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In 2015, the Philippine Statistics Authority (PSA) reported that there are 900,914 establishments in the Philippines. To ensure the safety and health of workers in these establishments, the Department of Labour and Employment (DOLE) is mandated with the overall administration and enforcement of OSH in the country.However, while the Philippines has a concrete legal framework on OSH as well as a central government agency tasked to implement it, the annual accident and medical reports based on Work Accident and Illness Report (WAIR), the Annual Medical Report AMR), and the nationwide sampling survey of the Bureau of Labour and Employment Statistics (BLES) put to question the effectivity of the programs of DOLE as well as other government agencies in implementing OSH standards. This study looked into the challenges, issues and concern in managing OSH in the Philippines.Document analysis and interviews were conducted to various duty of care bearers.The high incidence in occupational accidents, injuries and diseases is a manifestation that the battle towards decent work and safe work environments in the Philippines has a long way to go. The discrepancy on the law versus practice of OSH Standards in the Philippines is evident. The number of establishments, the archipelagic nature of the country’s geography, the low awareness on OSH, and the lack of manpower from government agencies are just some major reasons why managing OSH in the Philippines is a very daunting task.The nature of prevention measures on OSH in the Philippines can be described as a combination of both reactive and proactive policies. Considering the complexity of the challenges, issues and concerns involved, a holistic, integrated approach is therefore needed to upgrade the OSH situation in the Philippines.