Openiano, M. S. R. (2017). Establishment of a barangay health referral system: A strategy to increase facility based delivery rate in Sapang Dalaga, Misamis Occidental (Unpublished master's thesis). Graduate School of Public and Development Management, Development Academy of the Philippines.

Graduate School of Public and Development Management Health Systems and Development Batch 7 Thesis (MPM-HSD)--Development Academy of the Philippines.

Maternal health services is a primary issue of the Municipality of Sapang Dalaga as evidenced by a low percentage if facility based delivery. For the past three years, there is decreasing trend in the percentage of facility based delivery rate, however there were no noted maternal mortalities in the municipality. Increasing the proportion of women who deliver in a health facility can be important means in maintaining zero mortality. Hence, this study aims to identify an intervention to increase the facility based delivery rate in the municipality. Document Analysis, Survey, Key Informant Interview, Focus Group Discussion and Direct Observation were employed to determine the factors associated with the low status of facility based delivery identify the current strategies to increase the facility based delivery rate its gaps and, determine an intervention to address those gaps. Results show that the low facility based delivery status is attributed to different factors and barriers such as transportation, distance, financial constraint, lack of education and appropriate knowledge regarding safe delivery and other social barriers. Gaps in the strategies to increase facility based delivery rate were identified and it reflects that there is a problem in the functionality and potential of the birthing facility to provide adequate coverage for maternal deliveries and there is a poor linkage between the pregnant mothers in the community to the healthcare providers in the facility. In response, an intervention was formulated by making adjustments in the health system control knobs financing, payment, organization, behavior and regulation. The Barangay Health Referral System was formulated to address the gaps in the strategies focusing on the engagement of the community resources such as the BHWs and TBAs, provision of transportation and communication, and provision of incentives. Analysis show that the implementation of the project showed an improvement on the rate that of facility based delivery. Analysis of the Client Satisfactory survey also showed that majority of pregnant mothers were very satisfied with the process and services given during referral from the barangay and admission to the birthing facility.