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CASE  STUDIES

The overarching project goal is to reinforce public debates about the risks and consequences of authoritarian rule in the Philippines by enabling members of the academic community to become more active and persuasive participants in these debates. The project strategy is to establish a research network with representatives from the academic community, civil society and the media that will undertake a collaborative research project. Impact will be achieved through the establishment of a research network, research-specific capacity-building among network partners, the production of multi-disciplinary and high quality research, and effective dissemination oriented toward social impact. Taken together, these intermediate results will translate into improved research practices and new knowledge that can sustain a more nuanced and fact-based debate on the state of democracy, human rights, and violence in the Philippines.

Segregating Lives, Recycling Violence: Examining the Local Dynamics of Rodrigo Duterte’s Drug War in Barangay Payatas

Abstract Using the experience of Barangay Payatas under Duterte’s drug war, the study examines the continuity of violence as it manifests in a local community and as against the backdrop of state formation, rejecting the notion that violence is distributed equally...

Struggling Women in the Face of Tokhang: A Feminist Action Research on the Women Victim-Survivors in Duterte’s Drug War in Bulacan

When Tokhang was implemented by Duterte, he [my husband] surrendered to the police. He underwent community-based rehabilitation and was eventually released. There were three policemen who went to our house, even though he already surrendered, the police still went to...

The War on Drugs, The Abra Story

Abstract The drug situation in the province of Abra has been the subject of vacillating narratives.From being reported as having the worst case in its region in July 2016, to being, albeitunofficially, declared as drug-free just six-months into the Duterte...

Tokhang in North Caloocan: Weaponizing Local Governance, Social Disarticulation, and Community Resistance

(This is an edited excerpt from a case study written by the author for the project, “Violence, Human Rights, and Democracy in the Philippines.” The project is a joint undertaking by the Third World Studies Center, College of Social Sciences and Philosophy, University...

Dissent and Its Consequences under the Duterte Administration: The Cebu Experience

Abstract Rampant repression and persecution, oftentimes violent, underscore the response of the Duterte administration towards dissidents. Documentation of these incidences, however, has hardly included narratives from the Visayas region. Centering on the province of...

The Subnational Dynamics of the War on Drugs: The Case of Iloilo City

Abstract Uncovering the factors contributing to the spike of violent law enforcement in the Duterteadministration requires a research that carefully combines both structural and contextuallevels of analysis. The study analyzes the subnational political dynamics of the...

Factors and Forces That Led to The Marawi Debacle

(This is an excerpt from a case study written by the author for the project, “Violence, Human Rights, and Democracy in the Philippines.” The project is a joint undertaking by the Third World Studies Center, College of Social Sciences and Philosophy, University of the...

The Manobo Community of Han-ayan: Enduring Continuities and Changes in Militarization

(On December 4, 2019 Defense Secretary Delfin Lorenzana was quoted in media reports that he is not recommending to President Rodrigo Duterte the extension of martial law in Mindanao. The original declaration was made by President Duterte on May 23, 2017 in response to...

Mirroring Duterte

by Karol Ilagan, Agatha Fabricante, and Christine Fabro | Case Studies, Mindanao (This is an excerpt from a case study written by the authors for the project, “Violence, Human Rights, and Democracy in the Philippines.” The project is a joint undertaking by the Third...

Politics of Prowess: (Re)animating Violence, Politics, and Democracy in a Philippine Political Frontier

Abstract The political development of Davao indicates a pattern of leadership marked by tough, unconventional, and high-handed authority. Politicians who exhibit this kind of leadership are recognized and voted to power. They utilize coercive forces and offer the...

"The enemy is here," Omarkhayam was quoted as having told his younger brother, "why do I need to ask permission" to launch an attack? The enemy is here, why shouldn't we fight?" The military believed it was Abu Dar who reinforced Omarkhayam's unprovoked attack on the military detachment.

The formulation of an ethical and political response to the violence continuously visited by the state upon civilian indigenous communities entails a long, complex dialogue, and for that very reason, such a dialogue needs to be initiated soonest. perhaps sharing the tales of the manobo with which i have been entrusted can help in this process, especially as their stories are not simply astonishing, or moving, or interesting, but most importantly, true., the impact of tokhang could be similar to the demolition of communities but its methods are more brutal and sinister while shrouded in extralegal secrecy and affects a wider segment of the local population. it intensifies state intrusion into the lives of the poor, overkill police deployment is legitimized, and the community’s state of underdevelopment is entirely blamed on the drug problem. it also undermines solidarity among neighbors by instigating citizen surveillance which makes it more difficult to promote unity in challenging the reign of oppressive local authorities. community solidarity is shattered by tokhang where everybody is seen as a suspect or snitch in a supposedly drug-affected barangay., one manobo woman declared that “the symbol of martial law here is [the military’s] deployment of drones” (ang hulagway sa martial law diri kining pagpalupad nila og drone). this statement captures what, for the manobo, is the most salient characteristic of life under duterte’s martial law: it is not just the continuing, virtually constant threat or reality of militarization, which, after all, is not peculiar to the duterte administration. rather, it is the community’s perception that they—manobo residents of civilian communities—are actively being targeted by the state’s counterinsurgency forces and programs. because each appearance of the [drone] is, from bitter experience, linked to subsequent military ground operations, the drone is not merely an eye employed in surveillance, but is also a virtual gun sight used to aim the violence of militarization at manobo villages..

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Introduction, materials and methods, conclusions, supplementary data, data availability, acknowledgements, author contributions, reflexivity statement, ethical approval, conflict of interest statement.

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The policy environment of self-care: a case study of the Philippines

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Leonardo Iii Jaminola, Jana Marie Negre, Veincent Christian F Pepito, Arianna Maever Loreche, Manuel M Dayrit, The policy environment of self-care: a case study of the Philippines, Health Policy and Planning , Volume 38, Issue 2, March 2023, Pages 205–217, https://doi.org/10.1093/heapol/czac095

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Self-care is the ability and empowerment of individuals to maintain health through informed health-care decisions, with or without the support of a health provider. High-income countries have made advances to their conceptualization, research and institutionalization of self-care, given its reported benefits to patients, the health system and economy. A similar undertaking in low- and middle-income countries (LMICs) with already fragile health systems is warranted as highlighted by the coronavirus disease 2019 pandemic. Our article therefore aimed to describe and analyse the policy environment of self-care using the Philippines as a case study, which may have relevance to other similar countries and settings that are transitioning towards Universal Health Care (UHC) to reform and strengthen their primary care systems. We conducted 13 key informant interviews and 2 focus group discussions among representatives from the government, the pharmaceutical retail/industry, community retail pharmacy, primary health physicians and health workers, an infirmary administrator and patients and/or patient advocates. We triangulated our qualitative data with findings from our policy review. We found a total of 13 relevant policies on self-care in the Philippines recently drafted and/or implemented from 2016 to 2021 that fall under the broad categories of unifying frameworks and road maps, capacity building and institutional streamlining, regulations and disease guidelines. Our case study highlights the role of the UHC Law as a driver for self-care and patient empowerment towards better health outcomes with its passage resulting in the promulgation of self-care-related policies. Our findings also suggest that changes in the local policy and built environment, and the formal educational and health systems, are needed to foster a culture of responsible self-care. There are notable exemplars in advancing self-care in the region, including Thailand, from which LMICs like the Philippines can draw lessons to make progress on institutionalizing self-care and, ultimately, realizing UHC and Health For All.

The recent passage of the Universal Health Care (UHC) Law in the Philippines resulted in the promulgation of policies on self-care and served as an organizing and guiding principle, around which more policies on self-care can be created.

The value of self-care in the World Health Organization South East Asian region in promoting population health and improving health outcomes, particularly in low- and middle-income countries (LMICs), is only being recognized in recent years. A notable exemplar is Thailand in part due to its programmes in capacitating and supporting community health workers, allowing sufficient curriculum time for health, and a taxpayer-funded universal health insurance scheme. The Philippines and other similar LMICs may draw lessons from such models to make progress on institutionalizing self-care and realizing UHC and Health For All.

We propose the following: (1) developing and institutionalizing a national self-care policy to help guide future self-care interventions; (2) training community health workers and making other investments towards primary care; (3) promoting health literacy and integration of self-care throughout various stages in the life-course; (4) creating information, education and communication materials to guide people towards responsible self-care; (5) providing an environment supportive of responsible self-care with opportunities to pursue self-care activities and (6) expanding mental health and other primary care services in rural and remote communities.

Self-care: scope, policy and debate

Self-care involves a wide range of choices and practices, shaped by people’s experiences, beliefs and knowledge. There are many definitions of self-care with divergences across disciplines ( Vellone et al. , 2013 ; Narasimhan et al. , 2019 ; World Health Organization, 2019a ), and the concept of self-care has often been integrated and interchanged with self-efficacy, self-medication, self-management, symptom management and self-monitoring. It has also been associated with responsibility, self-direction and autonomy ( Martínez et al. , 2021 ). There are a variety of activities and areas that are considered self-care, which range from daily activities like maintaining personal hygiene and cleanliness in personal spaces to lifestyle and socialization activities such as ensuring proper nutrition and doing physical exercise and sports ( Tulu et al. , 2021 ). The World Health Organization (WHO) encapsulated self-care within six areas: (1) promotion of health; (2) prevention and control of disease; (3) self-medication; (4) provision of care to dependent persons; (5) seeking primary, hospital and specialist care if necessary and (6) rehabilitation ( World Health Organization, 2019a ). It further linked five outcomes with the implementation of self-care interventions: (1) expansion of access and coverage; (2) improvement in the quality of services; (3) higher equity and lower health disparities; (4) better health, social and human rights situation and (5) reduction in cost while having a more efficient utilization of health-care services and resources.

Recognizing the benefits of self-care with billions in cost savings ( Global Self-Care Federation, 2021 ), several high-income countries have formulated policies institutionalizing it. In Scotland and Wales in the United Kingdom, Manitoba in Canada, and some Australian states, policies focusing on self-management of chronic diseases have been implemented. These policies prioritized the provision of self-management skills for chronic disease patients and the conduct of educational programmes for health-care workers ( O’Connell et al. , 2018 ). Meanwhile, in England, the Expert Patients Programme—a lay-led self-care support programme—was developed to provide courses that aimed to improve the self-care skills of patients and was viewed as effective in increasing the energy levels and self-efficacy of individuals with long-term conditions ( Kennedy et al. , 2007 ). In Ireland, the ‘Living Well with a Chronic Condition: Framework for Self-management Support’ was published in support of an integrated programme to prevent and manage chronic disease with self-management as one of the workstreams ( Greaney and Flaherty, 2020 ). Self-care research and programmes have largely focused on chronic illnesses and noncommunicable diseases (NCDs), and even the proposed research strategy for self-care mirrors this ( Riegel et al. , 2021 ). Despite the progress in the field of self-care however, there have also been debates, raising concerns about governmental overreach that encroaches on people’s rights to their personal health and well-being. Self-care policies have also been criticized for their overreliance on patients, especially vulnerable ones, to personal autonomy and responsibility that can result in worse health outcomes. This is exemplified in reports of improper use of medicines for certain conditions, and not consulting with a health-care provider for life-threatening conditions until it is too late.

These advances in the field of self-care have been largely limited to high-income countries, the Americas and Europe, with only one monograph on self-care practices and policies in the WHO South East Asian region published in 2009 ( World Health Organization, 2009 ). The document found that while there are health policies and regulations related to concepts associated with self-care, there are no comprehensive self-care policies in the region and its neighbours, especially among the different low- and middle-income countries (LMICs). The monograph recommended assessing policies to institutionalize self-care; however, no further studies have documented and analysed self-care policies in LMICs since its publication. Fragile health systems in the context of a global health crisis, together with shortages of human resources and limited health-care capacity and health financing ( Amit et al. , 2021 ), highlight the need for a nuanced understanding of self-care policies in LMICs. This will enable context-specific recommendations on how to further promote self-care in these countries.

The Philippine Health System and the need for self-care

The Philippines, an archipelagic LMIC in Asia that is transitioning towards Universal Health Care (UHC), has incrementally improved its health system through legislation. In 1991, the country adopted a devolved model for health governance with the Department of Health (DOH) as the lead implementer of health policies and programmes in the country. This means that the agency is responsible for providing the country with regulatory services, strategic plans and policy directions, and guidelines and standards for health and health care. Aside from these, DOH also manages regional, speciality and government–corporate hospitals ( Dayrit et al. , 2018 ). Currently, there are 70 DOH hospitals across the country ( Department of Health , 2022a ), with both public and private sectors engaged in the delivery of health services in the country. The public sector is operated by the national and local governments and, as such, is mainly funded by taxes. Apart from DOH, local government units (LGU) supervise different types of health facilities and provide various kinds of services. For example, operations of the district and provincial hospitals fall under the function of provincial governments. Meanwhile, municipal governments are responsible for primary care services (e.g. preventive and promotive health services). These services are implemented by rural health units, local health centres and barangay health stations. Municipalities are also in charge of the construction of clinics and health centres and the purchase of medical supplies and medicines ( Uchimura, 2012 ; Dayrit et al. , 2018 ). There are also independent and highly urbanized cities that give services encompassing both primary and hospital care. The private sector, on the other hand, is made up of both for-profit and non-profit organizations providing different kinds of health-care services. Largely market-oriented, health care provided by the private sector is usually paid for by the clients ( Dayrit et al. , 2018 ).

The devolution of the health system was then followed by the establishment of a national health insurance programme, the Philippine Health Insurance Corporation (PhilHealth) in 1995 to provide financial risk protection and prevent catastrophic health expenditures ( Dayrit et al. , 2018 ). It works by creating benefit packages for certain diseases and procedures, which would be used to subsidize part of the cost of treatment and management and paid directly to the health-care provider upon documentation of service. As of 2021, PhilHealth has >52 million direct and indirect contributors ( Philippine Health Insurance Corporation, 2021 ). However, more than two decades after its establishment, total health spending is still largely out-of-pocket with 52% of health-care expenditures financed by out-of-pocket spending ( Department of Health, 2019a ), and on average, PhilHealth only covers 30% of health-related expenditures ( Dayrit et al. , 2018 ). The burden of paying for health-care services is greater among poorer populations who are more vulnerable to higher health spending in times of critical health situations. They are also more likely to suffer from catastrophic health expenditures, which keep them in poverty ( Banaag et al. , 2019 ).

In 2019, what may be the most significant development in the health sector was the passage of the UHC Act ( Dumaraos, 2014 ; Congress of the Philippines, 2019 ). The law aims to implement a systemic approach to realize universal health in the Philippines and ensure equitable access to quality and affordable health-care services. The law is envisioned to protect Filipinos from financial risk due to health-care expenditures ( Congress of the Philippines, 2019 ). Since its enactment, DOH, together with PhilHealth, has been working on its implementation in both national and local settings and even fast-tracking some developments to aid the country’s response to the coronavirus disease 2019 (COVID-19) pandemic ( Department of Health, 2021a ). The UHC Law builds on past policies and aligns with the WHO’s definition and concept of self-care. It therefore provides a good platform for self-care, given its emphasis on primary care and health promotion in the population. However, the implementation of the law has been significantly affected by the COVID-19 pandemic.

Through all these reforms, the Philippines made progress in achieving global health targets under the Sustainable Development Goals and its predecessor, the Millennium Development Goals ( Dayrit et al. , 2018 ). Even with these developments, challenges for the health sector remain. In terms of health-care capacity, the country only has 1.2 beds per 1000 population ( Department of Health, 2020a ), which is less than the 2.9 global average of hospital beds per 1000 people as of 2017, or its other neighbours in Southeast Asia ( The World Bank , 2020 ). There have also been issues regarding primary care services in ‘barangays’ (or villages). Only half of the ‘barangays’ in the country are capacitated with at least one barangay health station. Health-care staffing also is a public health issue with only 7.7 doctors per 10 000 population compared with the global average of 15.1 doctors per 10 000 population ( World Health Organization, 2019b , , 2020 ). This problem is more pronounced due to the maldistribution of health-care providers, including doctors, throughout the country, with most of them practising in urban areas ( Kanchanachitra et al. , 2011 ; Flores et al. , 2021 ; Haakenstad et al. , 2022 ).

Responsible self-care provides a cost-effective way of addressing the shortages and challenges in health-care resources and financing, and advancing the transition to UHC ( Amit et al. , 2022 ). The prevalence of self-care among Filipinos has not been previously estimated, but it has been reported that ∼3–6 in 10 Filipinos practise self-medication ( Barber et al. , 2017 ), which constitutes an aspect of self-care. If properly implemented and encouraged, the potential of self-care to improve population health and well-being makes it a vital, albeit under-appreciated, tool of a health-care system ( World Health Organization, 2009 ; 2010 ; Narasimhan et al. , 2019 ).

This article thus aimed to identify and analyse policies on self-care using the Philippines as a case study, with a particular focus on self-care to prevent and manage common acute health conditions including back pain, allergic rhinitis, general acute pain, cough, cold, diarrhoea, constipation and stress. These significantly contribute to the burden of disease and loss of economic productivity ( Sanico, 2004 ; Katelaris et al. , 2011 ; Dutmer et al. , 2019 ; Dierick et al. , 2020 ; Department of Health, 2022b ) but can be managed by patients on their own with strengthened health literacy to make responsible and informed health choices.

This article used a qualitative case study approach to identify and analyse self-care policies in the country. The findings of this article are part of a larger study on self-care that utilized a mixed methods design to identify local studies and policies on self-care and to assess its social value and economic impact. Our findings are informed by our key informant interviews (KIIs) and focus group discussions (FGDs) on existing self-care policies in the country, conducted from November 2021 to February 2022, and triangulated by our policy review conducted from January 2022 to March 2022. The policy review followed the general steps of Joanna Briggs Methodology ( Peter et al. , 2020; Antonio et al ., 2021 ). We reported the findings of our KIIs, FGDs and policy review following the consolidated criteria for reporting qualitative research ( Tong et al. , 2007 ) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews ( Tricco et al. , 2018 ) guidelines, respectively. Further information is provided in the Supplementary Appendix .

Search results

There were 767 records identified from the three databases and four records from expert interviews, with a total of 32 duplicate records. Based on the titles of the records, only 43 were deemed relevant while the remaining 696 were excluded. Two records were not accessible. Of the 41, a total of 26 records did not contain provisions relevant to self-care while two focused on chronic conditions. Our study therefore includes data from 13 policy documents ( Figure 1 ).

Policy review diagram

Summary of findings

All 13 policy documents identified through the interviews, FGDs and policy review were only institutionalized from 2016 onwards, with 12 of them only institutionalized from 2018 onwards ( House of Representatives, 2016 ; 2019 ; 2021 ; Congress of the Philippines, 2018 ; 2019 ; Food and Drug Administration, 2019 ; Department of Health, 2019b , c ; 2020b , c ; 2021b , c , d ) ( Table 1 ). Six documents were from the DOH Document Management and Archiving System database, five were from the House of Representatives Legislative Information System database with one also found in the Senate database and two were only identified through the interviews [i.e. one from DOH and another from the Food and Drug Administration (FDA)]. Two of the policy documents are laws, seven are DOH Administrative Orders (AOs) or Circulars, one is an advisory from the FDA and three are house bills.

Summary of policy documents related to self-care

Policies did not use the term ‘self-care’ but described self-care-related interventions and concepts including health promotion and health literacy. From these policy documents, we thematically identified four key themes: (1) unifying frameworks and road maps, (2) capacity building and institutional streamlining, (3) regulations and (4) disease guidelines.

The first theme, unifying frameworks and road maps, covers fundamental laws and policies that set goals and frameworks regarding health and the health-care system in the country. These cover republic acts and policies on health promotion and self-care strategies and serve as a basis for future and more specific policies and implementation guidelines. Meanwhile, documents classified under the theme of capacity building and institutional streamlining aim to establish and delineate the role of different agencies and offices in the implementation of health-related policies and strengthen the capacity of the health system on health promotion and self-care. Documents on the control of sale, access and distribution of medicines and health products and services fall under the theme of regulations. Lastly, disease guidelines refer to documents dedicated to the management of a particular disease with a focus on suggested self-care interventions.

Unifying frameworks and road maps

The UHC Act of 2019 and its Implementing Rules and Regulations (IRR) are crucial national policies in the formation of a healthier population. Under the UHC, the envisioned framework adopts a whole-of-society approach in health protection and promotion. Moreover, the UHC Law seeks to refocus the efforts of the health-care system towards primary health care indicating a focus on self-care practices. This entails encouraging individuals towards healthy living and protection from health risks and empowering them through health literacy ( Table 2 , Quote U1).

Illustrative quotes

As part of the law, the National Health Insurance Program (NHIP) was also expanded to protect Filipinos from financial difficulties during medical situations and ensure the provision of health care for all. For this purpose, every citizen is to be automatically included in the NHIP for immediate access and eligibility in availing of health services. The most recent primary care package by PhilHealth is called the ‘Konsultasyong Sulit at Tama’ (‘Konsulta’) ( Table 2 , Quote U2).

Despite this, Filipinos do not go ‘even if there is free testing, diagnostic and treatment, unlike when there is a shoe sale at 50% and you see them start lining up in the morning. Health is their last priority’ (Participant 5, FGD among patients and patient advocates). Beyond affordability, services need to be ‘available, accessible and convenient to access. Especially those who are working, they should be able to access services even on weekends or even 24/7. There is no shortage of innovation. We can definitely drive behaviour change if we address patient needs and preferences’ (Participant 1, FGD among patients and patient advocates).

In line with the UHC and recognition that health literacy among Filipinos needs to be strengthened, the Health Promotion Framework Strategy (HPFS) was developed. The DOH AO 2021-0063 (‘Health Promotion Framework Strategy 2030’) further substantiated health promotion provisions in the UHC Law. The framework serves as the foundation for the development and nationwide implementation of health promotion policies, programmes, plans and activities. The HPFS enumerates seven priority areas for health promotion: diet and physical activity, environmental health, immunization, substance abuse, mental health, sexual and reproductive health, and violence and injury prevention. Using the Ottawa Charter and Bangkok Declaration for Health Promotion as a reference, the HPFS identified five action areas for implementation: developing healthy public policies, creating supportive environments, developing personal skills, strengthening community action and reorienting health services. While all these areas are related to self-care, the most relevant are the development of personal skills and the reorientation of health services. The development of personal skills entails the provision of applicable and useful knowledge to allow for the adoption of health-seeking behaviours. Meanwhile, the reorientation of health services calls for shifting focus on disease prevention and health promotion which includes strengthening self-care practices in the country. The framework also prescribes the use of health literacy as a key strategy to further the promotion of health. This particular strategy necessitates interventions to improve the ability to process, understand and apply health-related information, encourage health-seeking behaviours and practices and apprise decisions related to health. This is a crucial element in the adoption of self-care, given that it is influenced by an individual’s level of health literacy.

Finally, Republic Act No. 11036 or the Mental Health Act of 2018 is another key legislation containing provisions relating to health promotion and self-care that was identified in our qualitative study: ‘I know that the Mental Health Law is meant to ensure that services are provided to individuals with regards mental health issues, which in a way impacts self-care’ (Participant 1, KII with a primary care physician). The law focuses on the integration of comprehensive and effective mental health care not only into the health-care delivery system of the country but also into educational institutions and the workplace. Specific self-care provisions contained in the law include strengthening public awareness campaigns on mental health issues and mental health promotion in educational institutions and the workplace. Moreover, the law also notes the provision of home care services for patients with special needs concretizing the role of self-care in mental health treatment.

Capacity building and institutional streamlining

The passage of the UHC Act paved the way for several developments in the DOH in relation to capacity building and institutional streamlining. As a response to UHC’s directive on the transformation of the Health Promotion and Communication Services (HPCS) to the Health Promotion Bureau (HPB), DOH released AO 2020-0058 (‘Guidelines on the Transformation of the Health Promotion and Communication Service (HPCS) to the Health Promotion Bureau (HPB)’) specifying and clarifying the mandates, roles and responsibilities of the HPB as a branch of the DOH. Under this, the HPB was tasked to coordinate with other concerned bureaus and agencies in the advancement of health promotion. Strategies and programmes of the HPB are expected to address the following: (1) behavioural risk factors, (2) social determinants of health, (3) functional health literacy and (4) healthy settings. Aside from this, there have also been efforts to localize health promotion initiatives through AO 2020-0042 (‘Health Promotion Framework Strategy in Province-wide and City-wide Health Systems’) mandating the implementation of health promotion in province-wide and city-wide health systems (P/CWHSs). With the HPFS in P/CWHSs, the DOH designed and implemented programmes related to it ( Table 2 , Quote C1).

The document also provided guidance and direction for LGUs to operationalize the health promotion mandate stipulated under the UHC and HPFS. The AO also defined the local governance structure of health promotion programmes designating the Provincial/City Health Board as the lead in implementing and evaluating health promotion programmes and policies in the P/CWHS. Through its LGUs, P/CWHSs are tasked to implement health promotion measures including self-care practices such as physical activity, proper nutrition and personal hygiene. The emphasis of policies on preventive aspects, especially among NCDs, was also noted by our participants: ‘I am not aware of any laws on self-care. At the local level, LGU policies are focused on promotion and prevention of NCDs’ (Participant 4, FGD among primary care physicians).

In addition, two records referred to the inclusion of Participatory Action Research (PAR) for health promotion and social mobilization in the national research agenda. DOH formulated a draft policy creating the Realizing Equity through Sustainable Health Action, Participation and Empowerment (RESHAPE) Programme to operationalize provisions regarding PAR in the UHC. The draft policy aims to establish guidelines regarding the provision of financial and technical assistance to implement PAR projects, produce PAR-trained health practitioners and make a network of researchers and institutions that can employ PAR methodology. In relation to this, DOH released Department Circular 2021-0456 (‘Public Consultation on the Draft DOH Administrative Order entitled “Guidelines for Implementing Participatory Action Research for Health Promotion and Social Mobilization Pursuant to Republic Act No. 11223, Establishing the Realizing Equity through Sustainable Health Action, Participation and Empowerment (RESHAPE) Program Thereof”’) to solicit comments on the draft policy. This was followed by the publication of AO 2021-0065 (‘Guidelines on the Implementation of Participatory Action Research for Health Promotion and Social Mobilization Pursuant to Republic Act No. 11223’). The guidelines enumerated themes to be prioritized in PAR projects, which are aligned with the same seven priority areas listed in the HPFS. Through this, the studies of healthy behaviours and self-care are pushed into the national research agenda. The focus on PAR is expected to yield a better understanding of the determinants of health relevant to different communities, examine the linkages between health system performance and social roles and responsibilities and cover the gap between knowledge and practice. As it is focused on health promotion, better self-care interventions for different medical conditions suitable in various contexts can be developed.

Our case study also found two bills that proposed the creation of a central agency for health promotion and a fund dedicated to the works of the agency: House Bill 3657, or the Health Promotion and Disease Prevention Act, and House Bill 05515, or the Health Promotion Act of 2019. The former was filed in September 2016, while the latter was filed in November 2019 (or after the enactment of the UHC Law). In general, these bills cover similar scopes but differ in their approaches and proposed implementation, such that our study is treated as different bills. Both bills seek to allocate funding sourced from taxes collected from the purchase of alcohol and tobacco for the use of the health promotion agency. However, House Bill 3657 proposed that the Philippine Center for Health Promotion and Disease Prevention be organized as a corporate body guided by a Board of Trustees. Meanwhile, House Bill 05515 forwarded the creation of the Health Promotion Commission, a national government agency, as the central body for health promotion. In the bill, the commission is set to work with other government agencies such as the Department of Agriculture, the Department of Education and the Department of Public Works and Highways (DPWH), among others to mainstream health in various areas. For example, the DPWH, together with the Metro Manila Development Authority, is called to design plans which ensure road safety. Moreso, parks and bike lanes are specified as a means of encouraging physical activities and mental wellness. Despite the differences, the ultimate goal of these proposals is to establish an agency to lead the health promotion efforts of the government, mainstream health in all policies and guide the population towards positive health behaviours. Presently, the responsibility is undertaken by the HPB as stipulated in the UHC Act.

Regulations

We identified two regulations: House Bill 10059 (‘An Act Strengthening the Traditional and Complementary Medicine System, Amending for the Purpose Republic Act No. 8423, Otherwise Known as the “Traditional and Alternative Medicine Act of 1997”’) and Advisory 2019-154 (‘Internet Sales and Access To Safe Medicine’) issued by the country’s FDA. WHO lists self-management, including self-medication, as one of the areas of self-care ( World Health Organization, 2019a ). Hence, the regulation of accessible self-care interventions such as medicinal products is regarded as a crucial element in bolstering self-practices.

House Bill 10059 aims to update Republic Act 8423 or the Traditional and Complementary Medicine Act of 1997 and modify provisions related to regulation and its enforcement by boosting the powers and functions of the Philippine Institute of Traditional and Alternative Healthcare (PITAHC). Specifically, the bill mandates PITAHC to ensure compliance of traditional, complementary and alternative medicine (TCAM) facilities with rules and regulations, grant licences for the practice of TCAM and develop product standards and requirements for TCAM products. The development and implementation of regulations on traditional and alternative health care are argued to lead to better quality and delivery of health-care services. However, there are perceptions that ‘over-regulating products discourage adoption’ (Participant 5, KII with a pharmaceutical retail/industry representative).

Aside from this, Advisory No. 2019-154 issued by the FDA in 2019 tackles the sale of medical products online as a response to the increasing sale of medicines online. The advisory was released to serve as a reminder to the general public that current laws do not permit the online selling of medicines. This problem is not limited to the Philippines as it has also been experienced in other countries and has even been regarded as a global phenomenon ( Vida et al. , 2020 ). Beyond conventional products like over-the-counter medicines being sold online, the sale of traditional therapies such as Chinese herbal products has also been on the rise on the internet ( He and Shi, 2021 ).

Disease guidelines

The Philippines has few policy guidelines providing step-by-step instructions on how to treat certain diseases at home or by oneself. In this study, DOH Circular 2019-0233 (‘Adoption of the National Food and Waterborne Disease Prevention and Control Program Clinical Practice Guidelines on Acute Infectious Diarrhea Reference Manual’) was the only document found related to the treatment of acute diseases. Through this, the Clinical Practice Guidelines (CPG) on Acute Infectious Diarrhoea Reference Manual to strengthen the implementation of the National Food and Waterborne Disease (FWBD) Prevention and Control Program was officially adopted. The aim of the guidelines is to standardize the approach regarding the diagnosis, management and prevention of acute infectious diarrhoea. The guidelines recommended several home interventions for mild cases of diarrhoea. For example, the formula for homemade oral rehydration solution (ORS) was described. The guidelines further noted that previously healthy adults who contract acute diarrhoea may also be managed at home with adequate ORS intake, approximately two times the estimated gastrointestinal losses. For health-care workers, there are also detailed criteria provided under what conditions can an adult with diarrhoea be sent home for treatment. Several of our participants in the KIIs and FGDs mentioned taking ORS, probiotics and over-the-counter medicines to self-manage diarrhoea: ‘When I have diarrhoea, I just hydrate myself. If it is bad, I mix sugar and salt in water and drink that solution’ (Participant 4, KII with a government representative). Non-traditional treatments were also identified: ‘In our communities, there are many concoctions to manage diarrhoea including banaba or avocado leaves’ (Participant 2, KII with a patient and/or patient advocate).

Policy recommendations

Policy recommendations to promote self-care in the Philippines varied greatly between the different stakeholders. But there was consensus that changes in the local policy and built environment, and the formal educational and health systems, are needed to foster a culture of responsible self-care. A central theme in our case study is the importance of strengthening health literacy, promoting self-care among children and young adults and having a built environment supportive of self-care ( Table 2 , Quote P1).

From the perspective of patients and patient advocates, they highlighted the need for patient and community involvement in policy-making ( Table 2 , Quote P2).

A participant also mentioned the importance of ‘providing routine and outpatient mental health services in rural areas’ (Participant 9, KII with a patient and/or patient advocate), highlighting the gaps between UHC ambition of providing health care to all and the inequities especially in remote and rural communities. A representative from the pharmaceutical sector suggested ‘making medications more easily accessible to people, but also having guidelines to prevent abuse’ (Participant 8, KII with pharmaceutical retail/industry representative). While DOH is leading the implementation of health programmes and initiatives, other government agencies and departments should also support the health agenda ( Table 2 , Quote P3).

Participants were unanimous in saying that how these policies are implemented also matters. One representative (Participant 3) from the pharmaceutical retail/industry said that ‘health promotion should be done at the local government and even the barangay level’, and an infirmary administrator (Participant 13) mentioned that individuals may be more receptive if health promotion is done on a person-to-person basis.

The UHC Law paved the way for self-care and patient empowerment in the Philippines through legislation, with the majority of the policy documents drafted and/or institutionalized during and after its passage in 2019. The recent development and institutionalization of self-care-related policies in the Philippines highlight the infancy of a formal and unified conceptualization of self-care relative to its advanced development in high-income countries, which may be the experience of other similar LMICs as well. In a 2009 monograph, member countries of the WHO South East Asian Regional Office described self-care policies as being focused on specific aspects of self-care such as TCAM and health promotion ( World Health Organization, 2009 ), similar to the existing Philippine policies. Notably absent in all countries assessed is a national self-care policy; however, among the countries in the monograph, Thailand was significantly advanced with its numerous healthy public policies. This is corroborated in the 2021 Self-Care Readiness Index Report ( Global Self-Care Federation, 2021 ), which assigns a high Self-Care Health Policy score to the country, even higher than developed countries like France, the UK and the USA. The report attributes Thailand’s performance to its tax-funded universal health insurance implemented since 2002, a system that allows its health-care providers to bill for time spent discussing self-care with patients and regulates the practice of TCAM and a strong primary care system including a successful Village Health Volunteer Program. This programme trained local leaders to build trusting relationships, recognize certain conditions, prevent NCDs, serve as early warning and disease surveillance systems and provide basic consultations. Together with sufficient time allotted for physical and mental health throughout the basic education curriculum, this programme was hailed as the main reason for improving health literacy at the community level, especially during the COVID-19 pandemic ( Global Self-Care Federation, 2021 ). In contrast, there are no existing mechanisms by which self-care expenses are reimbursed in the Philippines. The most recent primary care package of the Philippine, the Konsulta package, was identified in our qualitative data. It is a benefit package that aims to encourage access to primary care by reducing outpatient expenditures for routine primary care services and medicines ( Philippine Health Insurance Corporation, 2020 ). While mentioned, we did not include it in the policy documents of our case study since it focuses more on promoting access to primary care within the formal health system, rather than reimbursing self-care expenses. The Philippines also has similar volunteer health workers to Thailand—the ‘barangay’ (or village) health workers (BHWs)—who have been essential in the workforce and health programmes ( Mallari et al. , 2020 ). However, as a result of decentralization of health-care delivery, the effectiveness and functioning of BHWs vary depending on the resources and politics of a locality ( Dodd et al. , 2021 ). Unlike Thailand, the Philippine primary care system needs to be strengthened and its health workforce well supported and financed. With investments in self-care interventions, there should also be enough curriculum time for health as well as investments in community health workers, such as in the provision of technical training and incentives, among others, as this will improve health literacy and empower people to do self-care ( Mallari et al. , 2020 ; Global Self-Care Federation, 2021 ). While Thailand is an exemplar LMIC in the promotion of self-care, the report noted that one indicator Thailand may have to work on is the recognition of the economic value of self-care ( Global Self-Care Federation, 2021 ), which necessitates the evaluation of the impact of of self-care policies to inform government decision-making. Similarly, the Philippines should also fund research on the economic impact and value of self-care in the country.

A continuing debate especially among countries with advanced TCAM regulation, which is one aspect of self-care, is its integration into the formal health-care system due to its perceived lack of effectiveness and safety ( Lee Mendoza, 2009 ). However, misconceptions on regulation and over-regulation of such products remain among individuals who perceive them to be safe ( Marinac et al. , 2007 ), despite concerns by regulatory bodies about their safety and effectiveness. This debate and lack of consensus on TCAM use may be why the Philippines only has a single policy on strengthening TCAM in the country between 2010 and 2022. The purpose of House Bill 10059 was to amend Republic Act 8423 or the Traditional and Alternative Medicine Act of 1997, which has a 7-fold aim: (1) encourage scientific research on TCAM, (2) promote and advocate the use of TCAM, (3) develop and coordinate skills training courses for TCAM modalities, (4) formulate standards for practice of TCAM and manufacture of natural and organic products, (5) formulate policies for protection of indigenous and natural health resources, (6) formulate policies to strengthen the role of TCAM in the health system and (7) promote traditional and alternative health care in different venues. The 1997 law also established PITAHC which has supported studies on drug development from natural products ( Congress of the Philippines, 1997 ). However, since then, no TCAM bill has been passed into law, and a strong TCAM regulation is still lacking in the country. Similarly, most of the published TCAM studies in the country still focused on drug development studies and studies on the behavioural aspects of TCAM use ( Palileo-Villanueva et al. , 2022 ). The bill strengthening TCAM in Congress could be improved by legislating stricter regulation of TCAM modalities in the market, encouragement of research on TCAM–drug interactions and encouragement of health information literacy on TCAM and self-medication.

The COVID-19 pandemic has highlighted the need to empower patients and decrease the burden on the health system. It further served as a catalyst for the mainstreaming of health promotion in the country. Of note are recent Philippine House Bills on health promotion, which put greater emphasis on its implementation in local governments, allowing the implementation of health promotion activities applied to local needs and contexts ( Department of Health, 2020b ; 2021b ). It remains to be seen if these House Bills are eventually passed into law with the requisite appropriations. In addition to having enabling laws for self-care, our findings suggest that it is critical to improve health literacy or the ability to identify, understand, evaluate and apply information and services to make health-related decisions such as understanding prescription drug instructions and navigating the health system ( US Department of Health and Human Services, 2021 ). Previous studies illustrated the link between low levels of functional health literacy and poorer health outcomes ( Gazmararian et al. , 2003 ; Adams, 2010 ). The health literacy–health nexus has been well studied among chronic disease patients wherein adequate health literacy was seen to improve outcomes of self-management among asthma, diabetes and even cancer patients ( Papadakos et al. , 2018 ). Our case study similarly found a greater focus on noncommunicable and chronic diseases and general health compared with self-limiting conditions. These conditions substantially contribute to disease burden, can be managed with proper guidance and should therefore be included in policies and the proposed research agenda on self-care ( Riegel et al. , 2021 ). Given that research and policy should place the needs of individuals and communities at the centre, PAR as advocated by DOH Circulars and AOs should be considered as a design and methodology. Finally, as with TCAM, over-the-counter medications that are commonly used to manage acute conditions should be better regulated to avoid irrational use and antimicrobial resistance ( Rather et al. , 2017 ).

The establishment of a National Self-Care Service with the general aim of embedding self-care in the provision of routine care and engaging different stakeholders to practice self-care for better health ( Nichols et al. , 2020 ) is one policy that the Philippines can adopt. The integration of self-care in the continuum of primary care is done by enabling patients, consumers, laypeople and the media to be active partners in health care, maintaining quality, regular quality assurance and monitoring and evaluation. Our findings suggest that different stakeholders, agencies, implementers and patients need to be involved to support responsible self-care. This may be a tall order for LMICs, but studies in Brazil show that for every dollar invested in self-care activities, at least six dollars of health-care expenditures are prevented ( Global Self-Care Federation, 2021 ). Analyses from the USA have shown that investments in self-care save billions in health-care expenses and hours for both patients and providers, improving productivity and efficiency ( Global Self-Care Federation, 2021 ). Given the challenges and gaps in the Philippine health system and resources, self-care is a cost-effective strategy towards the realization of UHC and Health For All.

There is progress towards conceptualizing and/or integrating self-care into the health systems of LMICs, as illustrated by the Philippine case study. In the country, we found that 13 policies were only recently drafted and/or institutionalized during and after the passage of the UHC Act of 2019. Among these, four policy documents were categorized under unifying frameworks and road maps, six were categorized under the capacity building and institutional streamlining theme, two were categorized as regulations and one was categorized under disease guidelines. Among the 13 records, six stemmed from the passing of the UHC Act, highlighting the singular importance of the UHC Act in institutionalizing self-care and strengthening health promotion strategies in the Philippines. Moreover, the UHC Act and these policies associated with the UHC represent the growing importance of self-care in realizing Health For All and transitioning the Philippine health-care system from a curative health system to a primary health system. The COVID-19 pandemic hastened the mainstreaming of health promotion initiatives in the country, and while these recent policies and administrative issuances are a start, much more needs to be done to improve people’s understanding about self-care within the context of primary health care to achieve the goal of enhancing the health and quality of life of citizens. Additionally, self-care can be enhanced if we have strong institutions that provide information and confidence to individuals to take care of themselves. Previous analyses have shown the value of self-care and having a comprehensive national self-care strategy, which benefits not only the economy and health systems but patients and providers as well. We identified Thailand as an exemplar, which has outperformed high-income countries in terms of health literacy and self-care policies and outcomes. Other LMICs can draw lessons from such models and experiences to further improve their policies on self-care. Finally, we propose the integration of self-care into the educational and health-care systems, taking into account the evidence and critiques from other countries, which will be even more vital as LMICs accelerate progress on UHC.

Supplementary data are available at Health Policy and Planning online.

The data underlying this article are available in the paper, with policy documents accessible through the links provided in our reference list.

This work was supported by Sanofi Consumer Healthcare. The funder had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

We would like to thank Dr Lourdes Sumpaico-Tanchanco, Michelle Edillon and Kriselle Abcede for their invaluable support to this project.

L.J. and J.M.N. assisted with the data collection, data analysis and interpretation, drafting the article and final approval of the paper; A.M.L. and V.C.F.P. assisted with the conception of the work, data collection, data analysis and interpretation, drafting the article, critical revision of the article and final approval of the paper and M.M.D. assisted with the conception of the work, data collection, data analysis and interpretation, critical revision of the article and final approval of the paper.

L.J., J.M.N., A.M.L. and V.C.F.P. are research specialists in the fields of medicine, health policy and public health. M.M.D. is a health systems researcher and former policymaker. He is a Former Secretary of Health of the Republic of the Philippines and Director of the Department of Human Resources for Health at the WHO. All researchers are based in the Philippines.

This study was approved by the University Research Ethics Office of Ateneo de Manila University (Study No. SMPH SELFCARE2022).

None declared.

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• philippines
• statutes and laws
• health care systems
• health care
• universal health care

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3 case studies: How ready are Philippine schools for distance learning?

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This is AI generated summarization, which may have errors. For context, always refer to the full article.

Alejandro Edoria

As we approach school opening 2020, what is on everybody’s mind is how distance learning will be carried out in fact. 

Distance learning is completely new to all but a handful of private schools already attuned to online learning using the internet. Most schools and students, however, have connectivity and bandwidth limitations.  

Distance learning using school packets delivered and collected weekly will have to be the immediate solution because face-to-face contact carries with it the risk of spreading the coronavirus.  

The learning curve for distance learning will be steep.  

In development management, there is a principle of subsidiarity: Where a lower authority can handle a matter, a higher authority should not interfere. By driving authority as far down the decision-making chain as possible, this places decision-making closer to the people.  

In the case of education, this places decision-making at the level of the school.  

So, in this new normal, the drivers of distance education should not be the Department of Education (DepED) central office or the regions; rather, it should be the schools divisions and the schools themselves.  

Here are 3 cases to show how different levels are preparing for such.  

Bacjawan Sur ES (Concepcion, Iloilo)

In the 3rd class town of Concepcion, Iloilo, school principal Rogie Espulgar is working with his 14 teachers to figure out how to reorganize their small rural elementary school for distance learning this coming school year.

Bacjawan Sur Elementary School is located 3 kilometers from the town proper and is host to housing units of families displaced by Super Typhoon Yolanda (Haiyan) in November 2013. It has 330 pupils from kindergarten to Grade 6.   

Five modalities for meeting students have been identified:  

• Face-to-face (traditional, pre-Covid-19 modality)
• Online classes (using web-based and digitized lesson resources [LRs])
• Online-Offline modular (using web-based and digitized LRs )
• Offline modular (using digitized LRs)
• Modular (using printed LRs). 

With the DepED instruction of limited face-to-face contact, Principal Espulgar and his teachers have decided to meet their pupils in shifts.

Grades Kindergarten to Grade 2 will meet face-to-face . Kindergarten will meet daily for half the day, either in a morning or afternoon session. Grades 1 and 2 will be in shifts on alternate days (Monday, Wednesday, Friday or Tuesday, Thursday).   

Grades 3 to 6 will have a modified modular schedule with some face-to-face time . Grade 3 classes will do face-to-face on either Monday-Tuesday, Wednesday-Thursday, or Thursday-Friday (4 classes of 13 or 14 students per class). The other days will be modular with students working on learning assignments from home. A similar type of schedule will be worked out for Grades 4, 5, and 6.

Classes will be divided into groups with no more than 15 or 16 learners per group (Kindergarten is smaller at 10 per group).  This will allow for proper physical distancing when the kids meet face-to-face.

The total number of classrooms in the school are 13, but only 11 classrooms will be used; the other two classrooms will be utilized for online classes and as an isolation room in case of sickness.

“The world is rapidly changing,” said Principal Espulgar, “and along with it comes new innovations and technologies.

“Education has to evolve to keep pace.  The teacher’s role is not to be the sole provider of learning.  She has to be a guide, a motivator, and facilitator of learning…. Compassion, dedication, and commitment are no longer enough.  The modern-day teacher should also make herself (1) innovative, (2) tech-savvy, and (3) open to change,” he added.

How ready are the teachers?

Of the 14 teachers:

• 93% (13)  have smart phones
• 43% (6) have laptops or desktops
• 79% (11) have nternet connectivity
• 50% (7) have ICT gadgets and internet access sufficiency –
• 64% (9) have private space at home
• 29% (4) are able to do ICT troubleshooting with competence
• 79%-93% (11 to 13) are able to use web browser‘s, telecommunication platforms in messaging, social video platforms, video streaming platforms

To prepare for the new normal, the school went through the following types of training for the 14 teachers:

• Mental health and psychosocial debriefing seminar
• Walkthrough of the Minimum Education Learning Competencies (MELC) prescribed by DepED
• Basic and advanced computer software programs (depending on the level of experience of teachers)
• Different web-based platforms for communication, educational sites, learning approaches
• Orientation on the school’s learning continuity plan (LCP)

A physical facilities plan following health protocols was prepared in May to June. The single school entrance and exit for all 330 students plus faculty was modified and improved. More than half, or 9 of the 14 classrooms are considered makeshift classrooms .  Five of 14 classrooms are standard classrooms. One classroom (makeshift) has been set aside as an isolation room in case there are any health incidents. One standard is room is set aside for online classes.  There are 4 handwashing stations distributed in the center areas of the school.

In  July, before the start of classes, the teachers worked on the following:

• Learning resources plans
• School leadership expectations
• Parents participation and roles
• Community linkages
• School action plans
• The school risk management plan
• Health protocols and standards
• Enrollment guidelines

Navotas Schools Division (National Capital Region)

The Navotas Schools Division in Metro Manila is a small sized division of 24 schools of which 7 are high schools.  It is a highly urbanized, heavily populated schools division. 

“The schools in the division will use a modified modular distance learning approach,” schools division head Alejandro Ibanez explained.

“Individualized instruction will allow learners to use self-learning modules in print and digital form. Teachers will use Messenger chat or text messaging to communicate with and monitor students’ progress,” he added.

The schools division has designed a NAVOSchool in-a-box kit for every pupil and student in the division funded by DepED and the city government. 

At the kindergarten level, each child will receive a plastic bin loaded with learning packets, story books, donated school supplies, a hygiene kits and a toy from a partner. The kit also includes a Parent’s guide that covers home learning activities and a guide to organizing the study environment at home.  

Similar kits will be given by the division to students of all grade levels. The learning resource packets will include textbooks and self-learning modules by DepED, modules/materials prepared by the division office and schools, workbooks prepared by teachers, lesson guides for parents and guardians, school supplies, a dictionary, and a hygiene kit.

There is a project in the Division called Project PANATA (PAtnubay kay NApay at TAtay) which is a virtual training using Messenger and Google Meet intended for parents.  

Since the program will be largely packet-based given the connectivity difficulties, the process flow of the school-based modular distance learning is a weekly or biweekly cycle of packet distribution and collection throughout the school year for as long as face-to-face learning is disrupted.

To help students who might fall behind, a “Tutor A Learning Child” program is being organized with para-teacher tutor volunteers being recruited. The Navotas National HS has began recruiting young alumni at the university level to volunteer to work with students in difficult circumstances.  

5 operational stages

Stage 1:  Planning (Identify MELCs for module development by Education Supervisors and teachers).

Stage 2:   Development (by development teams) of learning materials with orientation sessions to provide a standards template.  

Stage 3:   Quality Assurance (QA team in coordination with learning area supervisors)

Stage 4:  Production and reproduction (procurement of teaching/learning resources through the Local School Board using the SEF [Special Education Fund] and the school MOOE [Maintenance and Other Operating Expenses]).

Stage 5:  Distribution of kits and packets

Teachers prepare learning materials, weekly study guides, and other tools which will be distributed in one of three ways:  Pick up from school, Hatid-Aral delivery to homes, or through distribution to barangay or community learning centers.

Taytay Senior High School, Rizal

Recently an ad was flashed on FaceBook that reads: “Do you have a bicycle or motorbike? Do you have an internet connection? Do you own a sari-sari store? Or do you love teaching? Why not be a volunteer of Taytay Senior High School?”

Four modes of voluntarism were spelled out:

• Learning Resource Mover (LR Mover) – Volunteer riders’ or bicycling group who will help deliver learning resources to homes or community kiosks of learners.
• Connect-a-Learner – Volunteer households who will provide learning space in their homes for internet access in their neighborhood.
• Learning Resources Pasabay/Kiosks – Sari-sari store and/or landmarks owners in far-flung communities to serve as pick-up centers for learning resources.
• Community-based Tutorial – Volunteers who will be tutoring learners within his/her community.

As shown in the above cases, DepED schools and divisions have worked hard to design a system to address the new normal of distance learning.  The challenge: Moving from simulation to full implementation where large numbers weekly will put stress on the system.  

How will the system address backlogs, shortages, and bottlenecks in real time?  How will the system address slow learners, learners falling behind or even learners becoming absent and dropping out?   

There will be two things to look at immediately: System efficiency and system effectiveness.

System efficiency

How well do the different parts interact and deliver as planned? What will stress the system is when week-in-and-week-out packets are going back and forth.   If families or teachers fall behind, what kind of support can help them catch up?  If a teacher cannot cope with the demands of distance learning, is there a system for substitution or support?  How do you keep the education materials production flowing efficiently and within budget?

System effectiveness

How do you ensure that learning is actually happening?  For Grades 1 and 2, this would be the 3 Rs (Reading, Writing, and Arithmetic or Literacy and Numeracy). For other grade levels, it is reading and learning at Grade level indicators.  

How do you pick up slow learners or learners with specific difficulties? Recognizing learning difficulties from a distance will be a challenge. Divisions and schools will be totally consumed with implementation issues when the school year starts with distance learning as the new normal.  They might miss many concerns. This is where the regional office comes in:  Quality Assurance, oversight (ensuring that schools and divisions are not overlooking processes or taking shortcuts), and monitoring and evaluation.

The regional office should be doing random testing of students to check effectiveness of the distance education modality and study the efficiencies of this new modality.  

The new normal must be matched by a new imagination about education.

In a recent meeting discussing the education budgets, former DepED Undersecretary for Finance Rey Laguda said: “It’s not enough to just plan for the future based on what we need today.  We need to imagine what an education future will look like.  Because we’ve never had to address something like distance learning at scale before, we need to let our imaginations help draw a picture of what that might be.”

We need to think of new approaches to on how our schools will operate in this new normal, from Imagination (What are the best ways to deliver distance learning?) to a theory of learning about distance learning. Plans can then be drawn up for delivery with scale done.  Once the school year has started, periodic and robust monitoring and evaluation will help us answer the most important question of all:  Are our children learning in this new normal?

Experimentation with distance learning will have to be led by schools and teachers who are closest to students at home. The degree of innovation at this level is a good indication of an education system that is slowly maturing. – Rappler.com

Juan Miguel Luz is former Head, Zuellig School of Development Management at the Asian Institute of Management.  Former Undersecretary, Department of Education. 

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Case Study: Philippines. Recognising Green Skills for Environmental and Sustainable Development in Four Selected Industries

• Open Access
• First Online: 05 August 2022

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• Elmer Talavera 6 , 7 , 8  

Part of the book series: Education for Sustainability ((EDFSU,volume 5))

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This chapter presents a study on the identification and recognition of knowledge, skills and competencies required to convert and maintain green enterprises in a Philippine context and in the light of Philippine policies, legislation and investments to stimulate the development of new green markets. It examines the use of ‘green’ practices in enterprises, the benefits and challenges in the application of such practices, the extent to which respondent micro, small and medium enterprises (MSMEs) have identified the green skills requirements and whether skills recognition mechanisms such as job cards or other portfolio systems have been put in place as part of recognition processes and workplace training programmes. This chapter begins by giving an overview of the Philippine economy and society and the role of MSMEs in four dynamically developing industry sectors namely, automotive, catering, PVC manufacturing and waste management. Given the environmental challenges and problems faced by enterprises in these sectors, the study looks at the extent to which the government’s green job policies, laws, qualifications framework, training regulations and standards address environmental challenges and problems faced by enterprises. The study thus examines connections between macro policies, rules, laws and regulations and micro-level application through practices and green skills and their recognition through recognition mechanisms.

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Environmental challenges

• Industries and services
• Green practices
• Green skills
• Workplace training

Assessment and certification

• Greening TVET

1 Introduction

A basic premise of the study is that if green skills and green practices are to be promoted and recognised, firms need to understand green skills requirements and the recognition of these skills as an important part of workplace training programmes. There is a lack of interest among micro, small, and medium enterprises (MSMEs) to recognise environmentally friendly practices. However, this could change with the Philippine government’s Green Jobs Act of 2016, which provides tax reduction and other incentives for MSMEs.

Thus, this paper will put an emphasis on the voices of employers, employees and enterprises that are largely absent from analysis and policy-making. It is important to know what workers in MSMEs think and are learning about green skills in their workplaces. Most notably, they reported that increasing changes around green skills are being implemented into both work roles but not equally in training.

The Technical Education and Skills Development Authority (TESDA) through its National Institute for Technical Education and Skills Development (NITESD) conducted the fieldwork for this study. The data considered stakeholder perspectives at all levels. The analysis will begin by studying the national government standpoint in addressing workplace environment-related issues in all sectors, and then move to obtaining insights on frameworks and standards established by government authorities in collaboration with industry associations or trade unions and other private sector agencies. Finally, it will look at green skills inclusion in recognition practices from the perspective of enterprises.

Rationale for conducting the empirical study in enterprises

While policies and environmental laws, as well as green standards, competences and qualifications have been developed, there is little information on whether they are implemented at the level of MSMEs or in promoting cleaner production processes in the workplace. In many MSMEs, workers involved in the everyday practice of production do not comply with new regulations and standards. However, the questions of compliance of environmentally friendly regulations should not only concern managers and executives, rather, compliance should concern each worker. Another neglected issue is non-formal education or workplace learning, which is believed to be the core element in meeting the training needs of workers. The training must be conducted on the job and in the working environment, adapting teaching methods to the learning abilities of workers, as well as addressing the issues of access and costs. The learning process must address the entire value chain to build an understanding of causalities, interdependencies and environmental impacts. Promoting green skills is not only about automation and Science, Technology, Engineering and Mathematics (STEM), but also about tracing compliance with environmental regulations at every step in the production process.

The socio-economic environment and the role of industry sectors

The 2019 International Monetary Fund (IMF) statistics ranked the Philippine economy as the 36th largest in the world (IMF 2019 ). The Philippines is considered one of the largest emerging markets and fastest-growing economies in Asia. The Philippine economy, which used to be agriculture-based, is transitioning to services and manufacturing. Its gross domestic product (GDP) based on purchasing power parity in 2016 was estimated at around US $304 billion. The primary exports include semiconductors and electronic products, transport equipment, garments, copper products, petroleum products, coconut oil and fruits. Major trading partners include the United States, Japan, the People’s Republic of China, Singapore, the Republic of Korea, the Netherlands, Germany and Thailand.

Box 11.1 The economic contributions of the industry and services sectors

Automotive industry

The Philippine automotive manufacturing industry (PAMI)—composed of two core sectors, namely manufacturing of parts and accessories for motor vehicles and the manufacturing of motor vehicles—is one of the major drivers of the Philippine industry, generating approximately P248.5 billion (US$5 billion) sales in 2013;

The industry roadmap has targeted 300,000 quality jobs by 2022;

The local vehicle manufacturing industry is expected to attract P27 billion (US$500 million) in fresh investments, manufacture 600,000 more vehicles and add P300 billion to the domestic economy (equivalent to 1.7% of GDP). This has the approval of the Comprehensive Automotive Resurgence Strategy (CARS) programme in 2016;

The comprehensive operation of the automotive industry extends to other complementary sectors such as textiles, glass, plastics, electronics, rubber, iron and steel. Hence, increasing PAMI’s productivity would likewise increase the economic activity of supporting industries, and the Philippine economy (Palaña 2014 ).

Catering services

As tourism serves as the main market for hotel and restaurant services, the increase in visitor traffic over the past 10 years resulted in a corresponding boom in the catering industry;

Catering services include hotels, motels, restaurants, fast food establishments and educational institutions that provide training and other types of organisations responsible for the promotion of hospitality services;

Businesses also purchase food, tools and supplies to help their establishments to generate revenue for supporting businesses;

The economy is stimulated by employing locals for jobs such as food preparation. In turn, these workers earn wages and become tax payers and contribute to economic growth;

The total income in 2012 by the road service (catering) industry reached P267.5 billion (about US$5 billion). More than half of the total income of the Philippines was earned by the National Capital Region (NCR) amounting to P151.6 billion (US$3 billion) (PSA 2012 ).

PVC manufacturing

Polyvinyl chloride (PVC) is a versatile thermoplastic material used in the production of hundreds of everyday consumer products. International and local investments have generated thousands of jobs for Filipinos since 2000.

The Philippine Resins Industries, Inc. (PRII) is embarking on a P1.68 billion (US$50 million) expansion of its polyvinyl chloride (PVC) manufacturing plant in Mariveles, Baatan (Ferriols 2001 ).

Waste management industry

The Philippine waste management sector, which has created many jobs, includes the following activities:

Water collection, treatment, and supply;

Waste removal and disposal services;

Formal recovery of recyclable;

Informal valorisation Footnote 1 of waste products; and

Sewage and remediation activities.

Output value of the different activities

Water collection, treatment and supply: PHP55.1 billion (about US$100 million) (91.1%);

Material recovery: PHP2.3 billion (about US$40 million) (3.8%);

Waste collection: PHP1.9 billion (about US$33 million) (3.1%);

Sewage and remediation activities and other waste management services: PHP0.8 billion (about US$15 million) (1.3%);

Waste treatment and disposal: PHP0.4 billion (about US$7.5 million) (0.6%) (PSA 2014 ).

Source: Authors

Formal sector enterprises

Data for formal sector establishments from the 2010 Annual Survey of Philippine Business and Industry (ASPBI) highlighted 148,266 formal sector establishments. In terms of employment, data collated by TESDA indicates that waste management had the highest employment figures at 47,176 people, followed by manufacturing at 41,528, automotive at 18,337 and catering at 7,479 people. However, many jobs are precarious or casual and operate on a contractual basis. Not all these jobs are salaried; often they are contractual (PSA 2010 ). Thus, despite considerable industrial development in the country, there are major income and growth disparities between the country's different regions and socio-economic classes. The challenges facing the government are high poverty incidence (33% of the population), increased unemployment rate (6.3% of the active population), and persistent inequality in wealth distribution (PSA 2014 ).

There are several challenges that come with greening the economy. Since 1990, the Philippines has seen significant growth in the services sector (55% of the labour force market), followed by agriculture (29%) and manufacturing/ industry (16%) (Central Intelligence Agency 2017 ). Thus, more green practices in the service sector are particularly important to address.

Challenges to achieving more inclusive growth remain. Even though the economy has grown and the unemployment rate has declined somewhat in recent years, it remains high at around 6.5%; underemployment is also high, ranging from 18 to 19% of the employed. At least 40% of the employed work in the informal sector (Central Intelligence Agency 2017 ). This means that most of the people working in the informal sector have achieved their skills through informal or non-formal education and training while on the job or outside the workplace.

Environmental challenges and national policy responses

The World Health Organization (WHO) reported that seven million people worldwide die annually from air pollution—over six million of them were recorded in Asia. Most of these cases are in the People’s Republic of China and India, but experts warned that the Philippines might not be far behind (Montano 2016 ). The Philippines is affected by the increasing density of air pollutants, particularly in cities caused by emissions from vehicles and factories; non-compliance of environmental standards; and incineration (Congress of the Philippines 1990 ). Incineration is defined as the burning of municipal, biomedical and hazardous wastes whose process emits toxic and poisonous fumes. Industry and enterprises are contributing greatly to these environmental hazards.

The increasing volume of household, commercial, institutional, and industrial wastes is an increasing concern. A single resident in Manila produces an average of 0.7 kg of waste a day, about 130% higher than the global average of 0.3 kg per person per day. According to the Department of Environment and Natural Resources (DENR), Metro Manila alone produced about 8,400 to 8,600 tonnes of trash per day in 2011. In addition, street sweeping, construction debris, agricultural waste and other non-hazardous/non-toxic waste products continued to pile up in many areas of the country. The lack of strict public compliance and enforcement powers of those in authority were identified as factors for improper waste management. Other salient issues related to the collection and segregation of solid wastes and monitoring of solid waste management.

Another pressing environmental challenge is the worldwide six-fold increase in consumer good production and subsequent increase in global waste generation by 900% since the 1990s according to the World Trade Organization (WTO). However, due to high costs, developed countries could only recycle 11% of their waste. Footnote 2 The rest were exported to developing countries like the Philippines, where environmental laws were weak and where these toxic and hazardous wastes were accepted as additional livelihood opportunities. In addition, the technological revolution has given rise to a new and growing form of toxic and hazardous waste, e-waste (waste electrical and electronic equipment or WEEE), a consequence of the prodigious growth in the number of computers, cell phones and electronic gadgets that started in the 1990s. The Philippines has continued to be one of the leading destinations for chemical products and toxic substances from developing countries and has become one of the leading importers of ‘persistent organic pollutants’ (POPs), which continually pollute agricultural lands and poison the rivers, lakes, and seas (Ilagan et al. 2015 ).

National policy responses to environmental challenge

The leading role of the government in terms of greening has been highlighted by researchers (e.g. Pavlova 2016 ). The Philippines is a good example. Several governmental policies address environmental challenges. The Philippines addressed its plans for a greener future in the 1990 Philippine Strategy for Sustainable Development (PSSD) supplemented in 2004 with the Enhanced Philippine agenda (EPA) 21. In the Philippine development plan (PDP) 2011–2016, the conservation, protection and rehabilitation of the environment and natural resources were highlighted (Baumgarten and Kunz 2016 ).

Administrative order No. 17 issued by the DENR in 2002 provides the national policy context for the analysis of skills for sustainability and the greening of the economy and society. A major authority for the implementation of environmental policies is the Environmental Management Bureau (EMB) (Department of Environment and Natural Resources 2002 ).

Box 11.2 Philippine environmental legislation

National laws were enacted in four broad areas.

Republic Act 6969—Toxic Substances and Hazardous and Nuclear Wastes Control Act of 1990 provides for a legal framework to control and manage the importation, manufacture, processing, distribution, use, transport, treatment and disposal of toxic substances and hazardous and nuclear wastes. The law prohibits, limits, and regulates the use, manufacture, import, export, transport, processing, storage, possession, and wholesale of priority chemicals that are determined to be regulated, phased-out, or banned because of the serious risks they pose to public health and the environment. The swelling issues of industrial waste, proliferation and waste dumping in the Philippines prompted the implementation of this Act (Congress of the Philippines 1990 ).

Republic Act 8749—Philippine Clean Air Act of 1999 provides a comprehensive air quality management policy and programme that aims to achieve and maintain cleaner air for all Filipinos. The law covers all potential sources of air pollution: (1) mobile sources such as motor vehicles; (2) point or stationary sources such as industrial plants; and (3) area sources such as wood or coal burning. Gas/diesel powered vehicles on the road will undergo emission testing, and violators will be subjected to penalties. The law also directs the complete phase-out of leaded gasoline; lowering the sulphur content of industrial and automotive diesel; and lowering aromatics and benzene in unleaded gasoline. All stationary sources must comply with the National Emission Standards for Source Air Pollutants (NESSAP) and National Ambient Air Quality Standards (NAAQS) and must secure their permission to operate, prior to operations (Congress of the Philippines, 1999 ).

Republic Act 9003–Ecological Solid Waste Management Act of 2000 provides for a legal framework for the country’s systematic, comprehensive, and ecological solid waste management programme that shall ensure the protection of public health and the environment. Under this law, there are several provisions to manage solid wastes (SW) in the country: (1) Mandatory segregation of SW to be conducted at the source; (2) Systematic collection and transport of wastes and proper protection of garbage collector’s health; (3) Establishment of reclamation programmes and buy-back centres for recyclable and toxic materials; (4) Promotion of eco-labelling and prohibition on non-environmentally acceptable products and packaging; and (5) Prohibition against the use of open dumps and establishment of controlled dumps and sanitary landfills, among others (Congress of the Philippines, 2001 ).

RA 9275–Philippine Clean Water Act of 2004 deals with poor water quality management in all surrounding bodies of water, pollution from land-based sources and ineffective enforcement of water quality standards. It also tackles improper collection, treatment, and disposal of domestic sewage, and wastewater charge systems (Congress of the Philippines, 2004 ).

Source: Authors’ compilation based on the Congress of the Philippines legal enactments

2 Terminology and Definitions

Republic Act (RA) 10,771, otherwise known as the Philippine Green Jobs Act of 2016, is the country’s legal mandate for promoting green economies amongst enterprises. The law also grants business incentives, such as special tax deductions from their taxable income and duty-free importation of capital equipment on top of the fiscal and non-fiscal incentives already provided for by existing laws, orders, rules and regulations of the government to encourage them to help generate and sustain ‘green jobs’ (Department of Labour and Employment 2017 ).

The law defines ‘green jobs’ as employment that contributes to preserving or restoring the quality of the environment, be it in the agriculture, industry or the services sector. ‘Green jobs’ shall produce ‘green goods and services’ that would benefit the environment or conserve natural resources. The Law envisions a ‘green economy’ which is low-carbon and resource-efficient, resulting in improved human well-being and social equity in the reduction of environmental risks and ecological scarcities.

The Philippine Development Plan (PDP) 2011–2016 (NEDA 2014 ) stipulated that green jobs can exist and flourish in all sectors. Green jobs can be found where there are measures taken to: (1) introduce low-carbon policies; (2) adapt to climate change; (3) reduce resource use and energy; and (4) protect biodiversity. The plan prioritised key areas identified as mainstream activities affected by climate change: agriculture, fisheries, forestry, energy, construction, transport (including automotive), manufacturing (including PVC production), services (including catering), tourism and waste management.

The pilot application of ‘Policy guidelines on the just transition towards environmentally sustainable economies and societies for all’ that is being conducted in three countries, including the Philippines, adopted by the ILO Governing Body in October 2015, enables the government, together with employers, workers, organizations and other stakeholders, to leverage the process of structural change towards a sustainable, low-carbon, climate-resilient economy to create decent jobs on a significant scale (ILO 2017 ).

The Philippines adopts the Cedefop notion of ‘green skills’ defined in terms of the technical skills, knowledge, values, and attitudes needed in the workforce to develop and support sustainable social, economic, and environmental outcomes in business, industry and the community.

Stakeholder involvement in green skills development in the Philippines

Several stakeholders are responsible for implementing the Green Jobs Law. Green jobs and green skills are being promoted through several departments: the Department of Labour and Employment (DOLE) for formulating the National Green Jobs Human Resource Development Plan (NGJHRDP) on the development, enhancement and utilisation of the labour force; the Department of Environment and Natural Resources (DENR) to establish and maintain a climate-change information management system and network; the National Economic and Development Authority (NEDA) for ensuring the mainstreaming of green jobs concerns in the development plans; the Department of Trade and Industry (DTI) for developing a special business facilitation programme for enterprises; the Department of Transportation and Communications (DOTC) to encourage more investments in public infrastructure and services that foster green growth; the Climate Change Commission (CCC) for developing and administering standards for the assessment and certification of green goods and services of enterprises; and the Department of Finance (DOF) to administer the grant of incentives to qualified enterprises. In relation to the education system, three entities are responsible for implementing respectively green standards, the green curriculum and green skills. These are the Department of Education (DepEd), the Commission on Higher Education (CHED) and TESDA. In addition, the Professional Regulation Commission (PRC) is responsible for facilitating the recognition of knowledge, skills and competency of professionals working in the green economy. The TESDA, the DOLE, and the Department of Science and Technology (DOST) will also analyse skills, training and retraining needs in relation to the use of green technology that has the potential to create new green occupations.

Meanwhile, the DTI, which has promoted the three-year Green Economic Development (ProGED) Project jointly with the GIZ of Germany since January 2013, aims to enhance the competitiveness of MSMEs by helping them adopt climate-smart and environmentally friendly strategies through a value chain approach (Silva 2016 ).

Challenges of greening TVET

TVET has been called upon to make a pivotal contribution to the national goals of inclusive growth, poverty reduction and greening of skills in the context of the Third cycle (2011–2016) of the National Technical Education and Skills Development Plan (NTESDP) anchored on the PDP. Under Strategic Direction 15, TVET needs to ‘develop and implement programmes intended for green jobs.’ This is pursued through the development of new training regulations (TRs) or amendment/ review of existing TRs for green jobs and sustainable development, including agro-forestry, developing the capacity of trainers and administrators to implement ‘green skills’ programmes and linking-up with local and international agencies in the design, implementation and monitoring of ‘green skills’ programmes. ( www.tesda.gov.ph ). TESDA is responsible for formulating the necessary TRs for the implementation of skills training, programme registration and assessment, and certification in support of the requirements for skilled manpower for the ‘green economy’ (Department of Labour and Employment 2017 ).

TVET plays a crucial role in enhancing workers’ productivity and employability and facilitates the active and meaningful participation of workers in the development process. The plan highlighted strategies that will address issues pertaining to innovation and the greening of skills. Most of all, TVET will be responsible for mitigating the effects of climate change in the world of work and workplaces. In this regard, TVET has the aims of (1) ‘greening’ existing jobs to meet the current demand for retrofitting and the retooling of the industry to ensure that existing industries continue to grow; and (2) training new workers with the appropriate green skills particularly for the renewable industries and emergent ‘green’ technology sectors. The challenge, therefore, is to strategise environmental education and skills development in anticipation of a green shift in the priority sectors that include agriculture, forestry, fishery, manufacturing (electronics and automotive) services, solid waste and waste water management, energy, transportation and construction (based on the draft NGJHRDP of DOLE 2017 ).

TVET has a big role to play to support the government policy of protecting and caring the environment. New competences need to be developed relevant to this concern. Going into ‘green jobs’ will require the retooling of skilled workers in sectors with high environmental impacts.

The status of the recognition of green skills

In the Philippines, recognition, validation and accreditation of learning outcomes and competencies of workers in enterprises (i.e. in non-formal learning) is one of the components of competency-based TVET and is part of the strategic directions of the National TESD Plan 2005–2009 (NTESDP) ( www.tesda.gov.ph ). As of December 2017, TESDA had 33 qualifications/TRs out of 2589 promulgated TRs covering environment-related knowledge, skills, and attitudes in the TRs and curricula. In catering services, automotive, PVC manufacturing and waste management sectors, 5S (sort, set in order, shine, standardise and sustain) and 3Rs (reduce, reuse, recycle) are included in the required knowledge and skills which were considered ‘green’. The 5S methodology is also a ‘must’ for all TVET trainers. TESDA likewise amended the TRs for automotive servicing NC III to include LPG conversion and repowering in the set of competences to promote cleaner emissions of vehicles. Ship’s catering takes precautions to prevent pollution in the marine environment by implementing waste management and disposal systems. See Table 11.1 for the list of TESDA TRs with a ‘green’ outlook related to the four industries.

TESDA also conducted a training programme in collaboration with the Department of Energy (DOE) to integrate the use of energy-efficient lighting in the TR for electrical installation and maintenance qualifications. All the qualifications with a green outlook have been accommodated in the Philippine Qualifications Framework (PQF). The Competency Standards are aligned with the PQF, a national policy describing the levels of educational qualifications and setting the standards for qualification outcomes. It is competency-based and labour market driven. It consists of eight levels of education and training that encourage lifelong learning to allow individuals to start at the level that suits them and then build-up their qualifications as their needs and interests develop and change over time ( www.gov.ph ). The Philippine TVET Qualification and Certification System (PTQCS), consistent with the PQF, has five different levels of complexity across the three different domains. The qualification levels under PTQCS start from NC I to Diploma.

Development of green qualifications

In accordance with international requirements, TESDA developed qualifications related to refrigeration and air-conditioning. This was done in partnership with DENR and practitioners as part of the national CFC phase-out plan and in accordance with the Montreal Protocol and the Clean Air Act. Through the TESDA training regulations (TRs) on the refrigeration and air-conditioning (RAC) sectors, competences for technicians are identified and addressed during training programmes on recovery, recycling, and retrofitting of RAC systems, which are major sources of ozone-depleting CFCs. In line with this, a code of practice (COP) for RAC was developed by the project with some funding from the World Bank and the Government of Sweden. The TRs promote safety parameters for workers, customers, tools/equipment, and most importantly environmental concerns.

The competency standards of the PQF follow the ILO Regional Model of Competency Standards (RMCS), which prescribes three types of competences, namely: (1) basic competences all workers in all sectors must possess; (2) common competences workers in a sector must possess; and (3) core competences workers in a qualification must possess. Environmental concerns/ concepts are integrated into the basic competences of the TRs. The three learning domains of the competency standards are aligned to the principles of lifelong learning: learning to live together, learning to be, learning to do, and learning to know, as well as to the twenty-first-century skills.

Inviting experts from industry to develop training regulations

TESDA invites experts from industry and/or industry associations who follow guidelines and procedures on how to align each unit of competency to the PQF descriptors. The TRs have four major parts: (1) description of the qualification and job title; (2) competency standards, including the basic, common and core competences; (3) training standards; and (4) national assessment and certification arrangements.

The competency-based TVET (CBT) system recognises various delivery modes in different learning settings – both on- and off-the-job – if CBT specified by the industry drives the training. TVET has developed three delivery modes: (1) Institution-based, which delivers training programmes in public and private TVET institutions, including regional, provincial, and specialised training centres; (2) Enterprise-based, which implements training programmes within enterprises/firms; and (3) Community-based, which delivers training programmes at the local/community level, mostly in partnership with LGUs and NGOs.

For every unit of competency that is completed by a learner during training, a certificate of training achievement is awarded, and after completing all the required units of competency, he/she is awarded with a Certificate of Training. The latter indicates the title of the course, the qualification level according to the PQF descriptors, and the units of competency that the learner has acquired. The attainment of each unit of competency is pre-conditioned on the attainment of specific learning outcomes as described in the competency standards. As a prerequisite for graduation, a learner undergoes the national competency assessment, and he/she is given a certificate of competency (COC) after satisfactorily demonstrating competence in a cluster of units of competency or a national certificate (NC) after satisfactorily demonstrating all units of competency comprising a qualification using the assessment criteria provided by the TR/CS computed by an accredited competency assessor.

Assessment and certification also include the recognition, validation, and accreditation of competences and learning and work experience. This system observes two major principles: (1) competency assessment to collect evidence relative to a unit or cluster of units of competency, and (2) RPL to give recognition to an individual’s skill, knowledge, and attitudes acquired through previous training, work, or life experiences.

3 Methodology of Primary Data Collection

The study adopts the overall methodology developed by the project for all participating jurisdictions and used the developed instruments such as survey/interview questions, the observation list and the list of generic green skills to collect data (see Chap. 1 ). This country study reflects results from 29 of 32 enterprises (targeting eight companies in each sector). The study was confined within the National Capital Region (NCR) or Metro Manila, given that in this area there were enterprises representing the four targeted industries (catering, automobile, PVC and waste management). Of the 29 respondent firms, seven were from the automotive industry, six from PVC manufacturing, eight from catering services and eight from waste management. Sixteen enterprises from the formal sector were interviewed and five from the informal sector. Given the limited size of the sample, the study does not pretend to generalise across the four industries. It is exploratory in nature and draws on preliminary insights into the recognition and development of greener skills in the identified industry sectors.

Box 11.3 General information on the enterprises

Enterprises in waste management undertook testing of used oil and waste products; microbiological and mechanical testing; verification and certification of public and private firms; and buying and selling recyclable materials such as plastics, meats and paper products.

Enterprises in automotive services and sales undertook servicing of new vehicles and restoration and sale of used vehicles.

Catering services included food delivery, fast food restaurants, stalls and eateries.

PVC enterprises included the sale and installation of plastic pipes and piping systems.

4 Results and Discussion

Educational attainment of the employees

Analysis of the educational attainment of 1,490 employees in the 29 firms showed that overall, the four industries displayed a very high level of education of personnel—81% of employees across all sectors had higher education, 9–10% had attained a secondary education and TVET qualification, and only 1% was below secondary. Enterprises in PVC manufacturing had 92% (454 out of 495) of their employees with a higher education qualification, followed by waste management, 78% (415 out of 529), automotive industry 76% (296 out of 391) and catering services, 55% (41 out of 75).

Environmentally friendly practices in the enterprises

On the question, ‘What environmentally friendly practices enterprises are followed?’ only 11 (42%) out of 26 respondent enterprises had ‘green jobs’ such as waste water management, renewable energy, energy saving and pollution minimisation. Waste management firms ranked the highest, with seven out of seven respondent enterprises attesting to having such ‘green jobs’, whereas only two of the four firms in PVC manufacturing claimed to have ‘green’ jobs and only one out of seven automotive enterprises had ‘green’ jobs. Only one out of the eight catering enterprises had ‘green jobs’. However, environmentally friendly practices were not only restricted to green jobs. This became clear when firms were asked about the various practices, illustrated in Table 11.2 , reflecting environmental sustainability at work in the four industries.

Promoting green practices

Respondents were asked to give their perceptions on how much importance they attached to the theme of green skills in their enterprises on a scale of 1 to 10, where 1 meant low consideration and 10 meant high consideration to these issues. Twenty-five out of 29 responses fell under the scale of 6–10. Four enterprises answered between scales 2–5. However, while high importance is placed on ‘green skills’, there is only a modest promotion of the required skills for the implementation of environment-friendly practices as illustrated in Table 11.3 . PVC enterprises employed the highest number of methods for promoting green skills.

Skill requirements for the implementation of environmentally friendly practices

Enterprises in the four industries described important green skills required for the daily operations undertaken by employees (Table 11.4 ).

How do the respondents acquire their skills?

The employees in the 29 firms across the four industries acquired their green skills in a variety of ways. Both the automotive and PVC manufacturing enterprises identified all the contexts of acquisition. In the catering services and waste management, employees acquired their skills predominantly through self-directed training (seven out of eight) and three out of five respectively (Table 11.5 ).

Benefits of practising green jobs and skills

On the question of whether including green skills in RVA mechanisms could be beneficial, responses from 25 firms showed that 36 per cent of respondents expected the recognition of green skills to be beneficial for enterprises. They said that it could improve productivity and make enterprises more competitive. On the other hand, 32 per cent of these enterprises expected green skills recognition to benefit the individual in strengthening confidence and motivation, and in promoting core generic skills, social inclusion, higher earnings and better career prospects. Another 32 per cent highlighted benefits for the country by recognising skills that are environmentally friendly.

The benefits of green practices and green skills were also confirmed by a 2012 survey conducted by the Employers Confederation of the Philippines (ECOP) in collaboration with ILO (ECOP & ILO, 2012 ) covering three areas (NCR, Cagayan De Oro, and Cebu) in the Philippines. Forty-three participants, representing enterprises from manufacturing, food and beverage, land development and real estate enumerated benefits at the level of enterprise, individuals and the nation (Table 11.6 ).

Reasons for not having ‘green’ jobs with ‘green’ practices

This study also examined the reasons for not adopting green practices. The background research by the ECOP and ILO ( 2012 ) pointed out the disadvantages of adopting green projects. They were:

Restrictive in terms of the permitted practices (38 per cent of survey respondents);

Threat of reducing the profit (25 per cent);

Causing job loss (13 per cent);

High start-up costs to implement initially (13 per cent);

Risk of business shut-downs (13 per cent).

The participants of that project further elaborated that, aside from financial considerations, there is also a lack of awareness and expertise in the Philippines on climate change, environmental issues and green jobs. Additional and appropriate financial and technical support is needed to shift towards green initiatives or launch environmentally friendly practices.

The current study revealed the following reasons why some enterprises did not have green jobs or green practices:

Lack of oversight due to sub-contracting especially in waste management and automotive, where a lot of jobs are outsourced to external contractors;

Lack of money to buy expensive equipment. This was mentioned by enterprises in the automotive and PVC manufacturing sectors;

Presence of policies (i.e. city ordinance) that prohibit the use of environmentally harmful materials, such as plastics, in the case of the catering sector.

Mechanisms for recognising skills, prior learning and work experience in the enterprises

Awareness of RVA frameworks

Very few firms (both employers and employees) said they were aware of the existence and use of RVA frameworks. Only two (1.67 per cent) of 120 respondents said they had heard of frameworks such as the Philippine Qualifications Framework, or other competency-based training frameworks or guidelines prepared by DENR. Only one (0.83 per cent) respondent was aware of a framework developed for human resource development.

Methods used to assess green skills

Only seven out of 30 total responses on methods used to assess green skills alluded to having a job-card system in which employees’ skills were documented. The identified green skills were in waste segregation and disposal, energy conservation, and knowledge of environmental laws such as the Clean Air Act and recycling, among others. In terms of the different sectors, six respondents highlighted the use of different methods, as illustrated in Table 11.7 .

The green skills that are not assessed include: the theoretical understanding of green practice; research and development; waste disposal and familiarity with hazardous waste products.

Enterprises did not have a systematic use of RVA mechanisms, in the absence of which, four respondents stated, the use of ad hoc examples such as ‘mentoring’, coaching and apprenticeships acted as approaches to RVA.

Vision for green skills recognition as part of workplace training

Most of the respondents in the four industry sectors talked about their enterprises’ increasing initiatives to implement ‘green’ training programmes for protecting the environment:

Box 11.4 Importance of green training programmes for protecting the environment

Automotive sector

Upgrading automotive technology to meet the demand for fuel efficiency and reduce emissions;

Providing green customer services;

Learning to use eco-friendly equipment and materials.

Important for recognising green skills;

Updating existing training manuals;

Waste management

Promoting sanitation standards;

Promoting the systematic collection of waste;

Promoting more programmes and incentives at the international level;

Promoting compliance with governmental efforts and standards (i.e. DENR and Laguna Lake Development Authority).

Prospects of staff training and RVA

In September 2017, the Implementing Rules and Regulations (IRR) for the Philippine Green Jobs Law was signed. Clearly, the potential for the inclusion of the green skills in RVA is great, not only at the macro level but also at the individual level. Enterprises made suggestions on the prospects of improving skills training and RVA as shown in Table 11.8 . Only 12 (41.38 per cent) out of 29 firms cited recommendations for the inclusion of green skills in RPL. All recommendations called for staff training programmes.

5 Conclusions and Recommendations

This chapter, based on research conducted by TESDA, has examined issues pertaining to skills recognition as a tool to improve the environmental and sustainable development in the four industry sectors, namely, automotive, catering services, PVC manufacturing, and waste management.

The Green Jobs Law of 2016 has been pivotal in the increase of green jobs and green practices in enterprises participating in this research. Most of the enterprises remarked on the absence of jobs specifically dealing with green practices before the promulgation of this law. Despite this, a huge majority of these firms observed several practices reflecting environmental sustainability in the workplace, such as waste segregation, waste management disposal, and compliance with environmental rules. The importance given to the topic of green skills and environmentally friendly practices is high, especially in the catering sector. However, the promotion of required skills for the implementation of environment-friendly practices is still modest and there is low utilisation of strategies such as the use of brochures and events, innovations, and incentives for cleaner products/ services and marketing.

Interestingly, employers perceived that the creation of green jobs would lead to improved competitiveness of workers, promotion of decent jobs, and additional employment. Some of them, however, cited disadvantages such as a reduction in profit, and increased costs related to the financial and technical support of green initiatives.

Assessment of RPL in some enterprises involves the verification of certificates. In other enterprises, documentation is undertaken with a job-card system while the certification of RPL is carried out by government agencies (e.g., some environmental authority), the mother company, or training institutions.

Employees’ green skills included technical, cognitive, intrapersonal and interpersonal skills. Employers appreciated the cognitive skills of their employees, the most prominent of which were environmental awareness and willingness to undertake green practices. However, both intra-personal and inter-personal competences registered low appreciation from the employees participating in the research.

The enterprises were not knowledgeable about the national RPL framework, and this was evident given the low utilisation of learning outcomes described in the Philippines Qualifications Framework, competency-based training, HRD frameworks and guidelines designed by the EMB-DENR.

A small number of these enterprises have mechanisms to recognise/assess existing green skills that employees acquire in the workplace, community, or through non-formal education and training programmes. There is no systematic use of RPL; rather, RPL is based on ad hoc examples such as mentoring, coaching and apprenticeship.

It was found that employers used simple methods of RPL assessment (i.e. self-evaluation and interview). Through such methods, employers noticed gaps and deficits in the green skills of workers. The areas where these gaps were most prominent were research and development, waste disposal and familiarity with hazardous waste products, among others.

Most workers acquired their skills non-formally or informally through self-directed learning or on the job or in-company training. Only a few workers had acquired their skills through initial and continuing vocational education and training.

Enterprises believed that green skills had a great potential if enterprises, associations and organizations would support their inclusion in RPL mechanisms. Green skills inclusion in RPL needs to be complemented by other elements such as awareness raising, efficient information dissemination, and technical and financial assistance. Such support activities must be implemented through governmental and societal support.

Factors, in order of prominence, contributing to the effective inclusion of green skills in RVA include: laws/ government policies; business opportunities; environmental and economic realities; support/funding/incentives from the government; international conventions; strong LGU enforcement. All these factors are predicated upon sustained information, education and communication (IEC) actions; advocacy; and social marketing.

The passage of the Green Jobs Law, which provides incentives and tax and duty-free importation of capital equipment, makes the potential for green skills inclusion in recognition in the Philippines realisable.

This study, which includes the participation of seven other Asian countries and one Asian territory, should provide valuable inputs in designing and implementing rules and regulations for the recently enacted Green Jobs Law in the Philippines. Specifically, the mechanisms in the identification of green jobs and the attendant green skills leading to the design of training and assessment and certification of programmes should investigate the different models, not only from the Philippines, but also from the international community.

International development organizations can strategically support the development and distribution of learning/ instructional materials – preferably with formats – that can be shared to facilitate massive and immediate learning to benefit the developing economies and the micro-enterprises of/ in the informal sector.

Individual, family, micro-, small-, and medium enterprises that extract valuable materials from the waste system and valorise them for own use, repair and sale, fabrication, or recycling.

The figure pertains only to the US because of unavailability of global data, and given that the US is the biggest producer of industrial waste, this figure is taken as some kind of watermark for all other industrialized countries for purposes of this study (see E. Stewards at http://e-stewards.org/learn-more/for-consumers/effects-of-e-waste/who-gets-stepped-on/ ).

Abbreviations

Reduce, Reuse, and Recycle

Sort, Set in order, Shine, Standardize, and Sustain

Association of Southeast Asian Nations

Annual Survey of Philippine Business and Industry

Board of Investment

Comprehensive Automotive Resurgence Strategy

Competency-based TVET

Centre Européen pour le Développement de la Formation Professionnelle

Commission on Higher Education

Compact Mobile Unit

Certificate of Competency

Code of Practice

Competency Standards

Department of Environment and Natural Resource

Department of Education

Department of Energy

Department of Labour and Employment

Department of Public Works and Highways

Department of Science and Technology

Department of Tourism

Department of Transportation and Communication

Department of Trade and Industry

Environmental Compliance Certificate

Employers Confederation of the Philippines

Environmental Management Bureau

Enhanced Philippine Agenda 21

Gross Domestic Product

Green Our DOLE Programme

Information, Education, and Communication

International Labour Organization

International Monetary Fund

Implementing Rules and Regulations

Information Technology

Local Government Unit

Laguna Lake Development Authority

Liquefied Petroleum Gas

Micro, Small, and Medium-Sized Enterprises

National Ambient Air Quality Standards

National Certificate

National Capital Region

National Economic and Development Authority

National Emission Standards for Source Air Pollutants

Non-governmental Organization

National Institute for Technical Education and Skills Development

National Technical Education and Skills Development Plan

Organization for Economic Co-operation and Development

Philippine Automotive Manufacturing Industry

Philippine Development Plan

Philippine Peso

Persistent Organic Pollutants

Philippine Qualifications Framework

Professional Regulation Commission

Philippine Resins Industries, Inc.

Promotion of Green Economic Development

Philippine Statistics Authority

Philippines Strategy for Sustainable Development

Philippine TVET Qualification and Certification System

Polyvinyl chloride

Refrigeration and Air Conditioning

Regional Model of Competency Standards

Recognition of Prior Learning

Recognition, Validation, and Accreditation

Solid Waste/s

Technical Education and Skills Development Authority

Toyota Motor Philippines

Training Regulations

Technical Vocational Education and Training

United Nations

United Nations Environment Programme

Waste Electrical and Electronic Equipment

World Health Organization

World Trade Organization

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Talavera, E. (2022). Case Study: Philippines. Recognising Green Skills for Environmental and Sustainable Development in Four Selected Industries. In: Pavlova, M., Singh, M. (eds) Recognizing Green Skills Through Non-formal Learning. Education for Sustainability, vol 5. Springer, Singapore. https://doi.org/10.1007/978-981-19-2072-1_11

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