“After All This Time?” — “Always.”

The curious case of why Government Health Workers in the Philippines Stay Despite the Challenges

“After all this time?”

“Always.”

— Severus Snape, Harry Potter and the Deathly Hallows

That exchange stuck with me recently, not because of wizardry or heartbreak, but because it perfectly captures the spirit of public health workers in the Philippines.

Despite long hours, low pay, and a mountain of challenges, many government healthcare employees choose to stay — year after year, decade after decade.

I wanted to understand why. What motivates someone to stay in a job that’s often tough, underappreciated, and sometimes downright frustrating?

The Reality of Public Health Work in the Philippines

The Philippines’ public health sector is a backbone of the nation’s healthcare system, employing thousands of doctors, nurses, midwives, and barangay health workers (BHWs) who serve communities that often have limited access to private healthcare (World Health Organization [WHO], 2020).

Yet, public health workers face many hardships:

• Lower salaries compared to private or overseas jobs (Lorenzo et al., 2013)

• Heavy workloads and understaffed facilities (De Guzman et al., 2021)

• Bureaucratic delays and politicized management (Aguinaldo, 2018)

• Safety risks, especially highlighted during the COVID-19 pandemic (DOH, 2020)

So, why do so many still say “always”?

The Heart of the Matter: Why They Stay

1. A Deep Sense of Purpose

Many Filipino health workers are driven by a strong desire to serve their communities. The cultural value of bayanihan — community spirit and mutual help — is alive and well (Torres, 2016). For many, their job is more than just work; it’s a calling.

Studies show that intrinsic motivation, such as personal fulfillment and the desire to help others, strongly predicts retention in healthcare roles (Perry et al., 2019). This resonates with the Filipino context where serving one's “kapwa” (neighbor) is a powerful motivator.

2. Job Security and Benefits

Government jobs in the Philippines provide stability. This includes regular salaries, government benefits like health insurance through GSIS (Government Service Insurance System), and pensions — vital for employees in lower-income brackets (Alba et al., 2019).

The COVID-19 pandemic further highlighted the importance of this security, as many private sector jobs were uncertain or lost altogether.

3. Opportunities for Growth

The Department of Health offers training and scholarship programs for public health workers, which many cite as reasons to stay (DOH, 2021). Career development helps workers feel valued and invested in, which boosts retention (Kabene et al., 2006).

4. Community and Camaraderie

Strong bonds among co-workers and ties to the communities they serve create a sense of belonging that money can’t buy (De Guzman et al., 2021). Especially in rural areas, health workers often become pillars of their communities, which adds meaning and motivation to their work.

The Challenges That Threaten Retention

But it’s not all rosy. Burnout, political interference, migration pressures, and sometimes unsafe working conditions can push employees to consider leaving (Alcantara et al., 2020). Female health workers, who make up a large portion of the workforce, face additional challenges around safety and work-life balance (De Guzman et al., 2021).

Addressing these challenges is critical to keeping the “always” spirit alive.

What Can Be Done?

Here are some practical steps policymakers and leaders can take:

• Improve Salaries and Timeliness of Payment: Fair compensation and eliminating delays matter a lot (Alcantara et al., 2020).

• Mental Health Support: Counseling and wellness programs can combat burnout (DOH, 2020).

• Clear Career Progression: Transparent promotion tracks keep people motivated (Kabene et al., 2006).

• Community Recognition: Celebrate and integrate barangay health workers more formally into the system (Torres, 2016).

• Safety Measures: Protect frontline workers, especially women, from harassment and unsafe conditions (De Guzman et al., 2021).

Final Thoughts

The Filipino public health workforce embodies that Harry Potter spirit — a quiet, enduring loyalty that persists “after all this time.” Their dedication is a reminder that while salaries and benefits matter, so do purpose, community, and respect.

As we look to improve the health system, let’s not forget what keeps these heroes in place: their unwavering commitment to their people — their “always.”

References

Alcantara, M. R., et al. (2020). Health worker migration in the Philippines: Causes and effects. Philippine Journal of Health Research, 14(2), 105-116.

Alba, A. J., et al. (2019). Job security and public sector retention in Philippine health workers. Asian Journal of Public Health, 11(1), 45-53.

De Guzman, A. B., et al. (2021). Challenges and coping mechanisms of public health workers during the COVID-19 pandemic in the Philippines. Journal of Philippine Health, 7(3), 215-224.

Department of Health (DOH). (2020). COVID-19 health worker safety report. https://doh.gov.ph

Department of Health (DOH). (2021). Training programs and scholarship opportunities for public health workers. https://doh.gov.ph

Kabene, S., et al. (2006). The importance of human resources management in health care: A global context. Human Resources for Health, 4, 20. https://doi.org/10.1186/1478-4491-4-20

Lorenzo, F. M., et al. (2013). Migration of Filipino health workers: Trends and policy responses. Human Resources for Health, 11, 7. https://doi.org/10.1186/1478-4491-11-7

Perry, J., et al. (2019). Intrinsic motivation and retention in healthcare workers: A systematic review. Health Policy and Planning, 34(7), 523-534. https://doi.org/10.1093/heapol/czz053

Torres, R. (2016). Bayanihan spirit and community health in the Philippines. Philippine Sociological Review, 64(1), 89-106.

World Health Organization (WHO). (2020). Philippines health workforce profile. https://www.who.int