Health Worker Benefits in a Period of Broad Civil Service Reform: The Philippine Experience

Developing countries that have to cope with pressures to reform their bureaucracies have to contend with increasing health worker benefits and salaries that are often intended to retain these health workers in government service. In the Philippines, the pressure to increase health worker benefits and salaries arose as a consequence of the antidictatorship struggle. A broader, parallel political move in the Philippines also led to the enactment of a Local Government Code that led to the devolution of basic services, including health services. In the last few years, national and local efforts in health have been forced to focus on guaranteeing some of these benefits, even as the entire bureaucracy is the target of increased benefits and salary increases to keep pace with the high health worker benefits. Local governments are feeling the financial limitations of their local funds and are calling for an end to the unfunded mandates that these increased benefits constitute. Lessons drawn from the recent years are discussed