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

BACKGROUND: This study aims to evaluate the effectiveness of the “Effective Written Communication Training” provided among 16 UP Manila administrative employees following Kirkpatrick's training evaluation model. OBJECTIVES: This study specifically examines the reaction of the employees to the training program (Level 1), changes in the level of learning (Level 2), and transfer of training in the workplace or behavioral changes (Level 3). METHODOLOGY: The study used a cross-sectional design, and the primary data was collected through survey questionnaires, a pretest, and a posttest. For the Level 1 evaluation, a training assessment survey was given to the participants. For the Level 2 evaluation, tests were given to the participants before and after the conduct of the training program. For the Level 3 evaluation, a survey questionnaire was given to the participants and their immediate supervisor five months after the end of the training. RESULTS: The Level 1 results showed that the participants' overall reaction to the training was Excellent in terms of training design, facilitation, resource speaker/facilitator, and overall experience. For the Level 2 evaluation, results showed that there is a significant change (t(15)=11.32, ρ<0.05) in the participants' learning about written communication, as shown in the difference between the pretest (M=16.56, SD=3.01) and posttest scores (M=20.25, SD=2.49). Results of the Level 3 evaluation showed that written communication competencies have been applied to the workplace. Employees confidently compose written correspondences, construct formal and official letters, and relay queries using a more appropriate choice of words, which the participants' supervisors also observed. CONCLUSION Overall, the training program was found to be effective in improving the participants' written communication skills, following Kirkpatrick's training evaluation model.

Since the COVID-19 emerged, a work-from-home (WFH) arrangement was implemented as an infection containment measure among employees. This lifestyle change is bound to affect health-promoting behaviors. The study aims to determine the health-promoting lifestyle behaviors of university employees in a WFH arrangement during the COVID-19 pandemic. This study utilized a quantitative descriptive research design. After consecutive sampling of employees of a state university in Manila, the response rate was 33.1% (395 out of 1, 195 eligible respondents), but only 31.8% or 380 respondents completed the validated online questionnaire through Google Forms™ from August to October 2021. The instrument was based on the Health Promoting Lifestyle Profile (HPLP) survey by Walker and Hill-Polerecky (1996). Descriptive data analysis was done via IBM® SPSS® Statistics v22. Majority were females (70.3%) and single (51.8%). Approximately 70% were staying at home with their family. The mean scores for the subscales of inner development, interpersonal relations, and stress management were 3.08 (SD±.24), 3.00 (SD±.30), and 2.70 (SD±.30), respectively. These were observed to be higher than other HPLP subsets. Subscales garnering the lowest mean scores were physical activity at 2.32 (SD±.21), nutrition at 2.68 (SD±.31), and health responsibility at 2.56 (SD±.12). The mean HPLP score of faculty members was the highest at 2.74 (SD±.36) as compared to administrative staff and research extension and professional staff (REPS) with mean scores of 2.73 (SD±.36) and 2.71 (SD±.39), respectively. Overall HPLPscores suggested that the majority (60.8%) practice “good” health-promoting lifestyle behaviors. These findings indicate that the WFH arrangement allows employees to develop social and coping skills while staying in their residences. Whereas limitations to opportunities for a more active lifestyle, availability of nutritious food, and access to health care also contribute to the low HPLP scores. Health promotion and protection strategies such as nurse-led health programs must be instituted to improve and develop the knowledge, skills, and attitude among employees working from home in the aspects of nutrition, physical activity, and health responsibility. Nurses must also use this opportunity to promote occupational health among employees through lifestyle programs in coordination with universities and colleges or other workplaces of similar nature. Health programs must capitalize on the increase in the utilization of social media and the Internet during the pandemic. There is a need for further research to examine associations between the variables in various institutions and settings.
Health Promotion ; COVID-19

Background: This research assesses the training needs of employees at the University of the Philippines Manila (UPM) to prepare a comprehensive plan and program intervention for the 2023 training calendar. Objectives: This study specifically examines the reaction of the employees to the training program (Level 1), changes in the level of learning (Level 2), and transfer of training in the workplace or behavioral changes (Level 3). This TNA survey is essential to identify skill gaps, set priorities, and tailor training programs suitable to the needs of UPM employees. Methodology: The study employed a quantitative survey method in assessing employees’ needs across different colleges, units, and offices using a training needs assessment (TNA) survey. A total of 382 employees were surveyed regarding their needs to enhance their core, technical, leadership, and job-specific competencies. Results: Results showed that based on the varying degree of necessity, all the training programs in the training needs assessment survey were considered needed by the employees. Twelve training programs were proposed in the 2023 training calendar as a result of this TNA including three programs for improving core competencies, four programs for technical competencies, two programs for leadership competencies, and three programs for job-specific competencies. Specifically, the training focus on Stress Management, Handling Complaints and Grievances, and Safety and Emergency for core competency; Written and Spoken Communication, Google Workspace/Microsoft Office Applications, Data/Records Management for technical competency; Succession Planning and Managing People for leadership competency; and Procurement, Research Skills, and Creative Design Training for job-specific competency. Conclusion The Training Needs Assessment conducted at the University of the Philippines Manila revealed crucial areas where tailored training programs can play a transformative role in boosting workforce competence and effectiveness. The findings highlight the importance of training in areas such as stress management, decision-making, safety protocols, ethical leadership, and conflict resolution.
Education

Background: Workplace bullying is defined as frequent, ongoing, and detrimental incidence of unreasonable acts/behaviors directed towards an individual. The consequences of bullying to individuals often lead to absenteeism, resignation, job dissatisfaction, and suicidal ideation making it a major public health concern. This organizational issue, when not addressed, will greatly affect the workflow in any organization. There is a paucity of literature on this problem in the Southeast Asian countries Objective: This study aimed to describe the extent of workplace bullying among employees of a public higher education institution. Methodology: The researchers used a descriptive, cross-sectional study design. Survey questionnaires in Google Form were emailed to all employees with a 35.96% participation rate. The survey instrument asked participants to indicate their awareness about any bullying behavior in their unit and to specify the typical profile of bullies and victims they know of. Responses to quantitative variables were summarized using the mean and standard deviation, while qualitative variables were reported as frequency and percentage distribution. The software used for analysis were Microsoft Excel and EpiInfo 7. Results: At least one-third (36.94%) of survey respondents indicated that they witnessed a form of bullying in the workplace with more awareness seen among faculty members and permanent employees. The most common type of bullying observed in the workplace was criticism in public. Notably, this type of bullying was similar across employee categories. The predominant reactions of victims of bullying include feeling of fear and loss of trust, and confiding to a friend or co-worker. Conclusion The phenomenon of bullying has been witnessed by the employees and reported to have adverse effects on victims. Informational campaigns coupled with anti-bullying policy and programs are necessary to promote employee well-being.
Occupational Stress ; Universities ; Occupational Stress ; Philippines

Objectives: The Pharmacy DOTS Initiative (PDI) was relaunched on a larger scale in 2014 through the Innovations and Multi-Sectoral Partnerships to Achieve Control of Tuberculosis (IMPACT) project. This paper aimed to assess the PDI program through IMPACT by identifying the facilitating and hindering factors in its implementation. The identified factors are classified as to the affected stakeholders or processes.

Methods: Semi-structured interviews were conducted with the PDI Program Manager and four NTP coordinators from selected project sites. Thematic analysis was done to determine the recurring facilitating and hindering factors as identified by the key informants.

Results: Facilitating factors identified include cooperation of the stakeholders, capability-building and a good referral system. The barriers to the implementation were grouped into patient-related, pharmacy-related, health center-related, program-related as well as external factors.

Conclusion: The referral system created through PDI facilitated the flow of referrals starting from the pharmacy. This enabled presumptive patients to have access to health facilities for TB. Hindering factors contributed to the inability of the engaged pharmacies to sustain their consistency and commitment in conducting the PDI interventions.

Key Words: barriers, facilitators, tuberculosis, directly observed therapy, program evaluation, pharmacy

Tuberculosis ; Directly Observed Therapy ; Program Evaluation ; Pharmacy

OBJECTIVE: This was an evaluation of the effectiveness of the technical assistance package for the Pharmacy DOTS Initiative (PDI) in the Philippines.

METHODOLOGY: Five pre-identified implementation sites were included in the evaluation. A survey was conducted to ascertain pharmacies currently implementing PDI and the number of TB presumptive cases referred by these pharmacies. Data abstraction was performed to determine the change in the number of TB cases seen by local TB programs after its implementation.

RESULTS: Findings revealed that the proportion of pharmacies actively referring presumptive TB patients is not significantly lower than 60% (p=0.1892). Furthermore, results showed that the average monthly referrals were not statistically lower than 20 clients per month (p=0.9159). Nevertheless, interrupted time series analysis found no statistically significant immediate effects (p=0.516) and long-term effects (p=0.3673) on the total number of new TB cases identified after the PDI was implemented in the year 2014.

CONCLUSION: The PDI was able to achieve outputs related to pharmacy engagement and referral of TB presumptive clients. However, the PDI was unsuccessful in increasing the actual number of TB presumptive cases seen by local TB programs in its implementation sites.

Tuberculosis ; Philippines

Background: Tuberculosis (TB) is a disease that has continuously burdened Filipinos. Various programs have been launched by public and private sectors to decrease the incidence of TB and to scale up TB prevention and control in the country. In line with this, pharmacists have been contributing in the campaign against TB since 2004 through the implementation of the Pharmacy DOTS Initiative (PDI). Through the project Innovations and Multi-Sectorial Partnerships to Achieve Control of TB (IMPACT), PDI was relaunched in the country in 2014. Objectives: This case study aims to evaluate the impact of PDI on TB prevention and control by assessing the effectiveness of the technical assistance package rolled out during program implementation. Methods: A review of documents was done to evaluate the achievement of the specific targets of PDI. Results: Among the targets, the percentage of actively referring pharmacies and the number of referrals made throughout the program failed to meet the target. The remaining program targets such as the establishment of a referral system, training of pharmacy personnel, adoption of a TB DOTS curriculum in pharmacy schools, and presence of national legislation, policies, and guidelines relevant to PDI were satisfactorily met. Conclusion PDI had a good response at the start of its implementation, but several issues resulted in the inability to sustain the interventions and achieve set targets.
Tuberculosis ; Program Evaluation ; Case Reports

Objective: This paper aims to characterize existing financial assistance available to patients with schizophrenia. Specifically, we described (1) the funding mechanisms for the treatment of patients with schizophrenia; (2) the process for accessing financial assistance; and (3) the experiences of consumers of services of these support mechanisms.

Methods: We employed qualitative techniques using key informant interviews (KII) and focus group discussion (FGD). Key informants were officials from institutions providing or offering financial assistance for patients with any health-related concerns, including schizophrenia. Focus group participants were support group members or caregivers of patients with schizophrenia. Purposive sampling was used to select participants for both providers and consumers of financial assistance or scheme. Topic guides for KII and FGD were used for data collection. Thematic analysis was performed on the qualitative data gathered from the informants and focus group participants.

Results: Securing financial assistance for schizophrenia followed a generally similar process, whether the source is from government offices or civil society organizations, and can be grouped into three main stages: (a) pre-application, (b) application, and (c) post-application. While the process of seeking financial assistance appears to be straightforward, issues were encountered in all of the stages by both providers and recipients alike, namely: (a) Financial assistance as an augmentation to patient resources; (b) Mismatch between demand and service capability; (c) Measures of organizational effectiveness; (d) Health professionals and support groups as "bridges" / "facilitators" to financial assistance providers; (e) Financial and non-financial costs incurred by caregivers in applying for financial assistance; and (f) Recipient-provider relationship as a barrier to the feedback process.

Conclusion: This study provides a glimpse of available financial and other relevant assistance to clients, including clients suffering from schizophrenia. More extensive research covering more organizations, support groups, and caregivers from different parts of the country is recommended.

Schizophrenia