Press Releases Archived (November 2015)

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In response to the invitation of the Metropolitan Manila Development Authority (MMDA), Philippine Institute for Development Studies President Dr. Gilberto Llanto delivered a lecture on the regulatory management system (RMS) on October 26 before its officials and staff. RMS was this years Development Policy Research Month theme.

Llanto emphasized that it is critical to talk about regulation reforms and regulatory quality measures in anticipation of the upcoming integration of the Association of Southeast Asian Nations.

He encouraged the MMDA's leaders to consider applying regulatory tools like regulatory impact statement and regulatory impact assessment to improve their planning and regulatory designs. A genuine answer to public criticisms would be to improve MMDA's policies and regulations by relying on evidence-based research, he said. If policies are well studied, they are less likely to be arbitrary and faulty.

The officials at the MMDA welcomed the recommendation of Llanto and expressed interest in working together with PIDS to undertake research and review of their regulations. Llanto praised MMDA for their responsiveness, and went as far as saying that EDSA's woes shouldnt be blamed solely on the regulatory body.

Currently, he says, the analysis of traffic in Metro Manila remains severely limited, with an overemphasis on what the traffic engineers can do and too little attention on the factors way beyond their control, such as population and infrastructure. A more indepth and broader understanding would require coordination between the MMDA and other national agencies to generate a more comprehensive response. ###

If you wish to learn more about the regulatory management system, you may access Dr. Llanto's study here or access related articles and presentations at the Development Policy Research Month website's presentations section.

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A study by state think tank Philippine Institute for Development Studies urges the Department of Health to address serious flaws and challenges in the implementation of its Health Facilities Enhancement Program (HFEP).

The research team of Oscar F. Picazo, Ida Marie T. Pantig, and Nina Ashley O. dela Cruz released their findings in a policy note titled, "More than infrastructure and equipment: Process evaluation of the Health Facilities Enhancement Program". Their evaluation of the DOH program revealed gaps in implementing practices in medical infrastructure.

The problematic areas they identified included service delivery, commissioned contracting, funding for building facilities, coordination, and facility licensing. Addressing the problems in these areas, urged the authors, will help improve the management of the HFEP.

Good program, weak implementation

An initiative by the Aquino administration, the HFEP was designed to provide "the largest capital investment in recent memory" to address the stagnant capital stock of public health facilities. The end goal was to build more health facilities, or improve the capabilities and expand the capacities of existing ones, so that every Filipino in every corner of the Philippines is given immediate access to medical and health services.

The study surveyed 83 percent of 37 health facilities across the provinces of Tarlac, Quezon, Catanduanes, Capiz, Surigao del Sur, and Zamboanga del Norte, which amounted to 19 infirmaries and hospitals, and 18 rural health units and birthing centers.

Forty-five percent have proven functional, 24 percent were only partially functional, and 14 percent were not functional at all. The functionality problems varied per facility, and they arose either from difficulties with physical infrastructure or from shortcomings of the services infrastructure.

Physical infrastructure problems include lack of access to electricity, construction defects, delays in construction, dysfunctional equipment, and improper maintenance or failure to deliver certain medical equipment. Services infrastructure problems include unavailability of doctors, problems with accreditation, and lack of proficiency training for midwives.

The authors identified the lack of national and regional health infrastructure plan as critical sources of these problems. There was lack of proper information and systematic prioritization when it came to upgrading and construction of medical infrastructure. Planning and coordination among health facilities and service providers in a particular area was also missing.

Another major cause of the HFEP's shortcomings involved the process of acquiring contractors.

"Health facilities under the HFEP were funded and contracted individually," revealed the study, which proved "unwieldy, time consuming, management intensive and uneconomical".

Commissioned contracting is preferable, whereby "a group of projects is pooled together and contracted out as a 'lot' or 'tranche' to allow contractors to economize on planning and design, bulk procurement of inputs, construction, monitoring, and equipping."

In practice, the design, construction, and equipping processes were individually commissioned, making coordination and sequencing of deliverables problematic.

"Individual infrastructures were built one by one, with inputs purchased locally from retail suppliers instead of procured wholesale under bulk procurement arrangements," the authors observed.

Constant back-and-forth coordination between the HFEP project staff and all involved parties and stakeholders over the strategic planning and design approval wasted precious time. The lack of strategic direction and the poor communication between health facilities and licensing units became a problem in ensuring the quality of facilities.

The decision to employ "small, incremental multiyear funding" also contributed to further fragmentation and delay of construction.

The project also encountered problems with licensing standards, affecting space and equipment requirements, quality of work, and facility staffing.

In summary, poor planning choices and poor coordination led to a significant percentage of health facilities being underused, only partially functional, or not functional at all.

Recommendations to improve HFEP implementation

The key to a better HFEP is improving coordination at all levels. It may also help to establish a manual operations for the entire project.

The authors also recommended establishing a civilian, health sector version of a SWAT team to address extraordinary situations of specific technical nature.

Commissioned contracting would also eliminate the fragmentation. The protraction of deliverables would be reduced if the incremental, multiyear infrastructure funding is replaced by a "finish one-at-a-time" funding scheme.

"DOH, as financier, will only be dealing with fewer contractors, and the commissioned contractors will take on the responsibility of construction monitoring," the authors added. ###

If you want to learn more about HFEPs, you may access the study's Policy Note here.

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Dr. Rosario Manasan, senior research fellow at state think tank Philippine Institute for Development Studies (PIDS), presents the key findings of an assessment of the government's bottom-up budgeting (BUB) program. The BUB program was launched with a twin objective of promoting participatory budgeting processes at the national and local levels, and of helping the poorest local government units (LGUs) work their way out of poverty by providing additional funding for the most critical poverty-alleviating programs identified by the LGUs and civil society organizations (CSOs).

Now on its fourth year, the program has performed well in accomplishing its first objective. The PIDS research team led by Manasan conducted focused group discussions and key informant interviews with the LGU officials, CSO leaders and members, and other parties involved in the BUB. They learned that the CSO participants were generally pleased with the BUB.

"For the first time, the CSOs felt free to speak and that their inputs were being listened to," Manasan related. The study showed that having enough time for discussions and deliberations enables CSOs to produce better project proposals that are characteristically more sustainable and beneficial to more people.

According to the accounts relayed to and observed by the researchers, without the BUB as a mechanism, the participation of CSOs in the prioritization of projects and programs would be close to nothing. Under the BUB process, CSO participation is at 50 percent, compared to the 25 percent participation of CSOs allowed in the normal local budgeting process under the Local Government Code (LGC).

Despite all of these, however, Dr. Manasan remarked that the CSOs will be more empowered and their decisionmaking more enhanced if the BUB process itself will be refined. Manasan noted that CSOs are generally only able to participate in the BUB process in terms of the planning and project prioritization stages. However, she noted that the mechanisms to monitor the implementation and evaluation of their projects do not exist. This, Manasan emphasized, dampens the inclusiveness of the BUB process.

On the BUB's second objective of alleviating poverty, the project has lagged behind in demonstrating that it has accomplished significant poverty reduction. Part of the reason is the lack of monitoring mechanisms and the slow implementation of the projects.

Dr. Mansan's team concluded that the BUB process works as far as empowering the political voice of CSOs and giving them a platform to exercise their decisionmaking to identify critical issues and ideas for the development of their local communities. She recommended that the LGC incorporate some of the BUBs lessons, and that the BUB as a program should enhance participation of the CSOs in the monitoring and evaluation phases. ###

If you wish to learn more about the BUB, you may read the PIDS Economic Issue of the Day on the BUB process or Dr. Manasan's study here.