Scaling up the bureaucracy

Yoly Villanueva-Ong
Scaling up the bureaucracy
Compared to their private sector counterparts, many government employees are disadvantaged in 3 areas: competence, confidence, compensation

There is a perception that in general, government employees in most parts of the world are “three-fers.” Compared to their private sector counterparts, they are disadvantaged in 3 areas: competence, confidence and most of all, compensation. Here, a call center agent is likely to get paid twice as much as a resident-doctor in a government hospital.

Not a few mocked that this simply confirms, “ If you pay peanuts, you get monkeys.” But like other idiomatic expressions, this one is also an idiotic expression. To borrow from John Locke, this premise is argumentum ad hominem – appeals to one’s prejudices and emotions without objective basis. It could even be argued that there are monkeys smarter than their two-legged foils.

To test this hypothesis, PLOS (Public Library of Science) Medicine conducted a systematic review of research studies investigating the performance of private and public sector delivery in low-income and middle-income countries.

They collected comprehensive peer review studies, then filtered and organized the database into 6 World Health Organization health system themes: accessibility and responsiveness; quality; outcomes; accountability, transparency, and regulation; fairness and equity; and efficiency.

The study debunked the claim that the private sector is usually more efficient, accountable, or medically effective than the public sector; however, the public sector appears frequently to lack timeliness and hospitality toward patients.

It was precisely this demeaning view of the bureaucracy that prodded Singapore’s Former Prime Minister Lee Kuan Yu, to mandate all middle to senior ranked government officials to earn a Master’s degree. Then he aligned the G-men salary scale with their multinational counterparts. Today, Singapore’s government officials are regarded as among the country’s “best and brightest.”


The Department of Health (DOH) in partnership with USAID is undertaking similar capacity-building strategies. The Communications for Communicators (C4C) School is the first of its kind in the country. C4C is the brainchild of the USAID-Philippines CHANGE (Communications for Health Advancement through Networking and Governance Enhancement) Project.

Together with the Johns Hopkins Bloomberg School of Public Health – Center for Communication Programs (JHU-CCP), the Ateneo School of Government and Campaigns & Grey, the goal of C4C is to raise the standard of communication skills among health workers from “messengers” to strategic communicators and thinkers, making them more effective change agents in the health sector.

An intensive 6-month blended learning program was designed for health promotions officers and middle-level managers of local government units (LGUs) and partner agencies.

As DOH devolves further from a national to a localized service, the need for effective health messaging becomes even more critical. The health service professionals need to become the change agents of the health sector.

The innovative program began with a 6-day intensive live-in training course followed by e-learning/e-lecturing through the C4C website portal. Continuous e-mentoring and midterm assessment through face-to face workshops ensured minimal dropout rate. At the end of the course, they implemented a real project in their respective communities and measured impact and result.

Outstanding graduates

On May 15, 2014 the first batch of 86 health service professionals, graduated from the C4C School. DOH Secretary Enrique Ona and the USAID/PH Deputy Mission Director Reed Aeschliman led the first awards ceremonies. Communications Secretary Herminio Coloma, Philhealth CEO Alex Padilla and Assistant Secretary Eric Tayag were also on hand to honor the pioneer C4C Fellows.

All graduates who completed their 6-month blended learning program improved significantly in 3 communication competencies: ability to think strategically in communication, resource mobilization for local communication activities and transformative leadership.

These skills will help them realize the local objectives of the national communications campaigns. Individual and team media-based projects centering on anti-TB, Family Planning and Maternal/Neonatal, and Child Health Nutrition served as the final requirement for graduation.

Five awards were handed to outstanding fellows and projects.

The Most Outstanding C4C Project, “Apat Dapat,” was launched by Santiago Gloria, Jr of CHD 8 encouraging pregnant women in Samar to avail of antenatal check-up at least 4 times during pregnancy and deliver safely in health facilities with trained birth attendants.

In the midst of post-disaster Tacloban, Joanna Manalili of PHIC 8 increased the level of knowledge among pregnant women on the availability and importance of delivering in a health care facility. This earned her the award for Most Responsive C4C Project.

The Most Strategic Project went to Project MAMA in T’boli, South Cotabato.  C4C fellows Agnes Barrion and Ana Liz Cabrido encouraged pregnant women and their children, to avail of health services and antenatal care.

Darlynn Remolino of POPCOM 7 was named Most Outstanding C4C Fellow, while Mary Joy Chiu of CHD 12 was recognized as most improved.

A start

Secretary Enrique Ona delivered the keynote address:

“As the diplomas are handed out today, I hope that the DOH and its partners will have more people equipped to translate our policies and messages into good operational ideas that will easily spread and, ultimately get everyone to move.”

Recognizing the unsung heroes, some of the most dedicated, overworked and underpaid employees toiling in DOH, Ona exhorted them, “I know that you will be the champions of the Department of Health, of PhilHealth, the champions of Kalusugang Pangkalahatan.”

It’s a good beginning.

The selection of C4C fellows for the second year will begin next week. Scaling up the public health sector can happen, one C4C fellow at a time.  –


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