The project had the overall aim of developing a coherent and consistent system of Local Government Unit performance assessment for local health systems. This is also part of world-wide efforts to scientifically search for and document approaches and effective techniques of applying the WHO Health System Performance Framework at national and sub-national levels, across time and across culture, within the context of a decentralized health service environment.
The research initiative had two phases: Phase 1, which centered on the development of the composite domains and indicators of each component identified in the WHO framework, and Phase 2, which entails the conduct of the pilot testing activity and fine-tuning of operational definitions of the composite domains and the reduction of indicators to make it easier to manage in local areas.
The implementation process of the Pilot Test Assessment involved two stages: The first stage was the general planning and selection of sites. The second stage was focused on orientation, training and planning among the participating regional assessment teams. The LGU assessment covered four provinces and three chartered cities. The pilot sites included some municipalities/component cities of the provinces of La Union, Cavite, Negros Oriental and Bukidnon. The chartered cities of Cebu, Pasay and Cagayan de Oro were also covered.
Conclusion. Several issues emerged from the pilot test activity: First, reducing the number of indicators and measures poses a difficult challenge because the information came from different sources and different levels or units of analysis. Second, while some parameters and indicators are found to be important, necessary information was not available in the local offices and facilities during the period of the assessment. As a result, these indicators were excluded from the statistical analysis. Third, while the number of indicators and measures has already been reduced, further reduction is needed to make it more parsimonious.
It is recommended that in the future conduct of the LGU performance assessment, a larger number of provinces and chartered cities should be included. The assessment results, however, will not be used as a basis for assessing the level of performance of LGUs, but as a baseline or benchmark against which future comparison of progress or tracking could be made. In addition, efforts will have to be exerted to further refine the framework and test the indicators system currently being developed. Further efforts aimed at reducing the parameters and indicators need to be made without sacrificing the substantive content domain of each of the components of the assessment framework.
