BACKGROUND

From 2013 to 2021, the University of the Philippines Community Health and Development Program (UP CHDP) was in partnership with Cavite and its five municipalities of Alfonso, Mendez, Indang, General Emilio Aguinaldo, and Amadeo (AMIGA). They aimed to improve the control of hypertension and diabetes through interventions such as the organization of community health clubs, as recommended by the Department of Health in 2016. Currently there is limited information on the experiences and outcomes related to this strategy. Data on this can help the community and public health institutions in understanding and maximizing the benefits of organizing community health clubs for noncommunicable disease control.

OBJECTIVES

This study aimed to determine a community health club’s membership profile, its organization and maintenance processes, and the benefits, challenges, and enabling factors experienced.

METHODS

This case study-mixed method was done in 2020 on the Challengers Health Club in Alfonso, Cavite. Group interviews of the club officers and barangay health workers were conducted to explore the club processes, their perceived benefits, challenges, and enabling factors. Health records were reviewed to determine the club’s membership profile.

RESULTS

The community health club showed an increase in membership since it was established. Most members are elderly, female, non-smoker, and hypertensive. There was increase in proportion of members with controlled hypertension after two years. However, this was not observed among those with diabetes. Perceived benefits for members were free, regular, and accessible services, improved knowledge and better control of their condition, and opportunity to socialize with others. Enabling factors were partnership with UP, teamwork and dedication of club leaders, effective management, and community support. The limited funding and supply of medicines, discontinuation of deployment of UP partners, and the COVID-19 pandemic were the challenges identified by the club.

CONCLUSION

This study described the experiences of a community health club established to control hypertension and diabetes. Benefits of this intervention were reported despite the challenges they encountered because of the support mechanisms that were in place.
 

Noncommunicable Diseases ; Case Study

BACKGROUND: The Philippine government aims for a modern information system to enhance data quality and provide more rational evidence to support timely and efficient delivery of health care, management of health systems, programs and policy. Hence, the Real-time Regular Routine Reporting for Health (R4Health) mHealth application was developed and field tested in 246 isolated and disadvantaged municipalities to support the campaign for Universal Health Care and the achievement of the Millennium Development Goals. The R4Health collected point-of-care-specific data on services routinely provided at the rural health facilities, aggregated them and presented in a dashboard for use by program managers and policy makers.

OBJECTIVE: This paper describes the use of R4Health, a mobile technology-based health reporting system. It will discuss the context of the R4Health implementation, its development and deployment to 246 municipalities in the Philippines. Furthermore, the paper sought to determine enablers and challenges to the adoption of R4Health in routine health care.

METHODS: Data was collected through surveys, focus group discussions, participant-observation and review of project reports. Quantitative data was summarized using descriptive statistical methods; qualitative data underwent content analysis. 

 

RESULTS AND CONCLUSION: A total of 515,855 R4Health reports equivalent to 48,856 patient transactions were received from 246 municipalities within a nine-month observation period, supporting the viability of the R4Health as an alternative option to the existing manual and paper based health information management to improve the quality of data. R4Health utilizes a tool that everyone is familiar with, can easily be incorporated in their workflow, can be brought and used anywhere and has an application that is clear, understandable, and easy to learn and use. R4Health data elements, however, have overlaps with other government health reporting systems and is already misconstrued to further duplicate work. More discussions are warranted to coordinate and integrate systems. Given the general positive perspectives, integration of this alternative system to the RHU workflow, an improved R4Health, has a high potential of being accepted and adopted by the first-line health workers across the country. 

Human ; Data Accuracy ; Point-of-care Systems ; Vulnerable Populations ; Delivery Of Health Care ; Health Personnel ; Telemedicine ; Health Information Management ; Health Facilities

Background and Introduction. The RxBox is a telemedicine device that measures and transmits vital signs to remote experts. It has been deployed to primary care health centers (PCHC) in the Philippines serving disadvantaged populations, to decrease morbidity and mortality due to common diseases and poor access to care. Factors affecting its adoption by healthcare workers is unknown.

Materials and Methods. The study determined social and behavioral factors that affect adoption of a telemedicine device into the clinical workflow using the Unified Theory of Acceptance and Use of Technology (UTAUT) framework. This is a mixed methods research using review of records, survey and focused group discussions.

Results and Discussion. RxBox telemedicine devices were installed in 79 primary care health centers (PCHC) and were used a total of 15,705 times within the study period. An ordinary least squares regression analysis using the combined site and individual-level data showed that among the UTAUT parameters, only compatibility, facilitating conditions, and social factors have significant relationships with intent-to-use of the RxBox. The innovation assisted primary care health workers in their clinical responsibilities, improved the stature of their PCHC in the community, and helped in the care for patients. Training and technology support after deployment as well as encouragement by peer and champions (the PCHC physician, local government leaders) reinforced continuous use after training. Users described the experienced improvements in quality of services provided by the PCHC and the consequent benefits to their patients.

Conclusions. These factors should be accounted for in designing strategies to reinforce health workers' attitudes and enhance support towards acceptance and use of novel telemedicine devices into clinical routine in local health centers. Lessons are immediately useful for local leaders in low- and lower middle-income countries that suffer disproportionately from unnecessary maternal deaths and mortality due to non-communicable diseases. This contributes to the body of knowledge and should bolster national-level advocacy to institute an enabling policy on telehealth Information Communication Technology (ICT) and use of Filipino innovations towards health systems strengthening. Results can be used by implementers, evaluators, and regulators of health ICT, especially in resource-poor settings. Likewise, the study can encourage more research in the field to spur more dynamic local health ICT and biomedical device industries.

Primary Health Care