BACKGROUND AND OBJECTIVES

Health promotion necessitates a multifaceted approach, focusing on individual, social, and environmental factors. Participatory Action Research (PAR) offers a process for community-level knowledge to inform these approaches, but little is known about its actual utilization. This review was conducted to explore the implementation and effectiveness of PAR in health promotion in the Philippine context. The specific objectives are: 1) to systematically map and analyze the existing literature on PAR in health promotion within the Philippine context; 2) to identify and categorize the levels of community participation in PAR initiatives; and 3) to evaluate the spheres of influence of health equity principles in PAR methodologies in health promotion.

A scoping review was implemented following the protocol by Mak and Thomas (2022), guided by the Health Equity Framework and the New Economics Foundation's Ladder of Participation, highlighting the empowerment and participation of communities in health research to produce relevant and sustainable outcomes. PubMed, HERDIN, and Google Scholar were searched to gather a comprehensive range of literature, then analyzed for themes relating to community engagement in health promotion through PAR.

A total of 452 articles were obtained from the initial search. After applying inclusion and exclusion criteria, 12 articles were included for analysis. The results highlighted the importance of engaging community leaders and advocacy groups as entry points in engaging community members, which were seen to be more effective in collaborating with the community. PAR was able to effectively identify gaps in health systems, particularly in access to programs for vulnerable sectors. The studies also exhibited differing levels of participation of the researchers with diverse population groups. This diversity in participant engagement led to more tailored and community specific interventions, fostering social innovation and better community well-being.

The integration of PAR in health promotion demonstrates a robust approach to addressing health inequities, showcasing the potential for community driven research to foster equitable health outcomes. PAR enabled communities to lead and shape interventions, making them more relevant and effective. The spectrum of participatory activities reveals the diversity of PAR as a research approach, and an opportunity to develop guidelines on what constitutes PAR in the global context. This approach is crucial in developing sustainable health strategies that are responsive to the needs of diverse communities, ultimately contributing to the global discourse on community-driven health promotion and equity.

Background: The enactment of the Philippine Universal Health Care (UHC) Act mandates the formation of Integrated Health Care Provider Networks (IHCPN), linking hospitals and health facilities, which includes government and privately-owned primary care providers. While hospitals and some health facilities are already under government regulation, primary care providers have not been subjected to formal licensing requirements. In this changing service delivery model, the possible impact of three regulatory policy options being considered need to be assessed according to the goal of ensuring that health services remain affordable and are of high quality. Methodology: A multi-method approach to regulatory impact analysis (RIA) systematically assessed three regulatory options: 1) one Department of Health (DOH) license per hospital and health facility (status quo); 2) one DOH license for all public hospitals and health facilities within an IHCPN and another for individual private hospitals and health facilities; and 3) one DOH license per individual hospital and health facility, and one DOH certification issued to individual hospitals and health facilities as part of an IHCPN. Information from literature, documents, focus group discussions, and cost analyses were triangulated. Results: Regulators are faced with two main risks: there is no standard for networked health care delivery that could provide a foundation for regulation, and provider participation is voluntary, which could lower the interest of private providers to integrate. The three regulatory options considered these risks. Option 1 requires the least change in regulatory policy, but is expected to increase costs to regulators due to the expansion of licensing and enforcement work covering primary care providers. Option 2 requires the most change in regulatory policy, but may be the least expensive to enforce, especially if all facilities join a network. This can also be preferred in a setting with existing interlocal health zones, and participation in the network by private providers poses the most challenge. Option 3 is a tiered regulatory set up that projects the highest cost to regulators as a result of both establishing new certification standards and guidelines on top of a wider scope for enforcement. Conclusion This is the first RIA conducted for the Philippine health system, with challenges similar to those experienced in developing countries. Across the three pre-determined regulatory models, the least costly option may not be the easiest to mount and enforce. Implementability appears to be a stronger consideration which seems to be hinged to the option requiring incremental rather than large form of changes.
Philippines ;

This virtual forum showcased successful women leaders in the Philippine health sector who shared their journeys and advice with early-career professionals. The speakers emphasized the significance of mentorship, claiming space, and taking risks. They also highlighted the need for support systems to encourage non-traditional career paths in the health sector for women. The discussion acknowledged the challenges faced by the LGBTQIA+ community in accessing appropriate healthcare and the importance of generating evidence and dialogue to address their unique health needs. Across these contexts, common themes emerged in the importance of mentorship for women leaders in overcoming societal biases and stereotypes.
Gender Equity ; Mentors

Objective: The primary objective of this study was to explore the acceptability of task shifting to volunteer barangay health workers (BHWs) in the implementation of community-based Diabetes Self-Management Education (DSME) in the Philippines. Methods: This study employed a descriptive qualitative study design. Data were collected through semi-structured interviews with twelve stakeholders. The study was conducted in the urban city of Marikina which has a high prevalence of diabetes, and high death rates for diabetes and cerebrovascular disease relative to the regional and national rates. A purposive sampling technique was used in selecting participants. Results: Task shifting Diabetes Self-Management Education to BHWs is generally acceptable to the participants. Expanding the roles of BHWs should be supported by adequate training, compensation, supervision, and financial and non-financial incentives. Ensuring adequate support and resources to execute BHWs’ duties and responsibilities as volunteer health workers can promote the effective implementation of task shifting DSME in primary care. Conclusion Findings from this study provide preliminary evidence of the acceptability of task shifting to BHWs in the management of diabetes mellitus. The study highlights the importance of institutionalizing task shifting in the health system to promote acceptance and sustainability.
Community Health Workers ; Diabetes Mellitus ; Primary Health Care

Introduction: Nosocomial contaminants such as Pseudomonas aeruginosa and Serratia marcescens are increasingly developing resistance to many antibiotics. One of the promising alternatives that may complement, if not substitute, the use of antibiotics is quorum quenching, the process of interfering with chemical signals that mediate communication between microorganisms. Eleusine indica, a ubiquitous grass used traditionally to treat infections, has been shown to contain metabolites, such as fatty acid derivatives and p-coumaric acid, capable of quorum quenching. To date, there has been no study on the quorum quenching activity of E. indica.

Objectives: This study aimed to determine the in vitro activity of crude ethanolic extract of E. indica leaves against selected quorum-sensing regulated virulence factors of P. aeruginosa and S. marcescens.

Methodology: E. indica leaves were collected, washed, air-dried, and homogenized. Following ethanolic extraction and rotary evaporation, the extract was screened for antimicrobial activity through disk diffusion test and broth microdilution assay. The quorum quenching activity of the extract against P. aeruginosa was measured through swarming motility assay, while the activity against S. marcescens was measured through swarming motility and pigment inhibition assays. The quorum quenching assays were conducted in triplicates, and analysis of variance (ANOVA) was performed to identify differences among the treatment groups.

Results: Disk diffusion test revealed that no zones of inhibition formed against both P. aeruginosa and S. marcescens for varying concentrations of up to 200 mg/mL of the crude extract. Likewise, the MIC of the extract against both P. aeruginosa and S. marcescens was determined to be >200 mg/mL. However, it was shown that the extract, at 50 mg/mL, has statistically significant activity (p<0.05) against the swarming motility of P. aeruginosa, and it is 71.6% as effective in reducing the swarming area of the bacteria compared to cinnamaldehyde. This was not observed when the extract was tested against the swarming motility of and pigment production by S. marcescens.

Conclusion: In this study, the quorum quenching activity of the crude ethanolic extract of E. indica leaves was found to be effective against P. aeruginosa but not against S. marcescens. The compounds that will be identified by further studies may conceivably be used as an adjunct therapy in P. aeruginosa infections and as coating agents in medical devices.

Objective: The primary objective of this study was to explore the acceptability of task shifting to volunteer barangay health workers (BHWs) in the implementation of community-based Diabetes Self-Management Education (DSME) in the Philippines. Methods: This study employed a descriptive qualitative study design. Data were collected through semi-structured interviews with twelve stakeholders. The study was conducted in the urban city of Marikina which has a high prevalence of diabetes, and high death rates for diabetes and cerebrovascular disease relative to the regional and national rates. A purposive sampling technique was used in selecting participants. Results: Task shifting Diabetes Self-Management Education to BHWs is generally acceptable to the participants. Expanding the roles of BHWs should be supported by adequate training, compensation, supervision, and financial and non-financial incentives. Ensuring adequate support and resources to execute BHWs’ duties and responsibilities as volunteer health workers can promote the effective implementation of task shifting DSME in primary care. Conclusion Findings from this study provide preliminary evidence of the acceptability of task shifting to BHWs in the management of diabetes mellitus. The study highlights the importance of institutionalizing task shifting in the health system to promote acceptance and sustainability
Community Health Workers ; Diabetes Mellitus ; Primary Health Care

BACKGROUND AND OBJECTIVE: Research plays an important role in generating new knowledge that could improve health outcomes when translated into action. As such, there must exist a supportive research policy environment that facilitates the provision of necessary resources and sustainably ensures an appropriate number of skilled researchers buttressed by institutions. These, in turn, are envisioned to provide facilities, information systems, financial grants, and avenues for career development and collaboration. This study aims to analyze factors in the current policy environment that makes health research possible in the Philippines.

METHODS: Qualitative exploratory design was used to characterize the Philippine health research environment. Guided by Adamchak's framework on policy environment, a content review of 39 policy documents (1991 to 2018) by the four core agencies of the Philippine National Health Research System was conducted. Seven elements of the policy environment were described.

RESULTS: The policies analyzed in this study mainly addressed the legal, political, cultural, economic, and ecological elements of the policy environment. Policies that support the demographic and technological elements are lacking, in that these leave out details that are essential for capacity building and use of research output. A cross-cutting effort to resolve gaps may be necessary.

CONCLUSION: Several factors continuously affect the environment in which policy is developed. There is room for improvement in terms of showcasing the government's regulatory quality and independence from political pressure. Equal attention must also be paid to human capital development, innovation partnerships, and mechanisms to improve knowledge impact, absorption, and utilization.