International Journal of Research and Innovation in Social Science (IJRISS) |Volume II, Issue VIII, August 2018|ISSN 2454-6186 www.rsisinternational.org Page 1 Factors Influencing the Quality of Health Care Provisions on Local Government Units John Paul R.Tumampus 1 , Mary Jane J. Romero 2 , Ma. Angela P. Espinoza 3 , Olive Chester Cuya-Antonio 4 1 Eduardo L. Joson Memorial Hospital, Cabanatuan City, Philippines 2 Department of Education, Division of Nueva Ecija, Nueva Ecija, Philippines 3 Tradoc, Philippine Army 4 Nueva Ecija University of Science and Technology, Gen. Tinio St., Cabanatuan City, Philippines Abstract – This study addressed the problem of determining the services provided by the RHUs in the municipalities of Aliaga, Licab, and Quezon and the factors that influence the delivery of these services. With the use of the descriptive method and employing a set of questionnaire, it was revealed that the three municipalities provide primary health care services but lack facilities for Level 1 hospital. Further, the factors of inadequate facilities, personnel complement, and unsound fiscal management affect the delivery of health care services to the residents in the municipalities concerned. From these findings, it was recommended that there should be a policy of the lead agency, the Department of Health, to prescribe penalties for the local governments to at least compel them to achieve the least requirement for healthcare provision. The healthcare services should be insulated from political control for it can be used as a tool for political gains. Finally, this study should serve as a reference for future studies on health care, particularly for rural communities. Keywords: healthcare, rural health, health facilities, health care services, local government unit I. INTRODUCTION A. Background The health care system of the Philippines has evolved tremendously through the numerous challenges it had encountered. With the inception of decentralization in 1991 and the implementation of the Local Government Code, much of the power was vested on the fragile shoulders of local leadership. Most healthcare service expenditures have been devolved in these sub-national governments though licensure regulations, other public goods like immunization and control of communicable diseases are retained in the Department of Health. In the last four decades after World War II (1945-1985), the healthcare system was controlled centrally. Then it was deconcentrated with the creation of eight(8) regional offices in 1958 and later expanded to 12 regional offices in 1972. The national agency for health located in the country’s capital continued to provide resources, health policies, supervision of healthcare programme and healthcare facilities. Healthcare services were impeded at the community level due to the concentration of health workers in the urban centers and Manila[1]. Local government was allocated funds in the form of unconditional block grants, called Internal Revenue Allotments (IRAs). The funds that were allocated depended upon the population (50%), land area (25%) and rested divided equally among all local governments. The funds that were allocated are unrelated to either actual expenses or capacity to carry out their tasks or raise their resources; neither did they have any other conditions attached[2]. With decentralization in motion, the impacts on human resource were wide-sweeping the foundation of the relationship between the health care providers, their managers, and financers. During the onset of devolution, healthcare provider and infrastructure were handed down to non-medical or non-health locally elected politicians and their administration. The Department of Health provided implementing rules and regulations in managing health in the local government units and series of health assemblies with their respective representatives to confer the responsibilities they would undertake, for there was no strategic plan for the introduction of devolution [3]. There were difficulties in hiring medical health workers for the local government units due to its great demand abroad. There was a loss in the career path as well. Before decentralization, a municipal health worker can pursue a career in provincial, national, regional and also up to the national level. Moreover, since the incorporation of health services was added, more frontline workload also expanded. Meanwhile, many public hospitals in the urban areas continued to decline services and decay their facilities. The flight of healthcare workers was among the dilemmas faced by the public health management. Many are paid poorly which might have resulted in a high turn over of personnel even in areas needed of high technical skills [4]. The Department of Health, the lead agency for the provision of universal health care for the nation. It is mandated to formulate and develop national public health policies, guidelines, standards and manual of operations for health care services and programs; issuance of rules and regulations, licenses and accreditations; promulgations of national health standards, goals, priorities and indicators; development of special health programs projects and