Baseline Assessment and Situation Analysis Tool

Health Workforce Building Block (HRH Management and Development)

Local Health System Maturity Levels (Preparatory Level)

Date Submitted:

Region: 2

X
Local Government Unit Mark if:
Province City/Municipality

DELFIN ALBANO

P/C/M Health Officer: KATRENE CAY R. ACERA

Baseline Year: 2023

I. OBJECTIVES

This tool aims to guide the local planners in conducting a baseline assessment/situation analysis and
identify investment needs for the development and strengthening of human resources for health
management.

The results/outputs that will be derived shall be the source/reference in drafting the situation analysis on
the locality’s health workforce as additional input to the Situational Analysis of the Local
Investment Plan (LIPH) for Health and Annual Operational Plan (AOP) for Health.

II. GENERAL INSTRUCTIONS

As provided in Department Memorandum 2021-0277 1 Key Result Area 1.1 on Baseline Assessment
Report must include the following minimum contents: a) distribution and staffing pattern within
Province-wide/City-wide Health Systems, b) HRH gaps/needs, c) learning and development needs
based on competency standards. To be able to accomplish this tool, all blank fields and attached
appropriate matrices/templates must be completed. A sequential step is also provided for each indicator
and a box for key results and interpretation to highlight significant information to guide the local
planner.

The following reports/documents will serve as the means of verification for KRA 1.1:
a. Baseline Assessment and Situation Analysis Tool
i. Matrix 2 on Estimated Demand and Supply of Human Resources for Health in Province
or City-wide Health System
ii. List of Certified and Not Certified Primary Care Workers

These matrices shall be approved and signed by the head of office/facility before submission to the
CHDs for validation and forward endorsement to the DOH Central Office.

III. BASELINE ASSESSMENT

1 FY 2022 Local Health Systems Marrity Levels (LHS ML) Annual Monitoring and Updated LHS ML Monitoring Tool
 A. Distribution and staffing pattern (filled and unfilled positions) within the Province-
Wide/City-Wide Health Systems (disaggregated by hiring authority)

Step 1: Provincial or City Health Offices (P/CHOs) shall determine the HRH distribution and
staffing pattern in areas of their jurisdiction by accomplishing the supply column in the below
matrices on Estimated Demand and Supply of Human Resources for Health (HRH) in
Province/City-wide Health Systems:

1. For PHOs: bit.ly/LHSML-Matrix2P

2. For CHOs: bit.ly/LHSML-Matrix2C

In the same matrices, P/CHOs shall likewise indicate and validate submission of signed NHWR
Update Report Form of each facility by accomplishing the KRA 2.2 NHWR Update Report
Form List sheet.

Step 2: Indicate the name and signature of staff who accomplished the matrix to be approved
by the head of office.

Step 3. Include one-paragraph key results and interpretation here.

The distribution and staffing pattern in Delfin Albano Health Workforce are quite complex
since apart from the Rural Health Unit (Primary Care Facility) it also has an Infirmary
hospital (LGU-owned) that is in an integrated set-up.

1. Based on the DOH DC No, 2020-0176: Circulation of the Manual of Standards for
Primary Care Facilities, the generated outcome of HRH Distribution and staffing
pattern on Matrix 2, the LGU needs to prioritize in creating plantilla positions for both
RHU and hospital.
2. Based on the Matrix 2 the LGU is required to hire 1 Dentist, additional 7 Midwives, 4
Public Health Nurses and 1 Primary Care Physician for the RHU only, in order to
satisfy the requirements on HRH
3. While in the Infirmary/LGU-owned Hospital there were enough staff however, need to
create plantilla positions since majority filled up positions where temporary (JO/COS)
most importantly the Medical Director since Licensing and Philhealth requires that
only 1 Physician can handle 1 facility at a time.
4. There is a need to present the outcome with the decision body through the LHB as a
prerequisite in the creation of plantilla positions.

B. HRH Gaps/Needs

HRH gaps/needs are computed using the formula in determining the variance between HRH
demands and HRH supply (LGU hired only; regardless of nature of employment) as illustrated
below. The computed variance identifies whether the P/CWHS has gaps (deficiency) or
surpluses (excess) of HRH.
 ● HRH Demand - refers to the minimum staffing requirements or the minimum number
of health workers needed to enable functional operation of health facilities according to
type, such as hospitals or primary health care facilities. This shall be based on the
policies/standards set by the DOH per facility type (please see List of
Policies/Standards on Health Facilities).

● Supply - refers to the current number of HRH employed by the LGU and working in
the health facility. They can either be permanent or temporary or contractual employees
(please see Metadata of NHWR Data Fields).

● Variance - refers to either gap or surplus from the required number of HRH based on
standards.

Step 1: Provincial or City Health Offices (P/CHOs) shall fill in the needed data in the demand
column and the demand calculator tab that will help compute the variance (gap/surplus) in the
below matrices on Estimated Demand and Supply of Human Resources for Health (HRH) in
Province/City-wide Health System:

1. For PHOs: bit.ly/LHSML-Matrix2P

2. For CHOs: bit.ly/LHSML-Matrix2C

Step 2: Indicate the name and signature of staff who accomplished the matrix to be approved
by the head of office.

Step 3: Indicate summary of result below.

Total Demand, Supply, Gaps, and Surplus of HRH in P/CWHS

Demand Supply Gap Surplus Supply Gap Surplus w/ Supply

w/o DOH w/o DOH w/o DOH w/ DOH w/ DOH DOH Distribution
Deployment Deployment Deployment Deployment Deployment Deployment (LGU-Owned)

29 11 -18 0 17 -13 1 65%

Total Variance of Demand and Supply of HRH in P/CWHS per cadre

 Profession Variance w/o DOH Variance w/ DOH Supply Distribution
Deployment Deployment (LGU-Owned)

Gap (-) / Surplus (+) Gap (-) / Surplus (+)

Dentist -1 -1 0

Medical technologist 0 1 50%

Midwife -8 -7 86%

Nurse -7 -4 50%

Nutritionist-dietitian 0 0 0

Occupational therapist 0 0 0

Optometrist 0 0 0

Pharmacist -1 -1 0

Physical therapist 0 0 0

Physician -1 0 50%

Radiologic Technologist 0 0 0

Speech Therapist 0 0 0

X-ray Technologist 0 0 0

Step 4: Include a one-paragraph key results and interpretation here.

1. Based on the DEMAND Requirements,

1. Highlighting on the positions owned by the facility, there is a significant gap

variance noted across the 3 focused health cadres (DENTIST, MIDWIVES
and NURSES)
2. Despite the DOH-HRH augmentation, we can still note a significant
disparities on the 3 focused cadres
3. However, on the supply distribution we can note a substantial achievements
on the HRH positioning on the other health cadres
4. In general, to meet the human resource ratio to population of the LGU, it is
imperative for the creation of plantilla that will be inclusive in the LIPH
and AOP reports

The OUTCOMEs, as per supply distribution LGU owned, should be included in the agenda
for discussion with LHB body for prioritization in the fulfilment and realization of the
UHC Act.

C. Learning and Development Needs based on Competency Standards

To enable P/CWHS integration, primary care provider networks shall be organised and complemented by
competent and practice-ready primary care workers (PCW) in primary care facilities (PCF) as mandated in the
 UHC Act. This requires continuous provision of relevant learning and development interventions in
accordance to the LD needs of the primary care workers as prescribed by DOH-PRC Joint Administrative
Order No. 2020-01, entitled “Guidelines on the Certification of Primary Care Workers for Universal Health
Care.”

Pursuant to the transitory provision of the JAO No. 2020-01, the DOH encourages all licensed physicians,
nurses, and midwives delivering primary care services and currently employed/affiliated in public and private
PCF to secure a Provisional Certificate in Primary Care. In order to obtain the Provisional Certificate, PCWs
are required to undergo LDIs (i.e. completion of two PCW-related e-learning courses).

Those without a Provisional Certificate will be identified as health workers who would need LDIs to satisfy
the competency requirements of a primary care provider. These LDIs shall serve as mechanisms in ensuring
that certified PCWs are capacitated to deliver comprehensive primary care services in the PCF.

Thus, it is critical to identify the health workers who need to undergo the LDIs to be certified as PCWs. This
can be achieved by accomplishing the following templates:

1. For Primary Care Facility: https://bit.ly/3qf9evj

2. For Municipal Health Office/Component City Health Office: https://bit.ly/3qf9evj
3. For Independent Component City/Highly Urbanized City Health Office: https://bit.ly/3qf9evj
4. For Provincial Health Office: https://bit.ly/3qf9evj
5. For Centre for Health Development: https://bit.ly/3ijhRk8

Note: For your reference, you may access the database on the number of primary care workers issued with a
provisional certificate in Primary Care per UIS & Non-US by the DOH:
https://bit.ly/CertifiedPCWs_Provisional

REFERENCES:
● DOH-PRC Joint Administrative Order No. 2020-0001 “Certification of Primary Care Workers
for Universal Health Care” (bit.ly/PCWCertification)
● Department Memorandum No. 2021-0261 “Advisory on the Provisional Certification of Primary
Care Workers for Universal Health Care” (bit.ly/PCWAdvisory)
● Department Memorandum No. 2022-0029 “Application for the Provisional Certification of
Primary Care Workers in 2022”

IV. FACTORS AFFECTING HRH MANAGEMENT

List down five (5) problems/issues/concerns in HRH management according to priority in column A and
the contributing factor/s affecting/causing the identified problem in column B. Propose strategies or action
points to address them in column C. The National Human Resources for Health Master Plan 2020-2040, a
long-term strategic plan for HRH management and development, shall be used as reference to craft
strategies. LGUs are also encouraged to recalibrate as needed to consider the own context of the locality.

Note:
AOP Annex C.1 Situational and Gap Analysis Summary can be used as reference.

Identified PRIORITY Contributing Factor/s Strategy or Action Points

Problems/Issues/Concerns in (Underlying direct or indirect (Proposed steps to address the
HRH management factor/s influencing/affecting a problem)
particular health problem)
(A)
(B) (C)
 1. Lack of permanent
positions for RHU Insufficient funds, non-inclusion on Continue to lobby for plantilla
HRH the AOP for the plan of absorption positions and to also facilitate
of qualified DOH-deployed HRH absorption of deployed HRH
once fully devolved

2. Integrated set-up of
RHU and Hospital Duplication of work; overworked
heads and program coordinators
(PHN vs other Nurse with
permanent item)
Continue to lobby the need of
permanent nurses to handle
different public health
programs and also for the
hospital

3. Lack of training for

newly hired staff Due to pandemic, decrease number Inclusion in the LIPH and AOP
of offered trainings for essential for the priority trainings of
programs health staff

4. Lack of permanent
position for Municipal Insufficient funds Continue to lobby for plantilla
Dentist position

5. Lack of permanent
positions for DAMH Insufficient funds Continue to lobby for plantilla
HRH position i.e. Medical Director

6. Lack of permanent
positions for RHU Insufficient funds, non-inclusion on Continue to lobby for plantilla
HRH the AOP for the plan of absorption positions and to also facilitate
of qualified DOH-deployed HRH absorption of deployed HRH
once fully devolved

SUBMITTED BY:
MARITES A. RAMIREZ, RN

Public Health Nurse

REVIEWED BY:

KATRENE CAY R. ACERA, MD, MPM

Municipal Health Officer

APPROVED BY:

ERLIEGY A. BUTAY, MPA

Municipal Gov’t Department Head I (MHRMO)