Quezon City and Ateneo Policy Center collaborate on design thinking for sustainable health financing

The Ateneo School of Government, through the Ateneo Policy Center, facilitated a two-day Design Thinking Workshop with the Quezon City Government on 5 to 6 August 2025. This initiative is part of their project titled Maximizing Local Government Fiscal Performance of Health Budget, supported by the Unilab Center for Health Policy.

Participants included representatives from key Quezon City offices and institutions involved in health and fiscal management, such as the Quezon City Health Department, Accounting Office, Internal Audit, City Treasurer’s Office, and Budget Office. Also present were staff from the Office of the Vice Mayor, Health Promotion Unit, Chair of the Health Committee, and health facilities including Rosario Maclang Bautista General Hospital, Novaliches District Hospital, and Quezon City General Hospital. Together, they examined public financial management challenges and collaboratively developed practical strategies to enhance health budgeting and expenditure.

Day 1 (5 August 2025): Surfacing Pain Points Across the Budget Cycle

On 5 August, the first day of the workshop centered on empathizing with stakeholders by mapping out pain points across the four phases of the public financial management (PFM) cycle: preparation, authorization, execution, and review and accountability.

The discussion opened by surfacing the gaps between urgent health service needs and fiscal constraints. Fiscal experts urged hospitals to improve PhilHealth collections and manage claims to boost revenue, while the health department emphasized diversifying funding sources to better support services.

The day culminated in the creation of journey maps visualizing these challenges. Among the mapped pain points were delays in procurement planning and misalignment between actual health needs and proposed budgets during the budget preparation phase; compressed review timelines and repeated revisions during authorization; execution challenges such as unsuccessful bidding processes, stock shortages, and stringent fiscal controls; and, during review and accountability, gaps in monitoring systems, incomplete documentation, and insufficient manpower.

Day 2 (6 August 2025): Defining Priorities and Co-Creating Solutions

Synthesizing insights from Day 1, the second day of the workshop began with the development of human-centered problem statements based on the PFM challenges identified to be the most critical by the participants. Key issues included the need to address information gaps and capacity limitations that hinder alignment with strategic plans during budget preparation, the rigidity of annual budget ceilings that restrict responsiveness during authorization, procurement delays caused by failed bidding and market mismatches during execution, and weak monitoring systems compounded by insufficient personnel during review and accountability.

Through structured ideation, stakeholders proposed innovative solutions aimed at enhancing data coordination, strengthening capacity in health informatics and budget planning, creating more flexible budgeting frameworks, improving procurement market studies, and expanding monitoring and feedback mechanisms.

The event concluded with the development of a power-interest matrix, identifying key stakeholders critical to driving meaningful reforms in health budget processes.

For Sustainable Health Financing in Quezon City and Beyond

The workshops anchored on Quezon City’s unique position as a ‘model city’ faced with complex health financing challenges. Participants from different offices actively engaged in identifying barriers and generating practical solutions to optimize local health budgets. These collaborative efforts laid a strong foundation for innovative but practicable approaches tailored to the city’s dynamic service delivery landscape.

Moving forward, these insights will guide targeted policy recommendations designed to enhance not only Quezon City’s fiscal performance in health but those of other urban local government units. These outcomes aim to support evidence-based and sustainable fiscal practices that can serve as a blueprint for other LGUs striving to achieve UHC goals.