak in enticing local governments to absorb the deployed health care workers.
To wit, DOH-AO 2014-0025 only requires local governments to “support and endeavor to
retain”, and to “implement ways and means to hire” deployed health workers. A more pointed
option may include deploying health care workers contingent on local government plans and
actions to hire their own or to absorb deployed health care workers.

Absorption of DOH-HRH deployed health care workers presupposes that local governments
are willing and have the capacity to absorb the deployed workers. In terms of capacity, fiscal
data from the Bureau of Local Government Finance show that local governments remain highly
dependent on block grants, i.e., Internal Revenue Allotment (IRA), from the national
government to finance their expenditures. In 2019, IRA constitute 78-, 41-, and 76% of total
incomes of province, city, and municipality governments, respectively. In terms of willingness,
while it has been documented that expenditures on population, health and nutrition services is
positively correlated with local government incomes (e.g., Abrigo and Tam, 2019), exogenous
expansion of local government incomes does not readily result in increased expenditures on
population, health and nutrition services (Abrigo and Ortiz, 2018).

Figure 3.Willingness to be absorbed by local governments by profession

100
Share willing to be absorbed (%)

80

60

40

20

0
Midwives Nurses Physicians
Same benefit 90% of benefit 80% of benefit 70% of benefit
Source: Authors’ calculations. Benefit levels are relative to the schedule of benefits received by respondents
during their tour of duty in the DOH-HRH deployment program. Sample sizes are as follows: Midwives (3),
Nurses (35), and Physicians (66).

Absorption post-DOH-HRH deployment program also assumes that deployed health care
workers are willing to be absorbed if offered a position. Results from the online survey of
DOH-HRH deployment program alumni, however, suggest that even with the current level of

25
deployment program benefits only 77% of nurses and 55% of physicians are willing to be
absorbed by their host local government if offered a position. These propensities, together with
those of midwives, decrease as wage premia are decreased, which may be expected when the
deployed health care workers are employed by local governments instead of the national
government through the DOH-HRH deployment program. This observation underscores both
the saliency of financial incentives to retain health care workers, as well as the need to
understand other factors that affect health care worker decisions regarding where to practice
their profession.

5.2. Program implementation

This section documents the actual implementation of the DOH-HRH deployment program and
compares it with stated intent or procedures of the program. This draws heavily from the online
survey of DOH-HRH deployed health workers, and from FGDs and KIIs with program
managers, deployed personnel, and local government representatives.

5.2.1. Organization

Program managers, deployed health care workers, and local government representatives appear
to be similarly aware of the goal of the DOH-HRH deployment program to ensure the delivery
of health care services in communities by augmenting the local supply of health care workers
in the public sector based on discussions during FGDs and KIIs. The participants generally
agree that the program has been able to meet this objective. However, while program managers
and deployed health care workers understand that the program is a stop-gap measure, many of
the local government representatives interviewed had expressed their desire to make the
program permanent if possible. This common sentiment, also expressed by some deployed
HRH and some program managers, seems to suggest a discrepancy in their understanding of
the implications of the HRH deployment program as an augmentation program.

When asked whether their motivation in joining the deployment programs have changed when
in their actual deployment after having experienced serving the community, majority of the
HRH participants in the FGD sessions responded to the affirmative. Interestingly, those who
have previous hospital experiences have similarly expressed their desire to continue serving in
the community as the deployment program allowed them to compare and contrast certain
aspects of their hospital and community experiences. This resonates the result of the study of
Leonardia, et. al. (2012) on the motivation of the respondents to participate in the rural health
deployment program, particularly the opportunity to serve rural populations.

5.2.2. Site selection

In addition to awareness of its objectives, program managers are also aware of the overall target
beneficiary of the DOH-HRH deployment program, i.e., underserved areas. In practice,
however, this may not necessarily be the case as shown in Table 5, which suggests possibilities
of inclusion error wherein health workers had been deployed in areas with high-income, high
HRH-to-population ratio, and low poverty incidence. While many of the program managers,
particularly those from DOH-ROs, expressed that the deployment of health care workers is
programmatic and are not likely to be influenced by particular requests from local governments,
they stated that they respond to requests based on availability of program slots.

26
Based on the experience of program managers, local governments that request for health care
personnel augmentation are likely beneficiaries based on need rather than because of the
request. In cases where HRH augmentation is requested, the same is not always approved.
Accordingly, there are instances when requests are not granted primarily due to lack of budget
or the unavailability of slots. Further, some program managers expressed their concern that the
target of having one health care worker per barangay may not be appropriate in some cases,
especially when a barangay is particularly large or covers geographically isolated areas.

The responses of some HRH concur with this apprehension particularly those who are assigned
to municipalities with a large number of barangays, barangays with large population, or health
facilities with large catchment areas. Some HRH detailed the challenges of reaching the
geographically isolated sites that hinder their supposed smooth delivery of health service to the
community.

5.2.3. Health worker selection

Based on discussion with program managers, selection and hiring of health care workers to be
deployed follows the hiring process for government personnel. The DOH offices post calls for
application, and applicants send the requirements to the DOH-CO, ROs, or PDOHO. The
applicants are pre-assessed based on their submitted documents. Shortlisted applicants are
invited for an interview.

An online survey with DOH-HRH deployment program alumni shows that knowledge about
the program comes largely from personal networks, including friends (69.2%), social media
(30.8%), and school (29.8%) (see Table 9). The DOH website and offices are also an important
source of information based on responses by program alumni (31.7%), although it appears to
be only secondary to personal networks. These observations appear to be largely consistent
across profession, sex, and marital status of health care workers.

In the DTTB program, physicians select where they wish to be deployed during their
orientation workshop in DTTB during which they are already hired. Preference over a site is
given to the health worker who has prior ties, e.g., current or previous resident, birthplace of
parents, etc., to their choice of site. Multiple claims to a deployment site are resolved by
bargaining among those with the same preference for sites. Health workers in other deployment
programs, on the other hand, self-select into their choice of deployment site when they apply
for the program. The deployment sites are made known to health workers during application,
who are then free to not continue with the application process when they are not amenable to
working in any of the available beneficiary sites.

5.2.4. Deployment

Prior to deployment, hired health care workers under the DOH-HRH deployment program are
expected to attend a pre-deployment orientation seminar (PDOS) at the DOH-CO, in the case
of DTTB program physicians, and in the DOH-ROs. Based on results of the online survey,
presented in Figure 4, almost 90% percent of respondents stated that they attended a PDOS,
with males more slightly more likely to respond in the affirmative relative to females.

27
Table 9. Source of information on the DOH-HRH deployment program by selected characteristics
By profession By Sex By Marital Status
All Ever Single, Single, not
respondents Midwives Nurses Physicians Female Male married dating dating
(n=104) (n=3) (n=35) (n=66) (n=57) (n=51) (n=15) (n=40) (n=52)
Radio 2.9 0.0 2.9 3.0 1.8 3.9 0.0 7.5 0.0
TV 6.7 0.0 8.6 6.1 1.8 11.8 6.3 10.0 3.8
Print 4.8 0.0 2.9 6.1 0.0 9.8 6.3 5.0 3.8
Social media 30.8 33.3 37.1 27.3 31.6 33.3 25.0 42.5 26.9
DOH 31.7 33.3 42.9 25.8 31.6 33.3 31.3 35.0 30.8
School 29.8 33.3 0.0 45.5 24.6 35.3 12.5 30.0 34.6
Family 11.5 0.0 17.1 9.1 14.0 7.8 25.0 10.0 7.7
Friends 69.2 100.0 80.0 62.1 70.2 68.6 56.3 75.0 69.2
Others 8.7 0.0 0.0 13.6 12.3 5.9 25.0 2.5 9.6
Notes: Authors’ calculations based on online survey with DOH-HRH deployment program alumni. Caution must be exercised when interpreting results from subpopulations
with small sample sizes. Values for “All respondents” exclude 4 responses with no profession stated.

28
Figure 4. Share (%) of alumni who attended PDOS by selected characteristics

By Marital Status
Single, not dating (n=52)
Single, dating (n=40)
Ever married (n=15)

By Sex
Male (n=51)
Female (n=57)

By Profession
Physicians (n=66)
Nurses (n=35)
Midwives (n=3)

All respondents (n=104)

0 20 40 60 80 100
Share of respondents (%)

Note: Authors’ calculations based on online survey with DOH-HRH deployment program alumni. Caution must
be exercised when interpreting results from subpopulations with small sample sizes. Values for “All
respondents” exclude 4 responses with no profession stated. PDOS – pre-deployment orientation seminar.

The PDOS conducted by DOH provides an important avenue for health care workers to set and
manage expectations about the latter’s areas of assignment, roles and responsibilities, and
program benefits, among others. Based on discussions during FGDs and KIIs, some of the
deployed health care workers opined that the orientation was sufficient while some of them
expressed the opposite. On one hand, some HRH are generally aware of the potential scenarios
in an underserved area, hence their expectations are usually commensurate to what they
actually experience at work. On the other hand, some of the FGD and KII participants find the
orientation to be insufficient to prepare them for their actual deployment.

While the orientation may be described as a “starter pack” according to some health care
worker-participants, some respondents expressed that the orientation that they received does
not fully provide details of what deployed workers need to expect or know prior to deployment,
including (1) other potential roles and responsibilities that they may be assigned to, (2) means
of communication available in deployment sites, (3) safety protocols in case of emergency
situations, and (4) medical equipment and other resources available for them to practice their
profession, among others.

29
It is to be noted that the orientation on the HRH’s job description, content of contract, program
benefits and reportorial obligations were appreciated, however, a counterbalance response can
be summed up by the statement of one HRH that the “actual situation is different from what is
provided in the orientation.” Suggestion to provide a more detailed and cadre-focused
orientation seem common among all cadres represented in the study.

Discussions during FGDs and KIIs with deployed workers, and results of the online survey
suggest that health care workers may be overworked during deployment. In one of the FGDs,
a participant mentioned having experienced being assigned multiple assignments and
responsibilities, including (1) administrator at the rural health unit, (2) health educator and
health care practitioner in communities, (3) health advocate in the local government, (4)
member in various local government committees, and (5) on-call clinician in birthing facilities.
The participant also expressed “frustration” over seeing many colleagues working beyond
regular working hours because of limited human resource in their deployment site. This is
substantiated by the responses of majority of the health care worker participants who claim that
“work continues even during weekends.” While their actual experiences vary in terms for
example on the number of patients they have to attend to every week, they are all in agreement
that they do administrative work apart from their basic roles and responsibilities.

Table 10. Average working hours by activity type, and number of patients per week
Hours per week on activities Average
number of
Clinical Community Adminis- patients per
practice visits trative work day
All respondents (n=104) 22.8 18.6 12.4 43.9

By Profession
Midwives (n=3) 8.0 28.7 2.7 21.7
Nurses (n=35) 18.8 22.7 8.8 39.4
Physicians (n=66) 25.6 16.1 14.6 47.3

By Sex
Female (n=57) 21.0 19.3 12.0 44.2
Male (n=51) 24.7 17.6 13.0 43.7

By Marital Status
Ever married (n=15) 21.8 19.7 14.1 52.9
Single, dating (n=40) 25.7 16.0 11.4 46.0
Single, not dating (n=52) 21.0 20.1 12.8 39.7
Note: Authors’ calculations based on online survey with DOH-HRH deployment program alumni. Caution must
be exercised when interpreting results from subpopulations with small sample sizes. Values for “All
respondents” exclude 4 responses with no profession stated.

This experience may not be unique to the focus group. As shown in Table 10, survey
respondents reported working for more than 50 hours per week on average. This is spent largely
on clinical practice (22.8 hours), and on community visits (18.6 hours), although a substantial
portion is also spent on administrative work (12.4 hours). When disaggregated by health care

30
worker characteristics, important differences in working hours may be observed across
profession, sex, and marital status. Physician work weeks, for instance, are the longest,
averaging 56.3 hours with about a quarter (14.6 hours) of that spent on administrative work.

It is worth noting, however, that there are also health care worker participants who shared that
in their areas of assignment, under normal circumstances, they are assured family time during
weekends. This means that they only work within the prescribed number of hours which may
be associated with the distant location of the health facility from the households. Being able to
work only within the required number of hours is also a choice HRH must make, as one
respondent conveyed. This does not remove the fact, nonetheless, that all HRH are aware that
they are on call during emergencies and calamities.

In order to further assess the experience of health care workers on their deployment experience,
we adopted the questionnaire by Leonardia, et. al. (2012) based on Bancroft (2006) that asks
deployed workers on their agreement on statements covering personal and job satisfaction,
career advancement, working environment, living conditions, and compensation. Table 11
presents net agreement, calculated as the difference in the proportion that sates either “Strongly
agree” or “agree” and either “Strongly disagree” and “disagree”, on each statement.

The results presented in Table 11 suggest that survey respondents have relatively high personal
satisfaction in their work as more respondents agree that they “find fulfillment” in serving the
community (+94.2 net agreement), “have good friends at work” (+92.3), “know what is
expected” of them at work (+91.3), find their work “meaningful and stimulating” (+90.4), and
feel appreciated in the community (+89.4). However, survey responses also suggest that many
deployed health care workers have issues in accessing equipment (+37.5), medical supplies
(+33.7), and essential drugs and medications (+32.7) that they need to perform their job safely
and efficiently. Further, the survey reveals that many deployed health care workers feel that
their work is not appreciated by their primary employer, i.e., DOH (+28.4), and that they are
not satisfied with the support that they receive from the latter (+26.0).

5.2.5. Benefits

Delays in the receipt of monthly compensation appear to be prevalent especially during the first
few months of hiring based on reports during FGDs and KIIs with both program managers and
deployed health care workers. According to program managers these delays, ranging from one
to three months, may be due to a number of factors, including (1) the length of time in
processing hiring documents, (2) delays in the sub-allotments to DOH-ROs, and (3) late
submission of daily time records or other pertinent documents of deployed health care workers.

Table 11 presents the frequency of receipt and satisfaction among deployed health care workers
on the DOH-HRH deployment program benefits. Among all respondents, 7.7% cited that they
receive their monthly compensation less frequently than once a month, with nurses reporting
higher prevalence of delayed receipts of monthly compensation (11.4%) compared to
physicians (6.1%).

The receipt of benefits other than monthly compensation appear to vary across health care
workers. For instance, only around half of nurses ever received monthly
allowance/honorarium, while more than nine in ten deployed physicians were provided
monthly allowance. Receipt of other benefits among nurses also appear to be less prevalent,

31
 such as those for meals (5.7%), transportation (8.6%), communication (2.9%), and board and
lodging (2.9%), compared to deployed physicians.

In some of the FGDs with deployed health care workers, participants raised the issue that they
have at times challenges in reaching communities, which may require traveling long distances
by foot. While the deployed health care workers admitted being aware of such tasks prior to
deployment, they intimated that they usually use their own resources (e.g., own salary to pay
for transportation fare or gas, if owning a vehicle) to be able to reach communities. Some FGD
participants mentioned that the transportation costs related to delivering health care services
are allegedly deducted from their salaries.

Table 11. Deployment experience

Net
Statement
agreement
I find fulfillment in serving my community. +94.2
I have good friends at work. +92.3
I know what is expected of me when I come to work. +91.3
The work I am doing is meaningful and stimulating. +90.4
The community where I am assigned generally appreciates my work. +89.4
The job matches my skill and expertise. +85.6
Considering everything, I am satisfied with my job. +80.8
I feel safe working in the community where I am deployed. +79.8
My family supports my decision to be part of the DOH deployment program. +78.8
The government officials in the community where I am assigned appreciates my work. +77.9
I feel safe living in the community where I am deployed. +76.0
I can take time to eat lunch and snacks every day. +75.0
I have the flexibility to balance workplace demands and my personal life. +73.1
I feel that my views are respected at work. +72.1
I have clean running water at my workplace. +70.2
The workload is manageable. +67.3
I am fairly evaluated on my work. +66.3
I have sufficient training to perform the task expected of me. +59.6
I receive recognition for doing good work. +59.2
I have regular electricity at my workplace. +58.7
I work with a competent local government. +56.3
I feel that there are sufficient opportunities to develop my career. +55.8
I am satisfied with the quality of care that my health facility can provide. +54.4
I am satisfied with the support that I receive from the local government I was assigned. +50.0
I receive words of encouragement from DOH or local government personnel. +50.0
I have access to equipment that I need to perform my job safely and efficiently. +37.5
I have access to medical supplies that I need to perform my job safely and efficiently. +33.7
My health facility has ready access to essential drugs and medications. +32.7
The DOH appreciates my work. +28.4
I am satisfied with the support that I receive from the DOH. +26.0
Note: Authors’ calculations based on online survey with DOH-HRH deployment program alumni. Net
agreement is calculated as the difference between the proportion of respondents indicating either “Strongly
agree” or “agree”, and those indicating either “Strongly disagree” or “disagree” on the statement. The
statements were adopted from Leonardia, et. al. (2012)

32
Table 12. Program benefits receipt frequency and satisfaction by profession
Frequency of receipt (%) Satisfaction (%)
Less
At least frequent Neither
once a than once Dis- dissatisfied
month a month Never satisfied nor satisfied Satisfied
A. Midwives (n = 3)
Monthly compensation 0.0 33.3 66.7 0.0 33.3 66.7
Funds, logistics and materials for programs/project 0.0 33.3 66.7 0.0 33.3 66.7
Monthly allowance/honorarium 33.3 33.3 33.3 33.3 33.3 33.3
Meals or meal allowance during duty 100.0 0.0 0.0 100.0 0.0 0.0
Transportation or transportation allowance 100.0 0.0 0.0 100.0 0.0 0.0
Communication allowance 66.7 33.3 0.0 66.7 33.3 0.0
Board and lodging, or commensurate allowance 66.7 33.3 0.0 66.7 33.3 0.0
Learning and development opportunities/activities 33.3 0.0 66.7 33.3 0.0 66.7

B. Nurses (n = 35)
Monthly compensation 80.0 11.4 8.6 14.3 8.6 77.1
Funds, logistics and materials for programs/project 48.6 31.4 20.0 31.4 11.4 57.1
Monthly allowance/honorarium 42.9 8.6 48.6 48.6 20.0 31.4
Meals or meal allowance during duty 5.7 2.9 91.4 60.0 31.4 8.6
Transportation or transportation allowance 8.6 0.0 91.4 62.9 28.6 8.6
Communication allowance 2.9 5.7 91.4 62.9 31.4 5.7
Board and lodging, or commensurate allowance 2.9 8.6 88.6 57.1 31.4 11.4
Learning and development opportunities/activities 20.0 45.7 34.3 14.3 37.1 48.6

33
Table 12. Program benefits receipt frequency and satisfaction by profession (Continued)
Frequency of receipt (%) Satisfaction (%)
Less
At least frequent Neither
once a than once Dis- dissatisfied
month a month Never satisfied nor satisfied Satisfied
C. Physicians (n = 66)
Monthly compensation 90.9 6.1 3.0 10.6 4.6 84.9
Funds, logistics and materials for programs/project 27.3 65.2 7.6 45.5 19.7 34.9
Monthly allowance/honorarium 90.9 0.0 9.1 19.7 15.2 65.2
Meals or meal allowance during duty 28.8 7.6 63.6 42.4 30.3 27.3
Transportation or transportation allowance 63.6 4.6 31.8 34.9 22.7 42.4
Communication allowance 40.9 6.1 53.0 48.5 22.7 28.8
Board and lodging, or commensurate allowance 62.1 0.0 37.9 28.8 19.7 51.5
Learning and development opportunities/activities 36.4 50.0 13.6 22.7 19.7 57.6

D. All respondents (n = 104)

Monthly compensation 87.5 7.7 4.8 11.5 6.7 81.7
Funds, logistics and materials for programs/project 35.6 52.9 11.5 39.4 17.3 43.3
Monthly allowance/honorarium 74.0 2.9 23.1 29.8 17.3 52.9
Meals or meal allowance during duty 20.2 5.8 74.0 50.0 29.8 20.2
Transportation or transportation allowance 43.3 2.9 53.9 46.2 24.0 29.8
Communication allowance 26.9 5.8 67.3 53.9 26.0 20.2
Board and lodging, or commensurate allowance 40.4 2.9 56.7 39.4 24.0 36.5
Learning and development opportunities/activities 31.7 48.1 20.2 20.2 25.0 54.8
Note: Authors’ calculations based on online survey with DOH-HRH deployment program alumni. Caution must be exercised when interpreting
results from subpopulations with small sample sizes. Values for “All respondents” exclude 4 responses with no profession stated.

34
In terms of training benefits, the DTTB respondents are unanimous in their position that there
is sufficient training provided to them as part of the program package. However, it is a common
observation among other health worker participants that there is no training available for them.
When asked about the specific trainings they are expecting to be provided, several mentioned
basic life support and other trends in health care as suggestions. Moreover, trainings related to
administrative functions also surfaced. In general, the trainings mentioned are basically
capacity-building in nature.

As far as the program managers are concerned, trainings are part of what should be offered to
the HRH. When trainings are DOH-sanctioned or externally conducted, the DOH shoulders the
expenses incurred by the HRH. The program managers however did not mention a regular
training conducted for the HRH particularly for the nurses and midwives.

Some health care worker participants in the FGD also raised not receiving sufficient learning
and development interventions which may hinder their capacities to competently carry out the
tasks assigned to them. Based on discussions with health care workers, these training
interventions are seen as important in enhancing their professional skills and expanding their
knowledge about their disciplines. However, among respondents in the online survey, about a
third of nurses, and about a fifth of physicians never received any learning and development
opportunity during their deployment.

When asked about additional incentives that local governments provide to deployed health care
workers that they host, FGD participants from local governments mentioned providing
transportation or transportation allowance, and other funding for special activities. Some
program managers concede that additional incentives are not being provided by low-income
local governments due to budgetary concerns. In some cases, the travel expenses are provided
on a refund basis. Further, some local governments provide non-monetary incentives, including
rice, meals and vaccines.

Overall, majority of deployed workers who responded in the survey (81.7%) stated that they
are satisfied with the monthly compensation that they received (Table 12). However,
satisfaction is much lower for other program benefits: learning and development opportunities
(54.8%); monthly allowance/honorarium (52.9%); funds, logistics and materials for
programs/projects (43.3%); board and lodging allowance (36.5%); transportation allowance
(29.8%); meal allowance (20.2%); and communication allowance (20.2%). There appears to
be differences in satisfaction on the program benefits by profession, with deployed physicians
being generally more satisfied than deployed nurses.

The benefits from the DOH-HRH deployment program may also be in terms of perceived
professional standing. In the online survey with program alumni, we asked respondents to rate
themselves relative to other professionals in their field at three time points: before deployment,
right after deployment, and currently. Table 13 shows the average percentile rank that
respondents perceived themselves to be in each of these time points. The results suggest that
nurses who were accepted into the DOH-HRH deployment program perceived themselves to
be in the upper 30 percent of nurses before they were deployed, after which they rank
themselves higher at the upper 10 percent of nurses. Deployed physicians, on the other hand,
ranked themselves lower before deployment, with self-ranking averaging at 41.6-th percentile
of all physicians. Their self-ranking increases significantly right after deployment, averaging
65-th percentile, and years after, with their current self-ranking averaging at 68.8-th percentile.

35
Table 13. Percentile self-rating by selected characteristics
Before Right after
Currently
deployment deployment
All respondents (n=104) 52.0 72.3 76.3

By Profession
Midwives (n=3) 56.7 68.3 78.3
Nurses (n=35) 70.7 86.7 90.3
Physicians (n=66) 41.6 65.0 68.8

By Sex
Female (n=57) 50.3 70.9 76.6
Male (n=51) 53.8 73.7 75.9

By Marital Status
Ever married (n=15) 58.6 74.3 82.0
Single, dating (n=40) 49.5 71.5 73.8
Single, not dating (n=52) 51.8 72.2 76.4
Note: Authors’ calculations based on online survey with DOH-HRH deployment program alumni. Caution must
be exercised when interpreting results from subpopulations with small sample sizes. Values for “All
respondents” exclude 4 responses with no profession stated.

5.2.6. Retention and absorption

Program managers perceive the retention and absorption of deployed health care workers to be
an important concern that the DOH-HRH deployment program needs to work on. During FGDs
with program managers, some expressed their concern that local governments appear to lack
initiative to hire deployed HRH to eventually become part of the local government’s personnel,
or to open positions to be able to hire needed health care workers. A common observation
expressed by the program managers is the seeming complacency of the local governments due
to the availability of assistance provided through the DOH-HRH deployment program.

Many local government representatives, on other hand, expressed that their governments have
endeavored to hire more health care workers alongside the deployment from DOH. However,
based on discussions with these representatives, the growing mandates on local governments,
including those coming from DOH, have increased their workloads, which the deployed health
care workers are able to ease. Further, many local government representatives cited hiring caps
based on local government income, which effectively limits their capacity to hire more workers
whether for health services or in others.

Among deployed health care workers, some cited being discouraged by resistance from the
community, which contributed to their decision to discontinue pursuing certain services or
renewing deployment contracts. For example, some HRH participants mentioned having
encountered resistance from barangay officials and residents who are uncooperative or
unsupportive of the health care programs and services that deployed HRH offer. Few
respondents also mentioned the lack of legislative support from the barangay council, cultural
beliefs of some indigenous communities, and having to deal with other functions beyond one’s
36
job description to be factors which affect their decision to discontinue with the deployment
program. More respondents, nevertheless, are willing to continue and be renewed for another
contract for varying reasons.

Based on our online survey with DOH-HRH deployment program alumni, program attrition is
relatively low at about 2% (see Figure 5). Among survey respondents, attrition is observed only
among physicians with a rate of about 3%. Among those who reported not having finished their
deployment contract, the cited reasons include (1) being hired by the DOH-RO as a permanent
employee, (2) being homesick, and (3) not being able to submit required documents (for
contract renewal) on time.

The absorption rate of DOH-deployed health care workers is at 42% among respondents in our
online survey (see Figure 6). When disaggregated by profession, more than half of nurses
(54%) reported currently working in the place of their deployment. The absorption rate is lower
among physicians at only 33%. Interestingly, males are statistically more likely to report that
they are currently working in their area of deployment compared with females.

Figure 5. Attrition rate by selected characteristics

By Marital Status
Single, not dating (n=52)
Single, dating (n=40)
Ever married (n=15)

By Sex
Male (n=51)
Female (n=57)

By Profession
Physicians (n=66)
Nurses (n=35)
Midwives (n=3)

All respondents (n=104)

0 5 10 15
Share of respondents (%)

Note: Authors’ calculations based on online survey with DOH-HRH deployment program alumni. Caution must
be exercised when interpreting results from subpopulations with small sample sizes. Values for “All
respondents” exclude 4 responses with no profession stated.

37
Figure 6. Absorption rate by selected characteristics

By Marital Status
Single, not dating (n=52)
Single, dating (n=40)
Ever married (n=15)

By Sex
Male (n=51)
Female (n=57)

By Profession
Physicians (n=66)
Nurses (n=35)
Midwives (n=3)

All respondents (n=104)

0 20 40 60 80 100
Share of respondents (%)

Note: Authors’ calculations based on online survey with DOH-HRH deployment program alumni. Caution must
be exercised when interpreting results from subpopulations with small sample sizes. Values for “All
respondents” exclude 4 responses with no profession stated.

6. Summary and Recommendations

6.1. Summary

The DOH-HRH deployment program is an important mechanism that allows the continuous
delivery of health care services in underserved areas. This process evaluation aims to assess
the program design and logic, as well as document the insights and experiences of key
stakeholders, including program managers, health care workers, and local government
representatives, on its implementation.

Various design aspects of the program are laudable. In terms of organization, having the
program managed by national and regional institutions theoretically allows the program to
reallocate human resources for health from areas with relatively ample supply of health care
workers to areas where health care workers are of more limited supply. The benefits provided
by the program are above median wages for the professions being deployed, and matches
optimal wage premia calculated from a willingness to accept experiment.

38
However, there are some design aspects that may need to be rethought. For example, while the
program was originally designed to deploy in underserved areas, it has since expanded to
include practically any area in the country. As documented in this report, the DOH-HRH
deployment program has been deploying even in areas with high income, with high HRH-to-
population ratio, and with relatively low poverty incidence. While this may be beneficial to
receiving local governments and may promote political support to expand the national HRH
deployment program, this nonetheless may be fiscally and operationally suboptimal. Further,
while eventual absorption of deployed HRH by local governments has been one of the longer-
term goals of the program, policies to support this has not been built into the program.

The experiences of local governments appear to be generally positive, with all interviewed
being appreciative of hosting deployed health care workers. Many were proposing to have the
program be permanent. The experience of deployed health care workers, however, are more
varied. As we documented in this report, the receipt of program benefits and satisfaction over
it vary among survey respondents. Delay in receiving monthly compensation among deployed
health care workers is common, while transportation allowance is not provided in a relatively
large number of cases, which may negatively impact the experience of deployed HRH.

Overall, deployed health care workers appear to derive non-pecuniary benefits from being part
of the DOH-HRH deployment program. We have documented that survey respondents have
relatively high personal satisfaction in their work despite issues on access to necessary medical
equipment, supplies, and medications that they need to perform their job safely and efficiently,
as well as their perceived low support that they receive from the DOH. In addition, we also
document increase in self-assessed professional ranking among health care workers after their
participation in the national HRH deployment program.

Although attrition among health care workers appear to be rather small over the duration of
their deployment contracts, the propensity for retention and absorption in host communities is
also small. This is an important concern for many program managers. However, as we
documented in this report, this may be expected since even with the same benefits offered to
deployed health care workers, a substantial portion of them are likely to not accept continuing
working in their area of deployment. When combined with the fact that the offered
compensation by local governments is likely to be below those offered by the DOH-HRH
deployment program, more deployed health care workers are likely to not accept being
absorbed by the local government if offered a position. This highlights the need to better
understand the motivations of health care workers, as well as the resources available to local
governments to attract them.

6.2. Recommendations

Based on the results of this process evaluation, we propose several actions that may be taken
to further improve the DOH-HRH deployment program.

• The program may need to return its original focus of augmenting health care workers
in underserved areas. This will allow the program to focus its resources on areas where
its interventions are most needed. As we have noted in this report, the inclusion criteria for
deployment sites have become relatively more general in recent years, which has allowed
sending health care workers to practically any local government in the country. This may
be contrary to the original design of the program.

39
• Selection of deployment sites must be designed in a way to discourage dependence
among local governments. This may include designing a scoring system that puts higher
weights on local governments that have (a) long term plans to develop their own cadre of
health care workers, or have actually (b) initiated activities to attract and hire health care
workers. This may be balanced with counterweights for perceived needs of local
governments that the national government have stakes on. In this way, the program may be
able to ensure the continuous delivery of health care services across the country without
distorting the incentives for local governments to build its own local HRH capacity.

• The delivery of program benefits needs to be strengthened. As we have noted in this

report, except for the receipt of monthly compensation paid by the national government,
the receipt of other benefits due from local governments vary. Program benefits that are
necessary to provide health care services, such as meals and transportation allowance
during community visits, need to be provided, otherwise this negatively impacts the
experience of deployed health care workers, which reflect negatively on the program. In
addition, delays in providing these benefits need to be resolved.

• The program benefits may need to be increased in areas where recruitment success
rates are relatively low. This will allow greater incentivizes for health care workers to
consider being deployed in underserved areas. However, it must be designed in such a way
to not crowd-out the private sector in underserved areas. Rather, the program should
leverage on its design that allows it to reallocate human resources for health across space.

• The program needs to leverage on identified factors that contribute to HRH retention.
In this study, we have identified that health care workers respond to monetary incentives to
accept to continue working in their place of deployment after their DOH-HRH deployment
program contract. There is a need to identify other levers, including characteristics related
to the program, the host communities and governments, and the health care workers
themselves, that may be used to increase the chances of deployed HRH to continue working
in underserved areas even in cases where benefits need to be cut down.

• The pre-deployment orientation program may need to be expanded. The pre-

deployment orientation program is an important avenue for program managers to set and
manage expectations of health care workers to be deployed in host local governments.
Expanding the orientation program to areas critical to delivery of service by health care
workers, but also their personal welfare may be beneficial.

References

Abrigo, M.R.M., and D.A.P. Ortiz (2018). Devolution of health services, fiscal
decentralization, and antenatal care in the Philippines. Philippine Institute for
Development Studies Discussion Paper No. 2018-42. Quezon City,
Philippines: PIDS.

Abrigo, M.R.M., and D.A.P. Ortiz (2019). Who are the health workers and where are
they? Revealed preferences in location decision among health care

40
 professionals in the Philippines. Philippine Institute for Development Studies
Discussion Paper 2019-32. Quezon City, Philippines: PIDS.

Abrigo, M.R.M., and Z.C. Tam (2019). Situational analysis of distal factors affecting
early childhood and development in the first 1000 days of life in Zamboanga
del Norte. Philippine Institute for Development Studies Discussion Paper No.
2019-28. Quezon City, Philippines: PIDS.

Alonso-Garbayo, A., and J. Maben (2009). Internationally recruited nurses from India
and the Philippines in the United Kingdom: the decision to migrate. Human
Resources for Health, 7: 37.

Andaya, M. (2011). Assessment of the deployment program of DTTB vis-à-vis the

operational guidelines. Unpublished manuscript. Master’s Thesis. Pasig City,
Philippines. Development Academy of the Philippines.

Araujo, E., and A. Maeda (2013). How to recruit and retain health workers in rural
and remote areas in developing countries: A guidance note. Health, Nutrition
and Population Discussion Paper 78506. Washington, D.C.: The World Bank.

Astor, A., T. Akhtar, M.A. Matallana, V. Muthuswamy, F.A. Olowu, V. Tallo, and
R.K. Lie (2005). Physician migration: Views from professionals in Colombia,
Nigeria, India, Pakistan and the Philippines. Social Science & Medicine,
61(12), 2492-2500.

Avancena, A.L.V., K.P.S. Tejano, and D.W. Hutton (2019). Cost-effectiveness

analysis of a physician deployment program to improve access to healthcare in
rural and underserved areas in the Philippines. BMJ Open, 9: e033455.

Barnighausen, T., and D.E. Bloom (2009). Financial incentives for return service in
underserved areas: A systematic review. BMC Health Services Research, Vol. 9: 86.

Bureau of Local Government Finance [Philippines] (2020). Statement of Receipts and

Expenditures, F.Y. 2019. Database. Manila, Philippines: BLGF.

Dolea, C., L. Stromont, J.-M. Braichet (2010). Evaluated strategies to increase attraction and
retention of health workers in remote and rural areas. Bulletin of the World Health
Organization, 88, 379-385.

Dussault, G., and M.C. Franeschini (2006). Not enough there, too many here: Understanding
geographical imbalances in the distribution of the health workforce. Human
Resources for Health, 4:12.

Guagliardo, M.F. (2004). Spatial accessibility of primary care: Concepts, methods and
challenges. International Journal of Health Geographics, 3:3.

Lawas N.D., E.J.A. Faraon, M.S.T. Yanga-Mabunga, C.A.T. Antonio, E.M. Tobias,
and R.S. Javier (2016). An evaluation of the Medical Pool Placement and
Utilization Program (MedPool PUP) of the Philippine Department of Health.
Acta Medica Philippina, 50(3), 186-93.

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Lehmann U., M. Dieleman, and T. Martineau (2008). Staffing Remote Rural Areas in
Middle- and Low-Income Countries: A Literature Review of Attraction and
Retention. BMC Health Services Research, Vol. 8: 19.

Leonardia, J.A., H. Prytherch, K. Ronquillo, R.G. Nodora, and A. Ruppel (2012).

Assessment of factors influencing retention in the Philippine National Rural
Physician Deployment Program. BMC Health Services Research, 12: 411.

Lorenzo, F.M.E., J. Galvez-Tan, K. Icamina, and L. Javier (2007). Nurses migration

from a source country perspective: Philippine country case study. Health
Services Research, 42(3p2), 1406-1418.

Mandeville, K.L., M. Lagarde, and K. Hanson (2014). The use of discrete choice experiments
to inform health workforce policy: A systematic review. BMC Health Services
Research, 14:367.

McPake, B., A. Scoot and I. Edoka (2014). Analyzing markets for health workers: Insights
from Labor and Health Economics. Washington, D.C.: The World Bank.

National Statistics Office [Philippines] (2012). 2010 Census of Population. Data file.
Manila, Philippines: NSO.

Philippine Statistics Authority (2016). 2015 Census of Population. Data file. Quezon
City, Philippines: PSA.

Philippine Statistics Authority (2019a). City and municipal-level small area poverty
estimates, 2009, 2012 and 2015. Database. Quezon City, Philippines: PSA.

Philippine Statistics Authority (2019b). Labor Force Survey, October 2018. Data file.
Quezon City, Philippines: PSA.

Politico, M.R.S (2011). Doctors to the barrios program: An assessment of the

implementation and its sustainability. Unpublished manuscript. Master’s
Thesis. Pasig City, Philippines. Development Academy of the Philippines.

Reyes, E.A. and O.F. Picazo (1990). Health manpower employment and productivity
in the Philippines. Philippine Institute for Development Studies Working
Paper 1990-19. Makati City, Philippines: PIDS.

World Health Organization (2010). Increasing access to health workers in remote and rural
areas through improved retention: Global policy recommendations. Geneva,
Switzerland: WHO.

World Health Organization (2013). Human resources for health country profiles: Philippines.
Geneva, Switzerland: WHO.

World Health Organization (2016). Health workforce requirements for universal health care
and the sustainable development goals. Background paper no. 1 to the Global
Strategies on Human Resources for Health. Geneva, Switzerland: WHO.

42
Appendix

Appendix A. Interview Guide for Program Managers

Objectives
The key-informant interviews with program managers, including those from the DOH central
and regional offices, is designed to generate information on program logic, design,
implementation, and challenges as perceived by the key informants. It also aims to generate
recommendations to improve similar programs in the future.

Guide questions
Discuss the background of the study, and the objectives of the interview. Ask the respondents
to sign the prepared consent if they agree to be part of the discussion. Ask the participants to
introduce themselves starting with their names, their work and education history, and their
current role as program manager. Remind them to wait for them to be recognized before
speaking during the discussion to allow the documenter/transcriptionist to properly record the
proceedings.
*** Get sample or related statistics

A. Program design and logic

1. In your opinion, what is the objective of DOH’s Health Human Resource Deployment
Program? Based on your experience working with DOH, has that objective been always
the same? Do you feel that the objectives have been met so far?
2. What is your agency’s roles and responsibilities in the implementation of the HRH
DEPLOYMENT PROGRAM? Do you feel that your agency is able to effectively
perform its roles and responsibilities?

B. Deployment process
Can you walk us through the whole deployment process? What is your and your agency’s role
in each of these processes? How do you coordinate with other offices who you work with in
these activities? Please note recent changes in the processes and roles.
1. Identification of HRH DEPLOYMENT PROGRAM slots: How many slots are
available? How is this number arrived at? What information is used? Who decides on
these targets? ***
2. Selection of sites for deployment: How are the sites selected? How is the criteria
decided? What information is used? Is there a standard scoring mechanism? Who
decides on the sites? ***
3. Acceptance of requests for personnel augmentation from local government units
(LGU): How many requests do you get in a year? How do you rank these requests?
Who gets the final say? Are there instances where some requests are not met? ***
4. Recruitment and selection of HHR: What are the requirements for HRH to be part of
the program? How many HRH apply? How do you choose which HRH to hire? What
information do you use? Is there a scoring mechanism? Are there instances where you
do not hire HHR? If so, why? ***
5. Pre-deployment orientation (HHR) and social preparation (LGU): How do you prepare
the HHR/LGU before deployment? What are your clients’ feedback? Do you think this
activity is effective? ***
6. Deployment of HHR, including matching of HRH and LGU: How do you match HRH
to their deployment site? What information or ranking system do you use? Is there a
scoring mechanism? Can HRH say no? ***

43
 7. Monitoring and evaluation of HHR: How do you ensure that deployed HRH are doing
their work? How do you guard against HRH doing other work during deployment? How
do you ensure their safety? Are there instances when HHRs are not able to finish their
contract? What do you do in such instances? ***
8. Reentry of HHR: Are there instances where HRH gets deployed in multiple cycles?
Why do they choose to get re-deployed, in your opinion? Do you think this is good for
them? Is this good for the program? In your experience, what do HHRs do after their
contract under the HRH DEPLOYMENT PROGRAM? ***
9. Other activities to capacitate LGUs to hire HHR: Do you have programs to capacitate
LGUs to hire HRH on their own? If so, do you think these are effective? If not, do you
think the program should have one?

C. Program benefits
1. What benefits do HRH get from the HRH DEPLOYMENT PROGRAM? How are these
benefits identified? Do you feel that these benefits are insufficient, sufficient or more
than sufficient?
a. Basic pay
b. Allowances
c. Education and training opportunity
2. Do you feel that the benefits package may be improved? How?

D. Administration and financing

1. How is the HRH DEPLOYMENT PROGRAM funded? How is the budget arrived at?
Can you walk us through the steps and processes of your annual budget and expenditure
cycle? In your opinion, are the financial resources available for HRH DEPLOYMENT
PROGRAM sufficient? ***
2. Do you have data detailing the major expenditure items, e.g. planning, administration,
honoraria/basic pay, training, etc.? How does your unit determine how much should be
allocated to each expenditure item? ***
3. Are local governments expected to provide counterpart funding? What is the
counterpart funding for? How is your experience with LGUs on this regard so far? What
does the program do if LGUs are not able to provide counterpart funding? ***
4. How many people are in-charge of running the program in your agency? Can you
describe their roles? Are they working on HRH DEPLOYMENT PROGRAM full time?
Do you think this is enough to run the program most effectively? ***
5. Besides your designation as program manager for HRH DEPLOYMENT PROGRAM,
do you have other roles and responsibilities in your agency? Do these additional roles
and responsibilities improve or hinder your capacity to manage the HRH
DEPLOYMENT PROGRAM?

E. Sustainability
1. In your opinion, is HRH DEPLOYMENT PROGRAM a permanent program or a
transitory augmentation program? Should it be otherwise? Why do you think so?
2. What is the current political and administrative support for HRH DEPLOYMENT
PROGRAM? Is the current administration for its continuance? How has this changed
through the years?
3. With the current set up of the HRH DEPLOYMENT PROGRAM, in your opinion, do
you think its operations are sustainable? Do you see the program HRH DEPLOYMENT
PROGRAM continuing into the not so near future? How do you think HRH
DEPLOYMENT PROGRAM should change?

44
4. Recommendations
1. Besides those that were already mentioned, are there other issues or problems that you
have experienced with the implementation of the HRH DEPLOYMENT PROGRAM?
What do you think caused these problems?
2. In your opinion, what are the main areas of HRH DEPLOYMENT PROGRAM that
need improvement?
3. Are there lessons that you would like to share to future HRH DEPLOYMENT
PROGRAM managers?
4. Do you have other concerns about HRH DEPLOYMENT PROGRAM that you want
to talk about?

45
Appendix B. Interview Guide for Deployed Health Care Worker

Objectives
The key-informant interviews/focus group discussion with past and presently deployed HHRs
is designed to generate information on the HHRs experiences during the whole deployment
cycle, as well as their motivations for pursuing employment under the HRH DEPLOYMENT
PROGRAM and future employment trajectory. It also aims to generate recommendations to
improve similar programs in the future.

Guide questions
Discuss the background of the study, and the objectives of the interview. Ask the respondents
to sign the prepared consent if they agree to be part of the discussion. Ask the participants to
introduce themselves starting with their names, their work and education history, and their
current role engagement with the HRH DEPLOYMENT PROGRAM. If the interview is with
a group, remind them to wait for them to be recognized before speaking during the discussion
to allow the documenter/ transcriptionist to properly record the proceedings.

A. Program design and logic

1. In your opinion, what is the objective of DOH’s Health Human Resource Deployment
Program? Do you feel that the objectives have been met based on your experience?

B. Deployment process
Can you walk us through your experience with the whole deployment process?
1. Motivation: How did you learn of the HRH DEPLOYMENT PROGRAM? Why did
you apply? Is this your first choice for employment? Has your motivation changed now
relative to when you applied to HRH DEPLOYMENT PROGRAM?
2. Recruitment and selection of HHR: Can you tell me how you were recruited? What are
the requirements that you need to submit? Do you feel that these requirements are
sufficient?
3. Pre-deployment orientation: How did you prepare for the deployment? Was there an
orientation given? What was covered during the orientation? Do you feel that the
orientation prepared you enough? What areas need to be improved?
4. Deployment of HHR: What were your expectations about your deployment sites? Is
reality far from your expectations?
a. Please describe the characteristics of the resources (e.g. facilities, equipment,
supplies, living conditions, security, organizational support, etc.) available to you
during deployment? Do you feel that the support given to you is sufficient?
b. Please describe your roles and responsibilities during deployment.
c. Please describe a usual day during your deployment. How many patients do you
see? Did you do any administrative work? What do you do during weekends?
d. During the course of your deployment, where there instances where you do not want
to continue or be deployed in another site?
e. What did you enjoy most during your deployment?
f. What challenges did you face during deployment?
g. How was your relationship with the community (e.g., mayor, other personnel and
organic staff, patients)? How was your relationship with the program managers?
h. How would you rate the service you provided to the community? Do you feel that
you were appreciated by the community? With your experience and knowledge of

46
 the HRH DEPLOYMENT PROGRAM, will you still apply for HRH
DEPLOYMENT PROGRAM?
5. Monitoring and evaluation of HHR: How are you monitored by DOH? In your opinion,
is the monitoring and evaluation mechanism implemented by DOH fair and
appropriate?
6. Retention and absorption: Were you ever encouraged by the LGU or the DOH to
continue working in your deployment site? What strategies did they use? Why did you
decide to or not to continue working in the community where you were deployed? What
circumstances will make you continue working there?

C. Program benefits
1. What benefits did you get from the HRH DEPLOYMENT PROGRAM? How did you
receive these benefits? Were they provided on time?
d. Basic pay
e. Allowances
f. Education and training opportunity
2. In your opinion, do you think the benefits you provided were sufficient? Do you feel
that the benefits package may be improved? How?

D. Recommendations
1. Besides those that were already mentioned, are there other issues or problems that you
have experienced with the implementation of the HRH DEPLOYMENT PROGRAM?
What do you think caused these problems?
2. In your opinion, what are the main areas of HRH DEPLOYMENT PROGRAM that
need improvement?
3. Are there lessons that you would like to share to future HHRs in HRH DEPLOYMENT
PROGRAM?
4. Do you have other concerns about HRH DEPLOYMENT PROGRAM that you want
to talk about?

47
Appendix C. Interview Guide for Local Chief Executives

Objectives
The key-informant interviews/focus group discussion with local chief executives is designed
to generate information on the motivation and experiences of local government units in
requesting HRH augmentation from DOH and the benefits from having HRH in the
community. It also aims to generate recommendations to improve similar programs in the
future.

Guide questions
Discuss the background of the study, and the objectives of the interview. Ask the respondents
to sign the prepared consent if they agree to be part of the interview. Ask the participants to
introduce themselves starting with their names, their work and education history, and their
current role in the local government unit. If the interview is with a group, remind them to wait
for them to be recognized before speaking during the discussion to allow the documenter/
transcriptionist to properly record the proceedings.

A. Program design and logic

1. In your opinion, what is the objective of DOH’s Health Human Resource Deployment
Program? Do you feel that the objectives have been met based on your experience?

B. Deployment process
Can you walk us through your or your team’s experience with the whole process of requesting
for HRH augmentation?
1. Motivation: How did you learn about the DOH’s Health Human Resource Deployment
Program? Why did you apply for HRH augmentation? Were all your requests been
accepted positively? How does your request tie with your overall agenda for the local
government unit? How many times have you applied for HRH augmentation? What do
you think make it more likely for you to get HRH augmentation from DOH?
2. Request for HRH augmentation: Can you explain the process that you did to request for
HRH augmentation? What information did you provide? Did you have to show proof
that you have exerted all efforts to hire, but were not able to do?
3. Social preparation: How did you prepare for the deployment? Did you have a media
campaign to introduce the new HHR? What was the general sentiment of the
community about the possibility of having HRH augmentation in your municipality?
4. Deployment of HHR: What were your expectations about the HHR? Was the deployed
HRH able to satisfy your expectation? What resources did you provide to the HHR?
i. Please describe the characteristics of the resources (e.g. facilities, equipment,
supplies, living conditions, security, organizational support, etc.) that your LGU
provided to the deployed HHR? Do you feel that the support that you gave was
sufficient for the HRH to do their tasks?
j. Were you able to interact with deployed HHR? How was your relationship with the
deployed HHR? Do you find him/her generally agreeable? Helpful? Can you
describe the HHR’s positive qualities? How about qualities that needs
improvement?
k. How would you rate the service that the deployed HRH provided to the community?
Do you feel that the HRH was appreciated by the community? With your experience
and knowledge of the HRH DEPLOYMENT PROGRAM, will you still request
augmentation from HRH DEPLOYMENT PROGRAM?

48
 5. Monitoring and evaluation of HHR: Do you monitor the activities of the deployed
HHR? What information do you use? In your opinion, is the monitoring and evaluation
mechanism that your LGU implements fair and appropriate?
6. Retention and absorption: Have you encouraged the deployed HRH to continue
working in your community? What strategies did you use? Why did you decide to or
not to encourage the deployed HRH to continue working in your community? What
circumstances will make you hire the HHR?

C. Program benefits
1. What benefits did you provide to the deployed HHR? How did you fund these benefits?
Were the benefits provided on time?
g. Basic pay
h. Allowances
i. Education and training opportunity
2. In your opinion, do you think the benefits provided were sufficient? Do you feel that
the benefits package may be improved? How?

D. Recommendations
1. Besides those that were already mentioned, are there other issues or problems that you
have experienced with the implementation of the HRH DEPLOYMENT PROGRAM?
What do you think caused these problems?
2. In your opinion, what are the main areas of HRH DEPLOYMENT PROGRAM that
need improvement?
3. Are there lessons that you would like to share to future HHRs in HRH DEPLOYMENT
PROGRAM?

49
Appendix D. HRH Deployment Program Alumni Survey

PAGE 1: ABOUT THE SURVEY

The Philippine Institute for Development Studies (www.pids.gov.ph), a government think-
tank administratively attached to the National Economic Development Authority
(www.neda.gov.ph), in partnership with the Department of Health (www.doh.gov.ph), is
currently conducting a process evaluation of the government’s health human resource (HRH)
deployment program. This survey aims to document the experiences of program alumni to
further improve the government’s HRH deployment program. The target respondents of this
survey are DOH-HRH Deployment Program alumni who were deployed between 2014 and
2018.

This survey has about 60 questions and should take approximately 30 minutes to complete.
You may edit your response from the same device until you submit the completed survey
form.

PAGE 2: RESPONDENT ELIGIBILITY: HHRDP COHORT

1. Are you a DOH-HRH Deployment Program alumna/alumnus who participated in the
program between 2014 and 2018?
1 – Yes (Go to page 3)
2 – No (Go to page 4)
PAGE 3: RESPONDENT ELIGIBILITY: PROFESSION
2. What is your profession?
1 – Physician (Go to page 5)
2 – Nurse (Go to page 5)
3 – Midwife (Go to page 5)
4 – Others (Go to page 4)
PAGE 4: THANK YOU!
Thank you so much for participating in this survey! Your answer(s) have been recorded.
Unfortunately, your qualifications do not match this survey's eligibility requirements. We are
looking forward to have you in our next surveys.

If you have questions about the study or the survey, you may directly contact the Project
Director, Dr. Michael R.M. Abrigo ([email protected]).

PAGE 5: INFORMED CONSENT

Before we begin with the survey, please go through the following information to know more
about your rights as survey participant, the potential benefits and risks of the survey, and
details of whom to contact in case you have questions about this study.

Voluntary Participation
Your participation in this survey is voluntary. You may refuse to take part in the research or
exit the survey at any time without penalty. You are free to decline to answer or skip any
questions you find sensitive or are not comfortable answering.

Benefits and Risks

You will receive no direct benefits from participating in this study. However, your responses
may help us and the DOH understand what motivates health professional to seek deployment
to rural or remote areas. This information will be very useful to DOH in strategies for

50
advocacy, recruitment, and incentives.

There are no foreseeable risks involved in participating other than those encountered in day-
to-day life.

Confidentiality
Your answers will be stored initially with Google forms where data will be stored in a
password protected electronic format. Your name and email address will not be shared to the
DOH and will only be used by the PIDS research team for monitoring and follow-up
purposes. After the data has been downloaded, your name, email address, and telephone
number will be removed from this data set. Data will be stored in password protected
computers only the PIDS research team can access.

Your responses will remain anonymous and strictly confidential. Outside of the PIDS
research team, no one will be able to identify you or your answers, and no one will know
whether or not you participated in the study. You will also not be personally identified in any
publication or presentation about this study.

Contact
If you have questions about the study or the survey, you may contact directly contact the
Project Director, Dr. Michael R.M. Abrigo ([email protected]).

For questions about your rights as a study participant or grievances, you may contact the St.
Cabrini Medical Center - Asian Eye Institute (SCMC - AEI) Ethics Review Committee at
(632) 8-898-2020 loc. 815 or email [email protected].

3. Do you with to continue with the survey?

1 – Yes (Go to page 6)
2 – No (Go to page 4)

PAGE 6: CONSENT FORM

4. By affixing your complete name and email address in below fields, you are voluntarily
accepting to take part in the study. Your responses in this survey are strictly confidential.
Only consolidated responses will be presented in the study’s final report.
1 – First Name
2 – Middle Name
3 – Last Name
4 – Email address
5 – Telephone
6 – Province
7 – City/Municipality

PAGE 7: DEMOGRAPHIC CHARACTERISTICS

5. What is your sex at birth?
1 – Male
2 – Female
1 – Choose not to answer
6. When were you born? (Please specify birthday)
7. What is your civil status at the time of your deployment?
1 – Single and not exclusively dating

51
 2 – Single and exclusively dating
3 – Married/Living in
4 – Separated/Annulled/Divorced
5 – Widowed
6 – Others (specify)
8. At the time of your deployment, did you have at least one child or were expecting to
have a child?
1 – Yes, had child(ren)
2 – Yes, expecting a child
3 – No
9. What is your current civil status?
1 – Single and not exclusively dating
2 – Single and exclusively dating
3 – Married/Living in
4 – Separated/Annulled/Divorced
5 – Widowed
6 – Others (specify)
10. What is your father's highest educational attainment?
1 – No grade completed
2 – Some elementary
3 – Elementary graduate
4 – Some high school
5 – High school graduate
6 – Technical/Vocational certificate
7 – Some college
8 – College graduate or higher
11. Where did your father spend most of his childhood?
1 – Province
2 – City/Municipality
12. What is your mother's highest educational attainment?
1 – No grade completed
2 – Some elementary
3 – Elementary graduate
4 – Some high school
5 – High school graduate
6 – Technical/Vocational certificate
7 – Some college
8 – College graduate or higher
13. Where did your mother spend most of her childhood?
1 – Province
2 – City/Municipality
14. Which of the following amenities does your household have? Please tick all that
apply.
1 – Radio
2 – Television
3 – CD/VCD/DVD player
4 – Component/Stereo set
5 – Refrigerator/Freezer
6 – Stove with oven/Gas range
7 – Washing machine

52
 8 – Air conditioner
9 – Personal computer (e.g. desktop, laptop, notebook, netbook, tablet, etc.)
10 – Landline/Wireless telephone
11 – Cellular phone
12 – Car, jeep, or van
13 – Motorcycle/Tricycle
14 – Motorized boat/banca

PAGE 8: EDUCATION AND BOARD EXAMINATION

15. In what year did you earn your degree? Please use YYYY format.
16. Where did you earn your degree? (Please provide complete name)
1 – Name of school
2 – Province
3 – City/Municipality
17. What was your primary source of financing for school while you were studying?
Please choose one.
1 – Self (own income, savings)
2 – Family, immediate (parents, siblings, spouse)
3 – Family, extended (grandparents, uncles, aunts)
4 – Scholarship grant, private
5 – Scholarship grant, government
6 – Loans taken by self
7 – Loans taken by family
8 – Others (Please specify)
18. What were your other sources of financing for school while you were studying?
Please tick all that apply.
1 – Self (own income, savings)
2 – Family, immediate (parents, siblings, spouse)
3 – Family, extended (grandparents, uncles, aunts)
4 – Scholarship grant, private
5 – Scholarship grant, government
6 – Loans taken by self
7 – Loans taken by family
8 – Others (Please specify)
19. In what year did you first take your board examination? Please use YYYY format.
20. How many tries did it take you to pass your board examination?
1 – One
2 – Two
3 – Three
4 – Four
5 – Five or more
PAGE 9: CURRENT EMPLOYMENT (SECTION 1)
21. In the past week, did you work for at least one hour?
1 – Yes (Go to page 11)
2 – No (Go to page 10)

PAGE 10: CURRENT EMPLOYMENT (SECTION 2)

22. Although you did not work, did you have a job or business during the past week?
1 – Yes (Go to page 11)
2 – No (Go to page 13)

53
PAGE 11: CURRENT EMPLOYMENT (SECTION 3)
23. What was your primary occupation during the past week? (Please specify.)
1 – Physician (Go to page 5)
2 – Nurse (Go to page 5)
3 – Midwife (Go to page 5)
4 – Others (Go to page 4)
24. Where is your primary occupation primarily located?
1 – Province
2 – Municipality/City
25. What is the nature of your employment?
1 – Province Permanent job/ business/paid family work
2 – Short-term or seasonal or casual job/business/unpaid family work
26. For whom did you work for in the past week?
0 – Worked for private households
1 – Worked for private establishment
2 – Worked for government/government corporation
3 – Self-employed without any paid employee
4 – Employer in own family-operated farm or business
5 – Worked with pay in own family-operated farm or business
6 – Worked without pay in own family-operated farm or business
27. What is the total number of hours you worked for your primary occupation during the
past week? Please round your answer to nearest number of hours.
28. Did you want more hours of work during the past week?
1 – Yes
2 – No
29. Did you have another job or business during the past week?
1 – Yes
2 – No
30. What is the total number of hours you worked for all your jobs during the past week?
1 – Less than 40 hours (Go to page 15)
2 – 40 hours to less than 48 hours (Go to page 15)
3 – More than 48 hours (Go to page 12)

PAGE 12: CURRENT EMPLOYMENT (SECTION 4)

31. Why did you work for more than 48 hours during the past week?
1 – Wanted more earnings (Go to page 15)
2 – Requirements of the job (Go to page 15)
3 – Exceptional week (Go to page 15)
4 – Ambition, passion for the job (Go to page 15)
5 – Others (Please specify) (Go to page 15)

PAGE 13: CURRENTLY NOT EMPLOYED (SECTION 1)

32. Had opportunity for work existed last week or within two weeks, would have you
been available?
1 – Yes
2 – No
33. Did you look for work or try to establish a business during the past week?
1 – Yes (Go to page 15)
2 – No (Go to page 14)

54
PAGE 14: CURRENTLY NOT EMPLOYED (SECTION 2)
34. Why did you not look for work?
1 – Tired/Believe no work available
2 – Awaiting results of previous job applications
3 – Temporary illness/Disability
4 – Bad weather
5 – Waiting for rehire/Job recall
6 – Too young/Old or retired/Permanent disability
7 – Household, family duties
8 – Schooling/Training
9 – Others (Please specify)

PAGE 15: DOH-HRH DEPLOYMENT EXPERIENCE

35. How did you learn about the DOH-HRH Deployment Program? Please tick all that
apply.
1 – Radio
2 – TV
3 – Print media (newspaper, magazine, etc.)
4 – Social media (Facebook, Twitter, etc.)
5 – DOH website/office
6 – School
7 – Family
8 – Friends
9 – Others (Please specify)
36. In what year did your original appointment under the DOH Deployment Program
start?
1 – 2014
2 – 2015
3 – 2016
4 – 2017
5 – 2018
37. In what year did your appointment under the DOH Deployment Program end?
1 – 2014
2 – 2015
3 – 2016
4 – 2017
5 – 2018
6 – 2019
7 – Currently deployed
38. Where were you deployed? In case of multiple deployment sites, please provide the
location of last or most recent deployment.
1 – Province (Specify)
2 – Municipality (Specify)
39. Where did you submit your application to get admitted to the DOH-HHR Deployment
Program?
1 – DOH Central Office
2 – DOH Regional Office (or DOH ARMM if in ARMM) or extension offices
3 – Others (Please specify)

55
 40. Prior to your deployment, did you attend a Pre-Deployment Orientation Seminar
conducted by the DOH Regional Office (or DOH ARMM if deployed in ARMM)?
1 – Yes
2 – No
41. During your deployment, how many hours in an average week did you spend on the
following activities?
1 – Clinical work (Specify)
2 – Community health visits (Specify)
3 – Administrative work (Specify)
42. During your deployment, how many patients do you see for health consultation on an
average day?
43. During your deployment, did you ever work in a night duty?
1 – Yes
2 – No
44. If yes, were you accompanied by a LGU-hired health personnel?
1 – Yes
2 – No
3 – Not applicable; Did not work in night duty
45. Have you received the following incentives or support from the Department of Health
or the host Local Government Unit?
Never Once Once Once Once Once Once
every every every every every a
week two month three six year
weeks months months

Monthly compensation

Funds, logistics and materials

for health-related
programs/project

Monthly allowance or
honorarium

Meals or meal allowance

during tour of duty

Transportation or
transportation allowance

Communication allowance

Board and lodging, or

commensurate allowance

Learning and development

opportunities/activities

56
 46. To what extent can you say that you were satisfied or dissatisfied with following
incentives or support from the Department of Health or the host Local Government
Unit?
Very Somewhat Neither Somewhat Very
satisfied satisfied satisfied dissatisfied dissatisfied
nor
dissatisfied

Monthly compensation

Funds, logistics and

materials for health-related
programs/project

Monthly allowance or
honorarium

Meals or meal allowance

during tour of duty

Transportation or
transportation allowance

Communication allowance

Board and lodging, or

commensurate allowance

Learning and development

opportunities/activities

47. On an average month, how much did you receive for the following during your
deployment? Please put "0" if not provided by DOH or the host local government
unit.
1 – Monthly compensation
2 – Meal allowance (or value of provided meals)
3 – Transportation allowance (or value of provided transportation)
4 – Communication allowance
5 – Board and lodging (or value if provided in-kind)
48. During your deployment, to what extent would you have agreed or disagreed with the
following statements?
Neither
Strongly Strongly
Agree disagree Disagree
agree disagree
or agree

The community where I am assigned

generally appreciates my work.

57
My family supports my decision to
be part of the DOH deployment
program.

I find fulfillment in serving my

community.

Considering everything, I am satisfied

with my job.

I have good friends at work.

I feel that my views are respected at

work.

The government officials in the

community where I am assigned
appreciates my work.

The DOH appreciates my work.

The work I am doing is meaningful and

stimulating.

I know what is expected of me when I

come to work.

I feel that there is sufficient

opportunities to develop my career.

The job matches my skill and expertise.

I receive recognition for doing good

work.

I am satisfied with the support that I

receive from the DOH.

I am satisfied with the support that I

receive from the local government I
was assigned.

I receive words of encouragement from

DOH or local government personnel.

I have sufficient training to perform the

task expected of me.

58
I am fairly evaluated on my work.

I am satisfied with the quality of care

that my health facility can provide.

I can take time to eat lunch and snacks

every day.

The workload is manageable.

I have the flexibility to

balance workplace demands and my
personal life.

I have regular electricity at my

workplace.

I have clean running water at my

workplace.

My health facility has ready access to

essential drugs and medications.

I work with a competent local

government.

I have access to medical supplies that I

need to perform my job safely and
efficiently.

I have access to equipment that I need

to perform my job safely and
efficiently.

I feel safe working in the community

where I am deployed.

I feel safe living in the community

where I am deployed.

49. Were you able to finish your tour of duty under the DOH-HHR deployment program
contract?
1 – Yes
2 – No, please specify reason
50. After your DOH-HHR deployment program contract has ended, did you continue to
work in your place of assignment?
1 – Yes
2 – No, please specify reason

59
 51. If you were offered a position with the same benefits (compensation, allowance, etc.)
in your place of assignment, would you stay and continue working at your place of
deployment?
1 – Yes (Go to page 16)
2 – No (Go to page 17)

PAGE 16: WILLINGNESS TO ACCEPT LOCAL ASSIGNMENT (SECTION 1)

52. Suppose you are only to receive regular monthly compensation at 90% of the original
rate provided to you, would you have continued working?
1 – Yes
2 – No
53. Suppose you are only to receive regular monthly compensation at 80% of the original
rate provided to you, would you have continued working?
1 – Yes
2 – No
54. Suppose you are only to receive regular monthly compensation at 70% of the original
rate provided to you, would you have continued working?
1 – Yes (Go to page 18)
2 – No (Go to page 18)

PAGE 17: WILLINGNESS TO ACCEPT LOCAL ASSIGNMENT (SECTION 2)

55. How much total compensation per month would have you been willing to accept to
stay and continue working at your place of deployment?
1 – No amount will be enough
2 – Refuse to answer
2 – Specific amount (PhP)

PAGE 18: PROFESSIONAL STANDING

Please read the following described scenario carefully.

Think of a ladder as representing all professionals in your chosen field in the Philippines.
Imagine everyone in this group is standing somewhere on this ladder.

At the TOP of the ladder are professionals who are the best in your profession -- those who
are most skilled, the most liked, and the most valuable in your profession.

At the BOTTOM are professionals in your field who are the worst off -- those who are the
least skilled, the least liked, and the least valuable in your profession.

The higher up you are on the ladder, the closer you are to the people at the very top. The
lower you are on this ladder, the closer you are to the people at the very bottom.

Suppose the ladder has 100 steps, with 100 being the TOP (best) and 0 being the BOTTOM
(worst).

56. Where would you place your self on this ladder compared to other professionals in
your field BEFORE you were accepted into the DOH-HHR deployment program?
57. Where would you place your self on this ladder compared to other professionals in
your field IMMEDIATELY AFTER your tour of duty under the DOH-HHR
deployment program?

60
 58. Where would you place your self CURRENTLY on this ladder compared to other
professionals in your field?

PAGE 19: PERSONAL ATTITUDE AND BEHAVIOR

The following section asks questions about you that will help us understand more about your
personal attitudes and behaviors. Please answer the following questions as honestly as
possible. There are no right or wrong answers, and all your answers will remain strictly
confidential.
59. Please read the following descriptions below and rate to what degree they describe
you.
Very Mostly Somewhat Not Not like
much like me like me much me at
like me like me all

New ideas and projects sometimes

distract me from previous ones.

Setbacks don’t discourage me.

I have been obsessed with a certain

idea or project for a short time but
later lost interest.

I am a hard worker.

I often set a goal but later choose to

pursue a different one.

I have difficulty maintaining my

focus on projects that take more
than a few months to complete.

I finish whatever I begin.

I am diligent.

60. Suppose there is a rich philanthropist who presents to you the following options. The
philanthropist offers you either a sure:

(a) PhP100,000 that you will receive one year from today, OR
(b) Some amount less than PhP100,000 that you will receive today. You may think of
the difference as processing fee necessary to facilitate the release of the cash offer.

There are no conditions to the offer. You may spend the amount for whatever reason
you see fit.

How much money would you be willing to receive today to not wait for one whole
year to receive the full PhP100,000?

61
 61. Please read the following descriptions below and indicate how frequently you
experience them.
A good A little
All of Most of Some of None of
bit of of the
the time the time the time the time
the time time

How much of the time,

during the past month,
have you felt so down in
the dumps that nothing
could cheer you up?

During the past month,

how much of the time were
you a happy person?

How much of the time,

during the past month,
have you been a very
nervous person?

How much of the time,

during the past month,
have you felt calm and
peaceful?

How much of the time,

during the past month,
have you felt downhearted
and blue?

62. Please read the following descriptions below and indicate how frequently you
experience them.

Suppose you entered a raffle contest wherein the winner will win a pot money of
PhP10,000. There is no cost to joining the raffle. There are no conditions to the winnings.
Joining the raffle is entirely anonymous among entrants – only the organizer will know
who are in the raffle.

Suppose out of only TWO entrants in the raffle, you won. You received PHP 10,000. Will
you be willing to part some of your winning to the other entrant? If so, how much will
you be willing to give to the other player? Each other’s information will remain
anonymous among the two of you regardless of your decision.

You may give an amount between 0 (nothing) to 10,000 (all).

-END of SURVEY-

62
Appendix E. HRH Deployment Program Student Survey

PAGE 1: ABOUT THE SURVEY

The Philippine Institute for Development Studies (www.pids.gov.ph), a government think-

tank administratively attached to the National Economic Development Authority
(www.neda.gov.ph), in partnership with the Department of Health (www.doh.gov.ph), is
conducting a process evaluation of the government’s health human resource (HHR)
deployment program.

This survey aims to assess the potential future supply of health personnel who are willing to
be deployed in under-served areas in the Philippines under the government's deployment
program. The target respondents of this survey are Filipino students currently matriculating in
the Philippines under the following degree programs: (a) Medicine, (b) Nursing, or (c)
Midwifery.

This survey has about 30 questions and should take approximately 30 minutes to complete.
You may edit your response from the same device until you submit the completed survey
form.

PAGE 2: RESPONDENT ELIGIBILITY: HHRDP COHORT

4. Are you a Filipino student currently attending any of the following degree program in
the Philippines: (a) Medicine, (b) Nursing, or (c) Midwifery?
1 – Yes (Go to page 4)
2 – No (Go to page 3)

PAGE 3: THANK YOU!

Thank you so much for participating in this survey! Your answer(s) have been recorded.
Unfortunately, your qualifications do not match this survey's eligibility requirements. We are
looking forward to have you in our next surveys.

If you have questions about the study or the survey, you may directly contact the Project
Director, Dr. Michael R.M. Abrigo ([email protected]).

PAGE 4: INFORMED CONSENT

Before we begin with the survey, please go through the following information to know more
about your rights as survey participant, the potential benefits and risks of the survey, and
details of whom to contact in case you have questions about this study.

Voluntary Participation
Your participation in this survey is voluntary. You may refuse to take part in the research or
exit the survey at any time without penalty. You are free to decline to answer or skip any
questions you find sensitive or are not comfortable answering.

Benefits and Risks

You will receive no direct benefits from participating in this study. However, your responses
may help us and the DOH understand what motivates health professional to seek deployment
to rural or remote areas. This information will be very useful to DOH in strategies for
advocacy, recruitment, and incentives.

63
There are no foreseeable risks involved in participating other than those encountered in day-
to-day life.

Confidentiality
Your answers will be stored initially with Google forms where data will be stored in a
password protected electronic format. Your name and email address will not be shared to the
DOH and will only be used by the PIDS research team for monitoring and follow-up
purposes. After the data has been downloaded, your name, email address, and telephone
number will be removed from this data set. Data will be stored in password protected
computers only the PIDS research team can access.

Your responses will remain anonymous and strictly confidential. Outside of the PIDS
research team, no one will be able to identify you or your answers, and no one will know
whether or not you participated in the study. You will also not be personally identified in any
publication or presentation about this study.

Contact
If you have questions about the study or the survey, you may contact directly contact the
Project Director, Dr. Michael R.M. Abrigo ([email protected]).

For questions about your rights as a study participant or grievances, you may contact the St.
Cabrini Medical Center - Asian Eye Institute (SCMC - AEI) Ethics Review Committee at
(632) 8-898-2020 loc. 815 or email [email protected].

5. Do you with to continue with the survey?

1 – Yes (Go to page 5)
2 – No (Go to page 3)

PAGE 5: CONSENT FORM

3. By affixing your complete name and email address in below fields, you are voluntarily
accepting to take part in the study. Your responses in this survey are strictly confidential.
Only consolidated responses will be presented in the study’s final report.
1 – First Name
2 – Middle Name
3 – Last Name
4 – Email address
5 – Telephone
6 – Province
7 – City/Municipality

PAGE 6: DEMOGRAPHIC CHARACTERISTICS

63. What is your sex at birth?
1 – Male
2 – Female
1 – Choose not to answer
64. When were you born? (Please specify birthday)
65. What is your civil status at the time of your deployment?
1 – Single and not exclusively dating
2 – Single and exclusively dating

64
 3 – Married/Living in
4 – Separated/Annulled/Divorced
5 – Widowed
6 – Others (specify)
66. What is your father's highest educational attainment?
1 – No grade completed
2 – Some elementary
3 – Elementary graduate
4 – Some high school
5 – High school graduate
6 – Technical/Vocational certificate
7 – Some college
8 – College graduate or higher
67. Where did your father spend most of his childhood?
1 – Province (specify)
2 – City/Municipality (specify)
68. What is your mother's highest educational attainment?
1 – No grade completed
2 – Some elementary
3 – Elementary graduate
4 – Some high school
5 – High school graduate
6 – Technical/Vocational certificate
7 – Some college
8 – College graduate or higher
69. Where did your mother spend most of her childhood?
1 – Province (specify)
2 – City/Municipality (specify)
70. Which of the following amenities does your household have? Please tick all that
apply.
1 – Radio
2 – Television
3 – CD/VCD/DVD player
4 – Component/Stereo set
5 – Refrigerator/Freezer
6 – Stove with oven/Gas range
7 – Washing machine
8 – Air conditioner
9 – Personal computer (e.g. desktop, laptop, notebook, netbook, tablet, etc.)
10 – Landline/Wireless telephone
11 – Cellular phone
12 – Car, jeep, or van
13 – Motorcycle/Tricycle
14 – Motorized boat/banca

PAGE 7: EDUCATION
71. What is the name and address of the school you currently attending? Please provide
complete name.
1 – Name of school (specify)
2 – Province (specify)

65
 3 – City/Municipality (specify)
72. What degree program are you currently attending?
1 – Medicine
2 – Nursing
3 – Midwifery
73. What year level are you currently in? Specify year level standing, and not actual years
of studying.
1 – First Year
2 – Second Year
3 – Third Year
4 – Fourth Year
5 – Fifth Year or Higher
74. What is your primary source of financing for schooling? Please choose one.
1 – Self (own income, savings)
2 – Family, immediate (parents, siblings, spouse)
3 – Family, extended (grandparents, uncles, aunts)
4 – Scholarship grant, private
5 – Scholarship grant, government
6 – Loans taken by self
7 – Loans taken by family
8 – Others (Please specify)
75. What are your other sources of financing for schooling? Please tick all that apply.
1 – Self (own income, savings)
2 – Family, immediate (parents, siblings, spouse)
3 – Family, extended (grandparents, uncles, aunts)
4 – Scholarship grant, private
5 – Scholarship grant, government
6 – Loans taken by self
7 – Loans taken by family
8 – Others (Please specify)

PAGE 8: STUDENT STANDING

Please read the following described scenario carefully.

Think of a ladder as representing all students in your batch currently enrolled in your
program. Imagine everyone in this group is standing somewhere on this ladder.

At the TOP of the ladder are students who are the best in your batch – those who are most
skilled, the most liked, and the most valuable in your program.

At the BOTTOM are students in your batch who are the worst off – those who are the least
skilled, the least liked, and the least valuable in your program.

The higher up you are on the ladder, the closer you are to the people at the very top. The
lower you are on this ladder, the closer you are to the people at the very bottom.

Suppose the ladder has 100 steps, with 100 being the TOP (best) and 0 being the BOTTOM
(worst).

66
 76. Where would you place your self on this ladder compared to other students in your
batch currently enrolled in your program? (Range of 0-100)

PAGE 9: PERSONAL ATTITUDE AND BEHAVIOR

The following section asks questions about you that will help us understand more about your
personal attitudes and behaviors. Please answer the following questions as honestly as
possible. There are no right or wrong answers, and all your answers will remain strictly
confidential.

77. Please read the following descriptions below and rate to what degree they describe
you.
Very Mostly Somewhat Not Not like
much like me like me much me at
like me like me all

New ideas and projects sometimes

distract me from previous ones.

Setbacks don’t discourage me.

I have been obsessed with a certain

idea or project for a short time but
later lost interest.

I am a hard worker.

I often set a goal but later choose to

pursue a different one.

I have difficulty maintaining my

focus on projects that take more
than a few months to complete.

I finish whatever I begin.

I am diligent.

78. Suppose there is a rich philanthropist who presents to you the following options. The
philanthropist offers you either a sure:

(a) PhP100,000 that you will receive one year from today, OR
(b) Some amount less than PhP100,000 that you will receive today. You may think of
the difference as processing fee necessary to facilitate the release of the cash offer.

There are no conditions to the offer. You may spend the amount for whatever reason
you see fit.

How much money would you be willing to receive today to not wait for one whole
year to receive the full PhP100,000? (Range of 1Php-100,000Php)

67
 79. Please read the following descriptions below and indicate how frequently you
experience them.
All of Most of A good Some of A little None of
the time the time bit of the time of the the time
the time time

How much of the time,

during the past month,
have you felt so down in
the dumps that nothing
could cheer you up?

During the past month,

how much of the time were
you a happy person?

How much of the time,

during the past month,
have you been a very
nervous person?

How much of the time,

during the past month,
have you felt calm and
peaceful?

How much of the time,

during the past month,
have you felt downhearted
and blue?

80. Please read the following descriptions below and indicate how frequently you
experience them.
Suppose you entered a raffle contest wherein the winner will win a pot money of
PhP10,000. There is no cost to joining the raffle. There are no conditions to the winnings.
Joining the raffle is entirely anonymous among entrants -- only the organizer will know
who are in the raffle.

Suppose out of only TWO entrants in the raffle, you won. You received PHP 10,000. Will
you be willing to part some of your winning to the other entrant? If so, how much will
you be willing to give to the other player? Each other’s information will remain
anonymous among the two of you regardless of your decision.

You may give an amount between 0 (nothing) to 10,000 (all). (Range of 0-10,000)

PAGE 10: DOH-HHR DEPLOYMENT PROGRAM (SECTION 1)

68
 81. Have you ever heard of any DOH health human resource deployment program?
1 – Yes (Go to page 11)
2 – No (Go to page 12)

PAGE 11: DOH-HHR DEPLOYMENT PROGRAM (SECTION 2)

82. Which deployment programs have you ever heard of? Please tick all that apply.
1 – Doctors to the Barrios Program
2 – Medical Pool Placement and Utilization Program
3 – Post-residency Deployment Program
4 – Dentists Deployment Program
5 – Nurses Deployment Program
6 – Pharmacists Deployment Program
7 – Medical Technologists Deployment Program
8 – Universal Health Care Implementer Deployment Program/Project
9 – Public Health Associate Deployment Program
10 – Rural Health Midwives Placement Program
11 – Physical Therapists Deployment Program
12 – Others (specify)
83. How did you hear about the DOH Deployment Program? Please tick all that apply.
1 – Radio
2 – TV
3 – Print media (newspaper, magazine, etc.)
4 – Social media (Facebook, Twitter, etc.)
5 – DOH website/office
6 – School
7 – Family
8 – Friends
9 – Others (Please specify)
84. Please describe, in your own words, why you think the DOH instituted a health
human resource deployment program.
85. Please describe, in your own words, the benefits that you remember are provided for
deployed health care workers under the DOH deployment programs.

PAGE 12: DOH-HHR DEPLOYMENT PROGRAM (SECTION 3)

The DOH implements a Health Human Resources Deployment Program (HHRDP) that
covers the deployment of different health professionals, including physicians, nurses,
midwives, dentists, nutritionists/dieticians, medical technologists, pharmacists, physical
therapists, occupational therapists, and public health managers to rural and remote areas. It’s
overarching purpose is to improve health care access and health service delivery in under-
served areas.

Under the program, interested HRH follow a prescribed application process, and, if selected,
are deployed to pre-identified under-served areas, including: (a) geographically isolated and
disadvantaged areas, (b) municipalities with indigenous people, and (c) fourth to sixth class
municipalities, among others.

Now, suppose you have already graduated from school, and obtained the necessary board
certifications from the Philippine Regulatory Commission. You are available and ready to
practice your chosen profession. You have a number of options. Two of your options may be:

69
Option A – To work in a health facility in any of the Philippines’ major cities
OR
Option B – To be deployed to a rural or under-served area through the DOH-HRH
Deployment Program

If you choose Option A...

...and you are a Physician: The average basic compensation for an entry level position in
your profession is PHP28,000 (Range: PHP11,000 to PHP40,000). The position offered is
residency training in your chosen field of specialization, with the option for continuing sub-
specialization training once diplomate board examination is passed. Standard working hours
is 40 hours per week, but you will be on-call. Magna carta benefits are available if working in
a government health facility. Being in a city, you have access to common urban amenities,
including cellular phone signal, commercial centers, etc.

...and a Nurse: The average basic compensation for an entry level position in your
profession is PhP14,500 (Range: PHP10,000 to PHP18,000). The position offered is in a
tertiary hospital, and only involves clinical practice. Standard working hours is 40 hours per
week. Magna carta benefits are available if working in a government health facility. Being in
a city, you have access to common urban amenities, including cellular phone signal, cable
internet, commercial centers, etc.

...and a Midwife: average basic compensation for an entry level position in your profession
is PHP13,000 (Range: PHP9,000 to PHP17,000). The position offered is in a tertiary hospital,
and only involves clinical practice. Standard working hours is 40 hours per week. Magna
carta benefits are available if working in a government health facility. Being in a city, you
have access to common urban amenities, including cellular phone signal, cable internet,
commercial centers, etc.

If you are to choose Option B:

The position offered has guaranteed one year of funding. The position is available in one of
the country’s 4th to 6th class municipalities. Modest allowance for board, lodging and food,
as well as magna carta benefits and representation and travel allowance are provided. The
nearest urban area from the duty station is about three hours (2 hours by boat/motorcycle/foot
+ 1 hour by bus). Cellular phone signal is patchy and only available in the town proper. The
rural health unit has basic amenities and supplies. Standard working hours are 8:00am to
5:00pm from Monday to Friday. The job usually involves three days of community practice
in barangay communities, and two days of clinical practice in the rural health unit in the town
proper.

86. Please choose one of the following [sets] to be directed to the next set of questions.
1 – Set A (Go to page 13)
2 – Set B (Go to page 14)
3 – Set C (Go to page 15)
4 – Set D (Go to page 16)
5 – Set E (Go to page 17)
6 – Set F (Go to page 18)
7 – Set G (Go to page 19)
8 – Set H (Go to page 20)

70
 9 – Set I (Go to page 21)
10 – Set J (Go to page 22)

PAGE 13: SET A

For each of the following number, please read the following options provided to you. Please
rank them from your least preferred scenario (Value = 1) to your most preferred scenario
(Value = 5).

For reference, these are the monthly basic pay (and inter-quartile range) among professionals
aged 35 years or below based on the latest available data:

Physicians: PhP28,000 (Range: PhP11,000 to PhP44,000)

Nurses: PhP14,500 (Range: PhP10,000 to PhP18,000)
Midwives: PhP13,000 (Range: PhP9,000 to PhP17,000)

87. Please read the following options and rank them from your least preferred (Value = 1)
to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. There will be no
additional regular allowance provided. I may elect where I will be deployed,
depending on slot availability. Scheduled training sessions, which may count
towards my Continuing Professional Development requirements, will be
provided.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I have no choice on
where I will be deployed. Scheduled training sessions, which may count
towards my Continuing Professional Development requirements, will be
provided.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. My area of
deployment will be limited to the province where I or may parents' were
raised. Training opportunities are not guaranteed.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
There will be no additional regular allowance provided. I have no choice on
where I will be deployed. Scheduled training sessions, which may count
towards my Continuing Professional Development requirements, will be
provided.
5 – I choose not participate in the government's HHR deployment program
given the available options.

88. Please read the following options and rank them from your least preferred (Value = 1)
to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I may elect where I
will be deployed, depending on slot availability. Training opportunities are not
guaranteed.

71
 2 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. There will be no
additional regular allowance provided. My area of deployment will be limited
to the province where I or may parents' were raised. Scheduled training
sessions, which may count towards my Continuing Professional Development
requirements, will be provided.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
There will be no additional regular allowance provided. I may elect where I
will be deployed, depending on slot availability. Training opportunities are not
guaranteed.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. There will be no
additional regular allowance provided. I have no choice on where I will be
deployed. Training opportunities are not guaranteed.
5 – I choose not participate in the government's HHR deployment program
given the available options.

89. Please read the following options and rank them from your least preferred (Value = 1)
to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
There will be no additional regular allowance provided. My area of
deployment will be limited to the province where I or may parents' were
raised. Training opportunities are not guaranteed.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I have no choice on
where I will be deployed. Training opportunities are not guaranteed.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. Regular housing
and travel allowance will be provided. My area of deployment will be limited
to the province where I or may parents' were raised. Scheduled training
sessions, which may count towards my Continuing Professional Development
requirements, will be provided.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
There will be no additional regular allowance provided. My area of
deployment will be limited to the province where I or may parents' were
raised. Scheduled training sessions, which may count towards my Continuing
Professional Development requirements, will be provided.
5 – I choose not participate in the government's HHR deployment program
given the available options.

PAGE 14: SET B

For each of the following number, please read the following options provided to you. Please
rank them from your least preferred scenario (Value = 1) to your most preferred scenario
(Value = 5).

72
For reference, these are the monthly basic pay (and inter-quartile range) among professionals
aged 35 years or below based on the latest available data:

Physicians: PhP28,000 (Range: PhP11,000 to PhP44,000)

Nurses: PhP14,500 (Range: PhP10,000 to PhP18,000)
Midwives: PhP13,000 (Range: PhP9,000 to PhP17,000)

90. Please read the following options and rank them from your least preferred (Value = 1)
to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. My area of
deployment will be limited to the province where I or may parents' were
raised. Scheduled training sessions, which may count towards my Continuing
Professional Development requirements, will be provided.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I may elect where I
will be deployed, depending on slot availability. Scheduled training sessions,
which may count towards my Continuing Professional Development
requirements, will be provided.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
There will be no additional regular allowance provided. My area of
deployment will be limited to the province where I or may parents' were
raised. Training opportunities are not guaranteed.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
There will be no additional regular allowance provided. My area of
deployment will be limited to the province where I or may parents' were
raised. Scheduled training sessions, which may count towards my Continuing
Professional Development requirements, will be provided.
5 – I choose not participate in the government's HHR deployment program
given the available options.

91. Please read the following options and rank them from your least preferred (Value = 1)
to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I have no choice on
where I will be deployed. Training opportunities are not guaranteed.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I may elect where I
will be deployed, depending on slot availability. Scheduled training sessions,
which may count towards my Continuing Professional Development
requirements, will be provided.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
There will be no additional regular allowance provided. I have no choice on

73
 where I will be deployed. Scheduled training sessions, which may count
towards my Continuing Professional Development requirements, will be
provided.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
There will be no additional regular allowance provided. I may elect where I
will be deployed, depending on slot availability. Scheduled training sessions,
which may count towards my Continuing Professional Development
requirements, will be provided.
5 – I choose not participate in the government's HHR deployment program
given the available options.

92. Please read the following options and rank them from your least preferred (Value = 1)
to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
There will be no additional regular allowance provided. My area of
deployment will be limited to the province where I or may parents' were
raised. Training opportunities are not guaranteed.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I have no choice on
where I will be deployed. Training opportunities are not guaranteed.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. Regular housing
and travel allowance will be provided. My area of deployment will be limited
to the province where I or may parents' were raised. Scheduled training
sessions, which may count towards my Continuing Professional Development
requirements, will be provided.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
There will be no additional regular allowance provided. My area of
deployment will be limited to the province where I or may parents' were
raised. Scheduled training sessions, which may count towards my Continuing
Professional Development requirements, will be provided.
5 – I choose not participate in the government's HHR deployment program
given the available options.

PAGE 15: SET C

For each of the following number, please read the following options provided to you. Please
rank them from your least preferred scenario (Value = 1) to your most preferred scenario
(Value = 5).

For reference, these are the monthly basic pay (and inter-quartile range) among professionals
aged 35 years or below based on the latest available data:

Physicians: PhP28,000 (Range: PhP11,000 to PhP44,000)

Nurses: PhP14,500 (Range: PhP10,000 to PhP18,000)
Midwives: PhP13,000 (Range: PhP9,000 to PhP17,000)

74
93. Please read the following options and rank them from your least preferred (Value = 1)
to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. There will be no
additional regular allowance provided. My area of deployment will be limited
to the province where I or may parents' were raised. Training opportunities are
not guaranteed.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I have no choice on
where I will be deployed. Training opportunities are not guaranteed.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. My area of
deployment will be limited to the province where I or may parents' were
raised. Training opportunities are not guaranteed.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I may elect where I
will be deployed, depending on slot availability. Training opportunities are not
guaranteed.
5 – I choose not participate in the government's HHR deployment program
given the available options.

94. Please read the following options and rank them from your least preferred (Value = 1)
to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. My area of
deployment will be limited to the province where I or may parents' were
raised. Training opportunities are not guaranteed.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. Regular housing
and travel allowance will be provided. I have no choice on where I will be
deployed. Scheduled training sessions, which may count towards my
Continuing Professional Development requirements, will be provided.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
There will be no additional regular allowance provided. My area of
deployment will be limited to the province where I or may parents' were
raised. Training opportunities are not guaranteed.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
There will be no additional regular allowance provided. I may elect where I
will be deployed, depending on slot availability. Training opportunities are not
guaranteed.
5 – I choose not participate in the government's HHR deployment program
given the available options.

75
 95. Please read the following options and rank them from your least preferred (Value = 1)
to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. My area of
deployment will be limited to the province where I or may parents' were
raised. Scheduled training sessions, which may count towards my Continuing
Professional Development requirements, will be provided.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
There will be no additional regular allowance provided. I have no choice on
where I will be deployed. Scheduled training sessions, which may count
towards my Continuing Professional Development requirements, will be
provided.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. My area of
deployment will be limited to the province where I or may parents' were
raised. Training opportunities are not guaranteed.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I may elect where I
will be deployed, depending on slot availability. Training opportunities are not
guaranteed.
5 – I choose not participate in the government's HHR deployment program
given the available options.

PAGE 16: SET D

For each of the following number, please read the following options provided to you. Please
rank them from your least preferred scenario (Value = 1) to your most preferred scenario
(Value = 5).

For reference, these are the monthly basic pay (and inter-quartile range) among professionals
aged 35 years or below based on the latest available data:

Physicians: PhP28,000 (Range: PhP11,000 to PhP44,000)

Nurses: PhP14,500 (Range: PhP10,000 to PhP18,000)
Midwives: PhP13,000 (Range: PhP9,000 to PhP17,000)

96. Please read the following options and rank them from your least preferred (Value = 1)
to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I have no choice on
where I will be deployed. Training opportunities are not guaranteed.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
There will be no additional regular allowance provided. I have no choice on
where I will be deployed. Training opportunities are not guaranteed.

76
 3 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. There will be no
additional regular allowance provided. I may elect where I will be deployed,
depending on slot availability. Scheduled training sessions, which may count
towards my Continuing Professional Development requirements, will be
provided.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
There will be no additional regular allowance provided. I have no choice on
where I will be deployed. Scheduled training sessions, which may count
towards my Continuing Professional Development requirements, will be
provided.
5 – I choose not participate in the government's HHR deployment program
given the available options.

97. Please read the following options and rank them from your least preferred (Value = 1)
to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. My area of
deployment will be limited to the province where I or may parents' were
raised. Scheduled training sessions, which may count towards my Continuing
Professional Development requirements, will be provided.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
There will be no additional regular allowance provided. I may elect where I
will be deployed, depending on slot availability. Scheduled training sessions,
which may count towards my Continuing Professional Development
requirements, will be provided.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I may elect where I
will be deployed, depending on slot availability. Training opportunities are not
guaranteed.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
There will be no additional regular allowance provided. I have no choice on
where I will be deployed. Scheduled training sessions, which may count
towards my Continuing Professional Development requirements, will be
provided.
5 – I choose not participate in the government's HHR deployment program
given the available options.

98. Please read the following options and rank them from your least preferred (Value = 1)
to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I may elect where I
will be deployed, depending on slot availability. Training opportunities are not
guaranteed.

77
 2 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. There will be no
additional regular allowance provided. I have no choice on where I will be
deployed. Scheduled training sessions, which may count towards my
Continuing Professional Development requirements, will be provided.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I have no choice on
where I will be deployed. Training opportunities are not guaranteed.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
There will be no additional regular allowance provided. My area of
deployment will be limited to the province where I or may parents' were
raised. Scheduled training sessions, which may count towards my Continuing
Professional Development requirements, will be provided.
5 – I choose not participate in the government's HHR deployment program
given the available options.

PAGE 17: SET E

For each of the following number, please read the following options provided to you. Please
rank them from your least preferred scenario (Value = 1) to your most preferred scenario
(Value = 5).

For reference, these are the monthly basic pay (and inter-quartile range) among professionals
aged 35 years or below based on the latest available data:

Physicians: PhP28,000 (Range: PhP11,000 to PhP44,000)

Nurses: PhP14,500 (Range: PhP10,000 to PhP18,000)
Midwives: PhP13,000 (Range: PhP9,000 to PhP17,000)

99. Please read the following options and rank them from your least preferred (Value = 1)
to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I have no choice on
where I will be deployed. Training opportunities are not guaranteed.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I may elect where I
will be deployed, depending on slot availability. Training opportunities are not
guaranteed.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
There will be no additional regular allowance provided. I may elect where I
will be deployed, depending on slot availability. Scheduled training sessions,
which may count towards my Continuing Professional Development
requirements, will be provided.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. There will be no
additional regular allowance provided. I may elect where I will be deployed,

78
 depending on slot availability. Scheduled training sessions, which may count
towards my Continuing Professional Development requirements, will be
provided.
5 – I choose not participate in the government's HHR deployment program
given the available options.

100. Please read the following options and rank them from your least preferred
(Value = 1) to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. My area of
deployment will be limited to the province where I or my parents' were raised.
Training opportunities are not guaranteed.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. My area of
deployment will be limited to the province where I or my parents' were raised.
Training opportunities are not guaranteed.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I have no choice on
where I will be deployed. Scheduled training sessions, which may count
towards my Continuing Professional Development requirements, will be
provided.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
There will be no additional regular allowance provided. I may elect where I
will be deployed, depending on slot availability. Training opportunities are not
guaranteed.
5 – I choose not participate in the government's HHR deployment program
given the available options.

101. Please read the following options and rank them from your least preferred
(Value = 1) to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
There will be no additional regular allowance provided. I may elect where I
will be deployed, depending on slot availability. Training opportunities are not
guaranteed.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. There will be no
additional regular allowance provided. My area of deployment will be limited
to the province where I or my parents' were raised. Scheduled training
sessions, which may count towards my Continuing Professional Development
requirements, will be provided.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I have no choice on
where I will be deployed. Scheduled training sessions, which may count

79
 towards my Continuing Professional Development requirements, will be
provided.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
There will be no additional regular allowance provided. I may elect where I
will be deployed, depending on slot availability. Training opportunities are not
guaranteed.
5 – I choose not participate in the government's HHR deployment program
given the available options.

PAGE 18: SET F

For each of the following number, please read the following options provided to you. Please
rank them from your least preferred scenario (Value = 1) to your most preferred scenario
(Value = 5).

For reference, these are the monthly basic pay (and inter-quartile range) among professionals
aged 35 years or below based on the latest available data:

Physicians: PhP28,000 (Range: PhP11,000 to PhP44,000)

Nurses: PhP14,500 (Range: PhP10,000 to PhP18,000)
Midwives: PhP13,000 (Range: PhP9,000 to PhP17,000)

102. Please read the following options and rank them from your least preferred
(Value = 1) to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. My area of
deployment will be limited to the province where I or my parents' were raised.
Scheduled training sessions, which may count towards my Continuing
Professional Development requirements, will be provided.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I may elect where I
will be deployed, depending on slot availability. Scheduled training sessions,
which may count towards my Continuing Professional Development
requirements, will be provided.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
There will be no additional regular allowance provided. I have no choice on
where I will be deployed. Training opportunities are not guaranteed.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
There will be no additional regular allowance provided. My area of
deployment will be limited to the province where I or my parents' were raised.
Scheduled training sessions, which may count towards my Continuing
Professional Development requirements, will be provided.
5 – I choose not participate in the government's HHR deployment program
given the available options.

80
103. Please read the following options and rank them from your least preferred
(Value = 1) to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. There will be no
additional regular allowance provided. I may elect where I will be deployed,
depending on slot availability. Scheduled training sessions, which may count
towards my Continuing Professional Development requirements, will be
provided.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
There will be no additional regular allowance provided. I may elect where I
will be deployed, depending on slot availability. Scheduled training sessions,
which may count towards my Continuing Professional Development
requirements, will be provided.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
There will be no additional regular allowance provided. I have no choice on
where I will be deployed. Scheduled training sessions, which may count
towards my Continuing Professional Development requirements, will be
provided.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I have no choice on
where I will be deployed. Training opportunities are not guaranteed.
5 – I choose not participate in the government's HHR deployment program
given the available options.

104. Please read the following options and rank them from your least preferred
(Value = 1) to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I have no choice on
where I will be deployed. Scheduled training sessions, which may count
towards my Continuing Professional Development requirements, will be
provided.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I have no choice on
where I will be deployed. Training opportunities are not guaranteed.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I have no choice on
where I will be deployed. Scheduled training sessions, which may count
towards my Continuing Professional Development requirements, will be
provided.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
There will be no additional regular allowance provided. I have no choice on
where I will be deployed. Training opportunities are not guaranteed.

81
 5 – I choose not participate in the government's HHR deployment program
given the available options.

PAGE 19: SET G

For each of the following number, please read the following options provided to you. Please
rank them from your least preferred scenario (Value = 1) to your most preferred scenario
(Value = 5).

For reference, these are the monthly basic pay (and inter-quartile range) among professionals
aged 35 years or below based on the latest available data:

Physicians: PhP28,000 (Range: PhP11,000 to PhP44,000)

Nurses: PhP14,500 (Range: PhP10,000 to PhP18,000)
Midwives: PhP13,000 (Range: PhP9,000 to PhP17,000)

105. Please read the following options and rank them from your least preferred
(Value = 1) to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. Regular housing
and travel allowance will be provided. My area of deployment will be limited
to the province where I or my parents' were raised. Scheduled training
sessions, which may count towards my Continuing Professional Development
requirements, will be provided.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
There will be no additional regular allowance provided. I may elect where I
will be deployed, depending on slot availability. Training opportunities are not
guaranteed.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. Regular housing
and travel allowance will be provided. My area of deployment will be limited
to the province where I or my parents' were raised. Training opportunities are
not guaranteed.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
There will be no additional regular allowance provided. My area of
deployment will be limited to the province where I or my parents' were raised.
Training opportunities are not guaranteed.
5 – I choose not participate in the government's HHR deployment program
given the available options.

106. Please read the following options and rank them from your least preferred
(Value = 1) to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
There will be no additional regular allowance provided. My area of
deployment will be limited to the province where I or my parents' were raised.
Training opportunities are not guaranteed.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.

82
 Regular housing and travel allowance will be provided. I may elect where I
will be deployed, depending on slot availability. Scheduled training sessions,
which may count towards my Continuing Professional Development
requirements, will be provided.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. There will be no
additional regular allowance provided. My area of deployment will be limited
to the province where I or my parents' were raised. Training opportunities are
not guaranteed.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
There will be no additional regular allowance provided. I have no choice on
where I will be deployed. Scheduled training sessions, which may count
towards my Continuing Professional Development requirements, will be
provided.
5 – I choose not participate in the government's HHR deployment program
given the available options.

107. Please read the following options and rank them from your least preferred
(Value = 1) to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
There will be no additional regular allowance provided. My area of
deployment will be limited to the province where I or my parents' were raised.
Training opportunities are not guaranteed.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. Regular housing
and travel allowance will be provided. My area of deployment will be limited
to the province where I or my parents' were raised. Training opportunities are
not guaranteed.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I may elect where I
will be deployed, depending on slot availability. Scheduled training sessions,
which may count towards my Continuing Professional Development
requirements, will be provided.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I may elect where I
will be deployed, depending on slot availability. Scheduled training sessions,
which may count towards my Continuing Professional Development
requirements, will be provided.
5 – I choose not participate in the government's HHR deployment program
given the available options.

PAGE 20: SET H

For each of the following number, please read the following options provided to you. Please
rank them from your least preferred scenario (Value = 1) to your most preferred scenario
(Value = 5).

83
For reference, these are the monthly basic pay (and inter-quartile range) among professionals
aged 35 years or below based on the latest available data:

Physicians: PhP28,000 (Range: PhP11,000 to PhP44,000)

Nurses: PhP14,500 (Range: PhP10,000 to PhP18,000)
Midwives: PhP13,000 (Range: PhP9,000 to PhP17,000)

108. Please read the following options and rank them from your least preferred
(Value = 1) to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. My area of
deployment will be limited to the province where I or my parents' were raised.
Scheduled training sessions, which may count towards my Continuing
Professional Development requirements, will be provided.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
There will be no additional regular allowance provided. My area of
deployment will be limited to the province where I or my parents' were raised.
Training opportunities are not guaranteed.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
There will be no additional regular allowance provided. I may elect where I
will be deployed, depending on slot availability. Training opportunities are not
guaranteed.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I may elect where I
will be deployed, depending on slot availability. Scheduled training sessions,
which may count towards my Continuing Professional Development
requirements, will be provided.
5 – I choose not participate in the government's HHR deployment program
given the available options.

109. Please read the following options and rank them from your least preferred
(Value = 1) to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. My area of
deployment will be limited to the province where I or my parents' were raised.
Scheduled training sessions, which may count towards my Continuing
Professional Development requirements, will be provided.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I may elect where I
will be deployed, depending on slot availability. Scheduled training sessions,
which may count towards my Continuing Professional Development
requirements, will be provided.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.

84
 There will be no additional regular allowance provided. My area of
deployment will be limited to the province where I or my parents' were raised.
Scheduled training sessions, which may count towards my Continuing
Professional Development requirements, will be provided.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I may elect where I
will be deployed, depending on slot availability. Training opportunities are not
guaranteed.
5 – I choose not participate in the government's HHR deployment program
given the available options.

110. Please read the following options and rank them from your least preferred
(Value = 1) to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
There will be no additional regular allowance provided. My area of
deployment will be limited to the province where I or my parents' were raised.
Training opportunities are not guaranteed.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
There will be no additional regular allowance provided. I may elect where I
will be deployed, depending on slot availability. Training opportunities are not
guaranteed.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I have no choice on
where I will be deployed. Training opportunities are not guaranteed.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. Regular housing
and travel allowance will be provided. My area of deployment will be limited
to the province where I or my parents' were raised. Training opportunities are
not guaranteed.
5 – I choose not participate in the government's HHR deployment program
given the available options.

PAGE 21: SET I

For each of the following number, please read the following options provided to you. Please
rank them from your least preferred scenario (Value = 1) to your most preferred scenario
(Value = 5).

For reference, these are the monthly basic pay (and inter-quartile range) among professionals
aged 35 years or below based on the latest available data:

Physicians: PhP28,000 (Range: PhP11,000 to PhP44,000)

Nurses: PhP14,500 (Range: PhP10,000 to PhP18,000)
Midwives: PhP13,000 (Range: PhP9,000 to PhP17,000)

111. Please read the following options and rank them from your least preferred
(Value = 1) to your most preferred (Value = 5) scenario.

85
 1 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
There will be no additional regular allowance provided. I may elect where I
will be deployed, depending on slot availability. Training opportunities are not
guaranteed.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. There will be no
additional regular allowance provided. My area of deployment will be limited
to the province where I or my parents' were raised. Scheduled training
sessions, which may count towards my Continuing Professional Development
requirements, will be provided.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
There will be no additional regular allowance provided. My area of
deployment will be limited to the province where I or my parents' were raised.
Scheduled training sessions, which may count towards my Continuing
Professional Development requirements, will be provided.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. There will be no
additional regular allowance provided. I have no choice on where I will be
deployed. Training opportunities are not guaranteed.
5 – I choose not participate in the government's HHR deployment program
given the available options.

112. Please read the following options and rank them from your least preferred
(Value = 1) to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. Regular housing
and travel allowance will be provided. I have no choice on where I will be
deployed. Training opportunities are not guaranteed.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
There will be no additional regular allowance provided. I have no choice on
where I will be deployed. Training opportunities are not guaranteed.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
There will be no additional regular allowance provided. I have no choice on
where I will be deployed. Scheduled training sessions, which may count
towards my Continuing Professional Development requirements, will be
provided.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
There will be no additional regular allowance provided. My area of
deployment will be limited to the province where I or my parents' were raised.
Training opportunities are not guaranteed.
5 – I choose not participate in the government's HHR deployment program
given the available options.

113. Please read the following options and rank them from your least preferred
(Value = 1) to your most preferred (Value = 5) scenario.

86
 1 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
There will be no additional regular allowance provided. I may elect where I
will be deployed, depending on slot availability. Scheduled training sessions,
which may count towards my Continuing Professional Development
requirements, will be provided.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
There will be no additional regular allowance provided. My area of
deployment will be limited to the province where I or my parents' were raised.
Training opportunities are not guaranteed.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. Regular housing
and travel allowance will be provided. I have no choice on where I will be
deployed. Scheduled training sessions, which may count towards my
Continuing Professional Development requirements, will be provided.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. Regular housing
and travel allowance will be provided. I may elect where I will be deployed,
depending on slot availability. Training opportunities are not guaranteed.
5 – I choose not participate in the government's HHR deployment program
given the available options.

PAGE 22: SET J

For each of the following number, please read the following options provided to you. Please
rank them from your least preferred scenario (Value = 1) to your most preferred scenario
(Value = 5).

For reference, these are the monthly basic pay (and inter-quartile range) among professionals
aged 35 years or below based on the latest available data:

Physicians: PhP28,000 (Range: PhP11,000 to PhP44,000)

Nurses: PhP14,500 (Range: PhP10,000 to PhP18,000)
Midwives: PhP13,000 (Range: PhP9,000 to PhP17,000)

114. Please read the following options and rank them from your least preferred
(Value = 1) to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I have no choice on
where I will be deployed. Training opportunities are not guaranteed.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I may elect where I
will be deployed, depending on slot availability. Training opportunities are not
guaranteed.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I may elect where I

87
 will be deployed, depending on slot availability. Training opportunities are not
guaranteed.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
There will be no additional regular allowance provided. I have no choice on
where I will be deployed. Scheduled training sessions, which may count
towards my Continuing Professional Development requirements, will be
provided.
5 – I choose not participate in the government's HHR deployment program
given the available options.

115. Please read the following options and rank them from your least preferred
(Value = 1) to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I have no choice on
where I will be deployed. Scheduled training sessions, which may count
towards my Continuing Professional Development requirements, will be
provided.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
There will be no additional regular allowance provided. My area of
deployment will be limited to the province where I or my parents' were raised.
Scheduled training sessions, which may count towards my Continuing
Professional Development requirements, will be provided.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I may elect where I
will be deployed, depending on slot availability. Training opportunities are not
guaranteed.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 150% higher relative to national average for my profession.
Regular housing and travel allowance will be provided. I have no choice on
where I will be deployed. Scheduled training sessions, which may count
towards my Continuing Professional Development requirements, will be
provided.
5 – I choose not participate in the government's HHR deployment program
given the available options.

116. Please read the following options and rank them from your least preferred
(Value = 1) to your most preferred (Value = 5) scenario.
1 – I will participate in the government's HHR deployment program. Monthly
compensation is 100% higher relative to national average for my profession.
There will be no additional regular allowance provided. I may elect where I
will be deployed, depending on slot availability. Training opportunities are not
guaranteed.
2 – I will participate in the government's HHR deployment program. Monthly
compensation is 50% higher relative to national average for my profession.
There will be no additional regular allowance provided. My area of
deployment will be limited to the province where I or my parents' were raised.

88
Scheduled training sessions, which may count towards my Continuing
Professional Development requirements, will be provided.
3 – I will participate in the government's HHR deployment program. Monthly
compensation is same as national average for my profession. There will be no
additional regular allowance provided. I have no choice on where I will be
deployed. Scheduled training sessions, which may count towards my
Continuing Professional Development requirements, will be provided.
4 – I will participate in the government's HHR deployment program. Monthly
compensation is 200% higher relative to national average for my profession.
There will be no additional regular allowance provided. I have no choice on
where I will be deployed. Training opportunities are not guaranteed.
5 – I choose not participate in the government's HHR deployment program
given the available options.

-END of SURVEY-

89