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Community needs assessment and status of primary health care in Middle Sitio Baloc

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Community needs assessment emphasizes the challenges and needs of individuals to enhance their standard of living, as well as the status of primary health care, which ensures that patients receive first-rate and all-inclusive care to supply the services they need. This study examined the primary health care status and community needs of the participants, which are the total enumeration of the heads of the family in Middle Sitio Baloc, Sto. Niño, San Pablo City, Laguna, Philippines. A descriptive-developmental research design was used to assess the community needs and health status, utilizing an adapted and modified questionnaire. Findings of the study showed that most of the participants’ monthly income ranges from 2,001 to 5,000 pesos only and most wives are unemployed. Electricity and water sources are not available within the community. In home and environmental conditions, poor ventilation and lighting and lack of proper materials to build a solid foundation of houses were evident. In terms of knowledge, attitude, and practices, it appeared that most of them are not utilizing health center services due to lack of transportation. Moreover, health care workers’ therapeutic management was found accessible when it comes to the status of primary health care. This study argues three categorical problems, including socioeconomic data, eight prioritizing problems in the community, and community knowledge, attitude and practice.

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Evaluate whether breastfeeding (BF) duration predicts later psychosocial development (PD) in a large low socioeconomic status (SES) sample in the Philippines. The sample consists of 2,752 children aged 5-6 years who were measured in 2004 as part of the Philippine government's Early Childhood Development Project. Duration of any BF was the primary independent variable in regression models predicting a cumulative index of PD that has been shown previously to predict school readiness. In this sample, mothers who breastfed their children for longer tended to have lower educational attainment and to come from lower income households. Despite this, BF duration was a positive predictor of future PD measured in late childhood, but only after adjustment for SES and related confounders. These findings add to growing evidence that BF could provide lasting economic and social benefits and underscore the importance of continuing current public health efforts to promote BF in the Philippines and across the globe.
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A key method of reducing morbidity and mortality is childhood immunization, yet in 2003 only 69% of Filipino children received all suggested vaccinations. Data from the 2003 Philippines Demographic Health Survey were used to identify risk factors for non- and partial-immunization. Results of the multinomial logistic regression analyses indicate that mothers who have less education, and who have not attended the minimally-recommended four antenatal visits are less likely to have fully immunized children. To increase immunization coverage in the Philippines, knowledge transfer to mothers must improve.
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Background The World Health Organization recommends exclusive breastfeeding (EBF) for the first six months after delivery. However, the EBF rate in the Philippines is only 29%. Existing literature suggests that the influence of infant formula marketing (IFM), communication channels, and traditional health beliefs are possible contributors to low EBF rates, but rare studies have been conducted in low-resource settings. Methods: To bridge the gap, 15 barangays in Palawan were selected; 97 interviews were conducted with lactating mothers (LM), health workers (HW), traditional healers, infant formula sellers, and community leaders (CL) to represent different perspectives. The results were coded and analyzed inductively. Results LM received EBF information through multiple resources. Poverty, lacking breast milk (BM), EBF education, and health benefits (HB) to infants are top contributors to EBF while maternal employment and no BM are top barriers to EBF. Elders, traditional health beliefs (THB), and the influence of COVID-19 can influence EBF in both directions. LM emphasized more on poverty and elders to EBF while HW and CL emphasized the role of EBF education and HB. Urban LM tend to have more regular EBF education, use pumps when going out, and are more influenced by IFM. LM in remote areas tend to have more THB, have more BM substitutes, and share BM. Social classes, locations, Indigeneity, migration, and poverty are intersectioned to influence EBF. Conclusions Multiple social and commercial determinants influenced EBF. LM is facing more challenges to EBF under globalization and capitalism. Remote LM are less benefited from new technologies and policies to promote EBF. Different stakeholders have echo chambers to perceive the determinants of EBF. To improve health equity and EBF, the situations of marginalized people in remote areas should be more considered in policy making. Community building should also be considered differently to assist in EBF. Key messages • The project focuses on social and commercial determinants of exclusive breastfeeding with people in extreme poverty. • The project includes plenty of Indigenous breastfeeding behavior that are underreported.
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This research aimed to describe the experiences of underemployed people and their subsistence strategies. The results in this study were gathered through a qualitative method, specifically narrative research design. The five participants were selected based on purposive sampling technique. In using narrative analysis, the recurring themes revealed that the underemployed people experienced financial instability, job difficulties due to a lack of educational attainment, and unprepared family planning. Meanwhile, the subsistence strategies in response to the experiences of the participants were allocation of responsibilities through spousal partners; financial management; entrepreneurial engagement; and seeking alternative resources. The study’s findings suggested an intervention program that aimed to aid the residents with their livelihood, and sought to provide underemployed individuals with means to maximize their income sources, specifically through a livelihood program collaborating with government agencies targeting the sustainable development goals of no poverty, decent work and economic growth. Through the collaboration among government agencies, underemployed individuals achieved their needs as well as their awareness and understanding of their condition. The findings were essential to the improvement of the community that sought to address the issues emerging amongst underemployed individuals. To further effectively sustain it, the researchers recommended conducting regular community profiling to track the recent situation, problems, and issues inside the community arising to possible solutions.
Article
We conducted qualitative research with family planning clients, potential clients, and service providers on barriers and opportunities for improving the quality of family planning services in the Philippines. The family planning service providers included the primary, secondary, and tertiary levels of the health system. Our goal was to aid in developing more effective family planning quality improvement (QI) programs. Our methods included focus groups, key informant interviews and thematic content analysis of the qualitative data. We found four themes: the components of quality of family planning care; factors influencing quality; challenges for improving quality; and provider bias in the types of family planning services offered to clients. We identified five implications for QI, including: reduce provider bias; level off the understanding of QI concepts and roles among the different family planning service providers; involve men more actively; design new digital communication strategies for reaching clients and potential clients; and explore collaborations with private sector pharmacies. The findings from this study can guide the development of a pilot family planning QI programme in the Philippines. The findings provide themes and practical insights for an intervention-focused theory of change on how to improve current programs, design new programs, be more responsive to the needs and concerns of clients and potential clients and be well-accepted and sustained by providers. This can lay the groundwork for improving family planning outcomes and reducing teenage pregnancy rates and the unmet need for family planning throughout the Philippines.
Article
Background: Vaccination is a cost-effective primary preventive measure against infectious diseases. However, protection for specific diseases may wane over time. The National Immunization Program was launched to improve vaccine coverage but despite this, some countries including the Philippines have erratic vaccine coverage. Objective: To determine the compliance to the National Immunization Program of Grade 1 students in a public elementary school Methodology: The study utilized a descriptive cross-sectional design. Simple random sampling of students enrolled in first grade for A.Y. 2017-2018 was done to determine the study respondents. Primary and secondary data were obtained through a pretested structured questionnaire with interview of the students’ caregiver and verification via the students’ immunization records. Compliance to immunization was correlated with the subjects’ age, birth rank, primary caregiver and socio-demographic profile of the caregiver, place of birth and place of vaccination. Data were analyzed using descriptive statistics and logistic regression was used to assess factors for increased vaccination compliance. Results: Most respondents had their mothers as primary caregivers. Majority were institutional deliveries and immunized at a health center. Mean compliance to vaccination was 69%. Among the factors, only place of birth, specifically, hospital delivery, was associated with increased compliance to vaccination (OR = 0.3312, 90% CI 0.1496 to 0.7333, p value 0.0064). Subjects whose primary caregivers were the mothers and whose parents had higher educational attainment or were both employed were shown to have higher vaccination compliance, although this was not statistically significant. Vaccination coverage was observed to decrease over time as the subjects grew older. Most common reasons cited for missing vaccinations were vaccine unavailability (68%), financial constraints 46%), and lack of information (40%). Conclusion: Compliance to vaccination in this study was 69% and is affected by multiple factors. Policymakers and stakeholders should address these barriers to improve vaccination coverage and overall health status.
Book
High-quality primary care is the foundation of the health care system. It provides continuous, person-centered, relationship-based care that considers the needs and preferences of individuals, families, and communities. Without access to high-quality primary care, minor health problems can spiral into chronic disease, chronic disease management becomes difficult and uncoordinated, visits to emergency departments increase, preventive care lags, and health care spending soars to unsustainable levels. Unequal access to primary care remains a concern, and the COVID-19 pandemic amplified pervasive economic, mental health, and social health disparities that ubiquitous, high-quality primary care might have reduced. Primary care is the only health care component where an increased supply is associated with better population health and more equitable outcomes. For this reason, primary care is a common good, which makes the strength and quality of the country’s primary care services a public concern. Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care puts forth an evidence-based plan with actionable objectives and recommendations for implementing high-quality primary care in the United States. The implementation plan of this report balances national needs for scalable solutions while allowing for adaptations to meet local needs.
Chapter
The practice of herbal medicine in the Philippines has come a very long way. Folkloric use of herbal plants by our forefathers in the ancient times has been passed on from one generation to another. In the past few decades, interests into finding scientific evidence on these folkloric claims have instigated the conduct of basic and preclinical researches mostly done in colleges and universities. The government also showed some support by identifying and recommending at least 10 medicinal plants as beneficial for health. However, their use did not become popular due to questions in their claimed effectiveness for lack of scientific evidence. In the last decade, at least three herbal drugs came out of the market: Vitex negundo (lagundi) for cough and mild asthma, Momordica charantia (ampalaya) for diabetes and Blumea balsamifera (sambong) as chemolithiatic for kidney stones. The major breakthrough happened in 2012 when the “Tuklas Lunas” program was launch by the Department of Science and Technology (DOST). To date, 28 standardized herbal drugs have already been developed for clinical testing.
Article
There are several problems that continue to plague the Philippine health care system. The cost of branded drugs in the Philippines is 22 times more than international reference prices while generic drugs are 4 times more.1 Despite price reductions due to legislations such as the Cheaper Medicines Act of 2008, as well as the Generics Act of 1988, those in the lower-income brackets still cannot afford maintenance medicines for hypertension and diabetes as well as antibiotics.2 Access to medicines and care from physicians and other healthcare professionals is especially challenging for geographically isolated and disadvantaged areas wherein the people are physically or economically inaccessible. Filipino traditional medicine, of which herbal medicine plays a large role has been around for centuries and is wellaccepted in the rural areas. Validating the use of these traditional medicinal plants through research is essential in order to have an evidence-based practice of herbal medicine. The main areas of research can be defined as (1) herbal medicine quality and standardization, (2) preclinical pharmacological assessments and action mechanisms, and (3) clinical efficacy and safety assessments.3 These types of researches aimed at developing safe and efficacious, as well as low-cost Philippine herbal medicines, may well be a long-term solution to the obstacles to a healthy population cited above. Our Philippine medicinal plants are a valuable but often underappreciated resource with innumerable applications for non-communicable and communicable disease indications. Limited research in this field had long been ongoing in the Philippines. Support for this movement came with the passage of the Traditional and Alternative Medicine Act of 1997 which affirmed the commitment of the government towards the support and development of traditional medicine including herbal medicine.4 Another boost was the endorsement of the Department of Health of the Sampung Halamang Gamot in the 1990s.5 The World Health Organization has advocated the integration of Traditional Medicine within national health care systems and has urged governments to develop and implement national traditional medicine policies and programs especially with Universal Health Coverage.6 It was the National Integrated Research Program of the Philippines (NIRPROMP) who was at the forefront of this field and conducted the initial studies of these Ten Medicinal Plants.7 Many of them have been developed into modern formulations. These include Lagundi (Vitex negundo) tablet and syrup for cough and asthma, Sambong (Blumea balsamifera) tablet as a diuretic and treatment of urolithiasis, Tsaang gubat (Ehretia microphylla) tablet for gastrointestinal and biliary colic, Akapulco (Senna alata) lotion for cutaneous fungal infections, Yerba Buena (Mentha villosa) tablet as an analgesic, Ulasimang bato (Peperomia pellucida) tablet for the treatment of gout and hyperuricemia. Ampalaya (Momordica charantia) tablet was also developed as a glucose-lowering agent, but it is presently undergoing researches on the reformulated tablet.8 Several of the articles in this issue present evidence for the use of some of the mentioned medicinal plants. The NIRPROMP was the forerunner and is still an integral part of the Institute of Herbal Medicine. Lagundi and Sambong have been integrated into the clinical practice of physicians in the Philippines, even by specialists. They have both been scientific and commercial successes.9 Their production has contributed to the revenue and growth of the Philippine Pharmaceutical Industry, as well as improved the economic status of farmers cultivating these crops. Developing more herbal medicines needed for primary health care would decrease our dependence on the importation of medicines, and increase the accessibility of drugs even in geographically isolated areas. Bringing back the herbal medicine gardens to the barangays in the rural communities will also assist in empowering the population. The integration of herbal medicines into mainstream clinical practice will only be possible if the researches performed, both non-clinical and clinical, are as robust as those for synthetic medicine. Cecilia C. Maramba-Lazarte, MD Director Institute of Herbal Medicine National Institutes of Health University of the Philippines Manila REFERENCES 1. Paris J. Pharma Companies Offer to Cut Drug Prices [Internet] Rappler. 2019 25 October [cited 2020 Jan 15]. Available from https://www. rappler.com/nation/243372-pharmaceutical-companies-offer-cut-drug-prices. 2. Clarete RL, Llanto GM. 2017. Access to medicines in the Philippines: Overcoming the barriers [Internet]. Philippine Institute for Development Studies. 2017 [cited 2020 Jan 14]. Available from http://hdl.handle.net/11540/7967. 3. Zhang AL, Xue CC, Fong HH. Integration of Herbal Medicine into Evidence-Based Clinical Practice Current Status and Issues. In: Benzie IFF, Wachtel-Galor S, eds. Herbal Medicine: Biomolecular and Clinical Aspects, 2nd ed. Boca Raton (FL): CRC Press/Taylor & Francis; 2011. 4. Traditional and Alternative Medicine Act (TAMA) of 1997, Republic Act No. 8423, Approved: December 9, 1997. 5. World Health Organization. Report of the Working Group on Herbal Medicines Meeting, March 1997. 6. World Health Organization. WHO Traditional Medicine Strategy: 2014-2023. 7. Eusebio JE, Umali BE. Inventory, documentation and status of medicinal plants research in Philippines. In: Batugal PA, Kanniah J, Young LS, Oliver JT, editors. Medicinal plants research in Asia, Volume 1: The framework and project workplans. Selangor DE, Malaysia: International Plant Genetic Resource Institute-Regional office for Asia, the Pacific and Oceania (IPGRI-APO), Serdang; 2004. 8. Purificacion J, Maramba N. Research Proposal Phase 1 Clinical Trial: Safety and Efficacy of Lyophilized Momordica charantia (Ampalaya) leaf tablet among Normal Volunteer Subjects (2018 version). 9. From Herbal Folklore to Modern Medicine [Internet]. World Intellectual Property Organization. 2013 [cited 2020 Jan 14]. Available from https://www.wipo.int/ipadvantage/en/details.jsp?id=3661.
Article
The Philippine herbal drug industry has been increasing over the years with continued support from the government agencies such as the Department of Health (DOH) and from the different private sector. At present, the herbal market accounts for still only just 1% of the total drug trade. Urbanization in the different parts of the Philippines may also negatively impact the usage of herbal medication along with the increasing consumption of physician-prescribed synthetic drugs. This study aims to determine the preference of specific community members in the Philippines (NCR) toward the usage of herbal medications compared to synthetic drugs. A survey about preference toward herbal medications or synthetic drug was handed out to 50 members of communities in the surrounding cities of the National Capital Region. The study found out that only a small percentage of the respondent community members take herbal medications regularly, i.e., daily (12%), weekly (12%), monthly (2%). More respondents claimed they do not regularly take herbal medications, i.e., yearly (8%), less than once a year (28%), does not take (14%). Accessory information which the study sought includes the most commonly used herbal medication, age and gender preference, concurrent usage of herbal and synthetic drugs, frequency of consultation. The most common herbal medicines utilized by the sample community members are Lagundi (24%), Oregano (14%), and Sambong (14%), and the sample community members do not have adequate exposure to medical practitioners such as pharmacists regarding herbal medications (62%).
Article
A set of propositions is offered to provide a frame of reference for proposed strategies to improve healthful behavior by placing personal choice-making in the context of societal option-setting. The health status of populations at a given point in time is seen as a result of customary personal choice-making. These choices in turn are limited by both the perceived and actual options available to individuals, depending on their personal and their community's resources, from which to make choices. Most people, most of the time will make the easiest choices, i.e., will do the things, develop the patterns or life-styles, which seem to cost them less and/or from which they will gain more of what they value in tangible and/or intangible terms.
Primary health care evidence and its contribution to health outcomes in selected municipalities and cities in the Philippines
  • J A Filoteo
  • Dela Cruz
  • E O Guarino
Filoteo, J. A., Dela Cruz, E. O., & Guarino, R. A. (2019). Primary health care evidence and its contribution to health outcomes in selected municipalities and cities in the Philippines. Journal of public health policy and planning, 3(3), 40-55.
Reach Health Assessing Cost-Effectiveness for Family Planning (RACE-FP) methodology report: Estimating the impact of family planning interventions in the Philippines
  • K E L Grimes
  • A J Walter
  • A A Honeycutt
Grimes, K.E.L., Walter. A.J., & Honeycutt, A.A. (2022). Reach Health Assessing Cost-Effectiveness for Family Planning (RACE-FP) methodology report: Estimating the impact of family planning interventions in the Philippines. Research Triangle Park (NC): RTI Press. https://doi.org/10.3768/rtipress.2022.op.0072.2205
Unemployment rate in January 2023 is estimated at 4.8 percent: republic of the Philippines
  • C D Mapa
Mapa, C. D. (2023, March 9). Unemployment rate in January 2023 is estimated at 4.8 percent: republic of the Philippines. Philippine Statistics Authority.
Challenges of barangay health workers in advent of health care emergencies
  • J M M Mirano
Mirano, J.M.M. (2024). Challenges of barangay health workers in advent of health care emergencies. International Journal of Research Studies in Psychology, 10(1), 143-160.
Philippines 2022 Demographic and Health Survey
Philippine Statistics Authority (2022). Philippines 2022 Demographic and Health Survey. https://dhsprogram.com/pubs/pdf/SR276/SR276.pdf
Nearby primary care facilities inaccessible to half of PH population -DOH exec
  • C M Ramos
Ramos, C.M. (2021). Nearby primary care facilities inaccessible to half of PH population -DOH exec. Inquirer. https://newsinfo.inquirer.net/1425324/half-of-ph-population-stilldont-have-access-to-nearby-primary-care-facilities-official
Community health needs assessment of barangay Antipolo Old
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  • G E Pacer
Rivera, M. N., & Pacer, G. E. (2019). Community health needs assessment of barangay Antipolo Old, Nabua Camarines Sur. Letran Research Center, 13(4), 6-18.
No nearby health facility for half of Filipinos. Cable News Network Philippines
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Santos, E. (2021, April, 29). No nearby health facility for half of Filipinos. Cable News Network Philippines. https://www.cnnphilippines.com/news/2021/4/29/primaryhealth-care-facility-access-philippines.html
Benefits of primary health care
  • Y Smith
Smith, Y. (2019). Benefits of primary health care. News Medical Life Sciences. https://www.news-medical.net/health/Benefits-of-Primary-Health-Care.aspx
Number of health centers in the Philippines in 2022
  • Statista
Statista (2023). Number of health centers in the Philippines in 2022, by type of establishment. https://www.statista.com/statistics/1370697/ ISSN 3082-4583 (Print) 3082-4591 (Online) | 67