Staffing and workload in primary care facilities of selected geographically isolated and disadvantaged communities in the Philippines

@#<strong>BACKGROUND AND OBJECTIVE</strong><p style="text-align: justify;" data-mce-style="text-align: justify;">Staffing shortages and health inequities are persistent barriers in the Philippines toward achieving universal health care. To ensure an adequate and responsive health workforce, there is a need to evaluate the Human Resources for Health (HRH) status across health facilities, particularly those in underserved communities. Hence, this study aims to determine the staffing requirements and workload pressure among primary care facilities in selected geographically isolated and disadvantaged areas (GIDAs) in the Philippines.</p><strong>METHODS</strong><p style="text-align: justify;" data-mce-style="text-align: justify;">The study utilized the workload indicators of staffing need (WISN) methodology from the World Health Organization to determine the staffing and workload situation among three health worker cadres (physicians, nurses, and midwives) in the study sites. Particularly, six primary care facilities (four rural health units and two community hospitals) located in Surigao del Norte were involved in the study. WISN-related data (health service statistics, available working time, and health professionals’ workload components) were collected through records review, focus group discussions, and key informant interviews. The WISN software was used to analyze the staffing levels and workload pressure in the selected facilities.</p><strong>RESULTS</strong><p style="text-align: justify;" data-mce-style="text-align: justify;">A total of 40 health workers, including physicians (n = 5, 13%), nurses (n = 21, 52%), and midwives (n = 14, 35%) participated in the study. The findings noted varying levels of staffing and workload pressures among the three cadres in selected primary care facilities, which were influenced by several factors. Particularly, health facilities with additional human resources obtained from deployment programs indicated adequate staffing and low to normal workload pressures. However, further analysis revealed potential HRH maldistribution and reliance on the temporary nature of the staff augmentation program in delivering primary care services, which need to be addressed to optimize health workforce planning. Service workload may also have been impacted by the temporary closure of health facilities due to disasters. Among the few cadres tha reported staffing shortage and high workload pressure, these were due to higher service demands, increased task delegation, and inadequate service coordination. Hence, context-specific challenges and situational factors in GIDAs need to be considered when determining the staffing and workload requirements.</p><strong>CONCLUSION</strong><p style="text-align: justify;" data-mce-style="text-align: justify;">There is a need to improve the capacities of health facilities and local government units (LGUs) to engage in evidence-based HRH planning through the WISN methodology. Doing so could improve staffing and workload distribution among health care facilities in the country. Moreover, interorganizational collaboration (DOH, LGUs, and health facilities) should be strengthened to improve delineation and prevent duplication/omission of health services, rationalize HRH distribution and augmentation, and streamline the priority health services based on the local contextual factors.</p>

Perceived competencies and training needs of public health nurses in the Philippines: Basis for the development of NurseLEAD: A leadership course on advanced practice nursing in public health

@#<strong>BACKGROUND AND OBJECTIVE</strong><p style="text-align: justify;" data-mce-style="text-align: justify;">Public health nurses (PHNs) perform more than the provision of direct care to clients. They are also expected to perform roles as leaders, managers, and collaborators in different settings, especially in areas where there are no physicians. Their continuous professional development must be facilitated to empower them to lead the delivery of health programs and services in pursuit of universal healthcare. This study aims to determine the perceived competencies of public health nurses and describe their training needs.</p><strong>METHODS</strong><p style="text-align: justify;" data-mce-style="text-align: justify;">A descriptive, cross-sectional study was utilized, where an online survey was administered to PHNs across the Philippines to determine their self-perceived competencies and training needs based on the eight domains of core competencies of public health professionals. Descriptive statistics was used to summarize the data.</p><strong>RESULTS</strong><p style="text-align: justify;" data-mce-style="text-align: justify;">A total of 330 PHNs answered the survey. The results showed that at baseline, PHNs perceived themselves to be competent (from most to least) in the following: communication, analytical/assessment, community dimensions of practice, policy development/ program planning, leadership and systems thinking, cultural competency skills, public health science, and financial planning and management. In terms of training needs, the enablers mentioned include a supportive work environment that can provide a work schedule that is inclusive of time for professional development and work-life balance; a learning environment where colleagues and supervisors support the need for training and innovation; strong internet connection; and enough equipment to participate and submit deliverables for courses taken.</p><strong>CONCLUSION</strong><p style="text-align: justify;" data-mce-style="text-align: justify;">Filipino public health nurses perceived themselves to be competent in the areas of communication and community practice, but less competent in public health science, and financial planning and management. Future capacity-building programs must be designed to meet this demand. Furthermore, to make training programs truly responsive to the needs of nurses, steps must be taken to promote capacity-building enablers.</p>

Normalizing advanced practice in public health nursing in The Philippines: A foucauldian analysis

@#<p style="text-align: justify;">This study provides a closer look to the possibility of having advanced practice in public health nursing by analyzing the power relations between nursing practice and social structures. Representatives from the public health sector, national authorities, and the private sector were invited in a round table discussion. Transcriptions were coded and later on categorized and analyzed drawing upon the concepts of Foucault. Foucauldian analysis hands an important insight on how social structures and institutions can steer the creation of an advanced practice in public health nursing in the Philippines. Various social institutions view the relevance of a master's prepared nurse according to their societal roles and functions. Requisite competencies of a master's prepared nurse in public health nursing include fulfilling the role of a clinician, leader and manager, supervisor, and a researcher. PRBON, CHED, DOH, and nursing schools need to work together to define the knowledge of an advanced practice in public health nursing, to implement appropriate surveillance mechanisms, and to establish a compliant practice.</p>

Capacity needs assessment of primary health care providers in selected municipalities in Cavite

PURPOSE@#Primary Health Care (PHC) refers to essential health care that is made accessible, acceptable and affordable to individuals and families in the community. As such, it is imperative for PHC providers to possess the necessary competencies responsive to the current health care demands. This study aims to determine the current capacity of PHC providers and their need for capability building.@*METHODS@#The study employed a quantitative descriptive design with 87 purposively-selected PHC providers and five administrators from selected rural municipalities in Cavite. It is adapted from the study, “Capacity-building of primary healthcare providers in 10+3 Southeast and East Asian Nursing Education and Research Network (SEANERN) countries”.@*RESULTS AND DISCUSSIONS@#The perceived level of knowledge of the PHC providers on the elements of PHC were all rated to be proficient. Maternal and child care received the highest score, while health education received the lowest score. The perceived level of skills of the PHC providers was also rated to be proficient. Sanitation and water received the highest score, while treatment of common diseases and injuries received the lowest score. Similar to the perceived levels of knowledge and skills, the perceived level of attitudes of the PHC providers were also proficient, with environmental sanitation having the highest score but treatment of common diseases and injuries having the lowest score. However, from the perspective of health administrators, they rated the PHC providers one level lower or needs minimal support. Training and capacity building in all elements of PHC was identified as the most needed by the PHC providers. Their most preferred method of training is workshop.@*CONCLUSIONS@#There are high perceived levels of knowledge, skills, and attitudes of the PHC providers in the elements of PHC. Despite the high scores, objective outcomes such as the MMR and immunization coverage do not reflect the proficient scores of the PHC providers. There are also other health conditions and issues such as noncommunicable diseases and injuries that need to be addressed using PHC approach. Given this, it is vital that appropriate training and adequate hiring of PHC providers be reinforced nationwide in order to meet the health goals and needs of the country.

Work environment of nurses in the Philippines: A preliminary study

@#<p style="text-align: justify;">Work environment has been described as an important factor in the job satisfaction of nurses and their quality of service provided. However, little is known of the present work environment of Filipino nurses in the country. This study used a cross-sectional design to describe work environment variables affecting Filipino nurses; determine the degree of nurses' job satisfaction;, and determine their intention to remain in their present work environment. A self-administered survey was developed by the study team and was distributed during the PNA national conference   through the Chapter Presidents. This   study discovered   that the lowest positive responses were in the Physiologic  and  Safety  Needs  but  despite  this  result,  nurses  reported  high  job satisfaction and intend to remain in their present work environment.</p>