BACKGROUND AND OBJECTIVE

Within a decentralized health system, barangay health workers (BHWs) are often the first point of contact for Filipinos seeking care. Despite their importance, BHWs are neglected in the health value chain. The study seeks to examine the lived experiences of BHWs, particularly their journey in navigating their roles within the community and the health system that encompasses their day-to-day realities, challenges, motivations, and the meanings they derive from their work.

The study draws on seven focus group discussions (FGDs) with BHWs (n=50), residents (n=7), and local government officials and health workers (n=7) of San Miguel, Bulacan. The qualitative data collected were analyzed using thematic analysis.

Findings show that BHWs perform many roles, which are not limited to health and are dependent on orders from their superiors. Guidelines are vague in appointing BHWs, with personal connections valued more than technical qualifications. Their accreditation is hardly conferred any significance. There is also a lack of formal and structured training. The informality of these processes leads to an absence of quality assurance on rendered health services. The non-provision of incentives and benefits stipulated in RA 7883 also places their health and lives at risk. Furthermore, BHW’s commitment to serve is used to excuse the inadequacy of their compensation and excessive workload.

BHWs take on diverse roles, from community organizers to healthcare providers, and are confronted with significant challenges encompassing politicization, inadequate training, and insufficient compensation. The study concludes with policy recommendations to improve the conditions of the neglected BHWs, with particular attention to coordinating, capacitating, compensating, career pathing, and connecting them to the health system.

BACKGROUND

Community Health Workers (CHWs) play a vital role in addressing community healthcare needs, yet little is known about their psychosocial status and job satisfaction. This study aimed to describe the psychosocial status and job satisfaction of CHWs, and examine the factors associated with their job satisfaction.

A cross-sectional study was conducted among 440 CHWs aged 25-60 years working in urban and rural areas of Batangas, Philippines. Linear regression models were used to examine the association between psychosocial factors and job satisfaction. Other factors associated with job satisfaction were also examined.

Despite 90.0% of CHWs reporting high perceived stress and 52.1% experiencing high depressive symptoms, they demonstrated relatively high job satisfaction (mean [standard deviation]= 80.05 [17.56]; range= 0-100) and high perceived social support (mean [standard deviation]= 25.09 [2.93]; range= 10-30). Among psychosocial factors, only perceived social support was associated with job satisfaction (unstandardized beta [B] 0.93; 95% confidence interval [CI] 0.44, 1.41). Other factors associated with job satisfaction include fixed working hours (B 4.71; 95% CI 0.49, 8.94), work amenities (B 7.37; 95% Cl 0.03, 14.72), ≥21 years of work experience (B 5.64; 95% CI 0.35, 10.93), and working in rural areas (B 5.88; 95% CI 2.77, 8.99).

Psychological factors such as perceived stress and depressive symptoms were not found to be associated with job satisfaction among CHWs. However, factors such as greater perceived social support, fixed working hours, work amenities, longer work experience, and working in rural areas were identified as contributors to higher levels of job satisfaction among CHWs.

BACKGROUND

This study explored the indigenous knowledge practiced by the traditional Panday in the care of pregnant Meranaw mothers during intrapartum care and how it is perceived by the midwives and the mothers. In analyzing their perspectives, qualitative method of research known as descriptive exploratory research design was utilized. The study gathered insights from 51 individuals.

Data collection methods included interview and observations through thematic content analysis. Four themes emerged: traditional Panday, practices in intrapartum care, midwives' perceptions of traditional Panday, reasons for home births among mothers, and suggested policies and programs for traditional Panday, and mothers.

Data revealed that most traditional Panday, exhibit satisfactory intrapartum care practices, which closely resemble those used in hospitals, indicating their capability to conduct safe home births. Some traditional Panday, demonstrate remarkable skills, such as identifying fetal position and even turning breech babies into the cephalic position during critical labor stages. The integration of herbal methods and Islamic practices, such as the recitation of Azan to the baby's ear, further distinguishes their approach. Regarding midwives' perspectives, opinions varied, with some viewing traditional Panday, as dependable partners, while others perceive them as threats to maternal safety. However, most midwives advocate for finding solutions and improving access to care rather than viewing traditional Panday, as obstacles.

Mothers' preference for home births is attributed to factors such as comfort, privacy, and financial considerations. Traditional Panday, are valued for their modest fees and cultural sensitivity, as they prioritize the well-being and modesty of women in their care.

Objectives: Community health workers (CHWs) fill in the insufficiency of health professionals in low-income countries. The CHWs’ roles include health education of their constituents whose health they likewise take care. This study aimed to describe the concept and understanding of diabetes among CHWs in the Philippines. Methods: Fifty female CHWs currently working in rural and urban areas participated in six focus group discussions with guidance from Kleinman’s eight questions. With the written informed consent of the participants, discussions were recorded and transcribed by the Research Assistant. A multi-disciplinary team manually analyzed the data. Disagreements were discussed among them and the physicians provided clinical analyses and explanations on the results. Quotations of an important point of view were also presented. Pseudonyms were utilized to uphold anonymity. Results: CHWs were aged 32 to 72 years; older participants reside in rural areas. Majority were married, housekeepers, and high school graduates. Some CHWs and their family were suffering from diabetes or dyabetis, the disease of the rich according to them. Its causes were food and lifestyle, and believed to be hereditary. Complications lead to death. Amputation was feared the most. Diabetes is incurable. Persons with diabetes should take maintenance medicines, and seek physicians’ and family’s help. Together with the patient, the family must decide on its management. Balanced diet, healthy lifestyle, maintenance medicines, food supplements, and herbal plants were perceived treatments. The internist should lower blood sugar level as well as prolong life span. Proper diet and regular check-up prevent diabetes. Conclusions CHWs’ concept and understanding of diabetes reflect some of the biomedical causes, effects, treatment, and prevention of diabetes as well as its social determinants. The efficacy and safety of herbal plants in the treatment of diabetes, however, should be further studied. Training on diabetes care should be provided to address their fears of amputation, insulin injection, and complications.
Community Health Workers ; Philippines

BACKGROUND

According to the World Health Organization, in 2016, there were more than 1.9 billion adults who were overweight. Of these, over 650 million were obese. Physical inactivity is one of the major risk factors for several non-communicable diseases. Healthcare workers who have direct contact with patients often influence their behaviors. However, health care workers who educate their patients but they themselves do not practice what they recommend, may be one of the barriers that can affect patient education and influence.

This research paper aimed to investigate the motivation to participate in physical activity among healthcare workers and to determine the association between the profile of respondents with the different types of motivation.

There was a total of 250 randomly selected respondents who were included in the study. Data were gathered through a self-administered questionnaire utilizing the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and the Behavioral Regulation in Exercise Questionnaire (BREQ-2). Descriptive statistics was used to summarize sociodemographic information, physical activity levels and BREQ-2 profiles. T-test was used to analyze differences in gender while analysis of variance (ANOVA) was used for levels of physical activity and professional category.

Female healthcare professionals have a higher average in amotivation (mean=0.56) while males have a higher average in intrinsic (mean=2.82) motivation. Nurses and ancillary services have higher average amotivation scores than physicians.

Health care workers who have high classification in physical activity have the highest average scores in terms of relative autonomy index, introjected, identified, and intrinsic scores. This demonstrates a positive association between motivation from internal regulation and increased physical activity.

In the realm of mental health promotion and public mental health, a consistent acknowledgment has prevailed, recognizing the imperative to enhance mental well-being while concurrently preventing mental illnesses. Such recognition extends to the pivotal role that healthcare providers’ overall health plays in their capacity to deliver comprehensive and quality patient care. This study embarked on a journey to illuminate the mental well-being landscape of healthcare workers within the ambit of Chong Hua Hospital, spanning the tumultuous peripandemic period and beyond. Employing a quantitative research design, the standardized Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) was methodically administered to discern the intricate threads of mental well-being. The study’s findings stand poised to serve as the cornerstone for the crafting of an institutional mental health program, meticulously tailored to the diverse needs of healthcare workers within the hospital. Results revealed that resident doctors and the PGIs while generally reporting a high level of mental well-being in the peripandemic period, a sizeable proportion of these medical healthcare workers still succumbed to manifesting poor mental well-being. The paper also proved that married and those who contracted the infection were a notable cohort who recorded a significantly poorer mental well-being. The need to prioritize well-being immediately and after the pandemic so that services are sustained cannot be overemphasized hence the myriad of recommendations for a comprehensive and sustainable institutional mental health program was proposed in this paper.

INTRODUCTION

Burnout is becoming more common among healthcare professionals, notably during the COVID-19 pandemic. It can result in lower performance and effectiveness at work as well as employment withdrawal, all of which affects the standard of healthcare services provided.

In order to ascertain the effectiveness of mindfulness meditation-based interventions (MMBIs) in reducing burnout among healthcare workers, a systematic review and meta-analysis was done.

Two investigators searched records in CENTRAL, PubMed/MEDLINE, Google Scholar, Preprints, Grey Literature, and cross-referencing to acquire articles using search terms related to “mindfulness meditation”, “healthcare workers”, and “burnout”. Inclusion criteria included randomized controlled trials (RCTs) and nonrandomized controlled trials (NRTs) that assessed the effectiveness of MMBIs on burnout as measured by the Maslach Burnout Inventory (MBI) among healthcare workers in the hospital setting. Study selection, data extraction, risk of bias assessment were done by the investigators independently. Analysis was done using RevMan 5 software, forest plots were generated, and subgroup analyses were done.

Of 25,453 identified records, 28 studies were included. The studies were rated with low to unclear selection bias and high risk of performance bias. MMBIs were associated with significant reduction on the emotional exhaustion, depersonalization and personal accomplishment subscales with pooled mean differences of -2.60 (95% CI = -3.64, -1.55), -0.51 (95% CI = -0.77, -0.26), and 0.82 (95% CI = 0.24, 1.39), respectively. On subgroup analyses, the types of MMBI implemented had no influence in the intervention effect noted on all subscales among RCTs but had significant influence among NRTs. Reduction of burnout was noted to be higher in nurses compared with physicians and mixed healthcare workers. Overall quality of evidence for RCTs was low to moderate and very low to low for NRTs.

The results suggest that MMBIs can reduce the burnout symptoms of healthcare workers. To address the high risk of bias of included studies and improve quality of evidence, future research should be done with high-quality RCTs.

BACKGROUND

Healthcare workers’ (HCWs) willingness to report to work despite personal risk is a requisite for an effective pandemic response. At present, there are no local studies that have examined the factors affecting willingness to report to work during the COVID-19 pandemic.

To determine the factors associated with willingness to report to work during COVID-19 pandemic among healthcare workers in a tertiary government hospital.

This was a cross sectional study among the nursing staff (nursing attendants, nurses), doctors (residents, fellows), medical technologists, radiologic technologists, and respiratory technicians in a tertiary government hospital, who were employed from January 2021 to January 2022. Data was collected through an online questionnaire and was analyzed using SPSS.

A total of 311 participants included in the study. The median age of the respondents was 34 (29-46) years old. More than a third of the workers were nurses (37%) followed by residents and fellows (34%), nursing attendants (19%), radiologic technologists, medical technologists, and respiratory technicians (10%). Over 4 out of 5 were assigned in a non-COVID area while 11% were assigned in the COVID area. The odds of willingness to report to work is 60% lower among males compared to females. On the other hand, the odds of willingness to report to work was 78% lower among nurses and 84% lower among residents and fellows compared to medical technologist, radiologic technologists, and respiratory therapists. The median rating of the staff on willingness to report to work was 80% (60-90), and 73% of respondents were willing to report to work during the entire COVID-19 pandemic.

Factors that were associated with willingness to report to work were female gender and occupation (radiologic technologists, medical technologists, respiratory technicians).

OBJECTIVES

While the chronically overburdened state of public school teachers in the Philippines is well-established, little is known about how they specifically provide ‘care’ and attend to their students’ health in the workplace. This article addresses that knowledge gap by illustrating the many forms of ‘health work’ undertaken by public school teachers on a daily basis, and analyzing the concrete challenges they face in doing such work. In so doing, this article provides a qualitative construction of school teachers as ‘health workers’ in the country.

This article draws from two focus group discussions conducted in Southern Luzon and Eastern Visayas between November 2018 to May 2019, as part of a multi-sited study on the health-related challenges faced by lowand middle-income Filipinos. A total of 19 teachers participated in those two discussions. We used the principles of thematic analysis to code and analyze the discussion transcripts.

Teachers regularly fulfill various tasks that can be considered health work, including measuring students’ anthropometrics; supervising and administering government programs like deworming, feeding programs, and vaccinations; providing first-aid and various forms of immediate medical attention; addressing students’ mental and psychological health concerns; and working with students’ families in ways that resemble social work. However, the study participants largely considered themselves unqualified to do health work, often sacrificed their own personal health and interpersonal relationships to take on the additional burden of health work, and felt they received insufficient institutional support.

Doing health work not only takes away from actual teaching time, but also comes at the expense of teachers’ own health. Hiring the appropriate personnel to conduct health work and improving legal safeguards are possible solutions to ameliorating the present working conditions of teachers. Yet, the larger and more long-term conversation demands the prioritiziation of teachers’ well-being and overall quality of life, and recognizing the cruciality of a healthy work-life balance for them. Future studies should involve more diverse geographic sites and teacher populations, and utilize more focused forms of analysis (e.g., comparative, policy-driven).

OBJECTIVE

To assess the knowledge, attitudes, and practices of Barangay Health Workers (BHWs) in Marawi City regarding Hansen’s Disease (HD).

A cross-sectional study was conducted among the Barangay Health Workers of Marawi City. This study was conducted in two phases. Phase 1 was questionnaire development where the knowledge, attitudes, and practices (KAP) questionnaire was formulated and administered to six Barangay Health Workers for pre-testing. Phase 2 of the study included the survey and focus group discussion (FGD). A questionnaire comprising of 27 questions was administered to BHWs to assess knowledge, attitude, and practices regarding HD.

A total of 49 BHWs underwent the Phase 2 survey and six BHWs joined the FGD. The mean age of all the survey participants was 34.9 ± 19.3 years. Among the 49 participants, 40 (81.6%) were females. The knowledge of BHWs was found to be adequate only in six (12%) BHWs. Positive attitude was observed in 12 (24.5%) and adequate practices regarding HD were observed in 33 (67.3%) BHWs. First-hand experience of diagnosing HD patients was significantly associated with adequate knowledge (p < 0.001) and positive attitude of BHWs (p < 0.001). There was a significant association between > 5 years of experience as BHWs (p = 0.027) and first-hand experience in diagnosing leprosy (p = 0.005) with adequate practices of BHWs regarding HD. In the FGD, BHWs expressed their lack of training which highlighted the need for refresher courses on HD.

Knowledge about HD is low among Marawi BHWs due to their inadequate training. The attitudes and practices of BHWs are also affected because of deficient knowledge regarding etiology and transmission of HD. There is a need for adequate training and refresher courses on HD to increase the knowledge of BHWs regarding HD.