Since 2018, the Australian Embassy in the Philippines and The Asia Foundation, through the Coalitions for Change (CfC) program, have provided learning opportunities for leaders to pursue policy reform using adaptive and entrepreneurial principles.

Keith Vincent A. Jablo is one of those leaders.  Keith serves as the Corporate Social Responsibility Lead for Ayala Business Club Iloilo, a Project Associate of Ayala Foundation Inc., and a University Lecturer at the University of the Philippines Visayas.  Keith is one of the 2^nd Cohort Mentees of CfC’s Development Entrepreneurship Mentoring Program. Below is his story, how he convinced the Mayor of Pavia, Iloilo, to sign an Executive Order that led to the formation of a Barangay Health Governance Bodies in the Municipality’s 18 Barangays.

Keith observed that barangay health programs and activities, such as medical missions, dengue campaigns, feeding programs, anti-rabies vaccinations, and barangay-based circumcisions, to name a few, are indeed useful and good, however these were mostly initiated by the Local Government Units, in reaction to emerging circumstances, and unsustainable. This inspired him to push for a formalized system for a more sustainable and proactive health interventions at the barangay level.

Before starting on his Development Entrepreneurship Mentoring journey, Keith was a resource person for the Barangay Health Leadership and Management Program (BHLMP) of the Department of Health’s (DOH) Western Visayas Center for Health and Development. The program aims to improve primary health care, focusing on the importance of active community participation, intersectoral collaboration, and health empowerment.

His experience with the BHLMP program showed him that: (1) most barangay LGUs (BLGUs) do not fully utilize the five percent prescribed budget for health programs; (2) BLGUs have no system in place for a proactive and responsive health administration; and (3) BLGUs do not have an Annual Barangay Health Plan or ABHP. While a Local Government Code of 1991 (“Local Health Boards”) exists, it stops at the municipal or city level, leaving barangays to fend for the health needs of their constituents themselves.

Improving health at the barangay level

Inspiration for Keith’s reform centered on the idea of improving the health administration at the barangay level by forming a system that is responsive, proactive, and sustainable through the Barangay Health Governance Body (BHGB).

He thought of a BHGB composed of barangay LGUs and their elected or appointed officials, stakeholders like people’s organizations (POs), civil society organizations (CSOs), non-government organizations (NGOs) and business representatives.  The BHGB would assess and identify health issues in the community; ensure community participation in the planning, implementation, monitoring and evaluation of health programs; ensure the delivery of health services to the community so that these would be regularly available, accessible, and equitable; and create an Annual Barangay Health Plan. While the BHGB is similar in function and complements the efforts done by Local Health Boards, it works at the barangay level.

Applying the Development Entrepreneurship Principles

As Keith applied for The Asia Foundation’s Development Entrepreneurship Mentoring Program, he knew what he wanted to achieve: legislation issued at the local level on the formation of a Barangay Health Governance Body or BHGB.  But he didn’t know where to start.

That’s where his mentor, Mr. Men Sta. Ana, came in.  He taught Keith to implement the “just start” principle using available resources and contacts.

Following the second principle to “make small bets,” Keith established his criteria for choosing an LGU partner: (1) the Mayor had to be a progressive mayor; (2) Keith had to have a good working relationship with the Mayor; and (3) the Mayor considers the wellbeing of his/her constituents as the priority agenda.

This led Keith to Mayor Luigi Gorriceta of the Municipality of Pavia in Iloilo.  Mayor Luigi was progressive; had worked with Keith through the various education and youth programs and donations implemented at the LGU level through Keith’s work at the Ayala Foundation; and placed the health and wellbeing of his constituents as one of his top priorities.

When he officially met Mayor Luigi to discuss his reform idea, Keith was surprised that the mayor approved his proposal within 20 minutes of their meeting. Remembering the DE principle “exploit and anticipate surprises,” Keith immediately requested the Mayor to ask his team to start drafting the Executive Order (EO) mandating the formation of BHGBs in all the barangays in the Municipality of Pavia. Unfortunately, three months after the Mayor’s approval, the EO was never drafted. Mayor Luigi said he and his team were overwhelmed with other matters and the upcoming election.

Keith then proceeded to befriend the Assistant of the Mayor’s Executive Assistant by “harnessing coalitions and networks.” One month later, the Assistant called Keith to inform him that the Mayor had already issued the EO — which turned out to be an Executive Order mandating the formation of a Local Health Board (this is the health governing body at the municipal level, not barangay).

It was at this instance that Keith decided to take matters into his own hands and “influence the future.” He drafted the EO mandating the formation of BHGBs in the 18 barangays in Pavia, and another draft template of a barangay resolution creating a BHGB with specific members (BLGUs simply needed to encode the names of the BHGB members and sign).

Signing of Executive Order for BHGBs

On August 3, 2022, roughly two weeks after submitting the drafts to the Mayor’s office, Executive Order 082-A, Series of 2022 (“An Order Mandating the Formation of Barangay Health Governance Body in the 18 Barangays of the Municipality of Pavia, Metro Iloilo”) was signed and issued. Currently, the Assistant, now a staunch ally of the reform, is now collecting the BLGU resolutions in support of the EO.

“My reform journey and experience was challenging, but at the same time meaningful and fulfilling. This would not have been possible without the opportunity given to me by TAF’s CfC and the Australian Embassy in the Philippines DE Mentoring program. To Mayor Luigi of Pavia and his team, and most especially to my mentor, Sir Men Sta. Ana, thank you for the patience, encouragement and guidance. Padayon! Maraming salamat po!,” said Keith.