BACKGROUND: Health-related quality of life is an important aspect of cancer research. Studies in the Philippines documenting this among survivors are limited in scope and number.
OBJECTIVE: To document quality of life indicators of Filipino cancer survivors starting at 12 months from diagnosis and identify predictors of these changes.
METHODS: The ACTION study is a prospective longitudinal study examining the economic and health impact of cancer in the Southeast Asian Region. A country-specific analysis for Filipino patients was conducted.
RESULTS: Of the 909 Filipinos included in the study, 462 survived month 12 and had health-related quality of life (HRQoL) data. HRQoL data showed significant improvement from baseline (0.73, SD: 0.15) to month 12 (0.79, SD: 0.24) as measured by the EQ-5D weight score. Similar trends were seen in the EQ5D VAS Scores and the QLQ30 Global function scores. There was, however, an increase in the proportion of respondents experiencing significant problems related to EQ5D domains by month 12. Data disaggregated according to cancer type showed a decrease in QLQ30 GF scores from baseline to month 12 for all types except breast cancer. Individuals at risk of anxiety and depression increased from 15.37% to 25.54% and 18.83% to 32.25%, respectively. Predictors of worsening HRQOL include experiencing economic hardship, progression of disease, and higher stage at baseline.
CONCLUSION: HRQOL scores were found to increase despite experiencing more difficulties in function among Filipino cancer survivors one year after diagnosis.

Human ; Male ; Female ; Adult ; Depression ; Quality Of Life ; Survivors ; Anxiety ; Surveys And Questionnaires ; Depressive Disorder ; Breast Neoplasms

BACKGROUND: Newborn screening (NBS) detects genetic and metabolic conditions that may be present in a newborn before clinical symptoms manifest. Early detection and treatment prevents catastrophic health outcomes. It was introduced into the public health delivery system with the enactment of the Newborn Screening Act of 2004. However, there still seems to be a trend of noncompliance.
OBJECTIVE: The study sought to determine the prevalence of NBS compliance in Quezon City lying-in clinics (LICs) between 2010-2015 and the factors that are associated with compliance of mothers with NBS.
METHODS: An analytic cross sectional study design was utilized. Records of 710 mothers who gave birth in Quezon City LICs were randomly selected. Multiple logistic regression was used to determine if the mothers' age, civil status, PhilHealth membership, gravidity, and parity were associated with NBS compliance.
RESULTS: A 6-year prevalence of NBS compliance of 36.6% was found. PhilHealth members were more likely to comply with newborn screening (AOR=4.1; 95%CI: 2.9 - 6.0). Moreover, the odds of compliance among married mothers were higher than unmarried mothers (AOR=1.6; 95%CI: 1.1 - 2.3). Finally, primiparous mothers were more likely to comply than multiparous mothers (AOR=1.5; 95%CI: 1.0 - 2.1). Age and gravidity were not found to have statistical association with NBS compliance.
CONCLUSION: The higher odds of compliance among PhilHealth members was expected since they can avail of NBS for free. Ninety-five percent of primiparous mothers included in the study were primigravid; they are more likely to go to prenatal checkups when NBS information is given, according to literature.

Human ; Female ; Pregnancy ; Infant, Newborn ; Gravidity ; Parity ; Illegitimacy ; Prevalence ; Mothers ; Public Health ; Maternal Age ; Parturition ; Neonatal Screening ; Marriage

BACKGROUND: Dissemination of health communication materials is one of the most important strategies to increase awareness on the prevention and control of leptospirosis. One of the projects under the Program on the Prevention and Control of Leptospirosis in the Philippines (LepCon) is the dissemination of health communication materials.
OBJECTIVES: This study assessed the dissemination of health communication materials to 14 city and municipal health offices in the National Capital Region (NCR), Philippines. Specifically, this study determined: (1) how the health communication materials were disseminated by the city and municipal health offices; (2) the placement of the materials in the health facilities; and (3) the challenges encountered during the dissemination process.
RESULTS: The city/municipal health offices used different approaches in disseminating the health
communication materials and these are classified into distribution for public consumption, utilization as health education materials, and maintenance of supply by reproducing the materials in other forms. Eleven (11) out of the 14 city/municipal health offices (78.6%) still had leptospirosis posters. Seven (50%) of them posted the poster in the health facility. However, only four (28.6%) facilities placed the posters in locations where health facility clients can easily see and read them. Two of the 14 city/municipal health offices (14.3%) had an information, education and communication (IEC) display area where the LepCon fan is one of the health communication materials on display. The number of materials provided to the health offices was noted to be inadequate to reach the health facilities' target audiences. Finally, the monitoring and evaluation of health communication materials disseminated to facilities under health offices' jurisdiction was also a big challenge.
CONCLUSIONS: Different approaches were used in disseminating the posters and fans to the health facilities under the jurisdiction of the city/municipal health offices. It was also noted that the number of materials provided to the health offices was not adequate to reach the health facilities' target audiences. Although three-fourths of the health offices covered still have health communication materials in their facility, only less than 25% of these facilities have posters placed in strategic locations in the facility. A formal scheme of monitoring the dissemination of the materials was expressed by the informants.

Human ; Health Communication ; Health Education ; Teaching Materials ; Maintenance ; Health Facilities ; Leptospirosis

BACKGROUND: There is a perceived need among policymakers and other actors in the local health system to better address the challenges in financing healthcare, in general, and chronic or debilitating conditions, in particular, in order to develop appropriate policy and program responses.
OBJECTIVE: This paper aimed to present perceived issues and challenges in financing schizophrenia and colorectal cancer in the Philippine context, as identified by stakeholders.
METHODS: Verbatim transcription of the proceedings of a moderated discussion of stakeholders in schizophrenia and colorectal cancer care was analyzed for themes on challenges and recommendations in the financing of the two conditions in the local setting.
RESULTS: A total of 28 stakeholders representing healthcare providers, professional organizations, health maintenance organizations, patient support groups, and government participated in the meeting. Three main issues on financing debilitating conditions were identified by participants: a) government support for the two conditions is currently limited; b) coverage by third-party payors for schizophrenia or colorectal cancer is either absent or restricted; and c) the process of accessing medicines or alternative modes of financing for healthcare was perceived to be disparate and inconvenient for patients and their caregivers. Participants also provided recommendations in improving the mechanism of healthcare financing.
CONCLUSION: The general picture that emerged from this moderated discussion pointed to limitations in the prevailing mechanisms for financing schizophrenia and colorectal cancer in the Philippines. Improvements in the current financing mechanisms, and identification of alternative modes, is necessary to ensure universal health coverage.

Human ; Healthcare Financing ; Health Maintenance Organizations ; Caregivers ; Universal Coverage ; Delivery Of Health Care ; Insurance, Health, Reimbursement ; Government ; Self-help Groups ; Colorectal Neoplasms ; Schizophrenia

This paper aimed to provide a review of mental health stigma in the Philippines, its implications on policy and programs, and interventions on addressing the issue. Stigma towards people with mental illnesses in the Philippines is rampant; there seems to be lack of sensitivity in referencing mental health issues. Many forms of stigma affect people with mental illnesses. Stigmatizing attitudes and discriminatory behaviors are evident at home, school, workplace and healthcare settings. Stigma is a major barrier to the recovery of mentally ill persons. Increasing the awareness of the public on mental illnesses through health education and promotion is already an established intervention. Various strategies can also be done, such as integrating culture and arts, by providing incentives to companies which have mental health policies, and recognizing institutions and media agencies which promote positive portrayals of people with mental illnesses.

Human ; Mentally Ill Persons ; Mental Health ; Motivation ; Social Stigma ; Stereotyping ; Mental Disorders ; Health Education ; Attitude ; Health Policy

Traditionally, programs related to maternal health are regarded as purely a woman's domain. Nevertheless, the role of the male as the decision maker in the household gave way to the recognition of the male's role in maternal and reproductive health. This paper aimed to provide a review on male involvement strategies and their impact on maternal health based on related studies, discuss the strategies in the Philippine context and suggest interventions given the current state of the Philippine health care system. These strategies utilize the decision-making role of the male by positing itself on the reproductive, sexual and maternal health aspects encompassing important factors, such as birth spacing, first pregnancy, family planning, utilization of skilled birth attendants (SBAs), and delivery in health facilities, antenatal and postpartum care and nutrition. However, negative repercussions include stigmatization of single mothers and reinforcement of the notion of a man's control over a woman's body. Given the current state of the Philippine health care system, the suggested interventions try to veer away from it as much as possible. These include integration of the male involvement strategy into the Pantawid Pamilyang Pilipino Program (4Ps), coursing it through a public-private partnership (PPP) and non-government organizations (NGOs), involvement of educational institutions, strengthening of the health service delivery at the grassroots level, reinforcement of existing laws, and research on its institutionalization. With carefully-planned strategies that recognize existing gender norms and other sociocultural factors, male involvement in maternal health could be a possible catalyst in decreasing the Philippine maternal mortality rate (MMR).

 

Human ; Male ; Female ; Pregnancy ; Maternal Mortality ; Reproductive Health ; Birth Intervals ; Family Planning Services ; Public-private Sector Partnerships ; Stereotyping ; Maternal Health ; Mothers ; Postnatal Care ; Parturition ; Family Characteristics ; Gender Identity ; Delivery, Obstetric ; Decision Making ; Institutionalization ; Health Facilities

BACKGROUND AND OBJECTIVE: Food security is a multifaceted issue experienced by nations worldwide. A trend currently being explored in recent studies in measuring food security at the micro level is the Dietary Diversity Score (DDS). Household Dietary Diversity Score (HDDS), a type of DDS, obtains a snapshot of the economic ability of a household, making it an effective food insecurity indicator. The objective of this study was to assess the validity of the HDDS as a tool for measuring food insecurity.

METHODOLOGY: The study employed a cross-sectional analytic design with 368 study households in Lucena City, Quezon Philippines. Household Food Insecurity Access Scale (HFIAS) and Household Mean Adequacy Ratio (HHMAR), being two of the most frequently used methods in measuring household food insecurity, were used as reference standards to assess the validity of the HDDS in identifying food insecure households. Receiver Operating Curve (ROC) Analysis was done to determine the appropriate HDDS cut-off for identifying food insecure households.

RESULTS: The areas under the curve (AUC) obtained (0.618, 0.70, 0.701, 0.743), classified HDDS as a "fair indicator" of food insecurity. HDDS of 6 was identified as the optimal score when evaluating food insecurity withconsideration of sensitivity and specificity.

CONCLUSION: In this study, HDDS was proven to be a valid measure of food insecurity. It shows the great potential of this quick assessment tool in identifying population-at-risk, which is crucial in the design of a timely and appropriate intervention to alleviate food insecurity and other nutrition and health-related problems whichmay arise.

Human ; Food Supply

BACKGROUND: Since 1976, the School of Health Sciences (SHS) in the Philippines has produced a broad range of health professionals serving depressed and underserved communities. Most researches about the SHS present the impact of its unique community-based ladder-type curriculum and only a few focus on the lived experiences of its students.

OBJECTIVES: This study described how the lived experiences of SHS students with their community-based curriculum manifested as academic resilience.

METHODOLOGY: This is an exploratory social research. Data were obtained from key informant and focus group interviews, observations of purposively chosen students, teachers, and alumni in Baler Campus, and document review. Data were analyzed using iterative terms and concepts describing respondents' patterns of activities that establish norms in SHS. Joint displays of these norms were constructed to describe the students' academic resilience.

RESULTS: Admission in SHS requires students to undergo a stringent, often political recruitment process. While in the degree program, students go through constant financial constraints, demanding academic requirements, and challenging balance of hospital and community work with their personal and academic lives. The interplay between inner strength and external support promoted academic resilience. Studying in the SHS is a transformative learning experience. Students experienced multi-faceted problems requiring them to resiliently meet academic standards and maintain their own well-being. The culture of 'damayan' was an important source of psychosocial support.

CONCLUSION: The SHS curriculum and culture are most instrumental in promoting academic resilience among its students.

Schools ; Curriculum

BACKGROUND AND OBJECTIVES: This study was conducted as the first attempt of reviewing Prime Minister Narendra Modi's almost four year-old ministry as an innovative health policy. Modi's administration has employed innovative strategies such as the embracement of indigenous transformation of health system side by side with the strengthening of modern medical technology and practices. This facilitated the birth of the Ministry of AYUSH. This paper analyzed the processes involving the development and implementation of Modi's innovations in India's health sector.

METHODOLOGY: Through contextual analysis, data were generated from various online sources including reports and modules available in the Ministry of Ayush and other government offices' websites.

RESULTS: It showed that the set of trends identified by Cavalcante and Camoes was present in the ministry as a public management innovation in health care in India. These are the improvement of transparency mechanisms, open government and accountability; promotion of e-government; ease access and citizen participation in public administration; new public policies that encourage more active role of citizens in the creation of political capital; networks and partnerships of state actors, social and private enterprises; and expansion of information technology to increase the quality and efficiency in the delivery of public services.

CONCLUSION: The establishment of the Ministry of Ayush and the policy on Indian System of Medicine and Homoeopathy is another example of indigenous transformation in public management in Asia which brings synergy between the traditional wisdom of AYUSH and modern diagnostic tools and technology.

Health Policy

Background: Teaching clinics provide low-cost health programs while offering valuable learning opportunities for student clinicians, which then contributes to increasing health care accessibility. To date, there is a paucity of literature exploring the satisfaction of patient seen in rehabilitation teaching clinics in developing countries. The Service Quality (ServQual) Scale is a valid and reliable tool that has been used to measure client satisfaction in different work settings and industries.

Objectives: The aim of this study was to demonstrate the usefulness of ServQual
in measuring the satisfaction of clients in a rehabilitation teaching clinic in a developing country.

Methodology: A cross-sectional survey was conducted for three months among CTS-AA (Clinic for Therapy Services- Adult and Adolescent Section) clients who are at least 18 years old; have attended at least three sessions; and can read. Prior to
administration in CTS-AA, the ServQual scale was translated to Filipino, validated
and pilot tested for reliability.

Results: Thirty-two respondents were included in the analysis. there was no
statistically significant difference between the expectation and the perceptions
of the clients for the domains of reliability (z=1.799, p=0.0721),responsiveness (z=0.839, p=0.4013), assurance (z=1.914, p=0.0556) and empathy (z=1.772, p=0.0764). However, there was a statistically significant difference between the clients' perception and expectation for tangibles (z=4.117, p<0.0001) and between the overall client perception and expectation (z=4.086, p<0.0001).The overall ServQual score for CTS-AA is -0.3782.

Conclusion: The ServQual has been shown to be useful in assessing the satisfaction of clients in rehabilitation clinics and the specific areas that needs improvement. The tool can still be further improved by including items on cost, relationship of students with supervisors and outcomes of treatment.

Philippines, Maternal Health, Maternal Mortality,