Scaling up primary health care in the Philippines: Lessons from a systematic review of experiences of community-based health programs

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> In view of renewed interest in primary health care (PHC) as a framework for health system development, there is a need to revisit how successful community health programs implemented the PHC approach, and what factors should be considered to scale up its implementation in order to sustainably attain ideal community health outcomes in the Philippines.</p><p style="text-align: justify;"><strong>OBJECTIVE AND METHODOLOGY:</strong> Using the 2008 World Health Report PHC reform categories as analytical framework, this systematic review aimed to glean lessons from experiences in implementing PHC that may help improve the functioning of the current decentralized community-level health system in the country, by analyzing gathered evidence on how primary health care evolved in the country and how community health programs in the Philippines were shaped by the PHC approach.</p><p style="text-align: justify;"><b>RESULTS:</b> Nineteen (19) articles were gathered, 15 of which documented service delivery reforms, two (2) on universal coverage reforms, three (3) on leadership reform, and one (1) on public policy. The literature described how successful PHC efforts centered on community participation and empowerment, thus pinpointing how community empowerment still needs to be included in national public health thrusts, amid the current emphasis on performance indicators to evaluate the success of health programs.</p><p style="text-align: justify;"><strong>CONCLUSION AND RECOMMENDATIONS:</strong> The studies included in the review emphasize the need for national level public health interventions to be targeted to community health and social determinants of health as well as individual health. Metrics for community empowerment should be developed and implemented by government towards sustainable health and development, while ensuring scientific validity of community health interventions.</p>

Community-managed health programs for better health outcomes: Preliminary results of a community participatory research in Murcia and Isabel, Negros Occidental, Philippines

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Community-managed health programs (CMHPs) were designed to promote community self-determination in addressing health needs, but there is a need to evaluate how CMHPs can lead to better outcomes while accommodating changes in the national health system, which requires analysis of current CMHP interventions, institutional and community readiness, and points of interface with other health facilities.</p><p style="text-align: justify;"><strong>OBJECTIVE AND METHODS:</strong> This preliminary study aimed to guide an eventual effort to develop a framework to ensure CMHPs sustainably improve health outcomes. A preliminary analysis of results from a community participatory research was done in which baseline health characteristics, related social determinants, level of involvement of CMHPs with the local government health system, and quality of life were documented through surveys, focus group discussions and key informant interviews, both in a community with an established CMHP (Murcia, Negros Occidental, Philippines), and a control area without a similar NGO sector (Isabela, Negros Occidental).</p><p style="text-align: justify;"><strong>RESULTS:</strong> There was higher NGO and local government involvement among respondents in Murcia, use of traditional medicine, and sense of awareness of the need to improve the water quality in Murcia, with noted persistence of sanitation concerns, pinpointing the need to assess community participation and the efficiency of CMHPs.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> Further study is needed in measuring community participation while considering its underlying cultural and socioeconomic contexts, in order to facilitate planning and implementation of strategies that intend to address community-recognized health needs while sustainably improving health outcomes.</p>