Republic of the Philippines

Department of Health
OFFICE OF THE SECRETARY

March 22, 2019

DEPARTMENT MEMORANDUM
No. 2019 - O13 4

FOR: ALL UNDERSECRETARIES, ASSISTANT SECRETARIES,

CENTRAL OFFICE AND CENTER FOR HEALTH DEVELOPMENT
DIRECTORS, HEADS OF ATTACHED AGENCIES AND OTHERS
CONCERNED

SUBJECT: Call for Applications for the Master in Public Management Major in
Health Systems and Development (Batch 4)

The Department of Health - Health Human Resource Development Bureau (HHRDB)

in continued partnership with the Development Academy of the Philippines (DAP) is now
accepting applications for the 4"" batch of Master in Public Management Major in Health
Systems and Development (MPM-HSD) for Municipal Health Officers, Rural Health
Physicians, Public Health Nurses, Development Management Officers and other health
professionals assuming the role of a health manager in his/her area of assignment. Classes
will commence on September 2019.

The MPM-HSD
is
a 38-unit interdisciplinary ladderized graduate program that will
run for 2 years, two-three weeks and twice a year face-to-face sessions. This program intends
to create health care managers and leaders who are responsive to the changing health care
needs of the community. It equips graduates with necessary skills, knowledge and technical
tools in pursuing reforms and proposing strategic interventions to the problems and concerns
in the health sector.

Interested applicants must meet the following eligibility criteria for the MPM-HSD
Scholarship:
1. Permanent Employee in the DOH for least 1 year;
2. Completed a Bachelor’s Degree or related discipline; and
at
3. Not more than 55 years old at the start of the Program.

All eligible applicants must submit their applications to HHRDB by June 28, 2019.
Attached are the checklist of documentary requirements and forms to be accomplished. For
queries, you may contact Ms. Nica Jane Nival and/or Mr. Aldinn Albrando of the Learning
and Development Division - HHRDB through telephone nos. (02) 651-7800 loc. 4250-53/
743-1776 (telefax) or email at dohacademy.scholarship@gmail.com.

By Authority of the Secretary of Health:

C. VILLAVERDE, MD, MPH, MPM, CESOI

Upders¢cretary of Health
ealth Policy and Systems Development Team

njn/idd/hhrdb/19-09

Building 1, San Lazaro Compound, Rizal Avenue, Sta. Cruz, 1003 Manila + Trunk Line 651-7800 local 1108, 1111, 1112, 1113
Direct Tine: 711-9502: 711-9503 Fax 743-1829 * URI.: httn://www.doh.gov.oh E-mail: ftduaue@doh.gov.nh
 Republic of the Philippines
Department of Health
HEALTH HUMAN RESOURCE DEVELOPMENT BUREAU
Bldg. 12-A San Lazaro Compound, Sta. Cruz, Manila
@ (02) 651-7800 Loc. 4250/4251; Telefax: (02) 743-1776

DOH LOCAL SCHOLARSHIP PROGRAM

(Masters in Public Management Major in Health Systems Development)
Name of Applicant:
Position: Office:

ee
CHECKLIST OF REQUIREMENTS

i
REQUIREMENTS.
Accomplished Personal Data Sheet with Work :
Experience Sheet. (CSC Form No. 212 Revised 2017)
2
Issued/
Accomplished by

Applicant
|

ay Remarks

2. Accomplished Certification and Endorsement (Form .

Applicant
B)
3. Accomplished DAP Student Information Form Applicant
4. Accomplished DAP Essay Examination Applicant
5. Three Passport Size Pictures (White Background) Applicant

Note: APPLICATION WITH INCOMPLETE RE UIREMENTS SHALL NOT BE ACCEPTED FOR SCREENING AND EVALUATION.

Additional
Rea ions:once Accepted Dy the DOH- HHRDB ~
Scholarship Service Contract duly Signed and
1.
Scholar
Notarized (4 original sets)
of Record - Please indicate in the
2. Original Transcript Higher Education
remarks: "COPY FOR DAP-GSPDM REGISTRAR" Institution

Higher Education
.
3. Certified True Copy of Diploma
.

Institution
4. Photocopy of Birth Certificate (original copy must be Philippine
presented upon submission) Statistics Authority
5. Photocopy of Marriage Certificate (original copy must Philippine
be presented upon submission) Statistics Authority
6. Medical Certificate (Physically and Mentally fit to Government
undergo study) Physician
To be filled out by the DOH HHRDB Staff:
Action taken/Recommendation:
["] Complete [7] tcompbete

Signature over printed name

 em
FORM B
eo, Republic of the Philippines
Department of Health
HEALTH HUMAN RESOURCE DEVELOPMENT BUREAU
Bldg. 12-A San Lazaro Compound, Sta. Cruz, Manila
@ (02) 651-7800 Loc. 4250/4251; Telefax: (02) 743-1776

DOH LOCAL SCHOLARSHIP PROGRAM

CERTIFICATION
Name
of Applicant:
Position: Office:

Certifying Officer

1. Years in the Institution (as permanent employee):

No. of Years Personnel Officer

2. Has not availed of any foreign or local scholarships

for the last six months; YN Personnel Officer

3. Have rendered at least 75% of service obligation

for scholarship previously availed; Y N
Personnel Officer

4. Have no pending administrative/ criminal charges. Y N

Legal Officer or
Personnel Officer

ENDORSEMENT

This is to recommend Mr./Ms. of to pursue

(Name of Applicant) (Office/ Agency)

(Course in lengthened term)

at the under the Department of Health -
(Name of Higher Education Institution)

Local Scholarship Program.

Immediate Supervisor *Head of Office*

(Name/Position and Signature) (Name/Position and Signature)

*Central! Office — Director

CHD — Director
DOH Hospitals - Medical Center Chief/ Chief of Hospital
LGU — Local Chief Executive
 STUDENT INFORMATION FORM
Academic Year:

1. Name (Please Print):

Last Name Given Name Middle Name

2. Date of Birth (mm/dd/yy) / / Place of Birth:

Age: Sex: Nationality:
Civil Status: ( ) Single ( ) Married Spouse Name:
( ) Separated { ) Widowed

Names and Ages of Children (if any):

3. Home Address:

Contact Details: (Landline) (Mobile) (Email)

4, Current Employment:
Agency: Years in Service:
Position/Designation: Unit:
Address:
Contact Details: (Landline) (Mobile) (Email)
Brief Description of Duties and Responsibilities: Awards/Citations:

5. Academic Background: (Give details of undergraduate and graduate studies taken starting from the most recent)

DAP-OAR-F7, Rev.0
 at

_
7. Current Social /Civic Involvement (Please specify current activities or contributions)

8. Previous Employment:

Agency: Years in Service:

Position/Designation: Unit:
Brief Description of Duties and Responsibilities of the Job Awards /Citations:

Organization: Years in Service:

Position/Designation: Unit:
Brief Description of Duties and Responsibilities of the Job Awards/Citations:

9. References: (list down three (3) individuals not related to you who can provide us information about your
academic/professional qualification and character)

Name: Name: Name:

Position: Position: Position:
Address: Address: Address:

Email: Email: Email:

Mobile: Mobile: Mobile:

10. Have you been criminally convicted in any court of law? ( )Yes ( )No
If yes, please explain briefly. Nature of offense, Data of conviction, Court which handled the case.

Signature over Printed Name

Date
Note: Please submit 2 pieces of 2x2 picture

DAP-OAR-F7, Rev.0
 development academy of the philippines
Graduate Schocl of Public and Development Management

ESSAY EXAMINATION QUESTIONNAIRE

(To be
filled out by Nominee)

This Essay Examination deals with the Nominee’s personal and professional attributes,
experiences, leadership abilities, and other relevant matters.

Read and answer each item thoroughly. Your response and incident cited should allow the
Graduate School of Public and Development Management (GSPDM) Learning Management
Team (LMT) and the Academy Registrar to get to know you on a personal level and gain
insight into your character as a government manager and as an expert. It should include
information relevant to your experience that would highlight your management and
leadership competencies. This is your opportunity to demonstrate to the GSPDM LMT and
the Academy Registrar that you deserve to be accepted.

The response to every item is to be written in English, in not more than 500 words,
typewritten or neatly printed in your best style and should not exceed one-page A4 bond
paper.

MPM-HSD REGULAR
 development academy of the philippines
Graduate School of Public and Development Management

ESSAY EXAMINATION QUESTIONNAIRE

(To be
filled out by Nominee)

1. Have you had an opportunity in your work to demonstrate your expertise? Describe
the situation you were in or the task that you had to do, which gave you the choice to
demonstrate your expertise; the action that you took in demonstrating your expertise; and
the result of your action.

This is to certify that all information / answers |

have written above are original, true and
correct
SIGNATURE OVER PRINTED NAME DATE ACCOMPLISHED

MPM-HSD REGULAR
 development academy of the philippines
Graduate School of Public and Development Management

ESSAY EXAMINATION QUESTIONNAIRE

dap (To be
filled out by Nominee)

2. What improvements and innovations have you introduced in your work and non-work
involvement? Give an example by stating the situation you were in or the task that you
had to do, which merited an introduction of an improvement/innovation; the action that
you took in the process; and the results of your action.

This is to certify that all information / answers | have written above are original, true and
correct
SIGNATURE OVER PRINTED NAME DATE ACCOMPLISHED

MPM-HSD REGULAR
 development academy of the philippines
Graduate School of Public and Development Management

ESSAY EXAMINATION QUESTIONNAIRE

dap (To be
filled out by Nominee)

3. Give an example where you assumed leadership in an undertaking. Describe the

situation or task that led you to take on this leadership role; your action in doing so; and
the resulting outcome of this action.

This is to certify that all information / answers |

have written above are original, true and
correct
SIGNATURE OVER PRINTED NAME DATE ACCOMPLISHED

MPM-HSD REGULAR
 development academy of
the philippines
Graduate School of Public and Development Management

ESSAY EXAMINATION QUESTIONNAIRE

(To be filled out by Nominee)

4. Recall an incident where you had to stand up to protect or promote the welfare of a
group. Give an example by providing a description of the situation or task where you had
to protect or promote the group’s welfare; the action that you took; and the result of your
action.

This is to certify that all information / answers |

have written above are original, true and
correct
SIGNATURE OVER PRINTED NAME DATE ACCOMPLISHED

MPM-HSD REGULAR
 development academy of the philippines
Graduate School of Public and Development Management

SAP ESSAY EXAMINATION QUESTIONNAIRE

(To be
filled out by Nominee)

5. Have you had the opportunity to work in a project/program involving inter-agency

cooperation or partnership beyond your agency? Tell us what happened by describing
the situation or task that presented such an opportunity; the action that you took as you
were faced with this opportunity; and the resulting outcomes of your actions.

This is to certify that all information / answers | have written above are original, true and
correct
SIGNATURE OVER PRINTED NAME DATE ACCOMPLISHED

MPM-HSD REGULAR
 development academy of the philippines
Graduate School of Public and Development Management

dap ESSAY EXAMINATION QUESTIONNAIRE

(To be
filled out by Nominee)

6. What is your motivation in taking up this Program?

This is to certify that all information / answers |

have written above are original, true and
correct
SIGNATURE OVER PRINTED NAME DATE ACCOMPLISHED

MPM-HSD REGULAR