Assessment of the role of community health volunteers in delivering primary health care in Manila, the Philippines

Abstract

Introduction

  The Philippines adopted the primary health care (PHC) strategy in 1978 to deliver essential health services in the community related to prevention and control of prevalent health problems. The barangay health workers (BHWs) are expected to play a key role in profiling the health of the community by maintaining and updating a comprehensive dataset of the community, called the “thirteen folders”, through conducting routine house visits (Appendix A). This study aimed to determine the utilization and challenges in updating the 13-folders and its usefulness in conducting community activities of BHWs at the primary care level.

Methods

  This study utilized a mixed- method of descriptive epidemiology and qualitative analysis, whereby data was collected from various resources as well as structured interview with 20 nurses and 31 BHWs in Districts I and VI, of Manila City. Questions related to activities of BHWs in identifying and profiling communities through house visits, utilization of feedback report and the challenges encountered were asked.

Results

  None of the health centers met the BHW to community ratio of 1: 20 residents. Only one out of 31 BHWs conducted community visits as required or four times a week. In fact, irregular visits resulted to failure in conducting community profiling and in delays in updating the 13-folder with missing information noted in some folders. The BHWs’ role is perceived by both nurses and BHWs as assisting in objective-specific activities and as health educators. Delays in honorarium and duplicating tasks in updating the 13-folders were revealed as potential issues that could hamper their performance.

Conclusion

  The BHWs are crucial in assisting health staff towards provision of responsive health services; however, lack of human resource should be addressed to reduce additional workload among BHWs. The 13-Folder is an imperative tool to identify the needs of the community other than health concerns but careful assessment is required to reduce repetitive tasks and to determine its value in improving community health outcomes. The delayed provision of honorarium should be dealt with to avoid further demotivation among BHWs. Finally, a refresher training should be considered to optimized the role of BHWs at the PHC level.