The Local Government Code (LGC) and subsequent policies led to a healthcare

system with many independent local health systems run by provinces, municipalities, and

cities. However, these systems had limited connections to the Department of Health (DOH).

The DOH worked with local governments at different levels but lacked significant influence

over local health spending. The responsibilities devolved to local government units (LGUs)

included managing local health facilities and providing health services such as public health

programs and preventive care. Each LGU had an elected local chief executive (LCE) and a

local health board (LHB) that advised the LCE and the local legislative council on health

matters. Despite devolution, health outcomes varied widely across LGUs. Some struggled to

adapt to their new responsibilities, resulting in poorly equipped and understaffed health

facilities. Financial constraints were a major issue, with many LGUs lacking funds to pay

salaries and not considering the costs of implementing health worker benefits.

The fragmentation of the healthcare system had the most significant impact on

geographically isolated and disadvantaged areas (GIDAs), where access to quality

healthcare was limited. To address post-devolution challenges and move toward Universal

Health Coverage (UHC), several policy reforms were introduced. The National Health

Insurance Program (NHIP) and the creation of the Philippine Health Insurance Corporation

(PhilHealth) aimed to collect additional health-related revenues and diversify payment

methods for health services. The Sin Tax Law increased funding for health, and the passage

of the UHC Act marked a significant step toward achieving UHC in the Philippines. Overall,

the healthcare system in the Philippines faced challenges post-devolution, including

financial constraints and disparities in health outcomes. Policy reforms and efforts to

address these issues were ongoing.