OBJECTIVE

The competence of health workers to attend to vulnerable and marginalized populations is critical to health equity. The study determines the competence of physicians in providing health care to LGBT adolescents in a national tertiary hospital.

All physicians from the departments of Pediatrics and Family and Community Medicine were recruited. An electronic form collected demographic data and responses to the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBTDOCSS).Theresponsesweresummarizedandanalyzed.

Most respondents are male, with a mean age of 34.21 years. They are mainly staff of the Department of Pediatrics and post- residency fellows. Not all recall their participation in gender sensitivity training. They report scores towards the higher end of the scale: an overall score of 5.27 and mean subscale scores of 4.43 for clinical preparedness, 6.13 for attitudinal awareness, and 5.24 for basic knowledge. The heterogeneity and pertinacity of their experiences with LGBT individuals mediate their attitudinal awareness. Attaining the level of consultant suggests a better understanding of barriers and disparities against LGBT individuals. The tool has good internal reliability.

The demographic profile of the respondents suggests their involvement in healthcare, continuing education, and staff development. They report adequate competence in providing health care to LGBT adolescents.

Costs And Cost Analysis ; Delivery Of Health Care

Palliative care has emerged as a crucial component of healthcare, particularly in the context of an aging population and the increasing prevalence of chronic and life-limiting illnesses. In the Philippines, however, access to palliative care remains significantly limited, especially in rural and underserved areas. This disparity is primarily driven by systemic challenges such as inadequate healthcare infrastructure, a shortage of trained professionals, and insufficient public awareness. While the inclusion of palliative care in the Universal Health Care (UHC) Act of 2019 (Republic Act No. 11223) reflects a progressive step toward addressing these needs, the implementation of comprehensive palliative services continues to face considerable hurdles. This paper advocated for the stronger integration of palliative care into primary health care systems at the barangay level, emphasizing the need to strengthen policy frameworks, ensure adequate resource allocation, and actively engage communities in this endeavor. Such efforts are essential to guaranteeing equitable, compassionate, and dignified care for all individuals, regardless of their stage of life or even socioeconomic status.

BACKGROUND

Lesbian, gay, bisexual, and transgender (LGBT) individuals continue to experience health disparities related to discrimination and health professional inadequacies despite increasing social acceptance of the LGBT community in society. Understanding the knowledge, attitudes, and practices concerning the healthcare of LGBT individuals among healthcare professionals can enable gender-affirming healthcare for the LGBT community. However, there is a need for a culturally relevant and updated tool to describe healthcare professionals' interactions with the LGBT community.

The objective of this study is to describe the development of the Knowledge, Attitudes, and Practices towards LGBT in Healthcare Questionnaire (KAP-LHQ) and demonstrate its content and face validity.

The KAP-LHQ was developed using a two-phase process. Phase 1 involved the generation of items through a literature review and discussions among the authors Phase two included the evaluation of its content and face validity. Content validity was determined by six experts using the Content Validity Index, while ten healthcare professionals evaluated the tool for face validity.

The KAP-LHQ demonstrated good content and face validity. Content validity indices were high. Item-Level CVI (I-CVI) ranges from 0.83 to 1.00 for the items under the Knowledge section and has a Scale-Level CVI (S-CVI) of 0.97. The Attitude section items scored an I-CVI of 0.83 to 1.00 and a S-CVI of 0.99, while most of the Practices section items scored an I-CVI of 1.00 with an overall S-CVI of 0.94. One item was omitted on the final version for having an I-CVI of 0.67. Face validity of the final questionnaire across parameters has a median of 4 out of 4, reflecting the appropriateness, comprehensibility, and relevance of the questionnaire.

The KAP-LHQ appears to be a valid tool that has the potential for assessing the KAP of health professions to improve training and increasese healthcare outcomes for the LGBT community. Using the tool on a larger population can firmly establish its efficacy, further validity, and even reliability.

BACKGROUND

PhilHealth serves as the Philippines’ national health insurance provider and is central to implementing the Universal Health Care (UHC) Law. Despite this, existing gaps and ongoing challenges in claims and financial management systems continue to affect public healthcare facilities’ operations and sustainability.

This article examined the effectiveness and challenges of PhilHealth’s claims and financial management systems in public healthcare facilities, focusing on accreditation, claims processing, reimbursements, and financial governance.

A qualitative multiple-case study design was employed in Quezon City and the provinces of La Union, Sorsogon, Leyte, and Bukidnon, with data collected from 2022 to 2023. Prior to data collection, a certificate of exemption was granted by the Department of Health – Single Joint Research Ethics Board (DOH-SJREB). Data were collected through key informant interviews with healthcare facility heads, claims processors, and PhilHealth personnel, supplemented by document reviews and facility observations. Thematic analysis was employed to examine the implementation of national health insurance policies at the facility level.

Accreditation standards are uniformly defined, yet compliance varies widely, directly influencing reimbursement outcomes. Facilities with compliance gaps often face provisional accreditation, downgrades, or suspension, resulting in reduced revenue. Although the Universal Health Care (UHC) Law guarantees patient access to PhilHealth benefits, the efficiency of claims processing remains uneven and highly dependent on administrative capacity, staffing adequacy, and digital infrastructure. Systemic inefficiencies at both PhilHealth and facility levels contribute to delays and claim denials. Reimbursements are further constrained by outdated case rate ceilings, inconsistent financial practices, inadequate recordkeeping, weak information systems, and poor storage conditions—particularly in lower-level hospitals and rural health units.

Reforms in claims processing workflows, information system integration, and financial management capacities are crucial to enhance reimbursement efficiency. Strengthening these systems is fundamental for supporting sustainable, equitable, and high-quality healthcare delivery in the public sector within the Universal Health Care (UHC) framework.

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.

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.

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.

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.

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.

Objectives: This study aimed to describe the roles and responsibilities of doctors and nurses in managing conditions like hypertension and diabetes in rural areas. Methods: This study employed a cross-sectional study design using the task analysis methodology. A self-administered questionnaire derived from a national health practice guideline was used. A combination of frequency, criticality, and performance was assessed to identify tasks that needed attention by educators and policymakers. Results: Of the 142 health workers who participated in the study, 81% were nurses and 19% were doctors. The tasks most frequently performed by these professionals were taking vital signs (88.7%), recording patient history (87.3%), and advising patients on regular follow-ups (86.6%). In terms of criticality, the top three tasks were performing diagnostic tests for acute chest pain (50.8%), diagnosing neurological disorders (49.2%), and referring patients for specialized tests at other facilities (43.6%). However, the tasks perceived as most challenging or outside their capability were the Fagerstorm test for assessing nicotine dependence (57.5%), the AUDIT tool for identifying binge drinkers (55.5%), and fundoscopy for diagnosing diabetic retinopathy (54%). Conclusion The primary care practice of the participants typically involved tasks that are centered on health promotion or disease prevention. Many of the tasks are shared by doctors and nurses, with some highly critical tasks performed less frequently due to a lack of training. Pre-service courses may need to be revised to ensure that health professionals have the required skills to carry out shared tasks.
Diabetes Mellitus ; Hypertension ; Primary Health Care ; Delivery of Health Care, Integrated ; Philippines ; Cross-Sectional Studies

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 AND OBJECTIVES

The adoption of electronic medical records (EMRs) in the Philippines has been initiated and adjusted since the last decade through the Philippine eHealth Agenda framework. EMRs are known to improve clinical management and have been widely adopted in advanced economies. However, empirical research on EMR implementation remains limited. This study aims to determine how public primary health care facilities in the country interacted with EMRs before and during the COVID-19 pandemic to understand EMR adoption.

More than 270,000 records generated from EMR usage logs in six rural primary health facilities in Western Visayas were analyzed. Average time of EMR use during work hours was estimated and compared before and during the pandemic. EMR adoption based on specific EMR features used was also determined.

In 2020, EMR use ranged from less than one hour to more than eight hours in selected rural health units (RHUs). There was a statistical increase and decrease in use of features during the pandemic. Some EMR users had efficient use indicated by complete adoption of EMR features although such features were not as frequently used as those pertaining to basic adoption.

This study demonstrates that for EMR use in rural settings, progressive use from basic to complete may vary among users. Public health emergencies such as a pandemic may also affect EMR use. Future research directions should explore other mechanisms which affect user behavior and encourage full adoption of technology such as use of games or non-monetary incentives.

OBJECTIVES

This study aimed to describe the roles and responsibilities of doctors and nurses in managing conditions like hypertension and diabetes in rural areas.

This study employed a cross-sectional study design using the task analysis methodology. A self-administered questionnaire derived from a national health practice guideline was used. A combination of frequency, criticality, and performance was assessed to identify tasks that needed attention by educators and policymakers.

Of the 142 health workers who participated in the study, 81% were nurses and 19% were doctors. The tasks most frequently performed by these professionals were taking vital signs (88.7%), recording patient history (87.3%), and advising patients on regular follow-ups (86.6%). In terms of criticality, the top three tasks were performing diagnostic tests for acute chest pain (50.8%), diagnosing neurological disorders (49.2%), and referring patients for specialized tests at other facilities (43.6%). However, the tasks perceived as most challenging or outside their capability were the Fagerstorm test for assessing nicotine dependence (57.5%), the AUDIT tool for identifying binge drinkers (55.5%), and fundoscopy for diagnosing diabetic retinopathy (54%).

The primary care practice of the participants typically involved tasks that are centered on health promotion or disease prevention. Many of the tasks are shared by doctors and nurses, with some highly critical tasks performed less frequently due to a lack of training. Pre-service courses may need to be revised to ensure that health professionals have the required skills to carry out shared tasks.