NEEDS ASSESSMENT OF BARANGAY HEALTH WORKERS (BHWs) IN

DELIVERING HEALTH CARE PROVISIONS IN BARANGAY DAWIS, DIGOS

CITY, PHILIPPINES

PROF. DENNIS JOHN F. SUMAYLO

Assistant Professor 1, Department of Humanities
College of Humanities and Social Sciences
University of the Philippines Mindanao

MS. MA. TERESA R. ESCANO, Instructor 7

MR. DOYLE FELIX T. ABRIO, Instructor 1
College of Humanities and Social Sciences
University of the Philippines Mindanao

ABSTRACT

It is the objective of this paper to document the needs of Barangay Health Workers in the
provision of health care program of the Department of Health in the Philippines. Furthermore, this paper
also documents the current communication tools used by the BHWs for both internal and external publics
of the Barangay Health Center to provide justifications of the needs of the BHWs in the provision of health
care programs.

Provided with the current framework of operation, the top-down model of communication is
widely implemented rendering all directives and communication are from the Department of Health
Central Office. The Central Office also provides a Manual on Interpersonal Communication and Counseling
as basis for the BHWs in implementing various health care programs. However, this method is linear in
nature and not transactional which is what health communication should be.

In the implementation of various health care programs in the barangay level in the Philippines, it
must be noted that inputs from those familiar with the locale and the people are important for a
successful communication flow. A transition from top-down to bottom-up communication is necessary in
situation where the focus of information is based on the needs of a community. This communication
system stresses the importance of empowerment of BHWs in event organization, strategic
communication planning and message development, and highlighting transactional communication in the
process.

The Barangay Health Workers (BHWs) need to come up with their own strategies in delivering
health care provisions to their clients/patients is a clear indication of this. This communication flow
provides top organization personnel with ideas/feedbacks from those working at the grass-roots level.

Keywords

Interpersonal Communication and Counseling, Health Communication, Health Promotion – Methods,

Health Service Accessibility, Public Relations, Transactional Communication, and Development
Communication

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I. INTRODUCTION
The systemic flow of communication in
the provision of health care services in the
Philippines starts with the Department of Health
(DOH) Central Office down to its Regional Offices.
From the Regional Offices, the
information/directives are passed on to the
Provincial and City Health Offices under each
region and then down to the Barangay Health
Centers (BHCs) manned by a government-paid
midwife and volunteer residents called Barangay
Health Workers (BHWs).
This system is known as top-down system
of communication. The inversion of the process
follows when information/data is submitted from
the grass-roots level of implementation of health
care provisions to the DOH Central Office. Given
this particular organizational structure and flow of
information, it is assumed that communication
breakdown may occur in any of the channels
involved.
This paper then documents the
communication tools used in this kind of
communication situation and further identifies the
needs of the implementers of health care
provisions in the grass-roots level. This involves
the volunteer residents or BHWs since most of the
data will emanate from them.
This paper also tries to present a needs
assessment base on a specific case in Barangay
Dawis, Digos City, Philippines in the form of
surveys and interviews of all fourteen BHWs in the
barangay.
Furthermore, this paper enumerates
variables that are deemed important by the BHWs
in a specific area of study. Its main purpose is to
document the needs of the implementers rather
than generalize.
II. BARANGAY DAWIS
Figure 1: Map of Barangay Dawis
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Barangay Dawis is home to people coming
from different cultures. The place was originally
inhabited by the Indigenous People called Calagan
before other settlers came. It is a coastal area
facing Davao Gulf. Its northern boundary is
Barangay Aplaya, Digos City while the southern
boundary is the Municipality of Hagonoy in Davao
del Sur. Living near a body of water is a common
trait of the Calagans in other parts of Mindanao.
Most of the residents are Catholics and the source
of livelihood is fishing. Since the area of study is a
coastal area, it is expected that there are resorts
and inns as well.
Barangay Dawis is called Lawis by the IP
(Indigenous People) group Calagan which means a
body of water that has no outlet. It has a total land
area of 175 hectares which is divided into
residential and commercial lots. The Barangay is
divided into nine puroks with 899 households. As
of 2007, the total population of the Barangay is
3,884.
The first inhabitants of the Barangay are
the Calagans but Dawis, as it progressed into a
commercial area with beach resorts and apartelles
as major businesses, became a melting pot of
several other local cultures which resulted to its
having several dialects (B’laan, Tagakaulo, Bagobo,
Muslim, Cebuano, Bol-anon, etc) spoken in the
area.
Currently, the barangay has 899
households divided into nine puroks. Each purok
has several households as follows and serviced by
14 BHWs:
Purok Number of Household
Bangus 145
Tanguigue 156
Maya-Maya 119
Talakitok 156
Bariles 32
Barongoy 47
Lapu-lapu 64
Kitong 124
Bolinao 56
Total 899
Table 1: Number of Households
III. RESULTS
This paper documents the needs of
Barangay Health Workers in delivering health care
provisions from the government focusing on
communication tools intended for both internal
and external publics of the Barangay Health In the survey conducted, respondents
Center. This involves inter-agency communication were asked to identify the various communication
and communication within the Barangay Health tools used in delivering health care provisions to
Center and communication between BHWs and clients/patients and communicate with the City
clients/patients. It is also necessary to establish Health Office. Each respondent was allowed to
the common health problems in the area to know choose more than one tool to properly document
if these are properly addressed by the the commonly used tools in these communication
communication tools used. scenarios.
Table
2 : Disease Frequency Percentage
The commonly used communication tool
Com High Blood 13 92.86
Pressure
between the Barangay Health Center and the City
mon
Tuberculosis 13 92.86 Health Office is monthly reports. Every month, the
Disea
Malnutrition 13 92.86 Barangay Health Center, through its head, receives
ses in
Baran Diabetes 4 28.57 monthly reports of the activities and projects of
gay Skin Diseases 3 21.43 the City Health Office. Meetings ranked second.
Dawis Dengue 2 14.29
, Hepatitis 2 14.29 On the other hand, Face-to-Face
Digos Interaction is common between Barangay Health
City Center and the Barangay as Local Government
Unit. This is attributed to proxemics. The Barangay
Each of the 14 respondents was asked to Health Center is located at the Barangay Hall. The
identify the common diseases in the Barangay. office of the Barangay Captain is directly above the
Majority of them answered Tuberculosis and Barangay Health Center, which is located at the
Hypertension as the most common diseases first floor of the building. Sending memoranda is
among the adults while Malnutrition is common not necessary because the Barangay Health Center
among children. This data is necessary to establish is under the City Health Office and most of the
the problems in the area and the tools used to communication through memos is coming from
address these problems. The data in Table 2 is the mother organization.
useful in the process of understanding the
strength of the communication tools and the need It should also be noted that some of the
of the BHWs in crafting these tools. respondents answered text messaging as an
alternative way of sending information. They rely
Base on initial studies, the following on technology depending on the urgency of the
communication tools were used in communicating message.
with the City Health Office (CHO) and the
Department of Health Region 11 (DOH-RXI) and in Meetings and face-to-face interactions
delivering health care services to clients/patients are common when communication is within the
in the area: Barangay Health Center. This means
communication situations involving the midwife
Communication Communication Tools and the BHWs.
Situation
Communication Memoranda, Monthly
Table 4 summarizes the commonly used
within the Reports, Semi-Annual
Barangay Health Reports, Annual
tools in communicating within and outside the
Center and other Reports, Face-to-Face Barangay Health Center.
Agencies Interaction, Meetings
Communication Flyers, Leaflets, Communication
Organization
between Posters, Brochures, Tools
Clients/Patients Fact Sheets, Public City Health Office Monthly Reports
Service Face-to-Face
Announcements, Face- Barangay (LGU)
Interaction
to-Face Interaction, Face-to-Face
Text Messaging Barangay Health Worker
Interaction
Table 3 : Communication Tools used by BHWs with the Table 4 : Effectiveness of Handling Information Per
System of Communication Organization

[43]
 Within the parameters of the system’s Communication and Counseling, but in other
framework of operation, as shown in Table 5, communication tools as well.
85.71% or 12 respondents said that the framework
of operation does not affect the delivery of the There is only one computer in the
message while 14.29% or 2 respondents said that Assistance Needed Modal Rank Importance
st
it is affected by the framework. Event planning 1 1
nd
Strategic 2 2
Responses Frequency Percentage Communication
Yes 2 14.29 Planning
rd
No 12 85.71 Message 3 3
Table 5 : Effect of the System’s Framework of Operation Development
th
to the Communication Process Audience Selection 4 4
th
Public Speaking 4 4
th
Despite this belief that the Framework of Media Relations 5 6
th
Operation does not necessarily affect the Materials 7 7
Development
communication process, BHWs still encounter th
Public Service 9 8
problems, which include delays of notices in
Announcements
program implementation, the inability to organize Internet Outreach 9 8
th

programs and conduct their own activities, and Advertising 10 10

th

information lag from the City Health Office.
It is understood that there are some
projects conceptualized by the Barangay Health
Workers specifically designed for the immediate
community that could be put on hold or worst,
trashed. This is attributed to the framework of
operation wherein all activities of the Barangay
Health Center require approval from the City
Health Office. The implication of this problem is
that there is a greater possibility that in due time
and because of immediate need, the Barangay
Health Center will conduct an activity without the
approval of the City Health Office.
However, in an interview with Mary
Divene C. Hilario, RN, MPH, the officer in charge of
the Health Advocacy and Promotion Unit of the
Department of Health Region XI, she emphasized
that Barangay Health Centers can actually come up
with their own communication tools without
approval from the City Health Office nor the
Regional Office provided that it follows the DOH
Guidelines.
This particular situation is an example of a
communication breakdown.
Therefore, it is appropriate to look at the
capacity of the 14 Barangay Health Workers in
terms of designing communication tools. To them,
lack of training in designing communication tools is
a major problem followed by lack of resources.
This further emphasizes the need of the BHWs to
gain more skills not just in Interpersonal
Barangay and it is not owned by the Barangay
Health Center. Moreover, only eight of the BHWs
have access it. Also, the respondents answered
that they need training in using the Internet and
designing communication tools.
Table 6 : Assistance Needed
Table 6 shows the kind of assistance the
Barangay Health Workers need to improve their
delivery of health services. Event Planning ranks
first in terms of importance followed by Strategic
Communication Planning and Message
Development. Event Planning involves organizing
effective events while Strategic Communications
Planning involves developing and implementing a
targeted communications blueprint for the
organization. Message Development, on the other
hand, means figuring out what to say for an
intended audience.
Event planning ranks first because most
of the time, the Barangay Health Center organizes
community meetings and consultations. These
community meetings and consultations require a
strategic communication plan and a specific
message before its implementation. The modal
ranking of the assistance needed coincides with
this model.
IV. IMPLICATIONS
Given the current framework of
operation, BHWs are still equipped with the basic
knowledge in delivering health care provisions in

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their assigned areas since the City Health Office
has trained these volunteers in Interpersonal
Communication and Counseling (IPC/C).
Furthermore, Hilario also emphasized the
importance of delivering correct medical
information to their clients/patients.
Given this, the IPC/C Manual from the
Department of Health Central Office focuses only
on factual information in delivering health care
provisions. The manual’s way of monitoring is very
clinical in nature relying on statistics as sole
measurement of success in any health care
program of the government. The same set of
statistics is often used to generalize.
However, these volunteers take their
tasks beyond the statistics it can provide. They
want to be able to come up with their own
strategies in delivering health care provisions to
their clients/patients. Despite the problems
identified with this kind of framework of
operation, these volunteers still believe that it is
still a good operational framework. As Max
Weber’s Theory of Bureaucracy explains, the best
way to manage the complexity of an organization
compose of individuals with one aim is to come up
with three basic rules - authority, specialization,
and rules. (Littlejohn, 2008) According to this
theory, the BHWs are considered legitimate
authorities since the City Health Office formally
authorizes them. Furthermore, in this framework
of operation, people are categorized according to
what they can contribute in achieving the goal
thus creating specializations. The BHWs specializes
in the grass-root implementation of various health
care programs of the government since they are
the ones familiar with the locale and the people.
Lastly, the BHWs follow the same set of rules and
guidelines coming from the Department of Health
Central Office.
The simplicity of Weber’s Theory of
Bureaucracy is not enough to document the on
site implementation of various health care
programs. The Cybernetic Tradition of Karl Weick
as cited in Littlejohn (2008) explains the BHWs
situation in a detailed way. According to Weick as
cited an Littlejohn (2008), an “interaction that
forms an organization consist of an Act, or a
statement or behavior of an individual…an Interact
that involves an act followed by a response…and a
Double Interact that consists of an act followed by
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a response and then an adjustment or follow-up by
the person who first acted.”
There is a need to go beyond statistics in
the implementation of health care programs in the
grass-roots level. Andres (1988) highlighted the
fact that trainers/facilitators/community leaders
should go beyond information dissemination and
statistics. As Hovland (2007) reiterated,
communication planners should be equipped with
planning and monitoring tools to implement
community-based projects. In fact, going beyond
information dissemination is practiced since 1947
starting with Radio Sutatenza in Colombia.
(Dagron, 2001) Hovland (2007) also highlighted to
package the message in various ways like stories
and highlight persuasion in the message rather
than pure information dissemination.
The need of the BHWs to use the Internet
is also relevant in the delivery of health care
provisions. As cited in Speaking of Health:
Assessing Health Communication for Diverse
Population (2002), health communication should
be more interactive. Face-to-face interaction is still
important but with the continuous change in the
communication landscape, alternative tools should
be developed or widely implemented. Monitoring
is also beyond statistics but rather on the
significant change that happened to the individual.
Hovland (2007) proposed several methods of
monitoring that are not included in the IPC/C
Manual. Most Significant Change (MSC) is used in
most Strategic Communications Planning. Other
monitoring tools include Outcome Mapping and
Communication for Social Change (CFSC)
Integrated Model. (Hovland, 2007)
Health Communication is Transactional
Communication and the current communication
scenario in the provision of health care services in
the Philippines is purely linear. Given this change
in the communication landscape, further trainings
for BHWs on Event Planning, Strategic
Communication Planning and Message
Development are deemed important.
V. BIBLIOGRAPHY
Andres, Tomas Quintin D. (1988). Community
Development: A Manual. New Day Publishers,
Quezon City, Philippines.
Dagron, Alfonso Gumucio. (2001) Making Waves:
Stories of Participatory Communication for Social
Change. The Rockefeller Foundation, New York.
Department of Health and HealthPRO. (2012)
Interpersonal Communication and Counselling
Manual for Health Service Providers.
Hovland, Ingie. (2007) Successful Communication:
A Toolkit for Researchers and Civil Society
[46]
Organisations. Overseas Development Institute.
London.
Institute of Medicine of the National Academies.
(2002). Speaking of Health: Assessing Health
Communication Strategies for Diverse Populations.
The National Academies Press. Washington, DC.
Littlejohn, Stephen W., & Karen A. Foss. (2008).
Theories of human communication (8th ed.).
Thomson