The 2019 Philippine Universal Health Care Act (Republic Act 11223) was set for implementation in January 2020 when disruptions brought on by the pandemic occurred. Will the provisions of the new UHC Act for an improved health system enable agile responses to forthcoming shocks, such as this COVID-19 pandemic? A content analysis of the 2019 Philippine UHC Act can identify neglected and leverage areas for systems’ improvement in a post-pandemic world. While content or document analysis is commonly undertaken as part of scoping or systematic reviews of a qualitative nature, quantitative analyses using a two-way mixed effects, consistency, multiple raters type of intraclass correlation coefficient (ICC) were applied to check for reliability and consistency of agreement among the study participants in the manual tagging of UHC components in the legislation. The intraclass correlation reflected the individuals’ consistency of agreement with significant reliability (0.939, p < 0.001). The assessment highlighted a centralized approach to implementation, which can set aside the crucial collaborations and partnerships demonstrated and developed during the pandemic. The financing for local governments was strengthened with a new ruling that could alter UHC integration tendencies. A smarter allocation of tax-based financing sources, along with strengthened information and communications systems, can confront issues of trust and accountability, amidst the varying capacities of agents and systems.

This chapter explores the governance issues in the implementation of insurance coverage for the informal labour sector in the context of universal health coverage (UHC). The COVID-19 pandemic highlights the vulnerabilities of the informal sector that remain overlooked by employer health insurance and are not targeted by the government’s cash transfer programmes for the poor. While universal health coverage may, on paper, assure every one of the basic minimum health care packages, issues of capturing subsidies for and availing of similar no user charges for the poor may be a Gordian knot before universal coverage is achieved. The chapter interrogates this issue as follows—firstly, we present key health financing features of the Philippine efforts to cover the informal sector in the national health insurance programme; and secondly, based on a concept approach, we analyse the elements of a social contract that may enhance or break down relationships in informal sector health insurance—with the market, bureaucratic and networks in health systems. Implications are drawn on the design of institutional arrangements to capture subsidies, contributions, and provider payments as part of a post-pandemic new normal of greater health security through the financing of health in the context of a social contract.

The study explores demand for maternal and family planning services among beneficiaries of the Pantawid Pamilyang Pilipino Program, a conditional cash transfer program in the Philippines. We analyzed 390 households across six provinces in the Philippines through multi-stage sampling. Three models were created: (1) pregnancy during the program, (2) facility-based delivery, and (3) non-utilization of antenatal care visits. The findings show that: (1) For every peso increase in received amounts from the program, the odds of getting pregnant decreased by 0.31%, a negative but weak association, while having more children, living in a high mortality region, having a teenage child, living far (self-perceived) from the health center, marrying at a younger age, and not completing high school also increased the odds of being pregnant. (2) Non-delivery from a health facility was likely for those who lived far from a facility and in a high mortality region, and (3) having a teenager at home increased the likelihood of seeking antenatal visits, while those who have been married longer slacked behind in terms of antenatal visits. The study points to directions for policy and research on access and use of maternal and reproductive health services, and the role of adolescent-aged children.