REGIONAL UNIFIED

HEALTH RESEARCH AGENDA

OF MIMAROPA
2017-2022

MIMAROPA Health Research and Development Consortium

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BACKGROUND

Research has a vital role to help boost the Philippine health economy, both locally and abroad.
Given the recent developments in local capacity, education, among others, the potential of
research in expanding innovation, health services, production of health goods, and building the
capacity of highly qualified Filipino health care managers and researchers has become very high.
To provide guidance on health research and development efforts of the country, the Philippine
National Health Research System (PNHRS) periodically constructs the National Unified Health
Research Agenda (NUHRA) helping ensure optimal benefit from national and international
investments.

In recognition of the diverse and specific health needs of the country, the NUHRA 2017 to 2022
was formulated using a mix of bottom-up and top-down approaches. As part of the bottom-up
approach, Regional Unified Health Research Agendas (RUHRA) were developed for the 17
regions of the country that was designed to reflect each region’s health research needs and
priorities.

In this RUHRA, the MIMAROPA’s health research topics and priorities for 2017 to 2022 are
presented and expounded based on the consultation with key stakeholders of the region. This
document also describes the framework and processes followed to formulate the health research
priorities of the region. Moreover, this RUHRA explains the broad points for the advocacy,
dissemination, and monitoring and evaluation of MIMAROPA’s health research priorities.

The succeeding sections cover the following: (1) framework used for the agenda-setting process
that governed the direction of the regional consultation; (2) regional situationer of MIMAROPA
describing the regional landscape of health research; (3) methodology utilized in the regional
consultation; and (4) the health research priorities of MIMAROPA; and (5) broad plans for
implementation, dissemination, and monitoring and evaluation.

FRAMEWORK

The basis of the process framework for the formulation of RUHRA was the Kingdon Model of
agenda-setting (Kingdon, 2001) (Figure 1). This public policy model acknowledges the problem,
policy, and political avenues of public priority that is visible during the regional consultation stage
(Figure 2). The details of the preparation and the consultation stages for the RUHRA were
presented in the methodology section.

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Figure 1. Kingdon Model

Figure 2. Process Framework for RUHRA 2017-2022

MIMAROPA SITUATIONER

The regional situationer of MIMAROPA aims to describe the health research landscape in the
region based on research areas and impact, the regional stakeholders, opportunities and
strengths as well as challenges, issues, and gaps confronting the region. It was drafted based on
review of literature and documents of the MIMAROPA Health Research and Development
Consortium (MHRDC), the Department of Health (DOH), Philippine Statistics Authority, published
articles, among others. Survey responses of 16 respondents from MHRDC member institutions
also served as basis for the situationer.

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Previous and Current Health Research Priorities

For 2006 and 2010, the first RUHRA was formulated for the whole Region IV including
CALABARZON and MIMAROPA. The process followed three phases, which were situational
analysis, identification of issues based on surveys and focus group discussions, and prioritization.
Ten research priorities were identified as follows: (1) environmental health; (2) health care
delivery/health information system; (3) infectious diseases; (4) policy formulation; (5) lifestyle; (6)
maternal and child health; (7) occupational health/ accidents; (8) reproductive health/ population
growth; (9) health technology; and (10) special groups. The first RUHRA was led by the Region
IV consortium, which was convened by the De La Salle Health Sciences Institute.

In 2010, the MHRDC was established to serve as a network of regional health research system
for MIMAROPA. Currently, it has 17 member institutions coming from the academe, hospital, and
government agencies. MHRDC is convened by Palawan State University, while the Department
of Science and Technology MIMAROPA provides secretariat support. The MHRDC led the health
research initiatives of the region.

Unlike the first, the second RUHRA, which was divided into two timeframes (i.e. 2011-2013 and
2014-2016) by MHRDC, relied on the topics of the NUHRA 2011 to 2016. The RUHRA 2011 to
2013 included three priority areas namely, herbal medicine for infectious diseases, nutrition and
functional foods, and impact of environment/climate change on health. For 2014 to 2016, the
previous three areas were adopted and then added two other priorities namely, indigenous people
(IP) and special populations, as well as information and communication technology (ICT) in
health.

In 2016, the DOST MIMAROPA led the formulation of the Research and Development Agenda
and Roadmap for 2016 to 2020. This roadmap was based on the integration of national priorities,
regional priorities, DOST priorities, and developments in the regional and international arena. To
align from the national priorities, a two-pronged approach to development, which are poverty
alleviation and disaster risk reduction and mitigation, is adopted. On the regional side, the regional
development goals are anchored on agriculture, fisheries, tourism, and gifts, housewares, and
decors (GHD), which the region has competitive advantage. Other regional priorities like micro-,
small-, and medium enterprises (MSME) growth, improved access, human resource
development, improved health and safety, environment protection, poverty reduction, and
indigenous people protection were included. There were 11 sub-areas that had health research
component and they focused on development of food, traditional medicines, health services, and
ICT.

Recent Health Researches and Outputs

Published researches from 2011 to 2016 was retrieved from Google Scholar, Scopus Elsevier,
and PCHRD Herdin. A total of 38 published health researches focused for the region were found.

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Majority (84%) of these publications were authored by individuals from institutions outside the
region, while only six were authored by institutions from Palawan, namely, Palawan State
University, Provincial Health Office of Palawan, and Ospital ng Palawan.

The researches were mostly about infectious diseases (53%), particularly on malaria (42%). The
malaria researches were about diagnostics, drug interventions, and preventive measures. Other
studies were focused on qualitative researches, traditional and alternative medicine, and
diagnostics. Matching them with the previous RUHRA priorities, five were related to herbal
medicine for infectious diseases, four were related to environmental health, two were about
indigenous peoples, while only one was about ICT for health. Most of them (26 researches) were
unmatched.

In terms of research impact, majority (47%) were health research-related, which focused on
increasing scientific knowledge and improving health research methods. Thirty-two percent (32%)
had societal impact, which was about knowledge, attitudes and practices, as well as, health
status. There were only seven studies that had health service impact and only one study about
health policy.

Based on the survey, a total of 18 researches (from 2011 to 2016) were conducted by researchers
from Palawan State University, Ospital ng Palawan, Marinduque State College, and Oriental
Mindoro State College of Agriculture and Technology. The researches were varied with majority
(or 4 researches) about bioprospecting for medicine and insecticide, followed by reproductive
health and health service delivery with three researches apiece. Other researches were about
occupational health, water, maternal and child health, and mining. Matching them with previous
RUHRA priorities, three were related to environmental health and three were about herbal
medicine for infectious diseases.

Causes of Mortality and Morbidity

Based on the report of the DOH - Regional Office IVB, the top cause of mortality in the region was
heart diseases from 2013 to 2015 (Table 1). It may be observed, however, the consistent
reduction in deaths from 1,571 (52 deaths per 100,000 population) in 2013 to 970 (32 deaths per
100,000 population) in 2015. The second and third ranked diseases, which were pneumonia and
cancer, in the same years also had a decreasing trend. For pneumonia, death rates dropped from
39 per 100,000 population in 2013 to 30 deaths per 100,000 in 2015. Similar to cancer cases,
mortality rates decreased from 28 deaths per 100,000 in 2013 to 21 deaths per 100,000 in 2015.

Table 1. Top 10 leading causes of mortality in Region IV-B (2013-2015)

Rank Leading causes of mortality
2015 2014 2013
Cause Cases Cause Cases Cause Cases
1 Heart diseases 970 Heart diseases 1,372 Heart diseases 1,571

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 2 Pneumonia 926 Pneumonia 950 Pneumonia 1,183
3 Cancer (all 631 Cancer (all forms) 618 Cancer (all forms) 852
forms)
4 TB (all forms) 356 Cerebro-vascular 538 Cerebro-vascular 590
diseases diseases
5 Hypertension/ 355 TB (all forms) 538 Hypertension/ 478
stroke stroke
6 Myocardial 278 Accidents (all 489 Myocardial 416
infarction kinds) infarction
7 Cerebro-vascular 199 Sexually 457 TB (all forms) 316
diseases transmitted
diseases
8 Renal failure 169 Hypertension/ 291 Degenerative 279
stroke diseases
9 COPD 114 Myocardial 253 COPD 262
infarction
10 Sepsis 103 COPD 242 Senility 186

Three of the top leading causes of mortality, namely tuberculosis (TB), cerebro-vascular disease
(CVD) chronic obstructive pulmonary disorder (COPD), had considerable reduction of cases from
2014 to 2015. TB (all forms) case rate reduced from 18 deaths per 100,000 population in 2014 to
11 deaths per 100,000 population in 2015. CVD case rate had the most reduction from 18 deaths
per 100,000 population in 2014 to only 7 deaths per 100,000 population in 2015. COPD case rate
also reduced from 8 deaths per 100,000 population in 2014 to 4 deaths per 100,000 population
in 2015.

On the other hand, some leading causes of mortality, like hypertension/stroke, myocardial
infarction (MI), had slight increase in number of cases and case rate. The case rate of
hypertension/stroke in 2014 was 10 deaths per 100,000 population, which increased to 12 deaths
per 100,000 population by 2015. MI had the least increase from 8.57 deaths per 100,000
population to 9.25 deaths per 100,000 population by 2015. Moreover, the emerging causes of
mortality in 2015 was renal failure and sepsis, which were not present in 2013 and 2014.

Based on the report of DOH RO IV-B, the top 10 leading causes of morbidity in the region were
mainly infectious diseases (Table 2). These were acute respiratory infection (ARI), urinary tract
infections (UTI), diarrheal diseases, pneumonia, and influenza, while were consistently present
since 2013. In the list, only one non-communicable disease (NCD) was present which was
hypertension. It was also the consistent second leading cause of morbidity in the region for 3
years.

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Table 2. Top 10 leading causes of morbidity in Region IV-B (2013-2015)
Rank Leading causes of morbidity
2015 2014 2013
Cause Cases Cause Cases Cause Cases
1 ARI/AURI/URTI 134,883 ARI/AURI/URTI 98,637 ARI/AURI/URTI 142,343
2 Hypertension 21,966 Hypertension/ 12,927 Hypertension/ 22,158
stroke stroke
3 Urinary tract 14,199 Influenza and 11,558 Urinary tract 16,322
infection pneumonia infection
4 Systemic viral 12,325 Diarrhea/AGE 8,610 Diarrhea/AGE 11,474
infection
5 Diarrhea/AGE 11,292 Skin problems/ 7,323 Wound (all 11,276
diseases types)
6 Influenza and 10,878 Urinary tract 6,224 Pneumonia 10,596
pneumonia infection
7 Wound (all 10,209 Wound (all 5,857 Influenza 9,164
types) types)
8 Skin problems/ 7,615 Bronchitis 4,805 Bronchitis 7,256
diseases
9 Malaria 4,640 TB (all forms) 4,159 Systemic viral 5,808
infection
10 Animal bites (all 4,274 Animal bites (all 3,818 TB (all forms) 5,546
types) types)

NCDs, like hypertension, stroke, and heart diseases, were reducing in number of deaths from
2013 to 2015. However, the number of cases of hypertension/stroke increased from 438 cases
per 100,000 population in 2014 to 731 cases per 100,000 population in 2015. Based on the
National Nutrition Survey done by Food and Nutrition Research Institute (FNRI), prevalence of
elevated blood pressure among adults (i.e. >20 years old) slightly increased from 22% in 2013 to
24.1% in 2015 (FNRI, 2016). The prevalence in the region was slightly higher than the national
prevalence of 23.9% in 2015. Among the provinces, Marinduque had the highest prevalence of
elevated blood pressure at 36% followed by Occidental Mindoro at 30% in 2015 (FNRI, 2016).

In terms of emerging causes of morbidity, systemic viral infection and malaria were notable in
2015 as they were not included in the 2014 and 2013 list. For the viral infection cases, there may
be a need to identify their etiologies in order to determine the challenges and appropriate
preventive measures.

For malaria, it remains a public health concern in the region, especially in Palawan. Palawan
remains to have the highest endemicity of malaria in the country. Based on DOH Field Health
Service Information System (FHSIS), there were 7,448 cases of malaria (248 cases per 100,000
population) in MIMAROPA in 2015 (DOH, 2017). Most of the cases originated in Palawan and a

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few in Occidental Mindoro. This was an apparent increase from 2014, 2013 and 2012 in which
there were 1,957, 4,137 and 3,707 cases reported, respectively (DOH, 2016; DOH, 2015; DOH,
2014).

Based on the searched published studies in the region, majority of these focused on diagnostic,
particularly looking into the availability, price, quality, transportation and storage of diagnostic test
kits. There is also a new diagnostic tool being developed named APDS (automated parasite
detection system) for field malaria diagnosis. It is an enhancement of the reference standard
conventional microscopy, intended to be developed into a low- cost tool to consistently read thin
blood films using software for rapid diagnosis (Cruz, et al., 2016).

Other researches focused on health service delivery. Matsumoto-Takahashi, et al. (2013) found
that microscopists played a significant role in providing appropriate treatment to individuals with
severe malaria symptoms. Moreover, increasing knowledge on malaria symptoms among at risk
population helps improve awareness, and can further progress towards self-triage among infected
individuals (Matsumoto-Takahashi, et al., 2015). Furthermore, preventive measures against
malaria can be strengthened through barangay health workers raising awareness in their
respective communities (Matsumoto-Takahashi & Kano, 2016).

Most of the survey respondents perceived that teenage pregnancy was emerging as a problem
as numbers are increasing. Pregnant teens were deemed vulnerable to maternal mortality,
stillbirths, low birthweight, and other complications. Other emerging health problems identified
were malnutrition, sexually transmitted infections (e.g. HIV/AIDS), climate change related
diseases, and multidrug resistant TB.

In terms of malnutrition, prevalence of stunting and underweight among children were noted to be
increasing in the region. In 2013, the region had the highest prevalence of underweight and
wasting/thinness in less than 5 years old children at 27.5% and 9.8%, respectively (FNRI, 2016).
Prevalence of wasting/thinness was also the highest among 5 to 10-year-old children and
adolescents at 12.6% and 16.1%, respectively (FNRI, 2016). Adults were also noted to have high
chronic energy deficiency in the region at 13.1%, ranked third among the regions (FNRI, 2016).

Health Systems, Infrastructure, and Financing

Based on the survey, health facilities remain a challenge despite current efforts on building and
renovation through the Health Facility Enhancement Program (HFEP) of the DOH-RO IVB.
Survey respondents said that there was still a lack of space for hospital admissions in the
provincial hospitals. There are also incidents of delayed implementation and incomplete
construction due to poor contracting, funding for building, and facility licensing.

On top of the challenge on health facilities, the lack of human resources for health further
aggravate the challenge on health service delivery. It was perceived that there was the lack of

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health workers in government hospitals. It was further identified by a respondent that medical
specialists (e.g., medical, surgical, orthopedic, obstetric, pediatric, and anesthesia) were very few
in the region, especially along the lines of traumatic injuries and emergencies. Not only
inadequacy was identified, but also, the uneven distribution of the human resources to cities.

Challenges on health information, reporting, and surveillance were also mentioned as major
concerns in the region. Respondents said that local hospitals and health units in the region cannot
provide updated information that can describe the health status of the region.

Furthermore, out-of-pocket (OOP) expenses for health services were considered a problem
because patients in the region are often facing high OOP expenses for services and prescription
drugs. This, in turn, affects their access to healthcare, especially for those patients with severe
and chronic conditions. Although membership to PhilHealth has been very high, survey
respondents stated that there may be low utilization of benefits, especially among the indigents
who either do not know their entitlements or cannot afford the still high OOP costs.

Strengths, Weaknesses, Opportunities, and Threats

Based on the review of literature and survey, the following internal strengths were identified:
1. Public Sector Representation – MHRDC has a strong representation of the public sector
with state universities and key government agencies. This may promote partnership and
coordination among the public sector in the conduct of health researches for the region.
The strong linkage of public institutions can be further explored to include private
institutions in the academe, hospitals, and industries.
2. Tourism – Tourism and ecotourism are one of the main advocacies in the region,
particularly in the provinces of Occidental Mindoro, Oriental Mindoro, and Palawan.
Therefore, health research topics that may touch on the topic of tourism and ecotourism
may be beneficial and strategically in line with the political advocacies in the region.

However, the region faces several internal weaknesses:

1. Research Capacity – Many institutions in the region have limitations in writing proposals,
lack of laboratory and office equipment, lack of trained staff for research support, and no
organizational focus on research. It was emphasized by a respondent that without skilled
human resources, provision of equipment and facilities will not improve the region’s
capacity. This may be reflected by relatively low number of research outputs like
publications.
2. Dissemination and Translation – Currently, there are limited platforms for dissemination
and translation of research findings. This may impact the utilization and value of the
researches being done in the region.
3. Private Sector Representation – The current private sector in the MHRDC are only from
two private universities. Involving non-government organizations, businesses, and
enterprises in health research may provide opportunities for collaboration and funding.

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 4. Research Ethics – Respondents mentioned the lack of ethics review board for the region
that can help ensure ethical implementation of research and safety of research
participants. There is also no institutional animal care and use committee that can help
oversee researches that use animals.

Meanwhile, external opportunities identified were:

1. National Political Priorities – Some of the priorities backed up by the national
government are health facilities, anti-drug abuse, mental health, and reproductive health.
These priorities had trickled down to the region and are significant regional priorities.
2. Potential Researchers and Staff – There are already experts in the region that needs
to be tapped and enabled. Young professionals in the region can be trained and
capacitated to become future researchers and support staff, particularly in the academic
institutions.
3. International and Local Funding – The MHRDC and survey respondents acknowledge
the presence of international and local research grants that the region can access and
utilize. By improving the research capacity, such grants and funding may become
accessible for researchers in the region.
4. Transfer of Regional Offices - The transfer of regional government offices from Metro
Manila to MIMAROPA may attract local health professionals to utilize the facilities and
stay in the region. These offices may also provide better local support for provinces and
municipalities in the region.

The external threats to health in the region were:

1. Non-Communicable Diseases – NCDs are rising in prevalence and lead the cause of
mortality and morbidity.
2. Emerging Communicable Diseases – Infectious diseases like UTI, viral infection, and
malaria were increasing in prevalence and may cause significant morbidities.
3. Disasters and Climate Change Impacts - Climate change can result to spread or
increase in prevalence/incidence of diseases like infectious, respiratory and heat-related
illnesses. Disasters, on the other hand, threatens human safety and capacity to deliver
adequate healthcare services. The region is considered by some respondents as not
disaster or calamity-prepared region, especially on health.
4. Environmental Degradation – The region relies heavily on its natural resources for its
economy (e.g. mining and tourism). Environmental degradation due to land-use and poor
management threatens both the residents’ health and safety, as well as the region’s
economy.

Using TOWS (threats, opportunities, weaknesses, and strengths) analysis, internal strengths and
weaknesses were partnered to external opportunities and threats. Table 3 enumerates the
analysis.

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Table 3. TOWS Analysis for Health Research of MIMAROPA
Strengths Weaknesses
Opportunities ▪ Strong public sector for political ▪ Low capacity in research affect
priorities trainings, maximization of health
▪ Tourism and health can be facilities, and conduct
potential research that has value researches
for international and local funding ▪ Weak dissemination and
translation limit the attainment of
political priorities and not
maximize funding
Threats ▪ Public institutions can collaborate ▪ Low research capacity will limit
to do research among the researches on threats
regional health threats ▪ Any research conducted on the
▪ Tourism and eco-tourism can listed threats will not help
heavily be affected by the threats address threats due to poor
of environmental degradation dissemination and translation
▪ NGO and private support will not
be maximized in addressing
threats

METHODOLOGY

This section discusses the process of formulating the RUHRA 2017 to 2022 that includes
preparation and regional consultation. Under the regional consultation, the activities, namely,
brainstorming of research topics, prioritization, consensus building, and implementation planning,
were explained.

Preparation for Regional Consultation

Four technical papers, which describe the national health research landscape, and the regional
situationer were prepared and drafted by the Alliance for Improving Health Outcomes, Inc. (AIHO).
AIHO was subcontracted by the PCHRD for the facilitation of the NUHRA and RUHRA
formulation. The situationers for national and regional health research landscape were prepared
to guide the formulation of health research agenda of MIMAROPA.

An orientation meeting with three members of Management Committee of MHRDC were

conducted by an AIHO support staff on February 6-7, 2017 in the DOST Region IVB. The
background of the development of NUHRA and the process framework of RUHRA formulation
were presented. After the meetings, the schedule of regional consultation was arranged on May
4-5, 2017. For diverse representation, 30 stakeholders, with 13 non-MHRDC agencies, were
identified and invited for the two-day consultation.

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Working closely with AIHO, the Health Development Institute (HDI) arranged the venue,
accommodations, travel costs, and registration materials for the consultation. The event was held
at Brentwood Suites, Diliman, Quezon City.

Regional Consultation

Twenty-six participants attended the regional consultation (Annex A). The two-day consultation
program (Annex B) was broken down into four main activities. For the first half of day one,
technical papers and regional situationer were presented. The second activity in the afternoon of
day one was brainstorming of research topics. The third activity in the morning of day two was
about prioritization of topics. Lastly, the planning of implementation, advocacy, and monitoring
and evaluation were done in the last half of the day two. The following sections will discuss the
details of the brainstorming, prioritization, and planning.

Brainstorming

In this session, the participants were divided into three groups:

1. Academe – The group was composed of representatives from public and private
academic institutions, as well as the Commission on Higher Education Region IVB. The
group was named ISLANDER or Innovative and Scientific Leaders Advocate Networking
and Enhancing Researchers.
2. Health Service Providers – This group included representatives from hospitals,
provincial health offices, and the Department of Health Regional Office IVB. The group
was named ACHIEVE.
3. Government Agencies – This was composed of representatives from the Department of
Science and Technology Region IVB, Department of Health Regional Office IVB, National
Economic and Development Authority Region IVB, Population Commission Region IVB,
Department of Tourism Region IV, Department of Environment and Natural Resources
Region IVB, and Philippine Institute of Traditional and Alternative Healthcare.

Each group was assigned with a facilitator to assist the brainstorming and group discussions.
Using metacards and markers, the stakeholders were given 10 minutes to write down research
topics. Each group member explained the rationale of their research topic to their respective
group. At the end of the period, the group generated various topics. These topics were grouped
under a theme.

After the grouping, a plenary presentation of each group’s outputs was conducted. Each group
was represented by a team leader to present their health research themes and topics. In this part
of the session, the participants analyzed and scrutinized the other groups’ presentations and
topics. After presentation, the participants decided to review them overnight and allowed the AIHO
facilitation team to combine the similar themes and topics.

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On the second day, the participants reviewed the three outputs and finalized the combination,
addition, and deletion of themes and topics. The facilitator guided the finalization of the themes
and topics through facilitation of suggestions, comments, and consensus of the participants.

Prioritization

To prioritize the generated health research themes, a set of criteria was selected by the
participants. The facilitator briefly presented examples criteria used for health research agenda
setting to provide guidance to the participants. After that, the participants wrote down their
preferred criteria on metacards and the facilitator grouped the similar criteria in front of the group.
After criteria selection, the participants decided to assign weights for each criterion based on the
number of metacards. Rough approximation of weights was given by the participants to each
criterion with the approval through consensus. The selected criteria and weights were:
1. Impact (30%)
2. Feasibility (20%)
3. Magnitude (20%)
4. Applicability (10%)
5. Acceptability (10%)
6. Responsiveness (10%)

For the scoring, numbers 1 to 10, with 10 being the highest, were used to rate each criterion per
theme. Scoring sheets, which included the themes, topics, and criteria, were printed and handed
out to the participants. Upon casting all the votes, the scores were encoded on an excel tool that
processed the computation and generated the ranking.

The scores of the ranked health research themes were presented (Annex C). None appealed on
the results of ranking. The theme “GIDA” (geographically isolated and disadvantaged areas) was
decided to be incorporated under the theme “health service delivery”. The group approved the 17
ranked health research topics for MIMAROPA.

Planning of Advocacy, Dissemination, and Monitoring and Evaluation

The planning was facilitated through a plenary discussion after prioritization. Considering the
tedious brainstorming and prioritization, the planning was just meant to come-up with broad plans
on how to disseminate the health research agenda, and how to monitor and evaluate the progress
and success of health research in the region.

To initiate discussions, the MHRDC was asked on how was the previous agenda was
dissemination and monitored. However, there were little to be discussed since the coordinator
and representatives were relatively new in the consortium. Nonetheless, the participants
discussed challenges and future plans on how to ensure proper dissemination, as well as

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 monitoring and evaluation of the agenda.

RESEARCH PRIORITY THEMES AND TOPICS

There are 17 prioritized health research themes for MIMAROPA (Table 4). These themes contain
60 topics and 14 corresponding subtopics. The topics and subtopics refer to more specific health
research topics that can be explored. The participants agreed that the enumerated topics and
subtopics will not limit the region from pursuing other topics that are relevant and can be
categorized under the 17 themes.

The top five highest ranked health research areas are: (1) environmental health and climate
change; (2) health service delivery; (3) reproductive health; (4) health financing; and (5) TB, HIV,
and AIDS. On the other hand, the five least prioritized themes are: human resources for health;
health and culture; information and communication technology; health research capacity; and
health economics.

Table 4. Health Research Themes and Topics of MIMAROPA

Rank Theme Topic and Subtopics Rationale
1 Environmental • Studies to develop cost-effective technologies to Address
health and prevent/ control/ monitor environmental pollution environmental
climate change o Environmental impact of poultry (broiler) health issues and
impact raising with emphasis on health aspect climate change
o Ecosystems and human health relations impact particularly
• Water Sanitation and Hygiene (WASH) on water sanitation
o Reduction of prevalence of water and and hygiene
sanitation-related diseases
o Water, sanitation and hygiene in the region
(e.g. isolated areas)
o Water quality in relation to diseases (e.g.
gallstones, goiter)
o Potability of drinking water supply
o Rehabilitation of bodies of water as potential
tourist hub (water quality, pollutants, etc.)
• Climate change
o Health impact of climate change
o Health impact of mining
o Green health facilities
2 Health service • Sustainability of better and more effective health To address issues
delivery care delivery on the access,
• Availability, accessibility and affordability of quality,
health care services governance, needs

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Rank Theme Topic and Subtopics Rationale
o Models for access and sustainability
o Access to quality hospital and healthcare on health service
facilities delivery especially
• Health promotion for high risk individuals (e.g. in special
vulnerable groups, occupational) population groups
• Health needs and services for special population and communities
groups (e.g. PWDs, mentally challenged,
occupational)
• Health governance
• GIDA and hard-to-reach areas (e.g. Health profile
data on GIDAs)
• Tourist health care systems
• Competency and expertise of medical and
paramedical personnel in hospitals located in
tourist destinations
• Readiness of Rural Health Units/Emergency
Hospitals in dealing with trauma patients
3 Reproductive • Maternal morbidity and mortality Address the
health • Effectivity of (Ovatel) saliva examination knowledge gap in
(Ferning) as adjunct to family planning program reproductive health
• Teenage pregnancy particularly on
• Attaining and sustaining zero unmet needs for maternal health
modern family planning through strict and teenage
implementation of RPRH law pregnancy
4 Health • Implementation of No Balance Billing (NBB) in To assess the
financing PhilHealth for the past years and its effect on the impact of policies
beneficiaries and services of
• Development and sustainability of more health DOH and
financing PhilHealth to the
• Health budget and expenditure studies region
5 TB, HIV, and • Multi- and extensively-drug resistant TB Explore on studies
AIDS • HIV cases looking into preponderance, in the epidemiology
comorbidities, practices, and occupation of HIV/AIDS and
• Factors contributing to increase in incidence of TB cases, and
HIV evaluate the
• Evaluation of HIV and AIDS monitoring and interventions and
interventions monitoring systems
6 Mental health • Prevention and management of mental illnesses To address gaps in
and substance • Alternative modalities in helping substance abuse the prevention and
abuse patients rehabilitation of
• Community-based substance use prevention mental illness and

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Rank Theme Topic and Subtopics Rationale
• Drug rehabilitation program substance abuse
7 Traditional, • Documentation on regional traditional medicine Enhance and
complementary, (e.g. Azolla, local Ashitaba, related to diabetes maximize locally
and alternative and hypertension) available natural
medicine • Biodiversity protection for flora and fauna as resources for
sources of traditional and complementary traditional,
medicine complementary,
• Success of combination of Western and Eastern and alternative
medicine (acupuncture, massage, herbs) in medicine
treating Filipino patients (e.g. clinical,
sociocultural)
• ICT on traditional and complementary medicine
8 Emerging and • Re-emergence of malaria Address knowledge
re-emerging • Evaluation of malaria program gaps on emerging
diseases • Other diseases (e.g. filariasis, Zika virus) and re-emerging
diseases
9 Drug discovery • Novel vaccines Develop vaccines,
and • R&D on natural products development and discover new
development commercialization (e.g. cultivations studies on products from
sources of natural products) natural and
• Screening of plants using agglutination of ABO indigenous
blood type materials
10 Food and • Research on foods that will improve the weight of Address knowledge
nutrition the severely malnourished children gaps on nutrition,
• Malnutrition the effects of
• Functional foods (e.g. Azolla) chemical in natural
• Organic food (e.g. native pig products)Effects of food, and the
chemicals on natural food nutritional impact of
functional and
organic foods
11 Health in • Role of health system in the region in disaster Assess the
emergencies risk reduction resilience of the
• Present response capacity of the region (and region’s health
national level) to any disaster system in disaster
• Post-disaster rehabilitation risk reduction and
• Soil analysis for increase in likelihood of erosion/ management
earthquake
12 Non- • Prevention and management of NCDs and Address gaps in
communicable lifestyle-related diseases the prevention and
diseases • Early detection/ intervention in children with management of
disability NCDs and lifestyle-

Page 16 of 37
Rank Theme Topic and Subtopics Rationale
• Effects of heavy traffic on the health of the people related diseases
13 Human • Limitations in the number of human resources Evaluate and
resources for (e.g. due to Basic Emergency Obstetric and address issues in
health Newborn Care or BEMONC, DOH requirements human resources
in hospitals, etc.) for health
• Capacitating human resources for health
14 Health and • Nutrition of indigenous people Determine the
culture • Development of a culture-sensitive health health needs and
program for IPs behaviors of
• Indigenous knowledge systems and practices indigenous peoples
(IKSPs)
15 Information and • Telehealth Address the gap in
communication o Impact of limited/ low- to no internet ICT for better
technology connectivity in some areas of the region health services
o Health workers on computer and social
media in rapidly changing world of health
• Telemedicine
16 Health research • Research capability building among institutional Strengthen the
capacity researchers and support staff research capacity
• Research ethics on human and animal (e.g. of the region
ethics review board, institutional animal care and
use committee)
17 Health • Assessment of availability of vaccines supplies Address knowledge
economics and distribution gaps on different
• Waterborne diseases economic value health issues in
• PWDs and OFWs terms of health
• Aging and health economics

IMPLEMENTATION PLAN

This section presents the result of the plenary discussion about the broad plans about advocacy,
dissemination, monitoring, and evaluation of the RUHRA.

Advocacy and Dissemination

The following broad plans for advocacy and dissemination are:
• Dissemination of the RUHRA will be led by the Research Information, Utilization and
Dissemination Committee of the MHRDC. The committee will incorporate the agenda in
their existing plans and strategies for research dissemination.
• Websites of MHRDC (link: http://www.mimaropa.healthresearch.ph) and NEDA-RDC, as
well as other online platforms (e.g. social media) will be used for dissemination.

Page 17 of 37
 • On-ground activities, such as research forums, will be used to disseminate RUHRA. An
example is the National Research Forum on Sustainable Development that is organized
by the Palawan Council for Sustainable Development.
• Tri-media can also be used to promote and advocate their RUHRA.
• To advocate and disseminate across the region, opportunities through the Social
Development Committee of the Regional Development Council (RDC) will be explored.

Monitoring and Evaluation

The following major points serve as guide in the future for the monitoring and evaluation of the
RUHRA:
• There is no committee or formal mechanism yet in place in MHRDC. There is a need to
discuss this on the next MHRDC meeting and establish the committee and formulate the
plan.
• Another challenge is the limitation of MHRDC in catering to its member institutions alone.
In order to expand monitoring and evaluating to the whole region, there may be a need to
establish the research committee in the RDC. This committee can help monitor and
evaluate the progress of the health researches in the whole region since key regional
government agencies are members and RDC can release a region-wide resolution.
• There is a need to discuss the plan on how to form the research committee in the RDC.

REFERENCES
Cruz, C. J., Labreque, M., Goh, M. C. & Rivera, P. (2016) APDS (Automated parasite detection
system) for field malaria diagnosis in the Philippines. Southeast Asian Journal of Tropical
Medicine and Hygiene 47(4):600-606.
DOH-RO4B. (2013) Leading causes of morbidity and mortality CY 2013.
DOH-RO4B. (2014) Leading causes of morbidity and mortality CY 2014.
DOH-RO4B. (2015) Regional health profile 2015.
FNRI. (2016) 8th national nutrition survey. Taguig City: Food and Nutrition Research Institute.
FNRI. (2016) Prevalence of non-communicable disease (NCD) risk factors: Time trends from
1998 to 2015 national nutrition survey and updating of the nutritional status of Filipino
children and other population groups.
Kingdon, J.W. (2001) A model of agenda-setting, with applications. Michigan State University Law
Review. 331.
Matsumoto-Takahashi, E. L. A. & Kano, S. (2016) Evaluating active roles of community health
workers in accelerating universal access to health services for malaria in Palawan, the
Philippines. Tropical Medicine and Health 44(10).
Matsumoto-Takahashi, E. L. A. et al. (2015) Patient knowledge on malaria symptoms is a key to
promoting universal access of patients to effective malaria treatment in Palawan, the
Philippines. PLoS ONE 10(6):e0127858.
Matsumoto-Takahashi, E. L. et al. (2013) Determining the active role of microscopists in
community awareness-raising activities for malaria prevention: a cross-sectional study in

Page 18 of 37
Palawan, the Philippines. Malaria Journal 12:384.

Page 19 of 37
 ANNEX A. Regional Consultation Participants

Name Affiliation Position

Ms. Nora C. Cabaral Mindoro State College of Instructor I
Agriculture and Technology
Mr, Zypher Jude Regencia PITAHC SRS II
Ms. Sabrina Arra P. Elechosa DOST-PCHRD SRS II
Dr. Patrick A. Regoniel Palawan State University Acting VP for Research
and Extension/Research
Director
Ms. Kristine Julie B. Yana Ospital ng Palawan Nurse II
Dr. Elsa Alberto Palawan Health Office Med Assistant
Ms. Keith Blanche C. Soriano DOT-MIMAROPA Administrative Officer IV
Mr. Ruby Ephrain Rubiano Marinduque Provincial Hospital OIC-COH/Medical Officer
Ms. Josephine Maria Coll PHO-Marinduque Medical Specialist III
Ms. Josefina L. Gom-os PHO-Marinduque Health Education and
Promotions Officer
Mr. Fernando S. Macabuag POPCOM-MIMAROPA Planning Officer III
Dr. Arthur R. Ylagan Romblon State University VP for RET
Sr. Rosalinda Guerrero Holy Trinity University VP for Research
Dr. Marpheo E. Marasigan Oriental Mindoro Prov. Hospital COH-II
Ms. Chona C. Zamora DENR-MIMAROPA SCOO
Ms. Angelie R. Songco DOH-MIMAROPA HPR
Ms. Angela Kaye T. Reyes DOH-MIMAROPA HPR
Ms. Krizel-an S. Gulle DOH-MIMAROPA Planning Officer II
Dr. Romeo P. Lerom Western Philippines University Research Director
Mr. Jezreel Sarabia Occidental Mindoro State College Program Head
Dr. Benedict Anatalio Romblon Provincial Hospital Chief of Hospital II
Dr. Virginia Akiate CHED-MIMAROPA Regional Director
Ms. Leynita M. Sanchez CHED-MIMAROPA Education Supervisor
Dr, Diosdado Zulueta Marinduque State College VP for R&D
Ms. Erlyn Querubin NEDA-MIMAROPA Senior Economic
Development Specialist
Dr. Ederlina E. Aguirre PHO-Romblon Provincial Health Officer II

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 ANNEX B. Regional Consultation Program

Day 1 (May 4, 2017, Thursday)

08:00 – 08:30 Registration

08:30 – 08:40 Opening Remarks
08:40 – 09:00 Introduction to the Philippine National Health Research System (PNHRS) and
the National Unified Health Research Agenda (NUHRA)
09:00 – 09:10 Participant Introductions
09:10 – 09:30 Orientation to the Agenda Setting Process: Why are We Here?
09:30 – 10:30 Presentation of Main Findings of Technical Papers 1-4: Setting the National
Health Research Landscape
10:30 – 10:45 Coffee break
10:45 – 12:00 Presentation of Main Findings of Regional Situationer: Setting the Regional
Context for Health Research and Development
12:00 – 1:00 Lunch break
1:30 – 3:30 Brainstorming Session on Identification of Research Topics
3:30 – 3:45 Coffee break
3:45 – 4:45 Plenary Presentation of the Identified Health Research Topics during the
Brainstorming Session
4:45 – 5:00 Briefing for day 2 activities

Day 2 (May 5, 2017, Friday)

08:00 – 09:00 Day 1 Sessions Synthesis and Finalization of the Initial Agenda List
09:00 – 10:30 Setting a Regional Criteria for Prioritization of Health Research Agenda and
Appeals Process
10:30 – 10:45 Coffee break
10:45 – 12:00 Health Research Agenda Prioritization Activity
(Ranking health research topics through an online tool/ printed forms)
12:00 – 1:00 Lunch break
1:00 – 2:30 Presentation of Ranked Health Research Topics, Consensus Building and
Appeals Process
2:30 – 2:45 Coffee break
2:45 – 4:15 Planning for RUHRA Dissemination, Funding, Monitoring and Evaluation
4:15 – 4:45 Recap of Proceedings and Evaluation Survey
4:45 – 5:00 Closing Remarks

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 ANNEX C. Scoring Results of Health Research Themes

Rank Theme Impact Feasibility Magnitude Applicability Acceptability Responsive Final

-ness score
1 Environmental 9.17 9.13 9.13 8.83 8.63 9.08 9.05
health and
climate change
impact
2 Health service 8.88 8.63 8.79 8.88 8.75 8.83 8.79
delivery
3 Reproductive 8.79 8.63 8.71 8.83 8.46 8.88 8.72
health
4 Health financing 8.83 8.33 8.25 8.42 8.42 8.29 8.48

5 TB and HIV/AIDS 8.92 8.17 8.54 8.25 7.96 8.25 8.46

6 Mental health 8.33 8.42 8.75 8.54 8.17 8.54 8.46

and substance
abuse
7 Traditional, 8.54 8.58 8.29 8.33 8.08 7.75 8.35
complementary
and alternative
medicine
8 Emerging and re- 8.42 8.42 8.33 8.25 8.25 8.17 8.34
emerging
diseases
9 Drug discovery 8.58 7.79 8.33 8.33 8.25 8.00 8.26
and development
10 Food and 8.42 8.29 8.13 8.17 7.92 8.17 8.23
nutrition
11 Health in 8.29 8.00 8.13 8.50 8.17 8.42 8.22
emergencies
12 NCDs 8.29 7.96 8.17 8.17 8.00 8.00 8.13

13 Human resources 8.04 8.29 7.83 7.96 8.13 8.00 8.05

for health
14 Health and 8.13 7.75 7.92 7.50 7.88 7.75 7.88
culture
15 ICT 7.96 7.58 8.00 7.79 7.83 7.71 7.84
16 Health research 7.75 7.50 7.54 7.54 7.21 7.38 7.55
capacity
17 Health 7.3333 7.33 6.71 7.21 7.13 7.04 7.13
economics 33333

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 ANNEX D. Groupings During Brainstorming

Group 1: TEAM ACHIEVE (Health service agencies and institutions)

1. Krizel-an Gulle (DOH MIMAROPA)
2. Angela Kaye Reyes (DOH MIMAROPA)
3. Benedict Anatalio (Romblon Provincial Hospital)
4. Marpheo Marasigan (OrMin Provincial Hospital)
5. Ederlina Aguirrre (PHO Romblon)
6. Ruby Ephrain Rubiano (Marinduque Provincial Hospital)
7. Josephine Maria Coll (PHO Marinduque)
8. Josefina Gom-os (PHO Marinduque)
9. Kristine Julie Yana (Ospital ng Palawan)
10. Elsa Alberto (Palawan Health Office)

Group 2: TEAM GOVERNMENT (Government agencies)

1. Zypher Jude Regencia (PITAHC)
2. Rhoda Lyn Ramos (DOST MIMAROPA)
3. Chona Zamora (DENR MIMAOROPA)
4. Fernando Macabuag (POPCOM MIMAROPA)
5. Angelie Songco (DOH MIMAROPA)
6. Erlyn Querubin (NEDA MIMAROPA)
7. Keith Blanche Soriano (DOT MIMAROPA)

Group 3: TEAM ISLANDER (Academic institutions)

1. Leynita M. Sanchez (CHED MIMAROPA)
2. Virginia Akiate (CHED MIMAROPA)
3. Rosalinda Guerrero (Holy Trinity University)
4. Patrick Regoniel (Palawan State University)
5. Arthur Ylagan (Romblon State University)
6. Romeo Lerom (Western Philippines University)
7. Nora Cabaral (MinSCAT)
8. Diosdado P. Zulueta (Marinduque State College)
9. Jezreel Sarabia (Occidental Mindoro State College)

Page 23 of 37
 ANNEX E. Photo Documentation

Stakeholders during a photo-ops session on the 2nd day of the consultation

Stakeholders during the presentations

Page 24 of 37
Brainstorming session with ISLANDER group

Brainstorming session with ISLANDER group

Page 25 of 37
Brainstorming session with Health Offices- TEAM ACHIEVE

Brainstorming session with Health Offices- TEAM ACHIEVE

Page 26 of 37
Brainstorming session with RLAs- TEAM GOVERNMENT

Page 27 of 37
 ANNEX F. Process Documentation of Regional Consultation

Day 1
Emcee: Mr. Paul Chua, AIHO
OPENING REMARKS
Dr. Patrick A. Regoniel
VP for Research
Palawan State University
Key point 1

The NUHRA 2011-2016 was a consolidation of research priorities of the four core agencies of the
Philippine National Health Research System (PNHRS). The Regional Unified Health Research Agenda
(RUHRA) was then crafted based on the final NUHRA. From 2011 to 2016, the top 5 research priorities
in MIMAROPA were: Herbal medicine for infectious diseases; Nutrition and Functional foods; Impact
of Environment/ Climate Change on Health; Indigenous People and Special Populations; and ICT in
Health. Meanwhile, other research priorities were focused on Gender, Financial Risk Protection,
Improving Access to Quality Hospitals, Drug Discovery and Development, and Chronobiology.

Key point 2

The formulation of the NUHRA and RUHRA 2017-2022 will be different. This year, the NUHRA will be
developed from the needs of the regions based on the Regional Unified Health Research Agenda
(RUHRA).

Key point 3

Researchers have a huge role in developing the health research priorities in MIMAROPA. Research
helps build knowledge and understand relevant issues. It also has a significant role in heightening the
country’s competitive edge in terms of health economy.

Key point 4

Health research can help expand innovations, provide better health services and health care access
in the country, produce health goods, and build the capacity of highly qualified Filipino health care
providers, managers, and researchers. The RUHRA and the NUHRA 2017-2022 must be able to
expedite and improve this process.

Page 28 of 37
 INTRODUCTION TO THE PNHRS AND THE NUHRA
Ma. Elizabeth Cajigas
Senior SRS
DOST-PCHRD
Key point 1

PNHRS is an integrated national framework for health research in the country. The PNHRS Core
agencies are: DOST Philippine Council for Health Research and Development (PCHRD), Department
of Health (DOH), UP National Institutes of Health (NIH), and Commission on Higher Education (CHED).

The PNHRS Mission is to generate and use knowledge, innovation, technology, products and services
in promoting the health and well-being of every Filipino by creating and sustaining an enabling
environment for health research.

Its Vision is to be a dynamic and responsive health research community working for the attainment of
national and global health goals.

Key point 2

PNHRS is institutionalized by PCHRD. PNHRS is organized as follows:

➢ Governing Council
➢ Secretariat
➢ Steering committee
➢ Six (6) technical working committees: Research Agenda Committee (RAC), Philippine
Research Ethics Board (PHREB), Capacity Building Committee (CBC), Research Utilization
Committee (RUC), Research Mobilization Committee (RMC), and Structure, Organization,
Monitoring, and Evaluation (SOME) Committee

RAC directs and oversees the formulation/updating of the National Unified Health Research Agenda.

Key point 3

The first ever NUHRA (2006-2010) was launched in 2006 to serve as the country’s template for health
research and development efforts specifying the areas and topics needed to be addressed in a 5-year
scope. It was updated on 2007-2008 to account for new developments. The output was another
document – the updated NUHRA from 2008-2010. The RAC shortlisted further the updated NUHRA.
Another document was produced – the Funding priorities for 2009-2010.

The NUHRA 2010-2016 (existing NUHRA) was a consolidation of institutional research priorities of the
PNHRS core agencies.

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Key point 4
In preparing the NUHRA 2017-2022, the RAC pursued the following guidelines:
1. Assessment of the NUHRA 2010-2016
2. Preparation of guidelines in formulating the health research agenda which shall be applied by
AIHO through the consultation activity
3. PCHRD commissioned AIHO to draft the 2017-2022 NUHRA document
PCHRD Announcements:
• PCHRD has a Call for Proposals for the Newton Agham. Deadline is on May 11, 2017.
• PCHRD also have a Call for Proposals for 2018 under Grants in Aid. Deadline is on May 31,
2017.
• Call for Research Ethics Proposals. Deadline is on June 30, 2017.
• For details, log in to their website.
INTRODUCTION TO THE NUHRA AND RUHRA AGENDA SETTING PROCESS
Mr. Lester SA Geroy
AIHO
Key point 1
This is very important because what gets in to the NUHRA gets money.
Key point 2
The Alliance for Improving Health Outcomes (AIHO) is a public health consultancy firm based in
Quezon City. It is made up of health professionals, and their goal is to enable people to make health
systems work for people. Their projects include: policy, research, health systems, financing, project
design, etc. They already have experience in agenda setting, like in PhilHealth and DOH.
Key point 3
NUHRA Vision 2017-2022:
➢ Inclusive
➢ Realistic
➢ Collaborative
The NUHRA and RUHRA is really the key for funding. It’s also a roadmap because it guides us what
to think. NUHRA is important but the RUHRA is relevant to the region. The RUHRA is the voice of the
region.
One sector not represented during the consultation is the private sector. In the final NUHRA, the 17
RUHRAs will be annexed. At the end of the consultation, the list of topics will be finalized. They would
also draft plans for monitoring, evaluation and advocacy in the region and collaborate with other
participants.
Key point 4
The funding comes from DOST, DOH and CHED, but there are also funds coming from the private
sector and other international agencies. In the regional consultation, the needs of the region will be
identified. There will be consensus-building.
Key point 5
Regional Consultation
DAY 1:

Page 30 of 37
 1. Orientation of the NUHRA-RUHRA process
2. Presentation of Technical Papers
3. Presentation of Regional Situation/ Context
4. Brainstorming
5. Initial list of priorities/topics
DAY 2:
1. Prioritization – Criteria setting, scoring
2. Appeals
3. Discussions on M&E and Advocacy
Comments:
Dr. Lerom from WPU expressed that they have proposed a project to DOH on Tongkat Ali. They have
raw materials in Palawan on Tongkat Ali. There is a big problem in terms of funding; they have the raw
materials but they are not utilizing it. Also, they, as a faculty, do research but one of their problems is
that some faculty members are not good in doing research.
INPUTS: TECHNICAL PAPERS
Yves Miel H. Zuñiga
Project Assistant
AIHO
The Philippine Socio-economic Development and Health Directions, and a Proposed Working
Framework for NUHRA Development
Key points:
➢ Global and national policies are cutting across socioeconomic development and health in the
Philippines.
➢ The DOST has allocated PhP 5.8 billion for research and development. Health as one of the
five key areas of research in the country under the National R&D Agenda of DOST.
➢ The DOH Agenda Aims for best HEALTH outcomes FOR ALL, promotion of health and delivery
of healthcare, and the protection of all families, especially those who are financially vulnerable.
It also aims to enhance service delivery networks and promote a universal health coverage.
➢ The AMBISYON NATIN 2040 video was shown. It envisions a prosperous middle class society
by 2040, wherein no one is poor and Filipinos live long and healthy lives. Health is a priority
sector seen to have a direct impact on AMBISYON.
➢ The SDGs and ASEAN integration influence the Phlippines‘ socio-economic direction. Health
is mentioned in economic and sociocultural blueprints.
➢ The United Nations SDGs focus on People, Planet, Prosperity, Peace and Partnership to
ensure that no one is left behind. There are 17 goals and 169 targets. A short video on what
the SDG is about was shown.
➢ These policies aim to be inclusive and produce effects that will impact the society.
➢ The Kingdon Model and Dialogue Model will be used in developing the NUHRA. This is a public
policy applied to health research.
Comments:
➢ Dr. Zulueta of MSC expressed that the SUCs are really the ones doing research but there are
still not enough researches. We are geographically challenged. In Marinduque, they have a

Page 31 of 37
 wellness program as spearheaded by Director Janairo of DOH-MIMAROPA.
➢ Ms. Gulle of DOH-MIMAROPA said that the Deaprtment of Health have efforts. They will try
their best (DOH and LGU) to improve healthcare delivery in MIMAROPA.
➢ Dr. Anatalio of RPH stated that in Romblon, they can feel the assistance from the national
government. The deployment of nurses by DOH was a big help, but now they are being pulled
out already. They are thankful for DOH and the national government. Romblon have long since
benefitted from the medical specialists, DTTBs in Rural Health Units, midwives, and medical
technologists even with limited resources. Now, there are DTTBs in all municipalities in
Romblon. PhilHealth is important in terms of financing and sustainability of the hospital. The
point of care program should be made available in all hospitals for 100% utilization. His focus
is on sustainable and effective health care delivery system because it is lacking in the region.
Research is slow. The staff are also busy doing their own work, but they are still the ones who
should do research.
Towards a Relevant and Responsive Philippine
Health Research Agenda: A Review
Key points:
➢ The first NUHRA used the health systems building blocks framework to cluster content-related
health related research priorities that were generated through a nationwide consultation.
➢ The second NUHRA mainly involved the core agencies, thus top to bottom approach.
➢ Out of the 422 research priorities in 1 st NUHRA, only 14% of the researches were completed.
Meanwhile, 80% of the 56 research priorities in the NUHRA 2011-2016 were completed.
➢ The development of the NUHRA 2017-2022 will require adequate representation and
consensus-building among stakeholders and horizontal and vertical approaches for integration.
➢ NUHRA development requires a framework for evaluating research utilization
➢ Research may be utilized in the following ways: evidence base; advocacy; policy; and in
behavior change.
Comments:

➢ The involvement of the LGU is important in crafting the NUHRA.

➢ Mr. Chua of AIHO expressed that top down approach is also important because funding comes
from them, but we are doing bottom approach up now.
A 20/20 Vision for the Philippine Health Sector
Key points:
➢ There is an increasing trend in non-communicable diseases in the Philippines.
➢ Another trend is the expansion of the private sector. There is a boom of Uber and Grab –
increasing traffic congestions. Private sectors have been operating in all three levels of the
health systems. It also has the largest share of HRF in the country.
➢ Policy developments like the Cheaper Medicines Act of 2008 improved accessibility of
medicines and medical products in the country.
➢ Sin Tax Law bloated the DOH budget. It significantly increased revenues with an additional $
3.8 B and decreased smoking prevalence from 31% in 2008 to 23.3% in 2015.
➢ During the Duterte administration, decentralization/federalism is expected to be implemented.

Page 32 of 37
 This may allow greater efficiency in delivery of basic health services.
Comments:
➢ Dr. Lerom of WPU commented that a very important concern is the behavioral change of
Filipinos.
➢ Dr. Anatalio explained that the concept of federalism is not clear to everyone. Not all regions
will be a federal state. It would be unfortunate if MIMAROPA will be made a federal state, unless
mining will be allowed. There will only be nine (9) federal states.
➢ Ms. Querubin of NEDA said that in 2016, MIMAROPA ranked 14 in the GRDP.

Private Sector Participation in Health Research

Key points:
➢ The private sector has three types of roles: Generators; Funders; and Adoptors.
➢ The following are the barriers between the government and the private sector:
1. Complex processes (of collaborating) – how should public agencies interact with
private agencies
2. Mismatching funding schemes – difficulty in getting money from private agencies to
public domain due to complex processes
3. Prohibitive regulatory environment – a need to ensure results despite prevailing
uncertainties and the need for initial trial and error approaches
4. Uneven capacities – strengths are not shared between the private sector and public
agencies
5. Asymmetry in sharing information
➢ Majority of funding is for public HEIs. Limited funding flows between the private sector and the
government.
➢ There have been successful Public-Private partnerships in Health Research like the Axis Knee
System and the research on Sambong. Given these success stories and barriers, technology
transfer is the entry point for collaboration between the private sector and public agencies.
➢ The four key areas to have a collaboration with the private sector are: Drugs and Vaccines;
Natural Products; Diagnostics; and Health Information.
Comments:
➢ Dr. Anatalio asked why the government funds private sectors. Government fund should be
government fund. Private companies already have the capacity.
➢ Mr. Regencia replied that the private sector includes private HEIs. They have specializations
that public HEIs do not have.
➢ As per PCHRD, DOST is supporting public-private sector collaboration on research. The
Private entity must have a counterpart funding. The share is almost 50-50. This is more
advantageous because there is already an adoptor.

Page 33 of 37
 INPUTS: REGIONAL SITUATIONER
Mr. Paul Lester Chua
Cluster Lead
AIHO
Key point 1
MIMAROPA is composed of 5 provinces and 2 cities. It is a mix of coastal areas and upland areas
(hills and mountains). The region has rich flora and fauna (terrestrial and marine species). As such, it
was the 2nd top fish producer in 2015 (13% of Phil.) and 2nd top seaweed producer (21% of Phil.).

Key point 2
Only 38 researches were published from 2011-2016 (from online journals like Scopus). Only six (6)
were authored by regional researchers. Majority was on Malaria and traditional and alternative
medicine.

Based on the survey conducted by AIHO, the underrepresented sectors in the region are private
sectors and IPs, while the under-researched area is acute respiratory infection.
Key point 3

The leading causes of mortality and morbidity were presented as well as the perceived challenges and
issues based on the survey conducted among the consortium member institutions.
PLENARY SESSION
Agreements:

➢ Other sub-topics are very specific and don’t give room for other crops, etc. If tongkat ali is very
very abundant, it can be a priority area.
➢ Dr. Patrick Regoniel explained that they only gave sample topics to come up with the main
theme.
➢ Mr. Paul Chua reiterated that the sub priorities will be the focus of research.
➢ Dr. Patrick Regoniel expressed that they were only representatives and they would have to
discuss this with other researchers from the SUCs.
➢ Dr. Romeo Lerom said that USAID is funding research on Tongkat ali. The population of
Tongkat ali is abundant in Palawan. The problem is that it is classified as an endangered
species. There is currently no assessment of the abundance of Tongkat ali but it is plenty in
mining areas. He added that the government is not supportive of this effort.

Day 2
Emcee: Mr. Paul Lester Chua, AIHO
SETTING THE CRITERIA FOR PRIORITIZATION
Mr. Paul Lester Chua
AIHO

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Final Criteria for Prioritization:
1. Impact - 30%
2. Feasibility – 20%
3. Magnitude of the Problem – 20%
4. Applicability of research – 10%
5. Acceptability – 10%
6. Responsiveness to the national policy or goals – 10%
Comments:
➢ The region is already a GIDA, is it still needed?
➢ Dr. Anatalio wanted the other areas in MIMAROPA to be re-classified as GIDA especially when
it comes to health issues. For example, the IPs refuse to go to the lowlands so health stations
need to be established there. In terms of health needs and health concerns, we can be
classified as GIDAs.
➢ Ms. Kaye Reyes of DOH-MIMAROPA suggested to have a baseline data on how to improve
health services in GIDA. It can be under the Health Service Delivery.
➢ Health service is needed in GIDA and not just profiling. There is a very limited knowledge on
health. Everyone agreed to move GIDA under service delivery.
➢ Mr. Paul Chua explained that the ranking will define the priority of the region and will have no
bearing if it will be funded or not
➢ Dr. Anatalio commented that if somebody conducted a research in herbal medicine, it will not
fall under health service delivery. It is a separate research before it can be considered in the
health service delivery and approved by DOH and BFAD. There will be clinical and human trials
first. Academe is not responsible for health service delivery, majority of the universities in the
region focus on agriculture. For example, tongkat ali will not fall under health service delivery.
➢ Mr. Zypher Regencia clarified that the proposed researches in PCHRD will be considered as
long as there is a S&T component. For example, it’s not only the monitoring of air pollution. The
data must be corellated with other available data. Now, PCHRD and PITAHC can fund
researches on drug discovery (50-60% of the budget of PCHRD is on drug discovery; Food and
Nutrition is 1-3%). Next is genomics and molecular technology. If a new technology will be
developed or baseline data will be gathered to develop new technology, it will be
allowed/funded.
➢ Mr. Lester Geroy asked if there are universities in MIMAROPA with a capacity in service
delivery.
➢ Dr. Patrick Regoniel said that it would be better to have partnerships. They would have to talk
with the users about their output and come up with a good arrangement. We have to work
together after asserting the needs. They have lack staff in the SUCs.
FINAL PRIORITY SCORING:
1. Environmental Health and climate change impact
2. Health service delivery
3. Reproductive health
4. Health financing
5. TB and HIV/AIDS

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 6. Mental Health and Substance Abuse
7. Traditional, Complementary and Alternative Medicine
8. Emerging and re-emerging disease
9. Drug discovery and development
10. Food and Nutrition
11. Health in Emergencies
12. Non-communicable Diseases
13. Human Resource for Health
14. Health and Culture
15. ICT for Health
16. Health research capacity
17. Health economics
PLANNING FOR RUHRA DISSEMINATION,
FUNDING, MONITORING AND EVALUATION
Mr. Paul Lester Chua
AIHO
Comments:
➢ Why is there a need for information dissemination when there is no specific agency dedicated
in this type of work.
➢ Ms. Querubin of NEDA-MIMAROPA informed the group on the process that the SDC follows
when proposing agenda items for inclusion. She said that the MHRDC needs to submit a one-
page briefer of the RUHRA to the SDC Secretariat.
➢ Ms. Reyes of DOH-MIMAROPA shared that popularization of Health R&D is included in the
plan of the RIUD Committee of MHRDC.
Output:
Information and Dissemination
- Through the Social development committee of the RDC
- Through the Regional Development Council (RDC)
- Through the Research Information, Utilization and Dissemination Committee (MHRDC)
- Use tri-media
- Use social media (websites of MHRDC and RDC)
mimaropa.healthresearch.ph
EVALUATION OF THE REGIONAL CONSULTATION / CLOSING REMARKS
Ms. Krizel-an Gulle
Planning Officer
DOH-MIMAROPA
Key point 1
It is our duty to ensure that health is being prioritized and observed at all times. Let’s look at health in
all lenses, especially in research where innovations and development efforts are at par.
Key point 2
In this consultation, may our priorities be included in the formulation of the National Unified Health

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Research Agenda which will guide researchers for the next six years.
Key point 3
May we continue to think outside the box and consider researches that would benefit our people.

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