Community participation in local health boards in a decentralized setting: cases from the Philippines

• Published in: Health policy and planning Vol. 16; no. suppl-2; pp. 61 - 69
• Main Authors: Ramiro, Laurie S, Castillo, Fatima A, Tan-Torres, Tessa, Torres, Cristina E, Tayag, Josefina G, Talampas, Rolando G, Hawken, Laura
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.12.2001; Oxford Publishing Limited (England)
• Subjects: Citizen participation; Community participation; Community Participation - statistics & numerical data; Community-Institutional Relations; Decentralization; Decision making; Decision Making, Organizational; Developing Countries; Empowerment; Health administration; Health boards; Health Care Reform; Health Planning Councils - organization & administration; Health services; Health Services Research; Hospitals; Humans; Interviews as Topic; Local government; Models, Organizational; Negotiating; Organizational Case Studies; Philippines; Policy Making; Politics; Power (Psychology); Public health; Public Health Administration; Sociology; Studies; Tropical diseases; Womens health; Philippines
• ISSN: 0268-1080; 1460-2237
• DOI: 10.1093/heapol/16.suppl_2.61

Decentralization has been associated traditionally with participation and empowerment in local decision-making. This study of four cases analyzed the role of local health boards in enhancing community participation and empowerment under a decentralized system in the Philippines. Local government units (LGUs) with functioning local health boards were compared with LGUs whose health boards were not meeting regularly as mandated by law. The study found that there were more consultations with the community, fund-raising activities, health initiatives and higher per capita health expenditure in LGUs with functioning local health boards. Only the mayors and municipal health officers felt empowered by devolution. In general, awareness of devolution and their potential roles in health decision-making was low among members of the community. These findings can be attributed to the socio-cultural and historical traditions of centralized governance with little popular participation, overall attitudes of the community and board members, perceptions of health as primarily a medical matter, economic circumstances of LGUs, and insufficient preparation for devolution. Recommendations are suggested in response to these findings.