BACKGROUND AND OBJECTIVE

In 2018, the Philippine Congress passed the Universal Healthcare (UHC) Law and its implementing rules which mandated the enrollment of all Filipinos to PhilHealth, the national social health insurance corporation. The Department of Health (DOH) and PhilHealth will leverage their strategic purchasing power by affiliating Health Care Provider Networks (HCPNs), established within the geopolitical boundaries of a province or a highly urbanized city, through service level agreements. This study aims to shed light on what is expected from providers, payers, and regulators to implement UHC successfully.

METHODS

The researchers conducted an inductive, content analytic qualitative study guided by the World Health Organization’s (WHO) Building Blocks Framework to determine the understanding and acceptance of the implementing rules of the UHC Law and the perceived barriers and enablers from the provider, payer, and regulator stakeholders in three provinces in the Philippines. Purposive sampling was utilized to provide the best representation across different economic and physical settings. A content analysis was done through an inductive process of coding concepts, which was the basis for categories grouped and matched deductively with the WHO framework. This formed the broader sub-themes and were used for the final data interpretation.

RESULTS

A total of 16 focus group discussions (FGDs) and nine in-depth interviews (IDIs) were performed with 84 participants. Inductive thematic analysis of categories and subcategories showed that the participants support the goals and objectives of the UHC Law. Still, perceived barriers refer to the lack of and improper use of funds, the need to clarify the implementing guidelines, and the role of politics. The participants indicated that solidarity and social connectedness with health system adaptability and resilience are enablers for the success of UHC reforms.

CONCLUSION

Proposals to mitigate the barriers include expanding the funding source, clarifying rules on the f inancial management system, and providing guidelines on health delivery integration to ensure access to patient care. Decentralization with autonomy will allow the stakeholders to align health programs with local needs. Proper representation in decision-making bodies is desirable to establish strong community involvement and solidarity. Resilience and adaptability based on a feedback loop are imperative.

Human ; Universal Health Care ; Health Financing ; Healthcare Financing ; Philippines

BACKGROUND

Mental health literacy (MHL) is an important mental health strategy since it contributes to early detection, enhances help-seeking behavior, and reduces stigma and discrimination against people with mental disorders.

OBJECTIVE

The objectives of the present study were to assess the level of mental health literacy and its correlation, and to examine the predictive effect of demographic profiles on mental health literacy among young and adult populations in the five cities of Caraga, using a standardized mental health literacy scale in 2023.

METHODS

This study applied a cross-sectional survey. It surveyed 729 individuals from five cities in Caraga using the Mental Health Literacy Scale from Dias et al. Descriptive analysis, such as frequency, percentage, mean, and standard deviation, and inferential statistics, such as Pearson correlation, independent t-test, and multi-linear regression, were used for data analysis.

RESULTS

The mental health literacy of the young and adult populations can be classified as adequate or good. Zooming in on details, the respondents have a very good understanding of help-seeking behavior and self-strategies but only a good understanding of knowledge and beliefs/attitudes. Pearson’s correlation analysis revealed a significant positive relationship between knowledge, erroneous beliefs, self-strategies, and help-seeking behavior (p < 0.001). In addition, Independent t-test and ANOVA revealed significant differences in sex, family income, employment, civil status, educational level, and age group (p < 0.01). A multiple linear regression indicated that demographic profile predictors were found to be statistically significant, and positively with mental health literacy, with education and family income as the strongest predictors.

CONCLUSION

The present study concluded that the young and adult populations in the five cities in Caraga have adequate literacy on mental health, encompassing knowledge, beliefs, self-strategies, and help-seeking behaviors. The increases in knowledge, belief, and self-strategies are associated with their higher level of help-seeking; in addition, the demographic profiles (e.g., sex, age, education, monthly income, and employment) have implications on young and adults’ mental health literacy in the five cities in Caraga. The result may not be generalizable beyond the studied region or demographic. In addition, it recommended that mental health literacy programs prioritize individuals with lower levels of education and family income as these factors Xwere found to have the most significant influence.

Human ; Mental Health

Background: Numerous studies have shown that air pollution is a serious public health threat and risk worldwide. Mongolia is the world leader in outdoor and indoor air pollution, and the morbidity and mortality caused by it are increasing every year. People spend most of their lives indoors, and it is necessary to regularly assess and study indoor air pollution. Aim: To study the concentration of PM2.5 particles in the indoor air of households in Ulaanbaatar and Darkhan cities in relation to some symptoms of respiratory diseases. Materials and Methods: The study was conducted using an analytical cohort design from October 2023 to July 2025, and the 4 districts of the central Ulaanbaatar city and Darkhan cities were included in the study. A total of 240 households were included in the study, including 48 households living in ger and house, 24 households living in apartments, and 48 households living in ger and house, and 24 households living in apartments from Ulaanbaatar city. A direct measurement device (PurpleAir) was installed in the households for 3-4 weeks to measure PM2.5 particles in the indoor air for 24 hours. After measuring PM2.5 particles in the indoor air of the household, data were collected through questionnaires from the participants aged 18-60 who participated in the study and underwent health examinations. The results were processed using STATA-19.0 and R programs. Result: 213-239 households were selected for the study, including households living in 17-26 apartments, 42-58 houses, and 38-50 houses. The 24-hour average concentration of PM2.5 particles in the ambient air of households in Ulaanbaatar city was measured relatively higher in winter and summer than in households in Darkhan city. Among the districts of Ulaanbaatar city, the highest concentration of PM2.5 particles was measured in Songinokhairkhan district, and the lowest concentration was measured in Bayanzurkh district. Considering the cities by heating type, households with stoves are more polluted than households with centralized heating. In Darkhan city, the lowest concentration was measured in apartments (22.78-31.53 μg/m³), houses (44.53-68.17 μg/m³), and the highest concentration was measured in traditional felt houses (houses) (63.20-68.25 μg/m³). In Ulaanbaatar, PM2.5 concentrations were relatively high in all types of housing, including apartments (41.61-58.37 μg/m³), houses (79.22-92.50 μg/m³), and traditional felt dwellings (76.69-86.31 μg/m³). In the summer, PM2.5 concentrations in Darkhan were 3.10-10.03 μg/m³ in apartments, 7.67-14.37 μg/m³ in houses, and 7.98-17.90 μg/m³ in traditional felt dwellings (houses). The concentration of PM2.5 particles in the ambient air of the settlement is statistically significantly associated with shortness of breath, fatigue, weakness, muscle pain, nausea, palpitations, sneezing, runny nose, conjunctivitis, pain in the eye socket, tearing of the eyes, headache, fever, nasal congestion, cough, loss of appetite, sore throat, phlegm, wheezing, and chest pain. Conclusion The 24-hour average concentration of PM2.5 particles in indoor air in households in Ulaanbaatar and Darkhan cities is higher than the Mongolian standard during winter and is statistically significantly associated with some symptoms of respiratory diseases.

Background: According to the World Health Organization (2021), low back pain (LBP) affected approximately 619 million people worldwide in 2020, and the number of cases is projected to increase to 843 million by 2050, mainly due to population growth and aging. A study conducted in the Neurosurgery Department of the National Trauma and Orthopedic Research Center reported that over the past five years, the number of surgeries performed due to spinal disorders, particularly intervertebral disc herniation causing compression of the spinal cord and nerve roots has increased four to fivefold. Furthermore, this condition accounts for the majority of patients seeking treatment abroad. According to the 2023 statistical report of the State Central Hospital, a total of 477 surgeries were performed in the Neurosurgery Department. However, there are relatively few studies that have compared and evaluated pain levels before and after spinal surgery among patients. Therefore, this study was conducted to address this research gap. Aim: To compare and examine the intensity of back pain before and after surgery among patients who have undergone spinal surgery. Materials and Methods: This study employed a cross-sectional design using a quantitative research approach. A total of 123 patients who underwent spinal surgery at the Neurological Clinical Center of the State Central Hospital were randomly selected and included in the study. Pain intensity in patients undergoing spinal surgery was assessed using the Visual Analogue Scale (VAS) developed by Hayes and Patterson et al. A linear pain intensity assessment method was applied, and the study utilized a questionnaire consisting of 13 sociodemographic items. Result: All participants (100%) reported pain prior to surgery. Assessment of pain intensity showed that 1.6% (n=2) had mild pain, 52.8% (n=65) had moderate pain, and 45.5% (n=56) had severe pain. On the third postoperative day, pain assessment indicated improvement, with 51.2% (n=63) reporting no pain and 48.8% (n=60) reporting mild pain. The mean pain intensity score decreased from 4.63±0.53 before surgery to 1.48±0.50 after surgery (p = 0.009). Analysis of factors affecting postoperative pain revealed a significant association with the type of surgical procedure performed (p<0.03). Conclusion Comparison of pain intensity before surgery and on the third postoperative day among patients who underwent spinal surgery demonstrated significant improvement. Preoperative pain intensity varied according to the surgical indication, while postoperative pain was significantly associated with the type of surgical procedure and body mass index (BMI).

Agarwood (Aquilaria spp.) is a resinous wood traditionally used in various medicinal systems across Asia for treating inflammation-related ailments. Despite its longstanding ethnopharmacological use, scientific validation of its anti-inflammatory effects remains fragmented. This scoping review aims to systematically evaluate and synthesize current evidence from animal studies investigating the anti-inflammatory potential of agarwood. A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science. Inclusion criteria focused on original animal studies assessing the anti-inflammatory effects of agarwood extracts, essential oils, or derivatives. Data on study design, animal models, agarwood species, treatment dosage, duration, biomarkers, and outcomes were extracted and summarized narratively due to methodological heterogeneity. Eight studies met inclusion criteria, involving models of inflammation-related conditions such as pain, neuroinflammation, gastrointestinal injury, cancer, and toxicity. Agarwood treatment consistently reduced pro-inflammatory cytokines (e.g., IL-1β, IL-6, TNF-α), modulated oxidative stress markers (e.g., NO, SOD, GSH), and regulated signalling pathways including NF-κB, p38 MAPK, and Nrf2–ARE. Notably, improvements were observed in behavioural and histological outcomes across models, with evidence of dose-dependent effects in several studies. In conclusion, preclinical evidence supports agarwood’s broadspectrum anti-inflammatory and antioxidant properties across multiple organ systems. These findings provide mechanistic insights and a scientific basis for its traditional use. However, variability in species, extraction methods, and study designs highlights the need for standardised protocols and clinical validation to advance agarwood as a potential therapeutic agent.

BACKGROUND

The survival advantage of HER2-positive breast cancer from targeted treatment is commonly undermined by catastrophic health expenditure (CHE), particularly in resource-limited areas. Recognizing that financial catastrophe leads to non-adherence to treatment and dissaving practices, we examined the out-of-pocket (OOP) expenses of patients with HER2-positive breast cancer.

OBJECTIVE

The study aimed to estimate the median total per-cycle out-of-pocket expenditure of HER2-positive breast cancer treatment from the patient perspective, in public and private clinics, evaluate the association of catastrophic health expenditure with non-adherence to treatment, and describe dissaving practices.

METHODS

This was a cross-sectional micro-costing analysis of the treatment of HER2-positive breast cancer from the patient perspective from a tertiary cancer center and select private clinics in the Philippines. Random sampling of patients with HER2-positive breast cancer was done. Using a validated questionnaire, a guided interview was administered. Catastrophic health expenditure was estimated as having OOP of >20% of the household income. OOP costs were assessed retrospectively from the time of confirmed HER2 diagnosis up to the date of survey, while household income referred to the corresponding period. The proportion of patients experiencing catastrophic health expenditure was computed. Fisher's exact was used to assess for any association between CHE and non-adherence to treatment. Descriptive statistics were used to report dissaving practices. All statistical analyses were performed using Stata analytical software version 12.

RESULTS

A total of 101 patients participated in the study. The mean age of participants from the tertiary cancer center and private clinics were 52 and 58 years old respectively. Patients from the private clinics had a median total OOP expenditure of PhP 54,737.06 (IQR = PhP 102,670.00), compared with patients from tertiary cancer center who had a median total OOP expenditure of PhP 13,920.66 (IQR = PhP 20,830.00). The overall prevalence of CHE (90.9%, 95% CI 0.81, 0.95) and nonadherence to treatment with trastuzumab (79%, 95% CI 0.70, 0.87) were high, and similar in both groups. A number of dissaving practices such as resignation from work, borrowing money from friends, selling assets were observed.

CONCLUSION

The high rate of CHE and treatment delay among patients with HER2-positive breast cancer were not addressed by the existing cancer programs. Most OOP expenditure was for trastuzumab. Current cancer support programs have potential to address the financial impact of their treatment.

Human ; Therapeutics ; Survival ; Patients ; Neoplasms ; Philippines ; Health Expenditures ; Breast Neoplasms

INTRODUCTION

Hypertension is a serious public health issue that puts individuals at risk for various morbidity and mortality indicators. One of the most crucial factors in managing blood pressure and preventing complications is medication adherence which is linked to several determinants. This study explored the correlation between medication adherence among middle-aged hypertensive adults and the different domains of quality of life (QOL), which includes physical, psychological, social relationship and environment.

METHODS

This cross-sectional study involved 96 Filipino residents of Brgy. San Jose, Navotas City aged 35 to 65 years old diagnosed with hypertension and prescribed anti-hypertensive medications. Pearson’s correlation coefficient was used to calculate the correlation between different domains of QOL as well as the overall QOL score.

RESULTS

Results revealed a statistically significant but weak positive correlation between overall QOL and medication adherence (r = 0.336, p<0.001). Among the QOL domains, environmental domain had the strongest correlation with adherence (r = 0.446, p = 0.00), followed by physical health (r = 0.443, p = 0.01) and psychological well-being (r = 0.382, p = 0.01). The social relationship domain showed negligible correlation (r = 0.163, p = 0.4).

CONCLUSION

The study demonstrates that while medication adherence is modestly associated with better perceived QOL, especially in physical, psychological and environmental aspects, other factors likely influence both outcomes. These findings highlight the need for holistic, community-based interventions that address not only medication adherence but also environmental and psychosocial barriers to care in managing hypertension.

Human ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Aged: 65-79 Yrs Old ; Quality Of Life ; Public Health ; Medication Adherence ; Antihypertensive Agents ; Blood Pressure ; Interpersonal Relations

OBJECTIVES

Adiposity rebound (AR), the childhood period at which body mass index (BMI) rises from its lowest point, is linked to increased risk of later obesity. The study aims to determine the average age at AR, describe baseline characteristics and analyze the correlation between these characteristics and timing of AR in a population of Filipino pediatric outpatients.

DESIGN

Seven subjects born between 2016 and 2019 from a University Hospital Outpatient Department participated in this cross-sectional analytic study. Childhood anthropometrics were retrospectively collected to determine the age at AR by plot visual inspection. Sex, birth weight and gestational age were obtained from hospital records; breastfeeding duration, maternal BMI, parental obesity, maternal age, maternal smoking, education, parity and family income were gathered through a questionnaire completed by mothers or guardians. Associations were assessed using bootstrap univariate linear regression.

RESULTS

The mean age at AR was 3.2 years (SD = 1.2). Vaginal delivery was significantly associated with later age at AR compared to cesarean section (p = 0.035). Socioeconomic status at ages 2 to 5 showed positive association with delayed AR. Higher monthly family income (≥₱19,000) at ages 2 to 5 years was significantly associated with delayed age at AR. Other baseline childhood and parental factors showed no significant correlation with age at AR.

CONCLUSION

These results highlight the complex and context-dependent nature of AR, emphasizing the need for further studies to better understand and mitigate early obesity risk in Filipino children.

Human ; Young Adult: 19-24 Yrs Old ; Universities ; Regression (psychology) ; Hospital Records ; Gestational Age ; Body Mass Index ; Obesity, Maternal

INRODUCTION

Stroke is one of the top five leading causes of disability in the Philippines. It has a significant impact on the quality of life (QoL) of patients, particularly in the functional and psycho-emotional aspects. Thus, it is important to understand the health-related quality of life in stroke patients (HRQoLISP), which focuses on the clinical impact of the disease and disability. The assessment of a stroke patient’s QoL is prognostically significant as it can predict a patient’s treatment success and survival.

OBJECTIVE

This study aims to translate the HRQoLISP-26 into Filipino and assess its content validity for Filipino adult stroke patients.

METHODOLOGY

The HRQoLISP-26 was translated into Filipino using a forward translation protocol and an expert analyzed the forward translation. Selected expert committee members reviewed the first version to assess for content validity and the questionnaire was modified accordingly. The content validity index (CVI) was used for content validity.

RESULTS

Majority of the revisions made were done to improve the semantic and grammatical accuracy of items in the Filipino version of the HRQoLISP-26. Only a few items had no revisions implemented. No revisions were done in the final version of the translated questionnaire as each item had a CVI of 1 indicating that it has good content validity.

CONCLUSION

The Filipino translated HRQoLISP-26 questionnaire is a validated questionnaire that allows assessment of a stroke survivor’s QoL.

Quality Of Life ; Patients ; Life ; Health ; Adult ; Stroke

BACKGROUND AND OBJECTIVES

Diet compliance is critical in managing Maple Syrup Urine Disease (MSUD) to prevent physiological and neurological damage. However, there is a lack of studies looking at factors critical to diet compliance. This study determined the caregivers’ nutrition knowledge, attitudes, and feeding practices (KAP); and its relationship to Filipino MSUD children’s leucine level, nutritional status, and nutrient intake.

METHODS

A cross-sectional, sequential explanatory research approach using survey was utilized. Data tools were questionnaires and food records.

RESULTS

The participants were 20 caregivers and 21 MSUD children (aged 6 to 83 months). Caregivers had moderately high feeding practices and knowledge scores and had positive attitudes towards providing adequate nutritional care; still, they were struggling with diet compliance.

Their nutrition knowledge was related to their attitude (p-value: 0.021), feeding practices (p-value: 0.037), and their children’s weight-for-age (p-value: 0.036). Furthermore, knowledge and feeding practices were related to the children’s natural-protein status (p-value: 0.043 and 0.006, respectively). The caregivers’ sex was related to the children’s leucine (p-value=0.010), those with female caregivers had lower leucine by 470 μmol/L on average. Moreover, children with good leucine control belonged to higher-income households (p-value=0.049).

CONCLUSION

With caregiver's nutrition knowledge having been possibly associated with the children’s weight-forage, and their knowledge and feeding practices with the children's natural protein status, as well as knowledge positively affecting both attitude and feeding practice, interventions for improving all caregivers’ nutrition knowledge and feeding practices are recommended. Additionally, with caregivers’ sex and income having been found to be related to metabolic control, it is suggested that strategies to better manage these barriers be carried out. These may include improving support for male caregivers, with children under their care having higher leucine than those cared for by their female counterparts. Added provisions may likewise be planned for further reducing the impact of income-related barriers.

Human ; Caregivers ; Attitude ; Maple Syrup Urine Disease ; Child ; Children