INTRODUCTION: In a healthcare system that has been specialty-centric for decades, the Universal Health Care (UHC) Act would try to refocus on primary health care (PHC) to better navigate the entire healthcare delivery system of the country. This paper determined the perception of clinical clerks on the relevance of UHC and PHC on the practice of medicine in the Philippines. METHODS: Clinical clerks rotating in Community Medicine were surveyed and focus group discussions were conducted to elicit the viewpoints of the students. Thematic analysis of the responses was subsequently performed. RESULTS: Majority of the 247 student-respondents viewed UHC and primary health care (PHC) as relevant, however, some did not see the need to shift the focus of care from a specialty-centric orientation to that of a PHC approach. Medical students still dream of becoming specialists, and the idea of general medicine practice was not very popular among them. There were negative perceptions on essential healthcare at the community setting, given the inadequacy of medical facilities and technology, medications, and healthcare services in the locality. CONCLUSION Sociopolitical factors remained important determinants of health, which often resulted in service delivery inequities, making access to health difficult for the marginalized and indigent. Given the efforts of the government to champion UHC amid the advances in modern medicine often localized in urban areas in the country, PHC was viewed to be relevant albeit not a priority for future Filipino doctors.
Universal Health Care ; Delivery of Health Care ; Primary Health Care ; Patient-Centered Care

The biopsychosocial approach to healthcare is fundamental to Family and Community Medicine specialists. Using the patient-centered, family-focused, community-oriented (PFC) matrix, the interplay of a myriad of biomedical and psychosocial factors is assessed in order to provide a thorough medical management that is custom-made to meet the needs and inherent values of a patient and his/her family. Family assessment tools are also utilized to better understand the family dynamics of a patient that may impact on the prescribed management plan. In addition, social determinants of health are evaluated to ascertain which ones may facilitate or hamper proper utilization of community resources. This family case analysis documented the medical ordeal of a young professional who had been diagnosed with two rare medical conditions: necrotizing fasciitis and Chiari malformation Type II. Employing the PFC matrix, the Family and Community Medicine specialist was able to provide inter-disciplinary care for the patient and his family in a holistic manner by recognizing patient needs, creating an enabling family support environment, and helping the family unit navigate various community resources.
Humans ; Social Determinants of Health ; Family Health ; Social Factors ; Patient-Centered Care

INTRODUCTION: This study measured the impact and outcome of an inter-professional community nutrition
program labeled as "NUTRI-CHIKA: Usapan Tungkol at para sa Nutrisyon." The program was a multidisciplinary
approach towards the attainment of proper nutrition for identified malnourished preschool
age children in Barangay San Isidro, Rodriguez, Rizal.

METHODS: This was a mixed quantitative-qualitative program evaluation. The quantitative part consisted
of a longitudinal observational study design, which reviewed the data of the children who received the
nutritional intervention. The qualitative study was done with a phenomenological approach, using a
thematic analysis for the process and impact evaluation by means of a focus group discussion and key
informant interview processes.

RESULTS There was a statistically significant increase in weight (2.32 kg) and height (3.04 cm) in terms of
Z-scores. A total of 29 out of 30 malnourished children graduated with 1 to 3 degrees of improvement in
their Z-scores. The program impact showed 1) overall improvement of the state of health of the children;
2) inculcation of family values, which emphasized the giving of more quality time of parents to their
children, and teaching them to socialize and be courteous; and 3) better orientation of the children
towards more nutritious food choices. The process evaluation focused on the positive disposition of the
inter-professional collaboration and brought out transference of this attitude to the children and parents.

CONCLUSION "NUTRI-CHIKA: Usapan Tungkol at Para sa Nutrisyon" achieved its program objectives and
impacted on the family and community, improving the overall state of health of the children and providing
positive disposition and family values to the participants.

Introduction: Due to COVID-19 pandemic, it became imperative for the education sector to shift to online curriculum and eventually hybrid education. However, this policy posed challenges to educators and students, such as increased workload, prolonged screen time, and burnout. This study determined the association of online screen media exposure and burnout among adolescent senior high school students enrolled in different online curricula in Metro Manila. Methods: This analytic cross-sectional study identified adolescent senior high school students in Metro Manila who were recruited via non-probability convenience sampling. Online screen media exposure was assessed based on the cut off value of four (4) or more hours of device usage related to online schooling, and participants answered the Copenhagen Burnout Inventory (CBI) to ascertain presence or absence of said condition. Data analysis included cross-tabulation for prevalence rate ratio (PRR), and Chi-square test for statistical significance. Results: Of the 117 respondents, most had significant online screen media exposure (75.21%). For the CBI, 51 study subjects garnered a score of 50 and above, suggesting that 43.59% of the adolescents might be suffering from burnout. In addition, PRR was calculated to be 3.9 (p-value of .002). Conclusion Among adolescent senior high school students with significant online screen media exposure of four hours or more, there was 3.9 higher risk of exhibiting burnout symptoms, and this was statistically significant.
Adolescent ; Burnout, Psychological

Pregnancy, Unplanned ; Reproductive Health

INTRODUCTION: Online learning was put at the forefront for the safe continuation of education amid the COVID-19 pandemic. This study determined the association of the level of social connectedness and symptoms of burnout in a purely online academic curriculum. METHODS: This analytical cross-sectional study design included medical students enrolled in a private tertiary institution in the National Capital Region as respondents in an online survey. The perceived social connectedness and symptoms of burnout were objectively measured, using previously validated questionnaires, the Social Connectedness Scale - Revised (SCS-R), and the Copenhagen Burnout Inventory (CBI). The prevalence risk ratio (PRR) was computed. RESULTS: Of the 119 respondents, majority reported reduced levels of social connectedness (72.3%) and experienced symptoms of burnout (85.7%). Among those with reduced levels of social connectedness (PRR: 1.25; 1.00, 1.55), there was a higher risk of having symptoms of burnout. CONCLUSION Amid the implementation of a purely online curriculum, medical students with reduced social connectedness had an increased risk of experiencing symptoms of burnout.

Introduction: A prosthesis is an artificial assistive device designed to replace a missing body part (e.g., limb), secondary to a disease, injury or congenital deformities. Prostheses are often used to restore functional capacity while improving the quality of life (QoL). Methods: An analytical cross-sectional study was conducted among adults aged 19 to 64 years who were permanent residents in Luzon who had undergone unilateral lower leg amputation. This epidemiologic study employed the Modified Barthel Index for activities of daily living (ADLs), the Frenchay Activities Index for instrumental activities of daily living (IADLs), and the WHOQOL-BREF for QoL. Descriptive and analytical statistics of the responses of the Lower Limb Amputees (LLA) were done. Prevalence odds ratio (POR) was calculated, and statistical significance was determined. Results: Among 165 LLA respondents, only 47.88% used prostheses. Unilateral LLA who exhibited greater independence in ADLs (POR=19.22), more actively performed IADLs (POR=5.51), and had good QoL (POR=3.83) were more likely to have been using prosthesis. All these findings were statistically significant. Conclusion This study revealed a statistically significant association between prosthesis use to the physical functioning and QoL among adult unilateral LLAs. It showed that prosthetic use was likely linked with improved performance in ADLs and IADLs, and better QoL compared to those without.
Quality of Life

Introduction: Soil-transmitted helminthiasis (STH) remains to be highly prevalent in the Philippines, despite the implementation of school-based bi-annual mass drug administration and other preventive measures under the Garantisadong Pambata Program by the Department of Health (DOH). Methods: This analytical cross-sectional study determined the association between the level of knowledge and the actual practices of family care givers in the prevention of STH among school-age children belonging to low-income families in an urban barangay. Results: Among 193 respondents, 97.93% had good level of knowledge of STH prevention and control, 83.42% had good hand hygiene practices, but only 39.90% adhered to the recommended bi-annual anti-helminthic prophylaxis for their school-aged children. A positive association was noted between level of knowledge and actual hand hygiene practices, but this was not statistically significant (i.e., prevalence odds ratio = 5.3, p = 0.129). Among those who did not comply with the bi-annual anti-helminthic administration, there was a prevalence odds ratio (POR) of 0.66 that the family care giver was knowledgeable on STH prevention and control, and this negative association was not statistically significant (i.e., p = 0.529). Conclusion Level of knowledge on STH prevention was positively associated with hand hygiene practices but was negatively associated with compliance with the bi-annual deworming prophylaxis. But these associations were not statistically significant.
Hand Hygiene

Introduction: This study investigated the association of selected biopsychosocial factors (i.e., CD4 cell count, self-stigma, and social stigma) with the quality of life and adherence to treatment of people living with HIV in the National Capital Region. Methods: A cross-sectional study design was conducted to document the health status and behavior of respondents affiliated with a clinic in Quezon City. Participants answered an online questionnaire containing the Berger HIV Stigma Scale, WHO-QOL for HIV, and HIV Treatment Adherence SelfEfficacy Scale. Bivariate analyses and prevalence risk ratios were used to determine the association of selected biopsychosocial factors with quality of life and adherence to treatment. Results: One hundred respondents were analyzed, of which 42% had CD4 cell counts < 350 cells/mm3, 43% had high self-stigma and 36% had high social stigma while 11% had poor QOL and 7% had poor ATT. There was no significant association of CD4 cell count, self-stigma and social stigma with quality of life and with adherence to treatment. Conclusion A weak association was noted between poor QOL and low CD4 cell counts and among those who felt higher social stigma, but the relationships were not significant. The association between poor ATT and the selected biopsychosocial factors was not significant.
CD4 Lymphocyte Count ; Social Stigma ; Quality of Life