BACKGROUND

In response to the need to provide for mental health services to address gender-related concerns in a higher education institute, the University of the Philippines (UP) Manila Center for Gender and Women Studies (CGWS) commissioned a project to formulate a framework for the increasing volume of referrals.

METHODOLOGY

A mixed methods study was done in order to gather data to create a responsive and practical mental health care service provision framework with and for service providers and service users in the university. An online survey (N=135), focus group discussion, key informant interviews, and a round table discussion were conducted, with constituents of the university recruited through purposive sampling.

RESULTS

A stepped-care model was proposed, consisting of: 1. Preventive Well-Being Resources, 2. Supportive Well-Being Interventions and Initial Screening Resources, 3. Structured Interventions, and 4. Interventions for Severe Mental Health Problems.

CONCLUSION

The framework formulated in collaboration with service providers and service users in the university addresses the goals of optimizing existing resources and enhancing service provision. Implementation and evaluation of this framework, as well as further information regarding the target population and their use of this model, are proposed avenues for further research.

Human ; Gender ; Gender Identity ; Sexual Harassment ; Mental Health ; Mental Health Services ; Lgbtq ; Sexual And Gender Minorities ; Psychiatry ; Psychology

BACKGROUD

In 1995, RA 7883 was enacted stating the incentives and benefits which can be provided for BHWs. In the advent of the Universal Health Care, the role of the BHWs will be crucial more than ever and to ensure the sustainability of the program is an urgent concern. There is a need to identify the hindrances in the provision of incentives and benefits for the BHWs in coming up with recommendations on how to improve it.

METHODOLOGY

Focus group discussions on selected BHWs and key informant interviews on policy makers and implementors were conducted to assess the reinforcing and hindering factors on the provision of incentives and benefits for the BHWs.

RESULT

The report outlines key factors affecting BHWs in Oriental Mindoro. While the BHW organization has potential to offer incentives, it needs stronger oversight from the Local Government Unit (LGU) to be effective. NGOs, provide crucial funding for training BHWs in remote areas. Political interference in appointing BHWs, with frequent changes in leadership, disrupts the program's stability. Training opportunities are limited by a lack of funding, leaving many BHWs undertrained. Additionally, local ordinances that offer benefits to BHWs often fail due to unclear policies, changing local leadership, and insufficient budgets.

CONCLUSION

The BHW program continues to face persistent challenges in the provision of incentives and benefits, largely due to the lack of clear, comprehensive, and enforceable policies and guidelines.

Human ; Health Services Needs And Demand

Databases, Bibliographic ; Evidence-based Practice ; Health Services Needs And Demand

BACKGROUND AND OBJECTIVE

Community-based rehabilitation (CBR) represents a multifaceted social intervention designed to tackle issues related to access, equity, and service quality. Within the framework of CBR, participation stands as a pivotal principle, albeit one that frequently goes unnoticed, particularly concerning children with disabilities. Consequently, this realist synthesis embarks on an exploration of the present landscape, participation mechanisms, and resulting outcomes within CBR initiatives tailored for children with disabilities in low and low-middle-income countries.

METHODS

The realist approach is utilized to explain the causal mechanisms and explore the context, mechanism, and outcome of participation in CBR programs. A systematic search was conducted across ten databases up to April 2021. Studies were included if they involved children with disabilities aged 17 years and below, were implemented in World Bank-classified low-income or low-middle-income countries, discussed implementation mechanisms and community participation, and described outcomes. No language restrictions or publication type limitations were applied. The search process employed double screening of title, abstract, and full-text levels, followed by a snowballing technique. Quality assessment followed the RAMESES standards for realist reviews. Data extraction and analysis yielded context-mechanism-outcome configurations.

RESULTS

Thirteen articles were included in the synthesis, from which three context-mechanism-outcome configurations were identified: (1) family-facilitated intervention through training in the immediate environment of children with disabilities leads to knowledge translation of caregivers, (2) inaccessible healthcare services require establishing a referral system and augmenting human resource to ensure the system’s capacity to accommodate the magnified need, and (3) established collaboration of researcher, professionals, and community with stakeholder involvement in the CBR management leads to program adoption and documented effectiveness. Both training and establishing referral systems as implementation mechanisms pose sustainability challenges due to dependency on funding. Overall, participation as a form of agency is more often an implied concept. Training is a common mechanism of implementation, where women play a critical role as proxies of children with disabilities, being their caregivers and advocates. Positive and negative outcomes focus on the condition of children with disabilities and the trainees’ knowledge and awareness.

CONCLUSION

A critical analysis of children's and community's participation in the context, mechanism, and outcome unravels the non-participation of children with disabilities and tokenism of the community stakeholders in the CBR programs. Maximizing the contribution of children with disabilities and community stakeholders is called for, aligned with the ladder of participation, toward their democratic participation. Study limitations include the paucity of published CBR programs reporting participation mechanisms in low and low-middle-income countries and the exclusion of studies from economically disadvantaged communities in high-income countries.

Human ; Community Participation ; Developing Countries ; Disabled Children ; Community Health Services

BACKGROUND

The pharmaceutical subsystem is a complex interrelationship among different stakeholders that ensure access to safe, effective, and quality pharmaceutical products in the market. Understanding the availability and affordability as key areas for access to medicines is essential to appreciate the strategies needed to strengthen the pharmaceutical subsystem.

OBJECTIVES

This study aimed to determine the availability and affordability of essential antihypertensive medicines in public primary care facilities and private retail drugstores in a 4th class municipality. Further, the study determined the price comparisons of these essential antihypertensive medicines with international reference prices.

METHODS

This is a quantitative, cross-sectional study design which employed a modified WHO/HAI methodology to quantify antihypertensive medicines’ availability and affordability in public and private primary care drug facilities. Selection of medicines was based on a criteria applicable for the primary care setting. Availability was measured through visual inspection of the selected medicines in the facility, affordability was estimated through the selling price of medicines in the public and private facilities, respectively, and was divided by the local minimum wage of the municipality. Median price ratio was computed using the local median prices over the MSH 2015 international reference prices adjusted for inflation.

RESULTS

Availability of essential antihypertensive medicines was found to be 12.96% in public facilities and 60.32% in private facilities (p=0.0002). Only amlodipine is observed to be available in both public (83.33%) and private (85.71%) facilities, while only metoprolol 50 mg tab (33.33%) and amlodipine 5 mg tab (83.33%) were available in public facilities. All medicines are below 1 MPR, but carvedilol 6.25 mg (1 tab BID: 1.32; 2 tabs BID: 2.65), 25 mg (BID: 2.65), and enalapril 5 mg (BID: 1.14; TID: 1.70) treatment regimens are unaffordable compared to a worker’s day wage.

CONCLUSION

Availability of essential antihypertensive medicines is diverse comparing public and private facilities. There is a need to increase the availability of antihypertensive medicines in public facilities as this is an important quality measure of primary care services. Public facilities can leverage on the availability of medicines in private pharmacies by forming Primary Care Provider Networks. While most medicines were deemed affordable in the private setting, there are still drugs such as carvedilol and enalapril, that need to be regulated. There is a need to strengthen the local pharmaceutical subsystem because it is essential to ensure safe, effective, and quality medicines in the local health system through adequate mobilization of resources.

Human ; Access To Medicines ; Health Services Accessibility ; Affordability ; Costs And Cost Analysis

BACKGROUND: The demand for aged-care services in Japan has surged due to the country's aging population. Furthermore, nationwide survey on the current state of aged-care services revealed that the primary reason for the resignation of women working in these sectors was poor interpersonal relationships. Moreover, given that women working in aged-care services work in shifts around the clock to manage the health and safety of the people in their care, they are at high risk of health-related issues including insomnia symptoms. Thus, we aim to examine the association between levels of satisfaction with interpersonal relationships (LSIR) and insomnia symptoms for women working in aged-care services in Japan, as well as the effect of work-life imbalance on the association between LSIR and insomnia symptoms. METHODS: In this cross-sectional study, the participants were 472 women aged 18-60 years who worked in aged-care services in Japan in 2014-2016. Insomnia symptoms were measured using the Athens Insomnia Scale, and scores of 6 or greater indicated the presence of insomnia. LSIR were assessed through self-administered questionnaires and evaluated at three levels. The association between LSIR and insomnia symptoms was evaluated using a multinominal logistic regression model. Path analysis was used to examine the potential effects of LSIR on insomnia symptoms by incorporating covariates such as work-family conflict, marital status, and depressive symptoms. RESULTS: Compared to high LSIR, the multivariable-adjusted odds ratios (95% confidence interval) of insomnia symptoms were respectively 1.36 (0.81-2.30) and 2.42 (1.11-5.23) for medium and low LSIR. The path analysis showed that low LSIR were significantly associated with having high work-to-family (W-to-F) conflict and being single. CONCLUSIONS Low LSIR were significantly associated with insomnia symptoms among women working in aged-care services in Japan. High W-to-F conflict exacerbated this relationship. Therefore, enhancing interpersonal relationships may be necessary for preventing insomnia. However, due to the cross-sectional nature of our study, causality cannot be inferred. Further longitudinal research is needed to better understand these associations.
Humans ; Japan/epidemiology* ; Sleep Initiation and Maintenance Disorders/psychology* ; Female ; Middle Aged ; Adult ; Cross-Sectional Studies ; Interpersonal Relations ; Young Adult ; Adolescent ; Personal Satisfaction ; Health Services for the Aged/statistics & numerical data*

BACKGROUND

Antenatal care (ANC) is a key maternal health intervention designed to prevent poor pregnancy outcomes, while pregnancy tracking by community healthcare workers (CHWs) serves as an important strategy to monitor its effective implementation and utilization. In Mati City, Davao Oriental, Philippines, a consistent decline in ANC quality and a rise in maternal and infant mortality have been observed, which may be linked to gaps in the implementation of maternal healthcare programs.

AIMS AND OBJECTIVES

To address this concern, the study aims to analyze the strategies and challenges faced by CHWs in pregnancy tracking, assess the perceptions of health officials regarding these gaps, and recommend governance strategies to enhance the overall quality of ANC services.

MATERIALS AND METHODS

A qualitative research design was employed, using purposive sampling to select Barangay Health Workers, midwives, and nurses for the focus group discussions, while the City Mayor, City Health Officer, and City Councilor on Health participated as key informants. Thematic analysis was conducted on manually transcribed data while adhering to strict ethical considerations.

RESULTS AND DISCUSSION

Findings revealed that proper implementation and monitoring of maternal healthcare services are crucial for effective pregnancy tracking. CHWs play a significant role in health service delivery; however, gaps such as weak health promotion efforts adversely affect community engagement, health-seeking behavior, and sociocultural dynamics, highlighting the need for stronger policy enforcement and sustained local government support. Systemic and logistical challenges must also be addressed to improve service delivery. Effective maternal healthcare requires robust policy implementation and close collaboration among local government units. A sustainable maternal health system further depends on depoliticized legislative processes, improved health financing, and continuous investments in primary healthcare and infrastructure. Based on these findings, the study developed the Strengthen, Empower, Engage, and Key Policy Reforms Framework – an innovative governance approach aimed at reducing maternal healthcare disparities through multisectoral collaboration, depoliticized legislative action, and evidence-based maternal health interventions.

CONCLUSION

Adopting the SEEK framework may enable local governments to ensure equitable access to high-quality ANC and ultimately improve maternal and infant health outcomes.

Human ; Female ; Maternal Health Services

Background: The pharmaceutical subsystem is a complex interrelationship among different stakeholders that ensure access to safe, effective, and quality pharmaceutical products in the market. Understanding the availability and affordability as key areas for access to medicines is essential to appreciate the strategies needed to strengthen the pharmaceutical subsystem. Objectives: This study aimed to determine the availability and affordability of essential antihypertensive medicines in public primary care facilities and private retail drugstores in a 4th class municipality. Further, the study determined the price comparisons of these essential antihypertensive medicines with international reference prices. Methods: This is a quantitative, cross-sectional study design which employed a modified WHO/HAI methodology to quantify antihypertensive medicines’ availability and affordability in public and private primary care drug facilities. Selection of medicines was based on a criteria applicable for the primary care setting. Availability was measured through visual inspection of the selected medicines in the facility, affordability was estimated through the selling price of medicines in the public and private facilities, respectively, and was divided by the local minimum wage of the municipality. Median price ratio was computed using the local median prices over the MSH 2015 international reference prices adjusted for inflation. Results: Availability of essential antihypertensive medicines was found to be 12.96% in public facilities and 60.32% in private facilities (p = 0.0002). Only amlodipine is observed to be available in both public (83.33%) and private (85.71%) facilities, while only metoprolol 50 mg tab (33.33%) and amlodipine 5 mg tab (83.33%) were available in public facilities. All medicines are below 1 MPR, but carvedilol 6.25 mg (1 tab BID: 1.32; 2 tabs BID: 2.65), 25 mg (BID: 2.65), and enalapril 5 mg (BID: 1.14; TID: 1.70) treatment regimens are unaffordable compared to a worker’s day wage. Conclusion Availability of essential antihypertensive medicines is diverse comparing public and private facilities. There is a need to increase the availability of antihypertensive medicines in public facilities as this is an important quality measure of primary care services. Public facilities can leverage on the availability of medicines in private pharmacies by forming Primary Care Provider Networks. While most medicines were deemed affordable in the private setting, there are still drugs such as carvedilol and enalapril, that need to be regulated. There is a need to strengthen the local pharmaceutical subsystem because it is essential to ensure safe, effective, and quality medicines in the local health system through adequate mobilization of resources.
Human ; access to medicines ; health services accessibility ; affordability ; costs and cost analysis

OBJECTIVES

This study sought to investigate citizens' awareness, availment, satisfaction, and perceived need for action with health services offered by a rural municipality in Samar, Philippines.

METHODS

This study utilized an explanatory-sequential research design, involving 150 participants selected through the Kish Grid Method via a multi-stage sampling approach within the community. The Citizen Satisfaction Index System was employed to assess the levels of awareness, utilization, and satisfaction with health services in the municipality.

RESULTS

Among the assessed health services, the cohort had low awareness and low availment on services for communicable diseases, basic dental/oral hygiene, and reproductive health. While high awareness was observed for childbirth services, there was low availment on these. The participants showed high awareness and availment for only two services namely, free general consultation and the free medicine program. While high satisfaction was seen among all services that were assessed, the participants also expressed a high perceived need for action to improve their delivery.

CONCLUSION

This study presents a comprehensive view of rural healthcare in Samar, Philippines. Despite high satisfaction rates, gaps persist in the citizen’s awareness and availment due to accessibility, costs, fear, misinformation, and cultural differences. The findings of this study can guide policymakers in identifying gaps in healthcare in rural areas.

Human ; Primary Health Care ; Health Services ; Awareness ; Personal Satisfaction

Objective: The study determined the effects of corporate wellness programs (CWP) on Filipino workers’ physical, occupational, socio-emotional, intellectual, and spiritual wellness. Methods: The study looked into the components of a CWP, its forms of communication, the respondents’ level of participation, motivation, and their physical, occupational, socio-emotional, intellectual, and spiritual well-being to determine their wellness status during the pandemic. The study utilized an online survey to examine questions related to the efficacy of such programs, descriptive statistics, correlation analysis to assess the respondents’ sociodemographic profiles, and point biserial correlation to test the association of CWP to their wellness status. Results: The research showed that 90% of the respondents participated in their organization’s CWP, contradicting most studies that state CWP suffers from a low participation rate. CWP initiatives are mostly publicized through electronic mail, printed in memos, then posted on the bulletin board, and shared through the company website and social media. In addition, the study showed that overall wellness mean scores were higher in employees who were aware of their wellness programs than those who were not and in participating vis-à-vis non-participating employees. Conclusion The study’s six assumptions showed positive results, indicating that CWPs are beneficial in improving employees’ overall wellness. However, the per paradigm and overall wellness scores were weakly associated with participation and awareness status based on the point biserial correlation. No adverse effects were recorded in the study. In addition, the study discovered that employees were active in personal wellness initiatives, leading to high scores in their wellness dimensions. The study showed different individual wellness initiatives implying that employees were also proactive about their total well-being.
Health Promotion ; Health Promotion ; COVID-19 ; Philippines ; Preventive Health Services