BACKGROUND: Community-managed health programs (CMHPs) were designed to promote community self-determination in addressing health needs, but there is a need to evaluate how CMHPs can lead to better outcomes while accommodating changes in the national health system, which requires analysis of current CMHP interventions, institutional and community readiness, and points of interface with other health facilities.

OBJECTIVE AND METHODS: This preliminary study aimed to guide an eventual effort to develop a framework to ensure CMHPs sustainably improve health outcomes. A preliminary analysis of results from a community participatory research was done in which baseline health characteristics, related social determinants, level of involvement of CMHPs with the local government health system, and quality of life were documented through surveys, focus group discussions and key informant interviews, both in a community with an established CMHP (Murcia, Negros Occidental, Philippines), and a control area without a similar NGO sector (Isabela, Negros Occidental).

RESULTS: There was higher NGO and local government involvement among respondents in Murcia, use of traditional medicine, and sense of awareness of the need to improve the water quality in Murcia, with noted persistence of sanitation concerns, pinpointing the need to assess community participation and the efficiency of CMHPs.

CONCLUSION: Further study is needed in measuring community participation while considering its underlying cultural and socioeconomic contexts, in order to facilitate planning and implementation of strategies that intend to address community-recognized health needs while sustainably improving health outcomes.

Human ; Community Participation ; Health ; Philippines

Background: People from rural communities are not spared from COVID-19. But implementing preventive measures and strategies can be made to control the spread. Objective: This study was conducted to describe the epidemiologic situation and the healthcare capacity of the locality, determine the responses and strategies implemented in the control of COVID-19, and explain the activities performed in relation to the epidemiologic situation in Tarangnan, Samar – a low-income class municipality in the Philippines. Methods: A mixed qualitative–quantitative design was employed in this study. Descriptive documentary research design through review of records from March to October 2020 was utilized. For the qualitative context, a case study design was employed whereby focus group discussions and key informant interviews using open-ended questions were performed. Results: A total of 66 individuals were recorded as having COVID-19 in the municipality from March to October 2020. The first recorded confirmed cases of COVID-19 in Eastern Visayas were two adults in Tarangnan, Samar, in March 2020. Since then, additional confirmed cases have been recorded every month, but confirmed COVID-19 dramatically reduced from August to October 2020. Qualitative analysis revealed stringent COVID-19 preventive measures reflected in the confirmed case numbers. The tailwinds of the COVID-19 response include: the SARS pandemic precedent, coordination and communication, outpouring of support from other government and nongovernment partners, and innovative community-based approaches. The headwinds of COVID-19 response were challenges in imposing minimum health and safety precautions, stigmatization, and discrimination. Conclusion Even if challenges have arisen in implementing measures against the spread of the disease, good outcomes have been achieved through persistent good practice, positive modifications, and community-based innovations.
Community Participation ; Community Health Services ; COVID-19 ; Rural Health ; Philippines

In mid-1987 a baseline microfilarial prevalence survey was conducted among five villages in the Mt Bosavi region of the Southern Highlands Province of Papua New Guinea. Through use of the Nucleopore filtration technique, it was determined that 48% of villagers had detectable microfilaraemia. The highest prevalence was documented in Fogomaiyu, where the microfilaraemia rate was 92%. On the basis of this initial survey and the expressed interest of the community, the Division of Health in the Southern Highlands Province undertook an integrated community-based pilot control program. The project used two principal control methods: (a) drug treatment with low-dose diethylcarbamazine citrate (DEC) distributed to the community weekly and (b) vector control with permethrin-impregnated bednets. Results six months after the intervention indicate that the program was successful in reducing microfilaraemia at Fogomaiyu village from 92% to 6%. The reduction is principally related to the effects of DEC, although the bednets, by limiting vector-person contact, are expected to reduce the incidence of both filariasis and malaria.
Adolescent ; Altitude ; Bedding and Linens ; Community Participation ; Elephantiasis, Filarial - epidemiology

BACKGROUND: In view of renewed interest in primary health care (PHC) as a framework for health system development, there is a need to revisit how successful community health programs implemented the PHC approach, and what factors should be considered to scale up its implementation in order to sustainably attain ideal community health outcomes in the Philippines.

OBJECTIVE AND METHODOLOGY: Using the 2008 World Health Report PHC reform categories as analytical framework, this systematic review aimed to glean lessons from experiences in implementing PHC that may help improve the functioning of the current decentralized community-level health system in the country, by analyzing gathered evidence on how primary health care evolved in the country and how community health programs in the Philippines were shaped by the PHC approach.

RESULTS: Nineteen (19) articles were gathered, 15 of which documented service delivery reforms, two (2) on universal coverage reforms, three (3) on leadership reform, and one (1) on public policy. The literature described how successful PHC efforts centered on community participation and empowerment, thus pinpointing how community empowerment still needs to be included in national public health thrusts, amid the current emphasis on performance indicators to evaluate the success of health programs.

CONCLUSION AND RECOMMENDATIONS: The studies included in the review emphasize the need for national level public health interventions to be targeted to community health and social determinants of health as well as individual health. Metrics for community empowerment should be developed and implemented by government towards sustainable health and development, while ensuring scientific validity of community health interventions.

Human ; Community Participation ; Government ; Philippines ; Primary Health Care

OBJECTIVES: The purpose of this study was to develop and execute the village heath worker(VHW) training program which based on short term overseas medical volunteer and medical mission. METHODS: Through case studies of previous VHW program and review articles about the state of medical volunteer and medical mission, we developed the VHW training program. Pilot test of the program was carried out in Tugeugarao city, Phillipines on July, 2008. The subject were 32 persons from 15 villages around Tuguegarao city. After training we surveyed regarding the satisfaction of training and the degree of getting knowledge and skills. RESULTS: Through article review, we got the common subjects of previous VHW training program and the limitations of overseas medical volunteer and medical mission. We developed VHW training program aiming to community health promotion through community participation and community change. The main text was "Where There Is No Doctor" of Hesperian Foundation. The program executed through 1 day intensive lecture and practice. The satisfaction of the program was 8.95+/-1.70 on 10 point rating scale. CONCLUSIONS: We strongly expect VHW training program can be available as new model of short overseas medical volunteer as well as medical mission if we could systemize it with the confirming subject before training, management after training and continuous support through connection with the field.
Community Health Workers ; Consumer Participation ; Health Education ; Health Promotion ; Humans ; Missions and Missionaries ; Philippines ; Primary Health Care

PURPOSE: The aims of this study were to identify successful strategies and propose a community-based participatory global health project model for primary health care capacity development. METHODS: The study used case study methodology. A unit of analysis was an international cooperation health project entitled "Community-based Primary Health Care Improvement in San Lorenzo, Ecuador" using community-based participatory research conducted in 2007~2008. Data were collected through windshield surveys, focus group discussion, and provider surveys. RESULTS: Identified successful strategies for the international cooperation health project were reciprocal partnerships between researchers and community, partners' capacity building, south-to-south cooperation, and continuous monitoring and feedback. Community participation was found to be an essential tenet to guarantee the improvement of primary health care in the underserved rural community. Evidence from the activities of community health practitioners in Korea was applicable to the development of training programs for primary health care providers in Ecuador. CONCLUSION: Strategies for primary health care capacity development may be tailored depending on socio-cultural, political, and economical situations of each country. The model, however, would be applicable to the entire process of community-based global health projects in underserved rural communities of other countries.
Capacity Building ; Community-Based Participatory Research ; Consumer Participation ; Ecuador* ; Education ; Focus Groups ; International Cooperation ; Korea ; Primary Health Care* ; Rural Population*

PIP: HIV/AIDS is transmitted in developing countries mainly through heterosexual sexual intercourse, and from mothers to babies. While the AIDS pandemic could actually reverse population growth in developing countries, it remains to be seen what future population growth trends will emerge. There are, however, current economic and personal costs to both countries and communities. HIV/AIDS has most severely affected the young, economically productive generations, and decimated some village populations in countries heavily dependent upon agriculture. 85% of Papua New Guinea's population lives in villages and depends upon their own labor for food. Other direct effects of HIV/AIDS upon communities are discussed, including the vertical transmission of HIV and the association of HIV/AIDS with other sexually transmitted diseases and tuberculosis. Fear and ignorance are discussed with regard to how communities have responded to HIV/AIDS, followed by consideration of strategies communities may use to deal with HIV/AIDS, the challenge to survive, and the interdependence of community and the individual.
Acquired Immunodeficiency Syndrome - epidemiology ; Acquired Immunodeficiency Syndrome - prevention & ; control ; Community Participation - methods ; Papua New Guinea - epidemiology ; Primary Prevention - methods

OBJECTIVES: The purpose of this study was to examine the performances and limitations of health community building project of 148 village in Gangbuk-gu, Seoul on community health organization perspective. METHODS: We conducted a qualitative study using both a systematic review of this project and in-depth interviews with the operators who had worked for the project from January 2012 to December 2012. RESULTS: In this project, activists worked by gathering the opinions of the residents and focusing on their growth. The residents themselves established a community health care plan. Based on social determinants of health, they continued projects to solve residents' needs. A variety of programs were activated by providing a health cafe, which was an alternative public participation health promotion space that was not a clinic or a public health center. As the various entities gathered, there were difficulties related to interests and role sharing, and there were limitations such as the fact that the performance and limit of the pilot project could not be clearly predicted beforehand. CONCLUSIONS: This case suggested that new possibility of health and medical movement, approaching health issues by the way of community organization principle. Through the health community building project as community health organization perspective is expanded, health promotion effect will be created in the whole society.
Community Health Services ; Consumer Participation ; Health Promotion ; Pilot Projects ; Public Health ; Residence Characteristics ; Seoul ; Social Capital ; Social Determinants of Health

BACKGROUND: As part of their requirements for Family Medicine rotation, the postgraduate interns (PGIs) are required to construct and present a family case report. Each team of PGIs, led by a family medicine (FM) resident, identifies a family to be enrolled in the Family Health Care Program. Although this has been ongoing for years, no feedback mechanism has yet been established.
OBJECTIVE: The purpose of this study was to determine the learning experiences and insights of PGIs in constructing and presenting a family case report during their rotation in the Family and Community Medicine.
METHODS: A survey questionnaire, consisting of 10 items, was given to the respondents. The respondents took as much time as they needed to complete the survey.
RESULTS: Overall, the results revealed that the construction and presentation of Family Case Reports provided the PGIs an avenue to practice certain competencies required in primary care setting such as patient engagement, health promotion and family oriented care. Critical thinking skills as well as patient-doctor communication were enhanced during this activity. However, a good number of PGIs resounded their sense of inadequacy and uneasiness with the application and interpretation of family assessment tools. They perceived this to be a main hindrance in coming up with the best possible case report.
CONCLUSION: The family case report remains to be a unique and productive learning endeavor for PGIs assigned in the Department of Family Medicine.

Human ; Male ; Female ; Community Medicine ; Family Health ; Patient Participation ; Family Practice ; Physician-patient Relations ; Primary Health Care ; Health Promotion

PURPOSE: Children in migrant villages in Kyrgyzstan have a high incidence of anemia and need effective health promotion programs. The purpose of this study was to evaluate a pilot study of a health promotion project for infants and toddlers based on community participation.METHODS: This was a retrospective study conducted to evaluate the effectiveness of the project. The project was carried out by nurses at a public health center, community health workers, and local residents in a migrant village. After the operational system of the project was established, health assessments, child-care education, provision of vouchers for iron supplements, and activities to improve residents' awareness were conducted during 6 months among 100 children, of whom 85 were finally analyzed.RESULTS: In international health projects, close cooperation of the project team with community residents and health workers is important. Access to the community-based program was feasible in the socially and economically poor migrant village, and improvements were shown in children's anemia and awareness of health care.CONCLUSION: By focusing on the effective aspects of this preliminary project, plans to utilize community health workers and promotion strategies can be added to the main project to improve health promotion among children in this area.
Anemia ; Child Health ; Child ; Community Health Centers ; Community Health Workers ; Community-Based Participatory Research ; Consumer Participation ; Delivery of Health Care ; Education ; Health Promotion ; Humans ; Incidence ; Infant ; Iron ; Kyrgyzstan ; Pilot Projects ; Program Evaluation ; Public Health ; Retrospective Studies ; Transients and Migrants