Nursing, med grads in PH get little support and low pay in local hospitals: Ateneo study

A health worker in a PPE cools herself in front of a fan at a testing center in Navotas City on August 20, 2020. George Calvelo, ABS-CBN News/File

MANILA — Filipinos who earned a degree in nursing or medicine struggle in securing jobs, getting fair pay and meaningful roles in the local public health setting, according to a study by Ateneo de Manila University.

In peer-reviewed paper entitled "Health Workforce Issues and Recommended Practices in the Implementation of Universal Health Coverage in the Philippines", Ateneo researchers found that many graduates feel "lost and unsupported" as they join the workforce.

This comes as the Department of Health recently recognized the lack of healthcare workers as among "major roadblocks" in achieving its goal of Filipinos to be "among the healthiest in Asia by 2040."

The DOH has acknowledged that the Philippines lacks 195,116 healthcare workers, including nurses.

The researchers said the Philippines has fewer than eight doctors per 10,000 people, which is below the international standard of 10:10,000.

They said there are over 127,000 vacancies for nurses, particularly in rural areas and private facilities.

Researchers quoted a munincipal health officer assigned to a remote area.

 “I finished my MD from one of the best schools in the country,” they said. “But when I worked here, it was an entirely different ballgame. We weren’t trained how to deal with the local administration and procurement, how to talk to local chief executives. I wasn’t prepared nor trained for this—but this is how we make things happen.”

The study explained that "the country’s medical and nursing education system is too focused on hospital-based care" which leaves health professionals unequipped to work within communities, government systems, and other health programs.

It also pointed out that many health facilities suffer from restrictive hiring rules and budget ceilings that hinder filling vacant posts.

Researchers said local government units are required to allocate no more than 45 percent of their annual budget to salaries of health professionals, which they said "forces overworked nurses to take on multiple roles, often without additional pay."

“The 45% cap on personnel services really prevents us from hiring,” said a case study who works for provincial health field.

“You see a ward nurse being assigned as the public health nurse… and also as a records officer. That’s extra work, no extra compensation.”

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NO JOB SECURITY FOR HEALTH WORKERS IN PH?

Ateneo researchers said graduates of nursing and medicine are caught in a dilemma: work in public sector, but either not qualified under strict civil service requirements or offered short term contracts.

They said both public and private facilities "lose workers to better-paying jobs abroad", as the latter supposedly struggle to match government's compensation.

“The nurses we lost are our best nurses,” said one hospital administrator. “It is painful that the trained ones are the ones who leave. The ones left with us are either the new ones or the very old.”

In 2023, a proposal was filed seeking to mandate new Filipino doctors and nurses to work in the country for a year before they can serve other countries.

This received backlash from netizens, especially from healthcare workers, who pointed out that they are in charge of their own careers and the problem on shortage of health professionals in the country stemmed from low compensation.

Nurses and doctors are often faced to a difficult choice: should they choose to serve their families or the country, as high-income countries often entice them with good offer amid global shortage of health professionals.

Family or country? The hard choice Filipino nurses must make

Resarchers added that training for health workers remain a problem as well, as they claimed some are forced to pay training fees and accreditation on their own.

The researchers emphasized that pursuing a career in healthcare remains worthy, but only if "key reforms are made, including scholarships with return service agreements; better integration of community health in school curricula; less restrictive hiring policies; and stronger support for newly-deployed health workers."