The Concept of Return of Service

Recognizing the importance of and the challenges with health human resource, Academic Institutions perhaps due to the suggestions and prodding of government have been institutionalizing return service programs with their medical students and other allied medical graduates. It is already an acceptable fact that there could be no health system if there are no health workers. The inherent challenge in countries like the Philippines is that not too many health professionals prefer working for and within the public health system as it is now. The lack of enabling environment and support, both for the practice of medicine and career growth, makes public health career unappealing. And yet majority of the population, particularly the poor who cannot afford medical services provided by private facilities, would access health care provided through the public health system. It seems that the devolved health set up is not helping the problem either. Being devolved, this requires that local government units are given the responsibility and accountability to implement health programs and provide healthcare services, both require the presence of health workers. Incidence of health professionals not receiving enough compensation or benefits and even being politicized makes it even worse. However, despite these challenges, it is an unchanged fact, that we need health professionals in public health system, especially in the more remote areas or areas that are usually outside the radar of mainstream society and government. And for some institutions and government, RoS may be one of the answers to this seemingly gargantuan problem.

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T1: What constitutes an effective RoS program?

Given the theory that RoS is indeed one of the solutions, albeit perhaps temporary and short-term, to the problem of lack of health human resource in the public health system, how can we improve or design an effective RoS that would really funnel in more health professionals to work in public health? If we are to evaluate an RoS program, how do we measure its success? What should be implemented in an RoS program?

T2: How can governments complement RoS programs of individual academic institutions?

So far, in the Philippine context, government has yet to issue a policy requiring all graduates of medical school or any allied health course to serve through an RoS program. So far, this is more of individual initiatives of academic institutions and usually are geared towards scholars, particularly government funded scholars or students from State Universities whose tuition fees are subsidized by government. Given the present context, how can government complement these initiatives to make sure that these RoS programs accomplish their objectives?

T3: What are other alternatives to RoS that can help address the problem on lack of health human resource?

It must be said that RoS is just one of the strategies in addressing the perceived problem in health human resource. What are other alternatives, short-term, long-term that can help address problems in health human resource, particularly the lack of health human resource in the public health system, specifically at the primary care level?

About The Author –

Bien Nillos, MD is a graduate of the University of Saint La Salle College of Medicine Batch 2006. He earned his Masters degree in Health Social Science at De La Salle University in 2014. He is a former Doctor to the Barrio (Batch 23) and served the far-flung municipality of Candoni in the heartlands of Negros Island. For his work as a DTTB, DOH cited Dr. Bien as Most Outstanding Doctor to the Barrio in 2009. He is currently Director of the Community Health Partnership Program of the Zuellig Family Foundation and also a part-time faculty at the De La Salle University Behavioral Sciences Department and University of Saint La Salle College of Medicine Family and Community Medicine and Bioethics Departments.

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