A health care delivery system, or healthcare system, is the organization of people, institutions, and resources that deliver health care services to meet the health needs of target populations (Williams-Tungpalan, 1981). This system’s effectivity and efficiency may be directly or indirectly affected by factors which could vary from the geographical location, financial capabilities of the people, attitudes and beliefs of the people, lack of initiative in the utilization of resources available, and even political support. These factors may contribute to the inadequacy of the system thus bringing about difficulty in ensuring health in the community and even worsening of existing condition if present.
Improving access to public health services is a fundamental goal of the Philippines’ health system. Public health in the Philippines consists of programme packages for the prevention, management and control of diseases, as well as the promotion and protection of health. To ensure access, these health program packages have been adapted to the various levels of health care delivery (from community-based to tertiary level facilities), to various population groups (mothers and infants, children and adolescents, adults and older persons), and to specific diseases (tuberculosis, malaria, cardiovascular diseases, cancer) (DOH, 2005). These programs are conducted in Barangay Manguiles. However, the services are not accessed by a percentage of the population due to lack of resources to carry out these programs, information drive on the importance of these programs and even manpower to carry out these programs.
Also, to be able to work, a health care delivery system must consist of facilities with adequate equipments that are made available to the population and manpower with adequate training available to render services. In Barangay Manguiles, the Barangay Hall is considered to be the existing structure for a Barangay Health Station. However, the midwife’s visit schedule in the area is only once a month leaving the station non-functional for most of the days within the month, except if there are special activities to be done which are not on regular basis. The Barangay Nutrition Scholar and Barangay Health Workers do not stay in the station because they do not have the necessary equipment, trainings nor a concrete plan on how to make the station functional all the days of the week or even in an emergency situations such as vehicular accidents. Referral system is also a problem in times of emergency. With these problems, the community people tend to resort to self-medicating practices leading to poor health seeking behavior because they already got used to it. In addition to this, the barangay is approximately 20 kilometers away from the Regional Health Unit of Mahayag and 14.8 km from the Health Center found in the neighboring municipality, Dumingag. Because of the long distance of travel via a motorcycle they have to spend much for the fare which makes it more difficult because of their low income.
For the pre-operation phase at the current situation, focus will be mainly on the assessment, presentation of the problem to various organizations and key personnel’s at the barangay, generating ideas with them in solving the issues, coordinating with the proper agencies concerned and activities aimed at program planning, conduction and sustenance.
After the identification of the root cause of the health issue our next proposal is the formation of a community health teams that would be responsible on spearheading the planned projects. Our next proposal to the community health team is to provide them with adequate trainings to be able to have the necessary knowledge and skills in providing the health care services needed. Along with this trainings are efforts to be able to acquire necessary equipment in rendering services to the population. Finally, a proposal for a better referral scheme for service delivery network of facilities of the barangay would be presented for better partnership of the Barangay Health Station and the Regional Health Unit in Mahayag as well as the Health Center in Dumingag.
Another proposal is proper information drive and health teaching that would eliminate cultural/traditional barriers through focused group discussions with them that could include increasing their knowledge regarding the advantages of proper health seeking behaviors as well as existing DOH programs and services available in the Regional Health Unit. Next is the proposal for better accessibility of health care services to help address the physical barriers that results to high incidence of poor health seeking behaviors. These includes the proposal for improvement scheduled service from their existing barangay truck for better transportation.
Sustainability of the proposed solutions will be obtained through formation of community health teams that would spearhead the initiated projects, monitor the results of these strategies and innovate for better outcomes and healthcare provision. Monthly report will be submitted to the barangay health center for record keeping and progress report will be done to help in assessing the community’s performance. In addition to this, a better scheme of referral and recording of cases would be proposed and monitored by the community health teams.
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