Harvy Joy Liwanag

Details

Sex: Male
Education:

  • Doctor of Philosophy in Epidemiology and Public Health. University of Basel, Switzerland, 2019
  • Doctor of Medicine and Master of Business Administration, Ateneo de Manila University, 2012
  • Bachelor of Science in Biology, Ateneo de Manila University, 2006

Field of Specialization:

Health Systems
Strategic Foresight
Equity
Global Health
Qualitative Research
Health Policy

Researches:

Article title: Dialogical reflexivity towards collective action to transform global health
Authors: Harvy Joy Liwanag and Emma Rhule
Publication title: British Medical Journal Global Health 6(8):e006825, August 2021

Abstract:
No available
Full text link https://tinyurl.com/58dcusn5

Article title: Who should decide for local health services? A mixed methods study of preferences for decision-making in the decentralized Philippine health system
Authors: Harvy Joy Liwanag and Kaspar Wyss
Publication title: BMC Health Services Research 20(1)

Abstract:
The Philippines decentralized government health services through devolution to local governments in 1992. Over the years, opinions varied on the impact of devolved governance to decision-making for local health services. The objective of this study was to analyze decision-makers' perspectives on who should be making decisions for local health services and on their preferred structure of health service governance should they be able to change the situation. Methods: We employed a mixed methods approach that included an online survey in one region and in-depth interviews with purposively-selected decision-makers in the Philippine health system. Study participants were asked about their perspectives on decision-making in the functions of planning, health financing, resource management, human resources for health, health service delivery, and data management and monitoring. Analysis of survey results through visualization of data on charts was complemented by the themes that emerged from the qualitative analysis of in-depth interviews based on the Framework Method. Results: We received 24 online survey responses and interviewed 27 other decision-makers. Survey respondents expressed a preference to shift decision-making away from the local politician in favor of the local health officer in five functions. Most survey participants also preferred re-centralization. Analysis of the interviews suggested that the preferences expressed were likely driven by an expectation that re-centralization would provide a solution to the perceived politicization in decision-making and the reliance of local governments on central support. Conclusions: Rather than re-centralize the health system, one policy option for consideration for the Philippines would be to maintain devolution but with a revitalized role for the central level to maintain oversight over local governments and regulate their decision-making for the functions. Decentralization, whether in the Philippines or elsewhere, must not only transfer decision-making responsibility to local levels but also ensure that those granted with the decision space could perform decision-making with adequate capacities and could grasp the importance of health services.
Full text link https://tinyurl.com/fu6md6uz

Article title: Optimising decentralisation for the health sector by exploring the synergy of decision space, capacity and accountability: Insights from the Philippines
Authors: Harvy Joy Liwanag and Kaspar Wyss
Publication title: Health Research Policy and Systems 17(4):1-16, January 2019

Abstract:
Several studies on decentralisation have used the ‘decision space’ approach to assess the breadth of space made available to decision-makers at lower levels of the health system. However, in order to better understand how decentralisation becomes effective for the health sector, analysis should go beyond assessing decision space and include the dimensions of capacity and accountability. Building on Bossert’s earlier work on the synergy of these dimensions, we analysed decision-making in the Philippines where governmental health services have been devolved to local governments since 1992. Methods Using a qualitative research design, we interviewed 27 key decision-makers at different levels of the Philippine health system and representing various local settings. We explored their perspectives on decision space, capacities and accountability in the health sector functions of planning, financing and budget allocation, programme implementation and service delivery, management of facilities, equipment and supplies, health workforce management, and data monitoring and utilisation. Analysis followed the Framework Method. Results Across all functions, decision space for local decision-makers was assessed to be moderate or narrow despite 25 years of devolution. To improve decision-making in these functions, adjustments in local capacities should include, at the individual level, skills for strategic planning, management, priority-setting, evidence-informed policy-making and innovation in service delivery. At institutional levels, these desired capacities should include having a multi-stakeholder approach, generating revenues from local sources, partnering with the private sector and facilitating cooperation between local health facilities. On the other hand, adjustments in accountability should focus on the various mechanisms that can be enforced by the central level, not only to build the desired capacities and augment the inadequacies at local levels, but also to incentivise success and regulate failure by the local governments in performing the functions transferred to them. Conclusion To optimise decentralisation for the health sector, widening decision spaces for local decision-makers must be accompanied by the corresponding adjustments in capacities and accountability for promoting good decision-making at lower levels in the decentralised functions. Analysing the health system through the lens of this synergy is useful for exploring concrete policy adjustments in the Philippines as well as in other settings. Electronic supplementary material The online version of this article (10.1186/s12961-018-0402-1) contains supplementary material, which is available to authorized users.
Full text link https://tinyurl.com/4mrz4x8p

Article title: What conditions enable decentralization to improve the health system? Qualitative analysis of perspectives on decision space after 25 years of devolution in the Philippines
Authors: Harvy Joy Liwanag and Kaspar Wyss
Publication title: PLoS ONE 13(11):e0206809, November 2018

Abstract:
Decentralization is promoted as a strategy to improve health system performance by bringing decision-making closer to service delivery. Some studies have investigated if decentralization actually improves the health system. However, few have explored the conditions that enable it to be effective. To determine these conditions, we have analyzed the perspectives of decision-makers in the Philippines where devolution, one form of decentralization, was introduced 25 years ago. Methods: Drawing from the "decision space" approach, we interviewed 27 decision-makers with an average of 23.6 years of working across different levels of the Philippine government health sector and representing various local settings. Qualitative analysis followed the "Framework Method." Conditions that either enable or hinder the effectiveness of decentralization were identified by exploring decision-making in five health sector functions. Results: These conditions include: for planning, having a multi-stakeholder approach and monitoring implementation; for financing and budget allocation, capacities to raise revenues at local levels and pooling of funds at central level; for resource management, having a central level capable of augmenting resource needs at local levels and a good working relationship between the local health officer and the elected local official; for program implementation and service delivery, promoting innovation at local levels while maintaining fidelity to national objectives; and for monitoring and data management, a central level capable of ensuring that data collection from local levels is performed in a timely and accurate manner. Conclusions: The Philippine experience suggests that decentralization is a long and complex journey and not an automatic solution for enhancing service delivery. The role of the central decision-maker (e.g. Ministry of Health) remains important to assist local levels unable to perform their functions well. It is policy-relevant to analyze the conditions that make decentralization work and the optimal combination of decentralized and centralized functions that enhance the health system.
Full text link https://tinyurl.com/pp5zuv4

Article title: Toward the 2020 goal of soil-transmitted helminthiasis control and elimination
Authors: So¨ren L. Becker, Harvy Joy Liwanag, Jedidiah S. Snyder5, Oladele Akogun,Vicente Belizario., Jr, et al.
Publication title: PLoS Neglected Tropical Diseases 12(8):e0006606, August 2018

Abstract:
No available
Full text link https://tinyurl.com/c6nwmh46

Article title: Assessing decentralisation is a challenging but necessary task if it should continue as a reform strategy: Reflections from the systematic review by Sumah, Baatiema, and Abimbola
Authors: Harvy Joy Liwanag and Kaspar Wyss
Publication title: Health Policy 121(4):468-470, February 2017

Abstract:
No available
Full text available upon request to the author

Article title: Soil-Transmitted Helminthiasis and Schistosomiasis in Children of Poor Families in Leyte, Philippines: Lessons for Disease Prevention and Control
Authors: Harvy Joy Liwanag, Jhanna Uy, Ramil Bataller, Janis Ruth Gatchalian, Betty De La Calzada, et al.
Publication title: Journal of Tropical Pediatrics 63(5):335-345, January 2017

Abstract:
Neglected tropical diseases (NTDs) continue to be a public health problem in the Philippines. We assessed the association of soil-transmitted helminthiasis (STH) and schistosomiasis with selected health-related and socioeconomic variables in four villages in Leyte, Philippines. Methods: Stool specimens from 418 adults and 533 of their children from 209 families were examined through the Kato-Katz technique. Results: STH and schistosomiasis were present in 64.6% and 12.5%, respectively, of study participants. Analysis through the generalized linear mixed model revealed a number of associations between infection in parents and their children. Findings indicate that years of disease prevention and control efforts in these areas have been unable to bring down prevalence in children and their parents. Eliminating NTDs as public health problems will require a systems thinking approach beyond implementation of vertical control programs alone.
Full text link https://tinyurl.com/4d5t9ya4

Article title: Parasitological and nutritional status of school-age and preschool-age children in four villages in Southern Leyte, Philippines: Lessons for monitoring the outcome of Community-Led Total Sanitation
Authors: Vicente Y.BelizarioJr., Harvy Joy C. Liwanag, June Rose A. Naig, Paul Lester C.Chua
Publication title: Acta Tropica 141((Pt A)):16-24, September 2014

Abstract:
While preventive chemotherapy remains to be a major strategy for the prevention and control of soil-transmitted helminthiases (STH), improvements in water, sanitation, and hygiene (WASH) comprise the long-term strategy to achieve sustained control of STH. This study examined the parasitological and nutritional status of school-age and preschool-age children in four villages in Southern Leyte, Philippines where two of the villages attained Open-Defecation-Free (ODF) status after introduction of Community-Led Total Sanitation (CLTS).
Full text available upon request to the author

Article title: Soil-Transmitted Helminthiases in Secondary School Students in Selected Sites in Two Provinces in the Philippines: Policy Implications
Authors: Vicente Belizario Jr, Paul Lester Chua, Harvy Joy Liwanag, June Rose Naig,1and Jeffrey Mark Erfe
Publication title: Journal of Tropical Pediatrics 60(4):303-307

Abstract:
The latest World Health Organization (WHO) strategic plan for eliminating soil-transmitted helminthiases (STHs) as a public health problem in children puts the emphasis on school-age children. On the other hand, the Philippine national helminth control program excludes secondary school students in mass deworming for STH. This study determined the prevalence and intensity of STH in a sample of 633 students (14–15 years old) in selected secondary schools in two Philippine provinces. Stool specimens were processed following the Kato-Katz technique and examined for the presence of helminth ova. Overall cumulative prevalence of STH was 31.3%, while prevalence of moderate–heavy-intensity infections was 7.7%, well beyond the WHO target of ≤1% for reducing morbidity in school-age children. Recommendations were made to update the Philippine helminth control program and to re-examine the WHO strategic plan so that helminth prevention and control strategies may also be emphasized for secondary school students especially in high-prevalence areas.
Full text link https://tinyurl.com/3bcna3wh