ABSTRACT
Background: Basic healthcare in the Philippines is provided via rural healthcare clinics (RHC) located in barangays and supervised by provincial health centers. These RHC are the cornerstone of the country's public health system and were designed to promote and prevent disease through basic healthcare services and education. However, RHC became nonfunctional during the COVID pandemic leaving the community without the resources necessary to address the acute problems associated with COVID and chronic conditions. Given the crucial role of RHC in disease prevention and control, identifying barriers to providing its services and programs is warranted. Aims: The purpose of this qualitative study was to explore multilevel barriers to the provision of healthcare services and education in RHC. Methods: We used a qualitative approach and the socioecological model as a framework to investigate the multilevel barriers affecting resource access at RHC. Four public health nurses and fifteen community healthcare workers (CHW) from five RHC across the country participated in individual interviews and group discussions. Traditional content analysis was used to examine the data. Results: Findings revealed barriers at the individual (insufficient motivation, incorrect beliefs), interpersonal (insufficient ability of CHW to provide services, and lack of training, unrealistic expectations, and lack of supervision and monitoring of CHW), organizational (excessive workload for CHW, lack of resources, inadequacy of evaluation and monitoring of CHW), community (lack of trust in CHW by people, lack of motivation to seek healthcare, continued belief in traditional healers), and policy (lack of financial support for RHC, lack of an organized system to meet community needs) levels. Conclusion: Examining individual, interpersonal, community, and policy level determinants that affect RHC can inform community-based health promotion interventions for the country's rural communities. Given the multidimensional barriers identified, it is recommended that a comprehensive program be developed and implemented in collaboration with licensed healthcare providers, CHW, district and regional healthcare department representatives, and healthcare policymakers.