Philippine lawmakers rejected President Rodrigo Duterte's choice of health secretary on Tuesday, making her the fifth cabinet member to have been turned down since Duterte came to power.
No reason was given for the rejection of Paulyn Ubial, who has been in public office for 27 years.
In the Philippines, all cabinet ministers must be approved by the Commission on Appointments and hearings can take place long after they start work.
Senator Gregorio Honasan, chairman of the commission's health committee, said it had decided to "withhold its consent" to the appointment of Ubial. He did not elaborate.
Presidential spokesman Ernesto Abella expressed regret, saying the government was grateful for her service.
Duterte has enjoyed strong opinion poll numbers since winning the presidency in last year's elections but heavy scrutiny of his war on drugs, which has killed thousands of Filipinos, appears to have impacted his ratings.
Trust and satisfaction in Duterte fell to the lowest of his presidency in the third quarter of this year, a survey showed on Sunday, although sentiment about his leadership remained positive overall.
Lawmakers have also rejected the appointments of Duterte's foreign, environment, agrarian reform and social welfare ministers.
Two of the ministers were recommended by Maoist rebel leaders who were still talking peace with the government. Duterte has stopped the negotiations because of continuing violence.
Duterte's picks for foreign and environment ministers, Alan Peter Cayetano and Roy Cimatu, have been confirmed.
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