Local level health governance strengthening for universal health coverage: implementing the Bayang Malusog-Municipal Leadership Development Program in Aklan, Philippines.

The devolution of health systems development to local governments in the Philippines in 1991 brought with it unintended consequences as local chief executives found themselves with new responsibilities for which they were not prepared. These unintended consequences were exacerbated with the implementation of the country's Universal Health Care Act in 2019. To address this problem, the Zuellig Family Foundation, a non-profit and non-government organization based in the Philippines with the aim of improving health outcomes, has designed a local level health governance strengthening intervention: the Bayang Malusog (literally Healthy Communities) Municipal Leadership Development Program (BM-MLDP). The BM-MLDP is a 12-month capacity building intervention for local chief executives and local health officials consisting of deep dive immersions, change management and leadership sessions, sustainability of health reform sessions, and co-design sessions to improve population health outcomes. Its implementation on the municipalities of Balete and New Washington in 2022-2023 contributed to improving and sustaining optimal population health outcomes despite resource constraints. This highlights the potential of health governance and capacity building interventions like the BM-MLDP in improving population health outcomes and advancing the implementation of universal health coverage in resource-constrained, devolved healthcare settings.