Buenafe, F. M. A. V. (2014). Analysis of physician retention factors in Cagayan: A framework for improving human resources for health (Unpublished master's thesis). Graduate School of Public and Development Management, Development Academy of the Philippines.

Graduate School of Public and Development Management. Health Systems and Development. Batch 4 Thesis (MPM-HSD)--Development Academy of the Philippines.

In December 2010, the Aquino government used the Universal Health Care (UHC) as a battle cry to govern the Philippine local health system. In achieving the thrusts of UHC, six strategies are optimized: (1) Health Financing, (2) Service Delivery, (3) Policy, Standards and Regulation, (4) Governance for Health, (5) Health Information and (6) Human Resources for Health (HRH) at its core. HRH is an essential part in the movement of health programs and attainment of good health outcomes. However, globally the HRH has been facing challenges especially with retention and unequal distribution of rural health work force. The Philippines has not been spared by this phenomenon with the continuous brain drain of the physicians, and the the low retention rate of Doctors to the Barrios (DTTBs) in rural areas. Cagayan, a relatively affluent province in the northeast Luzon is one of the provinces that do not have a Municipal Health Officer (MHO) for every municipality. The improvements of the HRH management in Cagayan through a policy framework based on the objectives of describing the current situation of the HRH in Cagayan and the factors that affect the motivation of physicians to work in rural areas were addressed in this study. The conceptual famework of the HRH action framework developed by the World Health Organization (WHO) in 2008 was used to anchor the recurring themes on the elements that were considered for a working HRH system:Leadership, Political, Finance, Education, Policy, and HRH management system (HRHMS). Document analyses of various memoranda and policies relating to international and local HRH were analysed along with Key Informant Interviews (KII) of physicians in Cagayan- MHOs and private practitioners. A Focus Group Discussion (FGD) was done with DTTBs assigned in Region 2 to validate the results of the initial findings. The current HRH status in Cagayan is problematic as iit is developed and fragmented in multiple levels, thus creating confusion in HRH policies, and work description. Furthermore, the compensation offered by the municipalities were Internal Revenue Allotment (IRA) dependent and may not be attractive enough to applicants. Factors that affect the decision of physicians to be an MHO were positive motivations such as family, service, and Local Chief Executive (LCE) support; while negative motivations were lack of career growth, nature of politics in the Local Government Unit (LGU). LGU capabilities to hire an MHO depended mainly on the finances of the municipality and the political will of LCE to hire an MHO. Lastly, a policy framework anchored on the current issues of the HRHMS and the factors that affect physician motivation can address the HR management problem of physician retention in Cagayan. The policy framework which resulted from this study recommended the need for training on health and local governance, a non-tangible motivation for compensation, obedience to the Magna Carta for Health Workers, counter parting in partnership, the encouragement of doctors as public managers, and the streamlining of the HR management system to improve the HRH management in Cagayan.