Effect of a brief training program on the knowledge of Filipino primary care providers in a rural and a remote setting: A before and after study

Background and Objective@#Primary care providers are key players in providing quality care to patients and advancing Universal Health Care (UHC). However, effective and quality healthcare delivery may be affected by inadequate knowledge and failure to adhere to evidence-based guidelines among providers. The Philippine Primary Care Studies (PPCS) is a five-year program that pilot tested interventions aimed at strengthening the primary care system in the country. Evidence-based training modules for healthcare providers were administered in Sorsogon and Bataan from the years 2018 to 2021. Module topics were selected based on common health conditions encountered by providers in rural and remote settings. This program aimed to evaluate the effectiveness of training in increasing provider knowledge.@*Methods@#A series of training workshops were conducted among 184 remote- and 210 rural-based primary care providers [nurses, midwives, barangay or village health workers (BHWs)]. They covered four modules: essential intrapartum and newborn care (EINC), integrated management of childhood illness (IMCI), non-communicable diseases (NCD), and geriatrics. A decision support system (UpToDate) was provided as a supplementary resource for all participants. We administered pre-tests and post-tests consisting of multiple-choice questions on common health conditions. Data was analyzed using paired one-tailed t-test, with an alpha of 0.05.@*Results@#The knowledge of nurses, midwives, and BHWs improved after the training workshops were conducted. The largest increase from pre-test to post-test scores were observed among the midwives, with a mean difference (MD) of 32.9% (95% CI 23.9 to 41.9) on the EINC module, MD of 25.0% (95% CI 16.6 to 33.4) in the geriatrics module, and MD of 13.5% (95% CI 6.9 to 20.1) in the NCDs module. The nurses had the greatest improvement in the IMCI module (MD 10.8%, 95% CI 2.5 to 19.1). The knowledge of BHWs improved in all participated modules, with greatest improvement in the NCD module (MD 9.0%, 95% CI 5.77 to 12.14). @*Conclusions@#Primary care workshops, even if conducted as single-sessions and on a short-term basis, are effective in improving short-term knowledge of providers. However, this may not translate to long-term knowledge and application in practice. Furthermore, comparisons across provider categories cannot be made as participant composition for each training workshop varied. Ultimately, this study shows enhancing provider knowledge and competence in primary care will therefore require regular and diverse learning interventions and access to clinical decision support tools.

Vocal acoustic measures of asymptomatic Filipino young adults at a private tertiary hospital in Quezon City - A pilot study

Objective@#To describe the vocal acoustic measures of nonsmoking Filipino young adults without voice complaints at a private tertiary hospital in Quezon City; to determine if our baseline values are distributed normally and comparable to data in similar studies done abroad; and to recommend normative voice parameters which may be used as baseline data in our institution and for comparison in future studies.@*Methods@#Design: Cross-sectional study Setting: Private tertiary hospital Participants: A total of 70 subjects were recruited at random.@*Results@#Values extracted for f0, Jitter %, Jitter dB, Shimmer %, Shimmer dB and NHR showed normal distribution of results. The average vocal acoustic values found in the present study for male voices producing the vowel /a/ were fo = 130.6 ± 13.65Hz, jitter = 0.0.46 % ± 0.184, jitter dB: 37.62dB ± 16.664, shimmer %= 0.23%, shimmer dB=0.23 ± 0.67 and NHR = 0.13 ± 0.010. The average values found for female voices, producing the vowel /a/ were fo = 218.38 ± 26.192Hz, jitter = 0.87% ± 0.61, jitter dB: 34.82 ± 22.5, shimmer %= 2.72 ± 1.07 shimmer dB=0.23db ± 0.67 and NHR = 0.12dB ± 0.016. Values retrieved from this study show similar trends with other papers abroad.@*Conclusions@#Voice acoustic systems are composed of different recording criteria, recording instrumentations and algorithms which primarily cause the differences in the results obtained in various studies, thus precluding a single normalization. Following international recommendations for individual normalization per institution, we have obtained our own values. Our data was comparable to the results of other international studies. However further investigation is recommended in areas where possibilities of interdialectic variation may produce an effect on the outcome of the study.