The report, commissioned by the Unilab Center for Health Policy (UCHP) and conducted by the Ateneo School of Government and Ateneo Policy Center, was presented during the second UCHP Symposium, “Investing in Health: Policy Forum on LGU Health Budget and PhilHealth Benefit Design.”
Dr. Maria Eufemia C. Yap, senior research fellow at the Ateneo School of Government and lead author of the study, said LGUs’ health budgets rose by as much as 5 percent from 2022 to mid-2025. But she cautioned that increases alone do not guarantee better health services.
Case studies across LGUs
The study, titled “Maximizing Local Government Fiscal Performance of Health Budget,” analyzed budgeting practices in four LGUs: Quezon City, Antique Province, the Municipality of Belison (Antique), and the Municipality of Odiongan (Romblon). A fifth case in Isabela City, Basilan, is being developed in collaboration with the Department of Budget and Management (DBM).
The research reviewed the full budget cycle—from preparation and authorization to execution and post-review—highlighting systemic barriers that prevent timely fund use.
Reliance on national funding
Despite the devolution of health services to local governments, the study showed, municipalities still rely heavily on the National Tax Allocation (NTA). The study found that 74 to 95 percent of their budgets come from national transfers, compared with 23 to 36 percent for provinces and highly urbanized cities.
Much of the money is also absorbed by salaries and personnel services, leaving less for operations, programs, and direct patient care. This imbalance, the report said, limits the impact of health spending on communities.
Overlapping requirements
Researchers flagged another major challenge: a tangle of overlapping planning and budget documents. LGUs must prepare annual investment plans, operational plans, procurement plans, and local health investment plans, often on conflicting schedules.
While funds may be available, delays in processing and mismatched requirements often keep them from being released or used in time.
“This misalignment, along with budget directives that do not always reflect local realities, often results in plans that fail to meet emerging health needs,” Yap said. She added that weak monitoring systems and local political dynamics can slow approvals and dilute accountability.
Push for alignment and accountability
The study urged stronger coordination between national and local governments to ensure health budgets translate into tangible benefits. It also supported the DBM’s push to build LGUs’ public financial management skills.
“Promoting financial accountability and aligning national and local priorities will ensure that resources for health are not just spent, but are truly felt by the people,” Yap said.
Call for stronger national support
UCHP program director John Basa emphasized that government agencies such as the DBM, Department of Finance’s Bureau of Local Government Finance, Department of the Interior and Local Government, and Department of Health must extend stronger technical support and clearer policy guidance.
He also highlighted the role of Congress in reviewing laws to ensure they foster sustainable health spending at the local level.
“With improved systems and alignment, LGUs can transform their health budgets from routine expenditures into powerful investments that directly improve the well-being of their constituents,” Basa said. —Ed: Corrie S. Narisma
