MANILA, Philippines — A comprehensive study released on Tuesday, March 31, 2026, has revealed a troubling trend in the Philippine healthcare system: a vast majority of Local Government Units (LGUs) are significantly underspending on primary health services, even as their national tax allotments have increased.
The research, conducted by a coalition of academic institutions and health advocacy groups, highlights a “systemic misalignment” between local budgets and the actual healthcare needs of constituents at the barangay and municipal levels.
Despite the implementation of the Mandanas-Garcia ruling, which expanded the share of national taxes given to LGUs, the study found that many provinces and cities have prioritized infrastructure and “visible” projects over the less-conspicuous but vital primary healthcare (PHC).
- Investment Shortfall: On average, LGUs are allocating only 3 to 5 percent of their annual investment plans to primary healthcare, far below the 15 percent recommended by international health organizations to achieve Universal Health Care (UHC).
- Personnel Vacuum: Over 60 percent of rural health units (RHUs) remain understaffed, with a critical shortage of permanent midwifes and community nurses.
- Medicine Scarcity: Nearly half of the surveyed municipalities reported “frequent stock-outs” of essential medicines for non-communicable diseases like hypertension and diabetes.
Health experts warn that this underspending creates a “bottleneck” at the top of the healthcare pyramid. When local health centers lack equipment or staff, patients bypass them and flock to provincial or national specialty hospitals for minor ailments.
“Our tertiary hospitals are overwhelmed because the first line of defense—the primary care provider—is underfunded,” said Dr. Elena Cruz, one of the study’s lead authors. “We are essentially practicing ‘hospital-centric’ care rather than ‘people-centric’ care.”
In response to the findings, the Department of Interior and Local Government (DILG) and the Department of Health (DOH) are reportedly drafting a joint circular that would set a “mandatory floor” for healthcare spending. Under the proposed rule, LGUs would be required to prove they have met minimum PHC standards before they can utilize funds for non-essential administrative projects.
The study concludes that without a drastic shift in local priorities, the Philippines’ goal of achieving “Health for All” by 2030 remains “statistically improbable.” Advocates are now calling on citizens to participate more actively in local budget hearings to demand better funding for their neighborhood health centers.