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An initiative of DOLE, in collaboration with BON-PRC, DOH, PNA, UPCN, OHNAP and othergovernment and non-
government entities to promote nurse entrepreneurship by introducing ahome health care industry in the Philippines:
1. to reduce the cost of health care for the country¶s indigent population by bringing primary health care services to
poor rural communities,
2. to maximize employment opportunities for the country¶s unemployed nurses and
3. to utilize the country¶s unemployed human resources for health for the delivery of public health services and the
achievement of the country¶s Millennium Development Goals on maternal and child health, consistent with the
Formula One for Health framework of the Department of Health.

 

The Davao Region will be the pilot area for the program wherein there will be one nurses¶ cooperative for each of the
five provinces and one for Davao City. It is chosen as the pilot area because the idea for the program was
conceptualized by Dole regional Director Jalilo dela Torre.
Nearly 500 nurses in Region 11 have now banded together to form nurses cooperatives and are busy complying with
the requirements for registration with the Cooperative Development Authority as a cooperative. After registration, they
will be assisted by MASICAP to put together business plans that they can use to ask for grants from government and
non-governmentsources. Among the potential sources of revenues for the cooperatives are the
local governmentunits, Philhealth¶s capitation fund, foreign donors and migrant Filipino organizations abroad. The
DOH will be a critical partner as source of data on the status of health services delivery in poor rural communities.
Even before CDA registration, the Davao del Norte group, buoyed by the expression of total support by Governor
Rodolfo del Rosario, have already started negotiating with local chief executives, with successful results.
The program¶s strategy is to encourage nurses to form cooperatives with a minimum number of nurse members of
500 and manage nurses¶ clinic, under the supervision of trained and experienced nurses, which will deploy newly
licensed nurses to poor rural communities with little or no access to basic health care.

Entreprenurse: The New Breed of Entrepreneurs

Posted by: Medical Butler on Sep 21, 2011
Tagged in: shortage of nurses

Nurses should try to explore other career opportunities such as becoming entrepreneurs, suggested the
Department of Labor and Employment last Sunday addressing the oversupply of nurses. Nurses can now
practice their entrepreneural skills by setting up their very own nursing clinics and small pharmacies.
Due to economic crisis, nurse-importer countries such as the US and UK have decreased its demand for
nurses. Filipino nurses are stuck in the country with limited job opportunities, that's why more and more
nurses are becoming unemployed.
The nursing clinics are being encouraged by the DOLE (Department of Labor and Employment). In fact,
several nurses, have already been given financial assistance to start up their very own clinics. The DOLE
allotted 1.6 Million worth of funds to these nurses, 850,000 PHP is for the equipment and 217,000 PHP as
the equity which will be sourced from the members.
Labor director in the Caraga region, Ms. Ofelia Domingo said that there are over 25 nurses in Surigao del
Norte, who have already put up their entreprenurse clinics. All of these 25 nurses worked for the NARS (
Nurses Assigned in Rural Service), a project of the DOLE and DOH, for six months.
The nurse clinic has several services including; consultation, laboratory procedures such as blood tests,
fasting blood sugar, random blood sugar, urinalysis, stool exam, sputum exam, private duty nursing,
parenteral medication, IVF insertion, ATS/ Tetanus injection, nebulization, wound cleaning and dressing,
catheterization, oxygen administration, foot and palm reflex and thermal therapy.
    
An initiative of DOLE, in collaboration with BON-PRC, DOH, PNA, UPCN, OHNAP and other government
and non-government entities to promote nurse entrepreneurship by introducing a home health care
industry in the Philippines:

1) to reduce the cost of health care for the country¶s indigent population by bringing primary health
care services to poor rural communities,

2) to maximize employment opportunities for the country¶s unemployed nurses and

3) to utilize the country¶s unemployed human resources for health for the delivery of public health
services and the achievement of the country¶s Millennium Development Goals on maternal and child
health, consistent with the Fourmula One for Health framework of the Department of Health.

Rationale
This initiative aims to achieve public health objectives and at the same time address the unemployment
problem of licensed nurses in the country. The strategy is to encourage nurses to form cooperatives and
manage nurses¶ clinics, under the supervision of trained and experienced nurses, which will deploy newly
licensed nurses to poor rural communities with little or no access to basic health care and with substantial
populations of sick, elderly and disabled patients. There services will be compensated by the LGU,
Philhealth, HMOs, by the patients themselves on a per visit basis, or from grants from local and foreign
donors. Congressmen¶s and Senator¶s Priority Development Funds shall also be tapped.

Quality health care is an expensive option for most Filipinos, many of whom do not have health
insurance. The popular saying, †

 


 is not only an attempt at dark humor but reflects a
reality that the overwhelming majority of Filipinos simply cannot afford quality health care. The data from
the HMOs is that only less than 15% of the population have health insurance. The rest pay for health care
services either out of pocket or through the Philhealth. In 2002, the World Health Organization estimated
that of total health expenditures in the Philippines, 47.5% is out of pocket.
Beyond the issue of the high cost of quality health care, access to primary health care is also a problem
amongst poor rural communities. In one report of one of our nurses under Project NARS, a pregnant
woman died under his watch simply because the island town lacked oxygen supplies. The Philippines has
one of the worst health manpower to population ratio in Asia. In 1999, our ratio of one doctor per 9,689
population is only slightly better than Cambodia¶s 9,997, but lower than Indonesia¶s 6,195, Thailand¶s
3,670, Myanmar¶s 3,291, Vietnam¶s 2,122, Malaysia¶s 1,465 and Singapore¶s 731.

In Region 11, the ratio of public health manpower to population is even more worrying: Compostela Valley
has only 1 government doctor for every 49,666 population and one government nurse for every 40,353;
Davao del Norte has one doctor for every 53,924 and one nurse for every 27,832; Davao del Sur has one
doctor for every 49,189 and one nurse for every 32,793; Davao City, the regional center, has one doctor
for every 73,484 and one nurse for every 39,891. Therefore, the deployment of nurses to poor rural
communities in these provinces is an urgent need and it is in the interest of these LGUs to support the
initiative.
The home health-care business, now a $55 B industry in the United States and is making inroads in India,
is one of the more effective strategies for reducing hospitalization costs for people who can¶t afford it.
Patients who are medically fit to go home continue to be cared for in a home setting by healthcare
professionals²nurses, physical therapists, nursing aides, LPNs, medical technologists²can expect to
see their medical services bill considerably reduced. These healthcare professionals, principally nurses,
aside from performing in-home services to qualified patients, may at the same perform public health
functions while in the community to serve indigent patients and educate the community on the prevention
of diseases.

On the other hand, the oversupply of registered nurses in the country, now estimated at 150,000,
resulting from the boom in the number of nursing schools and the spike in nursing enrolment from the
1980s to 2008 (there has been a 17% drop in enrolment for 2009) has brought home the issue of how to
provide employment opportunities for our unemployed nurses. The DOLE¶s Project NARS has provided
temporary employment for 11,000 nurses all over the country in 1,000 poverty-stricken municipalities, but
the sustainability of the project beyond 2009 still needs to be worked on.

Many local chief executives are now petitioning for the extension of the 6-month training program
because they have seen the public health value of Project NARS. Our nurses in their 3-month stint in
rural health units were involved in, among others, blood donation drive, birth delivery, dispensing of
medicines, immunization, pre-natal check-ups, nutrition evaluation, mass treatment of schistosomiasis,
cataract operation, pre-marriage counseling, OPD referrals, medical and dental services caravan, TB
program enrollment, minor surgery, family planning seminar, tubal ligation/vasectomy, dental health
program, distribution of AH1N1 information materials and dengue surveillance. Needless to say, our
Project NARS nurses made quite an impact on the rural health situation in the short time that they were
assigned in the rural areas, and we must build on the goodwill among our local government units which
the project has generated by introducing a similar beneficial initiative.

Unemployed nurses shall be organized into cooperatives, whose main purpose is to deliver home health
care services to its own members and members of HMOs, Philhealth members and self-paying members.
There shall be at least 500 members per cooperative for a city and at least 1,000 members for a province.
Metro Manila cities shall be considered a province for the purpose of this initiative. The objectives of such
cooperatives will not only be the personal health and well-being of its customers, but to collaborate with
rural health units in the achievement of Millennium Development Goals in maternal and child health and
other public health objectives.