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. 2020 Sep 11;20(1):860.
doi: 10.1186/s12913-020-05699-0.

Connecting communities to primary care: a qualitative study on the roles, motivations and lived experiences of community health workers in the Philippines

Eunice Mallari  1 , Gideon Lasco  2 , Don Jervis Sayman  1 , Arianna Maever L Amit  1 , Dina Balabanova  3 , Martin McKee  3 , Jhaki Mendoza  1 , Lia Palileo-Villanueva  1 , Alicia Renedo  3 , Maureen Seguin  3 , Benjamin Palafox  4
Affiliations

Connecting communities to primary care: a qualitative study on the roles, motivations and lived experiences of community health workers in the Philippines

Eunice Mallari et al. BMC Health Serv Res. .

Abstract

Background: Community health workers (CHWs) are an important cadre of the primary health care (PHC) workforce in many low- and middle-income countries (LMICs). The Philippines was an early adopter of the CHW model for the delivery of PHC, launching the Barangay (village) Health Worker (BHW) programme in the early 1980s, yet little is known about the factors that motivate and sustain BHWs' largely voluntary involvement. This study aims to address this gap by examining the lived experiences and roles of BHWs in urban and rural sites in the Philippines.

Methods: This cross-sectional qualitative study draws on 23 semi-structured interviews held with BHWs from barangays in Valenzuela City (urban) and Quezon province (rural). A mixed inductive/ deductive approach was taken to generate themes, which were interpreted according to a theoretical framework of community mobilisation to understand how characteristics of the social context in which the BHW programme operates act as facilitators or barriers for community members to volunteer as BHWs.

Results: Interviewees identified a range of motivating factors to seek and sustain their BHW roles, including a variety of financial and non-financial incentives, gaining technical knowledge and skill, improving the health and wellbeing of community members, and increasing one's social position. Furthermore, ensuring BHWs have adequate support and resources (e.g. allowances, medicine stocks) to execute their duties, and can contribute to decisions on their role in delivering community health services could increase both community participation and the overall impact of the BHW programme.

Conclusions: These findings underscore the importance of the symbolic, material and relational factors that influence community members to participate in CHW programmes. The lessons drawn could help to improve the impact and sustainability of similar programmes in other parts of the Philippines and that are currently being developed or strengthened in other LMICs.

Keywords: Community health workers; Health systems; Human resources for health; Philippines; Primary health care.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Timeline on the development of the Barangay Health Worker role in the Philippines (1978–2020). This figure illustrates the key events related to the introduction and developing role of Barangay Health Workers in the Philippines, since their introduction in the late 1970s to the present day. BHW Barangay Health Worker; CHW community health worker; LGU local government unit; NCD non-communicable disease; NGO non-governmental organisation; PHC primary health care
See this image and copyright information in PMC

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