Beruflich Dokumente
Kultur Dokumente
Acronyms:
BLE – Bureau of Local Employment
DBM – Department of Budget and Management
DTTB – Doctors to the Barrios
GHWA – Global Health Workforce Alliance
HHR – Health Human Resource
HHRDB – Health Human Resource Development Bureau
IMS – Information Management System
ICT – Information and Communications Technologies
MNCHN – Maternal, Neonatal and Child Health and Nutrition
MMR – Maternal Mortality Rate
MDGs – Millennium Development Goals
NDHS – National Demographic and Health Survey
PHAP – Private Hospitals Association of the Philippines
PHIP – Province-wide Investment Plan for Health
PNA – Philippine Nurses Association
PRC – Professional Regulatory Commission
DAPCN – Dean’s Association of the Philippine Colleges of Nursing
POEA – Philippine Overseas Employment Administration
SBA – Skilled birth attendant
TBA - Traditional birth attendant
UFMR – Under Five Mortality Rate
I. RATIONALE
The Philippines is one of the signatory nations of the Millennium Development Goals
(MDGs), aiming to improve the maternal, infant and child health of the country. The indicators in
achieving the goals are 1.) reduction of Maternal Mortality Rate (MMR) by three quarters (3/4) and
2.) increase of birth proportion attended by skilled health personnel. The target MMR reduction of
the Philippines is 52 deaths per 100,000 live births and that 90% of all births should be assisted by
skilled attendants by 2015.
The MDGs Midterm Report for 2007 however showed that the MMR has decreased at a
very slow rate in the Philippines. From the 172 deaths on a 1998 National Demographic and Health
Survey (NDHS), it declined to only 162 deaths in 2006. Over half of births occurred at home and
one-third of them were assisted by traditional birth attendants (TBAs). Around 75 percent of the
poorest quantile do not have access to skilled birth attendants (SBAs). Furthermore, 29 Filipino
children (out of 1,000 live births) die before reaching their first birthday. The leading causes of these
deaths are pneumonia, bacterial sepsis of the newborn, and disorders related to pre-mature births.
Forty (40) children (out of 1,000 live births) die before they reach 5 years old, most common cause
of which are pneumonia, accidents and diarrhea.
It could be noted that these deaths are caused by poor access to critical maternal, neonatal
and child health and nutrition (MNCHN) services. These services include family planning, prenatal
care, skilled birth attendance and immunization. The poor access is partly due to a lack of qualified
personnel at various levels of care especially the front liners in underserved areas.
There is shortage of qualified health personnel and they tend to flock in urban areas. This is
aggravated by the recruitment of developed countries. For a country that exports doctors, nurses
and midwives, the Philippines, unfortunately has the following health personnel to population ratio:
Table 1: HHR to population and patient ratio (WHO Updates, 2008 and PHAP, 2005)
In 2002, there were 658 doctors in government hospitals in the NCR, in contrast to the 85
doctors in CAR and 69 in ARMM. In 2004, there were 197 private and public hospitals in the NCR in
contrast to the 54 hospitals in CAR and 17 in ARMM.
Poor access to health-care significantly affects the quality of life in a region’s population.
While the mortality rate in the NCR is 8 per 1,000 children below five, the figure in CAR is 20 for
every 1,000 children. It is worse in ARMM where the child-mortality is 33 for every 1,000 children.
Women in the ARMM are likely to receive postnatal care several months longer than the average
Filipinos.
The three conditions go into a futile cycle where the increase of demand from foreign
countries draw job seekers in the urban centers where they can scout for job vacancies abroad
from recruitment agencies. Health professionals flock in big private and public hospitals (250-bed
capacity) for better work experience and availability of short term contracts. The lack of information
on vacancies, incentive packages and availability of individual health professionals lead to “frictional
local unemployment”. Hence, there exists a shortage of health professionals in rural areas resulting
to poor access to health care.
There are, however, several opportunities in the health sector that could be taken advantage
of in order to address the various factors that affect health human resources production,
deployment and retention: First is the glut among nurses and physicians due to overproduction and
decreased level of outmigration exceeds demand for them. PRC claimed in 2008 that the country
has a surplus of about 400,000 nurses, over 100,000 registered professional nurses are produced
every year. IMAP in 2009 claimed that 1,000-2,000 midwives are produced every year while the
DOH and LGU plantilla (15,600 health center midwives) jobs for them has not increased. Second is
the increase in budget of the DOH. This increase provides opportunities for leveraging LGU
investments in health human resources and realignment of DOH program budgets for hiring
contractual staff for strategic deployment. Third is the MNCHN and grant facility that provides
additional resources to address the high maternal and child deaths in our country. Fourth is a strong
political commitment from the Secretary of Health and other partners to reduce the maternal
mortality rate (MMR) and the under-five mortality rate (UFMR) in the country. Fifth, there is growing
presence and experience of information and communications technology applications that can
facilitate recruitment, matching and deployment of health care providers. The use of ICT to assist
the recruitment, matching and deployment of HHR shall be the focus of this paper.
II. OBJECTIVES
The project aims to develop a sustainable health human resources job placement/matching
portal using the available information and communications technology.
Specifically, the project shall: 1.) Develop a web-based placement portal including beta
testing and soft launching 2.) Development of guidelines and operational manual on the web-based
placement portal.
III. CONCEPTUAL FRAMEWORK
The DOH envisions that each health center should have a health team which includes a doctor,
nurse, midwife, dentist and sanitation inspector. However, the minimal fund allocation for health
care by the local government has made HHR opportunities not enticing. To alleviate the problem,
DOH, although decentralized, trickles its resources to class 4-6 municipalities. The following are
limited programs by the Health Human Resource Development Bureau of the DOH in addressing
the shortages:
1.) Rural Health Midwives Program – an ongoing program accommodating licensed midwives to
work in the rural areas with a monthly stipend of 8,000.00 pesos / month. From 2009 to 2011, they
will be accepting 240 midwives with a monthly salary of 10,000 with benefits such as Philhealth,
GSIS, Pag-ibig membership and other bonuses. Recruitment involves passing an advisory or
memorandum to seventeen (17) regional centers in the Philippines. On the average 15 midwives
are assigned per region. The recruitment has not generated a 100% employment. Three regions
lacked applicants. Recruitment, application, selection, orientation and deployment are done by the
Center for Health Development.
2.) Nurses Assigned in Rural Services - a 6-month training program for newly licensed nurses. This
is a partnership program between DOLE, PRC and the DOH, of which the large supply of nurses
who are not accommodated in training hospitals, are given 3 months training in rural hospitals and 3
months training in the community with a stipend of 8,000.00 pesos / month. The intention of the
program is to temporize the lack of training ground for nurses who will eventually be exported
outside of the Philippines. The program started on its recruitment and selection on February 20. It
was disseminated through schools and announcements during the oath-taking. A website
(www.nars.dole.gov.ph) was launched for online registration. A total of 12,400 applicants registered
with the needed 5,000 slots. Selection was done by the Department of Labor and Employment.
Area orientation and deployment were facilitated by the Center for Health Development. This
program is intended to run for one year.
3.) Doctors to the Barrios Program – A 2-year service program for doctors to targeted marginalized
areas in the Philippines. The doctors assume the position of a local health leader, rural health
physician and municipal health officer with a salary of 20,000 to 30,0000 per month with benefits of
PAG-IBIG, GSIS, Philhealth membership and bonuses. Continuing medical education is included in
the package. The DDTB program has a fixed slot of 80 doctors including those on the field. On the
average, the program recruits 25 doctors per period. Since its inception, the 80 slots have not been
filled. Their recruitment involved putting up posters and booths in medical schools. This year,
improvement of applicants increased with the First Gentleman and Pinoy MD Scholarships where
the new doctors are streamlined to the DTTB program. At present, there are 21 municipalities
requesting for a physician through DTTB. Some doctors who are not absorbed in the rural health
unit have a tendency to look for doctorless municipalities for employment.
The DOH launched the Doctors to the Barrios Program in 1992 in an effort to fill the 271
municipalities that are without Doctors. In 2008, there were still 120 municipalities that were still
without doctors. There were 600 vacancies in rural and urban hospitals (both public and private). In
the last 3 years, there has been a 30% decrease enrolment in hospital residency specialty training
programs. The Private Hospitals Association of the Philippines (PHAP), reported closure of
hospitals due to decreasing number of medical personnel. The number of private hospitals went
down from 1700 in 2000 to only 700 in 2005.
B. ICT Facilitated Recruitment, Matching and Deployment of HHR
Many strategies have been tried to prevent or to reduce the maldistribution of health personnel.
Below is a schematic diagram suggested by the Global Health Workforce Alliance in compliance to
the MDGs.
Most have focused on reforming the medical education system. The focus of this project is to
develop quick win solutions through the use of ICT. Once established, this system complements the
other medium and long term strategies.
A review was done on existing web-based job portals, namely commercial websites such as
JobsDB.com, and Jobstreet.com; free websites such as Sulit.com and PinoyMD.com; and
government websites such as that of PRC, DOLE and DOH. Multiple searches were done for job
offering for a doctor, nurse and midwife. Despite the constant clamor for lack of HHR, there was no
local job vacancy in paid websites.
On initial visits, the DOLE website, phil-job.net, registered no local jobs but only jobs offered
by recruitment agencies for abroad both for POEA and BLE. A job search for doctors, nurse or
midwife generated a table with the recruitment agency and the country such as Saudi Arabia,
Angola, Bahrain or United States. An interview with DOLE IT officers revealed that it was no longer
the responsibility of the department to post jobs but it was up to the employers, of which recruitment
agencies are very persistent in doing in a free per post website maintained by DOLE. However,
during the recently concluded Kalayaan (Independence Day) Job Fair, eight hundred twenty-two job
vacancies were posted from the health sector particularly from DOH. A visit of the website showed
local job vacancies for doctors, nurses and midwives. A month after the event, the local jobs still
registered local jobs for doctors, nurses and midwives.
Both paid websites and DOLE websites enjoy high Google page ranks suggesting high
number of visitors (See Table 2). They also have user-friendly job search and posting interface.
However, the paid websites have better notification schemes of which an e-mail alert is sent to the
job seeker to matched job offerings. The paid job posting costs Php5,000.00(106.38 USD) to
P5,600.00(119.15USD) per job listing which will be visible for 30 days with weblinks to national
newspaper websites such as Manila Times, Daily Tribune and Philippine Daily Inquirer. Considering
the payment, they have excellent customer service in their marketing department. A call center
regularly update the employer. Accordingly, their customer support has garnered them with regular
employers who seek their assistance.
Local employers cannot compete with recruitment agencies in paying for job ads. Thus, they
resort in free ads at Sulit.com and PinoyMD.com. Unfortunately these websites do not have job
matching capability. The contents of a free ads website and community forum are also not well
moderated resulting to poor credibility. Despite of the lack of credibility, these sites enjoy a lot of
visitors with their free advertisements, and nonrigorous posting and viewing.
A job search was also done at DOH E-jobs which showed one job listing. Vacancies for the
NARS, Rural Health Midwives and DTTB were not posted. E-jobs was created to be a centralized
venue for electric posting of job vacancies in the DOH System, other government agencies, local
government units and private facilities or organization involved in health care. However, in its 2 year
operation, only jobs that are part of the DOH plantilla are posted.
It is mandated in all offices of DOH that any vacancy should be posted in the E-Jobs. A print
out of the job vacancy is then placed in all offices of DOH. However a request to fill a plantialla job
would sometimes last for 5 months since it has to pass the Department of Budget and
Management. It could only be posted on E-jobs after the approval. Temporary jobs such as DTTB
can be directly posted in E-jobs without approval from the DBM. However, this is occasionally not
utilized by the HHRDB.
HHRDB receives the requests for doctors, midwives or nurses from the rural areas.
However, they can only recruit, select and employ limited health professionals. HHRDB is taking the
role of an employer and recruitment agency for rural health units.
Clearly, there is a local demand for HHR which is however not reflected in internet
recruitment networks. There exists government websites which passively support recruitment
agencies for jobs abroad. While there should be a listing of regions requiring doctors, midwives or
nurses.
The provision of a web-based portal for local jobs entail the following options: (a) Increase
publicity of local jobs by paying in internet recruitment networks (Jobs.DB or JobStreet) (b) Increase
publicity by posting in free ads websites such as Sulit.com and PinoyMD (c) enhancement of
existing government websites. Taking these into consideration a comparison matrix of currently
running employment-related websites was done. This matrix gives weighted point average to
comparable sets against different criteria. The points are given by the authors of this paper based
on actual website browsing and interviews to their corresponding IT officers. Table 2 shows eight (8)
portals: paid, free and government websites.
Table 2: Comparison Matrix of Job-Related Websites, June 2009
Google Job Job
JOB RELATED Page Rank Posts Search Good SMS User Credibility Free Total
WEBSITES & IMS capability Friendli
Matching ness
Weighted Percentage 10% 10% 10% 20% 10% 10% 20% 10% 100%
PAID WEBSITES (Comprehensive Data Set and Excellent Customer Service but requires fees)
6/10= 6 5 10 12 0 10 16 5 64
www.Jobstreet.com.ph
7/10 = 7 5 10 10 0 10 16 4 62
www.Jobsdb.com.ph
FREE WEBSITES (Not well moderated but has free advertisement and easily accessible)
2/10 = 2 7 0 4 0 7 10 10 40
www.Pinoymd.com
5/10 = 5 8 0 8 0 8 8 8 45
www.Sulit.com.ph
GOVERNMENT WEBSITES (Highly credible in its job postings and free but lacks advertising)
6/10 = 6 0 0 16 0 6 17 10 55
www.prc.gov.ph
4/10 = 4 6 10 18 0 8 16 10 72
www.nars.dole.gov.ph
4/10 = 4 8 8 14 0 8 18 10 70
http://umis.doh.gov.ph/ejob
6/10 = 6 6 10 18 7 8 16 10 81
www.phil-job.net
“Google Page Rank” is a measure of popularity based on the number of unique visitors and
weblinks to the website. This was determined using a downloadable Google software. “Job Posts”
was based on whether the contents were updated with LGU job postings. “Job Search and
Matching” is based on the interface of the webpage that allows jobseekers to inquire and post
resumes with a matching system. “Good IMS” refers to the organization of the IT officers in
delivering the service. “SMS capability” refers to the link of a website and text messaging. “User
Friendliness” refers to the easiness in navigating through the website’s platform. “Credibility” is
based on the reliability of the job offerings and least likelihood of a scam based on effective website
moderation. A “Free” website is more enticing to local employers or recruiters where employers
don’t have to pay advertisement fees. The jobseekers also have a free registration.
Using the matrix, the www.phil-job.net has highest total points of eighty-one (81). This
suggests that it is the most functional website that can be enhanced to facilitate the HHR
recruitment, matching and deployment. Its job posting is for free, has satisfactory Google page
rank, user friendly with job search and posting interface, and most of all it has SMS-linked capability
which is crucial for jobseekers in rural areas with no internet connection. At present, it is called I-
Text Trabaho which works for Globe and Smart Telecommunications where an SMS of
Trabaho_area_position send to 2376 or 2476, respectively, generate job results in a certain area.
IV. METHODOLOGY
A. Phase I: Synchronization
from
Philjob
Figure 2: Suggested Synchronization of E-job and Phil-job. Phil-job generating the data
within the framework of E-jobs.
This has the following advantages: 1.) Improves the E-jobs interface which allows job
seekers to register and be matched 2.) Eliminate system lag since Phil-job was developed to handle
multiple visitors. (i.e. 8,000 to 10,000 visitors during the Independence Day Job Fair 3.) There is
sharing of job posting and job seekers from multiple agencies which increases the traffic of the
website 4.) DOLE is able to delegate some of its function to a partner agency, DOH.
This synchronization entails the following: 1.) Coordination between the DOH and DOLE IT
personnel or IMS 2.) Signing of a memorandum of agreement on the privacy, security, data sharing,
maintenance and administration of the websites 3.) Standardization of the data set.
Table 3: Compared Data Sets from E-jobs, Phil-jobs, JobsDB/JobStreet and Synchronized Set
Specifically, the required fields are: username, E-mail Address, Password w/ confirmation,
First Name, Last Name, Middle Initial, Date of Birth, Sex, Municipality or City, Contact. No., Civil
Status, Preferred Job or Skill, Preferred Job Location, Search Jobs/Submit.
The optional fields are: Weight, Height, Civil Status, Spouse Name, Disabilities, Tin. No.,
Passport, Religion, Employment Status. The SMS linked fields are: First Name, Last Name,
Preferred Job, Preferred Location. The SMS linked fields are needed to generate search when
using the SMS.
Resume Upload
>>Need Assistance? Hotline (632) 527 8000 For Globe/TM Call 2910<<<
Doctor:
ABC:1234567 DEFG:345678
QWD:1234567 WERT:1234567
RGKLM:1234567 For more:
Text “Trabaho Doctor Page 2”
or Visit www.phil-job.net
or call local PESO 123445
A downloable PDF file of the application form and job posting form should also be made for
those without internet and find texting inadequate. The form shall contain the agreed standardized
data set for both agencies. If the DOLE decides to be more extensive, the PESO form can be used.
Visit: www.phil-job.net
or www.doh.gov.ph/ejob
Need Assistance? Hotline (632) 527 8000 For Globe/TM Call 2910
Figure 5: At the bottom of the Application Form, the SMS, website and hotline should also be
included.
Together with the job posting form, other documents (BIR Registration Certificate, SEC, DTI
, CDA license, etc.) required for private institutions should be enclosed. Job posting through SMS is
currently not feasible due to the number of characters needed to key in just to complete the
required fields. The address, fax or email address should be included to increase the efficiency. The
job posting should be included as well so as not to resend another document once approved by
DOLE.
Table 4: Job Posting Data Sets from E-jobs, Phil-job and JobsDB/JobStreet
Table 5: The common data set for job posting is as follows:
Required Fields
Username, Password w/ confirmation, E-mail Address, Tin No., Name of Company, Acronym, Industry, Address, Municipality
or City, Country, Contact Person First Name, Contact Person Last Name, Middle Name, Tel. No., Position or Job, Location
of Job, Opening and Closing, Registrations on the license to operate
Office, Division,Experience, Training, Eligibility, Key Task, Terms and Condition, Printable Format
Optional Fields
Enhancements
DOLE and DOH have similar required fields. However, DOH has more fields needed for its
bulletin board posting of the job vacancy of which a printable format is needed. To synchronize this
different requirements, DOLE which is an open source for all agencies whether public or private,
could generate an additional data set when a user chooses a local health sector industry.
Additional Information:
___________________
Eligibility (i.e.MD, RN)
___________________
Key Task
Figure 7: E-job Interface with additional required fields for Local Health Industry job posting
The country is an important required field since only local jobs will be shown in the DOH E-
jobs website. The future enhancement of uploading the required documents will make the system
more efficient, saving the time of having to fax or mail the documents.
To be able to do a job posting in phil-job.net, there are three major steps to be done. 1.) You
have to fill-out the online application form 2.) Send documents to verify authenticity of the company
3.) Wait for approval and start posting the job. All these can be done at once if during the online
application, the required documents can be uploaded and the job posting can be sent as well. All
these are in queue. Once approved, the job will be posted and the employer will be informed of a
successful posting. If rejected, the employer is informed as well.
Phase I involves the execution of the following a.) Establish a Memorandum of Agreement
between stakeholders b.) Synchronization of the different Information Management Systems c.
Publication of modules with list of partners, contact numbers, guidelines, application forms, job
posting forms, I-text trabaho and website instructions, and frequently asked questions
The prospective functions of the Deparment of Health are: 1.) Advocate the HHR Pinoy
Exchange/E-jobs/Philjobs/HealthPro to its constituents, providing seminars and modules 2.)
Coordinate DOH-IMS with BLE-IMS and DOLE Call Center in the synchronization of websites 3.)
Manage job postings and jobseekers relating to local health care by communicating thru email, text
or call if the jobs are already taken or the jobseeker has been employed. 4.) Actively search and
post job vacancies (Personnel>IMS) including DTTB, NARSP, RHMPP, Residency Trainings, etc.
The prospective functions of the Department of Labor are: 1.) Advocate the HHR Pinoy
Exchange/E-jobs/Philjobs/HealthPro to its constituents (hospitals and schools), providing seminars
and modules (i.e. HHR Month, PESO Convention) 2.) Coordinate BLE-IMS to the DOLE Call Center
and DOH-IMS in the synchronization of websites. Orient the Call Center on how to address queries.
Allow DOH-IMS to manage data relating to local health care jobs (categories under
Philippines+Health Industry or local health industry). Coordinate with TERIX Technologies on the
SMS changes. 3.) Manage job postings and jobseekers by communicating thru email, text or call in
assisting applicants and employers, moderate fraudulent jobs, encode jobs from internet deprived
agencies. 4.) Actively search and post local health care job vacancies through its PESO network
B. PHASE II: MULTILEVEL LAUNCHING
Table 6: Table of Partners and their Corresponding Units in Implementing the Project
LEVEL AGENCY UNIT Coverage
National Level DOH HHDRB Organize an HHR Month, launching the
project and actively posting jobs and
trainings (DTTB, NARSP, RHMPP,
Residency Training, etc)
As mentioned, there are several secondary partners in this project. They will require different
assistance or counterparts to commit them into regularly posting job vacancies or generate
applicants. A team has yet to be organized to determine their specific concerns (i.e. administrative
order for agencies under DOH, advertisement for private hospitals, MOA for LMP and the like). In
general, the most common reason why agencies post online is advertisement. This has been a
lucrative business for Sulit.com and Ayosdito.ph. Integrating job search and company advertisement
would generate enthusiasm in the website. A single job posting could be given a free advertisement
banner of the company. An update of the job vacancy could also be given a free ad to encourage
them to inform phil-jobs if the job has been taken.
V. REFERENCES
An Assessment of the Health Human Resource Development Provisions of the Philippine Nursing
Act of 2002, Tiongco, 2008
4th International Health Conference on Primary Health Care/Family Health, Brazil, The Health Workforce:
Scaling Up Through Primary Health Care, Dr Mubashar Sheikh, 2008
Bring Health Experts to the Barrios through Telehealth System, to aid RP in fighting Influenza
A(H1N1) or Swine Flu, Senate of the Philippines 14th Congress, May 8, 2009.
Human Resources for Health Migration in the Philippines: A Case Study and Policy Directions, Ronquillo et al,
2005
Midwifery in the Philippines : ‘A Laudable Service’ but there are Issues and Challenges, Alice de la Gente,
former president of the Integrated Midwives Association of the Philippines (IMAP), International Midwifery
Publication, December 1, 2008
Not enough there, too many here: understanding geographical imbalances in the
distribution of the Health Workforce, Human Resources for Health, Gilles Dussault, 2006
No Nurse Surplus, Only Unqualified Graduates-Recruiters, Philippine Daily Inquirer, Veronica Uy, September
1, 2008
Proportions of Births Attended by a Skilled Health Worker- World Health Organization 2008 Updates.
Pinoys Dying from Lack of Doctors, The Philippine Star, August 11, 2008
Philippine Government Warns of Medical Crisis Due to Exodus of Professionals, November 24, 2005,
http://english.peopledaily.com
Philippine Midwife Opens Well-Family Clinic, USAID Telling Our Story, 2003,
www.usaid.gov/stories/philippines
The National Nursing Crisis: Seven Strategic Solutions, Dr. Jaime Galvez Tan, 2005