Evolution of the Philippine Health Care System During the Last Forty Years of Development Administration

This article discusses the influence of the evolving development administration emphases - centralisation and decentralisation — to health care delivery in the Philippines during the last four decades. It shows how prescriptions during the 1950s and 1960s led to the creation of a centrally planned Philippine health care system. The dysfunctions of this centralised system motivated development administration specialists to call for decentralisation in the 1970s. Initial attempts at decentralisation were mainly functionally and structurally-oriented, that is, the health care bureaucracy was reorganised and streamlined to ensure improved programme implementation especially at the local community level. However, the limitations of structural decentralisation created the demand for process decentralization efforts — an approach which concentrates on more social-behavioural changes and active stakeholder participation. Process decentralisation was used not only to improve implementation but also to ensure susta...