Developing the community health team navigators model in improving the management of barangay health workers in San Sebastian, Samar /
Albert M. Ong, Jr.
- xi, 92 leaves : illustrations (some color), map
Graduate School of Public and Development Management.
Community health workers (CHWs) are considered efficient and effective way of improving the health outcomes in a community, yet strategies that employ the use of them become unsustainable despite policies institutionalized towards them. In the Philippines, barangay health workers are heavily subject to politicking, affecting their organizational structure, selection, recruitment, and provision of incentives. Recently, a set of community health workers was employed to monitor select families under the National Household Targeting System to improve their access to the formal health care sector. the structured task, different source of monetary compensation, and their organizational structure, notably their retention, different from the BHWs provided another model for CHWs management. A recently introduced framework for CHW management, the 5-SPICE framework, served as a guide for the interventions. Starting September 2013, all trainings conducted for CHWs invited CHT navigators exclusively. Retention was strictly observed even after the October 28, 2013 barangay elections. Some incentives were legislated exclusively for CHT navigators. Incentives from the national government were also released thrice during this period. CHT navigators were also tapped to conduct health programs during barangay visits. At the end of one year, focus group discussion were done on CHT navigators, barangay captains, and health staff to assess the said policy by the municipal health office. The study found out that while retention and maximization of investment train the CHWs is important for public health managers, supervision and education is the most important motivators for the CHT navigators. Retention is acceptable for the barangay captains as long as this does not usurp their power to appoint BHWs, which they usually deem as political and financial reward to their supporters, suggesting a municipal policy independent from barangay wherein they may or may not cooperate. Retention also made it easier to the health staff to train CHT navigators on new skills and delegate new tasks since they are already used to the health-related duties and skills. The study also noted that retention should not be the end goal, but there should be a way to enrich the CHWs ability through a proper management among them, in the context of the 5-SPICE framework used as a guide in this study. The current CHT navigator framework is a possible template for future models. Further concrete models on CHW management is recommended to be formulated and tested.
Community health workers. Health care. Public health.