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Draft as of August 30, 2013, ver

Republic of the Philippines


Department of Health
OFFICE OF THE SECRETARY

ADMINISTRATIVE ORDER
No. 2013 - ____________

SUBJECT:

I.

Guidelines on the Deployment of Human Resources for Health (DRAFT)

RATIONALE

Select cadre of Human Resources for Health (HRH) are being deployed by the Department of
Health to marginalized populations and other areas of need for the purpose of augmentation and
health service delivery. Currently, the department deploys nurses, doctors, midwives, and other
health professionals under the following programs: RN Heals Program, Doctors to the Barrios
Program, Medical Pool Placement Program and Rural Health Team Placement Program. Despite
these endeavors, equity and access to critical health services remains inadequately addressed.
With the commitment to attain universal health care, the HRH must be responsive to the needs of
our country and support the achievement of our MDG targets. This would require the right
quantity, quality and relevance of HRH to our health system needs. Therefore, there is a need to
harmonize the policies and processes for the placement and distribution of health professionals
through the deployment programs.
In order to ensure the success of HRH as a strategy for universal health care, there is a need to
create standard operational and administrative directions for all HRH deployed by DOH.
This Order aims to provide the structure and mechanism for the deployment of HRH managed by
DOH.
II.

OBJECTIVES

General:
To provide policies and guidelines for implementation of the HRH deployment programs for the
purpose of improving access and health service delivery under universal health care.
Specific:
1. To provide guidelines for implementation to program managers and implementers.

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2. To facilitate the implementation of deployment of HRH by influencing the manner by which


provinces and component LGUs and cities manage their local HRH
3. To provide a mechanism for program monitoring
III.

SCOPE

This order shall apply to the entire public health sector, DOH bureaus, Centers for Health
Development, hospitals, DOH attached agencies including Philhealth, local government units,
and external development partners that are involved in the deployment of human resources for
health.
This order shall cover the implementation of deployment programs from the pre-recruitment to
program evaluation. This intends to unify existing guidelines for deployment of health
professionals for the purpose of improving access and health service delivery through provision
of HRH.

IV.

DEFINITION OF TERMS

1. Community health team (CHT)- is a group of health volunteers assigned to each barangay/
priority population area led by a midwife that tracks eligible population for public health
services, assist families in assessing and acting on health needs, provides information on
available services in the locality and facilitates the organization of transportation,
communication systems, outreach services and linkages with other providers in the service
delivery network (Barangay health Station, Rural Health Unit, other small private and public
hospitals and facilities).
2. Deployment- means by which select health professionals are physically transferred in areas
of need to complement the existing HRH in health facilities and for effective and efficient
health service delivery.
3. Doctors to the Barrio Program- is a DOH program that deploys doctors to doctor-less
municipal health offices/ rural health offices as prioritized by the program to serve as their
municipal health officers or rural health physicians.
4. DOH retained hospital- refers to government hospitals managed and supervised by the DOH
5. Geographically isolated and disadvantaged area (GIDA)- communities with marginalized
population, physically and socio-economically separated from the mainstream society such
as island municipalities, up-land communities, hard-to reach areas, and conflict-affected
areas
6. Human Resources for Health (HRH) refers to health professionals currently engaged in
actions whose primary intent is to enhance health. They include physicians, nurses,
midwives, dentists, and allied health professions with valid license/registration from the
Philippine Regulatory Commission (PRC). They work in the different domains of the health
system including curative, preventive and rehabilitative care services as well as health
education, promotion and research. Under UHC it is an instrument to ensure that all Filipinos
have access to professional health care providers capable of meeting their health needs at the
appropriate level of care
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7. Indigenous cultural communities/indigenous peoples -as defined in Republic Act No. 8371,
otherwise known as "The Indigenous Peoples Rights Act of 1997;"

8. Learning and development intervention a process of imparting skills, knowledge or


competencies in order to improve performance and meet an agreed standard of proficiency.
This includes continuing professional education, training and other non-training
interventions.
9. Local health system- all organizations institutions and resources devoted to undertaking local
health actions. These include all provinces and their component LGUs, cities, private and
public health care providers local partners and families
10. Medical Pool Placement and Utilization Program- is a DOH program that deploys
physicians to government medical centers/ hospitals for augmentation of medical officers/
medical specialists
11. National Anti-Poverty Commission created by Republic Act No.8425 to serve as the
coordinating and advisory body for the implementation of the Social Reform and Poverty
Alleviation Program

12. National household targeting system (NHTS) a data bank and an information management
system managed by the Department of Social Welfare and Development (DSWD) that
identifies who and where the poor are. The system generates and maintains the
socioeconomic database of poor households
13. Poor families- refers families whose income fall below the poverty threshold as defined by
the National Economic and Development Authority and/or cannot afford in a sustained
manner to provide their minimum basic needs of food, health, education, housing and other
essential amenities of life
14. Registered Nurses for Health Enhancement and Local Service (RNHeals)-is a DOH
program that deploys registered nurses to government health facilities utilizing training cum
deployment approach.
15. Rural Health Midwife Placement Program- is a DOH program that deploys registered
midwives to RHUs and/or BEmONC facilities particularly in the far flung areas to provide
quality health services with focus on Maternal, Newborn, and Child Health Nutrition.
16. Rural Health Team Placement Program-is a DOH program that recruits and deploys allied
health professionals to complement existing workforce of hospitals and RHUs utilizing
training cum deployment approach. This may include dentists, nurses, pharmacists, medical
technologists, physical and occupational therapists, nutritionist-dieticians, midwives, and
sanitary inspectors.
17. Universal health care (UHC)- a focused approach to health reform implementation ensuring
that all Filipinos especially the poor receive the benefits of health reform
V.

GENERAL GUIDELINES

1. All deployment programs for HRH shall promote improved access to professional health
care providers capable of meeting their health needs at the appropriate level of care
2. The success of the deployment programs shall then be monitored in terms of progress in
health outcomes, attainment of the MDGs, improvement in access to quality health facilities
and services and improvement of local health systems.
3. Deployment programs shall prioritize the poor and marginalized populations.
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4. The DOH shall deploy appropriate HRH to either LGU health facilities or DOH- retained
hospitals.
5. The DOH shall engage local health systems and recognize that the LGUs have the primary
mandate to finance and regulate the local health systems including the provision of HRH
6. There shall be coordinated and harmonized participation of stakeholders, public and private
partnership; including academe, professional societies, non-government organizations
aligned to the objectives of the program.

VI.

SPECIFIC GUIDELINES/IMPLEMENTING MECHANISMS

A. Organizational Structure
HEALTH HUMAN RESOURCE DEVELOPMENT BUREAU

CENTERS HEALTH DEVELOPMENT

LGU

DOH/ DOH-RETAINED
CENTERS/ HOSPITALS

HOSPITAL

MUNICIPAL/
CITY HEALTH
OFFICE

B. Roles and Functions


1. The Health Human Resource Development Bureau
a.
b.
c.
d.

Over-all management and supervision of the deployment of HRH


Formulate policies and guidelines relevant to the deployment program
Allocate funds for implementation of deployment programs.
Provide technical assistance and support services as may be necessary for the effective
implementation of the program
e. Conduct regular monitoring of program implementation.
f. It shall ensure that all skilled health professionals deployed possess the clinical
competencies required to deliver the health services in their facility or catchment area.

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g. Decide on equitable allocation of deployed HRH


h. Provide policy directions that will ensure sustainability of programs and projects in
areas where HRH are deployed.
i. Provide learning and development interventions to select HRH
2. Recipient CHDs
a. Coordinate with the LGUs, hospitals, and DOH for strengthening of local health
systems in areas where HRH are deployed
b. Utilize funds for operationalization of deployment programs as allocated by DOH.
c. Facilitate deployment and conduct the HRH to areas
d. Determine the baseline competencies of the currently engaged HRH in relation to
needed health services in their area and provide for learning and development
interventions for the HRH.
e. Provide technical assistance and support services as may be necessary for the effective
implementation of the program
f. Conduct regular monitoring and evaluation of deployed HRH and overall program
implementation
g. Advocate and assist the LGU in the planning and implementation of retention
strategies
h. Conduct pre-deployment orientation of HRH
i. Conduct pre-deployment community preparation and LGU coordination through their
provincial health team office
3. Recipient Hospitals
a. DOH retained hospitals and facilities shall endeavor to become effective instruments
to influence local health systems including but not limited to establishment of referral
systems and networks
b. Ensure proper coordination with DOH through the CHD and HHRDB for
implementation of deployment programs
c. Provide necessary capacity building for deployed HRH.
d. Conduct regular monitoring and evaluation of deployed HRH as scheduled by the
program and as necessary
e. Provide regular items within 3 years from the initial appointment of the deployed
personnel
f. Provide a hospital development plan in consonance with the national hospital
development plan
g. Participate in the registration and regular updating of health facility data to the
NDHRHIS

4. The LGU
a. Establish a functional local health board of which the deployed HRH shall be part
b. Utilize resources including but not limited to the following: internal revenue allotment,
Philhealth capitation fund, reimbursements, users fees and other sources to support
programs, activities, supplies, commodities, and incentives as support to the deployed
HRH

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c. Allocate funds for honoraria, remote allowance, and other provisions of under the
Magna Carta for Public Health Workers as may be applicable.
d. Provide appropriate financial and logistic counterparts for the benefit and welfare of
the deployed HRH as stipulated in the governing laws for health workers including
but not limited to transportation, lodging and miscellaneous expenses related to
conduct of their duties.
e. Support learning and development interventions and other related opportunities of
deployed HRH by allowing them to attend such activities and providing needed
allowances
f. Support policies and plans aligned with the implementation of universal health care
and adoption of national health laws.
g. It shall endeavor to hire an adequate number of skilled health professional to attain
ideal ratio or staffing standard as prescribed by DOH
h. Ensure safety of deployed HRH
i. Encourage and support innovative projects for health systems development through
financial and administrative means including provision of incentives
j. Enter into and abide by a standard contract/ Memorandum of Agreement (MOA) with
the DOH
k. Provide feedback to CHDs on the performance of deployed HRH and program
implementation
5. Deployed HRH
a. Ensure client-centered delivery of services
b. Respond effectively and efficiently to the health needs consistent with accepted
standards of care
c. Aggressively promote healthy lifestyle to reduce and prevent non-communicable
diseases
d. Initiate and participate in public health measures to prevent and control of
communicable diseases and adequate surveillance and preparedness for emerging and
re-emerging diseases.
e. Promote inter-agency and inter-sectoral cooperation for health
f. Perform other functions as mandated under the existing pertinent national laws and
protocol (eg. Local Government Code, Hospital Institutional Policies, Civil Service
Code)
g. Enter into and abide by a standard contract/ Memorandum of Agreement (MOA) with
the DOH
h. Provide feedback to CHDs on the performance of recipient LGUs/ hospitals and
program implementation
6. PhilHealth and other development partners
a. Utilize financial instruments and strategies to motivate HRH and promote retention
through grants, incentives, capitation, and other means.
b. Allocate funds for improvement of health facilities and working environment/
conditions of deployed HRH
c. Provide support for the development of HRH and local health systems projects,
scholarships, and research.

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d. Ensure the sustainability and institutionalization of assistance projects for HRH


e. Cooperate in the establishment of monitoring systems to track effectiveness of
development projects
C. Policies and Procedures
The manner of implementation shall include recruitment, selection, and deployment.
Criteria in Selecting Priority Areas for Deployment
The DOH shall determine the ideal number and type of HRH needed for the delivery of
health services based on the following criteria:
1. Estimated number of clients (based on population in catchment area)
2. Geographic and socio-economic distribution of the area (GIDA, CCT target areas,
NAPC target areas)
3. Presence of public and private providers in the area
4. Number of currently deployed HRH and staffing standards
The ideal number shall be based on ratio of 23 HRH per 10,000 populationi for rural
health units and on staffing standards set by NCHFD for hospitals as published and
disseminated to provide guidance to sustainable staffing plan of necessary skilled health
professionals.
5. Accreditation status (PhilHealth, specialty training program, or others as may be
applicable)
6. Specialized care or services as mandated by law (medical centers, provisions under
Responsible Parenthood and Reproductive Health law, Sin Tax law, and others as may
be applicable). Graduates of residency programs from DOH can be deployed as
specialists to LGU hospitals provided that it will not compromise the staffing standards
of the DOH facility.
Requirements to be submitted to CHD by requesting LGUs
The DOH may provide support to LGUs upon request in order to attain adequate
number of HRH through deployment of HRH provided that:
a. The LGU has met the criteria set by the program and after submission of required
documents including but not limited to the following:
a.1 Signed request from the head of office addressed to the CHD
a.2 Signed SB resolution supporting the request
a.3 Copy of the latest health budget reflecting the percentage of budget allocated for
health including for personnel services
a.4 Current HRH to population ratio
a.5 PhilHealth accreditation certificate (if applicable)
b. All existing and available plantilla positions have been filled and opportunities
provided under sec 325 of the local government code have been fully exhausted
c. Graduates of residency programs from DOH hospitals can be deployed for in service
training programs in LGU hospitals that require specialists and met other criteria as
prescribed by the program.

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d. In addition, hospitals must submit hospital development plan in consonance with


national hospital development plan.

Procedures for Deployment


Pre-recruitment
A. Hospitals
1.
Hospitals submit request for additional HRH to CHD
2.
CHD evaluates and validates:
2.1 Hospital as a qualified recipient
2.2 Request for additional HRH
3.
CHD submits to HHRBB a list of qualified recipients based on set criteria
along with required documents. It shall be submitted in within the 1st week
of the month of submission as prescribed by the program.
4.
HHRDB evaluates request, finalizes number of HRH to be allocated for the
hospitals, the list of qualified recipients and their HRH allocation for
feedback to CHD. HHRDB shall publish and inform the CHDs of the
number of HRH allocated for the hospitals and LGU in their catchment
areas based on approved budget and number of positions for the current
year.
5.
HHRDB shall validate the requests and finalize the list of qualified
recipients 1 month prior to the start of recruitment.
6.
CHD coordinates results with requesting hospitals
7.
The HHRDB and CHDs shall announce the opening of recruitment to their
target stakeholders.
B. RHUs and CHOs
1.
2.

3.
4.
5.

LGUs submit requests for additional HRH to CHDs along with necessary
supporting documents
CHDs evaluate and validate:
a. LGUs as qualified recipients
b. LGUs request for additional HRH
CHDs submit a list of qualified recipients to HHRDB
HHRDB evaluates requests and finalizes the list of qualified recipients and
their HRH allocation for feedback to CHD
CHD coordinates results with requesting LGUs

Recruitment and Selection

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The HHRDB shall open the application for the deployment programs on their
prescribed schedule. Job posting/ publication shall be done through the web page,
school announcements/ publication, contact persons, media, civil service
commission bulletin, as deemed appropriate. It shall include the requirements,
core competencies, and benefit package. The information on where to apply shall
also be included.
A. Hospitals
1. HRH applies to the hospital and undergoes hospital recruitment and selection
process.
2. Hospital endorses qualified HRH to DOH through the CHDs
3. CHDs validate the list of selected applicants and submit to HHRDB
4. For Physicians: HHRDB processes the appointment papers/ contracts of
selected HRH
5. For other HRH: CHD processes the appointment papers/ contracts of selected
HRH
B. RHUs and City Health Offices (CHOs)
1. HRH accomplishes the application form and undergoes recruitment and
selection process of the CHD-HRDU or through its extension offices. All
regional applicants must file a letter of application addressed to the regional
director.
2. CHD-HRDU recommends qualified HRH to the Regional Director
3. CHDs endorses the list of selected applicants to HHRDB
For Doctors: HHRDB processes the appointment papers/ contracts of selected
HRH
For Other HRH: CHD-HRDU processes the appointment papers/ contracts of
selected HRH
Pre-deployment
HHRDB shall conduct pre-deployment orientation for doctors.
CHDs will conduct regional pre-deployment orientation for other HRH to be
deployed in the RHUs and CHOs within their catchment areas. A maximum of 2
week regional orientation or exposure shall be observed provided that the necessary
preparations in the area of deployment and other conditions for deployment have been
met.
Hospitals shall also conduct institutional pre-deployment orientation
Deployment

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A. Hospitals
For Physicians:
1. Upon approval of appointment or contract, HHRDB issues a Department
Personnel Order (DPO) relevant to their places of assignment
2. Physicians report to their areas of assignment
3. HRH submits daily report of attendance to Hospitals
4. Hospitals submit the monthly report of attendance to HHRDB
5. HHRDB process payments for deployed HRH
For Other HRH
1.
2.
3.
4.
5.

HRDU submits list of selected HRH for approval of Regional director


CHD issues Regional Personnel Order relevant to their places of assignment
HRH report to their areas of assignment
HRH submits daily report of attendance to Hospitals
For DOH Hospitals: hospitals process payments in form of salary or stipend as
appropriate
For LGU Hospitals: hospital submits daily report of attendance to the CHDs.
CHDs process payments for the deployed HRH

B. RHUs and City Health Offices (CHOs)


For Physicians:
1. Upon approval of appointment or contract, HHRDB issues a Department
Personnel Order (DPO) relevant to their places of assignment
2. HHRDB conducts pre-deployment orientation
3. CHDs conduct necessary LGU preparation and coordination which
includes: orientation of LGU/ Health Board, processing of MOA, and social
preparation
4. Physicians report to their areas of assignment
6. Physicians submit daily report of attendance to their respective CHDs
7. CHDs submit the copy of the daily report of attendance to HHRDB
8. HHRDB process payments for deployed physicians
For Other HRH
1. Upon approval of appointment or contract, CHDs issue a Regional Personnel
Order (DPO) relevant to places of assignment of HRH
2. CHDs conduct pre-deployment orientation
3. CHDs conduct necessary LGU preparation and coordination which
includes: orientation of LGU/ Health Board, processing of MOA, and social
preparation
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4. HRH report to their areas of assignment


5. HRH submit daily report of attendance to their respective CHDs
6. CHDs process payments for deployed HRH
Appointment/ Contract is evaluated yearly and renewed based on satisfactory
performance
Salaries and Benefits
Deployed HRH shall receive payments in the form of salary or stipends, whichever is
appropriate. HHRDB shall process payments for deployed physicians. CHD shall process
payments for other deployed HRH.
Deployed HRH with approved appointments under temporary regular items shall receive
other benefits as mandated by applicable laws (CSC, Magna Carta for Public Health
Workers, etc).
Deployed HRH with signed contracts shall receive other mandatory benefits as stated in
their contracts to include but may not be limited to PhilHealth and GSIS group insurance.
Sanctions
Any deployed HRH and concerned government personnel found and verified to have
violated provisions stated herein for purposes of graft and other related offense shall have
administrative liabilities subject to CSC rules and regulations, and implementing policies
and regulations in their respective health facility or institution.
Continuing Education and Capacity Building
DOH shall provide financial support for learning and development interventions (includes
trainings, continuing education, and other capacity building activities) pursuant to existing
guidelines. The LGU shall shoulder the transportation and living expenses of attending
HRH during the training as their counterpart.
Monitoring and Evaluation
1. The deployed HRH shall be monitored semi-annually and evaluated annually.
2. The monitoring should reflect availability of HRH, performance of HRH, factors
hindering utilization of health services in relation to HRH
3. Parties conducting monitoring shall utilize a prescribed monitoring tool prescribed
by the HHRDB.
4. HHRDB shall validate and monitor compliance of CHDs and Hospitals to
deployment guidelines
5. Results of the monitoring shall be forwarded to the HHRDB through a memo with a
monitoring report form provided by HHRDB. Likewise, the recommendations and
actions taken shall be included in the report.
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Retention strategies
The recipient of deployed HRH shall support and endeavor to retain the deployed HRH in
their facility and abide by stipulations of their signed MOAs.
For Hospitals: Within 3 years from the date of initial appointment, shall endeavour to
provide regular items for deployed HRH
For RHUs and CHOs: Within 2 years from date of initial deployment, shall prepare ways and
means for hiring of deployed HRH

In cases, wherein the recipient facility fails to retain the deployed HRH from the national
government, it shall ensure that the loss of the HRH that will not result to the following:
a. Loss of existing PHIC accreditation of health facility
b. Discontinuation of development projects from funding of development partners
c. Compromise of critical health programs related to attainment and sustainability of
HRH
Logistical support, Funding Source, and Budget utilization
a.
The deployment of HRH shall be considered a special program under the HHRDB
b. All direct and incidental expenses related to deployment shall be charged against
DOH funds.
c.
HHRDB shall sub-allot fund to CHDs for the payment of salaries or stipends of other
HRH and other related activities as specified by the program.
d. All direct and incidental expenses for activities conducted by CHD personnel related
to conduct of technical assistance, capacity building, monitoring, and providing
logistical support to deployed HRH shall be charged against CHD funds.
e.
All direct and incidental expenses on activities conducted by HHRDB personnel
related to program implementation and monitoring shall be charged against HHRDB
funds.
f.
Transportation expenses incurred during the initial deployment of HRH to the areas
of assignment and during the termination of the contract or end of appointment shall
be charged to DOH funds. Expenses incurred during attendance to learning and
development activities shall be charged to the sending office unless otherwise
specified by the sponsoring office.
Other special provisions
Recruitment of HRH for deployment programs shall prioritize recipients of national
scholarship programs. After having complied with the minimum requirements,
graduates from the scholarship programs sponsored and managed by DOH shall be
accepted in the HRH deployment programs.
The implementation shall be consistent with the governments commitment to zerocorruption and anchored on participatory governance transparency and accountability
in all levels.
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VII.

REPEALING CLAUSE

All other issuances inconsistent with the provisions of this Order are hereby repealed/rescinded
and modified accordingly.
VIII. SEPARABILITY CLAUSE
If for any reason, any part or provision of this Order be declared invalid or unconstitutional, such
shall not affect the other provisions which shall remain in full force and effect.
IX.

EFFECTIVITY DATE

This Order shall take effect 15 days upon approval.

ENRIQUE T. ONA, MD, FPCS, FACS


Secretary of Health
Office
Signature
Date

HHRDB

HPDPB

ATC

OSEC

The minimum threshold of 23 doctors, nurses and midwives per 10,000 population that was established by WHO as necessary
to deliver essential maternal and child health services
i

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