Despite producing thousands of nurses and doctors each year, the Philippines is grappling with a critical shortage of healthcare workers, hindering its ability to fully implement the Universal Health Care (UHC) Law, a recent study from Ateneo de Manila University has revealed.
Published in the journal Human Resources for Health, the study highlights a mismatch between the country’s strong health worker export record and its domestic healthcare needs. A combination of outdated education models, low pay, and restrictive hiring practices has left both government and private healthcare institutions struggling to fill positions.
Researchers pointed to a glaring issue: while the country continues to send skilled professionals abroad, the remaining workforce is either inexperienced or nearing retirement. “The nurses we lost are our best nurses. It is painful that the trained ones are the ones who leave,” said an administrator of a public tertiary hospital. “The ones left with us are either the new ones or are very old, because their salary (overseas) is five times what we pay here.”
The study also found that many medical graduates are ill-equipped for public health work, largely due to curricula that are heavily focused on hospital-based care. New doctors and nurses often lack grounding in community health and UHC principles, leaving them unprepared to serve in local health systems that the 2019 UHC Law was designed to strengthen.
Even those who opt to serve locally face bureaucratic barriers. A primary care provider from an urban facility lamented that rigid Department of Health (DOH) staffing requirements force nurses to take on multiple roles. “The nurse is the administrator, she is also in the records. So, the nurse is also the IT… just to meet the criteria,” the provider said.
While Republic Act No. 11223 promised access to quality healthcare for all Filipinos, implementation has lagged due to poor coordination between national and local health units, limited service capacity, and a fragile health workforce infrastructure—issues further aggravated by the COVID-19 pandemic.
The numbers tell a stark story: the physician-to-population ratio in the Philippines is just 7.92 per 10,000, below the World Health Organization’s minimum benchmark of 10. The nursing sector is even more strained, with an estimated shortage of 127,000 nurses nationwide—most severely felt in private hospitals.
To address these structural issues, the study outlined a ten-point agenda. Key recommendations include linking academic institutions more closely with health facilities, expanding post-graduate opportunities, revising medical education to focus on public health, and providing targeted incentives to retain professionals in underserved areas. The authors also advocate for more equitable international labor agreements to address the ongoing brain drain.
Ultimately, the study warns that unless systemic reforms and sustained investment in human resources are prioritized, the promise of Universal Health Care will remain largely unmet for millions of Filipinos.
