Background and Objectives: The Philippine Department of Health (DOH) is mandated by law to, among others, develop capacities and accredit physicians and rehabilitation practitioners across the country on the assessment and management of drug dependence. This paper describes the design and presents the outputs of an advanced course on screening and assessment of drug dependence developed by DOH in partnership with the College of Public Health of the University of the Philippines Manila, Philippine College of Addiction Medicine, and the Group for Addiction Psychiatry of the Philippines.

Methodology: Review, abstraction and synthesis of data from training-related documents and records for the training activities implemented in 2014.

Results: The Level 2a course is a five-day program that focuses on enhancing the skills of physicians and rehabilitation practitioners on the screening and assessment of drug dependence using team-based and practical learning approaches, and builds on learnings from the basic accreditation course. A total of 36 participants from ten Drug Abuse Treatment and Rehabilitation Centers (DATRCs) in nine regions completed the pilot implementation of the course in 2014. In general, the overall participant feedback on the training was mainly favorable based on data from 47% of participants who agreed or strongly agreed to statements on the relevance and attainment of the course aims (mean rating of 1.10±0.31, 1 = Strongly agree, 5 = Strongly disagree), and the appropriateness of its content (1.24±0.43) and design (1.18±0.39). A paired-samples t-test comparing scores for 44% of participants showed that there was a highly statistically significant difference in the pre-test (54%±13%) and post-test scores (69%±10%); t(16)=6.4240, p <0.0001.

Conclusion: Development and design of capability-building initiatives in the field of drug rehabilitation will necessitate alignment with practice standards, grounding in the real-world setting in which professionals work, and orientation towards practical learning.

Background: 'Inter-organizational collaboration' and 'partnership' have been emphasized in drug treatment and rehabilitation over the decades. Nevertheless, the synthesis of knowledge of related arrangements has been limited in scope. This study fills a gap by systematically reviewing the features, outcomes, facilitators, and barriers of inter-organizational collaborations in drug rehabilitation to propose insights to improve policy and practice. Methodology: This review is based on searches of MEDLINE, CINAHL Complete, Embase, and PsychINFO databases. All retrieved papers were independently screened and underwent quality assessment based on the protocol proposed by Peters et al. (2017). Data charting from the included sources was performed using NVivo. Results: A total of 5,631 unique records were retrieved, of which 54 were included in the analysis. Most of the papers were published between 2011 and 2019, and primarily described, or tested, a collaborative activity from a case study or survey research. Treatment services were often partnered with public health, primary care, or social service organizations. The outcomes of initiatives were commonly about the increase in service utilization or the enhancement of service provision. Facilitators and barriers to collaboration were reported by two-thirds of the papers, which primarily pertained to contextual or organizational dimensions. Conclusion This piece of evidence provides good descriptive content on what, how, and how well the interorganizational collaborations have been conducted in drug treatment and rehabilitation. Implications for promoting good practices that range from University education, staff exchange, and incentives to support by governments are discussed.
Intersectoral Collaboration ; Substance-Related Disorders ; Substance Abuse Treatment Centers

Background: The local health center (LHC) is the locus of public health service delivery in the barangays of Makati City. It should be the first-line for consultation and should be able to address most health concerns of the community. Considering the many services offered in the LHC, one must study the reasons why constituents opt to consult in the city hospital or in private institutions rather than the LHC. Objective: This study sought to determine the correlation between community perception of the LHC and utilization of the LHC in Barangay Rizal and Barangay Southside, and the correlation between demographic variables and the utilization of the LHC in Barangay Rizal and Barangay Southside. Methods: This is an observational study that utilized a cross-sectional survey. Utilization of the Local Health Center was operationally defined as any consultation in the local health center in the past year, regardless of occurrence of illness. The survey questionnaire had a 5-point Likert Scale and utilized the Patient Satisfaction Questionnaire-18 and added other possible factors affecting utilization based on related literature. Results: Utilization of the LHC had a weak correlation with barangay (Rizal versus Southside), older age, and having more co-morbid illnesses. Community perception of General Satisfaction, Availability of doctors, and Availability of free medications had a weak correlation with consulting in the LHC and had good community perception ratings. Conclusion Patient-Doctor Relationship also showed a weak correlation with consulting in the LHC but merits attention because it had a somewhat low community perception rating.
Cross-Sectional Studies ; Community Health Centers

Background: The benefits of infant massage in hospital and community settings have been documented in literature: better weight gain of preterm and low birthweight infants, shortened hospital stay, slightly better scores on developmental tests, fewer postnatal complications, and effects on physical and mental health. Objectives: This study described the perceptions and experiences of infant massage among caregivers of infants 2-6 months old consulting in two public health centers in Quezon City before and after infant massage training. Methods: This qualitative study assessed perceptions and experiences at baseline and after infant massage training of mothers and caregivers taking care of infants 2-6 months old. Pre-training interviews were conducted, as well as immediately after, and seven days after training on infant massage delivered by the Philippine League of Government and Private Midwives, Inc. (PLGPMI). Training consisted of lectures and demonstrations, after which mothers/caregivers gave their babies the massage under the trainer's supervision. Post-training interviews were conducted immediately after the training and seven days after. Responses to the interviews were transcribed. The transcripts and interview notes were analyzed independently by two research team members. Qualitative Content Analysis (QCA) was done. Disagreements were settled by discussion. Results: The infant’s mother was identified as the best person to perform infant massage. Infant massage was a new concept to many participants before the training. In general, the perception was positive. It was believed to promote the baby's physical development and bonding with the mother/caregiver. These same benefits were reported after the training. Post-training, all 11 participants who returned for follow-up interviews reported having massaged their babies at home. They were also able to describe the process and timing of massage as taught to them. The participants’ responses centered on seven (7) identified themes, identified at baseline and after training: 1) general concepts of infant massage, 2) benefits of infant massage, 3) methodologies, materials, and considerations, 4) persons credible to perform infant massage, 5) application/performance of infant massage, 6) intentions and 7) infant massage as a public health measure. Conclusion There was a positive perception of infant massage among mothers and caregivers of infants 2-6 months old, whether or not they had prior knowledge. The sharing of information and the training given enhanced this. Participants showed good reception and retention of infant massage's basic concepts and process and improved their confidence in handling their babies and massaging them.
Mother-Child Relations ; Caregivers ; Health Education ; Community Health Centers

Objective: Explore the usage of anti-hypertension drugs and the rationality of hypertension prescription among the primary health centers in Dongcheng District, Beijing. Method: This cross-sectional and retrospective study was applied to analyze the hypertension prescriptions from the 8 community health centers in Dongcheng District. The anatomical, therapeutic and chemical classification (ATC) codes were used to determine the drug category. ATC information was used to filter data containing antihypertensive drugs, and group the number and proportion of ATC categories. The type of drug was judged by its generic name. According to the diagnosis information in the prescription, the prescription containing the Western medicine diagnosis of hypertension was screened out. The comorbidities of hypertension in the study included 7 types of diseases including diabetes, chronic kidney disease, coronary heart disease, heart failure, atrial fibrillation, stroke, and dyslipidemia. The analysis of prescription rationality included rationality of combination medication, rationality of drug dosage and rationality of drug price. The agreed daily dose (DDD) method was used to analyze the rationality of drug dosage. The drug utilization index (DUI) was used as a quantitative indicator to estimate the rationality of medication, and overdose was expressed by DUI>1. The reasonableness of the drug price was judged based on the price of the drug and whether it was a drug in the "4+7" plan. Results: A total of 658 140 prescriptions were extracted as the final data set, involving 7 categories and 60 commonly used anti-hypertensive drugs, and the corresponding cost of medication was ￥96.58 million. Drugs were prescribed according to comorbidities, and the choice followed the international guidelines. Calcium channel blockers (CCB) were the most prescribed drugs in the prescriptions of patients with comorbidities, and α-adrenergic receptor antagonists were the least prescribed drugs. The proportion of diuretics prescribed in hypertensive patients complicating with heart failure was 21.17% (505/2 385), which was much higher than that of patients complicating with other comorbidities (P<0.05). The proportion of diuretics prescribed in hypertension patients complicating with dyslipidemia was lower than that of patients with other comorbidities (2 639 (0.94%), P<0.05), and β-blockers (BB) or angiotensin Ⅱreceptor blockers (ARB) were more likely to be selected (BB: 59 348 (21.08%), ARB: 51 356 (18.24%))in these patients. The proportion of BB in prescriptions for hypertension patients with chronic kidney disease was lower than that of patients with other comorbidities (P<0.05). The proportion of BB in prescriptions for hypertension patients with coronary heart disease was higher than that of other comorbidities (P<0.05). Hypertension patients with atrial fibrillation or stroke accounted for a higher proportion of CCB prescriptions (P<0.05). Single antihypertensive drug prescriptions accounted for the highest proportion, 61.19% (402 745/658 140). Two-combination prescriptions accounted for the highest proportion of combination prescriptions, 72.19% (184 392/255 395). CCB based two-combination prescriptions accounted for the highest proportion, 122 350(66.36%). ARB-based tri-combination prescriptions accounted for the highest proportion, 48 915(89.50%),followed by CCB based tri-combination prescriptions (44 732(81.85%)).There were 2 174 (0.33%) prescriptions with unreasonable combination therapies and DUI>1 were found in 48 out of 60 commonly used drugs. In all possible antihypertensive drugs, only 40.92% (109 227/266 993)followed the "4+7" plan. Conclusions: The anti-hypertensive agents from these prescriptions in the primary health centers are diverse, and the choice is generally complied with the guidelines, but some unreasonable situations existed, especially on the combined anti-hypertensive medication, overdose, and"4+7"plan is not followed completely.
Angiotensin Receptor Antagonists/therapeutic use* ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use* ; Antihypertensive Agents/therapeutic use* ; Beijing/epidemiology* ; Calcium Channel Blockers/therapeutic use* ; Community Health Centers ; Cross-Sectional Studies ; Humans ; Hypertension/drug therapy* ; Prescriptions ; Retrospective Studies

Throughout the past 2020, the pandemic COVID-19 has caused a big global shock, meanwhile it brought a great impact on the public health network. Trauma emergency system faced a giant challenge and how to manage trauma under the pandemic of COVID-19 was widely discussed. However, the trauma treatment of special population (geriatric patients and patients taking anticoagulant drugs) has received inadequate attention. Due to the high mortality following severe traumatic hemorrhage, hemostasis and trauma-induced coagulopathy are the important concerns in trauma treatment. Sepsis is another topic should not be ignored when we talking about trauma. COVID-19 itself is a special kind of sepsis, and it may even be called as serious systemic infection syndrome. Sepsis has been become a serious problem waiting to be solved urgently no matter in the fields of trauma, or in intensive care and infection, etc. This article reviewed the research progress in areas including trauma emergency care, trauma bleeding and coagulation, geriatric trauma and basic research of trauma within 2020.
COVID-19 ; Community Networks ; Disseminated Intravascular Coagulation/therapy* ; Emergency Medical Services ; Female ; Health Services for the Aged ; Hemorrhage/therapy* ; Hemostasis ; Humans ; Male ; Pandemics ; Public Health ; Sepsis/therapy* ; Time Factors ; Trauma Centers ; Wounds and Injuries/therapy*

Background and Objectives: Tuberculosis (TB) continues to be a public health concern in the Philippines. Vulnerable populations in congregate settings such as drug abuse treatment and rehabilitation centers (DATRCs) have higher risks of TB transmission and infection. With the Duterte administration’s intensified campaign against illegal drugs, government-retained DATRCs are filled to capacity. There is an identified need to profile drug users and dependents living in DATRCs. Furthermore, national guidelines for TB management specific to this population is absent. A study was conducted to determine the profile of admitted clients diagnosed with TB, TB prevalence, treatment outcomes and choice of TB diagnostic modalities in six (6) Luzon-based DATRCs from 2013-2015. Methods: All medical records of drug users admitted in this period were reviewed. Information on the total patient census was sought from DATRC heads and used to compute for prevalence. Results: A total of 347 records were obtained. Overall TB prevalence in the study sites was 7,216 per 100,000 population. The typical individual diagnosed with TB in a DATRC was male, with a mean age of 35 years, with at least high school education, and unemployed. Weight loss and fatigue were the most common symptoms reported. The majority (79.83%) completed TB treatment in the DATRCs. Sputum microscopy and chest x-ray were both used for TB diagnosis in 92.80% (322) of the cases. Conclusion The high burden of TB in Luzon-based, government-retained DATRCs is alarming and underscore the critical need for standards and guidelines in the National Tuberculosis Control Program addressing the unique context of these facilities.
Substance Abuse Treatment Centers ; Prevalence ; Philippines ; Tuberculosis ; Psychiatric Rehabilitation ; Behavior Therapy

PURPOSE: The aim of this study was to examine the effect of self-assertive training applying the reality therapy techniques (SATART) on self-esteem and internalized stigma of schizophrenia patients. METHODS: This study was a non-equivalent control group pretest-posttest design and enrolled 55 people with schizophrenia (experimental group=27, control group=28) from two community mental health centers. The SATART was offered twice a week for 6 weeks in a total 12 sessions. Data were collected from February to April, 2017, using the Korean version of the Internalized Stigma of Mental Illness Scale and Rosenberg Self-Esteem Scale. The collected data was analyzed using χ2 test, independent t-test, one-way ANCOVA, and repeated measures ANOVA with using the SPSS/WIN 22.0 program. RESULTS: The experimental group showed significant improvements in self-esteem and recudction of internalized stigma compared to the control group. However, there was no significant improvement on stigma resistance measurement among the subscales of internalized stigma between two groups. CONCLUSION: The findings indicate that the SATART program is effective and could be recommended as a psychosocial intervention for self-esteem enhancement and internalized stigma reduction of people with schizophrenia.
Assertiveness ; Community Mental Health Centers ; Humans ; Reality Therapy ; Schizophrenia ; Self Concept ; Social Stigma

PURPOSE: To determine whether maternal attitude toward sex during pregnancy and health-related quality of life could influence sexual function of pregnant women. METHODS: In this study, 138 second and third trimester pregnant women completed self-report questionnaires during their visits to women's hospitals or community health centers to assess their general characteristics, attitude toward sex during pregnancy (PIES-M), health-related quality of life (EQ-5D), and sexual function (FSFI-6K). Multiple regression analysis was performed to test the research model with SPSS version 23. RESULTS: Pregnant women who had discontinued their sexual life after recognizing their pregnancy accounted for 27.5% of women questioned. The average sexual function score of pregnant women was higher in the second trimester than the third trimester. Attitude toward sex during pregnancy (β=−.38, p< .001), maintaining sexual life (β=.20, p=.028), health-related quality of life (β=.18, p=.030), and adverse symptoms during sex (β=.18, p=.042) were determinants of sexual function during pregnancy. CONCLUSION: Nurses in antenatal care units need to help pregnant women maintain a positive attitude toward sexual activity during pregnancy and manage their health-related quality of life to maintain their sexual life during pregnancy.
Community Health Centers ; Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Pregnant Women ; Quality of Life ; Sexual Behavior

OBJECTIVE: The aim of this study is to assess the prevalence and determinants of folic acid supplementation among women referred to community health centers. METHODS: This was a cross-sectional study conducted in 325 women referred to community health centers. The subjects were selected from 8 community health centers, using a stratified sampling technique. Data regarding demographics, socioeconomic status, obstetrics, folic acid supplementation status, and household food security status were obtained via questionnaires. The data was analyzed in SPSS v22. RESULTS: The prevalence of folic acid supplementation both before and during pregnancy was 54.5%. The results of the study showed that folic acid supplementation had a significant positive association with education level (odds ratio [OR],0 .441; 95% confidence interval [CI], 0.199–0.977; P<0.05), being employed (OR, 0.353; 95% CI, 0.148–0.840; P<0.05), and planned pregnancy (OR, 18.113; 95% CI, 7.371–44.51; P<0.001). However, other variables, including age, husband's age, husband's education and employment status, the number of prior pregnancies, economic satisfaction, and household food security, were nonsignificant factors affecting folic acid supplementation. CONCLUSION: Women with lower socioeconomic status are less likely to take folic acid supplements, and more effort should be made to increase their awareness of the importance of supplementation. Unplanned pregnancy is another strong risk factor for not supplementing with folic acid, and thus should be avoided.
Community Health Centers ; Contraception ; Cross-Sectional Studies ; Demography ; Education ; Employment ; Family Characteristics ; Family Planning Services ; Female ; Folic Acid ; Food Supply ; Humans ; Obstetrics ; Pregnancy ; Pregnancy, Unplanned ; Prevalence ; Referral and Consultation ; Risk Factors ; Social Class