OBJECTIVE: To describe the epidemiology of motorcycle related trauma (MCRT) admitted to the Philippine General Hospital (PGH).

METHOD: Restrospective analysis of records of motorcycle crash victims admitted to the Trauma Division, Department of Surgery, PGH from January 1, 2004 to December 31, 2006.

RESULTS: MCRT victims comprised 6.7% of all trauma admissions to PGH. Most were males (83.8%) and young adults (median age 26 years), and 38.6% were road users other than motorcycle drivers or passengers (primarily pedestrians). Two-thirds of victims suffered multiple injuries (68.9%). Common injuries were maxillo-facial (78%), fractures of the lower and upper extremeities (46.9% and 36.1%, respectively) and traumatic brain injuries (40.7%). The median length of hospital stay was 13 days. The in-hospital mortality rate was 5.8%, 43% of fatalities were due to traumatic brain injuries. Based on self-reported information, 88% of the motorcyclist victims were riding under the influence of alcohol, and 13% were wearing helmets at the time of the crash.

CONCLUSIONS: A significant proportion of MCRT victims are not motorcycle users. There is an urgent need to implement effective strategies to prevent MCRT in the Philippines, including the implementation of enforcement of national laws agains drink driving and use of standard helmets.

Human ; Male ; Female ; Adult ; Motorcycles ; Head Protective Devices ; Hospital Mortality ; Pedestrians ; Hospitalization ; Brain Injuries, Traumatic ; Multiple Trauma

BACKGROUND AND OBJECTIVE

Barangay Health Workers (BHW) are a crucial part of the local health system. Health services at the barangay level are heavily dependent on BHWs. However, despite their significant role in the local health system, support has been minimal and not commensurate with their contributions. The study aimed to identify the perceived external and internal factors that affect the performance of BHWs.

METHODS

The study identified the BHW-perceived external and internal factors affecting performance, through mixed quantitative and qualitative methods. A self-administered questionnaire with a 4-point Likert scale that will assess the factors was given to 561 BHWs from five different upland municipalities of Cavite. A focus group discussion using open-ended questions was conducted to gain an in-depth understanding of their experiences. Emerging themes were reported into narratives.

RESULTS

BHWs maintained a strong level of participation at required health activities, but more than half were often late, owing to their volunteer status and external responsibilities. They were perceived to have a high sense of duty reflected by punctual submission of reports and confidence in delivering health services. Job satisfaction emerged as a substantial motivator while burnout was not a significant demotivator. Leadership and support from local government and health program management were perceived positively by most BHWs. Service delivery confidence was high among BHWs as reflected in their capability to provide expected services. BHWs perceived that challenges were present in terms of the adequacy of medicines and supplies, and on data transmission, although half were generally satisfied with the organization of health records. Human resources were perceived to be sufficient. Financial aspects showed that while most BHWs do not contribute personally to patient care, a significant minority shell out resources for patients, reflecting financial strains within the health system. The study also revealed the varying motivations for volunteering, including community service, staff shortages, knowledge acquisition, and additional income.

CONCLUSION

External and internal factors affect the performance of BHWs at the local level. These were related to current health systems, political climate, personal household duties, and financial status. Despite facing these challenges, the BHWs showed commendable involvement in local health programs. BHWs remained motivated through training opportunities and positive community feedback but were hindered by a lack of health science knowledge and the need for supplementary income.

Human ; Local Government