Legazpi — A 2026 study by Jenie Mellicent L. Balete and Amelita Ramirez-Bello of University of Santo Tomas reports that Republic Act 7305, known as the Magna Carta of Public Health Workers, is only partially implemented in the Province of Albay. The findings highlight gaps in compensation, career support, and employment protection that affect the stability of the public health workforce and the quality of local healthcare services.
Published in the East Asian Journal of Multidisciplinary Research, the study evaluates how the Magna Carta is applied in Level I government hospitals in Legazpi City, Ligao City, and Tabaco City. The results provide important evidence for policymakers working to strengthen workforce retention and improve public-sector healthcare delivery in the Philippines.
Republic Act 7305 was enacted in 1992 to protect the welfare, compensation, and professional development of public health workers. The law guarantees benefits such as hazard pay, subsistence allowance, laundry allowance, job security, training opportunities, and safe working conditions. Despite these protections, implementation varies widely across local government units.
This issue has become increasingly urgent as the Philippines faces a growing shortage of healthcare workers. National data show the country has only about 21.2 healthcare workers per 10,000 people, far below the World Health Organization benchmark of 44.5 per 10,000. Without policy improvements, the country could face a shortage of approximately 290,000 healthcare professionals by 2030. These workforce gaps place pressure on hospitals and weaken access to essential services.
Balete and Ramirez-Bello of University of Santo Tomas examined how the Magna Carta is implemented in selected government hospitals in Albay Province, where provincial and city hospitals serve as primary healthcare providers for large communities. Nurses were selected as the main respondents because they represent the largest segment of the public health workforce and play a central role in patient care, treatment monitoring, and community health education.
The researchers used a mixed-method research design combining survey data and interviews with policy implementers. A total of 77 permanent government nurses from hospitals in Legazpi City, Ligao City, and Tabaco City participated in the quantitative survey. In addition, six hospital administrators, chief nurses, and administrative officers provided institutional perspectives through interviews. This approach allowed the researchers to measure both the extent of policy implementation and the operational barriers affecting it.
The findings show that the Magna Carta’s provisions on social and economic welfare are only partially implemented across Albay Province, with an overall weighted score of 1.79. This indicates that several mandated benefits remain inconsistently delivered at the local level.
Benefits that are fully implemented include:
- Vacation leave, sick leave, and maternity leave
- Salary scale compliance under the national Salary Standardization Law
- Allowances integrated into payroll systems such as hazard pay and subsistence support
However, several critical compensation provisions remain largely unimplemented, including:
- On-call duty compensation
- Overtime pay
- Night-shift differential pay
These gaps affect workers who provide extended or irregular hours of service, which are common in hospital environments.
The study also found that professional development support for health workers is partially implemented, with an overall score of 2.43. Nurses reported access to seminars, training programs, and continuing professional development activities. Participation in professional organizations and conferences was among the most consistently supported areas across all three cities.
In contrast, long-term career advancement opportunities linked to postgraduate education remain limited. Position upgrades and salary increases for nurses pursuing advanced degrees were only partially implemented, suggesting funding constraints and limited institutional support for higher education pathways.
Institutional interviews identified several structural barriers that continue to limit full compliance with Republic Act 7305. Local government budget limitations remain the most significant challenge. Administrative delays in benefit processing also affect implementation timelines. Changing local policy priorities further reduce consistency in program delivery.
The study also highlights governance concerns in some facilities. Respondents reported politicized hiring and promotion practices, commonly described as the “padrino system,” as well as delays in granting permanent employment status. These factors weaken workforce morale and reduce confidence in public-sector career stability.
According to Jenie Mellicent L. Balete of University of Santo Tomas, the effectiveness of Republic Act 7305 depends not only on national legislation but also on sustained commitment from local governments. She explains that stronger financial allocation and clearer administrative procedures are essential to ensure that health workers receive the protections guaranteed by law. Amelita Ramirez-Bello of University of Santo Tomas emphasizes that responsive policy implementation models tailored to local conditions can help bridge the gap between national mandates and frontline healthcare realities.
The study proposes a responsive implementation framework designed to strengthen local compliance with the Magna Carta. Recommended strategies include increasing budget allocation for worker benefits, simplifying administrative procedures, improving transparency in promotion systems, and strengthening institutional accountability. These measures can help improve retention among public health workers and support more stable healthcare service delivery across provincial hospitals.
The findings are especially relevant as governments worldwide seek to strengthen healthcare workforce resilience after the COVID-19 pandemic. Improving working conditions for public health professionals is widely recognized as a critical step toward ensuring sustainable healthcare systems.
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