'Kontra-partido': untangling oppositional local politics and healthcare devolution in the Philippines.

A long-recognized problem of healthcare devolution in many developing countries is its inextricability from the influences of local politics. This has been particularly self-evident in the Philippines, where, since the adoption of the Local Government Code of 1991, the devolution of health governance, planning, administration and service delivery has placed the health system largely under the control of individual provinces, cities, municipalities and villages or barangays. In this article, we utilize the notion of 'kontra-partido' (the Filipino term connoting 'oppositional politics') to concretize local, oppositional politics as a lived experience of health workers, government officials and ordinary citizens in the country. Through multi-sited qualitative fieldwork, we demonstrate how 'kontra-partido' politics ultimately worsens health outcomes in any locality. We show how such politics figures in the relational dynamics of health governance, often resulting in petty infighting and strained relationships among local health authorities; how it leads to the politicization of appointments and prevents the local workforce, especially those at the grassroots, from doing their jobs efficiently amid environments rife with hostile patronage; and how it impedes service delivery as politicians prioritize 'visible' projects (over sustainable ones) and selectively deliver health care to their known supporters. In turn, health workers and ordinary citizens alike have been actively negotiating their roles within this political milieu, either by joining the so-called political frontlines or by engaging in the transactional relationships that develop between politicians and their constituents during perennial election seasons. We conclude with a reflection on the vulnerability of health to politicization and the visceral consequences of 'kontra-partido' politics to health workers, as well as an identification of possible areas of intervention for future policy reform, given the deepening political polarization in the country and the upcoming implementation of the recently passed Universal Health Care Law.

Fear, mistrust, and vaccine hesitancy: Narratives of the dengue vaccine controversy in the Philippines.

This article applies a qualitative approach to the 2017 dengue vaccine controversy involving Sanofi Pasteur's Dengvaxia to understand vaccine hesitancy and related anxieties in contemporary Philippines. Through a multisited project that investigated the health aspirations and lived experiences of low- and middle-income Filipinos across urban and rural Philippines, this article distills the perspectives of both ordinary community members and health workers in local and national capacities regarding the controversy-and how it altered their perceptions toward vaccines, health care, and government. Our study reveals widespread mistrust and fear in the communities toward both the state and health institutions following the controversy, with frontline health workers bearing the brunt of the communities' apprehensions, and the media partly responsible in fomenting these fears. Given the repetitive nature of health and vaccine controversies, this article suggests the importance of responsible journalism, well-calibrated crisis communications, and a people-centered health paradigm that involves exploring local contexts of vaccine hesitancy and mining people's lived experiences in tackling present and future health crises-especially now in the advent of COVID-19 vaccinations.

Modeling the residential distribution of enrolled students to assess boundary-induced disparities in public school access.

Given school enrollments but in the absence of a student residence census, we present a gravity-like model to infer the residential distribution of enrolled students across various administrative units. Multi-scale analysis of the effects of aggregation across different administrative levels allows for the identification of administrative units with sub-optimally located schools and highlights the challenges in allocating resources. Using this method, we verify that the current scheme of free cross-enrollment across administrative boundaries is needed in achieving universal education in the Philippines.

The Philippines' antidrug campaign: Spatial and temporal patterns of killings linked to drugs.

BACKGROUND: As soon as President Rodrigo Duterte assumed office in 2016, the Philippine government launched a nationwide antidrug campaign based on enforcement-led anti-illegal drugs policies primarily implemented by the national police. This was followed by a spate of killings resulting from both acknowledged police operations and by unidentified assailants. This study assembles a victim-level dataset of drug-related killings covered by the media during the Philippine government's antidrug campaign, and presents a spatial and temporal analysis of the killings. METHODS: The dataset covers information on 5021 people killed from May 10, 2016 to September 29, 2017. Data collected systematically through online search procedures and existing listings of media organizations detailing information about incidences of drug-related police operations and drug-related killings in 'vigilante-style' manner reveal patterns for who were being killed, where, and how. RESULTS: Over half of the killings were due to acknowledged police operations, and the rest were targeted in so-called 'vigilante-style' killings. The first three months after Mr. Duterte was sworn in were the deadliest months. Those who were killed were mostly low-level drug suspects. The analysis of temporal pattern reveals the scale of killings in the country, with rapid escalation starting in July 2016 and lasting throughout the rest of that year. Observable declines occurred during periods when the 'drug war' was suspended and operations were moved to a non-police enforcement unit and rose again when police were brought back into operations. The spatial analysis indicates a large concentration of deaths in the National Capital Region (40%) compared to the rest of the country with wide variations across cities and regions. CONCLUSIONS: Overall, the Philippine 'drug war' exhibits similarities with violent wars on drugs waged in other countries such as Thailand, with heavily police-led interventions leading to fatalities in the thousands over a span of under two years. Findings of this study point to important policy adjustments that need to be made, including the role that local governments play in drug policy implementation, the disproportionate negative impacts of enforcement-led policies against drugs on urban and poor areas, the targeting of low-level suspected drug dealers and users, and the importance of proper data monitoring and transparency by the government to inform policy adjustments in the face of high costs to human life. We also discuss the importance of independent monitoring systems when the government reports conflicting information.

Reliance on Facebook for news and its influence on political engagement.

This paper examines the link between reliance on Facebook for news, political knowledge, and political engagement in the Philippines. We tested five hypotheses using data gathered from an online survey of 978 Filipinos conducted from February 1 to March 31, 2016. Findings support the hypothesis that those who rely less on social media as a news source exhibit higher levels of perceived knowledge about politics than those who rely more on it for news. Controlling for traditional news use, following political officials or institutions on social media is associated with higher levels of political interest and engagement, those with more politically active friends on Facebook have higher levels of exposure to political content online, and there is a positive correlation between Facebook being a source of information about politics and discussing politics more often with others. However, the hypothesis that those with more friends on their network who are politically active, will have greater political knowledge and more political engagement than those who have few politically active friends on their Facebook network is not supported.

Quality of nursing schools in the Philippines: Trends and evidence from the 2010-2016 Nurse Licensure Examination results.

BACKGROUND: The quality of undergraduate nursing programs offered by higher education institutions (HEIs) in the Philippines is usually evaluated using Nurse Licensure Examination (NLE) results. PURPOSE: To describe NLE trends in 2010 to 2016, compare low- and high-performing HEIs, and examine the association of HEIs' characteristics with NLE passing rate. METHODS: NLE and HEI data were collected from two Philippine government agencies. Descriptive statistics were used to present NLE trends, while multiple linear regression was used to determine the association of HEI characteristics with NLE passing rate. DISCUSSION: There was a downward trend for NLE takers and passers from 2010 to 2016. Regression results showed that location, size, type, year of establishment, and student-faculty ratio were associated with NLE passing rate. CONCLUSION: HEIs should consider decreasing their student-faculty ratio to improve NLE performance. Relevant government agencies should take measures to improve most HEIs' NLE performance in the Philippines.

Tweeting Supertyphoon Haiyan: Evolving Functions of Twitter during and after a Disaster Event.

When disaster events capture global attention users of Twitter form transient interest communities that disseminate information and other messages online. This paper examines content related to Typhoon Haiyan (locally known as Yolanda) as it hit the Philippines and triggered international humanitarian response and media attention. It reveals how Twitter conversations about disasters evolve over time, showing an issue attention cycle on a social media platform. The paper examines different functions of Twitter and the information hubs that drive and sustain conversation about the event. Content analysis shows that the majority of tweets contain information about the typhoon or its damage, and disaster relief activities. There are differences in types of content between the most retweeted messages and posts that are original tweets. Original tweets are more likely to come from ordinary users, who are more likely to tweet emotions, messages of support, and political content compared with official sources and key information hubs that include news organizations, aid organization, and celebrities. Original tweets reveal use of the site beyond information to relief coordination and response.